Culture

By discovering a potential new cellular mechanism for migraines, researchers may have also found a new way to treat chronic migraine.

Amynah Pradhan, associate professor of psychiatry at the University of Illinois Chicago, is the senior author of the study, whose goal was to identify a new mechanism of chronic migraine, and propose a cellular pathway for migraine therapies. The study, "Neuronal complexity is attenuated in preclinical models of migraine and restored by HDAC6 inhibition, is published in eLife.

Pradhan, whose research focus is on the neurobiology of pain and headache, explained that the dynamic process of routing and rerouting connections among nerve cells, called neural plasticity, is critical to both the causes and cures for disorders of the central nervous system such as depression, chronic pain, and addiction.

The structure of the cell is maintained by its cytoskeleton which is made up of the protein, tubulin. Tubulin is in a constant state of flux, waxing and waning to change the size and shape of the cell. This dynamic property of the cell allows the nervous system to change in response to its environment.

Tubulin is modified in the body through a chemical process called acetylation. When tubulin is acetylated it encourages flexible, stable cytoskeleton; while tubulin deacetylation - induced by histone deacetylase 6, or HDAC6, promotes cytoskeletal instability.

Studies in mice models show that decreased neuronal complexity may be a feature, or mechanism, of chronic migraine, Pradhan said. When HDAC6 is inhibited, tubulin acetylation and cytoskeletal flexibility is restored. Additionally, HDAC6 reversed the cellular correlates of migraine and relieved migraine-associated pain, according to the study.

"This work suggests that the chronic migraine state may be characterized by decreased neuronal complexity, and that restoration of this complexity could be a hallmark of anti-migraine treatments. This work also forms the basis for development of HDAC6 inhibitors as a novel therapeutic strategy for migraine," the researchers report.

Pradhan said this research reveals a way to possibly reset the brain toward its pre-chronic migraine state.

"Blocking HDAC6 would allow neurons to restore its flexibility so the brain would be more receptive to other types of treatment. In this model we are saying, maybe chronic migraine sufferers have decreased neuronal flexibility. If we can restore that complexity maybe we could get them out of that cycle," she said.

Once out of the cycle of decreased neuronal complexity, the brain may become more responsive to pain management therapies, Pradhan said. HDAC6 inhibitors are currently in development for cancer, and HDCA6 as a target has been identified for other types of pain.

"It opens up the possibility of something we should be looking at on a broader scale," she said. "Are these changes maybe a hallmark of all sorts of chronic pain states?"

Migraine is a common brain disorder that is estimated to affect 14% of the world population. Current U.S. cost estimates for migraine are as high as $40 billion annually. One particularly debilitating subset of migraine patients are those with chronic migraine, defined as having more than 15 headache days a month. Migraine therapies are often only partially effective or poorly tolerated, creating a need for more diverse drug therapies.

MINNEAPOLIS - Chronic kidney disease is when a person's kidneys progressively lose their ability to filter waste from the blood and eliminate fluids. Now a new study has found that people with reduced kidney function may have an increased risk of developing dementia. The study is published in the May 5, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Chronic kidney disease affects approximately 15% of adults in the United States and it is more common as people age. However, since many people don't experience symptoms until later stages, it is estimated that 90% of people with chronic kidney disease don't know they have it.

"Even a mild reduction in kidney function has been linked to an increased risk of cardiovascular disease and infections, and there is growing evidence of a relationship between the kidneys and the brain," said study author Hong Xu, M.D., Ph.D., of Karolinska Institute in Stockholm, Sweden. "Just like with chronic kidney disease, the risk of dementia increases as people age. With no effective treatments to slow or prevent dementia, it is important to identify possible modifiable risk factors. If we could prevent or delay some cases of dementia by preventing or treating kidney disease, that could have important public health benefits. Our study shows that reduced kidney function is linked to the development of dementia, however it does not prove that it is a cause."

For the study, researchers used a database to identify nearly 330,000 people 65 years and older who received health care in the city of Stockholm and were followed for an average of five years. None of the participants had dementia or had undergone kidney transplants or dialysis at the start of the study. Over the course of the study 18,983 people, or 6% of participants, were diagnosed with dementia.

Creatinine is a waste product from muscles that is removed from the blood by the kidneys and released into the urine. Using blood tests of plasma creatinine, researchers estimated the glomerular filtration rate for each participant, a measure of how well the blood is filtered by the kidneys and that is commonly used to approximate kidney function. An estimated filtration rate of 90 milliliters (mL) per minute or higher is considered normal in most healthy people.

Using this measure, researchers then determined the rates of dementia in people with different levels of kidney function. They used person-years to calculate the difference. Person-years take into account both the number of people in the study and the amount of time each person spends in the study.

Researchers found as kidney function decreased, the rate of dementia increased. In people with a normal kidney filtration rate of 90 to 104 mL per minute, there were seven cases of dementia per 1,000 person-years. In people with severe kidney disease, or a filtration rate of less than 30 mL per minute, there were 30 cases of dementia per 1,000 person-years.

After adjusting for other factors that could affect dementia risk like smoking, alcohol use, hypertension and diabetes, researchers determined that people with filtration rates of 30 to 59 mL per minute, which indicates moderate chronic kidney disease, had a 71% higher risk of developing dementia compared to those with normal kidney function, and people with filtration rates of less than 30 mL per minute had a 162% higher risk.

Researchers also examined data on 205,622 participants who had multiple blood tests over one year. They used those tests to estimate the speed of kidney function decline. They found that a steeper decline in a person's filtration rates during this time frame was also associated with a higher risk of a dementia diagnosis later on.

According to researchers, 10% of the dementia cases could be attributed to a filtration rate of 60 mL per minute or less, which is a higher proportion of dementia cases than those attributed to other dementia risk factors like cardiovascular disease and diabetes.

"Our study identifies chronic kidney disease as a possible risk factor for dementia, however while it shows an association, it does not prove that it is a cause," said Xu. "More research is needed to determine the exact reasons for the association. Still, our findings raise awareness of the link between these two conditions and may help health professionals develop and implement strategies to screen for kidney disease and monitor kidney function in people at risk of dementia. Identifying and treating cases sooner may reduce the risk of dementia."

A limitation of the study was that dementia was identified by clinical diagnoses. Access to participants' medical records may have helped to identify more cases.

Virtual care provided through telephone or videoconference has been broadly implemented in recent months because of the COVID-19 pandemic. A new analysis of published studies has examined the accuracy and reliability of virtual compared with in-person cognitive assessments for diagnosing dementia or mild cognitive impairment.

The analysis, which is published in the Journal of the American Geriatrics Society, included 121 studies. Three studies comparing videoconference with in-person cognitive assessments demonstrated good reliability and accuracy of virtual cognitive assessments in diagnosing dementia. Investigators did not identify any studies comparing telephone with in-person cognitive assessments.

The analysis also allowed the researchers to identify virtual cognitive test cut-offs suggestive of dementia or mild cognitive impairment, as well as barriers to implementing cognitive assessments for older adults.

"Our results highlight serious knowledge gaps and challenges associated with implementing virtual care for older adults--especially when you consider that the majority of older adults continue to access virtual care via the telephone," said lead author Jennifer A. Watt, MD, PhD, of St. Michael's Hospital-Unity Health Toronto, in Canada.

A new study published in the British Journal of Educational Technology has identified the different needs of students across primary, middle, and high school related to online learning during the COVID-19 pandemic.

For the study, investigators surveyed 1,170,769 Chinese students from the Guangdong Province of China.

Based on their findings, the researchers recommend that educational authorities and schools provide sufficient technical support to help students overcome potential internet and technical problems, and customize the delivery of online learning tools for students in different school years.

"Utilizing data from a large sample, we identify that student requirements of online learning are not homogeneous. For young children, there is a need for guidance from teachers and parents. In contrast, older students require opportunities to collaborate," said lead author Lixiang Yan, of the Centre for Learning Analytics at Monash University, in Australia. "Our study also showed an overwhelming use of smartphones over other devices by all age groups. This finding has direct implications for the design of online courses in K12 education; however, this can potentially pose a significant limitation for an effective learning experience."

The population growth of an endangered butterfly species is greatest in habitats with microclimatic variability, demonstrates a study carried out collaboratively by the Faculty of Biological and Environmental Sciences and the Helsinki Institute of Life Science of the University of Helsinki as well as the Finnish Environment Institute.

Insects are often very restricted in their capacity for movement. In many species, specific stages of life are spent entirely immobile, making them dependent on the temperature and moisture conditions of their immediate surroundings. In the Åland Islands on the southwest coast of Finland, Glanville fritillary butterflies (Melitaea cinxia) spend roughly 10 months of the year in the larval stage. In the middle of summer, the newly hatched larvae eat, as a group, the host plant, on whose leaf the female happened to lay the eggs. Prior research has shown that plants can wither entirely in dry summers, with prolonged dry periods sealing the fate of butterfly larvae. In such cases, only those larvae survive whose eggs have been laid on a plant growing in an exceptionally moist spot.

"We investigated how varying microclimates affect larval growth and survival in the spring after the overwintering. We found that warm and sunny days in March woke up the larvae and made them look for food. However, very little food was to be found, since the few warm days in early spring were followed by a cool April, with the growing season of the larval host plants only beginning in earnest in May," says doctoral researcher Susu Rytteri from the University of Helsinki's Research Centre for Ecological Change. She defended her thesis at the end March 2021.

It was observed that, in sunny and warm microclimates, larvae grew faster but also perished in large numbers because of lack of food. In cooler and shadier microclimates, larval growth was slow, a boost to the sufficiency of food: food plants had the time to grow in sync with the nutritional requirements of the larvae. Comprehensive survey data from the Åland Islands also demonstrated that Glanville fritillary populations grew the most in meadows where their larvae inhabited varying microclimates.

"The growth of butterfly populations increased when larval groups were located in particularly warm spots on sunny southward slopes. At the same time, the larvae also benefited from cooler and shaded microclimates. Due to the unpredictability and variability of weather conditions, the optimal egg-laying strategy for insects would appear to be laying eggs in varying microclimates which have the capacity to protect their immobile offspring from unfavourable conditions. The problem is that habitats have declined in number and become increasingly uniform. Consequently, varying microclimates are not necessarily on offer," Rytteri says.

More microclimatic variability in yards and gardens

Promoting microclimatic variability in your backyard helps insects and other animals. The sunniest spot in the yard can be turned into an even warmer place for sunbathing by, for example, constructing a section of stone wall that stores heat and offers protective crevices for small creatures. An oasis in the shade can be built in the coolest location in the yard by planting lush plants that thrive away from the sun and by adding a water element that is not only pleasing to the human eye but also serves as a watering place for animals during dry spells.

"Butterflies benefit from diverse plants, and in butterfly gardens, the goal should be floral splendour stretching from early spring long into the autumn. Many garden plants are good melliferous plants, that is, plants rich in pollen and nectar, but wild meadow plants shouldn't be overlooked either. Trees, bushes, rocks and knolls form variable microclimates and offer protection from unfavourable weather conditions," Rytteri points out.

Joyce WG, Rollot Y, Evers SW, Lyson TR, Rahantarisoa LJ, Krause DW. 2021. A new pelomedusoid turtle, Sahonachelys mailakavava, from the Late Cretaceous of Madagascar provides evidence for convergent evolution of specialized suction feeding among pleurodires. Royal Society Open Science 8:210098. https://doi.org/10.1098/rsos.210098

First author: Prof. Dr. Walter Joyce (walter.joyce@unifr.ch), Professor of Paleontology, University of Fribourg, Switzerland

Co-authors:

- Yann Rollot (yann.rollot@unifr.ch), PhD student, University of Fribourg, Switzerland

- Serjsocha Evers (serjoscha.evers@unifr.ch; preferred: serjoscha.evers@googlemail.com), Postdoctoral Researcher, University of Fribourg, Switzerland

- Tyler Lyson (Tyler.Lyson@dmns.org), Associate Curator of Vertebrate Paleontology, Denver Museum of Nature and Science, USA

- Lydia Rahantarisoa (ralyhanta@yahoo.fr), Professor of Geology, Université d'Antananarivo, Madagascar

Senior author: David Krause (David.Krause@dmns.org), Senior Curator of Vertebrate Paleontology, Denver Museum of Nature & Science, USA

Figure details

Fig. 1 Life reconstruction of Sahonachelys mailakavava, preying upon tadpoles of the giant Madagascan frog Beelzebufo ampinga using specialized suction feeding. Artwork by Andrey Atuchin.

Fig. 2 Fossil of Sahonachelys mailakavava, showing the preserved skull parts.

Fig. 3 Fossil of Sahonachelys mailakavava, showing the preserved shell.

Content and importance

We here describe a new species of pelomedusoid turtle from a geological formation in Madagascar otherwise known for its exquisitely preserved fossil birds, dinosaurs, crocodilians, and mammals. The new turtle possesses an unusually flattened skull combined with a particularly gracile lower jaw and enlarged tongue bones (hyoids), which not only gave it a frog-like appearance, but also suggests that it was adapted to a specialized feeding mode called suction-feeding.

Suction feeders open their mouths rapidly to suck in prey items under water, which is in contrast to other subaquatic feeding modes in which animals shoot their heads forward to reach for prey. The new turtle has several modifications in its head skeleton that show that it was well suited for suction feeding: its skull is low but wide, and the jaws are strongly bowed and angled forward, which creates a strongly rounded mouth opening that is physically beneficial for creating large suction forces. The tongue bones are strongly developed, and this hints at large muscles that pulled the tongue skeleton backwards and opened the esophagus during the strike at prey - again creating more suction. As in all modern turtles, the new species lacks teeth, but in addition the surfaces at the upper and lower jaws that face toward each other are poorly developed, showing that this turtle did not use its jaws to process food, but instead swallowed prey whole, which is typical for suction feeders. We hypothesize that the turtle fed on small-bodied living prey, such as insect larvae, fish fry, and tadpoles using quick strikes. We, therefore, name the new species Sahonachelys mailakavava, which means "quick-mouthed frog turtle" using Malagasy and Greek words. Special about the turtle is also its preservation: it is known from a nearly complete skeleton, despite its small body size, barely more than a foot long.

Turtle fossils often come either as shells or skulls that have been separated from one another; for many extinct turtles, we only either one or the other, but not both. Having a complete skeleton helps us to understand the whole animal, and also makes it possible to compare it to other turtle fossils, regardless of how these are preserved. Based on such comparisons, we constructed a family tree of turtles that shows that Sahonachelys mailakvava was an early relative of podocnemidid turtles, which today are native to Madagascar and South America, but which were more widespread in the past.

The palaeontological fauna of Madagascar is known for animals that are very specialized, which is in part due to its long isolation from surrounding continents. Our turtle shows that the Madagascan fauna was already unique in the Late Cretaceous: Sahonachelys mailakavava is the only representative of its group to have evolved suction-feeding, which is otherwise only known in distant relatives, so-called snake-necked turtles.

Quotes by the authors:

"This is the best-preserved turtle of the entire Late Cretaceous of the southern continents and as such very significant in terms of reconstructing its way of life and relationships with other turtles" (Prof. Walter Joyce, first author of study)

"As palaeontologists, we try to understand the biology and evolution of past life. Fossils like this give a wealth of information that is not always present. The identification of suction feeding in a new turtle lineage is exciting and was unexpected. It shows how animals evolve similar traits for similar functions, even if they are only distantly related." (Serjoscha Evers, co-author of study)

"Sahonachelys is a stunning example of evolution in isolation. It represents a lineage that evolved on Madagascar for over 20 million years and joins a litany of other bizarre Late Cretaceous vertebrate animals that we've found on the island. This specimen is, by far, the best turtle fossil we discovered during the 28 years of conducting field research there." (David Krause, co-author of study)

Journal

Royal Society Open Science

DOI

10.1098/rsos.210098

Measures to contain the Corona pandemic are the subject of politically charged debate and tend to polarize segments of the population. Those who support the measures motivate their acquaintances to follow the rules, while those who oppose them call for resistance in social media. But how exactly do politicization and social mobilization affect the incidence of infection? Researchers at the Max Planck Institute for Human Development have examined this question using the USA as an example. Their findings were published in Applied Network Science.

Limit crowds, keep a safe distance, and wear masks. Such non-pharmaceutical interventions, which should be implemented by everyone if possible in order to contain the incidence of infection, have played a central role since the beginning of the Corona pandemic. These measures have been disseminated via not only traditional media such as newspapers, radio, and television but also social media to a large extent. We can see that the appeals, recommendations, and regulations of governments are not only met with approval and understanding but also stimulate politically charged discussions, polarization, conspiracy narratives, and mobilization against the measures - often mixed with personal opinions.

But what does the rejection of Corona measures depend on? And is there a connection between the politicization of Corona topics in social networks and the development of the infection figures? Researchers at the Max Planck Institute for Human Development have investigated this using a mobilization model based on the example of Facebook in the USA. The subject of the study was a hypothetical political campaign in which the Democratic Party recommends non-pharmaceutical measures to combat the spread of Corona virus.

The results of the model calculations show that the hypothetical Democratic campaign would have spread to Democratic states three times faster than to Republican states. No matter in which direction, this political polarization makes it difficult to reach most segments of the population equally. "Accordingly, the acceptance and further dissemination of measures depends on whether the sender and receiver are politically like-minded," says Inho Hong, lead author of the study and a research grant holder in the Center for Humans and Machines at the Max Planck Institute for Human Development.

The researchers then examined the relationship between social mobilization and the actual spread of COVID-19 cases in the USA. They found that, on one hand, mobilization can have a positive effect on pandemic response when large numbers of people join together online to support the regulations by disseminating them quickly and early. On the other hand, there are indications that the political charge and resulting actions may have exacerbated the incidence of infection in some geographies. For example, infection rates spiked starting in mid-April 2020 after Republicans demonstrated against the first lockdown and did not consistently comply with the specified hygiene rules. This means that political regulations such as lockdowns can have the opposite effect after they are reinterpreted by politically polarized opponents - and even exacerbate the situation.

The researchers used a mobilization model to simulate the processes of social mobilization. The data for this came from two sources: The "Facebook Social Connectedness Index", a measure for calculating social connections between people from different regions, and demographic information and data sets from election protocols of the New York Times. Based on this data, the researchers calculated how the Democratic campaign would have spread via Facebook and whether it would have led to political actions such as demonstrations.

In previous studies, researchers have used this mobilization model to examine how political actions have formed and spread on social networks in the USA. "The model has allowed us to show a link between the social divide in the USA, the spread of information via Facebook, and the evolution of the incidence of infection," says Alex Rutherford, senior research scientist and principal investigator with the Center for Humans and Machines at the Max Planck Institute for Human Development and co-author of the study.

The study results show that a political charging of the measures to combat the pandemic can have a counterproductive effect and even fuel the incidence of infection. "On social media, the mask was quickly re-interpreted as a political statement and used to polarize the population. Governments should therefore consider to whom and through which channels they disseminate information and whether they want to target mobilization," says Manuel Cebrian, Leader of the Digital Mobilization Research Group at the Center for Humans and Machines at the Max Planck Institute for Human Development and co-author of the study.

The focus of the study was on political attitudes of US citizens. Other possibly decisive social factors such as occupation, income, gender, and origin would have to be investigated in further studies. These could provide information for planning the communication of future measures - for example, government vaccination strategies.

Honeybees have a complex communication system. Between buzzes and body movements, they can direct hive mates to food sources, signal danger, and prepare for swarming - all indicators of colony health. And now, researchers are listening in.

Scientists based in Germany - with collaborators in China and Norway - have developed a way to monitor the electrostatic signals that bees give off. Basically, their wax-covered bodies charge up with electrostatic energy due to friction when flying, similar to how rubbing your hair can make it stand on end. That energy then gets emitted during communications.

"We were thrilled by the potential of directly accessing the social communication of bees with our method," says Dr. Randolf Menzel, of the Free University of Berlin. "For the first time we can ask the bees themselves whether their colony is in a healthy condition or whether they suffer from unfavorable environmental conditions including those caused by humans."

The paper, recently published in the open access journal Frontiers in Behavioral Neuroscience, likens honeybee colonies to a canary in a coal mine. Bees are usually among the first species to be affected by pollutants such as insecticides, and weakened communications can signal their damaging effects. Such evidence may point to potential harm to other wildlife and ecosystems in a way that is quicker and cheaper than other methods.

Menzel and his colleagues worked with 30 beekeepers across Germany over a period of five years. They placed sensors and a central recording device inside and outside a specially designed hive, and monitored the honeybees' electrostatic field (ESF) data.

They were particularly interested in what is known as the "waggle dance," a sophisticated messaging system in which honeybees walk in a figure-eight pattern, then "waggle" back and forth through the stretched part of the intersection. This bee ballet communicates flight directions and distance. "Other bees follow the dancing bee, read the message of the dancer, and apply the information about distance and direction to an attractive food source in their outbound flights," says Menzel.

The primary purpose of their research study was to measure the feasibility of their recording system, which did indeed work, although Menzel notes that scaling up their system would be challenging, and "to get meaningful knowledge about the impact of pesticides and health conditions of bees in a larger area, we will have to use many devices across that area."

Still, the researchers learned more about hive communication, and found what Menzel described as "unexpected phenomena." For example, they found that bees perform waggle dances at night as well as during the day, and that insecticides used for treatment against pest mites had a negative impact on honeybees' communication. They also found that ESF signals were emitted in preparation of swarming, and that their strength didn't depend on environmental conditions such as humidity and UV radiation.

Menzel says that their system collected a large amount of data, and that they need further studies to improve and finetune interpretation. "So far we have only begun to apply machine learning algorithms to separate and quantify the electrostatic field signals." In the future though, it's possible that eavesdropping on bees may provide rich and important information beyond the local pollen hotspot. Their communications could be crucial in understanding - and protecting - whole ecosystems.

T-cell acute lymphoblastic leukemia (T-ALL) is a very aggressive type of blood cancer. It is relatively rare but still draws a lot of attention as it mostly develops in children under the age of 20. The standard treatment for T-ALL involves heavy chemotherapy procedures, which result in favorable outcomes with an overall survival of 75% after 5 years.

However, some patients do not respond to this treatment, or they only respond for a short period, after which the disease grows back. These patients therefore need alternative therapies.

Researchers from the Faculty of Health and Medical Sciences, University of Copenhagen, have now identified a combination treatment, which could potentially benefit patients that do not respond to standard chemotherapy.

'Our study suggests that we could use personalized medicine to target the cancer cells in the subgroup of T-ALL patients that do not initially respond to or stop responding to the standard chemotherapy. By combining two specific protein inhibitors, we have shown that we can obtain a strong and durable effect on leukemia cell growth. This might improve the overall survival of T-ALL patients', says Giulia Franciosa, Assistant Professor at the Novo Nordisk Foundation Center for Protein Research.

Targeting two proteins to avoid resistance

The majority of T-ALL patients have mutations in the so-called Notch1 gene. This mutation causes a cell surface receptor to induce cancer cell growth. By using a drug that inhibits this receptor, it is possible to stop the cancer cells from dividing and growing. Unfortunately, the cancer cells are good at adapting and in many cases develop resistance towards the Notch-inhibitor.

'The challenge we are facing with drug resistance is very hard to overcome as long as we are only targeting one protein, in this case the Notch1 receptor, at a time. That is why we have been looking for a therapy option that targets two proteins at the same time, making it much more difficult for the cancer cells to develop resistance. And we found one', says Giulia Franciosa.

Mass spectrometry proteomics gives unbiased answers

By comparing cells that are sensitive to Notch-inhibition with cells that are resistant - either from the beginning or develop resistance over time - the researchers identified a specific signaling protein responsible for the drug resistance: Kinase C. By targeting both proteins at the same time, they were able to eliminate the resistance.

'We used high-resolution mass spectrometry based proteomics to study the underlying molecular mechanisms that cause the resistance. The proteomics technology allows us to analyze the entire set of proteins, the proteome, present in a cell at the same time. By using this technique, we can map out differences and similarities between the responsive and non-responsive cells in an unbiased way. And that is how we found that Protein Kinase C activity is upregulated in resistant cells', says Jesper Velgaard Olsen, Professor at the Novo Nordisk Foundation Center for Protein Research.

The researchers hope that their findings in time can be used in the treatment of T-ALL patients who do not tolerate or respond to standard chemotherapy.

When COVID-19 patients began filling up ICUs throughout the country in 2020, health care providers faced difficult decisions. Health care workers had to decide which patients were most likely to recover with care and which were not so resources could be prioritized.

But a new paper from the University of Georgia suggests that unconscious biases in the health care system may have influenced how individuals with intellectual disabilities were categorized in emergency triage protocols.

The state-level protocols, while crucial for prioritizing care during disasters, frequently allocated resources to able-bodied patients over ones with disabilities, the researchers found.

The study, published in Disaster Medicine and Public Health Preparedness, found that some states had emergency protocols saying that individuals with brain injuries, cognitive disorders or other intellectual disabilities may be poor candidates for ventilator support. Others had vague guidelines that instructed providers to focus resources on patients who are most likely to survive. Adults with disabilities are significantly more likely to have comorbidities, such as heart disease and diabetes. In the case of COVID-19, those conditions were considered risk factors for poor outcomes, relegating these patients to the bottom of care hierarchy.

To compound the problem, COVID-19 hospital protocols that banned visitors often shut out advocates and family members who might have been able to advocate for these individuals. For patients unable to communicate their needs, the situation could easily turn deadly.

"I think when you leave people out of the conversations making these decisions, you see an issue like structural discrimination and bias," said Brooke Felt, lead author of the paper who graduated from UGA in 2020 with Master of Social Work and Master of Public Health degrees.

"Ableism, which is when people discriminate against those with disabilities and favor people with able bodies, is just so ingrained into the health care system. It is definitely a bias that a lot of people have, and sometimes people don't even recognize it."

Priority of care

Triaging, or prioritizing care and resources during emergencies or disasters, can be a subjective process. State protocols offer a degree of guidance about how to allocate resources, but in the moment, decisions about care often come down to individual health care providers.

In the case of the COVID-19 pandemic, hospitals were overwhelmed with patients and frequently had to make these judgment calls without extensive medical histories or patient advocates.

Curt Harris, corresponding author of the paper and director of the Institute for Disaster Management in UGA's College of Public Health, stressed that this research isn't an attack on clinical providers, who have shouldered an enormous burden throughout the pandemic.

"I do not believe clinicians are deliberately doing this," he said. "I just don't think they have been given the requisite education needed for population-level health issues, nor is it easy for clinicians to reconcile what constitutes high quality of life for patients with intellectual disabilities. This is more of an educational opportunity for clinicians to recognize that an issue exists and begin to make systemic changes, so we do not repeat the same mistakes in the future."

Addressing inequities

At the center of these emergency protocols is the underlying implication that an able-bodied person is more worthy of life-saving treatments than one who is intellectually disabled, Felt said.

One way to address this oversight would be to integrate social workers into the emergency response process, the authors said. They can act as advocates for those who can't speak on their own behalf.

"Involving social workers means you may be more likely to have someone who recognizes the structural inequalities, biases and discrimination and can bring those issues more into focus so they can be addressed," said Felt.

Altering pre-medical and medical education curricula to incorporate training on how to work with individuals with disabilities--something that often isn't covered--could also go a long way in closing the gap in care.

Felt had asked a friend in a medical program about bias and discrimination trainings in his coursework. She was shocked to learn his clinical education did not cover this topic.

"I feel like that should be a foundational class," she said. "That's something that definitely needs to change."

(Boston)--If you come from a family where people routinely live well into old age, you will likely have better cognitive function (the ability to clearly think, learn and remember) than peers from families where people die younger. Researchers affiliated with the Long Life Family Study (LLFS) recently broadened that finding in a paper published in Gerontology, suggesting that people who belong to long-lived families also show slower cognitive decline over time.

The Long Life Family Study has enrolled over 5,000 participants from almost 600 families and has been following them for the past 15 years. The study is unique in that it enrolls individuals belonging to families with clusters of long-lived relatives. Since 2006, the LLFS has recruited participants belonging to two groups: the long-lived siblings (also called the proband generation) and their children. Since they share lifestyle and environmental factors, the spouses of these two groups have also been enrolled in the LLFS as a referent group.

To assess cognitive performance, the researchers administered a series of assessments to the study participants meant to test different domains of thinking, such as attention, executive function and memory, over two visits approximately eight years apart. This allowed researchers to ask whether individuals from families with longevity have better baseline cognitive performance than their spouses do and whether their cognition declines more slowly than does that of their spouses.

To study this question, LLFS researchers used a model to determine the change in score on several neuropsychological tests from one visit to the next. "This model allows us to assess both the cross-sectional effect of familial longevity at baseline visit and the longitudinal effect over follow-up time," says co-lead author Mengtian Du, a doctoral student in biostatistics at Boston University School of Public Health.

They showed that individuals from long-lived families performed better than their spouses on two tests: a symbol coding test, which has participants match symbols to their corresponding numbers and provides insight into psychomotor processing speed, attention, and working memory, and a paragraph recall test, which asks participants to remember a short story and assesses episodic memory. The researchers from the LLFS also found that individuals in the younger generation (participants born after 1935) exhibited a slower rate of cognitive decline on the symbol coding test than did their spouses.

"This finding of a slower decline in processing speed is particularly remarkable because the younger generation is relatively young at an average age of 60 years and therefore these differences are unlikely to be due to neurodegenerative disease," explains corresponding author Stacy Andersen, PhD, assistant professor of medicine at Boston University School of Medicine. "Rather we are detecting differences in normal cognitive aging."

According to Andersen this suggests that people with familial longevity demonstrate resilience to cognitive aging. "By studying the LLFS families we can learn about the genetics, environmental factors, and lifestyle habits that are essential in optimizing cognitive health throughout the lifespan."

A new auroral phenomenon discovered by Finnish researchers a year ago is probably caused by areas of increased oxygen atom density occurring in an atmospheric wave channel. The speculative explanation offered by the researchers gained support from a new study.

Observations made by University of Helsinki researchers increased the validity of a speculative mechanism according to which a type of aurora borealis named 'dunes' is born. In the new study, photographs of the phenomenon taken by an international group of hobbyists in Finland, Norway and Scotland were compared to concurrent satellite data.

The rare type of aurora borealis was seen in the sky on 20 January 2016 and recorded in photos taken by several hobbyists.

"The dunes were seen for almost four hours in a very extensive area, with the pattern extending roughly 1,500 kilometres from east to west and some 400 kilometres from north to south," says Postdoctoral Researcher Maxime Grandin from the Centre of Excellence in Research of Sustainable Space coordinated by the University of Helsinki.

Useful photographic and video material was collected in close cooperation with Finnish aurora borealis hobbyists, utilising both the internet and social media. Among other things, a time lapse video shot on the night in question by a Scottish hobbyist was found. The video was used to estimate the dunes' propagation speed at over 200 m/s.

The study was published in the esteemed AGU Advances journal.

Validity of the wave guide theory confirmed

Northern Lights are born when charged particles ejected by the Sun, such as electrons, collide with oxygen atoms and nitrogen molecules in Earth's atmosphere. The collision momentarily excites the atmospheric species, and this excitation is released in the form of light.

New types of aurora borealis are rarely discovered. The identification of this new auroral form last year was the result of an exceptional collaboration between hobbyists who provided observations and researchers who started looking into the matter.

The new auroral form named dunes is relatively rare, and its presumed origin is peculiar.

"The differences in brightness within the dune waves appear to be caused by the increased density of atmospheric oxygen atoms," says Professor Minna Palmroth.

A year ago, researchers at the Centre of Excellence in Research of Sustainable Space concluded that the dune-like shape of the new auroral emission type could be caused by concentrations of atmospheric oxygen. This increased density of oxygen atoms is assumed to be brought about by an atmospheric wave known as a mesospheric bore travelling horizontally within a wave guide established in the upper atmosphere.

This rare wave guide is created in between the boundary of the atmospheric layer known as the mesosphere, which is called the mesopause, and an inversion layer that is intermittently formed below the mesopause. This enables waves of a certain wavelength to travel long distances through the channel without subsiding.

The electron precipitation and temperature observations made in the recently published study supported the interpretations of the dunes' origins made a year earlier. An independent observation was made of the wave channel appearing in the area of the dunes, but there are no observation data for the mesospheric bore itself yet.

"Next, we will be looking for observations of the mesospheric bore in the wave guide," Maxime Grandin says.

According to the observation data, electron precipitation occurred in the area where the dunes appeared on 20 January 2016. Therefore, it is highly likely that electrons having the appropriate energy to bring about auroral emissions at an altitude of roughly 100 kilometres were involved. The observations were collected by the SSUSI instrument carried by a DMSP satellite, which measures, among other things, electron precipitation.

On the night in question, there was an exceptionally strong temperature inversion layer in the mesosphere, or a barrier generated by layers of air with different temperatures. The inversion layer associated with the origins of the wave channel was measured with the SABER instrument carried by the TIMED satellite. The observation supports the hypothesis according to which the auroral form originates in areas of increased oxygen density occurring in the upper atmosphere wave guide.

This overlay shows radio (orange) and infrared images of a giant molecular cloud called W49A, where new stars are being formed. A team of astronomers led by Chris DePree of Agnes Scott College used the National Science Foundation's Karl G. Jansky Very Large Array (VLA) to make new, high-resolution radio images of this cluster of still-forming, massive stars. W49A, 36,000 light-years from Earth, has been studied for many decades, and the new radio images revealed some tantalizing changes that have occurred since an earlier set of VLA observations in 1994 and 1995.

The VLA radio images show the shape and movement of giant clouds of ionized hydrogen gas formed by the intense ultraviolet radiation from young stars. Comparing old and new VLA images of these ionized regions has shown changes indicating new activity in some of the regions. This new activity includes a narrow, fast-moving jet in one region, supersonic gas motions in three others, and an unexpected reduction in the radio brightness in another.

The astronomers, who reported their findings in the Astronomical Journal, plan to continue observing this region regularly to track changes that will reveal new details about the complex processes of star formation and interactions of the outflows from young stars.

Scientists at the Walter Reed Army Institute for Research demonstrated that biomarkers associated with traumatic brain injury were elevated among law enforcement and military personnel, particularly in active duty participants with longer duration of service. Most notably, these elevated biomarker levels were observed in individuals without a diagnosed brain injury or concussion.

Some law enforcement and military personnel are regularly exposed to low levels of blast, particularly during training, due to the use of explosive charges and high caliber weapons. Understanding effects from these occupational exposures is a military health care priority to improve diagnosis and mitigation of ill effects.

While repeated exposure to low level blast is not known to result in clinically diagnosed traumatic brain injury, exposures have been linked to a series of reported symptoms such as headaches, fatigue, dizziness, memory difficulties, and tinnitus (ringing in the ears) -- collectively referred to as "breacher's brain" among members of affected communities.

This study, published in the Journal of the American Medical Association, measured neurotrauma biomarker concentrations in blood samples from 106 military and law enforcement personnel who were not actively engaged in training or physical activity at the time of blood collection and compared those concentrations with commercially available samples from individuals who were similar in sex and age but unlikely to have been exposed to blast.

"We found that five biomarkers previously associated with TBI and brain diseases were elevated among personnel when compared to controls," said Dr. Angela Boutte, lead author on the paper and a researcher at the WRAIR Brain Trauma Neuroprotection branch. "Given the difficulty of identifying and evaluating injury associated with repeated low level blast exposure, we hope these data are the first step in our collective goal to identify objective biomarkers as clinically relevant diagnostic tools."

Dr. Bharani Thangavelu and Dr. Walter Carr, WRAIR brain health researchers and co-authors, emphasized the potential impact of blast exposure experienced by military personnel stating, "Low level blast exposure in routine military training should not be expected to result in acute, gross behavioral deficits for the majority of personnel. However, repeated exposure across years does correlate with symptomology, especially when a history of chronic exposure is exacerbated by new, large magnitude exposures."

Efforts to identify and quantify the impact of blast and traumatic brain injury on Service Members have increased dramatically in recent years, including initiatives in response to Congressional mandates. Biomarkers of blast effects on brain health will be a useful tool in this effort, especially as tools that augment decision-making based on symptoms reported by personnel.

Hypertension is a common medical condition and a primary cause of cardiovascular diseases and stroke worldwide. Unfortunately, as Professor Wei-Li Zhang of the Chinese National Center for Cardiovascular Diseases notes, "the unaffordability of drugs is a major barrier to medication adherence among patients living in low- and middle-income areas."

One of the countries where hypertension is becoming a major problem is China where, researchers estimate, between 244 million and 300 million adults are living with hypertension. But true to Prof. Zhang's words, most cases of hypertension in China are not adequately controlled, and patients who do seek treatment for hypertension must pay for outpatient clinic visits and bear medication costs out-of-pocket.

An emerging option for controlling the costs of antihypertensive pharmacotherapy is to prescribe generic drugs, which have the same active ingredients as their brand-name counterparts but cost substantially less. Several countries have taken steps to encourage the prescription of generic drugs as a way of reducing healthcare spending and enabling more patients, but some clinicians have reservations about prescribing generics due to concerns that such drugs may not be as effective as their brand-name counterparts. A team of researchers led by Prof. Zhang therefore decided to conduct an investigation to determine whether generic antihypertensive drugs are as effective as brand-name drugs at controlling blood pressure over the long term. Their results appear in a paper recently published in Chinese Medical Journal.

In their study, they analyzed data from a cohort study of patients with hypertension conducted across 18 hospitals in 12 Chinese provinces. Baseline screenings occurred between 2013 and 2015, and follow-up assessments continued until August 1, 2017. The researchers focused on 2,176 study participants who used brand-name antihypertensive drugs and 4,352 participants who used generic drugs. They conducted statistical analyses to compare the two groups in terms of changes in blood pressure over the follow-up period.

They found that generic drugs were just as effective as brand-name drugs at lowering blood pressure. Between the group using generic drugs and that using brand-name drugs, the percentages of patients who achieved well-controlled blood pressure levels (defined here as systolic blood pressures below 140 mmHg and diastolic blood pressures below 90 mmHg) and the likelihoods of experiencing adverse cardiovascular outcomes, such as coronary heart disease and stroke, were similar. After adjusting for age, sex, body mass index values, the number of antihypertensive drugs taken, and traditional cardiovascular risk factors, the mean reduction in systolic blood pressure was 7.9 mmHg for participants who took brand-name drugs and 7.1 mmHg for participants who took generic drugs.

However, some differences in outcomes did emerge when the researchers examined specific participant subgroups. Among participants who were younger than 60 years old, those who took brand-name drugs were more likely to achieve well-controlled blood pressure levels than their counterparts who took generic drugs were. A similar difference between brand-name drugs and generic drugs emerged when the investigators restricted their analyses to men with hypertension.

Despite the differences observed in the subgroup analyses, the results provide strong evidence overall for generic drugs being just as effective as brand-name ones at lowering blood pressure levels. Importantly, the generic drugs achieve these effects at a much lower cost; a 1-mmHg reduction in systolic blood pressure turned out to be US$315.40 cheaper with generic drugs than with brand-name ones. This cost difference means that treatment with generic drugs is only half as expensive as treatment with brand-name drugs, and this will doubtless mean a great deal to the many people in China and beyond who live on low-to-medium incomes.

That's why Prof. Zhang expresses hope that these findings will provide "an impetus for physicians and patients to preferentially use generic drugs instead of expensive brand-name drugs to lower blood pressure levels." By expanding access to antihypertensive treatment, the use of generic drugs will provide important benefits to public health within China and other developing countries.