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New York, NY--Research-practice partnerships (RPPs), long-term collaborations between researchers, policy makers and practitioners, represent an especially promising strategy for making sure that all children benefit from early childhood education, according to a journal released today by Princeton University and the Brookings Institution.

The journal, Future of Children, edited by Daphna Bassok of the University of Virginia and Pamela Morris of New York University's Steinhardt School, argues that RPPs are crucial for solving today's most pressing question in early childhood education--how to deliver high-quality prekindergarten programs at scale.

"Too often there is a disconnect between the questions researchers tackle and the ones that are more urgent and salient for policy makers or practitioners," said Bassok. "The findings from rigorous, well-designed research studies may not be particularly useful for addressing the real-life complexity that educators and policymakers face."

"The idea of research practice partnerships is that through close collaborations, researchers can do work that really helps policy makers address the big problems they are tackling and do the work fast enough to actually inform change," continued Morris. "Our hope is that this journal makes that clear."

RPPs are Designed to Improve Educational Outcomes

RPPs are defined by longevity, mutual decision-making and compromise, and the commitment of both parties to large-scale, systems-level problem solving, rather than a single project or research question.

In study after study, early childhood education programs developed by researchers have shown large benefits, holding out the promise of substantially narrowing the achievement gap between disadvantaged children and their better-off peers. But when cities and states establish large-scale prekindergarten programs, Bassok and Morris noted, the results are often far more modest. The important questions today aren't about whether early childhood education "works," but about how to invest limited resources to improve the quality of large-scale prekindergarten programs, support the early childhood workforce, and reach the children who need the most help.

"Delivering effective early childhood education at scale remains elusive," said Bassok. "Findings from promising research studies rarely make their way into early childhood practice; at the same time, policy and practice decisions are often made without research evidence to guide them."

That's partly because policy makers and practitioners have different priorities and work on different timelines than researchers do. Through collaboration, compromise, and long-term commitment, RPPs can help bridge the gap and produce research that's relevant and useful to policy makers and practitioners, while at the same time offering scholars opportunities for broad and innovative research wouldn't be possible in one-off studies of a single program or topic.

The Journal is a User Manual for Partnerships

Each article in the journal describes how a successful early childhood RPP confronted a major challenge or exploited an unexpected opportunity in the process of working together to create a research or funding agenda, develop measurement tools, take innovation to scale, navigate conflicting timelines, find a balance between academic rigor and feasibility, or build research capacity. In this sense, the journal offers both a user manual and a road map for future partnerships to follow.

"The COVID-19 pandemic has underlined the benefits of RPPs," Morris said. "Where RPPs were in place, researchers used their familiarity with the local context to help ease the sudden transition to remote learning."

For example, as COVID-19 spread in New York City, researchers in an established RPP there quickly assembled materials about remote learning, including a tool kit for teachers citywide, and offered resources to answer policy makers' most urgent questions.

"The pandemic has created large gaps in the services provided to our youngest learners, and opened the door for new collaborations as policy systems race to meet children's needs," continued Morris. "In this context, RPPs can support efforts to rebuild and reimagine early childhood education systems that can help all of our nation's children acquire strong foundations for kindergarten and beyond."

People living with a child who attends school in-person have an increased risk of reporting evidence of COVID-19, but teacher masking, symptom screening, and other mitigation measures in schools may be able to minimize that excess risk, suggests a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

For their study, the researchers analyzed nearly 600,000 responses from an ongoing Facebook-based COVID-19 symptom survey in the United States over two periods between November 2020 and February 2021 before vaccines were widely available in the U.S. The researchers found that those living with a child engaged in full-time, in-person pre-K-to-12 schooling were about 38 percent more likely to report COVID-19-like symptoms such as fever, cough, or difficulty breathing, compared to those living with a child schooled exclusively in a home setting.

A key finding was that school-based mitigation measures--the survey asked about 14 mitigation measures--were associated with less risk per mitigation measure. For example, 9 percent less risk of COVID-related illness per measure, and 7 percent less risk of a positive SARS-CoV-2 test per measure. Each additional mitigation measure reduced risk. Teacher masking and daily symptom screening appeared to be the strongest risk reducers.

The study was published online April 29 in Science.

The analysis included three outcomes as reported by survey respondents: COVID-19-like illness, i.e., fever and respiratory symptoms within the last 24 hours; loss of taste or small within the last 24 hours; and a positive COVID-19 test in the last 14 days.

The survey responses indicated that most pre-K-to-12 schools had some mitigation measures in place, such as mask mandates for teachers, daily screening of students and teachers for symptoms, and curtailment of extracurricular activities. The researchers found that when schools used seven or more mitigation measures, the excess risk associated with in-person schooling mostly disappeared--and completely disappeared when 10 or more mitigation measures were reported.

"These findings support the idea that mitigation measures at schools can greatly reduce the excess COVID-19 risk to adults living with children who attend school in-person," says study first author Justin Lessler, an associate professor in the Department of Epidemiology at the Bloomberg School.

The issue of in-person schooling has been much debated in the United States from the start of the COVID-19 pandemic, leading to different school policies across the country. This policy diversity effectively set in motion a "natural experiment" with schooling and COVID-19 risk in the U.S. population. A chief concern has been that children going to school every day, even if they are not very susceptible to COVID-19 themselves, may bring home the virus to parents and other adult family members who are at higher risk of disease.

To examine these issues, Lessler and colleagues used the COVID-19 Symptom Survey, an ongoing Facebook-based survey managed by Carnegie Mellon University's Delphi Group in collaboration with Facebook that garners about 250,000 responses per week. The researchers looked at responses during two recent periods--roughly from Thanksgiving to Christmas last year and mid-January to mid-February this year--from respondents in households where at least one child was enrolled in a school, from pre-kindergarten through high school. Of the 576,051 people in this group, about 49 percent, or 284,789, reported being in a household with a child attending pre-K-to-12 school in-person rather than online or homeschooled.

In their analysis, Lessler and colleagues examined how the in-person school group differed from the online or homeschooled group in terms of reported COVID-19-related symptoms and outcomes. They adjusted the results to account for obvious confounding factors such as differences in local COVID-19 rates.

In addition to the 38 percent increase in the odds of getting a COVID-19-related illness among respondents in households with an in-person-schooled child, the researchers found a 21 percent increase in the odds for the loss of taste or smell--one of the core symptoms of COVID-19--and a 30 percent increase in the odds for testing positive for SARS-CoV-2 infection in the previous two weeks.

The strength of these associations appeared to increase with grade level. At the K and pre-K level, the association with COVID-19 outcomes was not significant for all outcomes, but the strength of those associations rose steadily, peaking at the grade 9-12 level--where the excess risk of a recent positive SARS-CoV-2 test for household members was over 50 percent. These findings are consistent with past studies suggesting less susceptibility to SARS-CoV-2 infection and COVID-19 illness among younger children compared to older ones.

The survey data included responses about COVID-19 mitigation measures in schools attended by children in the respondent's household. These mitigation measures included mask mandates for teachers and students, extra space between desks, suspension of school clubs, sports, and other extracurricular activities, and daily symptom screening among teachers and students. Respondents with a child in their household attending school in person reported a mean of 6.7 mitigation measures at school--with significant variations in that figure across the country, from a mean of 4.6 measures in South Dakota schools to 8.9 in Vermont schools.

The analysis also suggested that most of the increased COVID-19-related risk was concentrated in schools with fewer than seven mitigation measures, and that in-person schooling was not associated with increased risk for any COVID-19-related outcomes among respondents living with children in schools with ten or more measures.

"Because the study is based on a self-reported symptom survey and a setting where we can't randomize students to different schooling modes and mitigation measures, it has limitations," Lessler says. "But having hundreds of thousands of respondents and the ability to control for geographic and individual-level characteristics helps make up for those limitations."

He and his colleagues plan to follow up with studies of how in-person schooling and school-based mitigation measures affect community-wide spread of COVID-19.

"Household COVID-19 risk and in-person schooling" was co-authored by Justin Lessler, M. Kate Grabowski, Kyra Grantz, Elena Badillo-Goicoechea, C. Jessica Metcalf, Carly Lupton-Smith, Andrew Azman, and Elizabeth Stuart.

A new study led by University of Minnesota astrophysicists shows that high-energy light from small galaxies may have played a key role in the early evolution of the Universe. The research gives insight into how the Universe became reionized, a problem that astronomers have been trying to solve for years.

The research is published in The Astrophysical Journal, a peer-reviewed scientific journal of astrophysics and astronomy.

After the Big Bang, when the Universe was formed billions of years ago, it was in an ionized state. This means that the electrons and protons floated freely throughout space. As the Universe expanded and started cooling down, it changed to a neutral state when the protons and electrons combined into atoms, akin to water vapor condensing into a cloud.

Now however, scientists have observed that the Universe is back in an ionized state. A major endeavor in astronomy is figuring out how this happened. Astronomers have theorized that the energy for reionization must have come from galaxies themselves. But, it's incredibly hard for enough high energy light to escape a galaxy due to hydrogen clouds within it that absorb the light, much like clouds in the Earth's atmosphere absorb sunlight on an overcast day.

Astrophysicists from the Minnesota Institute for Astrophysics in the University of Minnesota's College of Science and Engineering may have found the answer to that problem. Using data from the Gemini telescope, the researchers have observed the first ever galaxy in a "blow-away" state, meaning that the hydrogen clouds have been removed, allowing the high energy light to escape. The scientists suspect that the blow-away was caused by many supernovas, or dying stars, exploding in a short period of time.

"The star-formation can be thought of as blowing up the balloon," explained Nathan Eggen, the paper's lead author who recently received his master's degree in astrophysics from the University of Minnesota. "If, however, the star-formation was more intense, then there would be a rupture or hole made in the surface of the balloon to let out some of that energy. In the case of this galaxy, the star-formation was so powerful that the balloon was torn to pieces, completely blown-away."

The galaxy, named Pox 186, is so small that it could fit inside the Milky Way. The researchers suspect that its compact size, coupled with its large population of stars--which amount to a hundred thousand times the mass of the sun--made the blow-away possible.

The findings confirm that a blow-away is possible, furthering the idea that small galaxies were primarily responsible for the reionization of the Universe and giving more insight into how the Universe became what it is today.

"There are a lot of scenarios in science where you theorize that something should be the case, and you don't actually find it," Eggen said. "So, getting the observational confirmation that this sort of thing can happen is really important. If this one scenario is possible, then that means that there are other galaxies that also existed in blow-away states in the past. Understanding the consequences of this blow-away gives direct insight into the impacts similar blow-aways would have had during the process of reionization."

DALLAS, April 29, 2021 – Last Friday, the Centers for Disease Control and Prevention (CDC) and the U.S. Food & Drug Administration (FDA) lifted the pause in administration of the Johnson & Johnson (Janssen) COVID-19 vaccine in the U.S. The temporary pause was due to reports of a serious condition called cerebral venous sinus thrombosis (CVST), which refers to blood clots in the brain’s veins - not in the arteries, as is the case for most strokes - in combination with thrombocytopenia (low blood platelet count). CVST and thrombocytopenia together is called thrombosis-thrombocytopenia syndrome (TTS). When TTS is linked to receiving a COVID-19 vaccine, it is called vaccine-induced immune thrombotic thrombocytopenia (VITT). CVST has also been associated with cases of TTS in adults who received the AstraZeneca COVID-19 vaccine available in Europe, according to the European Medicines Agency, the agency responsible for the scientific evaluation, supervision and safety of medicines in the European Union.

The American Heart Association/American Stroke Association Stroke Council Leadership convened quickly to provide important guidance about CVST, TTS and VITT – the signs and symptoms and the best treatment options. The special report, “Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia,” published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

“COVID-19 infection is a significant risk factor for CVST. A preliminary analysis of U.S. data during the COVID-19 pandemic, available online, preprint on April 15, 2021, found that the risk of CVST due to infection with COVID-19 is 8-10 times higher than the risk of CVST after receiving a COVID-19 vaccine,” said Karen L. Furie, M.D., M.P.H., lead author of the special report, chair of the department of neurology at The Warren Alpert Medical School of Brown University, and chief of neurology at Rhode Island Hospital, The Miriam Hospital and Bradley Hospital in Providence, Rhode Island. “The public can be reassured by the CDC’s and FDA’s investigation and these statistics – the likelihood of developing CVST after a COVID-19 vaccine is extremely low. We urge all adults to receive any of the approved COVID-19 vaccines.”

The analysis included data from 59 health care organizations, totaling 81 million patients, more than 98% of whom were in the U.S. Among the nearly 514,000 patients in the database who were diagnosed with COVID-19 infection from January 20, 2020 through March 25, 2021, 20 patients were diagnosed with CVST. This data was compared to the incidence of CVST in adults who received either the Pfizer or Moderna COVID-19 vaccine before March 25, 2021, excluding those who had previously been diagnosed with COVID-19. No cases of thrombocytopenia (low platelets) were diagnosed among almost 490,000 vaccinated adults.

“CVST blood clots are very rare adverse events. We recommend immediate screening of all patients who arrive in the ER with a suspected clot – did they receive a COVID-19 vaccine during the recent weeks prior to this event?” said Furie. “Patients who present with the symptoms of CVST or blood clots and who recently received the COVID-19 vaccine should be treated using non-heparin anticoagulants. No heparin products in any dose should be given for suspected CVST, TTS or VITT. With the right treatment, most patients can have a full recovery after CVST, TTS or VITT.”

CVST is an extremely rare but serious type of stroke caused by a blood clot in a part of the brain known as the venous sinus, involving veins that carry blood away from the brain. CVST clot symptoms are very similar to several other neurological conditions, and the symptoms can include severe headache; blurry vision; fainting or loss of consciousness; weakness; sensory changes; confusion or trouble speaking; seizures; abdominal pain; leg pain; difficulty breathing or shortness of breath. CVST occurs in the veins of the brain; blood clots may also occur in other blood vessels, like those in the legs, lungs or abdomen. Among the cases reported in the U.S., the most common symptoms were severe headaches; vomiting; back pain; fatigue; weakness or the inability to move one side of the body (hemiparesis); inability to speak or understand speech (aphasia); loss of consciousness; and abdominal pain.

If associated with the COVID-19 vaccine, cases of TTS/VITT occurred several days up to 2-1/2 weeks after being vaccinated with the Johnson & Johnson (Janssen) COVID-19 vaccine in the U.S., or up to 3-1/2 weeks after receiving the AstraZeneca COVID-19 vaccine in Europe.

The CDC and FDA’s report on April 23, 2021, confirms the agencies investigated 15 reported cases of TTS in the U.S., in women ages 18-59 years, from the nearly 7 million adults who received the Johnson & Johnson COVID-19 vaccine before the temporary pause on April 13, 2021. The European Medicines Agency’s investigation, reported on April 7, 2021, lists 62 cases of CVST, among adults ages 22-60 years, mostly women, from the more than 25 million people who received the AstraZeneca COVID-19 vaccine throughout the European Union .

The special report from the Stroke Council leaders details treatment for suspected CVST, TTS or VITT:

All patients with suspected CVST due to a COVID-19 vaccine should be treated with non-heparin anticoagulants such as argatroban, bivalirudin, danaparoid, fondaparinux or a direct oral anti-coagulant (DOAC). No heparin products in any dose should be given.

Magnetic Resonance Imaging with a venogram (MRI/MRV) or computed tomography with venogram (CT/CTV) is recommended to accurately detect and diagnose CVST.
Blood tests should include a CBC (Complete Blood Count) plus:
platelet count - to determine the number of platelets per liter of blood;
a peripheral smear - examination under a microscope to count the number of various types of blood cells and if they appear normal;
a prothrombin time – to measure how long it takes the blood to clot;
a partial thromboplastin time – a measurement of how long it takes the blood to clot, specifically measuring for these clotting factors: factor VIII, factor IX, factor 1V and factor XII;
a fibrinogen test – to measure for the presence of fibrin, a protein found in the blood that indicates that blood clotting has been activated;
a D-dimer test – to measure for the presence of D-dimer, a small protein that’s made when blood clots are dissolving in the body; and
a PF4 antibody ELISA test – to test for PF4 antibodies, which the body sometimes creates in the blood to fight against the anticoagulant heparin.
Anticoagulation treatment doses may need to be tailored if platelet counts are extremely low (<20,000/mm3) or if there is low fibrinogen.
Anticoagulants should be used to treat CVST even if there is a secondary hemorrhage in the brain in order to prevent progressive thrombosis and to control bleeding.
Platelet transfusion should be avoided.
Once platelet counts return to normal (150,000 to 450,000/mm3), most patients can be transitioned to an oral anticoagulant if there are no contraindications.
The authors note that based on their evaluation of the American Society of Hematology’s recommendations and two recently published studies, individual patient factors should be considered regarding the use of a direct oral anticoagulant (DOAC) or a vitamin K agonist (VKA) after there is full platelet count recovery.
The authors recommend all cases of thrombosis after a COVID-19 vaccine be reported to the U.S. Department of Health and Human Services Vaccine Adverse Event Reporting System: https://vaers.hhs.gov/reportevent.html. This data will be important to understanding the incidence of CVST, TTS and VITT.
There is still much to be investigated:
Are there any preexisting conditions that may predispose someone to CVST or VITT?
What is the true prevalence and risk of PF4 antibodies, low platelet count and CVST after the COVID-19 vaccine?
Since there is currently no data about people who did not develop CVST, TTS or VITT after a COVID-19 vaccine for comparison, it is not possible to definitively state that the vaccine is the cause of the PF4 antibodies, low platelet count (thrombocytopenia) or blood clots (thrombosis).

“We are learning the various intricacies of COVID-19 live, in real-time with the patients we see in our hospitals every day. CVST is extremely rare, however, further research and investigation are necessary as the pandemic continues. We will need data and robust research on the people who did not develop blood clots after the vaccine, too, so that we can fully understand the molecular and cellular mechanisms underlying CVST related to COVID-19 infection or after vaccination,” concluded Furie.

The following statement reflects the views of the American Heart Association/American Stroke Association and its science leaders:

President Mitchell S.V. Elkind, M.D., M.S., FAHA, FAAN,
Immediate Past President Robert A. Harrington, M.D., FAHA,
President-Elect Donald M. Lloyd-Jones, M.D., Sc.M., FAHA,
Chief Science and Medical Officer Mariell Jessup, M.D., FAHA, and
Chief Medical Officer for Prevention Eduardo Sanchez, M.D, M.P.H., FAAFP.

“The American Heart Association continues to urge everyone to receive a COVID-19 vaccine as soon as they can. We concur with the CDC’s and FDA’s recommendations for people who receive the Johnson & Johnson (Janssen) vaccine – if they develop severe headache, abdominal pain, leg pain or shortness of breath within 3 weeks of receiving the vaccine, they should quickly contact their health care professional.

COVID-19 has disproportionately negative effects on older adults; people with underlying medical conditions; and Black, LatinX and American Indian/Alaska Native people. The American Heart Association strongly encourages everyone to get vaccinated with an approved COVID-19 vaccine. In particular, people with cardiovascular risk factors such as high blood pressure, obesity and type 2 diabetes, those with heart disease, and heart attack and stroke survivors should get vaccinated as soon as possible because they are at much greater risk of a negative outcome from the virus than they are from the vaccine.

We are confident the benefits of vaccination far exceed the very small, rare risks. The risks of vaccination are also far smaller than the risks of COVID-19 and its potentially fatal consequences.

We recommend people who have medical conditions, especially those with the propensity for blood clotting, consult with a health care professional before seeking vaccination to discuss the very rare potential increased risks.

In addition, the Association reiterates the importance of handwashing, social distancing and wearing masks as vaccinations continue, particularly for people at high risk of infection and/or severe COVID-19. These simple precautions remain crucial to protecting people from the virus that causes COVID-19. They also are crucial to getting us all back to normal activities.

Individuals should refer to their local and state health departments for specific information about when and where they can get vaccinated. We urge everyone to get vaccinated.”

DALLAS, April 29, 2021 -- Health care professionals should consider prescribing medication for patients with slightly elevated blood pressure if levels do not decrease after six months of healthy lifestyle changes, according to a new scientific statement from the American Heart Association. The statement, published today in the Association's journal Hypertension, fills a gap in guideline recommendations by addressing how to manage untreated, stage 1 high blood pressure - levels of 130-139/80-89 mm Hg - that was not fully addressed in the 2017 treatment guidelines.

The 2017 American College of Cardiology/American Heart Association Blood Pressure Management Guidelines' recommendation for patients with stage 1 hypertension and a low (10%) 10-year risk for heart attack or stroke, the guidelines recommend anti-hypertensive medication in addition to healthy lifestyle.

Today's scientific statement suggests clinicians should consider medication for patients with a low ten-year risk if the blood pressure goals (

"There are no treatment recommendations in current guidelines for patients who are at relatively low short-term risk of heart disease when blood pressure does not drop below 130 mm Hg after six months of recommended lifestyle changes," said Daniel W. Jones, M.D., FAHA, chair of the statement writing group, professor and dean emeritus at the University of Mississippi School of Medicine in Jackson, Mississippi, and a past president of the American Heart Association. "This statement fills that gap."

Many patients who have stage 1 high blood pressure are adults under the age of 40. Randomized controlled trials following these patients for cardiovascular disease risk are lacking, therefore, the statement writing committee relied on other forms of evidence including observational studies focused on the relationship between blood pressure and cardiovascular disease.

"We know that people with blood pressure lower than 130/80 mm Hg have fewer markers of cardiovascular risk like elevated coronary calcium, enlargement of the heart, or buildup of fatty deposits called atherosclerosis in arteries of the neck. There is strong evidence that treating high blood pressure saves lives by reducing the risks for heart attack and stroke," Jones said.

Healthy lifestyle changes to lower blood pressure include achieving ideal body weight, exercising (30 minutes on most days of moderate to vigorous physical activity, if possible), limiting dietary sodium, enhancing potassium intake and following the Dietary Approaches to Stop Hypertension (DASH) diet (combination diet of fruits and vegetables with low-fat dairy products and reduced saturated fat and total fat). In addition, patients should be recommended to limit alcohol and not smoke. These remain the cornerstone of cardiovascular disease prevention.

"If after six months with lifestyle changes, blood measure does not improve, clinicians should consider adding medications to control blood pressure," said Jones. "That's an important message for patients to hear as well because they should check their blood pressure regularly to monitor progress. If they don't achieve average daily systolic blood pressure less than 130 mm Hg, it's probably time to initiate a conversation with their doctor about practical next steps, which may include adding medication, to manage their blood pressure."

For people who took blood pressure-lowering medication as adolescents, there is evidence that, without intervention, these individuals are likely to develop markers of cardiovascular disease in young adulthood. The statement suggests the original indication for beginning treatment, usually to ward off organ damage from long-term high blood pressure, should be considered in assessing the need to continue medication.

The statement writers acknowledge that the goals of lifestyle change are difficult to achieve and maintain over time. "It is very hard in America and most industrialized countries to limit sodium sufficiently to lower blood pressure," said Jones, "and it is difficult for all of us to maintain a healthy weight in what I refer to as a toxic food environment. We want clinicians to advise patients to take healthy lifestyle changes seriously and do their best. We certainly prefer to achieve blood pressure goals without adding medication; however, successfully treating high blood pressure does extend both years and quality of life."

CHAMPAIGN, Ill. -- Researchers have created a new, open-access tool that allows doctors and scientists to evaluate infant brain health by assessing the concentration of various chemical markers, called metabolites, in the brain. The tool compiled data from 140 infants to determine normal ranges for these metabolites.

Published in the journal NMR in Biomedicine, the study describes an easier and more reliable way to evaluate metabolite concentrations in the infant brain than was previously available, said study lead Ryan Larsen, a researcher at the Beckman Institute for Advanced Science and Technology at the University of Illinois Urbana-Champaign.

Metabolites play an important role in normal brain growth, development and function, said study co-author Dr. Ellen Grant, the director of the Fetal Neo-Natal Neuroimaging and Developmental Science Center at Boston Children's Hospital and a professor of radiology and of pediatrics at Harvard Medical School. High or low metabolite levels in the brain may be the first sign of problems with brain function or development.

"For example, we look at choline, which plays a role in building myelin, the sheath that allows electrical impulses to travel along neurons," Grant said. "Another metabolite, called NAA, is important to the healthy growth and proliferation of dendrites, the branches on neurons that receive signals from other neurons."

By measuring the concentration of key metabolites like these, researchers can spot some problems early - allowing interventions in time to prevent damage to the growing brain, she said.

Assessing metabolites in the brain normally involves proton magnetic resonance spectroscopy, a technology that uses an MRI not for visual imaging but to detect and identify specific molecules in the tissues of interest. The most common approach requires extensive imaging and detailed calculations of the amount of water inside and outside brain tissues to standardize these measures, a costly and time-consuming approach.

To address this difficulty, Grant and study co-author Borjan Gagoski, a radiology instructor at Boston Children's Hospital, used proton MRS to scan the brains of 140 infants at approximately one month and three months of age. In addition to using water as a reference, the team also compiled data from several key metabolites in their calculations. This allowed them to create a tool that makes use of standard values for several metabolites when assessing the concentration of any one metabolite in an infant's brain.

"What most everybody does is they look at a simple ratio between metabolite 1 and metabolite 2," Larsen said. "But if that ratio is low, does that mean that metabolite 1 is low or that metabolite 2 is high? It becomes a problem of interpretation."

Instead, the team painstakingly assessed relationships between seven key metabolites to build a database of normal values for each one at different time points, and to show how metabolite concentrations change in relation to one another as the infant's brain develops.

The tool the team developed offers a checklist of reference brain metabolites that users can select in different combinations to more clearly understand an individual infant's profile.

"Spectroscopy is really tough to do but when it's done in the right way, it can help us find out more about the brain," Gagoski said. "This approach has great potential because we can detect abnormalities and diseases before we can actually see anything on the structural scans. And it's really important to monitor brain health at this stage of life."

Eye contact plays a fundamental role in human communication and relationships. When we look into each other's eyes, we show that we are paying attention to each other. However, we do not only look at each other but also at our four-legged companions. According to new research by Hungarian ethologists, at least four independent traits affect dogs' ability to establish eye contact with humans. Short-headed, cooperative, young, and playful dogs are the most likely to look into the human eye.

Dogs adapted uniquely well to live with humans, and communication plays a vital role in this. They are sensitive to the direction of the human's gaze, which helps them decide whether the message is directed to them. Forming eye contact with the owner raises oxytocin levels in both parties, which plays a role in developing social bonding. However, individual dogs are not equally prone to make eye contact; the anatomy of the eye, the original function of the breed, i.e., the task they were bred for, age and personality might also affect the tendency to form eye contact.

"One hundred and thirty family dogs were examined at the Department of Ethology, Eötvös Loránd University. We measured the length and width of their heads because this is related to their vision." - said Zsófia Bognár, Ph.D. student, first author of the study, published in Scientific Reports. "The boxer, bulldog, pug, and snub-nosed dogs, in general, have a more pronounced area centralis in the retina, so they can better respond to stimuli in the central field, which may make it easier for them to form eye contact with humans."

In contrast, long-nosed dogs, such as greyhounds, see a wide panoramic image because the nerve cells that process the visual information distribute more evenly in their retina. Therefore, if they have to focus on the center of their visual field, they may be distracted by visual stimuli from the periphery more easily.

In the behavior test, the experimenter first initiated play with the dog. In another test, she measured how quickly and how many times the dog formed eye contact with her within five minutes. "The experimenter did not speak and remained motionless until the dog looked at her. Every time the dog looked at her, she rewarded this with a treat. Meanwhile, the owner sat on a chair, silent. We measured how much time elapsed after eating the treat until the next eye contact." - presented the test Dr. Dóra Szabó, ethologist. See the video summary of the research here.

It turned out that the shorter the dog's nose, the faster it made eye contact with the experimenter. "It is likely, that they see the human face more sharply because of their special retina, but it is also possible that their owners gaze at them more often as their facial features resemble a small child, a powerful cue for humans. Because of this, dogs with shorter noses may be more experienced in making eye contact." - explained Zsófia Bognár.

The researchers also examined whether the original role of the breeds still influenced eye contact forming. Shepherd dogs, for example, are visually cooperative who follow the direction of the owner's hand (stick) during their work with the stock. In contrast, visually non-cooperative sled dogs running in front of the musher can only rely on vocal cues, while dachshunds also cannot see their owner in the underground life-and-death struggle. Long- and short-headed dogs evenly distributed across the different breed groups.

As expected, dogs bred for visually guided work made eye contact faster than those driven by voice or selected for independent work. Surprisingly, the mixed breeds performed similarly well, even though 70% were adopted from a shelter. Perhaps their willingness to make eye contact even helped them to get adopted in the first place.

The research was part of the European Research Council funded Senior Family Dog Project, aimed at aging research. The oldest dog participant was 15 years old.

"We assumed that aging dogs would find it more difficult to control their attention and would be slower to switch from eating to looking at the face of the experimenter. That's what happened. Since we pre-screened our participants for potential visual and auditory impairments, the slower establishment of eye contact seems to be a natural consequence of aging." - says Dr. Eniko Kubinyi, the leader of the project.

This research emphasizes the fact that many factors affect the way dogs and humans communicate. It also sheds new light on our knowledge of short-nosed dogs. Many researchers, including Konrad Lorenz, suggested that these dogs were selected for their baby-like facial appearance. However, it is also plausible that people preferred individuals that were more attentive to them and looked at them for a longer duration, facilitating communication.

The Korea Institute of Civil Engineering and Building Technology (KICT) has announced the development of an effective structural monitoring technique to monitor massive infrastructures, such as long-span bridge. The method provides accurate and precise responses over whole structural system densely by fusing advantages of multi-fidelity data.

Rapid advances in sensing and information technologies have led to condition-based monitoring in civil and mechanical structural systems. The structural monitoring system plays a key role in condition-based monitoring to evaluate structural safety from responses measured by sensors. In other words, following method allows to examine the health of an existing structures, such as a long-span bridge. The structural monitoring system can enable early detection for an unsafe condition and enable proactive maintenance. As a result, it greatly reduces the inspection burden as well as maintenance costs. The prerequisite for the successful condition-based monitoring is to obtain accurate responses through the whole structural system. Especially in civil-infrastructures, high cost, and technical difficulty are some challenging issues.

In order to solve this problem, a research team in KICT, led by Dr. Seung-Seop Jin, has developed an effective as well as efficient data-fusion method for condition-based monitoring. With the following method, the complementary data-fusion for the point and distributed strain sensor is performed to combine their advantages in order to obtain the accurate strain distribution over whole infrastructures; thereby, responses can be estimated with high accuracy densely over whole infrastructures.

For structural response, the multi-fidelity data consists of point and distributed sensors, which have different fidelities. The point sensor provides high accurate and reproducible responses at discrete measurement positions (High-fidelity data, HF-data), while a distributed sensor utilizes the scattering-based or scanning sensing technique to obtain very dense responses using the quasi-continuous sensing (Low-fidelity data, LF-data). The LF data is relatively easy to acquire, so it is possible to produce large amounts of relatively inaccurate data for response trend over whole infrastructure. On the contrary, the HF data provides high accuracy; however, it is limited to acquire in terms of both time and technical limitations. Therefore, the limited amount of data is available and this can significantly impair the ability to diagnose structural conditions over whole infrastructures. Although they can be complemented each other, their complementary data-fusion has not been studied yet for the structural monitoring system. KICT firstly recognizes their potentials and developed the complementary data-fusion framework by exploiting a multi-fidelity modeling in Computational statistics and Geo-statistics. The basic concept of the developed method is to transfer knowledge of the abundant but potentially inaccurate LF-data (response trend) to enhance their accuracies by fusing the information from the HF-data (accuracy at some points).

The newly developed method was verified by a number of the numerical tests with other existing multi-fidelity data-fusion methods. In order to consider possible situations in real applications, the developed method was extensively evaluated through Monte Carlo simulations by varying the number and locations of multi-fidelity data with the noise. The results show that the prediction performance of the developed method is consistently superior to other existing methods. In both experiments, the relative percentages of accuracy (maximum absolute error) are improved up to 171.3% and 192 % to the existing methods.

The method is very versatile for structural monitoring, especially for massive infrastructures. The developed method is currently improved to make it more robust and efficient. For better generalized capability, the developed method requires flexible learning capability for extracting the information from both the HF-data and LF-data and fusing them. Such improvements include the following.

Dr. Jin said, "The rationale behind this improvement is similar to our decision-making in real life. We seek different options and combine them to make the best decision. Similar to our decision-making, we do not have high confidence on the unknown damages. In the current method, we have to utilize specific models and some parameters in these models. It should be noted that a best model and its parameters are case-dependent. Therefore, we pursue several options for flexible modeling. To deal with various conditions in infrastructures, we can adopt a flexible and self-learning framework such as optimal kernel learning for better data-fusion. This idea takes a step towards autonomous and efficient monitoring system for massive infrastructures."

VANCOUVER, Wash. - Putting on a happy face might not be enough for entrepreneurs to win over potential investors.

Despite perceptions that entrepreneurs should always be positive about their ventures, a study led by a Washington State University researcher found that entrepreneurs whose facial expressions moved through a mix of happiness, anger and fear during funding pitches were more successful.

"Our findings show that there's a role for different emotions in pitches," said Ben Warnick, WSU assistant professor in WSU's Carson College of Business and lead author on the study published in the Journal of Business Venturing. "For example, an angry facial expression can convey how much you care about something, instead of just smiling, which on the extreme end can come off as insincere or overoptimistic. It's good to balance that out. There are different reasons for using different expressions."

While previous research--and advice for entrepreneurs--has focused on using happy or positive attitudes in pitches, Warnick and his co-authors looked at several emotions: happiness, anger, fear and sadness.

For the study, the researchers analyzed nearly 500 pitch videos from the online crowdfunding site, Kickstarter. They used facial analysis software to code the presenters' facial expressions for the four emotions as well as neutral expressions for every frame of each video. They measured the percentage of the pitch that the entrepreneurs expressed each emotion. Then, they compared the display of these emotional expressions with the ultimate success of the pitch by three measures: whether the entrepreneurs met their stated fundraising goal, total amount raised and how many people contributed.

The study showed that those who used a variety of three emotional expressions--happiness, anger and fear--had the most fundraising success. The only emotion that had a negative effect on funding was sadness.

In a qualitative analysis, the authors found that many successful entrepreneurs used different emotional expressions at different points in the pitch. For instance, many entrepreneurs would start their pitch in a happy way, introducing themselves and talking about how proud they are of their team. They would then use anger to talk about their determination or the problem they were trying to address. When the entrepreneurs talked about obstacles, the risk they were taking or need for resources, they would often use facial expressions conveying fear.

In contrast, people who expressed very little emotion on their faces did not do well in garnering funds even if the words they were saying were compelling. Entrepreneurs who stuck to just one emotion also did not do as well.

Yet there were limits to the use of emotion in pitches, even if it was varied.

"There's a Goldilocks point where you can have too little or too much," said Warnick. "Expressing happiness, anger and fear all promote funding up to a point. But if you express any one of these emotions too frequently, you're hurting your funding prospects."

This study only looked at the use of facial expressions. Warnick suggested that further research might look into other channels of expression or at the connection between what people actually feel and what they express, as the two don't always align.

"Some people might be very expressive, where what they're feeling on the inside shows quite readily to other people," said Warnick. "Others might be engaging in impression management, in other words, faking it."

Scientists have recreated the reaction by which carbon isotopes made their way into different organic compounds, challenging the notion that organic compounds, such as amino acids, were formed by isotopically enriched substrates. Their discovery suggests that the building blocks of life in meteorites were derived from widely available substrates in the early solar system.

Their findings were published online in Science Advances on April 28, 2021.

Carbonaceous meteorites contain the building blocks of life, including amino acids, sugars, and nucleobases. These meteorites are potential providers of these molecules to the prebiotic Earth.

The small organic molecules found in meteorites are generally enriched in a heavy carbon isotope (13C). However, the most abundant organic matter in meteorites is depleted in 13C. Such a difference has long since puzzled scientists. It has been thought the small molecules came from 13C enriched substances found in the extremely cold outer solar system and/or the solar nebula.

However, a team of researchers from Tohoku University and Hokkaido University has presented a new hypothesis. They argue that the formose-type reactions, the formation of sugar from formaldehyde, create sizeable differences in the 13C concentration between small and large organic molecules.

Recreating the formose-type reaction in the lab, the researchers found that the carbon isotope components of meteorite organics are created by the formose-type reaction even in a hot aqueous solution.

Their findings suggest that the organic compounds were formed without the use of isotopically enriched substrates from the outer solar system; rather, their formation may have taken place using substrates commonly present in the early solar system.

"The discrepancy in carbon isotopic composition between the small organic compounds and large insoluble organic matter is one of the most mysterious characteristics of meteorite organic compounds," said Tohoku University's Yoshihiro Furukawa, lead-author of the study. "However, the behavior of 13C in this reaction solves the puzzle completely."

"Even though the compounds were synthesized 4.6 billion years ago, the isotope compositions tell us the process of synthetic reaction," added co-author Yoshito Chikaraishi, from Hokkaido University.

Looking ahead, the research group is planning to investigate the impact of the formose-type reaction in nitrogen and carbon isotope characteristics in a number of meteorite organics and carbonates.

Scientists from Stony Brook University and the Max Planck Institute of Animal Behavior have pieced together a timeline of how brain and body size evolved in mammals over the last 150 million years. The international team of 22 scientists, including biologists, evolutionary statisticians, and anthropologists, compared the brain mass of 1400 living and extinct mammals. For the 107 fossils examined--among them ancient whales and the oldest Old World monkey skull ever found--they used endocranial volume data from skulls instead of brain mass data. The brain measurements were then analyzed along with body size to compare the scale of brain size to body size over deep evolutionary time.

The findings, published in Science Advances, showed that brain size relative to body size--long considered an indicator of animal intelligence--has not followed a stable scale over evolutionary time. Famous "big-brained" humans, dolphins, and elephants, for example, attained their proportions in different ways. Elephants increased in body size, but surprisingly, even more in brain size. Dolphins, on the other hand, generally decreased their body size while increasing brain size. Great apes showed a wide variety of body sizes, with a general trend towards increases in brain and body size. In comparison, ancestral hominins, which represent the human line, showed a relative decrease in body size and increase in brain size compared to great apes.

The authors say that these complex patterns urge a re-evaluation of the deeply rooted paradigm that comparing brain size to body size for any species provides a measure of the species' intelligence. "At first sight, the importance of taking the evolutionary trajectory of body size into account may seem unimportant," says Jeroen Smaers, an evolutionary biologist at Stony Brook University and first author on the study. "After all, many of the big-brained mammals such as elephants, dolphins, and great apes also have a high brain-to-body size. But this is not always the case. The California sea lion, for example, has a low relative brain size, which lies in contrast to their remarkable intelligence."

By taking into account evolutionary history, the current study reveals that the California sea lion attained a low brain-to-body size because of the strong selective pressures on body size, most likely because aquatic carnivorans diversified into a semi-aquatic niche. In other words, they have a low relative brain size because of selection on increased body size, not because of selection on decreased brain size.

"We've overturned a long-standing dogma that relative brain size can be equivocated with intelligence," says Kamran Safi, a research scientist at the Max Planck Institute of Animal Behavior and senior author on the study. "Sometimes, relatively big brains can be the end result of a gradual decrease in body size to suit a new habitat or way of moving--in other words, nothing to do with intelligence at all. Using relative brain size as a proxy for cognitive capacity must be set against an animal's evolutionary history and the nuances in the way brain and body have changed over the tree of life."

The study further showed that most changes in brain size occurred after two cataclysmic events in Earth's history: the mass extinction 66 million years ago and a climatic transition 23-33 million years ago.

After the mass extinction event at the end of the Cretaceous period, the researchers noticed a dramatic shift in brain-body scaling in lineages such as rodents, bats and carnivorans as animals radiated into the empty niches left by extinct dinosaurs. Roughly 30 million years later, a cooling climate in the Late Paleogene led to more profound changes, with seals, bears, whales, and primates all undergoing evolutionary shifts in their brain and body size.

"A big surprise was that much of the variation in relative brain size of mammals that live today can be explained by changes that their ancestral lineages underwent following these cataclysmic events," says Smaers. This includes evolution of the biggest mammalian brains, such as the dolphins, elephants, and great apes, which all evolved their extreme proportions after the climate change event 23-33 million years ago.

The authors conclude that efforts to truly capture the evolution of intelligence will require increased effort examining neuroanatomical features, such as brain regions known for higher cognitive processes. "Brain-to-body size is of course not independent of the evolution of intelligence," says Smaers. "But it may actually be more indicative of more general adaptions to large scale environmental pressures that go beyond intelligence."

Adult heterosexual women and men are often jealous about completely different threats to their relationship. These differences seem to establish themselves far sooner than people need them. The finding surprised researchers at the Norwegian University of Science and Technology (NTNU) who studied the topic.

"You don't really need this jealousy until you need to protect yourself from being deceived," says Professor Leif Edward Ottesen Kennair at NTNU's Department of Psychology.

Romantic jealousy can be experienced as horrible at its worst. But jealousy associated with a partner's infidelity has clearly been an evolutionary advantage.

"Jealousy is activated when a relationship we care about is threatened. The function is probably to minimize threats to this relationship. These threats have historically been somewhat different for men and women," says Per Helge H. Larsen, a master's student in the Department of Psychology at NTNU.

Evolutionary psychology can help explain the gender differences having to do with this jealousy.

The differences in sexual jealousy between the sexes, simply put, revolve around the possibilities for their own children. Previous research has already established that:

Men more often react more negatively when their partner has had sex with others than if she falls in love or spends time with someone without having sex.

It's easy to explain: if the woman is sexually unfaithful, it ultimately means that her partner might need to use his own resources to raise another man's children.

Women, on the other hand, are always sure that the child is theirs. They tend to react more negatively to their partner having feelings for another woman than that he's had sex with her.

This response can also be explained. Historically, she could suffer a loss of resources and status for herself and their child if he left her for someone else.

We should note that these differences have been with us since long before birth control pills and the possibility for women to feed and raise their children alone. A few generations aren't enough to change either biology or culture very much.

The gender differences that lead to jealousy are easy to explain. They are evolutionary adaptations that get passed on to the next generation - but why does this gender difference arise so early?

Precisely this question presents theoretical challenges for the researchers, because jealousy has historically not been risk-free, either.

"Jealousy is potentially a costly reaction, perhaps especially for the man before he is physically strong enough to defend himself and his partner against rivals, and before he would normally have had the opportunity to have a steady partner through marriage," says Kennair.

Throughout history, jealous boys and men have run a great risk by expressing their jealousy. Being ostracized, injured or killed in competing for women is all too well known.

"Throughout evolutionary history, the usefulness of man's form of jealousy would probably have been reserved for men of high status who had a great ability to defend themselves," says Kennair.

So why be jealous before you're able to take care of your partner?

"We knew that this difference becomes established in the early 20s, but through our study we've shown that it appears even earlier," says Larsen.

The research group at NTNU wanted to find out when these gender differences around jealousy, sex and emotions begin.

To this end they studied 1266 pupils aged 16 to 19 years in upper secondary school. However, it turns out the participants weren't young enough for the researchers to answer this question as to when gender differences develop.

"The gender difference was stable and clear throughout the age range of the study. This is pretty startling," says Professor Mons Bendixen in the Department of Psychology.

"The gender difference wasn't affected by whether the teens currently had a boyfriend or girlfriend, or whether they had made their sexual debut. The difference thus doesn't seem to have anything to do with experience," Bendixen adds.

We can imagine, and perhaps assume, that the gender differences in jealousy responses arise even earlier than age 16. But we don't know that for sure yet. To confirm it, we need to study even younger boys and girls.

"It's also unclear how young study participants can be to research this in a meaningful way," says Kennair.

Distinguishing between sexual jealousy and other types of jealousy can quickly become meaningless for the very youngest among us.

In one way or another, the benefits of this early, gender-specific sexual jealousy must have outweighed its dangers.

"It could be that the early development of sexual jealousy is simply preparing us for adulthood, and that it has no other function at a younger age."

But Kennair emphasized that jealousy is a dangerous feeling. Young men could put themselves in danger by experiencing this feeling before it was appropriate and they were physically strong enough to defend the relationship.

But the researchers are clear that this idea is still speculation.

"We need further research and theory development on the basis of these findings," Kennair said.

More than a quarter of American infants in 2018 had not received common childhood vaccines that protect them from illnesses such as polio, tetanus, measles, mumps and chicken pox, new research from the University of Virginia School of Medicine reveals.

Only 72.8% of infants aged 19-35 months had received the full series of the seven recommended vaccines, falling far short of the federal government's goal of 90%. Those less likely to complete the vaccine series include African-American infants, infants born to mothers with less than a high-school education and infants in families with incomes below the federal poverty line.

The researchers warn that failure to complete the vaccine series leaves children at increased risk of infection, illness and death. It also reduces the herd immunity of the entire population, allowing diseases to spread more easily.

"These findings highlight that significant disparities still exist in protecting infants from preventable diseases in the United States," said researcher Rajesh Balkrishnan, PhD, of UVA's Department of Public Health Sciences. "The low seven-vaccine series rates in low-income families are disheartening, especially with federal programs such as Vaccine for Children, which provides coverage for their service."

Trends in Childhood Vaccination

Some good news: There was a 30% increase in the overall number of infants getting the full vaccine series during 2009-2018, the 10-year period the researchers examined.

However, disparities in vaccine uptake grew between low-income families and higher-income families in that time. In 2009, families below the federal poverty line were 9% less likely to get the full vaccine series than families with annual income above $75,000. In 2018, low-income families were 37% less likely to complete the vaccine series.

The researchers say the lower rate among low-income families is especially disheartening considering the availability of federal programs such as Vaccine for Children, which provides free vaccines for uninsured, underinsured and Medicaid-eligible children.

"Free vaccination coupled with no physician administration fees, linked with potential programs that are frequently accessed by low-income families, could be a potential solution to increase immunization rates," Balkrishnan said "The role of healthcare professionals such as pharmacists could also be expanded to provide these services cost effectively."

The study found that mothers who had not completed high school were almost 27% less likely to have their infants fully vaccinated than moms with college education. That disparity had increased sharply from a previous study evaluating 1995-2003. The previous study found that mothers with less than high-school education were 7.8% less likely to complete the vaccine series.

Among African-Americans, completion of the vaccine series was significantly lower than in both whites and Hispanics. The researchers call this disparity "unacceptable" and say cost-effective interventions are needed to increase immunization rates and address vaccine hesitancy.

"These findings are particularly important in the context of the current COVID pandemic," Balkrishnan said. "Particular attention needs to be paid to vulnerable populations in ensuring the availability and access to important life-saving vaccines."

Human decision-making depends on the flexible processing of complex information, but how the brain may adapt processing to momentary task demands has remained unclear. In a new article published in the journal Nature Communications, researchers from the Max Planck Institute for Human Development have now outlined several crucial neural processes revealing that our brain networks may rapidly and flexibly shift from a rhythmic to a "noisy" state when the need to process information increases.

Driving a car, deliberating over different financial options, or even pondering different life paths requires us to process an overwhelming amount of information. But not all decisions pose equal demands. In some situations, decisions are easier because we already know which pieces of information are relevant. In other situations, uncertainty about which information is relevant for our decision requires us to get a broader picture of all available information sources. The mechanisms by which the brain flexibly adapts information processing in such situations were previously unknown.

To reveal these mechanisms, researchers from the Lifespan Neural Dynamics Group (LNDG) at the Max Planck Institute for Human Development and the Max Planck UCL Centre for Computational Psychiatry and Ageing Research designed a visual task. Participants were asked to view a moving cloud of small squares that differed from each other along the four visual dimensions: color, size, brightness, and movement direction. Participants were then asked a question about one of the four visual dimensions. For example, "Were more squares moving to the left, or right?". Prior to seeing the squares, the study authors manipulated "uncertainty" by informing participants which feature(s) they could be asked about; the more features that were relevant, the more uncertain participants were expected to become about which features to focus upon. Throughout the task, brain activity was measured using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI).

First, the authors found that when participants were more uncertain about the relevant feature in the upcoming choice, participants' EEG signals shifted from a rhythmic mode (present when participants could focus on a single feature) to a more arrhythmic, "noisy" mode. "Brain rhythms may be particularly useful when we need to select relevant over irrelevant inputs, while increased neural 'noise' could make our brains more receptive to multiple sources of information. Our results suggest that the ability to shift back and forth between these rhythmic and 'noisy' states may enable flexible information processing in the human brain," says Julian Q. Kosciessa, LNDG post-doc and the article's first author.

Additionally, the authors found that the extent to which participants shifted from a rhythmic to a noisy mode in their EEG signals was dominantly coupled with increased fMRI activity in the thalamus, a deep brain structure largely inaccessible by EEG. The thalamus is often thought of primarily as an interface for sensory and motor signals, while its potential role in flexibility has remained elusive. The findings of the study may thus have broad implications for our current understanding of the brain structures required for us to adapt to an ever-changing world. "When neuroscientists think about how the brain enables behavioral flexibility, we often focus exclusively on networks in the cortex, while the thalamus is traditionally considered a simple relay for sensorimotor information. Instead, our results argue that the thalamus may support neural dynamics in general and could optimize brain states according to environmental demands, allowing us to make better decisions," says Douglas Garrett, senior author of the study and LNDG group leader.

In the next phases of their research, the authors plan to investigate the underlying neurochemical bases of how the thalamus permits shifts in neural dynamics, and whether such shifts can be "tuned" by stimulating the thalamus using weak electrical currents.

People with diabetes are at increased risk of developing a severe course of COVID-19 compared to people without diabetes. The question to be answered is whether all people with diabetes have an increased risk of severe COVID-19, or whether specific risk factors can also be identified within this group. A new study by DZD researchers has now focused precisely on this question and gained relevant insights.

The COVID-19 pandemic poses unprecedented challenges to science and the health sector. While in some people with a SARS-CoV-2 infection the disease is hardly noticeable, in others it is much more severe and sometimes fatal. So far, knowledge about the course of a COVID-19 disease is still quite meager. However, diabetes has increasingly emerged as one of the risk factors determining the severity of the disease. Several studies on diabetes and SARS-CoV-2 have already observed an approximately two- to threefold increase in mortality due to COVID-19 in people with diabetes compared to people without diabetes. This makes it all the more important to conduct studies that examine the risk factors of people with diabetes for severe COVID-19 disease in more detail.

A new study of the German Diabetes Center, partner of the DZD, led by Dr. Sabrina Schlesinger, head of the junior research group Systematic Reviews at the Institute for Biometrics and Epidemiology, therefore examined the risk phenotypes of diabetes and their possible association with the severity of COVID-19. In their meta-analysis, the researchers combined the results from 22 published studies, so that a total of more than 17,500 people with diabetes and confirmed SARS-CoV-2 infection were included in this study. For individuals with diabetes and SARS-CoV-2 infection, male sex, older age (>65 years), high blood glucose levels (at the time of hospital admission), chronic treatment with insulin, and existing concomitant diseases (such as cardiovascular disease or kidney disease) were identified as risk factors for a severe COVID-19 course. On the other hand, the results showed that chronic metformin treatment was associated with a reduced risk of a severe course of COVID-19.

"This current systematic review and meta-analysis describes within the high-risk group, namely diabetes mellitus, those individuals with the highest risk of a severe COVID-19 course," said Professor Michael Roden, scientific director and board member of the German Diabetes Center. "These results will help to classify individuals with diabetes even better in order to improve their therapy and mitigate the course."

The risk factors identified in the study - i.e. older persons, usually male, with comorbidities of diabetes and chronic insulin treatment - can thus be seen as indicators of diabetes severity or overall poor health. "However, some results, especially on diabetes-specific factors such as type or duration of diabetes and further treatments, are still imprecisely assessed and the significance is low. In order to strengthen the significance, further primary studies are needed that examine these specific risk factors and consider other relevant influencing factors in their analysis," said Dr. Schlesinger. Her research team is therefore already working on a next version of this review: "This review presents the current study situation and will be updated regularly as long as new findings on this topic are available," said Dr. Schlesinger.