Culture

In a new nationwide poll, the GeneSight® Mental Health Monitor found that 83% of people with depression agree that life would be easier if others could understand their depression. Yet, most people who have not experienced depression may not be able to understand the challenges, including its treatment.

"Depression is one of the most misunderstood disorders. When people misinterpret patients with depression as 'lazy' or 'dramatic,' they are vastly underestimating and misunderstanding the debilitating symptoms of major depressive disorder," said Mark Pollack, M.D., chief medical officer for the GeneSight test at Myriad Genetics. "That is why we are working with the Depression and Bipolar Support Alliance, so that loved ones can offer more empathetic support and people with depression won't feel so alone."

For Mental Health Awareness Month (May), GeneSight and the Depression and Bipolar Support Alliance (DBSA) have partnered to raise awareness and understanding for how a person who has major depressive disorder feels, and why it can be so hard to seek treatment.

Lack of Understanding and Empathy about Depression

Three out of four people living with depression said they desire support from their loved ones including just listening or saying supportive things like: "How can I help?" or "Do you want to talk about it?". Instead, nearly half of those with depression said they were more likely to hear statements like: "You need to get over it/snap out of it" or "We all get sad sometimes".

"Depression is a serious but treatable medical condition that affects how a person feels, thinks, and acts. Though, typically characterized by feelings of sadness, depression symptoms may appear as irritability or apathy," said Michael Thase, M.D., professor of psychiatry, Perelman School of Medicine and the Corporal Michael J. Crescenz VA Medical Center, and DBSA scientific advisory board member. "We must work together - providers, patients, family and friends - to continue to reduce the impact of stigma. Misunderstanding the disorder may lead to people feeling embarrassed and/or unwilling to seek the treatment they need."

Nearly half of those either diagnosed with depression or concerned they may have depression say they feel ashamed/embarrassed when others found out they were suffering from depression, according to the GeneSight Mental Health Monitor.

Pandemic Prompts Search for New Treatment

More than half of those diagnosed with depression indicated in the poll that they started a new treatment since the start of the pandemic. Nevertheless, for some, starting a new depression medication doesn't guarantee success.

More than half of people diagnosed with depression said they have tried four or more depression medications in their lifetime, with nearly 1 in 4 respondents reporting they have tried six or more medications to try to find relief.

"I couldn't get out of bed to take care of my children, much less go to the doctor multiple times to try new medicines that 'might' help," said Amanda, a 25-year-old woman who was diagnosed with major depressive disorder. "The years of trial and error were so frustrating and discouraging. You feel like you are stuck living that way."

Those who indicated in the GeneSight Mental Health Monitor that they had experienced the trial-and-error process described the experience as:

"On a rollercoaster" (51%)

"I'm just waiting for the next side effect" (45%)

"Walking through a maze blindfolded" (44%)

"Playing a game of darts, only I'm the dartboard" (42%)

While 4 in 10 of those diagnosed with depression say they are not confident that their depression medications will work for them, 7 in 10 would feel "hopeful" if their doctor recommended genetic testing as part of their treatment plan.

Genetic testing, like the GeneSight Psychotropic test, analyzes how a patient's genes may affect their outcomes with medications commonly prescribed to treat depression, anxiety and other psychiatric conditions.

"With just a simple cheek swab, the GeneSight test provides your clinician with information about which medications may require dose adjustments, be less likely to work, or have an increased risk of side effects based on a patient's genetic makeup," said Dr. Pollack. "It's one of many tools in a physician's toolbox that may help get patients on the road to feeling more like themselves again."

Conquering the Depression Disconnect

While 7 in 10 adults said that they are more conscious about their own or others' mental health challenges than they were before the pandemic began, less than half of adults are very confident they can recognize if a loved one is suffering from depression, according to the GeneSight Mental Health Monitor.

For a better understanding of depression and treatment, visit KnowMentalHealth.com. For more information on how genetic testing can help inform clinicians in depression treatment, please visit genesight.com.

Whether you hanker for a hard hit of caffeine or favour the frothiness of a milky cappuccino, your regular coffee order could be telling you more about your cardio health than you think.

In a world first study of 390,435 people, University of South Australia researchers found causal genetic evidence that cardio health - as reflected in blood pressure and heart rate - influences coffee consumption.

Conducted in partnership with the SAHMRI, the team found that people with high blood pressure, angina, and arrythmia were more likely to drink less coffee, decaffeinated coffee or avoid coffee altogether compared to those without such symptoms, and that this was based on genetics.

Lead researcher and Director of UniSA's Australian Centre for Precision Health, Professor Elina Hyppönen says it's a positive finding that shows our genetics actively regulate the amount of coffee we drink and protect us from consuming too much.

"People drink coffee for all sorts of reasons - as a pick me up when they're feeling tired, because it tastes good, or simply because it's part of their daily routine," Prof Hyppönen says.

"But what we don't recognise is that people subconsciously self-regulate safe levels of caffeine based on how high their blood pressure is, and this is likely a result of a protective genetic a mechanism.

"What this means is that someone who drinks a lot of coffee is likely more genetically tolerant of caffeine, as compared to someone who drinks very little.

"Conversely, a non-coffee drinker, or someone who drinks decaffeinated coffee, is more likely prone to the adverse effects of caffeine, and more susceptible to high blood pressure."

In Australia, one in four men, and one in five women suffer from high blood pressure, with the condition being a risk factor for many chronic health conditions including stroke, heart failure and chronic kidney disease.

Using data from the UK Biobank, researchers examined the habitual coffee consumption of 390,435 people, comparing this with baseline levels of systolic and diastolic blood pressure, and baseline heart rate. Causal relationships were determined via Mendelian randomization.

Prof Hyppönen says how much coffee we drink is likely to be an indicator of our cardio health.

"Whether we drink a lot of coffee, a little, or avoid caffeine altogether, this study shows that genetics are guiding our decisions to protect our cardio health," Prof Hyppönen says.

"If your body is telling you not to drink that extra cup of coffee, there's likely a reason why. Listen to your body, it's more in tune with what your health than you may think."

Cells breathe, to an extent, exchanging gases, taking in energy sources from the environment and processing it. Now, researchers from Tohoku University in Japan have shone a light on the process in a new way.

Their demonstrated visualization method in model systems was made available online on March 12th in Biosensors and Bioelectronics, ahead of the June print edition.

The researchers used spheroids - cultured cells within a close-to-natural environment - to mimic a biological tissue using mesenchymal stem cells (MSCs). Due to MCSs' ability to self-renew and differentiate into various tissues, they are of significant interest for use in regenerative medicine and to test different therapeutics in different tissue models.

They settled the spheroids on a gold electrode dosed in luminescent solution. The researchers applied stepped electric potential - the energy needed to convert oxygen - to the set up where the solution was then oxidized sensitized to produce luminescent, which is dependent on oxygen concentration. The spheroids glowed brightly, surrounded by a ring of darkness where oxygen concentration was low due to gas exchanges. They call the process potential step-based electrochemiluminescence (ECL) imaging.

"As living spheroids consume oxygen to produce energy, the respiratory activity was elegantly visualized by the distribution of luminescence around the spheroids," said Kaoru Hiramoto of the JSPS Research Fellowship for Young Scientists, who developed the ECL imaging system.

The researchers used a digital camera to visualize multiple spheroids with a single shot, demonstrating both the high spatial resolution of their system, as well as the low background noise.

"The system offers high throughput analysis of spheroids, in addition to highly improving resolution of the images compared to conventional electrode array devices," said co-corresponding authors Kosuke Ino and Hitoshi Shiku, assistant professor and professor in the Graduate School of Engineering, Tohoku University. "The system offers novel insights into electrochemical devices and imaging systems for cell spheroids."

ECL imaging is still in the development phase, the researchers said. They plan to improve the sensitivity and selectivity, as well as analyze other data that might be collected in the system, such as cellular metabolites attached to the electrode. They also plan to use the system to investigate more complicated biological models, as well as patient-derived cell spheroids.

"To the best of our knowledge, this is the first attempt to visualize the respiratory activity of spheroids by direct conversion of oxygen concentration into ECL imaging," Ino said. "The features of the proposed system - high spatial resolution with the ability for simultaneous imaging of multiple spheroids - are promising for transplantation research and drug screening utilizing cell spheroids."

Our bodies and behaviors often seem to have rhythms of their own. Why do we go to the bathroom at the same time every day? Why do we feel off if we can't go to sleep at the right time? Circadian rhythms are a behind-the-scenes force that shape many of our behaviors and our health. Michihiro Mieda and his team at Kanazawa University in Japan are researching how the brain's circadian rhythm control center regulates behavior.

Termed the superchiasmatic nucleus, or SCN, the control center contains many types of neurons that transmit signals using the molecule GABA, but little is known about how each type contributes to our bodily rhythms. In their newest study, the researchers focused on GABA neurons that produce arginine vasopressin, a hormone that regulates kidney function and blood pressure in the body, and which the team recently showed is also involved in regulating the period of rhythms produced by the SCN in the brain.

To examine the function of these neurons, and only these neurons, the researchers first created mice in which a gene needed for GABA signaling between neurons was deleted only in vasopressin-producing SCN neurons. "We removed a gene that codes for a protein that allows GABA to be packaged before it is sent to other neurons," explains Mieda. "Without packaging, none of the vasopressin neurons could send out any GABA signals."

This means that these neurons could no longer communicate with the rest of the rhythm control center using GABA. On the surface, the results were simple. The mice showed longer periods of activity, beginning activity earlier and ending activity later than control mice. So, lack of the packaging gene in the neurons disrupted the molecular clock signal, right? In fact, the reality was not so simple. Closer examination showed that the molecular clock progresses correctly. So, what was happening?

The researchers used calcium imaging to examine the clock rhythms within the vasopressin neurons. They found that while the rhythm of activity matched the timing of behavior in control mice, this relationship was disturbed in the mice whose GABA transmission from the vasopressin neurons was missing. In contrast, the rhythm of SCN output, i.e. SCN neuronal electrical activity, in the modified mice had the same irregular rhythm as their behavior. "Our study shows that GABA signaling from vasopressin neurons in the suprachiasmatic nucleus help fix behavioral timing within the constraints of the molecular clock," says Mieda.

WASHINGTON, D.C, (April 28, 2021) - A new study reveals the use of a potassium ferrate hemostatic patch (PFHP) reduces the time to hemostasis for patients receiving cardiac catherization. The findings indicate a faster approach to removing the compression band used during the procedure, without compromising safety. Positive results of the STAT2 trial follow an initial pilot study and are being presented as late-breaking clinical science at the Society for Cardiovascular Angiography and Interventions (SCAI) 2021 Virtual Scientific Sessions.

Cardiac catherization is a procedure performed to evaluate the heart or arteries for patient diagnosis and interventions. This is increasingly performed using transradial approach, where a catheter is inserted through radial artery in the arm to the heart. A compression device called a TR band (TRB) is used to close the hole in the wrist made during the catherization process. Standard protocols require the band to be left on for at least two hours following the procedure.

The study evaluated the use of the StatSeal device patch compared to using a TRB alone in order to reduce time to hemostasis after transradial access. The study enrolled 443 patients across three centers, including 27.5% receiving percutaneous coronary intervention (PCI). Patients were randomized 1:1 to either the TRB alone or the TRB in addition to the potassium ferrate hemostatic patch. Both groups had complete TRB deflation attempted at 60 minutes post-procedure. Findings demonstrate the adjunctive use of the patch is safer and faster in deflating the TRB and reduced rebleeding. From a prior pilot study, discharge times were reduced with the use of the Statseal.

"By bringing observation times down from two hours to one, the use of the hemostatic patch has the potential to change practice because we can move toward same-day discharge protocols for cardiac catherization patients," said Arnold H. Seto, MD, MPA, FSCAI, Long Beach VA Health Care System. "We would be able to shift from long observation times and more frequently tell a patient, 'you are going home today.' This is really important for both the clinician and the patient."

Results showed the time to complete TRB deflation was shorter with the PFHP compared to for TRB alone (65.9 ± 14.1 min vs. 112.8 ± 56.3 min, P

"From an operator stand point, these findings are key to improving cath lab throughputs," said Jordan G. Safirstein, MD, FSCAI, Morristown Medical Center. "Now we know that we can safely discharge patients quicker than we have before, which not only improves efficiencies but is also beneficial for the quality of life for the patient. We hope our results generate positive health care benefits so more patients can be treated with life-saving cardiac solutions."

The authors highlighted the benefits for PCI patients receiving stents, that typically spend four to six hours under observation. Their findings challenge this standard of care and indicate they may be able to safely reach discharge sooner, a trend consistent with the recent SCAI document "Length of stay following percutaneous coronary intervention." Further, authors from Morristown Medical Center note they are taking initiatives in their radial lounge to base discharge on when safety concerns and adequate hemostasis is met and the patient feels well, rather than on a framework of time.

Whether you hanker for a hard hit of caffeine or favour the frothiness of a milky cappuccino, your regular coffee order could be telling you more about your cardio health than you think.

In a world first study of 390,435 people, University of South Australia researchers found causal genetic evidence that cardio health - as reflected in blood pressure and heart rate - influences coffee consumption.

Conducted in partnership with the SAHMRI, the team found that people with high blood pressure, angina, and arrythmia were more likely to drink less coffee, decaffeinated coffee or avoid coffee altogether compared to those without such symptoms, and that this was based on genetics.

Lead researcher and Director of UniSA's Australian Centre for Precision Health, Professor Elina Hyppönen says it's a positive finding that shows our genetics actively regulate the amount of coffee we drink and protect us from consuming too much.

"People drink coffee for all sorts of reasons - as a pick me up when they're feeling tired, because it tastes good, or simply because it's part of their daily routine," Prof Hyppönen says.

"But what we don't recognise is that people subconsciously self-regulate safe levels of caffeine based on how high their blood pressure is, and this is likely a result of a protective genetic a mechanism.

"What this means is that someone who drinks a lot of coffee is likely more genetically tolerant of caffeine, as compared to someone who drinks very little.

"Conversely, a non-coffee drinker, or someone who drinks decaffeinated coffee, is more likely prone to the adverse effects of caffeine, and more susceptible to high blood pressure."

In Australia, one in four men, and one in five women suffer from high blood pressure, with the condition being a risk factor for many chronic health conditions including stroke, heart failure and chronic kidney disease.

Using data from the UK Biobank, researchers examined the habitual coffee consumption of 390,435 people, comparing this with baseline levels of systolic and diastolic blood pressure, and baseline heart rate. Causal relationships were determined via Mendelian randomization.

Prof Hyppönen says how much coffee we drink is likely to be an indicator of our cardio health.

"Whether we drink a lot of coffee, a little, or avoid caffeine altogether, this study shows that genetics are guiding our decisions to protect our cardio health," Prof Hyppönen says.

"If your body is telling you not to drink that extra cup of coffee, there's likely a reason why. Listen to your body, it's more in tune with what your health than you may think."

WASHINGTON, D.C, (April 28, 2021) - A retrospective analysis of risk factors for coronary artery disease (CAD) in young African American patients is being presented today at the Society for Cardiovascular Angiography and Interventions (SCAI) 2021 Virtual Scientific Sessions. The findings reveal this specific patient segment, African-Americans under age 45, experiences greater CAD risk factors related to smoking, drug and alcohol abuse, HIV as well as mental health conditions including anxiety and depression.

CAD is the most common type of heart disease, with high blood pressure, obstructive sleep apnea and diabetes among traditional risk factors. African Americans are disproportionally impacted by heart disease, and are more likely to develop the chronic, progressive condition earlier in life. Despite this, the prevalence of and risk factors for CAD in a younger, African American patient population is understudied.

A retrospective analysis of the National Inpatient Sample was performed to identify all the patients with CAD in 2017. 139,657 African American patients with CAD were identified using international classification of disease-10 ICD 10 codes and then classified into two groups based on age. Group 1 consisted of 7,093 African American patients aged 18-45 years old and Group 2 consisted of 131,520 African American patients older than 45 years old. Patient baseline characteristics and co-morbid conditions were recorded and analyzed.

Results showed African Americans aged 18-45 years who present with CAD have lower incidence of traditional risk factors and higher incidence of non-traditional risk factors. In the younger patient group (Group 1) there was significant higher prevalence of obesity [31.2% vs. 19.4%], drug abuse [17.8% vs. 6.7%], alcohol abuse [5.2% vs. 4.3%], smoking [49.8% vs. 46.6%], HIV [1.88% vs. 0.88%] end-stage renal disease [20.7% vs. 14.6%] and depression [13.8% vs. 10.4%] compared to patients over 45. There was no statistically significant difference between groups for hypertension, diabetes mellitus, congestive heart failure, obstructive sleep apnea and gender.

"In our practice, we are seeing more African American patients come in with heart attacks caused by coronary artery disease at a younger age, causing major health and lifestyle implications," said Ahmad Awan, Cardiology Fellow, Howard University Hospital in Washington, D.C. "As we look at how to tailor prevention for a population already at high-risk for cardiovascular diseases, our data points to a need to look beyond the standard risk factors to help address the complex burden of disease and interventions needed for effective early prevention. Understanding the unique risk profile is a first step for more individualized patient interventions."

The authors state that the analysis is part of a larger study and that further well powered randomized controlled trials are needed to validate these findings.

The National Climate Center (NCC) of China has just completed a report that gives an authoritative assessment of China's climate in 2020. It provides a summary of China's climate as well as the major weather and climate events that took place throughout the year. This is the third consecutive year that the NCC has published an annual national climate statement in Atmospheric and Oceanic Science Letters (AOSL).

"Against the background of global warming, extreme weather and climate events occur more frequently and have wide influence on society and economies. Last year, floods, droughts, typhoons, low-temperature freezing and snow disasters, and dust storms attacked China and caused severe losses," says Wei Li, Director of the Climate Services Division of the NCC.

According to the report, in 2020, China's climate was warm and wet on the whole, and disasters caused by rainstorms and flooding were more serious than those by drought. The mean air temperature in China was 0.7? above normal, and the annual rainfall was 694.8 mm, which was 10.3% above normal.

In summer, southern China experienced the most severe flooding with extreme heavy rainstorms since 1998. Drought brought slight impacts and losses in China. High temperatures occurred earlier than normal with extreme values, and lasted longer than normal in summer over the south of China. The number of landfalling typhoons was lower than normal, while three typhoons successively affected Northeast China from late August to early September, which was the first time since 1949. Cold-air processes had a wide influence and brought a substantial decrease in air temperature in local areas.

Compared with the average values of the past 10 years, the affected crop area and the numbers of deaths and missing persons in 2020 were significantly smaller, while direct economic losses were slightly larger.

Nonetheless, Li warns that the hazards of climate disasters are increasing: "The WMO announced in January 2021 that the global average air temperature in 2020 was 1.2°C ± 0.1°C above the pre-industrial level and one of the three warmest on record. China also experienced a serious heatwave in summer and the mean air temperature in China was warmer than normal. Disaster prevention and reduction remains the focus of society."

Individuals who self-identify as Republicans became more skeptical of a potential COVID-19 vaccine and other inoculations, such as the flu shot, over the course of the pandemic, reveals a new study by the University of California San Diego’s Rady School of Management.

The paper, published in PLOS ONE, measured general attitudes toward vaccines and assessed whether study participants would get a potential COVID-19 vaccine as well as the seasonal flu shot. It also gauged trust in media.

“We found Republicans became increasingly vaccine hesitant and less trusting of media from March to August of 2020, while Democrats’ views on the two topics stayed the same,” said lead author Ariel Fridman, a PhD candidate in behavioral marketing at the Rady School.

The study also measured the perceived threat of the COVID-19 virus and where participants got their news. 

Republicans consistently viewed the virus to be less threatening than Democrats. Among Democrats, the perceived threat of COVID-19 grew greater with time, while there was no change among Republicans.

The most commonly checked news sources for Republicans was Fox News, followed by Facebook or Instagram. For Democrats, CNN was the most popular news source, followed by The New York Times.

“Our data offers one potential explanation for the polarization of threat perception: Republican and Democratic participants in our study reported consuming different sources of information,” write Fridman and co-authors, Ayelet Gneezy, associate professor in behavioral sciences and marketing at the Rady School and Rachel Gershon, assistant professor of marketing at the Rady School.

The researchers recruited 1,018 respondents using Amazon’s Mechanical Turk platform and asked them to complete surveys in March, April, May, June, July and August of 2020.

“When we started the study in March, early in the pandemic before the first lockdowns, we were expecting people to begin viewing vaccines more favorably because they were seeing the huge threat of a new disease and inoculations are the one thing that could get us out of this mess,” said Fridman. “We were anticipating to document people coming together on the issue, but found the exact opposite.”

He added, “We didn’t expect the paper to be political in nature. We collected a lot of demographic data such as age, gender, race, income, etc. It just happened to be that political party was the best predictor of the divergent trends.”

The study ended in August before a vaccine for the novel coronavirus was approved in December 2020. Despite the safety and efficacy of the vaccines, the research supports continuing evidence of vaccine hesitancy among conservative voters.

A Monmouth poll earlier in April showed that 36 percent of Republicans said they had received at least one shot of the vaccine — compared with 67 percent of Democrats and 47 percent of Independents — and 43 percent of Republicans said they would likely never get the vaccine.

Unique to the PLOS ONE study is that it surveyed the same set of participants over time. The surveys drew participants from every U.S. state (except Wyoming) with ages ranging from 18 to 82. About 50 percent of respondents were male and the other half were female. 

The research reveals an overall rise in vaccine hesitancy, but it is primarily driven by Republicans. It points to the larger role that ideology can play in public health crises.

“We now know that political affiliation is an important predictor of how communities respond to public health concerns,” the authors noted. “If we understand which areas and communities where vaccine hesitancy may be rising, it can help inform effective communication and health interventions.”

The COVID-19 and vaccine hesitancy: A longitudinal study paper was supported by UC San Diego’s Global Health Institute.

Journal

PLoS ONE

DOI

10.1371/journal.pone.0250123

The discovery of ancient kumara pits just north of Dunedin dating back to the 15th century have shone a light on how scientific evidence can complement mātauranga Maori around how and where the taonga were stored hundreds of years ago.

A new study published in the science journal PLOS ONE reports that early Polynesians once stored kumara - American sweet potato - in pits dug into sand dunes at Purākaunui, eastern Otago, less than 30km north of Dunedin. The pits were first discovered in 2001 and are found over 200km south of the currently accepted South Island limit of cooler-climate Māori kumara storage.

These Purākaunui features have the novel form of semi-subterranean, rectangular pits used for the cool seasonal storage of live kumara roots in bulk, known as rua kumara. Research into their age, contents and context has been led by Associate Professor Ian Barber of the University of Otago's Archaeology Programme with the support of university grants and a Marsden award, and the input of radiocarbon expert and co-author Professor Tom Higham of Oxford University.

The research was carried out with the approval and engagement, through successive hui, of Purākaunui Block owners and Kāti Huirapa Runaka ki Puketeraki as manawhenua.

In this historic study, statistical modelling has dated the Purākaunui pits by radiocarbon to the very tight range of 1430-1460 CE at 95% probability, making it some of the most accurate carbon dating to have taken place in New Zealand thanks to advanced technology. Researchers believe rua kumara were stored there due to the discovery of microscopic starch granules with distinctive kumara characteristics from secure deposits at the base of the pits.

The find, Polynesia's southern-most ancient kumara dicovery adds incredible weight to local Māori oral history and tradition that has been considered enigmatic if not overlooked by archaeologists. A number of these traditions refer to southern kumara loss or failure, but some reference kumara memories, atua (deities), stores and cultivations notably from the North Otago Huriawa Peninsula headland and pā less than 30km north of Purākaunui. Ancient rua kumara discovered along the same coastline represent an intriguing connection between these traditions and archaeology.

Purākaunui Block Incorporation chairperson Nicola Taylor says there is significant excitement surrounding the significant research.

"This confirms for us at Purākaunui the importance of our very long history and connection with the land," she says.

"These findings reinforce our very long association with the land and contribute to our own compilation of stories designed to capture the history for future generations."

Those sentiments were echoed by Kāti Huirapa Runaka ki Puketeraki manager Suzanne Ellison.

"Ian's research has been really interesting for the Runaka to follow & with the confirmation via carbon dating of the kumara pit at Purākaunui, it is very affirming about traditions and mātauraka relating to Huriawa Peninsula," Ellison says.

Associate Professor Barber says the study highlights the important connection between te ao Māori and traditional archaeological practices.

"We hope to have modelled respect as much as science in the engagement of Māori knowledge and archaeology," he says.

Associate Professor Barber says there are some questions that still remain about whether the stored kumara roots were imported from warmer northern localities or harvested locally in microclimate production.

"However the dark, sandy archaeological soil at Purākaunui suggests it may have been used for ancient cultivation."

In either case, this discovery represents the earliest securely dated rua kumara in Aotearoa. It joins a small number of examples of American kumara in Polynesia dated securely before explorer Christopher Columbus' navigations. He says the tight chronology also identifies and places the rua kumara storage at around the time of moa extinction, perhaps as mitigation for the loss of this valuable food source.

Two teams have created a new generation of highly specific CAR T cells, which safely cleared solid tumors in mice with mesothelioma, ovarian cancer, and the deadly brain cancer glioblastoma while outlasting and outperforming conventional CAR T cell designs. The results suggest these cells could minimize the risk of dangerous side effects and address the traditionally poor performance of CAR T cells against solid tumors in the clinic. CAR T cells are genetically modified human T cells and have shown impressive performance in patients with leukemia. However, CAR T cells don't work as well against solid tumors, as these cancers lack molecular targets that the cells can easily recognize. Furthermore, the targets that do exist also frequently appear on healthy tissues, meaning that CAR T cells can have devastating side effects in patients with solid tumors. To address these obstacles for the treatment of glioblastoma, Joseph Choe and colleagues engineered new "prime-and-kill" molecular circuits for synNotch-CAR T cells, a cell design that only activates when it recognizes tumor antigens. The circuits integrate receptors that recognize multiple "imperfect" tumor antigens, including either the EGFRvIII receptor on glioblastoma cells or the protein MOG in healthy brain tissue. The receptors prime and activate the CAR T cells only when all the antigens are present, meaning the CAR T cells only target cancerous cells in the nervous system. The synNotch-CAR T cells shrunk glioblastoma tumors and maintained remission in mice without affecting other tissues, while more traditional CAR T cells were either ineffective or couldn't prevent tumor recurrence. Similarly, Axel Hyrenius-Wittsten and colleagues engineered synNotch-CAR T cells bearing receptors that recognize ALPPL2, a protein that appears specifically on solid tumors such as mesothelioma. This design showed strong effects and extended survival in mouse models of mesothelioma and ovarian cancer. Compared with traditional cells, the synNotch-CAR T cell designs also showed fewer signs of exhaustion, a state where CAR T cells lose their effectiveness over time. "These circuits essentially give improved capability for nuanced recognition of a tumor ... and thus open up many new possibilities for how to recognize and attack tumors in safer and more specific ways," Choe et al. say.

The number of distinctive sources and voices on the internet is proven to be in long-term decline, according to new research.

A paper entitled 'Evolution of diversity and dominance of companies in online activity' published in the PLOS ONE scientific journal has shown between 60 and 70 percent of all attention on key social media platforms in different market segments is focused towards just 10 popular domains.

In stark contrast, new competitors are struggling to survive against such dominant players, with just 3 percent of online domains born in 2015 still active today, compared to nearly 40 percent of those formed back in 2006.

The researchers say if these were organic lives, the infant mortality rate would be considered a crisis.

Paul X. McCarthy, a co-author of the paper and Adjunct Professor from UNSW Sydney's Engineering faculty, said: "The internet started as a source of innovation, new ideas and inspiration, a technology that opens up the playing field. But it is now becoming a medium that actually stifles competition, promotes monopolies and the dominance of a small number of players.

"The results indicate the end state of many new industries is likely to be more concentrated than in the analogue economy. With a winner-takes-most outcome for many.

"It means that there's not as much natural competition in established domains, for example in retail with Amazon or in music with Spotify. This may lead to non-competitive behaviour by market leaders such as price discrimination and the use of market power to control suppliers and stifle potential future rivals.

"That is why some see a new role for market regulators to step in here."

The research team, which also included Dr Marian-Andrei Rizoiu from UTS, Sina Eghbal from ANU, and Dr Daniel Falster and Xian Gong from UNSW, performed a large-scale longitudinal study to quantify the distribution of attention given in the online environment to competing organisations.

They tallied the number of external links to an organisation's main domain posted on two large social media channels, namely Reddit and Twitter, as a proxy for online attention towards an organisation.

More than 6 billion user comments were analysed from Reddit, dating back to 2006, while the Twitter data comprised 11.8 billion posts published since 2011. In total, a massive trove of 5.6Tb data was analysed from over a decade of global activity online -- a data set more than four times the size of the original data from the Hubble Space Telescope.

And the results proved that over the long run, a small number of competitive giants are likely to dominate each functional market segment, such as search, retail and social media.

For example, the top 10 most popular domains mentioned on Reddit received around 35% of all links in 2006, which grew to 60% in 2019. On Twitter, the top 10 domains grew from 50% in 2011 to 70% in 2019.

The paper notes: "If there are too few competitors or a small number of players become too dominant within any economic sector, there emerges the potential for artificially high prices and constraints to supply. Even more importantly, in the long-term, this gives rise to constraints on innovation."

Co-author Dr. Marian-Andrei Rizoiu, who leads the Behavioural Data Science lab at the UTS Data Science Institute, said: "This research indicates the environment for new players online is becoming increasingly difficult. In the way pine trees sterilise the ground under their branches to prevent other trees competing with them, once they are established dominant players online crowd out competitors in their functional niche.

"Diversity of sources is in long term decline and although the worldwide web continues to grow, the attention is focused on fewer and few organisations.

"Attention online is a new form of currency. This new research illustrates that using a variety of analytic techniques and large-scale, global, longitudinal data, we can reveal patterns hitherto unseen on a global scale."

The research team's review of data going back 15 years allowed them to observe some specific dynamics that often play out when a new online market or function starts to flourish.

At first, there is a great burst of diverse businesses that appear and attempt to serve the market. After that comes a development phase when the number of competitors peaks and then starts to dwindle.

Finally, in the maturity phase, there is a significant reduction in diversity as users converge around at a single dominant organisation - such as Google in terms of web searching and Amazon for online shopping.

Co-author Dr Daniel Falster, who leads his own lab in Evolutionary Ecology in the School of Biological, Earth and Environmental Sciences at UNSW, said: "As with the natural environment, we can see the birth, growth and survival patterns of companies online when we look at them on a large enough scale.

"Now we can see consistent patterns of competitive dynamics that are becoming clearer and clearer. The loss of diversity is a cause for concern."

Despite the findings, Professor McCarthy believes there are still opportunities for new global business to emerge and thrive.

"Businesses looking to grow and expand in the online world should be focused on innovation and collaboration - two salient features of many of the biggest winners in the digital economy," he said.

"This new research - inspired in part by ecology - illustrates while 'species diversity' is in decline, there are also many new functional openings continually emerging in the jungle with global potential."

WASHINGTON, D.C., (April 28, 2021) - Two new studies, presented today as late-breaking clinical science at the Society for Cardiovascular Angiography & Interventions (SCAI) 2021 Scientific Sessions, provide new treatment insights for cardiogenic shock (CS) patients. A study of the SCAI cardiogenic shock stages consensus document confirms the accuracy of the shock classification. In addition, an analysis of the National Cardiogenic Shock Initiative demonstrates use of a shock protocol emphasizing early use of mechanical circulatory support may lead to improved survival for patients with CS.

CS is a rare, life-threatening condition in which the heart stops pumping enough blood to supply the vital organs of the body, and is the most common cause of death in patients with acute myocardial infarction (AMI). Despite advancements in pharmacological, mechanical and clinical interventions, the overall in-hospital mortality rate for patients with CS is 39%. For patients 75 years and older, the mortality rate increases to 55%.

Analysis of SCAI Shock Stages Consensus Statement

A 2019 joint SCAI consensus statement proposed a new classification system describing the stages of CS, from A to E, to standardize classification of the disease. To understand if the SCAI shock stages provide mortality risk classification, an analysis of studies in PubMed was conducted examining clinical outcomes.

Researchers identified 14 manuscripts of more than 15,000 patients presenting with CS, cardiac arrest (CA) or those admitted to the cardiac intensive care unit. The studies examined seven separate definitions of the SCAI shock stages, and each study demonstrated a stepwise increase in short-term (in-hospital or 30-day) mortality with each higher SCAI shock stage.

Findings show mortality varying across shock stage (A, 1-5%; B, 0-34%; C, 11-54%; D, 24-68%; E, 42-77%) and increased with additional risk factors including the presence of CA, systemic inflammation, poor hemodynamics, worsening shock and older age.

"These findings confirm the efficacy of the SCAI shock stage classification, allowing physicians a staged approach to communicate with their colleagues and the broader heart team how sick a patient is in a very consistent way," said lead researcher Jacob Jentzer, MD, critical care specialist, Mayo Clinic. "Our analysis should enhance physician confidence in the protocol to appropriately identify high-risk and low-risk patients, ultimately helping tailor therapy based on level of shock to improve patient outcomes."

Final Update to the National Cardiogenic Shock Initiative

The National Cardiogenic Shock Initiative, a single-arm, prospective, multi-center study assessing outcomes of early mechanical circulatory support (MCS) in acute myocardial infarction and cardiogenic shock (AMICS) in patients treated with percutaneous coronary intervention (PCI), reveals improved survival rates when using early MCS.

Between July 2016 and December 2020, 73 sites enrolled 406 patients with AMICS who were treated using a standard protocol emphasizing invasive hemodynamic monitoring and early initiation of MCS. The average patient age was 64 (±12 years), 24% were female and 67% were admitted in shock.

Results found that early use of MCS and invasive hemodynamics is associated with an increased patient procedural survival (99%), survival to discharge (79%), survival to 30-days (77%), and survival to 1-year (62%) for patients presenting in stage C/D shock and 98%, 49%, 46%, 32% for patients in stage E shock (p=0.01).

"Cardiogenic shock is the leading cause of death in heart attack patients and outcomes have not improved over the past two decades," said lead author Babar Basir, DO, director of acute mechanical circulatory support at Henry Ford Health System in Detroit, MI. "With early use of MCS coupled with hemodynamic monitoring we have the potential to increase survival to 80%, and save 20,000 life per year in the United States."

Study investigators call for further research to build on their findings and connect best practices for different stages of CS. With additional data, researchers hope to provide a benchmark for clinicians to use when treating CS patients, ultimately standardizing care.

New research shows that physical activity equivalent to 100 PAI a week can counteract excessive weight gain.

PAI stands for Personal Activity Intelligence and tracks how physically active you are throughout the week. You can measure PAI with just about any device that can measure heart rate.

The activity metric has been developed by the Cardiac Exercise Research Group (CERG) at the Norwegian University of Science and Technology (NTNU) under the leadership of NTNU Professor Ulrik Wisløff.

"Previously, we found that 100 PAI a week can give us a longer and healthier life without cardiovascular disease. Our new study shows that PAI can also help people maintain a healthy body weight," says researcher Javaid Nauman at NTNU's Department of Circulation and Imaging and the UAE University College of Medicine and Health Sciences in the United Arab Emirates.

Nauman is one of the researchers behind a recent article in The Lancet Regional Health - Europe. The study includes more than 85 000 healthy Norwegians who have been followed for more than 20 years.

Personal Activity Intelligence

PAI measures all physical activity that causes the heart rate to increase above a certain level. The higher the heart rate, the faster you earn PAI points.

The PAI algorithm calculates a weekly score based on your personal profile and variations in heart rate over the period. The PAI score can easily be measured with the free PAI Health app that is available for both iPhone and Android, for example.

Less weight gain by maintaining 100 PAI

The new study has obtained its data from the HUNT Study - a large-scale, longitudinal population health study in Norway. This study is one of the largest and lengthiest health surveys in the world. Trøndelag county residents number 240 000 in the research centre database, with even more participants since the start in 1984.

Of the total participants, 85 000 were weighed and asked about their level of physical activity as many as three times through 2008.

On average, participants' body weight increased by about eight kilos between 1984 and 2008 for both women and men who participated at each follow-up. Important to note is that the weight gain was significantly lower among individuals who were physically active enough to achieve at least 100 weekly PAIs during the period.

But there is still hope for those of us who haven't been as active all our lives. The study shows that even people who weren't physically active in the 1980s, but who increased their activity levels in the 1990s and in the 2000s, managed to avoid excessive weight gain.

Effective strategy

Overweight and obesity are a major health problem that contributes to nearly five million deaths worldwide each year.

"We already know that physical activity is an effective strategy to minimize or prevent weight gain in adults. The new study, and previous PAI studies, indicate that PAI can guide people so that they get enough physical activity each week to avoid the health hazards of excessive weight gain," says researcher Nauman.

More sleep could offset children's excess indulgence over the school holidays as new research from the University of South Australia shows that the same decline in body mass index may be achieved by either extra sleep or extra exercise.

The striking new finding is part of a study that shows how children can achieve equivalent physical and mental health benefits by choosing different activity trade-offs across the 24-hour day.

Conducted in partnership with the Murdoch Children's Research Institute, and supported by the National Heart Foundation of Australia, the team examined the optimal balance between children's physical activity, sleep, and sedentary time across the 24-hour day to better inform tailored lifestyle choices.

On a minute-for-minute basis, moderate-to-vigorous physical exercise was shown to be 2-6 times more potent than sleep or sedentary time.

While exercise has a greater and faster impact on physical health and wellbeing, children may be able to achieve the same 7.4% reduction in body mass index (BMI) by either:

exercising 17 more minutes (moderate-to-vigorous exercise) OR

sleeping an extra 52 minutes OR

reducing their sitting or sedentary time by an extra 56 minutes.

Similarly, children may significantly improve their mental health by either:

exercising 35 minutes more (moderate-to-vigorous exercise), OR

sleeping an extra 68 minutes OR

reducing their sitting or sedentary time by 54 minutes.

The study assessed 1179 children aged 11-12 years, from the cross-sectional Child Health CheckPoint Study. Physical wellbeing was measured via BMI, waist girth and body fat; mental wellbeing was measured via self-reported responses on the Paediatric Quality of Life Inventory.

Lead researcher, UniSA's Dr Dot Dumuid, says that the findings provide options for busy families looking to get the most value out of their day.

"There are many competing time demands in modern families ¬- whether it's after school soccer, music lessons, or simply walking the family dog, finding the time to fit everything into a single day, can be a challenge," Dr Dumuid says.

"International guidelines suggest that children need 9-11 hours' sleep, 60 minutes of physical exercise, and no more than two hours of recreational screen time per day, yet only seven percent of children are regularly meeting these goals.

"With so many competing priorities and commitments, it's helpful to know which activities deliver the greatest 'bang for your buck'.

"In this research we calculated how much sleep, sedentary time, light exercise, and moderate-to-vigorous exercise was associated with the same improvements in mental health, physical health and academic achievement.

"For families with very little available time, small increases in moderate-to-vigorous exercise could be an option to improve children's health and wellbeing; alternatively an earlier night could equally deliver the same health benefits - importantly, it's the flexibility that these findings offer that make them so valuable.

"Exploring trade-offs between children's activities is a promising way for families to make healthy choices that suit their regular family schedule."

The Heart Foundation's Director of Physical Activity, Adjunct Professor Trevor Shilton, said the Heart Foundation was happy to support such an innovative approach to investigating children's physical health and mental wellbeing.

"This study confirms that physical activity is the quickest and most effective way to deliver benefits for children's physical health and mental wellbeing. But the findings also offer some flexibility for families," Professor Shilton says.

"Helping young people make healthy choices and helping families create an environment that supports them in these choices can improve their quality of life in the future, as well as reducing their risk of chronic diseases, such as heart disease."