Culture

NEUROSCIENCE EXPERTS from the University of Leicester have released research that breaks with the past fifty years of neuroscientific opinion, arguing that the way we store memories is key to making human intelligence superior to that of animals.

It has previously been thought and copiously published that it is 'pattern separation' in the hippocampus, an area of the brain critical for memory, that enables memories to be stored by separate groups of neurons, so that memories don't get mixed up.

Now, after fifteen years of research, Leicester University's Director of Systems Neuroscience believes that in fact the opposite to pattern separation is present in the human hippocampus. He argues that, contrary to what has been described in animals, the same group of neurons store all memories. The consequences of this are far reaching, as such neuronal representation, devoid of specific contextual details, explains the abstract thinking that characterizes human intelligence.

Leicester University's Director of Systems Neuroscience Professor Rodrigo Quian Quiroga explains,

"In contrast to what everybody expects, when recording the activity of individual neurons we have found that there is an alternative model to pattern separation storing our memories.

"Pattern separation is a basic principle of neuronal coding that precludes memory interference in the hippocampus. Its existence is supported by numerous theoretical, computational and experimental findings in different animal species but these findings have never been directly replicated in humans. Previous human studies have been mostly obtained using Functional Magnetic Resource Imagining (fMRI), which doesn't allow recording the activity of individual neurons. Shockingly, when we directly recorded the activity of individual neurons, we found something completely different to what has been described in other animals. This could well be a cornerstone of human's intelligence."

The study, 'No pattern sepaeration in the human hippocampus', argues that the lack of pattern separation in memory coding is a key difference compared to other species, which has profound implications that could explain cognitive abilities uniquely developed in humans, such as our power of generalization and of creative thought.

Professor Quian Quiroga believes we should go beyond behavioural comparisons between humans and animals and seek for more mechanistic insights, asking what in our brain gives rise to human's unique and vast repertoire of cognitive functions. In particular, he argues that brain size or number of neurons cannot solely explain the difference, since there is, for example, a comparable number and type of neurons in the chimp and the human brain, and both species have more or less the same anatomical structures. Therefore, our neurons, or at least some of them, must be doing something completely different, and one such difference is given by how they store our memories.

Expansion of Medicaid eligibility under the Affordable Care Act is associated with decreased mortality for patients with newly diagnosed breast, lung, or colorectal cancer.

The mortality improvement was due to earlier stage of diagnosis in states that have expanded Medicaid.

BOSTON - In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major forms of cancer are significantly lower than in states that have not expanded their Medicaid, a new study by researchers at Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Harvard University shows.

Data from the study, published online today in JAMA Network Open, suggest that the improvement in mortality results from cancers being diagnosed at an earlier stage in states with Medicaid expansion. Early detection of cancer is often critical to successful treatment of the disease.

The ACA, passed in 2010, gave states the option of expanding eligibility for Medicaid - the government-funded health insurance program for low-income families and individuals - to nonelderly adults with incomes at or below 138% of the federal poverty level. Previous studies involving cancer patients have shown Medicaid expansion to be associated with fewer uninsured patients, increased screening, and stage of disease diagnosis. (Currently, 39 states have expanded Medicaid programs.)

"There has been little research into the impact of Medicaid expansion on cancer mortality [the time from initial cancer diagnosis to death]," says the lead author of the new study, Miranda Lam, MD, MBA, of Dana-Farber, Brigham and Women's Hospital, and Harvard T.H. Chan School of Public Health. "It's been thought that expansion might improve mortality by fostering earlier detection, earlier stage of diagnosis, and improved access to treatment. On the other hand, it could worsen mortality by creating an influx of newly covered patients that strains hospitals' resources."

For the study, researchers used the National Cancer Database to track 523,802 patients across the country who were newly diagnosed with breast, lung, or colorectal cancer from 2012 through 2015. They compared mortality rates for these patients in states that expanded their Medicaid programs and those that did not. (Twenty-four states and the District of Columbia expanded their programs on Jan. 1, 2014.)

"We found that Medicaid expansion was associated with a significant decrease in mortality compared to states without such expansion," Lam remarks. The expansion group had a 2% decline in hazard of death from the pre- to the post-expansion period. The non-expansion group, by contrast, showed no change in mortality.

If the 2% reduction was achieved in all states with expanded Medicaid, then among the approximately 69,000 patients diagnosed with cancer in those states, 1,384 lives would be saved yearly, researchers calculated.

The biggest difference between the two groups was in patients whose cancers hadn't reached a metastatic stage and are considered curable. When investigators adjusted for the stage at which cancers were diagnosed, improvements in mortality were no longer seen - whether between expansion and non-expansion states or between the pre-expansion and post-expansion period. This suggests that the decline in mortality associated with Medicaid expansion is a byproduct of diagnosing cancer at an earlier stage.

"Increased Medicaid coverage may remove barriers to accessing the healthcare system for screening and timely symptom evaluation, and that can translate into better outcomes for patients," Lam comments.

The investigators also found that the decrease in mortality in Medicaid-expansion states occurred across population groups. "We were reassured to find that patients living in areas of the lowest quartile of median household income showed a modest decrease in mortality after Medicaid expansion," Lam observes. "We also found that the mortality improvements occurred in both Black and white populations."

A new global analysis led by Imperial College London, and published in journal The Lancet, has assessed the height and weight of school-aged children and adolescents across the world.

The study, which used data from 65 million children aged five to 19 years old in 193 countries, revealed that school-aged children's' height and weight, which are indicators of their health and quality of their diet, vary enormously around the world.

There was a 20 cm difference between 19-year-olds in the tallest and shortest nations - this represented an eight-year growth gap for girls, and a six-year growth gap for boys. For instance, the study revealed that the average 19-year-old girl in Bangladesh and Guatemala (the nations with the world's shortest girls) is the same height as an average 11-year-old girl in the Netherlands, the nation with the tallest boys and girls.

The international team behind the study warn that highly variable childhood nutrition, especially a lack of quality food, may lead to stunted growth and a rise in childhood obesity - affecting a child's health and wellbeing for their entire life.

The research, which reported data from 1985 to 2019, revealed that the nations with the tallest 19-year-olds in 2019 were in northwest and central Europe, and included the Netherlands, Montenegro, Denmark and Iceland.

These nations with the shortest 19-year-olds in 2019 were mostly in south and southeast Asia, Latin America and East Africa, including Timor-Leste, Papua New Guinea, Guatemala and Bangladesh.

The largest improvements in average height of children over the 35-year period were seen in emerging economies such as China, South Korea and some parts of southeast Asia. For example, 19-year old boys in China in 2019 were 8 cm taller than in 1985, with their global rank changing from 150th tallest in 1985 to 65th in 2019. In contrast the height of children, especially boys, in many Sub-Saharan African nations has stagnated or reduced over these decades.

Global height ranking for UK has worsened over past 35 years, with 19-year-old boys falling from 28th tallest in 1985 (176.3 cm) to 39th in 2019 (178.2 cm), and 19-year-old girls from 42nd (162.7 cm) to 49th (163.9 cm).

The study also assessed children's Body Mass Index (BMI) - a measure of height to weight ratio, which gives an indication of whether a person has a healthy weight for their height. The analysis found that 19-year-olds with the largest BMI were found in the Pacific islands, Middle East, USA and New Zealand. The BMI of 19-year-olds was lowest in south Asian countries such as India and Bangladesh. The difference between the lightest and the heaviest BMIs in the study was around 9 units of BMI (equivalent to around 25 kg of weight).

The research team explain the analysis also revealed that, in many nations, children at age five had a height and weight in the healthy range defined by the World Health Organization (WHO). However, after this age, children in some countries have experienced too small an increase in height, and gained too much weight, compared to the potential for healthy growth.

The team say the most important reason for this is the lack of adequate and healthy nutrition and living environment in the school years, as both height and weight gains are closely linked to the quality of a child's diet.

Professor Majid Ezzati, senior author of the study from Imperial's School of Public Health said: "Children in some countries grow healthily to five years, but fall behind in school years. This shows that there is an imbalance between investment in improving nutrition in pre-schoolers, and in school-aged children and adolescents. This issue is especially important during the COVID-19 pandemic when schools are closed throughout the world, and many poor families are unable to provide adequate nutrition for their children."

Dr Andrea Rodriguez Martinez, the lead author of the study from Imperial's School of Public Health, added: "Our findings should motivate policies that increase the availability and reduce the cost of nutritious foods, as this will help children grow taller without gaining excessive weight for their height. These initiatives include food vouchers towards nutritious foods for low-income families, and free healthy school meal programmes which are particularly under threat during the pandemic. These actions would enable children to grow taller without gaining excessive weight, with lifelong benefits for their health and wellbeing."

Asian ethnicity is strongly linked to COVID-related stroke, reveals an analysis of stroke centre activity in England and Scotland during the first wave of the coronavirus pandemic, and accepted for publication in the Journal of Neurology Neurosurgery & Psychiatry.

Among patients with ischaemic stroke, which is caused by a blocked artery, nearly 1 in 5 (20%) of those with COVID-19 infection when they had their stroke were Asian--more than twice the proportion seen in ischaemic stroke patients without COVID-19.

Ischaemic strokes were also more extensive and severe, and more likely to result in greater disability and death, when associated with COVID-19, the findings indicate.

Previous research has suggested that COVID-19 infection might make the blood stickier and so more liable to clot, so potentially boosting the risk of a stroke, but this finding has been undermined by the poor quality of the evidence to date and the reliance on comparisons with historical stroke data.

To obtain a clearer real-time picture of the potential impact of COVID-19 on stroke risk, the researchers collected data for 1470 strokes among patients admitted to 13 hospitals between March and July this year, during the first wave of the coronavirus pandemic.

During this period, there were 86 strokes in patients with evidence of COVID-19 at the time: 81 of these strokes were ischaemic (caused by blocked blood vessels); the remainder were intracerebral haemorrhages (caused by burst blood vessels).

Evidence of infection was determined by a positive coronavirus test within 4 days of admission or suspected COVID-19 at the time of admission and confirmed on testing at any point during the subsequent 10 days.

The features of these 'COVID' strokes were compared with 1384 (1193 ischaemic and 191 intracerebral) among patients admitted during the same time period, but with no evidence of COVID-19.

Ethnicity was recorded in 86% of COVID cases and 78% of non-COVID cases. Among patients with ischaemic stroke nearly 1 in 5 (19%) of those with COVID-19 infection when they had their stroke were Asian--more than twice the proportion seen in ischaemic stroke patients without COVID-19 (7%).

This rate was higher than that seen in people of Afro-Caribbean ethnicity. *Lead study author, Dr Richard Perry, comments: "Our study suggests that COVID-19 has had more impact on strokes in the Asian community than in other ethnic groups. We cannot say from our data whether this is because Asians are more likely to catch COVID-19, but it seems unlikely that this is the sole explanation.

"Evidence from Public Health England suggests that, in the UK, people of Afro-Caribbean origin are at the highest risk of catching COVID-19, whereas those of Asian descent have only a marginally higher risk than White people. We suspect, therefore, that Asian people who contract COVID-19 may have a higher risk of COVID-19-associated stroke than is seen in other ethnic groups."

Ischaemic strokes in COVID patients were around twice as likely to be caused by the blockage of more than one large blood vessel in the brain (18% vs 8%), and to be more severe, with an average stroke severity (NIHSS) score of 8 vs 5.

Levels of D-dimers, a protein marker for the stickiness of blood, were also higher in COVID-19-related strokes than in other strokes.

Ischaemic strokes in COVID-19 patients were associated with more severe disability on discharge--average disability score of 5 (out of a possible 6)--and death while in hospital (20% vs 10%), even after accounting for other influential risk factors.

In the 45 COVID patients who had had an ischaemic stroke, and for whom both dates were recorded, cardinal COVID-19 symptoms occurred an average of 6 days before the stroke.

Among the 3 patients who had a brain bleed, and for whom both dates were recorded, COVID-19 symptoms occurred an average of 4 days after the stroke. Although the numbers are small, this difference is significant, say the researchers.

They found no evidence to back up previous suggestions that SARS-CoV-2, the virus responsible for COVID-19 infection, is associated with younger age or male sex in stroke patients.

The researchers acknowledge that a major limitation of their study was that they were only able to report investigations done as part of routine clinical care. But they included patients from 13 centres across the UK, so it may be more representative than existing studies from a single hospital system or city, they suggest.

"These findings...confirm that COVID-19 has an important influence over the onset, characteristics and outcome of acute ischaemic stroke," they write. How the virus exerts its influence is still unclear, but one single factor is unlikely to be responsible, they explain.

"We suggest that COVID-19 may provoke the onset of an ischaemic stroke through a variety of thrombotic [clot forming] and inflammatory mechanisms, promoting generation of thrombus [blood clot] in the heart or large vessels or via small vessel occlusion [blockage]," they write.

"Which of these mechanisms manifests in a given patient may be determined by that individual's conventional vascular risk factors, such as atrial fibrillation [abnormal heart beat], large vessel atheroma [artery narrowing], hypertension [high blood pressure] or type 2 diabetes mellitus."

And they conclude: "Our study provides the most compelling evidence yet that COVID-19-associated ischaemic strokes are more severe and more likely to result in severe disability or death, although the outlook is not quite as bleak as previous studies have suggested."

Unrelated mutations, when present in the blood, can lead to false positive results in men with advanced prostate cancer who are undergoing liquid biopsies. Such tests, which look for variants in the cell-free DNA that tumors shed into the blood plasma, help determine suitable treatment options.

"You can actually measure what's happening with a patient's tumor by taking a blood draw," said Dr. Colin Pritchard, associate professor of laboratory medicine and pathology at the University of Washington School of Medicine in Seattle. He also is the associate director of the Genetics and Solid Tumors Laboratory at UW Medicine.

The testing can guide therapy for already-diagnosed cancers by finding mutations that can suggest precision medicine choices. Cell-free DNA testing offers the ease and convenience of testing a blood sample for patients with advanced cancer.

Nonetheless, Pritchard and his team point to the urgency of evaluating the performance of cell-free DNA testing in actual practice and understanding sources of potential interferences with the accuracy of test results.

Two cancer treatment medications, recently approved by the U.S. Food and Drug Administration, or FDA, in fact, are indicated for possible use if certain cell-free DNA mutations appear in the plasma of men whose prostate cancer has spread.

However, other kinds of non-cancer DNA mutations can exit blood cells and get into the plasma.

Pritchard said that precision medicine scientists are learning more about a phenomenon called "clonal hematopoiesis" that can often interfere with cancer liquid biopsy findings. Mutations in some DNA repair genes - BRCA1, BRCA2, and ATM - are associated with male and female cancers.

"Unfortunately, these same genes are also commonly mutated as a result of clonal hematopoiesis," Pritchard said.

He and his research team at UW Medicine and the Brotman Baty Institute for Precision Medicine, a partnership among UW Medicine, Seattle Children's and Fred Hutchinson Cancer Research Center, looked at the degree to which clonal hematopoiesis was confounding prostate cancer liquid biopsy results.

They examined both the prevalence and the gene spectrum of this interference in patients undergoing cell-free DNA testing.

Their research paper appears this week in the Nov. 5 edition of the medical journal, JAMA Oncology.

The researchers discovered that CHIP (clonal hematopoiesis of indeterminant potential) variants accounted for almost half of the somatic DNA repair mutations that the liquid biopsy detected. The presence of these CHIP variants became exponentially more common with advancing age of the patients.

False positives have become an even greater concern as two new classes of PARP inhibitors for prostate cancer became approved in May of 2020 - rucaparib and olaparib. People with a positive liquid biopsy test can be candidates for these drugs. A false positive for these biomarker-guided treatments can lead to misdiagnosis and to patients receiving unnecessary, unhelpful therapy.

About half the time when the plasma is thought to contain a mutation that would guide therapy with these drugs, it actually contains CHIP variants, not prostate cancer DNA variants.

That means that in about half of those tested, a patient could be told that he should be administered a drug that is not indicated to treat to his cancer, Pritchard explained.

Solving this problem of potential misdiagnosis and misguided treatment is fortunately quite simple. Pritchard said that at UW Medicine and at Brotman Baty Institute for Precision Medicine, the laboratory medicine staff examine a sort of paired control: the whole blood cells where the clonal hematopoiesis is and the plasma.

"The good news is that, by looking at the blood cellular compartment, you can tell with pretty good certainty whether something is cancer or something is hematopoiesis," he said.

The research team noted that some of the limitations of their study were the small sample size (69 men), its retrospective approach, and the similarities within their patient population, including the men's prior therapies.

Findings from an international study into the costs and outcomes of informal end of life care have today been published BMC Medicine.

The study found that in the UK, Ireland and the US, care provided by informal carers, meaning family and friends, accounted for more than half of total care costs in the last three months of life.

Researchers concluded that there was an urgent need in all three countries to improve the integration and support for dedicated community palliative care services to improve the care quality and support people across the whole journey of care.

The study surveyed 767 carers in three countries about the last three months of life for the person they cared for. This is the first study of its kind and found:

Costs to informal carers are larger than those to formal care services (health, social and voluntary combined) for people in the last three months of life.

Poor quality home care was associated with greater burden to carers.

If well supported informal carers can play an important role in providing care, and this can be done without detriment to them, providing that they are helped.

Improving community palliative care and informal carer support should be a focus for future investment.

The study was led by researchers from the Cicely Saunders Institute at King's College London in collaboration with King's College Hospital Foundation Trust (UK), Trinity College Dublin (Ireland), Mater Misericordiae Hospital (Ireland), Beaumont Hospital (Ireland), University of Bristol (UK), University of California, San Francisco (USA) and Icahn School of Medicine at Mount Sinai (USA).

The research was funded by Cicely Saunders International, The Atlantic Philanthropies and the National Institute for Health Research Applied Research Collaboration South London.

In the last three months of life, formal care costs are high, but little is known about the costs of informal care and their effects on outcomes. This research is an important contribution to increasing the recognition and understanding of the effort and costs of informal carers, such as families and friends, who do so much. As well as identifying areas where support and investment could help improve care for both the patient and informal and formal carers.

The study Associations between informal care costs, care quality, carer rewards, burden and subsequent grief: the international, access, rights and empowerment mortality follow-back study of the last three months of life (IARE I study) uses the experiences reported by informal carers to determine and compare the informal care costs and their associations with the burden, rewards and subsequent grief, taking the quality of care into account.

The study surveyed 767 carers in London, Dublin, New York and San Francisco. Participants reported the hours and activities of informal care they gave, care quality, the positive aspects and burdens of caregiving, and completed the Texas Revised Inventory of Grief (TRIG).

All costs (formal, informal) were calculated by multiplying reported hours of activities by country specific costs for that activity. Informal care costs used country-specific shadow prices, e.g. average hourly wages, unit costs for nursing care. The study also examined the positive aspects and burdens of caregiving, and the carer's subsequent grief.

Professor Irene Higginson lead of the study said: "Family and friend carers do so much in helping people who need palliative care. Alongside being a wife, husband, partner, daughter, son, friend or other relation, our study shows the huge amount of practical help, advocacy, co-ordination and 'being there' that they provide. This costs more to society that do the formal care services, and when home care is of poor quality the burden on informal carers increases."

Dr Steve Pantilat, from the University of California, San Francisco said: "Family and friends provide tremendous help with the practical and emotional issues that people need as they approach the end of life. We know that this kind of help is priceless and unpaid. We learned that, if paid, the care provided by family and friends would cost more than all the formal care provided by the healthcare system. In addition, caregiving while seen as a privilege for many, also takes its toll on the caregiver. As a society we need to recognise and support these caregivers to keep them healthy and to allow them to continue to care for their loved ones. Palliative care services are among the ways that we can better support caregivers to improve the quality of life for them and the person they are caring for."

Much of what we know regarding how life--as we know it--came into existence is through the recovery of fossils from various sites in the word. The Chengjiang lagerstatte in Yunnan Province, China, is one such unique site containing very well-preserved fossils (also called the "Chengjiang fauna"), which include soft-bodied animals that normally do not get fossilized. Most of these fossils are 520 to 518 million years old, spanning a part of the Cambrian period when life on earth exploded in diversity, leading to a huge increase in number of species--a phenomenon called the "Cambrian explosion." In a new study, two scientists who spent many years digging deeper into this field, including Dr Degan Shu from Northwest University in Xi'an and Dr Jian Han from Northwest University in Shaanxi Xi'an, present an overview of their research on the Chengjiang fauna and emphasize its significance. These findings, which are published in Earth Science Frontiers, include significant contributions from Chinese paleontologists, including Prof Shu's group, in collaboration with other international scientists.

The research spanned three decades, each decade bringing important developments. The first decade (1984-1994) led to important findings on basal animals (e.g., sponges and jellyfish) and the subkingdom Protostomia (e.g., molluscs). In the second decade (1995-2005), scientists including Shu's team continued to discover newer animal groups, the most significant being deuterostomes (a large group of animals, which includes humans). In the third stage (2005-now), the Chinese teams continued to add new groups to the animal tree and dug deeper into the relationships between the formation of the tree and the multi-episodic Cambrian explosion. This paved the way for not only the formulation of a three-part phylogenetic tree of early animals but also the hypothesis that the Cambrian explosion occurred in three episodes--the evolution and diversification of basal animals, followed by protostomes, and finally deuterostomes--forming the basis of all forms of animal life today.

On the importance of the Chengjiang fauna, Dr Shu comments, "Today, many people still believe in creationism, and a common argument that they use is an incomplete fossil record. We feel that filling the gaps in the evolutionary tree with transitional forms, such as those found at Chengjiang and other sites, will help us to gradually dispel misinformation about the theory of evolution, especially when we consider the question of how humans came to be. In essence, we can trace the origins of all extant animals, including us, to ancestors in the Cambrian."

In particular, Dr Shu points to the discovery of seminal fossils that demonstrate the early forms of our basic organs evolved during the Cambrian explosion. These include the mouth, brain, heart, and vertebrae. It is through comparisons of Chengjiang fossils from the Cambrian period with those from the Precambrian (before Cambrian) period that researchers realized that Precambrian life did not have these basic organs. This reveals the importance of Chengjiang as a reservoir of fossilized soft body parts, such as the nervous system. In fact, some specimens have such well-preserved nervous systems that scientists could use them to infer how certain species behaved, working from the idea that a complex nervous system implies complex behaviors. This incredible insight offered to us by the Chengjiang lagerstatte provides direct evidence explaining the gradual evolution in the animal kingdom. Dr Shu concludes, "As a compelling testimony of Darwinian theory, the Chengjiang fossils have profound scientific and humanistic significance. Our hope is that the fascinating discoveries at this site will help improve scientific literacy in the public, while also providing new generations of scientists with a framework that they can use to flesh out the animal tree of life."

The Chengjiang fauna, indeed, holds immense significance--both scientific and philosophical. And the extensive efforts by scientists like Dr Shu bring us closer to understanding the most fundamental question today: where lies the origin of life?

A group of Skoltech scientists developed machine learning (ML) algorithms that can teach artificial intelligence (AI) to determine oil viscosity based on nuclear magnetic resonance (NMR) data. The new method can come in handy for the petroleum industry and other sectors, which have to rely on indirect measurements to characterize a substance. The research was published in the Energy and Fuels journal.

An important parameter of oil and petrochemicals, viscosity has implications for production and processing, while helping to better understand and model the natural processes in the reservoir. Standard oil viscosity assessment and monitoring techniques are very time and money consuming and sometimes technically unfeasible. NMR can help determine the properties thanks to a material's ability to absorb and emit electromagnetic energy. Oil is a chemically heterogeneous mixture of hydrocarbons, which makes the interpretation of NMR results extremely difficult.

A group of scientists from Skoltech, the University of Calgary (Canada), and Curtin University (Australia) processed NMR data using ML algorithms. Their model trained on NMR data on various types of oil from fields in Canada and the United States produced an accurate prediction of viscosity, which was confirmed by lab tests.

According to Dmitry Koroteev, a professor at the Skoltech Center for Hydrocarbon Recovery (CHR) and one of the study leads, their research illustrates how ML algorithms can help characterize materials' properties measured indirectly and, more specifically, by using NMR measurements instead of viscosimetry at the lab. In practical terms, this means that one can obtain information about oil in the subsurface reservoir without extracting samples and taking them to the lab for tests. "Surprisingly, ML works better here than the traditional correlations," comments Professor Koroteev. "The direct and indirect experimental measurements that we had at our disposal were a good training set for our ML algorithms. The tests demonstrated that the algorithms have good generalization ability and do not require retraining."

"What is especially interesting is the high accuracy ML models achieve on extra-heavy oil and bitumen samples. Due to their complex chemical composition, the relationship between NMR relaxation and viscosity is not well defined for these oil types. For the empirical models, the workaround for this is to make additional measurements to determine the relative hydrogen index (RHI) of the oil -- the information which is often not readily available or difficult to measure in the field accurately. Our study shows that by using ML-derived NMR viscosity models, these measurements are not necessary." - explains Skoltech-Curtin Ph.D. student Strahinja Markovic, the first author of the paper.

The scientists are positive that their method can find use beyond the petroleum industry. It is not infrequent that the test sample is unavailable for direct tests, which makes indirect measurements a lucky alternative for a variety of sectors, such as the food industry where the quality of fruit could be tested without even cutting them open, or in agriculture where soil quality assessment could cover much larger areas.

The climate seems to be getting warmer. This could be bad news for species that depend on stable and abundant access to food at certain times of the year.

"If the changes happen too fast, species can become extinct," says Emily Simmonds, an associate professor at the Norwegian University of Science and Technology's (NTNU) Department of Biology.

She is the first author of an article in Ecology Letters that addresses how great tits can be affected if the supply of larvae changes in the spring.

Several bird species depend on the abundance of larvae while their young are small. If the larvae supply peaks earlier in the spring than normal, there may simply be too little food for the hatchlings.

The warming climate can bring about changes like this. An earlier spring causes trees to leaf out earlier, which in turn causes the larvae that feed on the plants to hatch out earlier.

"When the climate changes, the interactions between different species changes too," Simmonds says.

She and a team of researchers at the University of Oxford used population models to calculate the consequences of different climate scenarios. They wanted to see at what point the changes would happen too fast for the great tit to modify its behaviour quickly enough to keep up with the larvae.

Great tits have genetic variations and varying abilities to adapt to different conditions. This means that they can evolve in tandem with their prey up to a point.

An earlier larvae hatch can be advantageous for the great tits that also hatch their young earlier in the spring. This advantage can be transferred to the next generation of birds, which can in turn become early birds. And so on.

For this advantage to last, the great tits have to evolve fast enough and be flexible enough to keep up with the genetic variation in their prey.

"Given conditions with big greenhouse gas emissions, the great tits won't always be able to keep up with the changes in the larvae supply," says Simmonds.

In the worst case scenario, whole populations of great tits will simply disappear by the year 2100 because they aren't able to procure enough food for their young.

"This could happen even if the great tits are also modifying their behaviour faster in a rapidly changing environment. The larvae might be changing even faster than the great tits," Simmonds says.

The researchers found that populations of great tits would be guaranteed to become extinct by the year 2100 if the larvae appeared about 24 days earlier than the current norm in 2020. This also applies to populations that appear to be completely stable now.

"It could be that the apparent stability today is hiding a future collapse," says Simmonds.

The reason is that we might reach a kind of threshold where the great tits aren't keeping up. The rubber band gets stretched too far, you could say.

"The good news is that the populations will be able to survive scenarios with lower or medium warming trends," Simmonds says.

New research from Tel Aviv University will allow cameras to recognize colors that the human eye and even ordinary cameras are unable to perceive.

The technology makes it possible to image gases and substances such as hydrogen, carbon and sodium, each of which has a unique color in the infrared spectrum, as well as biological compounds that are found in nature but are "invisible" to the naked eye or ordinary cameras. It has groundbreaking applications in a variety of fields from computer gaming and photography as well as the disciplines of security, medicine and astronomy.

The research was conducted by Dr. Michael Mrejen, Yoni Erlich, Dr. Assaf Levanon and Prof. Haim Suchowski of TAU's Department of Physics of Condensed Material. The results of the study were published in the October 2020 issue of Laser & Photonics Reviews.

"The human eye picks up photons at wavelengths between 400 nanometers and 700 nanometers -- between the wavelengths of blue and red," explains Dr. Mrejen. "But that's only a tiny part of the electromagnetic spectrum, which also includes radio waves, microwaves, X-rays and more. Below 400 nanometers there is ultraviolet or UV radiation, and above 700 nanometers there is infrared radiation, which itself is divided into near-, mid- and far-infrared.

"In each of these parts of the electromagnetic spectrum, there is a great deal of information on materials encoded as 'colors' that has until now been hidden from view."

The researchers explain that colors in these parts of the spectrum are of great importance, since many materials have a unique signature expressed as a color, especially in the mid-infrared range. For example, cancer cells could be easily detected as they have a higher concentration of molecules of a certain type.

Existing infrared detection technologies are expensive and mostly unable to render those "colors." In medical imaging, experiments have been performed in which infrared images are converted into visible light to identify the cancer cells by the molecules. To date, this conversion required very sophisticated and expensive cameras, which were not necessarily accessible for general use.

But in their study, TAU researchers were able to develop cheap and efficient technology that could mount on a standard camera and allows, for the first time, the conversion of photons of light from the entire mid-infrared region to the visible region, at frequencies that the human eye and the standard camera can pick up.

"We humans can see between red and blue. If we could see in the infrared realm, we would see that elements like hydrogen, carbon and sodium have a unique color," explains Prof. Suchowski. "So an environmental monitoring satellite could 'see' a pollutant being emitted from a plant, or a spy satellite would see where explosives or uranium are being hidden. In addition, since every object emits heat in the infrared, all this information could be seen even at night."

After registering a patent for their invention, the researchers are developing the technology through a grant from the Innovation Authority's KAMIN project, and they have already met with a number of both Israel-based and international companies.

Climate - Ice breaker data

With the conclusion of an unprecedented yearlong expedition to the North Pole called MOSAiC, data from instruments installed on an Arctic ice floe are available to the scientific community to improve models that predict the environmental future of the planet.

Researchers at Oak Ridge National Laboratory were part of an international team that collected a treasure trove of data measuring precipitation, air particles, cloud patterns and the exchange of energy between the atmosphere and the sea ice. The data were captured by a suite of 63 instruments from the Department of Energy's Atmospheric Radiation Measurement User Facility. ORNL has processed these measurements and made massive amounts of observational data easily accessible and usable for climate modelers.

"We've never had this type of data for the northernmost reaches of the Arctic before," said Giri Prakash, director of the ARM Data Center at ORNL. "These data will be an invaluable resource for scientists to improve predictions of global environmental changes."

Media Contact: Kim Askey, 865.576.2841, askeyka@ornl.gov

Image: https://www.ornl.gov/sites/default/files/2020-11/49464987002_20dab0acb6_o.jpg

Caption: Researchers set up ARM instruments on the ice floe near the ship that served as home during the MOSAiC expedition. Credit: U.S. Dept. of Energy ARM User Facility

Image: https://www.ornl.gov/sites/default/files/2020-11/49464270498_a1ff680b23_o.jpg

Caption: Radiometer instruments collect data on the Arctic ice. Credit: U.S. Dept. of Energy ARM User Facility

Image: https://www.ornl.gov/sites/default/files/2020-11/50192950163_44318b4fe9_o.jpg

Caption: The icebreaker R/V Polarstern carried more than 60 ARM instruments for the MOSAiC expedition. Credit: U.S. Dept. of Energy ARM User Facility

Biology - Bacterial shield breakdown

An international research team discovered a mechanism that disease-causing bacteria use to anchor their protective outer membranes. Their findings could inform strategies to disrupt a microbe's cell structure, ultimately helping to combat pathogens that affect humans and plants.

Scientists from Oak Ridge National Laboratory used high-performance computing to create protein models that helped reveal how the outer membrane is tethered to the cell membrane in certain bacteria. These Gram-negative bacteria sandwich their cell walls between an outer and inner membrane, and the layers act as a shield that allows them to persist under harsh conditions.

ORNL's models informed further simulations and experiments by collaborators who observed these unusual linkages.

"Modeling and simulating membrane proteins help us understand complex cell structures," ORNL's Jerry Parks said. "These approaches are particularly important when relatively little is known about an organism, because it is challenging to study in the lab."

Media Contact: Kim Askey, 865.576.2841, askeyka@ornl.gov

Image: https://www.ornl.gov/sites/default/files/2020-11/Biology-gram-negative.jpg

Caption: ORNL assisted in investigating proteins called porins, one shown in red, which are found in the protective outer membrane of certain disease-causing bacteria and tether the membrane to the cell wall. Credit: Hyea (Sunny) Hwang/Georgia Tech and ORNL, U.S. Dept. of Energy

Batteries - Catching heat

Oak Ridge National Laboratory researchers proved that the heat transport ability of lithium-ion battery cathodes is much lower than previously determined, a finding that could help explain barriers to increasing energy storage capacity and boosting performance.

Research on lithium-ion batteries, which are used primarily in smart phones and laptops, has shown that lower heat transport is hampered, which leads to less energy density and poorer performance.

In the study, researchers used quantum mechanical calculations to predict the inherent heat transport capabilities of battery cathodes and the impacts of charging. Further evaluation looked at how strong vibrational forces among ions between the material's layers can influence heat.

"We found heat transport to be more inefficient than thought due to the non-harmonic vibrational forces among ions, worsening during charging," ORNL's Tianli Feng said. "Our results resolve long-standing issues regarding heat transport and provide guidance for how future high-density batteries can be designed."

Media Contact: Jennifer Burke, 865.414.6835, burkejj@ornl.gov

Image: https://www.ornl.gov/sites/default/files/2020-11/Batteries-Catching_heat.jpg

Caption: ORNL researchers determined lower heat exchange in lithium-ion batteries is caused by the strong non-harmonic forces among ions and weak interaction between layers, providing guidance for high-density battery design. Credit: Tianli Feng/ORNL, U.S. Dept. of Energy

Neutrons - Finding order in disorder

Researchers have revealed a new understanding of disordered ceramics - materials with nonuniform atomic arrangements used in a variety of energy-related applications including electronics, nuclear fuels and fuel cells.

Pauling's Rules is the standard model used to describe atomic arrangements in ordered materials. Neutron scattering experiments at Oak Ridge National Laboratory confirmed this approach can also be used to describe highly disordered materials.

Researchers demonstrated the model's ability to determine the distance between neighboring atoms and predict how the atoms move once disorder is introduced. The new knowledge overturns conventional wisdom that ions in disordered materials are mixed randomly, but instead arrange themselves in building blocks with a high degree of order.

"Disorder is the basis for many interesting properties and applications," said Maik Lang of the University of Tennessee and corresponding author of the Science Advances study. "A better understanding of how these materials behave could lead to realizing improved materials with more functionality."

Media Contact: Jeremy Rumsey, 865. 576.2038, rumseyjp@ornl.gov

Image: https://www.ornl.gov/sites/default/files/2020-11/Neutrons-disordered_ordered.png

Caption: UTK researchers used neutron probes at ORNL to confirm established fundamental chemical rules can also help understand and predict atomic movements and distortions in materials when disorder is introduced, as arrows show. Credit: Eric O'Quinn/UTK

CAMBRIDGE, MA - November 4, 2020--Rapid Reviews: COVID-19 (RR:C19), an open-access overlay journal published by the MIT Press that accelerates peer review of COVID-19-related research preprints, is currently soliciting reviews of the following COVID-19 preprints. These preprints have been selected for review because they have the potential to enhance our understanding of SARS-CoV-2 or have been flagged as potentially misleading. Preprints with two finished reviews should be published within 10-14 days. Additional information or early access to these peer-reviews is available upon request.

Highlights from Rapid Reviews editorial team:

"Testing mobile air purifiers in a school classroom: Reducing the airborne transmission risk for SARS-CoV-2"

This preprint estimates that the use of air purifiers in school classrooms can reduce an inhaled dose of COVID-19 by a factor of six. Will be useful to parents and school districts planning how to safely reopen schools.
 

"Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results"

Remdesivir, Hydroxychloroquine, Lopinavir, and Interferon regimens have been touted as potential therapeutics for COVID-19 patients, but this preprint finds they have little to no effects on overall mortality, initiation of ventilation, or duration of hospital stay. This research has the potential to directly impact point of care decisions.
 

"Global projections of potential lives saved from COVID-19 through universal mask use" by Emmanuela Gakidou, et al.

This preprint shows that universal mask mandates could reduce deaths by 815,600 globally before the year's end. It adds to the growing science showing masks are an effective tool in fighting the spread of COVID-19.
 

"The relationship between neighborhood poverty and COVID-19 mortality within racial/ethnic groups (Cook County, Illinois)" by Justin M. Feldman, et al.

This large cross-sectional study explores how socioeconomics and race affect COVID-19 mortality. Its findings could lead to a more detailed understanding of the specific processes that result in health inequities.
 

"Less severe course of COVID-19 is associated with elevated levels of antibodies against seasonal human coronaviruses OC43 and HKU1 (HCoV OC43, HCoV HKU1)"

This research explores whether previous infections with seasonal coronaviruses protects against a severe COVID-19 disease course. This immunological cross-reactivity has important implications on vaccine strategies.
 

Physical Sciences/Engineering

"TRANSCOM/AMC commercial aircraft cabin aerosol dispersion tests" by David Silcott, et al.
"The effect of temperature and humidity on the stability of SARS-CoV-2 and other enveloped viruses" by Dylan H. Morris, et al.
"Multivalency transforms SARS-CoV-2 antibodies into broad and ultrapotent neutralizers" by Edurne Rujas, et al.
"Development, evaluation, and validation of machine learning models for COVID-19 detection based on routine blood tests" by Cabitza Federico, et al.
"Sniffing methanol in hand sanitizers" by Andreas T. Guntner, et al.

"A high-throughput microfluidic nano-immunoassay for detecting anti-SARS-CoV-2 antibodies in serum or ultra-low volume dried blood samples" by Zoe Swank, et al.
 

Biological/Chemical Sciences

"Early induction of SARS?CoV?2 specific T cells associates with rapid viral clearance and mild 2 disease in COVID?19 patients" by Anthony T. Tan, et al.
"Co-infection of influenza A virus enhances SARS-CoV-2 infectivity" by Lei Bai, et al.
"Preferential recognition and antagonism of SARS-CoV-2 spike glycoprotein binding to 3-O-sulfated heparan sulfate" by Vaibhav Tiwari, et al.
"Antigen-based testing but not real-time PCR correlates with SARS-CoV-2 virus culture" by Andrew Pekosz, et al.
"The effect of influenza vaccination on trained immunity: impact on COVID-19" by Priya A. Debisarun, et al.
"SARS-CoV-2 proteins and anti-COVID-19 drugs induce lytic reactivation of an oncogenic virus" by Jungang Chen, et al.

"Functional Landscape of SARS-CoV-2 Cellular Restriction" by Laura Martin-Sancho, et al.
 

Public Health

"Excess risk of COVID-19 to university populations resulting from in-person sporting events"
"COVID-19 and (un)desired fertility: The effect of stay-at-home orders on abortions in Mexico City" by Fernanda Marquez-Padilla, et al.
"Misinformation on COVID-19 origin and social distancing: A cross-sectional study"
"Economic precarity, social isolation, and suicidal ideation during the COVID-19 pandemic"
"Modelling testing and response strategies for COVID-19 outbreaks in remote Australian Aboriginal communities"
"Evaluating the sensitivity of SARS-CoV-2 infection rates on college campuses to wastewater surveillance"
"A cohort of SARS-CoV-2 infected asymptomatic and pre-symptomatic contacts from COVID-19 contact tracing in Hubei Province, China: short-term outcomes" by Peng Zhang, et al.
"Modelling the potential impact of mask use in schools and society on COVID-19 control in the UK" by J. Panovska-Griffiths, et al.
"Implication of backward contact tracing in the presence of overdispersed transmission in COVID-19 outbreak"

"SARS-CoV-2 sequencing reveals rapid transmission from college student clusters resulting in morbidity and deaths in vulnerable populations" by Craig S. Richmond, et al.
 

Medical Sciences

"Enoxaparin is associated with lower rates of thrombosis, kidney injury, and mortality than Unfractionated Heparin in hospitalized COVID patients" by Colin Pawlowski, et al.
"Neuroinvasive potential of SARS-CoV-2 revealed in a human brain organoid model" by Eric Song, et al.
"Targeting androgen regulation of TMPRSS2 and ACE2 as a therapeutic strategy to combat COVID-19" Qu Deng, et al.
"Treatment with human umbilical cord-dervied mesenchymal stem cells for COVID-19 patients with lung damage: a randomised, double-blind, placebo-controlled phase 2 trial" by Lei Shi, et al.
"Risk of death during the 2020 UK COVID-19 epidemic among people with rare autoimmune diseases compared to the general population. Preliminary results from the RECORDER project" by Emily Peach, et al.
"Validation of a derived international patient severity phenotype to support COVID-19 analytics from electronic health record data"
"Dynamic dysregulation of IL-6 and genes functional in NETosis, complement and coagulation in severe COVID-19 illness"

"High and increasing prevalence of SARS-CoV-2 swab positivity during end September beginning October 2020: REACT-1 round 5 updated report"
 

RR:C19 is published by the MIT Press and the editorial offices are located at UC Berkeley, headed by editor-in-chief Stefano M. Bertozzi, Professor of Health Policy and Management and Dean Emeritus of the School of Public Health at University of California Berkeley. The journal is funded by a grant from the Patrick J. McGovern Foundation and hosted on PubPub, an open-source publishing platform from the Knowledge Futures Group. 

To learn more about this project and its editorial board, or to sign up for future news and alerts, visit rapidreviewscovid19.mitpress.mit.edu.

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Agência FAPESP – Yellow fever virus is normally confined to the Amazon region, but the virus circulated in the Southeast of Brazil between 2016 and 2018, causing the worst epidemic and epizootic outbreaks there for decades. The Ministry of Health confirmed 2,251 cases of yellow fever in humans and 1,567 cases in monkeys in Brazil between December 2016 and June 2019.

According to a study published in the journal PLOS Pathogens, the three epidemic/epizootic waves that occurred in this period in the state of São Paulo, the most populous in the Southeast region, were caused by different lineages of the virus. In the first wave (July 2016-January 2017), the virus entered the state from the north, probably coming from neighboring state Minas Gerais, and spread mainly in cities such as São José do Rio Preto and Ribeirão Preto. The second wave (February-June 2017) was more intense, washing over the area from the border with Minas Gerais at Poços de Caldas all the way to Campinas. The largest number of cases was notified in the third wave (July 2017-February 2018). After reaching São Paulo City, the virus spread south to the Ribeira Valley area, where it found densely populated cities with low vaccination coverage rates and became a major public health problem.

These findings, reported in the journal by an international group of researchers supported by FAPESP, were based on genomic analysis of 51 viral isolates extracted both from mosquitoes collected in the affected areas and from monkeys that died from the disease. The material was sent by the Center for Epidemiological Surveillance (CVE) – an agency of the São Paulo State Department of Health – to Adolfo Lutz Institute (IAL), the central laboratory for public health in São Paulo.

“Based on the geographical and temporal distribution of the cases in non-human primates, on phylogenetic analysis [studying the mutations in the viral genome that lead to the emergence of novel lineages] and on phylogeographical analysis [studying the processes that determined the geographical distribution of the different lineages], it was possible to pinpoint when the virus entered the state of São Paulo, how fast and which way it spread, and all facets of its circulation,” Renato de Souza, a researcher at IAL and one of the lead authors of the article, told Agência FAPESP.

This level of detail in the description of an epidemic was only possible thanks to the use of MinION genetic sequencing technology, Souza explained. The platform is portable, fast and cheap, permitting real-time monitoring of cases at the location where they are happening.

The strategy was first used in Brazil in 2016 to track the movement of zika virus in the Americas (read more at agencia.fapesp.br/25472). More recently it has helped researchers at the Brazil-UK Center for Arbovirus Discovery, Diagnosis, Genomics and Epidemiology (CADDE) track the progress of COVID-19 in Brazil. The project is led by Ester Sabino, a researcher at the University of São Paulo, and Nuno Faria at the University of Oxford in the UK, and is supported by FAPESP (https://bv.fapesp.br/en/auxilios/103130), the UK Medical Research Council and the Newton Fund.

Accidental host

Yellow fever virus circulates permanently in the Amazon region and occasionally meets favorable conditions that let it escape. For this to happen, Souza explained, a population of the vector mosquito has to come into contact with a population of wild primates that is dense enough to maintain the chain of transmission for some time.

“This expansion isn’t permanent,” he said. “The virus eventually loses the capacity to circulate in the environment concerned and returns only if it’s reintroduced. Between 2016 and 2018, the circulation area expanded to an unprecedented extent. The conditions for the virus to spread were just right. It infected wild primates in Serra da Mantiqueira [forest area of the state of São Paulo] and reached an area near the large Zoological Park on the outskirts of São Paulo City. This may happen again in a few years, whenever there is sufficient growth of the populations of primates in these places.”

Epidemiologically speaking, there was an outbreak of sylvatic yellow fever in the period, Souza said. Although there were many cases among humans, transmission occurred solely outside the urban environment via arboreal mosquitoes such as Haemagogus and Sabethes.

“In this case, human exposure was accidental. Growing human penetration of natural environments and forests was one of the contributing factors,” he said, adding that if an urban transmission chain had been established via Aedes aegypti, the incidence of the disease would have been far greater, reaching the level seen in dengue outbreaks.

“The problem is that the sylvatic transmission structure is growing ever closer to urban areas, heightening the risk of introduction of the virus into the urban context,” he said.

Tracking the pathogen’s circulation in populations of monkeys has been considered an effective epidemiological surveillance strategy, as it facilitates early identification of high-risk areas and planning of control strategies such as vaccination campaigns.

“A surveillance strategy based solely on monitoring of cases in humans detects only 20% of those infected, which is the proportion of symptomatics, so that under-reporting will always be significant. Among monkeys, there are species in which 90% develop symptoms and die from the disease. Monitoring these animals identifies the disease as the virus is starting to spread and in time to implement combat programs,” Souza said.

The article “Genomic surveillance of yellow fever virus epizootic in São Paulo, Brazil, 2016-2018” can be read at: journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008699.

Journal

PLoS Pathogens

DOI

10.1371/journal.ppat.1008699

The volume and timbre of music have a significant impact on how people perceive the acoustics in a concert hall, according to two recent studies carried out by the research group of Aalto University Professor Tapio Lokki. Both have been published in the Journal of the Acoustical Society of America, one of the most prestigious journals in its field.

The first study demonstrated that, based on the music alone, it is difficult to distinguish which concert hall a piece of music is being played in. The test subjects listened to recordings of a single violin and of part of Beethoven's Seventh Symphony, all played in four different concert halls: the rectangular Concertgebouw in Amsterdam and Herkulessaal in Munich, the vineyard-shaped Berlin Philharmonic, and the fan-shaped Cologne Philharmonic. They first heard a sample from the reference location, after which they tried to identify the reference location from four music samples.

It was easier to identify the hall when the same music sample played in each concert halls. If the reference sample was from a slightly different part of the same piece of music as used in the control locations, it was harder to identify the hall.

'Even small differences in the music listened to made it very difficult to identify concert halls of similar size and architecture. Halls that were very different to each other were clearly more easily identified regardless of the music,' explains postdoctoral researcher Antti Kuusinen.

Another study showed that the acoustics of a concert hall are experienced differently depending on the volume at which the orchestra is playing. The concert halls used in the study were the Helsinki's Musiikkitalo, Munich Herkulessaal, Berlin Philharmonic and Berlin Konzerthaus.

The subjects listened to the orchestra playing at different volume levels, from the quietest piano pianoissimo to the strongest forte fortissimo, after which they placed the concert halls in order according to how loud and enveloping they experienced the music to be. The order of the concert halls changed in some cases related to the volume of the music.

'Traditionally, the acoustics of concert halls are studied by using objective measurements to calculate acoustic parameters, such as reverberation time, which is independent of the characteristics or dynamics of the music. Our research clearly shows that this is insufficient for understanding the acoustics in its entirety, because both the timbre of the sound and the listeners' perceptions shift as the volume changes,' Lokki explains.

Lokki's research group has also previously studied how the acoustics of concert halls affect the emotional reactions evoked by the music. The studies indicated that halls with acoustics that support large dynamic fluctuations evoke the strongest emotional experiences in listeners.

People who experience strokes while infected with COVID-19 appear to be left with greater disability after the stroke, according a study led by UCL and UCLH researchers.

Having COVID-19 at stroke onset was also associated with more than double the mortality rate of other stroke patients, according to the findings published in the Journal of Neurology, Neurosurgery & Psychiatry.

The researchers found evidence that people of Asian descent might be more likely to experience COVID-19-associated ischaemic strokes (those caused by blockage of blood vessels supplying the brain) than those in other groups in the UK.

Lead researcher Dr Richard Perry (UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, UCLH) said: "By comparing characteristics and outcomes of strokes experienced by people with and without COVID-19, we found that there were differences between the groups, suggesting that COVID-19 exerts an influence over the presentation of stroke.

"Some of the differences relate to what other studies are uncovering about COVID-19, in that it might make blood stickier and more likely to clot."

The findings build on previous studies led by UCL researchers which have also suggested that some people with COVID-19 are experiencing neurological symptoms, and that the infection may increase the risk of stroke.

The researchers reviewed evidence from 86 people who had a stroke in England or Scotland and had COVID-19 at stroke onset, between March and July this year, and compared them to 1,384 stroke cases during the same period in people who did not have any evidence of COVID-19.

Evidence of infection was determined by a positive coronavirus test within four days of admission or suspected COVID-19 at the time of admission and confirmed on testing at any point during the subsequent 10 days.

The researchers found that ischaemic stroke patients who also had COVID-19 were only half as likely to leave hospital without any disability as those without COVID-19. The researchers do not yet have data on how long these excess disabilities might persist.

Ischaemic strokes in COVID-19 patients were around twice as likely to be caused by the blockage of more than one large blood vessel in the brain (18% vs 8%), which the researchers say suggests evidence of abnormal blood clotting. They also found that the COVID-19 associated strokes were more severe, with an average stroke severity (NIHSS) score of 8, compared to 5 in the control group.

Levels of D-dimers, a protein marker for the stickiness of blood, were also higher in COVID-19 related ischaemic stroke than in other ischaemic strokes. The new findings fit with other studies showing that people with COVID-19 appear to have sticky blood that is more liable to clot.

The researchers found differences by ethnicity, as people of Asian descent were overrepresented (by more than double) in the COVID-19 group than White or Black patients.

Dr Perry said: "Our study suggests that COVID-19 has had more impact on strokes in the Asian community than in other ethnic groups. We cannot say from our data whether this is because people of Asian descent are more likely to catch COVID-19, or whether Asian patients with COVID-19 are more likely to have ischaemic strokes, or both."

Co-author Professor David Werring (UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, UCLH) added: "Our findings suggest that in some people, COVID-19 may influence stroke risk through its effect on excessive blood clotting or inflammation, and may also influence the characteristics and outcome of the stroke, including greater severity with a higher chance of multiple large vessel blood clots.

"Our findings support testing people for COVID-19 if they come into hospital with a stroke, and further research is needed to determine whether treatments (such as the use of early full dose anticoagulation) should differ depending on this test result."