Culture

Currently, approximately 1.6 million Virginians live in primary care shortage areas and 2.2 million in mental health care shortage areas (Kaiser Family Foundation, 2019), yet only three percent of Virginia's high school career and technical education courses are in the health sciences. As the Commonwealth's population grows and ages and demand for care rises, finding effective models for expanding the pipeline of certified health workers is increasingly urgent.

New research published in the VASCD Journal, A Case Study in Growing the Health Workforce Pipeline in Virginia, seeks to address these critical shortages in Virginia's health care workforce by evaluating collective impact partnership models in Career and Technical Education (CTE) for secondary and postsecondary educators and health care providers. The research was led by Tammie Jones, research manager and PhD candidate in the Department of Health Administration and Policy at the George Mason University College of Health and Human Services.

CTE plays a key role in providing young people with industry-certified technical skills that meet labor market needs. However, there is little empirical evidence about what models of partnership exists and what factors help communities succeed.

Jones and Dr. P.J. Maddox, professor and department chair, evaluated the Claude Moore Scholars technical education and training program model to identify what training, education, and collaboration practices have been most effective in bringing secondary and postsecondary students into the health workforce. The study explored questions such as how are programs leveraging assets and resources, such as qualified instructors and clinical lab space, of health care providers and public schools to establish effective health sciences training and education programs in K-12 and postsecondary institutions and what factors were effective in developing communities of practice?

"The study seeks to inform the future approach to health workforce planning and development and serve as a model to align existing programs to form a collective approach for the state," says Jones.

The program evaluation shows that the partnership models used by the Claude Moore Scholars initiative stimulate growth in Virginia's health workforce pipeline in three important ways: 1) building effective community partnerships between K-12 school systems, community colleges, and health care providers/employers, 2) expanding delivery of health sciences training and education programs in K-12 and postsecondary institutions, and 3) providing resources and support to educators and students in the form of communities of practice.

"Our analysis shows that for the plan to succeed, each of the parties took on very specific yet complementary responsibilities. Alignment between the educators and employers' needs is critical to ensure a smooth transition from the classroom to the workplace," says Jones who evaluated the practices of the Claude Moore Scholars programs in 23 school districts, five higher education institutions, and numerous employers in Virginia.

Evaluation of technical education programs across Virginia identified three models for Scholars program collaborations with communities to address these gaps in local health workforce: the public school systems-led approach; the community college-led model; and the emerging employer-led model. The commonality in the models is how partnering communities work together to identify the high-demand health occupations and then work together to resource and implement training and education programs.

Jones underscores that the Scholars program is successful in developing collaborative partnerships that identify community needs, particularly the needs of the employers that provide health services to those in the community. The paper provides examples of how collective impact partnerships can successfully address the largest barriers to CTE: adequate clinical lab space, qualified teachers, and clinical sites for experiential learning.

A study involving more than 5,000 COVID-19 patients in Houston finds that the virus that causes the disease is accumulating genetic mutations, one of which may have made it more contagious. According to the paper published in the peer-reviewed journal mBIO, that mutation, called D614G, is located in the spike protein that pries open our cells for viral entry. It's the largest peer-reviewed study of SARS-CoV-2 genome sequences in one metropolitan region of the U.S. to date.

The paper shows "the virus is mutating due to a combination of neutral drift -- which just means random genetic changes that don't help or hurt the virus -- and pressure from our immune systems," said Ilya Finkelstein, associate professor of molecular biosciences at The University of Texas at Austin and co-author of the study. The study was carried out by scientists at Houston Methodist Hospital, UT Austin and elsewhere.

During the initial wave of the pandemic, 71% of the novel coronaviruses identified in patients in Houston had this mutation. When the second wave of the outbreak hit Houston during the summer, this variant had leaped to 99.9% prevalence. This mirrors a trend observed around the world. A study published in July based on more than 28,000 genome sequences found that variants carrying the D614G mutation became the globally dominant form of SARS-CoV-2 in about a month. SARS-CoV-2 is the coronavirus that causes COVID-19.

So why did strains containing this mutation outcompete those that didn't have it?

Perhaps they're more contagious. A study of more than 25,000 genome sequences in the U.K. found that viruses with the mutation tended to transmit slightly faster than those without it and caused larger clusters of infections. Natural selection would favor strains of the virus that transmit more easily. But not all scientists are convinced. Some have suggested another explanation, called "founder's effects." In that scenario, the D614G mutation might have been more common in the first viruses to arrive in Europe and North America, essentially giving them a head start on other strains.

The spike protein is also continuing to accumulate additional mutations of unknown significance. The Houston Methodist-UT Austin team also showed in lab experiments that at least one such mutation allows spike to evade a neutralizing antibody that humans naturally produce to fight SARS-CoV-2 infections. This may allow that variant of the virus to more easily slip past our immune systems. Although it is not clear yet whether that translates into it also being more easily transmitted between individuals.

The good news is that this mutation is rare and does not appear to make the disease more severe for infected patients. According to Finkelstein, the group did not see viruses that have learned to evade first-generation vaccines and therapeutic antibody formulations.

"The virus continues to mutate as it rips through the world," Finkelstein said. "Real-time surveillance efforts like our study will ensure that global vaccines and therapeutics are always one step ahead."

The scientists noted a total of 285 mutations across thousands of infections, although most don't appear to have a significant effect on how severe the disease is. Ongoing studies are continuing to surveil the third wave of COVID-19 patients and to characterize how the virus is adapting to neutralizing antibodies that are produced by our immune systems. Each new infection is a roll of the dice, an additional chance to develop more dangerous mutations.

"We have given this virus a lot of chances," lead author James Musser of Houston Methodist told The Washington Post. "There is a huge population size out there right now."

Several other UT Austin authors contributed to the work: visiting scholar Jimmy Gollihar, associate professor of molecular biosciences Jason S. McLellan and graduate students Chia-Wei Chou, Kamyab Javanmardi and Hung-Che Kuo.

The UT Austin team tested different genetic variants of the virus's spike protein, the part that allows it to infect host cells, to measure the protein's stability and to see how well it binds to a receptor on host cells and to neutralizing antibodies. Earlier in the year, McLellan and his team at UT Austin, in collaboration with researchers at the National Institutes of Health, developed the first 3D map of the coronavirus spike protein for an innovation that now factors into several leading vaccine candidates' designs.

The researchers found that SARS-CoV-2 was introduced to the Houston area many times, independently, from diverse geographic regions, with virus strains from Europe, Asia, South America and elsewhere in the United States. There was widespread community dissemination soon after COVID-19 cases were reported in Houston.

This study was supported by the Fondren Foundation, Houston Methodist Hospital and Research Institute, the National Institutes of Health, the National Institute of Allergy and Infectious Diseases, the Welch Foundation, the National Science Foundation and the Defense Advanced Research Projects Agency. Ilya Finkelstein is a CPRIT scholar in cancer research, funded by the Cancer Prevention and Research Institute of Texas.

An earlier version of the paper was posted last month to the preprint server medRxiv.

In ecosystems around the globe, the danger of being a common or widespread species is the tendency to be overlooked by conservation efforts that prioritize rarity.

In forests, the most common species can be essential to ecosystem structure and function, which crumble with the decline of these pivotal trees, known collectively as foundation species.

In an effort to identify forest foundation species and elevate their conservation status before they disappear, a unique research collaboration between Chinese and American scientists has synthesized long-term biodiversity data from 12 immense forest study plots spanning 1,500 miles, from China's far north to its southern tropics.

Their results, published today in the journal Ecology, point to maple trees - long appreciated for their autumn foliage and the syrup that graces our tables - as potential foundation species in both China and North America.

The study comes on the heels of the latest "Red List" published by Botanic Gardens Conservation International, which showed that 36 out of the 158 maples species worldwide - nearly a quarter of all maples - are at high risk of extinction in the near future in the wild. Fourteen of those high-risk species exist only in China.

"Foundation species are the species upon which ecosystems are built and supported, just like the foundation of your house," explains Aaron Ellison, Senior Research Fellow at the Harvard Forest and a co-author of the study. "But they can be so common that they hide in plain sight, overlooked because they lack the cachet and appeal of rarities."

The study was led by Xiujuan Qiao, an Associate Professor at the Wuhan Botanical Garden of the Chinese Academy of Sciences, who spent all of 2019 in residence at the Harvard Forest facilitating this global collaboration. She adds, "We should pay more attention to foundation species, identifying and protecting them before their inevitable decline."

DES PLAINES, IL -- Mobile smartphone technology can accelerate first responder dispatch and may be instrumental to improving out of hospital cardiac arrest (OCHA) survival. That is the conclusion of a study published in the October 2020 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The lead author of the study is Dr. Clement Derkenne, an emergency physician in the emergency medical department, Paris Fire Brigade, Clamart, France. The findings of the study are discussed in a recent AEM podcast, We Didn't Start the Fire, But Can Antiacid Monotherapy Stop the Fire?

In France, the introduction of the mobile application "Staying Alive" (a free mobile smartphone application, available in 18 languages and compatible with all operating systems) improved healthcare delivery and OHCA survival outcomes within one year in the Greater Paris area (July 2017 to 2018).

The application allows registered first responders, commonly referred to as "Bons Samaritains" (BS), located near an OHCA scene, to be alerted via a "push notification." Upon acknowledgment of the notification, available BS are directed toward the scene of OHCA and receive a map of AEDs in the area.

SA is available on all smartphone platforms and uses geolocalization services to flag nearby AEDs. It was first integrated to the Paris Fire Brigade Greater Paris Area CPR protocols in 2017.

The study researchers concluded that smartphone apps that match trained responders to nearby cardiac arrest victims may be a valuable way to improve response times in out of hospital cardiae arrest; however, their impact on clinical outcomes and overall cost effectiveness remains unclear.

CAMBRIDGE, MA - October 27, 2020-- In a preprint paper, "Impact of Glucose-Lowering Drugs on Mortality and Other Adverse Outcomes in Patients with Type 2 Diabetes Admitted for COVID-19," researchers conclude a neutral effect on mortality and other adverse outcomes. Though, given the close relationship between diabetes and COVID-19, they call for more prospective studies.

In their peer reviews of the study, Susanna Hofmann (Division Head, Helmholtz Diabetes Center) and Tamaryn Fox (Internal Medicine, Albert Einstein Medical Center) write in MIT Press Journal Rapid Reviews: COVID-19 that the study is reliable, but would require further research. Their conclusion: "While this study is strong, drugs used during the hospital stay were not noted, making these conclusions hard to generalize."

Fox notes the need for this type of research: "There is a paucity of evidence concerning the impact of glucose-lowering drugs and their effect on those infected with COVID-19; thus, this study is relevant and brings insight to this ever-growing topic."

While Hofmann notes the study may be useful to point of care providers, writing, "Importantly, the authors report here valuable information how glucose-lowering drugs taken by [Type 2 Diabetes] patients at home affect hospital stay outcomes. This knowledge may come in very handy at hospital admission and for the treatment strategy during the hospital stay of these patients."

The RR:C19 Editorial Board highlights this research saying, "With Type 2 Diabetes being a known risk factor of COVID-19 and affecting millions worldwide, it is urgent to know whether the use of glucose lowering medications contributes to a patient's risk of mortality or ICU admission if they are diagnosed with COVID-19. In this study, administering commonly-administered drugs did not pose additional risk of ICU admission or hospital death as a result of COVID-19."

ORIGINAL RESEARCH PROJECT

Impact of Glucose-Lowering Drugs on Mortality and Other Adverse Outcomes in Patients with Type 2 Diabetes Admitted for COVID-19

Pérez-Belmonte, Luis Miguel and Torres-Peña, José David and López-Carmona, María D. and Ayala-Gutiérrez, M. Mar and Fuentes-Jiménez, Francisco and Jorge Huerta, Lucía and Alonso Muñoz, Jaime and Rubio-Rivas, Manuel and Madrazo, Manel and Guzmán Garcia, Marcos and Vicente Montes, Beatriz and Fernández Sola, Joaquim and Ena, Javier and Gonzalez Ferrer, Ruth and Mella Pérez, Carmen and Ripper, Carlos J. and Napal Lecumberri, Jose Javier and El Attar Acedo, Iris and Plaza Canteli, Susana and Fuente Cosío, Sara and Amorós Martínez, Francisco and Cortés Rodríguez, Begoña and Pérez-Martínez, Pablo and Ramos-Rincón, José M. and Gómez-Huelgas, Ricardo and Group, SEMI-COVID-19 Network.

Find peer reviews and information about this study at Rapid Reviews website.

Peer review 1 by Susanna Hofmann - Evidence Scale Rating: Reliable

Peer review 2 by Tamaryn Fox - Evidence Scale Rating: Potentially informative

Summary of reviews: Glucose-lowering medications have a neutral effect on mortality and adverse outcomes in those with Type 2 Diabetes hospitalized. While this study is strong, drugs used during the hospital stay were not noted, making these conclusions hard to generalize.

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

Since the earliest study about nursing faculty and students attitudes and beliefs about caring for people living with HIV/AIDS (PLHIV) in the early 1990's, there have only been 17 additional studies. Knowledge in this area of study is still lacking to fill some gaps in understanding attitudes towards people living with the disease. Primary investigators, Dr. Juan Leyva (Universitat Autonoma de Barcelona), Dr. Patrick Palmieri (Universidad Norbert Wiener and A.T. Still University), and Dr. Joan Edwards (Texas Woman's University) sought to understand HIV-related attitudes of nursing faculty in three continents from six countries (Canada, Colombia, England, Peru, Spain, and the United States) and how it correlates to three dimensions of prejudice, stereotypes and discrimination. The collaborators have published their research in an article, Attitudes toward caring for people living with HIV/AIDS: Across-sectional study of nursing faculty in six countries, in The Open AIDS Journal.

"Although prior research largely focused on nursing students, the findings from this study will result in a stigma-reduction intervention for nursing faculty at schools of nursing" says Dr. Juan Levya. The two-year project was supported by the Center for Global Nursing at Texas Woman's University. Founding director, Dr. Joan Edwards, commented "this research was part of an international collaboration to advance positive social change in South America through nursing research." The Center actively supports postdoctoral scholars and develops international researchers through mentored research projects in low- and middle-income countries.

The researchers found that HIV-related stigma about caring for PLHIV are slightly positive with notable differences between countries. Apart from Peru, and to a lesser extent neighboring Colombia, the results are consistent with other findings from a few smaller studies. The results can be explained, among other reasons, by the high HIV-related stigma in South America and the pervasive discrimination experienced by the LGBTQ community. Although myths and knowledge deficits about HIV/AIDS remain problematic, the results appear to be influenced by nationality in terms of prejudices, stereotypes, and discrimination.

Faculty attitudes about caring for PLHIV can impact student attitudes and the care they provide. According to Dr. Palmieri, "nursing faculty attitudes can become part of an informal curriculum where implicit learning is impregnated with personal values." The researchers note that in terms of HIV/AIDS education, faculty might not be comfortable teaching what they do not understand. The researchers conclude that theory-derived, evidence-informed interventions need to be developed to advance the knowledge and attitudes of nursing faculty about caring for people living with HIV. The researchers plan to attempt to address negative attitudes with a stigma-reduction intervention based on the information from similar studies.

On the eve of the November 3 election, Bright Line Watch--the political science research project of faculty at the University of Rochester, the University of Chicago, and Dartmouth College--finds that experts are concerned about substantial risks to the legitimacy of the election, including potential problems in the casting and counting of votes, the Electoral College, and in the resolution of electoral disputes.

Meanwhile, among the US public surveyed, a majority of those who support Trump--as well as a plurality of those who oppose him--believe voter fraud to be far more prevalent than the evidence shows.

These are among the findings of the watchdog group's latest (October 2020) surveys.

"It's really disconcerting that the myth of voter fraud is so broadly accepted," says Gretchen Helmke, professor of political science at Rochester and one of the founders of Bright Line Watch. "There is absolutely no systematic evidence to support any of the various claims made about widespread voter fraud, yet more than three quarters of Trump supporters continue to believe that this is a real danger, as do more than 20 percent of Trump opponents."

Helmke says that this myth has long been used as a pretext for laws that suppress votes. "In the short run," she adds, "it also potentially allows Trump to sow doubt and chaos about any election results that do not go his way."

The group's immediate past survey, released in August, found the health of democracy in the United States at its lowest point since Bright Line Watch began tracking its performance in 2017.

As they had done before, the group fielded two separate surveys in October: one to political experts and one to a representative sample of the US population.

As in previous surveys, the team asked each group to assess the quality of US democracy overall and to rate the performance on 30 distinct democratic principles. Additionally, the Bright Line Watch team asked the experts to rate the likelihood of 28 election scenarios that could produce political crises, while they polled the public about the legitimacy of different 2020 election results, their confidence that votes will be counted fairly, their beliefs about voter fraud, and their willingness to tolerate political violence.

Key findings

The experts anticipate a flood of online misinformation and potentially destabilizing rhetoric from President Trump during and after November 3.

The experts see substantial risks of scenarios that could threaten the election, including potential problems in the casting and counting of votes, the Electoral College, and in the resolution of electoral disputes.

The experts rate President Trump's statement that the 2020 election should be delayed and his refusal to commit to a peaceful transfer of power as the most important and abnormal of the 169 events they have rated over the course of his presidency.

Americans are generally confident their votes will be counted as intended at the local level and as voters intend in their states, but somewhat less confident in the process at the national level.

Only 44 percent of Trump supporters say they would regard a Biden victory as legitimate and only 34 percent of Trump opponents said they would view a Trump victory as legitimate.

Both supporters and opponents of President Trump recognize that the election result may not be clear on November 3. Majorities of both groups say they are prepared to recognize outcomes that differ from the initial count on election night as legitimate.

Trump's supporters and opponents have starkly different beliefs about the prevalence of voter fraud in US elections.

Most Americans, regardless of political affiliation, reject the use of violence to advance political goals, but substantial minorities are willing to condone violence and incivility.

Americans' confidence that their government protects them from political violence and guarantees their right to peaceful protest has declined since March.

The result of their survey of the American public shows a clear partisan divide over the allegation of possible voter fraud: the percentage of Americans who believe that thousands of each type of illegal votes are cast in elections ranges from 41 to 50 percent overall. However, it never rises above 29 percent among those who disapprove of President Trump, whereas the percentages range from 67 percent (voting more than once) to 78 percent (non-US citizens voting or stealing or tampering with ballots) among Americans who approve of Trump.

2020 election nightmare scenarios

The team asked the experts to rate the likelihood of a catalogue of potential crises scenarios.

The scenarios rated as most likely concern potential problems on Election Day, such as widespread false claims on social media about the integrity of the election, and misleading reports about long lines and delays at the polls.

The experts also ranked near the top several items directly related to President Trump--that he would decry as false an anticipated "blue shift" as mail-in ballots are counted and instead insist that the initial totals on election night were correct; that he would encourage violence and intimidation during voting or ballot counting; and that he would refuse to concede the 2020 election after having been declared to have lost by the Associated Press.

Bright Line Watch's experts also predicted that the disqualification of mail-in ballots will surpass 5 percent in at least one state, that early vote counts, which are expected to underrepresent mail ballots, will lean Republican, and that at least one candidate will declare victory before the Associated Press regards the outcome as sealed.

"Our experts rate President Trump's discussion of delaying the election and refusal to commit to the peaceful transfer of power as the most important and abnormal of his presidency," says Brendan Nyhan, professor of government at Dartmouth College, and one of the founders of Bright Line Watch. "This finding reinforces the need for concern about democratic stability in this election and in the future."

Decaying jellyfish blooms fuel the rapid growth of just a few strains of seawater bacteria, effectively keeping this organic material within the water column food web, reveals a new study published in Frontiers in Microbiology. This research furthers our understanding of how marine ecosystems are impacted by jellyfish blooms, which have been observed to be happening on a more frequent basis.

"When jellyfish blooms decay, the sinking detritus is likely to be a temporary but significant source of food for marine microorganisms," says Dr Tinkara Tinta, author of this research, based at the Marine Biology Station Piran, National Institute of Biology, Slovenia. "We show that organic matter leaching from decaying jellyfish is rapidly consumed by a few opportunistic fast-growing bacteria that in turn will provide food for other marine animals in the water column."

The problem with jellyfish

Observed increases in jellyfish populations in several marine ecosystems around the world have been blamed on climate change and the degradation of marine ecosystems. These blooms can be vast and have serious consequences.

"Large jellyfish blooms block cooling intakes of coastal power and desalinization plants, interfere with ship operations, and cause damage to the tourism, fishing and aquaculture industries," says Gerhard J. Herndl , co-author of this study, and a Professor at the Department of Functional and Evolutionary Ecology in the University of Vienna. "It is therefore important to fully understand the role and impact of these blooms on the marine ecosystem. To date, very few studies have examined the link between jellyfish detritus and its most probable consumers and degraders, marine microorganisms."

Bacteria - small but mighty

Using state-of-the-art analytical tools and techniques, the researchers investigated the detailed composition of a decaying bloom of Moon Jellyfish from the northern Adriatic Sea and how quickly bacteria in the seawater responded to this potential food source.

"We identified a small number of key microbes that consumed the jellyfish detritus very quickly, rapidly multiplying in the process. Temporarily, these bacteria will form an important component of the water column food web, feeding plankton that are then consumed by larger marine animals. These findings also imply the amount of food reaching the seafloor, the organic material from jellyfish detritus, is effectively reduced by just a few strains of bacteria in the water column," elaborates Dr Tinta.

Expanding the study

Professor Herndl explains that while the results of this study fills some of the knowledge gaps surrounding the impact of large jellyfish blooms on marine food webs, more research is needed.

"There are many jellyfish species and other gelatinous organisms, such as salps and comb jellies, which can form large blooms with the potential for causing similar temporary changes in the food web. In addition, not all ecosystems where they occur are alike and these differences may not support the same strains of bacteria. Our investigation can be used as a template and expanded to other gelatinous animals and marine habitats, so that we have a better appreciation of their wider impact on the marine ecosystem."

Firefighters and emergency medical workers in New York City were 15 times more likely to be infected during the first wave of the COVID-19 pandemic compared to the general public, according to a study published in ERJ Open Research. [1]

The study, which includes almost all the 15,000 front-line workers at the Fire Department of the City of New York (FDNY), also shows that workers who had been experiencing a deterioration in their lung health prior to the pandemic were more likely to suffer a severe COVID-19 infection, meaning they were admitted to hospital or died.

Researchers say their study supports the proper use of PPE and other measures to protect emergency workers around the world and maintain capacity of emergency services during any subsequent waves of the COVID-19 pandemic.

The research was by David Prezant, Chief Medical Officer for FDNY and Professor of Medicine at Albert Einstein College of Medicine, Michael Weiden, Medial Officer at FDNY and Professor of Medicine at New York University Medical School, and colleagues in New York, USA.

The study included 14,290 FDNY front line workers, the vast majority of all those employed by the service at the beginning of March this year. Of these, 10,789 were firefighters and 3,501 were emergency medical service providers, such as emergency medical technicians and paramedics. All had been given tests to assess their lung health on at least two occasions prior to the pandemic.

From the beginning of March to the end of May, a total of 5,175 FDNY front-line workers were either confirmed as having the virus with a positive COVID-19 PCR viral test or suspected as having the virus due to COVID-19 symptoms. This equates to 36.2% of FDNY front line staff, compared to a rate of 2.4% of the city's general population in the same period of time.

Sixty-two workers were classified as suffering severe COVID-19 infection and four died following an infection. Their rate of serious COVID-19 illness and death was lower than the city's general population, which researchers say could be the result of the 'healthy worker effect' (all those in the study were working and therefore possibly younger and healthier on average).

Compared to the firefighters, the FDNY's emergency medical workers were at a higher risk of becoming infected and five times more likely to develop a severe COVID-19 infection.

The risk of severe COVID-19 infection was also higher among workers who had experienced a decline in their lung health prior to the pandemic. This was measured by the amount of air each worker could force out of their lungs in one second, with a decline of 100ml of air per year corresponding in an increased risk of severe COVID-19 infection of 71%.

Dr Prezant said: "Our study emphasises the higher risk of COVID-19 infection for FDNY responders corresponding with the surge in pandemic-related emergency calls. Although all staff follow the same PPE protocol, it could be that emergency medical workers were more exposed to COVID-19 than firefighters, for example while traveling with patients to hospital and administering treatment to help them breathe.

"These findings highlight the importance of protecting emergency workers in countries around the world and maintaining the capacity of our emergency services in the event of subsequent waves of the pandemic. This means proper use of PPE, but also ensuring emergency workers get flu vaccinations and, when available, COVID-19 vaccinations."

Professor Anita Simonds, President of the European Respiratory Society, noted: "It is important to note that this group is predominantly male, and we know that men are at a higher risk of COVID-19 infection. However, this study highlights the risk of infection encountered not only by emergency medical workers, but also to firefighters. The nature of their work means they cannot avoid entering homes or having close contact with members of the public and co-workers. No matter where we live in the world, we rely on these key workers, so we need to do all we can to protect them.

"These findings also suggest that people whose lung health is declining face a higher risk of developing a more serious infection and those individuals may need additional protection or redeployment at work."

"Scientific knowledge of climate change and its drivers has been growing exponentially during the past decades, yet the degradation of nature and continued growth in greenhouse gas emissions has yet to even cease let alone start reversing. We have to ask if just trying to adjust 'business as usual' can safeguard our future on this planet" says Prof. Michael Norton, EASAC's Environment Programme Director. EASAC's new publication lays out the scale of the problems that face humanity to match human development with the capacity of the Earth and examines the calls for a fundamental transformation of our current economic and social systems across technological, economic and social domains.

Demand for energy and resources has been growing as a result of population growth and increased consumption to the point where all the scientific evidence shows we are bumping up against fundamental planetary boundaries on which our civilizations depend. EASAC summarises this evidence with a focus on climate and biodiversity, describing what many international scientists have been thinking since the 1970s - that current unsustainable trajectories are built into our economic theories and our political reward systems. These fundamentals need to be reset so that long-term sustainability is built into our decision-making at all levels rather than just left to altruism at the fringes.

The short-term perspective of many vested interests in continuing the status quo (whether in fossil fuels, resources extraction, high consumption in the linear economy, overfishing, conversion of forests and so on) is a formidable barrier to change. "Decision-makers seem to listen more to vested interests than to science," says Anders Wijkman, Member of the Royal Swedish Academy of Sciences. "The science message has been consistent since the 1970s on the finite nature of the planet but been ignored. Incremental emissions reductions - achieved so far - are far from what is needed."

Emission Gap is widening

Climate warming is proceeding too fast to meet the Paris Agreement objective of avoiding dangerous climate change. Positive feedback effects that accelerate warming are already occurring. Even with the extreme effects of the COVID19 pandemic, the gap between what is needed in terms of reducing emissions of greenhouse gases (GHG) and what is being achieved continues to widen.

At the same time, biodiversity is being lost at a rate that will weaken and degrade the services we rely on from nature and sabotage progress towards the UN Sustainable Development Goals (SDG) in poverty, hunger, health, water, cities, climate, oceans and land. That is what drives the conclusion that achieving sustainability may only be achieved through transformative changes.

What keeps us from listening to the science?

"There is much talk of redirecting our values and reward systems towards a more sustainable economy whereby we can live well within our planet for more than just a few more years. But the inertia of the 'brown economy' cannot be underestimated", says Norton. Even now, fossil fuel interests have succeeded in capturing almost double the post-COVID19 recovery funds in G20 countries allocated to renewable energies. Food and agricultural interests are driving deforestation, land clearing and over-fishing but continue to be subsidised and escape paying for the environmental costs of their activities.

Wijkman: "The problem is the short-term nature of our political and economic system. I call it the tyranny of the now. So-called wealth is detached from the real wealth of our environment and our well-being. We have even delegated stock market speculation to algorithms and regard that as wealth - even though it has no real value. That's just one illustration of our disconnect with the physical reality of our planet and its limits."

Concrete change measures

"Generation Greta gets it," continues Wijkman. "Our focus should be on well-being and welfare, but our economic system puts all focus on growth and GDP which adds fuel to the climate and biodiversity crises. Yet, we are not becoming happier by consuming more and more and more material goods. The pandemic hopefully has demonstrated that consumption in itself is not the main objective or goal in life. It's well-being that is the main goal."

The scientists list some of the most urgent and transforming change measures:

Replace GDP by measures of real well-being that don't rely on exploiting and destroying the planet's resources

Overcome the vested interests in the brown economy - starting with replacing perverse subsidies with positive incentives for environmental responsibility

Steer our economic system to think long-term
- Engage industry and finance sectors to drive the changes and engage the public through new approaches (examples provided in the publication)

Grasp the opportunities now of the post-COVID and Green Deal stimuli to start to fix the system which is no longer fit for purpose.

"We are aware that our conclusions challenge political leaders and global elites who have campaigned for the traditional economy, expecting science and technology to allow economic growth to be indefinitely sustained," says Prof. Louise Vet, Netherlands Institute of Ecology. "But we all have to accept the realities of our finite planet. Only if we push the reset button now and work with nature instead of against it, our children get the chance of having a future."

Grocery store employees are likely to be at heightened risk of COVID-19 infection, with those in customer-facing roles 5 times as likely to test positive as their colleagues in other positions, suggests the first study of its kind, published in the journal Occupational & Environmental Medicine.

What's more, among those testing positive, three out of four had no symptoms, suggesting these key workers could be an important reservoir of infection, say the researchers.

Published research focusing on essential/key workers has largely focused on healthcare workers. To try and plug this knowledge gap and find out how COVID-19 has affected the health and wellbeing of other key workers, the researchers studied 104 employees of one grocery store in Boston, Massachusetts.

Each employee was tested for SARS-CoV-2, the virus responsible for COVID-19 infection, in May this year as part of a mandatory testing policy across Boston.

But before doing so, they completed detailed questionnaires on: their lifestyle; medical history; employment history; working patterns and role at the store; commuting to and from work; and the protective measures they were able to take against infection at work.

They were also asked to provide information on COVID-19, including any symptoms and exposure to anyone with confirmed SARS-CoV-2 over the past 14 days. Information on mental health was gleaned from two validated questionnaires for depression and anxiety: PHQ-9 and GAD-7.

One in five (21 out of 104) workers tested positive for SARS-CoV-2, indicating a prevalence of 20% at that point in time. This was significantly higher than the prevalence of the infection in the local community at the time: 0.9-1.3%.

Three out of four of those testing positive (76%) had no symptoms. And of those testing positive, most (91%) had a customer facing role compared with 59% of those testing negative.

Workers in customer facing roles were five times more likely to test positive than their colleagues in other types of role, after accounting for potentially influential factors, such as the prevalence of SARS-CoV-2 where they lived. Those in supervisory roles were six times more likely to do so.

Ninety-nine employees filled in the mental health questionnaires: 24 workers reported at least mild anxiety. Only half (46%) of them said they were able to practice social distancing consistently at work, whereas most (76%) of those who weren't anxious were able to do so.

Eight employees were deemed to be mildly depressed from their questionnaire answers. They were less likely to practice social distancing consistently at work and more likely to travel to and from work on public transport or shared rides compared with those who weren't depressed.

Those able to commute on foot, by bike or in their own car were 90% less likely to report depressive symptoms.

This is a small observational study of workers in one store in one city at one point in time, which relied on subjective reports, and as such, can't establish cause, caution the researchers.

Nevertheless they say: "This is the first study to demonstrate the significant asymptomatic infection rate, exposure risks, and associated psychological distress of grocery retail essential workers during the pandemic."

And they point out: "Once essential workers are infected with SARS-CoV-2, they may become a significant transmission source for the community they serve."

They believe their findings support: "the policy recommendations that employers and government officials should take actions on implementing preventive strategies and administrative arrangements, such as methods to reduce interpersonal contact, repeat and routine SARS-CoV-2 employee testing, to ensure the health and safety of essential workers."

And they add: "Our significant mental health finding calls for action in providing comprehensive employee assistance services to help essential workers cope with the psychological distress during the COVID-19 pandemic."

The results of a survey of 1038 doctors, nurses, pharmacists, administrators and allied health professionals (such dieticians and physiotherapists) working in oncology in the UK National Health Service (NHS) during the spring wave of COVID-19 will be presented at the NCRI Virtual Showcase.

The results of the COVID-NOW study show that 69% of oncology staff believe patients' access to 'standard of care treatment' (meaning the standard NHS treatment available) has been compromised as a result of the COVID-19 pandemic and 94% of staff felt that 'patient management' (meaning treatments such as surgery and chemotherapy) had altered.

The study also found that while 66% felt able to do their job without compromising their personal safety, 42% of staff felt they were likely to be 'at risk' of poor wellbeing and 34% indicated signs of burnout. However, the majority said that they felt able to work well during this time and an average score of around 7 out of 10 was reported, where 10 indicates being able to work to their best.

The survey also uncovered the coping strategies staff use, with doctors tending to use planning and humour as strategies, whereas allied health professionals sought out emotional support and information from others. Staff were also asked how valued they felt by their organisation and by the public. Overall, 68% said they felt valued by the public and 66% said they felt valued in the workplace. On average, doctors felt the most valued by the UK public (79%) and their workplace (73%). Support services staff (such as research administration staff, health care assistants and phlebotomists) felt the least valued (47% felt valued by the public and 60% in the workplace).

The study will be presented at the NCRI Virtual Showcase by Dr Susana Banerjee, Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust and Reader in Women's Cancers at The Institute of Cancer Research, London, UK. She said: "As a result of the COVID-19 pandemic, the entire oncology community has been facing rapid changes to help ensure the safety of our cancer patients while maintaining their cancer care.

"Increasing our understanding of oncology professionals' experiences since COVID-19 is essential to making evidence-driven decisions on how best to help the oncology workforce and NHS organisations. The NHS and the global oncology community must work collaboratively to ensure that limited resources are used in the best way possible to support oncology staff and their patients."

The COVID-NOW study continues with further surveys planned as well as in-depth interviews to learn more about the impact of COVID-19 and how best to support oncology staff.

Dr Iain Frame, Chief Executive of NCRI, said: "This study gives us some important insights into how oncology staff were managing during the spring peak of COVID-19. As we see rates of the infection rise again around the world, it's crucial that we learn lessons to protect oncology staff and cancer patients and ensure patients get the best treatment now and in the coming months."

Silver Spring, Md.-- Innovative scientific research results on Coronavirus disease (COVID-19) and its impact on obesity will be presented through oral and poster abstracts at the 38th Annual Meeting of The Obesity Society (TOS) at ObesityWeek® Interactive. This online event will take place Nov. 2-6, 2020 at http://www.obesityweek.org. On-Demand materials and other elements of the interactive conference will remain available online through Dec. 31, 2020.

"COVID-19 disproportionately affects people with obesity, who are at greater risk for complications and death," said Jaime Almandoz, MD, co-chair of the TOS Program Planning Committee. "This year's program highlights the latest research on the impact of COVID-19 for people with obesity. This includes presentations covering the effects of COVID-19 on the immune system and outcomes in critically ill patients with obesity, in addition to the influence that the pandemic is having on eating, health behaviors, television watching and telemedicine."

TOS's program chairs haves selected a sampling of top abstracts from the nearly 40 abstracts focused on COVID-19 and obesity that will be presented at the meeting.

Samples of the science that will be presented include:

"Binge Watching During COVID: Associations With Stress and Body Weight" - Aghababian et al.

"Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children With Obesity: A Longitudinal Study" - Heymsfield et al.

"Obesity Management in Times of COVID-19 Restrictions: Patient Survey in Center Offering Telemedicine" - Pachter et al.

"Impact of COVID-19 Stay-at-Home Orders on Weight-Related Behaviors Among Patients With Obesity" - Almandoz et al.

"Effect of Obesity and Metabolic Disease on Severity of SARS-CoV-2 Infection" - Jirapinyo et al.

"Association of BMI with Outcomes in Critically Ill Patients with COVID-19: Multicenter Cohort Study" - Pattou et al.

"Inflammatory Markers and Clinical Outcomes in Patients With Obesity Admitted With COVID-19" - Mostaghim et al.

LA JOLLA, CA--Examining data from the first six weeks of their landmark DETECT study, a team of scientists from the Scripps Research Translational Institute sees encouraging signs that wearable fitness devices can improve public health efforts to control COVID-19.

The DETECT study, launched on March 25, uses a mobile app to collect smartwatch and activity tracker data from consenting participants, and also gathers their self-reported symptoms and diagnostic test results. Any adult living in the United States is eligible to participate in the study by downloading the research app, MyDataHelps.

In a study that appears today in Nature Medicine, the Scripps Research team reports that wearable devices like Fitbit are capable of identifying cases of COVID-19 by evaluating changes in heart rate, sleep and activity levels, along with self-reported symptom data--and can identify cases with greater success than looking at symptoms alone.

"What's exciting here is that we now have a validated digital signal for COVID-19. The next step is to use this to prevent emerging outbreaks from spreading," says Eric Topol, MD, director and founder of the Scripps Research Translational Institute and executive vice president of Scripps Research. "Roughly 100 million Americans already have a wearable tracker or smartwatch and can help us; all we need is a tiny fraction of them--just 1 percent or 2 percent--to use the app."

With data from the app, researchers can see when participants fall out of their normal range for sleep, activity level or resting heart rate; deviations from individual norms are a sign of viral illness or infection.

But how do they know if the illness causing those changes is COVID-19? To answer that question, the team reviewed data from those who reported developing symptoms and were tested for the novel coronavirus. Knowing the test results enabled them to pinpoint specific changes indicative of COVID-19 versus other illnesses.

"One of the greatest challenges in stopping COVID-19 from spreading is the ability to quickly identify, trace and isolate infected individuals," says Giorgio Quer, PhD, director of artificial intelligence at Scripps Research Translational Institute and first author of the study. "Early identification of those who are pre-symptomatic or even asymptomatic would be especially valuable, as people may potentially be even more infectious during this period. That's the ultimate goal."

For the study, the team used health data from fitness wearables and other devices to identify--with roughly 80% prediction accuracy--whether a person who reported symptoms was likely to have COVID-19. This is a significant improvement from other models that only evaluated self-reported symptoms.

As of June 7, 30,529 individuals had enrolled in the study, with representation from every U.S. state. Of these, 3,811 reported symptoms, 54 tested positive for the coronavirus and 279 tested negative. More sleep and less activity than an individual's normal levels were significant factors in predicting coronavirus infection.

The predictive model under development in DETECT might someday help public health officials spot coronavirus hotspots early. It also may encourage people who are potentially infected to immediately seek diagnostic testing and, if necessary, quarantine themselves to avoid spreading the virus.

"We know that common screening practices for the coronavirus can easily miss pre-symptomatic or asymptomatic cases," says Jennifer Radin, PhD, an epidemiologist at the Scripps Research Translational Institute who is leading the study. "And infrequent viral tests, with often-delayed results, don't offer the real-time insights we need to control the spread of the virus."

The DETECT team is now actively recruiting more participants for this important research. The goal to enroll more than 100,000 people, which will help the scientists improve their predictions of who will get sick, including those who are asymptomatic. In addition, Radin and her colleagues plan to incorporate data from frontline essential workers who are at an especially high risk of infection.

DALLAS - Oct. 29, 2020 - About half of all tumors have mutations of the gene p53, normally responsible for warding off cancer. Now, UT Southwestern scientists have discovered a new role for p53 in its fight against tumors: preventing retrotransposons, or "jumping genes," from hopping around the human genome. In cells with missing or mutated p53, the team found, retrotransposons move and multiply more than usual. The finding could lead to new ways of detecting or treating cancers with p53 mutations.

"There's been long-standing literature associating retrotransposons with cancer," says John Abrams, Ph.D., professor of cell biology at UTSW and senior author of the study published recently in Genes & Development. "What this work does is deliver the first empirical link between p53 and retrotransposons in humans."

The role of p53 as an anti-cancer, or tumor suppressor, gene has been well-established. It works by blocking cell growth, or inducing cellular suicide, when cells are under stress or dividing abnormally, as is the case in tumors. But researchers have long wondered whether the gene has another function. Even when the previously known targets of p53 - genes involved in cell growth and death - are removed or mutated, p53 still protects cells from cancer, suggesting additional, unknown targets. Moreover, the gene is found throughout evolution, including in ancient single-celled organisms.

"These genes existed long before the need for blocking cancer," Abrams says. "My lab has wondered what originally drove the evolution of p53 genes and whether that knowledge can help us target cancer."

Retrotransposons are stretches of DNA that, after being transcribed into RNA, can insert themselves into new spots in the genome. These mobile genetic elements are considered beneficial to some degree - they can help genes evolve with new functions. However, they also have the potential to shuffle genomes and insert themselves into genes that are critical for cell health and growth, potentially contributing to cancer.

In 2016, Abrams and his colleagues discovered that retrotransposons were especially mobile when p53 was inactivated in cells of flies and fish. In the new work, they set out to study whether the same was true in human cells.

When the researchers used CRISPR-Cas9 gene editing technology to remove p53 from human cells, they found that the abundance of retrotransposons quickly increased. Cells derived from both cancers and normal lung tissue that were engineered to lack p53 had roughly four times the rate of retrotransposon movement than cells still containing p53.

Abrams' team also introduced a synthetic, fluorescent-tagged retrotransposon to cells that let them follow the movement of the retrotransposon throughout the genome in real time. The results were similar to their first experiment; the retrotransposon was about four times more mobile, and therefore became more prevalent over time when cells lacked p53. The finding hints that one way in which p53 works to prevent cancer is by blocking retrotransposons from leading to other cancer-causing mutations.

"In the clinic, one could use this information to possibly detect or mitigate p53-driven cancers by quantifying or blocking retrotransposon activity," says Abrams. A liquid biopsy, for instance, could be developed to detect an overabundance of retrotransposons that, theoretically, may precede cancers or be easier to detect than other cancer mutations.

The research team further solidified the link between p53 and retrotransposons by showing that the p53 protein binds directly to one region of human retrotransposons. And they showed that a drug blocking the ability of retrotransposons to copy themselves prevented inflammation otherwise seen in cells with high levels of retrotransposon movement. More work is needed to determine whether a drug targeting retrotransposons could slow or stop the growth of existing cancers.