Culture

While Russia seems to have successfully tackled its historic problem: food shortage - with the agri-food sector becoming one of the most steadily developing of the national economy - the country is already facing a new set of challenges. Today, Russia needs to address several key growth factors, such as sustainability, missing national strategies and lagging research and development progress. These are the topics of the research articles comprising the latest special issue of the open-access peer-reviewed Russian Journal of Economics. An overview and introduction for the issue is provided by its guest editor Eugenia Serova of the Institute for Agrarian Studies at HSE University in Moscow.

Since 2012, Russia's agriculture is the most steadily developing sector of the national economy. Production of selected crops is reaching historical records. Today, Russia is a world champion for export of wheat and buckwheat and amongst the top ten in terms of export of many other crops. The country has also begun exporting livestock products and value-added food products. Additionally, the past ten years have seen a significant progress in the food quality and safety in Russia, which has already been recognised. According to conventional indicators applied to food security, the country keeps a consistent place amongst the top three in the world.

However, even though Russia has been successful at achieving national food security, largely contributed to a strong emphasis on self-sufficiency, world known experts in food security at KU Leuven (Belgium) and International Food Policy Research Institute (USA) point out that this might have come at the expense of neglecting nutrition in the national policies, thus potentially exposing the nation at a higher risk of already concerning and quite common public health risks, such as malnourishment and obesity. In their paper, Saule Burkitbayeva, Johan Swinnen and Nele Warrinnier evaluate the state of art of food security in major Eurasian countries, in order to see where Russia stands compared to other former Soviet republics. The researchers also discuss the advantages and disadvantages of self-sufficiency policy.

Along with growth in the food sector in Russia, there have been drastic changes in the agrarian structure. With their profound analysis of two censuses from 2006 and 2016, recognised experts on Russia's farming structure Renata Yanbykh and Valeriy Saraikin (both affiliated with the Institute for Agrarian Studies at HSE University, Moscow) and Zvi Lerman (The Hebrew University of Jerusalem, Israel) conclude that the old classification used for statistical purposes (organisations, family farms and households) does not reflect adequately the dynamic changes stemming from the response to market signals. In their study, the authors find that over 90% of the agricultural producers contribute less than 5% of the total standard revenue.

A need to shift budget support to general services which support all Russian producers is highlighted in the research article by Olga V. Shik of the Institute for Agrarian Studies at HSE University. The renowned expert in the field conducts an exhaustive analysis of the public expenditures in the Russian agri-food sector from the last decade to conclude that despite having a positive effect on agricultural growth, Russia's budget support benefits mostly the larger and already the most successful producers. The second major drawback of budget support in agriculture the author identifies is the inefficient distribution of support between the federal and regional budgets, which leads to market disintegration and reduces the efficiency of budget spending.

In their article, distinguished American experts on Russia's agri-food trade William M. Liefert and Olga Liefert of the United States Department of Agriculture Economic Research Service (USDA ERS) report on how Russia's move from planned to a market economy has fundamentally restructured the country's agricultural production and trade since the 1990s. Most notably, previously a large importer of grain, soybeans, and soybean meal, the former Soviet state has transitioned to becoming one of the world's major grain exporters. In fact, Russia has become the world's top wheat exporter, responsible for 20-23% of the total world exports in 2017-2018. Having also discussed the consequences for the world agricultural markets, the researchers forecast further increase in Russia's presence in the global market along with slight growth in its produce of value-added foods.

The last article, authored by researchers of the Institute for Agrarian Studies at HSE University Natalia Karlova and Eugenia Serova also addresses the issue of Russia's presence in the world agri-food market with a focus on the trade with China. Since the significant increase in export is one of the major targets of Russia's modern agri-food policy, China is seen as the most prospective market. However, there are a number of obstacles and risks that need to be taken into consideration. On one hand, Russia has a fairly limited list of exported agri-food products that have comparative advantages in the Chinese market. On the other hand, the Chinese market is limited by the scale of the country's domestic demand. Moreover, China has already embarked on a course to self-sufficiency in terms of staple food produce.

UNIVERSITY PARK, Pa. — China’s control measures during the first 50 days of the COVID-19 epidemic may have delayed the spread of the virus to cities outside of Wuhan by several days and, by interrupting transmission nationwide, prevented more than 700,000 infections across the country, according to an international team of researchers. The findings, published today (March 31) in the journal Science, could be useful to countries that are still in early phases of the COVID-19 outbreak.

“The number of confirmed cases in China by day 50 (February 19) of the epidemic, was around 30,000,” said Christopher Dye, visiting professor of zoology and visiting fellow at the Oxford Martin School, University of Oxford. “Our analysis suggests that without the Wuhan travel ban and the national emergency response there would have been more than 700,000 confirmed COVID-19 cases outside of Wuhan by that date. China’s control measures appear to have worked by successfully breaking the chain of transmission — preventing contact between infectious and susceptible people.”

The researchers used a unique combination of case reports, human movement data and public health intervention information to investigate the spread and control of COVID-19. They examined the movements of 4.3 million people out of Wuhan before the travel ban, the types and timing of control measures implemented across the cities of China and the numbers of COVID-19 cases reported each day in every city.

“One fascinating aspect of our work is that it shows the power of novel data streams such as cell phone mobility data,” said Ottar Bjornstad, distinguished professor of entomology and biology, Penn State. “Since the time period we studied included the Spring Festival holiday and Chinese Lunar New Year, we were able to compare patterns of travel into and out of Wuhan during the outbreak with cell phone data from two previous spring festivals. The analysis revealed an extraordinary reduction in movement following the travel ban of January 23, 2020. Based on this data, we could also calculate the likely reduction in Wuhan-associated cases in other cities across China.”

The team’s model also analyzed the specific effects of the Wuhan shutdown and found that it delayed the arrival of COVID-19 in other cities by several days. “This delay provided extra time to prepare for the arrival of COVID-19 in more than 130 cities,” said Huaiyu Tian, associate professor of epidemiology, Beijing Normal University.

These cities banned public gatherings, closed entertainment venues and suspended public transport, among other actions. As a result, they reported 33% fewer confirmed cases during the first week of their outbreaks than cities that did not implement a Level 1 Response.

While the control measures taken thus far have reduced the number of COVID-19 infections to very low levels, China, is by no means out of the woods.

“Given the small fraction of the Chinese population that has been infected, a much larger number of people remains at risk of COVID-19,” said Tian. “We are acutely aware that resident or imported infections could lead to a resurgence of transmission.”

Bjornstad noted that SARS-CoV-2 may establish as a human endemic globally in the years to come.

“It is critical to keep in mind that this virgin epidemic likely will affect people of different ages and susceptibilities, and therefore have different fatality levels, than possible subsequent seasonal epidemics,” he said.

Oxford, United Kingdom. A team of medical researchers and bioethicists at Oxford University has published results today in Science that furthers our understanding of coronavirus transmission. This evidence is enabling several international partners, including NHSX, a joint unit comprised of teams from NHS England and the UK's Department of Health & Social Care, and the Norwegian Institute of Public Health (FHI), to assess the feasibility of developing mobile apps for instant contact tracing in record time. If rapidly and widely developed, these mobile apps could help to significantly slow the rate of transmission, and support countries to emerge from lockdowns safely, as restrictions are gradually eased.

Professor Christophe Fraser from Oxford University's Big Data Institute, Nuffield Department of Medicine, a lead author on the Science paper explains, "We need a mobile contact tracing app to urgently support health services to control coronavirus transmission, target interventions and keep people safe. Our analysis suggests that about half of transmissions occur in the early phase of the infection, before you show any symptoms of infection. Our mathematical models also highlight that traditional public health contact tracing approaches provide incomplete data and cannot keep up with the pace of this pandemic."

The project is co-led by Dr David Bonsall, senior researcher at Oxford University's Nuffield Department of Medicine and clinician at Oxford's John Radcliffe Hospital, who explains "The mobile app concept we've mathematically modelled is simple and doesn't need to track your location; it uses a low-energy version of Bluetooth to log a memory of all the app users with whom you have come into close proximity over the last few days. If you then become infected, these people are alerted instantly and anonymously, and advised to go home and self-isolate. If app users decide to share additional data, they could support health services to identify trends and target interventions to reach those most in need."

The authors argue that a mobile app can reduce transmission at any stage of the epidemic, in countries or regions where the epidemic is just emerging, at the peak of the epidemic, or to support a safe transition out of restricted movement or lockdown. It could also help to reduce the serious social, psychological and economic impacts caused by widespread lockdowns. Critically, the researchers suggest a mobile app can help slow the spread of infection until vaccines and antiviral treatments become widely available.

Prof Fraser explains, "A contact tracing app can foster good citizenship by alerting people at risk, it can also help ease us out of confinement If we know we've not been in contact with anyone infected we can leave home safely, whilst still protecting our loved ones and avoiding a broader resurgence of coronavirus in our community."

Given the level of infection across much of Europe, the team believe ongoing development of a mobile app partnership across the union would massively reduce transmission and avoid a resurgence in the number of cases, providing an opportunity for all citizens using mobile contact tracing apps to contribute towards ending the epidemic. An app strategy could also be used by low and middle income countries, earlier in the epidemic, to rapidly control transmission and get ahead of the epidemic now.

The Oxford team highlight that the mobile contact tracing app should still be combined with isolation of cases, tracing and quarantine of contacts, physical distancing, scaled-up diagnostic testing, decontamination and hygiene measures.

As Dr Bonsall explains "If the mobile app is widely adopted in any country, and combined with other critical interventions such as physical distancing and widespread testing, our models suggest the epidemic could be brought under control. This app is a tool for each and every person affected to contribute towards protecting their health services, supporting vulnerable people and simultaneously gradually releasing communities out of extended quarantine."

Today's Science study highlights the importance of rigorous ethical standards underpinning the successful and appropriate use of mobile phone technology in addressing the coronavirus pandemic; including a number of ethical requirements needed to foster well-founded public trust and confidence. Professor Michael Parker, Director of the Wellcome Centre for Ethics & Humanities and one of the paper's authors, highlights, "With transparent and inclusive ethical oversight to ensure genuine public trust, it is possible to both save lives and protect civil liberties. The app should be opt-in, provide secure data storage and privacy protection, and be informed by public and user engagement at every stage of implementation. With these guarantees and, if widely installed by users across a country or regional bloc, a mobile app could even help to end the epidemic."

As mobile apps launch over the coming weeks and months, the Oxford research team urges people to support official apps, developed by trusted institutions, and their partners, such as the mobile contact tracing apps under advanced assessment in several European countries. Professor Fraser concludes, "Our hope is to support communities with life-saving information as the pandemic worsens, and help to release countries from large-scale isolation. The maths is clear: the more people that use a contract tracing app the better chance we have of getting ahead of this epidemic and eventually stopping it in its tracks. If a country reduces the epidemic growth rate to below zero, the epidemic will rapidly decline and eventually stop. Together we can make this possible."

Destinations in nature, such as a lakeside or a walking trail, are the most commonly perceived environmental features motivating older adults to engage in outdoor mobility. In a study conducted at the University of Jyväskylä, Finland, it was however observed that reporting a motivating feature did not necessarily mean the same thing as being more physically active.

Environmental features perceived as motivating for outdoor mobility and levels of physical activity were investigated alongside the neighbourhood types in which the older adults lived. Based on these findings, it could be seen that environmental features associated with higher levels of physical activity differed between neighbourhood types. Differences existed especially between densely populated and sparsely populated areas.

"In densely populated areas destinations close to nature were associated with older adults' brisk physical activity," says PhD student Kirsi Keskinen. "Yet in sparsely populated areas, perceiving features that improved pedestrian infrastructure close to home were important for reporting higher levels of physical activity."

Peaceful walkways, even sidewalks, and street lighting are examples of features that make an environment more walking friendly for older adults. They are also features that commonly differ in their amounts between densely and sparsely populated areas.

"The specific conditions of a neighborhood type should be considered when planning measures to promote older adults' physical activity," Keskinen concludes.

For the research, 848 people between the ages of 75 and 90 living in Jyväskylä and Muurame, Finland, were interviewed about their physical activity, perceived environmental features that attracted to outdoor mobility, and health and socioeconomic factors. Characteristics of neighborhood types were retrieved from geospatial data.

This study is part of the project Geographic characteristics, outdoor mobility and physical activity in old age (GEOage) conducted in the University of Jyväskylä's Faculty of Sport and Health Sciences and in the Gerontology Research Center. The research has been financially supported by the Foundation for Municipal Development, the Finnish Cultural Foundation, the Finnish Ministry of Education and Culture, the Academy of Finland, and the European Research Council.

Some call it baby fat. But recent research has shown that adults have it too--which is a good thing. Brown fat, the so-called good fat that can protect against obesity and associated health risks, like cardiovascular disease and diabetes, is located in small pockets throughout the body. Most mammals use brown fat (and its closely related cousin beige fat) to stay warm.

"In mice and humans, if you have more brown or beige fat, you are more protected from metabolic disease," says Liangyou Rui, Louis G. D'Alecy Collegiate Professor of Physiology at U-M Medical School, whose lab studies the molecular and physiological mechanisms of obesity, diabetes and fatty liver disease.

In a new study published in Nature Communications, Rui, first author Lin Jiang, Ph.D. and their colleagues reveal a pathway by which the hormone leptin contributes to weight loss.

Leptin regulates body weight by controlling appetite and energy expenditure, but exactly how has been a mystery. What is known, says Rui, is that leptin activates brown and beige fat. The new study elucidates a molecular accelerator of leptin action in the brain called Sh2b1.

His team has found that Sh2b1 in the hypothalamus, an important brain region controlling body temperature and hunger among other functions, promotes the stimulation of the sympathetic nervous system. The sympathetic nervous system sends signals to brown and beige fat to activate it, thus maintaining body weight and metabolism.

The team demonstrated this proof-of-principle by creating two mouse models. Mice that lacked the Sh2b1 gene in the leptin receptor neurons "had an incredibly reduced sympathetic drive to the brown/beige fat and reduced capability to promote energy expenditure," says Rui.

This reduced the ability of brown fat to be metabolized into heat, lowering the mice's core body temperature. What's more, the mice also developed obesity, insulin resistance and a fatty liver. In contrast, mice with extra expression of Sh2b1 in their brains were protected from obesity.

"No one knew that Sh2b1 in the brain controls the sympathetic nervous system or was required for leptin to activate brown fat to increase energy expenditure," notes Rui. As for how this finding could be applied to humans, he says the hope is to eventually find a way to increase expression of Sh2b1 or its ability to enhance leptin signaling and fat burning.

Despite intensive research effort, the process of metastasis, which allows carcinoma cells to leave the tumor of origin, to migrate and to grow tumors within other organs, is still the leading cause of mortality for cancer patients. It is acknowledged that the acquisition of migrating capacities by cancer cells relies on a process called Epithelial to Mesenchymal Transition (EMT). During this process, cancer cells lose their ability to attach to other cells, become independent cells and gain abilities to migrate, thus switching from an epithelial state to a so-called mesenchymal state. However, this process seems to rarely complete, as many cancer cells maintain properties of both epithelial and mesenchymal cells. These hybrid cells may be the most dangerous ones, as they appear to survive treatments with chemotherapeutic drugs and to cause new tumors. A very large number of molecules or signals inside the cell has been shown to control this process. In addition, cells in the neighborhood of tumor cells, as well as the web of proteins on which cells are seated, called the extracellular matrix, send a multitude of signals to tumor cells to cause or prevent the EMT process. Yet it remains to be uncovered which of these molecular signals should be targeted to alt metastasis, to kill hybrid cancer cells and to prevent the formation of new tumors.

The large number of signals involved in metastasis is now far beyond the capability of any researcher to be integrated in order to predict how a cell will behave. To get around this problem, the research's groups lead by Claudine Chaouiya and Florence Janody at Instituto Gulbenkian de Ciências (IGC) and Instituto de Investigação e Inovação em Saúde (i3S) have built a virtual computational cell, with numerous molecules interacting with each other. This virtual cell can become epithelial, mesenchymal or hybrid cancer cell. It is also under the influence of many signals coming from outside the cell. According to Claudine Chaouiya "computational models permit to perform virtual experiments that are cheaper and faster than experiments with alive cells, to test hypotheses and to make predictions". Predictions given by the virtual cell were tested using alive human and canine cells. Among these predictions, Chaouiya and Janody research teams confirmed that hybrid cancer cells expressing the oncogene Src become mesenchymal if they are seated on a more rigid extracellular matrix.
They have also discovered that, as predicted by the virtual cell, mesenchymal cancer cells expressing the oncogene Src become hybrid cancer cells when they contain the RPTP-kappa molecule, which connects cells to each other. Florence Janody explains that "experiments combining virtual and alive cells allowed us very efficiently to propose new ways by which we could prevent metastasis and the formation of new tumors".

This study demonstrates that collaborative efforts between mathematicians and biologists bring up a very powerful plan of attack to explain the behavior of cancer cells. This work has permitted to discover molecules and signals in the cell environment, which instruct cancer cells to migrate and invade the body. These signals could be used as targets for developing therapeutic strategies against cancer cells with these behaviors.

The idea of a complex spider society--in which thousands of spiders live, hunt, and raise their young together in a single colony--is unsettling to many of us. We are perhaps lucky then that this scene is relatively rare among arachnids. Among the 40,000 known species of spiders, the vast majority live solitary lives and will often show aggression toward other spiders they encounter, even within their own species. There are fewer than 25 known species of social spiders, distributed broadly across 6 different families and 9 different genera. Not only do these spiders live in social groups, but they produce populations that grow over time as new offspring are added to the nest, enabling the capture of increasingly large prey as the colony expands, and even give rise to new daughter colonies. As social creatures ourselves, humans have long been interested in the evolutionary innovations that enable social cooperation. In a new article in Genome Biology and Evolution titled "Comparative genomics identifies putative signatures of sociality in spiders", researchers provide one of the first glimpses into the genetic underpinnings for how a solitary spider evolves into a social one.

The research, led by Dr. Chao Tong, a postdoc in the lab of Dr. Timothy Linksvayer at the University of Pennsylvania, represents one of the first comparative genomic studies to be conducted in spiders. According to Dr. Tong, "The high complexity and large size of spider genomes has constrained the development of genomic resources for spiders." Because of this, earlier studies compared individual spider genomes to insect genomes and sought mainly to identify venom and silk genes. In the new study, however, a curiosity about the genetic basis of social life led Dr. Tong and his colleagues to compare the genomes of 7 spider species: two social species in the genus Stegodyphus that evolved sociality independently, and five solitary species in the genera Parasteatoda, Acanthoscurria, Nephila, Loxosceles, and Latrodectus.

The analysis revealed a number of interesting findings. First, rapidly evolving genes in the two social species were involved not only in behavior but also in immunity, indicating that group living may require better defenses against pathogens that spread more easily in dense social groups. In contrast, genes that were rapidly evolving in the solitary species were enriched for energy metabolism processes. Dr. Tong notes that this is the opposite pattern from what is observed in social insects such as bees and ants, in which metabolic genes evolve more rapidly. Still, in both insects and spiders, there appear to be metabolic differences between solitary and social organisms that may reflect differences in hunting and feeding behaviors.

In addition, the researchers found that the genomes of the two social spiders exhibited a higher rate of evolution overall than those of the solitary species. While this might reflect a greater number of genes under positive selection, the authors are quick to point out that this pattern may also stem from demographic features that characterize social spiders, such as a female-skewed sex ratio (social spiders have more female offspring than males) and high levels of inbreeding. Perhaps most interesting of all, the new study identified a set of rapidly evolving genes that showed brain-specific expression and were enriched for social behavioral processes. These genes represent top candidates for those that influence social behavior and may have been involved in the evolution of spider sociality.

The researchers note an important limitation of their analysis: since the two social spiders they studied are from the same genus and they did not have access to a solitary spider from this genus, it is difficult to untangle which patterns are directly related to sociality and which may simply characterize spiders in the genus Stegodyphus--both social and non-social species. Thus, the group has already started their next comparative genomics project to verify the above patterns in a larger set of species, including more social spiders and their solitary relatives within the same genus. Realizing that the success of this endeavor may require establishing new collaborations due to the scarcity of spider genomic resources, Dr. Tong would like to put out a call to other researchers: "We welcome samples from other researchers, as we want to include as many spiders as possible in future studies, including social, subsocial, and solitary spider samples from multiple genera."

A study published in the JAMA Otolaryngology-Head & Neck Surgery examines the effect of Medicaid expansion on head and neck cancer patients, finding that the expansions under the Affordable Care Act (ACA) were associated with improved access to care for these patients and selective Medicaid expansion may worsen existing regional disparities in terms of access to care and outcomes.

Medicaid expansion refers to a provision in the ACA that called for expansion of Medicaid eligibility to cover more low-income Americans. It was determined that each state would decide whether to participate in the expansion - accept federal funds - or not. As of 2020, 37 states including the District of Columbia accepted Medicaid expansion. South Carolina is one of 14 states that has not. As a result, there are gaps in coverage for adults who have incomes above Medicaid eligibility limits yet still below the poverty level, exacerbating challenges with access to care, which is vital in the early detection of cancer.

"We performed the study because delivering timely head and neck cancer care is critical for optimal outcomes," said Evan Graboyes, M.D., a researcher at Hollings Cancer Center at the Medical University of South Carolina and senior author on the study. The surgeon at MUSC Health specializes in the treatment of head and neck cancers.

The team analyzed data from a national sample of nearly 91,000 adults with newly diagnosed head and neck cancer who were identified from the National Cancer Database. In this observational study, researchers examined the effect that Medicaid expansion, as part of the ACA, had on the patients' stages of cancer at the time of diagnosis as well as treatment delays for these patients.

Medicaid expansions are known to increase the percentage of patients getting treatment who have localized (stages I or II) cancer at diagnosis for cancers such as colon and breast cancer that have screening tests. Graboyes said the researchers wanted to know the effect of Medicaid expansions on head and neck cancer, which lacks a screening test, he said.

The study showed in states that expanded Medicaid as part of the ACA, patients with head and neck cancer were more likely to be diagnosed with localized (stages I to II) cancer and initiate treatment in a timelier fashion than patients in nonexpansion states. Because of the strong association with a particular stage at diagnosis and the timely treatment that leads to survival for head and neck cancer, the study suggests that Medicaid expansion that offers insurance coverage may help to improve outcomes for these patients.

"I hope that the data we produce gets referenced and is used by policy makers in the future," Graboyes said.

Helmneh Sineshaw, M.D., lead author on the study and a principal scientist at the American Cancer Society, said the study found that Medicaid expansion provided a huge benefit to those who didn't have access to insurance, leading to earlier diagnosis and timely treatment.

"What we find is that patients, in states that expanded Medicaid, had a greater chance of being diagnosed early, whereas patients living in nonexpansion states were likely to be diagnosed in a more advanced stage," Sineshaw said.

Graboyes said delays in the delivery of head and neck cancers are a key driver of suboptimal survival for patients with head and neck cancers and contribute to racial disparities in mortality. Head and neck cancers are rising in number and carry a high mortality rate, with black patients even more likely to die from it.

This study adds to a growing portfolio of other health disparity studies by Graboyes and colleagues, including:

A 5-year $1.2 million grant from the National Cancer Institute awarded in 2019 to decrease mortality and racial disparities in survival for head and neck cancer patients by developing innovative interventions to improve the timeliness, equity and quality of care delivery.

A 2018 study in JAMA Otolaryngology-Head & Neck Surgery that found that ensuring head and neck cancer patients receive postoperative radiotherapy within six weeks of their surgical procedure maximizes their chances of a cure.

Graboyes said more research is needed to understand more fully how changes in insurance coverage affects patients with head and neck cancer. Although there is a strong relationship between the patient's stage at diagnosis and timely treatment, the current study does not address whether Medicaid expansion is associated with fewer recurrences or better survival since there has not been enough time since the implementation of Medicaid expansion to answer this question.

Another limitation of the current study is that it did not analyze how Medicaid expansion was associated with changes in the cost of treatment for head and neck cancer patients. More research is needed to understand the relative costs of expansion of Medicaid provisions as compared to the assumed cost savings of catching and treating head and neck cancers in a more localized stage (I to II) versus advanced stages (III to IV), he said.

"The study is an important first step in understanding how insurance coverage affects health care delivery for patients with head and neck cancer, particularly those who, due to lack of insurance coverage, are more likely to present with advanced disease and experience treatment delays."

Cross-border regions have great potential for cooperation, yet very few border regions are integrated, a new study from the University of Eastern Finland shows. Conducted by Dr Francesco Cappellano and Professor Teemu Makkonen at the University of Eastern Finland's Karelian Institute, the study sheds light on the fact that although there is plenty of talk about promoting integration in cross-border regions, the reality is very different. In the border region of Cascadia that connects Seattle in the US with Vancouver in Canada, economic cooperation has been modest despite local decision-makers' high regard of it. The region has a long history of initiatives geared towards supporting cross-border cooperation, but visible results remain few and far between.

Published in Planning Practice & Research, the study was carried out within the Cross-Border Fellowship programme funded by the Western Washington University in the US and the University of Victoria in Canada.

Cross-border cooperation has very little concrete evidence to show for

The study analysed concrete outcomes of cross-border cooperation by using survey and statistical data. In particular, the researchers focused on innovation cooperation, i.e. cooperation in science, research and product development, as measured by the number of co-publications, co-patents and networking. The study shows that in Cascadia, the cross-border network of cooperation is very sparse, which can be seen in the scarcity of concrete collaborative scientific outcomes and patents. According to the researchers, this can be considered surprising.

"The economic profiles of Seattle and Vancouver are very similar, and increasingly close collaboration between the two is encouraged. This should foster cross-border cooperation, but it is still very seldom that partners are sought from across the border," Dr Cappellano says.

The situation is not unique nor specific to border regions in North America alone. Professor Makkonen has observed similar development also in European border regions.

"Although cross-border cooperation in the European Union and in its adjacent areas is supported by, e.g., the Interreg and ENI programmes, the outcomes have remained modest in terms of cooperation in science, research and product development. For instance, patents filed as a result of cross-border cooperation are rare."

Cross-border cooperation in the Öresund region connecting Sweden and Denmark is often regarded as a textbook example of well-functioning innovation cooperation. According to Professor Makkonen, however, this cooperation is not very impressive considering the resources, except in certain specific fields of medicine.

The findings of the study highlight the fact that although there is plenty of talk about promoting integration in cross-border regions, concrete outcomes remain few and far between.

"The current relations between the EU and Russia, and the coronavirus pandemic, put the sustainability of cross-border cooperation to test. How to maintain cooperation even at current levels is a cause of concern," Professor Makkonen says.

A paper published in the academic journal Neuro-Oncology by NF experts has demonstrated an increased understanding of low grade gliomas (LGG) occurring in children and adults with NF1. While the biology of LGG has become better known over the past decade, the complexities of these tumors have inhibited practical application of this knowledge to NF1 related LGGs, which can potentially impact close to a third of NF1 patients. According to Dr. Roger Packer, the Gilbert Family Foundation consensus conference held last year with NF1 and LGG experts was aimed at pulling together NF and low grade glioma experts to assess whether new therapeutic strategies could be developed for patients with LGG.

The paper can be accessed here: https://bit.ly/2UvCnD1

In response to the timing of the meeting, Dr. Packer said that "the LGG Synodos teams, funded by CTF had collaborated to analyze for the first time in NF history a large enough number of specimens to draw some important conclusions which probably will have implications in how LGG patients will be treated going forward."

Researchers from the University of British Columbia (UBC) and the Central South University (CSU) in China have for the first time identified a gene that increases the risk of Alzheimer's disease.

In the study, published recently in the journal JCI Insight, the researchers found two mutations in the gene endothelin-converting enzyme 2 (ECE2) which impaired its ability to break down amyloid beta protein. These mutations were present significantly more often in people with Alzheimer's than in controls--suggesting that the genetic variants in ECE2 could be causing, or at least contributing to, Alzheimer's symptoms.

"Since amyloid beta protein is unique to Alzheimer's disease, the majority of drug development was targeted here," says Dr. Weihong Song, who is the Canada Research Chair in Alzheimer's disease, Jack Brown and Family Professor, and director of UBC's Townsend Family Laboratories. "If we can prevent amyloid beta protein build-up or at least find a way to get rid of some of it, we could prevent and treat the disease."

Song's laboratory at UBC collaborated with Dr. Lu Shen's team at Xiangya Hospital at CSU for the study. The study's lead author is Dr. Xinxin Lio who completed a joint PhD at UBC and CSU.

The scientists looked at 741 people with late-onset Alzheimer's and compared them to controls. Unlike early-onset which affects people as young as 30, late-onset Alzheimer's is the most common form of this disease, generally affecting individuals after the age of 65.

Song's lab focuses its efforts on looking at the role amyloid beta protein plays in Alzheimer's. It's well established that increased production (or reduced degradation) of amyloid beta protein results in the formation of neuritic plaques in the brain, which is a hallmark of Alzheimer's disease neuropathology.

The team injected the mutated forms of the ECE2 gene into mice. They found mice with the mutation had increased levels of amyloid beta protein and plaque formation, and also exhibited some signs of Alzheimer's such as memory loss. When they expressed the wildtype form of the gene in the mice (i.e. the non-mutated form), amyloid beta protein levels decreased and the mice recovered some of their learning and memory deficits.

"These findings mean that ECE2 is a risk gene for people to develop Alzheimer's later in life," says Song. "Moving forward, we can try to target this gene and increase its expression as a way to treat Alzheimer's."

The researchers are now screening further for genetic mutations in a larger dataset as a way to validate these findings and to search for other variants in the ECE2 gene that could be contributing to Alzheimer's symptoms.

WASHINGTON--In patients with diabetes, loss of the gland that helps lubricate the eye may be a sign of elevated blood glucose levels, according to research accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting. The study will be published in a special supplemental section of the Journal of the Endocrine Society.

Meibomian glands in the eyelid play a role in tear film production and tear film stabilization.

"In this small study, we found that loss of meibomian glands occurred more frequently with elevated hemoglobin A1c, perhaps due to microischemia, or damage to the small blood vessels, of the eyelids," said co-author Gloria Wu, M.D., adjunct faculty at the University of California, San Francisco in San Francisco, Calif. "Loss of meibomian glands may suggest the need for A1c testing to track average blood glucose levels during the past two to three months and additional monitoring in individuals with diabetes."

Individuals with diabetes often complain of dry eye and eye pain. Infrared images of the eyelid may help characterize dry eye in individuals with diabetes, and new infrared photography techniques have recently enabled meibomian glands to be easily photographed.

To study meibomian gland loss in patients with diabetes as well as dry eye, Wu and her colleagues conducted a retrospective electronic health record chart review of patients with type 2 diabetes and of patients who did not have diabetes and were diagnosed with "dry eye" between 2017 and 2019. The participants were between the ages of 18 and 90, and those with diabetes had A1c levels higher than 5.7%. The researchers analyzed participants' A1c levels and reviewed their infrared eyelid photos.

For each participant, the researchers averaged the percentage of the meibomian glands that were lost in both eyes. Of the 60 patients with diabetes, 35 of 37 with A1c levels higher than 6.6% had more than 40 percent loss of the meibomian glands. In comparison, 12 of 23 diabetes patients who had more controlled A1c levels of less than 6.5% had lost less of the meibomian glands.

Of the 60 control patients, 41 of 50 patients with A1c levels lower than 5.5% had minimal loss of the meibomian glands. Seven of 10 control patients with A1c levels higher than 5.6 percent had greater loss of the meibomian glands.

"It can be useful to check the eyelids of individuals with diabetes who complain of dry eye," Wu said. "It is important for people with diabetes and their family members to consider that dry eye and painful 'sand in the eyes' feelings may mean they should check their blood sugar and see an ophthalmologist about their eye health, including their eyelids."

Certain smartphones have cameras capable of capturing images to gauge eyelid health, including the Samsung Galaxy 10S and iPhone models 10, Xs and 11, Wu said.

"We used an infrared camera in this study, but patients can examine their own eyelids, using selfie and black-and-white settings on their smartphone," she said. "This technique gives patients and health care workers, including those in community and rural health clinics, one more way to control diabetes."

Better glucose control can help people with diabetes who have a common type of stroke to preserve their cognitive function, according to a study accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting. The abstract will be published in a special supplemental issue of the Journal of the Endocrine Society.

"As the population is aging, the prevalence of diabetes and stroke is increasing, and both diseases are risk factors for cognitive dysfunction and dementia," said lead study author Tali Cukierman-Yaffe, M.D., M.Sc., a physician and researcher at the Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Tel Aviv, Israel. "Identifying modifiable risk factors that are associated with cognitive dysfunction in people with type 2 diabetes who experience a lacunar stroke has major public health implications."

Lacunar strokes are a common type of stroke that occurs deep in the brain. A lacunar stroke occurs when an artery that provide blood to the brain's deep structures is blocked.

Cukierman-Yaffe and her colleagues conducted a post-hoc analysis of data from 942 people 30 years of age or older with diabetes who had a lacunar stroke and participated in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. The researchers examined hemoglobin A1c, a glucose control index that provides an estimate of average glucose levels in the three months prior to blood test, and scores on the Cognitive Assessment Screening Instrument (CASI) score over time among participants.

Better glucose control at baseline and during follow-up was associated with greater cognitive function and less cognitive decline, while worse glucose control was linked with poorer cognitive function and steeper cognitive decline. Every 1% increase in baseline A1C was linked with a 0.06 lower standardized CASI z-score. Higher baseline A1C values were linked with lower cognitive scores over time, and a 1% increase in A1C over time corresponded to a CASI score decrease of 0.021 during follow-up.

All these numbers remained statistically significant after the authors adjusted for age, sex, education, race, depression, hypertension, hyperlipidemia, body mass index, cardiovascular disease, obstructive sleep apnea, diabetic retinopathy, nephropathy, insulin use, and white matter abnormalities.

"Intervention studies are needed to investigate whether tighter glucose control may slow the rate of cognitive decline in this population," Cukierman-Yaffe said.

WASHINGTON--Patients with type 1 diabetes who use Medtronic's MiniMedTM 670G insulin pump system are able to maintain blood glucose levels in the targeted range over 71% of the time, according to a study that analyzed some 6 million days of real-world data. Results of the industry-supported study were accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting, and will be published in a special supplemental issue of the Journal of the Endocrine Society.

In patients with diabetes, the current goal is to be in the target glucose range of 70-180 mg/dL over 70% of the time.

"Real-world experience does not necessarily live up to the results seen in a clinical trial that recruits highly motivated participants and who are under close supervision," said study principal investigator Robert Vigersky, M.D., chief medical officer of Medtronic Diabetes, Northridge, Calif. "Our results demonstrate that the glycemic [blood glucose] control using the MiniMedTM 670G in the real world is excellent and mirrors the results of the small pivotal trials that led to the system's approval."

Sometimes called an "artificial pancreas," the MiniMed TM 670G system is the first hybrid closed-loop system approved by the U.S. Food and Drug Administration (FDA) for people with type 1 diabetes, Vigersky said. This system consists of an insulin pump with a tiny insulin infusion catheter worn under the skin and a small continuous glucose monitor (CGM) also worn under the skin, whose sensor measures glucose levels every five minutes and sends the result to the pump. The pump then automatically adjusts the amount of insulin given every 5 minutes. The MiniMed TM 670G gained approval in 2016 for people ages 14 and older and in 2018 for children ages 7 to 13 years, he said.

Since then, use of the MiniMed TM 670G has grown to more than 180,000 Americans, according to the study abstract. Many patients have uploaded their sensor glucose data from their devices to a web database called CareLink to track their glycemic control and share their data with their physicians.

In this study, the researchers analyzed information uploaded to the CareLink database from March 2017 to July 2019 by 118,737 persons with type 1 diabetes using the MiniMed TM 670G.

Overall, the percentage of time spent within the target glucose range of 70 to 180 mg/dL was 71.3%, Vigersky reported.

Additionally, the researchers assessed the impact of the system's AutoMode insulin delivery feature in a subgroup of 51,254 individuals who had at least seven days of sensor glucose readings for both Auto Mode turned on and turned off (manual mode). In that subgroup, the percent of time in target glucose range increased from 60.9% in manual mode to 69.9% in Auto Mode, the investigators reported. Both the time spent below (low blood sugar) and above the target glucose range (high blood sugar) decreased in AutoMode, Vigersky said.

Medtronic Diabetes funded the study.

Last month, the U.S. Food & Drug Administration announced Medtronic had recalled MiniMed 670G insulin pumps that have a broken or missing retainer ring following reports that a broken or missing part could lead to incorrect dosing. Insulin pumps with the retainer ring intact do not need to be returned to Medtronic.

What The Study Did: This observational study analyzed data from about 2,900 older residents of Stockholm to examine the association between long-term exposure to air pollution and the risk of developing dementia, along with what role cardiovascular disease might have.

Authors: Giulia Grande, M.D., of the Karolinska Institutet and Stockholm University in Stockholm, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamaneurol.2019.4914)

Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the articles for additional information, including other authors, author contributions and affiliations, conflicts of interest and financial disclosures, and funding and support.