Tech

MIT engineers have designed a Velcro-like food sensor, made from an array of silk microneedles, that pierces through plastic packaging to sample food for signs of spoilage and bacterial contamination.

The sensor's microneedles are molded from a solution of edible proteins found in silk cocoons, and are designed to draw fluid into the back of the sensor, which is printed with two types of specialized ink. One of these "bioinks" changes color when in contact with fluid of a certain pH range, indicating that the food has spoiled; the other turns color when it senses contaminating bacteria such as pathogenic E. coli.

The researchers attached the sensor to a fillet of raw fish that they had injected with a solution contaminated with E. coli. After less than a day, they found that the part of the sensor that was printed with bacteria-sensing bioink turned from blue to red -- a clear sign that the fish was contaminated. After a few more hours, the pH-sensitive bioink also changed color, signaling that the fish had also spoiled.

The results, published today in the journal Advanced Functional Materials, are a first step toward developing a new colorimetric sensor that can detect signs of food spoilage and contamination.

Such smart food sensors might help head off outbreaks such as the recent salmonella contamination in onions and peaches. They could also prevent consumers from throwing out food that may be past a printed expiration date, but is in fact still consumable.

"There is a lot of food that's wasted due to lack of proper labeling, and we're throwing food away without even knowing if it's spoiled or not," says Benedetto Marelli, the Paul M. Cook Career Development Assistant Professor in MIT's Department of Civil and Environmental Engineering. "People also waste a lot of food after outbreaks, because they're not sure if the food is actually contaminated or not. A technology like this would give confidence to the end user to not waste food."

Marelli's co-authors on the paper are Doyoon Kim, Yunteng Cao, Dhanushkodi Mariappan, Michael S. Bono Jr., and A. John Hart.

Silk and printing

The new food sensor is the product of a collaboration between Marelli, whose lab harnesses the properties of silk to develop new technologies, and Hart, whose group develops new manufacturing processes.

Hart recently developed a high-resolution floxography technique, realizing microscopic patterns that can enable low-cost printed electronics and sensors. Meanwhile, Marelli had developed a silk-based microneedle stamp that penetrates and delivers nutrients to plants. In conversation, the researchers wondered whether their technologies could be paired to produce a printed food sensor that monitors food safety.

"Assessing the health of food by just measuring its surface is often not good enough. At some point, Benedetto mentioned his group's microneedle work with plants, and we realized that we could combine our expertise to make a more effective sensor," Hart recalls.

The team looked to create a sensor that could pierce through the surface of many types of food. The design they came up with consisted of an array of microneedles made from silk.

"Silk is completely edible, nontoxic, and can be used as a food ingredient, and it's mechanically robust enough to penetrate through a large spectrum of tissue types, like meat, peaches, and lettuce," Marelli says.

A deeper detection

To make the new sensor, Kim first made a solution of silk fibroin, a protein extracted from moth cocoons, and poured the solution into a silicone microneedle mold. After drying, he peeled away the resulting array of microneedles, each measuring about 1.6 millimeters long and 600 microns wide -- about one-third the diameter of a spaghetti strand.

The team then developed solutions for two kinds of bioink -- color-changing printable polymers that can be mixed with other sensing ingredients. In this case, the researchers mixed into one bioink an antibody that is sensitive to a molecule in E. coli. When the antibody comes in contact with that molecule, it changes shape and physically pushes on the surrounding polymer, which in turn changes the way the bioink absorbs light. In this way, the bioink can change color when it senses contaminating bacteria.

The researchers made a bioink containing antibodies sensitive to E. coli, and a second bioink sensitive to pH levels that are associated with spoilage. They printed the bacteria-sensing bioink on the surface of the microneedle array, in the pattern of the letter "E," next to which they printed the pH-sensitive bioink, as a "C." Both letters initially appeared blue in color.

Kim then embedded pores within each microneedle to increase the array's ability to draw up fluid via capillary action. To test the new sensor, he bought several fillets of raw fish from a local grocery store and injected each fillet with a fluid containing either E. coli, Salmonella, or the fluid without any contaminants. He stuck a sensor into each fillet. Then, he waited.

After about 16 hours, the team observed that the "E" turned from blue to red, only in the fillet contaminated with E. coli, indicating that the sensor accurately detected the bacterial antigens. After several more hours, both the "C" and "E" in all samples turned red, indicating that every fillet had spoiled.

The researchers also found their new sensor indicates contamination and spoilage faster than existing sensors that only detect pathogens on the surface of foods.

"There are many cavities and holes in food where pathogens are embedded, and surface sensors cannot detect these," Kim says. "So we have to plug in a bit deeper to improve the reliability of the detection. Using this piercing technique, we also don't have to open a package to inspect food quality."

The team is looking for ways to speed up the microneedles' absorption of fluid, as well as the bioinks' sensing of contaminants. Once the design is optimized, they envision the sensor could be used at various stages along the supply chain, from operators in processing plants, who can use the sensors to monitor products before they are shipped out, to consumers who may choose to apply the sensors on certain foods to make sure they are safe to eat.

Tropical Storm Paulette has run into wind shear that is pushing the bulk of clouds and showers away from its center of circulation, and that is apparent on infrared imagery from NASA.

A large upper-level trough or elongated area of low pressure is located to the northwest of Paulette, and this feature is producing 20 to 30 knots (23 to 35 mph/37 to 56 kph) of south-southwesterly wind shear over the cyclone. Wind shear occurs when winds blowing outside of a tropical cyclone at different levels of the atmosphere push against the tropical cyclone and can weaken it. The wind shear Paulette is experiencing is pushing the bulk of clouds to the north-northeast of the center.

NASA's Infrared Data Reveals Heavy Rainmakers

Tropical cyclones are made up of hundreds of thunderstorms, and infrared data can show where the strongest storms are located. That is because infrared data provides temperature information, and the strongest thunderstorms that reach highest into the atmosphere have the coldest cloud top temperatures.

On Sept. 9 at 12:50 a.m. EDT (0450 UTC), the Moderate Imaging Spectroradiometer or MODIS instrument that flies aboard NASA's Aqua satellite used infrared light to analyze the strength of storms within Paulette. MODIS found the most powerful thunderstorms were near Paulette's center where cloud top temperatures were as cold as minus 80 degrees Fahrenheit (minus 62.2 Celsius). However, strong storms with cloud top temperatures as cold as minus 70 degrees Fahrenheit (minus 56.6. degrees Celsius) were being pushed east-northeast of those most powerful storms. NASA research has found that cloud top temperatures that cold indicate strong storms with the potential to generate heavy rainfall.

Hurricane Specialist Robbie Berg of NOAA's National Hurricane Center in Miami, Fla. noted, "Morning visible satellite images show that Paulette's center is located beneath a thin veil of cirrus and displaced to the south of the deep convection."

Paulette's Status on Sept. 9

At 11 a.m. EDT (1500 UTC) on Sept. 9, the center of Tropical Storm Paulette was located near latitude 20.0 degrees north and longitude 46.5 degrees west. Paulette is 1,090 miles (1,755 km) east of the Northern Leeward Islands. Paulette is moving toward the west-northwest near 9 mph (15 kph). Maximum sustained winds are near 60 mph (95 kph) with higher gusts. The estimated minimum central pressure is 996 millibars.

Paulette's Forecast from NHC

The NHC forecasts a general westward or west-northwestward motion through Friday, followed by a turn toward the northwest Friday night and Saturday. Some weakening is forecast during the next couple of days.

NHC said, "Swells generated by Paulette are expected to reach portions of the Leeward Islands Thursday night and Friday and will continue to spread westward to portions of the Greater Antilles, Bahamas, and Bermuda into the weekend. These swells are likely to cause life-threatening surf and rip current conditions."

Tropical Storm Rene weakened to a tropical depression late on Sept. 8 but regained tropical storm status on Sept. 9. Infrared imagery from NASA's Aqua satellite captured Rene as it was twice transitioning.

Rene has been battling wind shear in the eastern North Atlantic Ocean and when NASA's Aqua satellite passed over the storm on Sept. 8, it found Rene weakening although still a tropical storm. Wind shear occurs when winds blowing outside of a tropical cyclone at different levels of the atmosphere push against the tropical cyclone and weaken it.

NASA's Infrared Views of Rene

Tropical cyclones are made up of hundreds of thunderstorms, and infrared data can show where the strongest storms are located. That is because infrared data provides temperature information, and the strongest thunderstorms that reach highest into the atmosphere have the coldest cloud top temperatures.

On Sept. 8 at 10:59 a.m. EDT (1459 UTC), NASA's Aqua satellite analyzed the storm using the Atmospheric Infrared Sounder or AIRS instrument. The AIRS imagery showed the strongest storms east of the center of circulation, and in fragmented bands west of the center where coldest cloud top temperatures as cold as or colder 210 Kelvin minus 81 degrees Fahrenheit (minus 63.1 degrees Celsius). NASA research has shown that cloud top temperatures that cold indicate strong storms that have the capability to create heavy rain.

By 11 p.m. EDT on Sept. 8, although Rene had weakened to a tropical depression, infrared imagery revealed a burst of strong convection with cloud tops colder than minus 80 degrees Celsius (minus 112 Fahrenheit) had developed over and to the west of the center, while a fragmented band of convection had formed in the northern semicircle.

On Sept. 8 at 11:15 p.m. EDT (Sept. 9 at 0315 UTC), the Moderate Resolution Imaging Spectroradiometer or MODIS instrument that flies aboard NASA's Aqua satellite used infrared light to analyze the strength of storms within Rene. MODIS showed that burst of convection and showed the most powerful thunderstorms had cloud top temperatures were as cold as or colder than minus 80 degrees Fahrenheit (minus 62.2 Celsius). Strong storms with cloud top temperatures as cold as minus 70 degrees Fahrenheit (minus 56.6. degrees Celsius) surrounded that area. NASA research has found that cloud top temperatures that cold indicate strong storms with the potential to generate heavy rainfall.

Rene's outflow was symmetrical in all quadrants, but because scatterometer data showed that its winds dropped to 30 knots (35 mph/56 kph) per hour, it was classified as a tropical depression. Less than six hours later, infrared imagery showed Rene was becoming better organized and in an additional six hours, it would regain its strength.

On Sept. 9 at 11 a.m. EDT, Richard Pasch, Senior Hurricane Specialist at NOAA's National Hurricane Center in Miami, Fla. noted, "Although easterly wind shear has been affecting the system, Rene is producing vigorous deep convection, along with a broad convective band, over its western semicircle. Scatterometer data indicate winds to 35 knots [40 mph/65 kph] over the northwestern quadrant, and therefore the system is again being designated as a tropical storm."

Rene's Status on Sept. 9

At 11 a.m. EDT (1500 UTC) on Sept. 9, Rene re-strengthened into a tropical storm. At that time, the center of Tropical Storm Rene was located near latitude 17.6 degrees north and longitude 31.5 degrees west. Rene is moving toward the west-northwest near 13 mph (20 kph). The estimated minimum central pressure is 1003 millibars. Satellite-derived wind data indicate that the maximum sustained winds have increased to near 40 mph (65 kph) with higher gusts.

Rene's Forecast from NHC

The NHC forecasts additional strengthening during the next 48 hours and a motion toward the west-northwest is expected for the next couple of days, followed by a turn to the northwest.

Hailed for its ability to erase distance between health care providers in cities and patients in rural areas, telehealth has ironically enabled medical care to continue in a time when we all must keep our distance.

Across the country, telehealth use has spiked as providers offer virtual patient visits to ensure medical needs are met while minimizing COVID-19 exposure. Regulatory agencies have loosened some restrictions on telehealth during this crisis, and more and more payers have begun to reimburse for it as they would for any other medical service.

The Medical University of South Carolina, one of only two Telehealth Centers of Excellence nationwide, quickly mounted a four-pronged response to the COVID-19 pandemic that ensured both continuity of care for patients with suspected or confirmed COVID-19 and continued ambulatory, also referred to as outpatient, care for all other patients. The team of telehealth and bioinformatics experts who led the effort documented their approach and its success in a recent article in the Journal of the American Medical Informatics Association.

Early on, MUSC Health and telehealth leaders saw the need for a coordinated response to the pandemic.

"The same realization was coming to the forefront of the minds of the leadership, myself included, in telehealth that this was going to be a big problem," said Dee Ford, M.D., director of the MUSC Telehealth Center of Excellence and lead author on the article. "We needed in our own way to create some kind of response to what we believed to be a pretty significant public health problem. Planning started before we even had a case in the state."

Very quickly, MUSC Health was able to stand up virtual screening of patients with suspected COVID-19 and mobile testing sites across the state, a remote home-monitoring program for patients with less severe COVID-19 and a telesitter program for hospitalized patients that enabled providers to monitor and communicate with patients via an audiovisual monitor, minimizing health care exposure and preserving personal protective equipment.

It was able to do so in part because it had long been building its telehealth and bioinformatics capacity. With generous funding from the state, the MUSC Health Center for Telehealth, in coordination with the South Carolina Telehealth Alliance, has been expanding its telehealth services throughout even the remotest regions of the state.

"The state of South Carolina made an investment in MUSC years ago to develop telehealth programs, which then led to a high state of expertise and readiness to pivot when COVID-19 arrived," said Patrick J. Cawley, M.D., CEO of MUSC Health. "The MUSC Health Center for Telehealth is to be congratulated for this ability to lead during this crisis."

Since 2012, when MUSC Health adopted EPIC, an electronic health record, the MUSC enterprise has continued to recruit bioinformatics researchers, mainly housed in the Biomedical Informatics Center (BMIC) and Information Solutions, to customize EPIC to the health system's needs and to learn how to improve care by analyzing EHR data.

Existing telehealth tools would prove invaluable to the initiative, but they had to be radically reimagined and integrated for the purpose of responding to COVID-19. Realizing that the scale of the effort would require easy-to-use options, telehealth leaders also onboarded some new tools, such as the user-friendly telemedicine platform doxy.me, created by BMIC researcher Brandon Welch, Ph.D.

"We had a battlefield-type mentality that we had to all get together to form a new structure," said James McElligott, M.D., executive medical director of the MUSC Health Center for Telehealth.

As they worked to build a unified response and fashion existing tools so as to be COVID-19 relevant, telehealth leaders had the full support of hospital leadership, their colleagues in bioinformatics and the South Carolina Clinical & Translational Research Institute, which provided technical and logistical support.

"No one ever said no, even if that meant working for five months straight and into the late hours of the night and calling up Bioinformatics and saying, 'Make this work like this or change it like this,'" said article co-author Kathryn King, M.D., co-director of the MUSC Telehealth Center of Excellence. "No one ever said no because I think we just knew that it had to happen."

MUSC Health chief research information officer and BMIC director Leslie Lenert, M.D., who is senior author of the article, is proud of his bioinformatics team, which put research aside for a time to help meet this urgent clinical need.

"We took the research capacity we had for EPIC support and improvement, and we told them to stop, and we put them on this full time. That's why we were able to respond so fast," said Lenert. "So we took our best people, and we put them on this problem immediately. We protected their time, and we told them to get something done. We started early, we committed absolutely and we worked with our clinicians to solve practical problems that they had."

With BMIC's help and SCTR's support, existing tools were quickly revamped to ensure continuity of care for patients with suspected or confirmed COVID-19 and continued ambulatory care for all other patients.

Virtual urgent care

Virtual urgent care technology, meant to provide patients a convenient way to be seen for minor illnesses, had to be adapted into a platform for screening patients with suspected COVID-19 and scheduling appointments for them at mobile testing sites throughout the state. Previously, patients reporting serious symptoms, such as shortness of breath, would have been kicked out of that system; therefore, Edward O'Bryan, M.D., telemedicine director for the Emergency Department and direct-to-consumer and institutional telehealth at MUSC, along with other telehealth leaders, had to work rapidly with the virtual urgent care vendor to adapt the technology to screen for COVID-19 symptoms. At the same time, they had to begin staffing up to meet the anticipated demand, increasing the number of providers dedicated to virtual urgent care from fewer than ten to more than a hundred. O'Bryan estimates that more than 150,000 patients have now been screened for COVID-19 through the modified virtual urgent care program.

"We were the first people in South Carolina to offer free virtual care COVID screenings," said O'Bryan. "I'm really proud that we were able to roll it out so quickly and that so many South Carolinians took advantage of it."

BMIC researchers developed an artificial intelligence algorithm that could analyze symptom data provided by patients during virtual urgent care screenings and prioritize those most likely to have COVID-19 for testing. The algorithm proved critical when testing capacity was challenged and should continue to play a key role with the implementation nationwide of "batch testing." Essentially, samples from patients thought to be at low risk of having COVID-19 could be tested in batches of five to extend testing capacity. If the test comes back negative, all five patients are presumed to have a negative result. The algorithm helps identify low-risk patients appropriate for such batch testing while reserving individual testing for higher-risk patients.

"What we were able to do is make a very functional system, which, on the outside, might seem simple -you fill out a questionnaire on a telehealth platform, it goes in and everything happens behind the scenes," said McElligott. "But all of that had to be protected for the patient and linked in with the medical record and the lab. We had to know what to do to get testing sites set up with tents and then use the platforms to guide people there. There's just a whole lot of stuff that had to happen to be able to do this: not one patient at a time, but thousands at a time. We couldn't have done it without the Bioinformatics group stepping in and helping to connect all the dots and then bringing new ideas to the table about how to monitor patients."

Remote patient monitoring

In the second prong of the four-pronged approach, patients who tested positive were then invited to enroll in a remote patient monitoring (RPM) program. That program, which had been used to track data on patients with chronic disease, was transformed into a virtual means of monitoring and delivering acute care to patients with less severe COVID-19 who were recovering at home. RPM nurses contacted patients by telephone or text to ask if they wished to enroll in the program. Enrolled patients were asked to answer online survey questions daily about the symptoms they were experiencing and to provide temperature and oxygen saturation values. BMIC researchers created a "best practice alert," which notified a patient's RPM nurse should his or her condition begin to deteriorate. The nurse could then call the patient, alert the patient's primary care provider or arrange for a video consultation with a physician at MUSC Health. Patients who developed more severe disease could be hospitalized.

By the end of August, 735 patients had been treated through the RPM program. Of those patients, 20% were considered high risk and 32% medium risk. Some of these patients lived alone or in rural areas, and the daily contact and calls with RPM nurses were an emotional, as well as a medical, lifeline.

"The lead nurse ends up being a connection to care for a pretty decent number of people who are otherwise fairly isolated," said Ford. "They may live in rural areas. They may be elderly and live alone. They're also supposed to be in quarantine, so they're not supposed to be out and about and have people around them. So, it ends up being an important kind of emotional support tool for folks with cases of COVID-19 that are on home quarantine."

Telesitter program

The third prong of the approach, a telesitter program, is intended for patients hospitalized with more severe disease. An audiovisual cart, previously used to monitor patients to keep them from falling, was adapted so that caregivers could monitor and interact with patients with COVID-19 without having to don and doff personal protective gear each time, at the same time limiting the exposure of the health care worker.

"That's been a real satisfier for the clinical teams. They are able to have that kind of ease of communication without having to go into the patient's room each time," said Ford.

Reimagining outpatient care

In addition to ensuring a smooth continuum of care for patients with COVID-19, the team of telehealth and bioinformatics experts also wanted to provide a way for providers to continue to treat all of their patients, not just those with COVID-19. During the lockdown, most in-person outpatient visits were canceled, leaving many patients without needed medical care. Leaders at the Center for Telehealth quickly began preparing to transition most outpatient visits to telehealth visits -a gargantuan task.

"The scale of response was ... it was something I never thought I'd see," said McElligott.

Article co-author Jillian Harvey, Ph.D., associate professor in the Department of Healthcare Leadership and Management at MUSC, agrees.

"Telehealth has always been seen as the promising solution for access to the health care system, but its utilization hasn't picked up as quickly as we expected," explained Harvey. "Now, because of COVID, there has been a huge ramping up of telehealth across the country, especially in March, April and May."

During that timeframe, telehealth visits soared from less than 5% to more than 70% of all visits at MUSC Health. Between March and July, almost 30,000 outpatients met with their physicians via secure video teleconferencing. To make that happen so quickly, the Center for Telehealth, which previously had been predominantly focused on providing services externally to patients in remote areas of the state, suddenly had to integrate itself more deeply into clinical practice at MUSC Health.

"We had to replicate the whole design of the health system in a microcosm," said McElligott.

Typically, he explained, the Center for Telehealth would have smoothed out work processes and flows for such an initiative, but due to the public health emergency, there was no time.

"So, we set up an organizational structure to try to get this done, changed video technologies to more user-friendly ones, built a bunch of tip sheets about how to do it, and we just rolled it out and let everybody innovate."

And innovate they did. Physicians in every specialty took those tip sheets and figured out for themselves how to overcome every obstacle so that they could begin seeing patients virtually.

"So, the true heroes in all of this are the front-line providers who took the information and figured out how to do it themselves because they knew they had to or patients weren't going to be seen," said McElligott.

The way forward

Due to the pandemic, many more providers, payers and patients have become aware of what telehealth can offer. How deeply it will remain integrated into health systems will depend, in part, on whether payers continue to reimburse for telehealth visits at a similar rate as for in-person care, as they are now doing during the public health emergency.

"This ambulatory care conversion required an infrastructure rebuild but is probably the initiative with the most lasting impact," said King. "Now that providers and patients know what telehealth can do, I don't think they will ever give it up."

"There's no real going back to a lack of telehealth use," said McElligott. "That has probably been forever changed."

Indeed, McElligott believes that the pandemic has helped to transform how providers and the public view health care.

"Our health care system has always been very focused on a provider-centric view of health care. In other words, you as a patient come to the provider, and that's how we work," explained McElligott. "Just using distance technologies starts to reverse that. This terrible pandemic has forced a reckoning and a realization that, in terms of the long-term goals of improving health, it's really more important to meet the needs of patients where they're at."

Editor's Note: The last sentence in the third graf and the fifth graf from the end of the release has been removed because they contained embargo-sensitive information.

It's 5 o'clock somewhere. And while here on Earth, "happy hour" is commonly associated with winding down and the optional cold beverage, that's when things get going on Bennu, the destination asteroid of the University of Arizona-led OSIRIS-REx NASA mission.

In a special collection of research papers published today in the Journal of Geophysical Research: Planets, the OSIRIS-REx science team reports detailed observations that reveal Bennu is shedding material on a regular basis, most often during Bennu's local two-hour afternoon and evening timeframe.

The OSIRIS-REx spacecraft has provided planetary scientists with the opportunity to observe such activity at close range for the first time ever, and Bennu's active surface underscores an emerging picture in which asteroids are quite dynamic worlds.

The publications provide the first in-depth look at the nature of Bennu's particle ejection events, detail the methods used to study these phenomena, and discuss the likely mechanisms that cause the asteroid to release pieces of itself into space.

The OSIRIS-REx spacecraft will grab a sample from the surface of Bennu in October and return it to Earth on Sept. 24, 2023. The first observation of particles popping off the asteroid's surface was made in January 2019, mere days after the spacecraft arrived at Bennu. This event may have gone completely unnoticed were it not for the keen eye of the mission's lead astronomer Carl Hergenrother, a scientist in the UArizona Lunar and Planetary Laboratory and one of the lead authors of the collection and its introductory paper.

Much like ocean-going explorers in centuries past, the OSIRIS-REx space probe relies on stars to fix its position in space and remain on course during its years-long voyage. A specialized navigation camera onboard the spacecraft takes repeat images of background stars. By cross-referencing the constellations the spacecraft "sees" with programmed star charts, and course corrections can be made as necessary.

Hergenrother was poring over these images that the spacecraft had beamed back to Earth when something caught his attention. The images showed the asteroid silhouetted against a black sky, dotted with many stars - except there seemed to be too many.

"I was looking at the star patterns in these images and thought, 'huh, I don't remember that star cluster,'" Hergenrother said. "I only noticed it because there were 200 dots of light where there should be about 10 stars. Other than that, it looked to be just a dense part of the sky."

A closer inspection and an application of image-processing techniques solved the mystery: The "star cluster" was, in fact, a cloud of tiny particles that had been ejected from the asteroid's surface. Follow-up observations made by the spacecraft revealed the telltale streaks typical of objects moving across the frame, setting them apart from the background stars that appear stationary due to their enormous distances.

"We thought that Bennu's boulder-covered surface was the wildcard discovery at the asteroid, but these particle events definitely surprised us," said Dante Lauretta, OSIRIS-REx principal investigator and professor in the UArizona Lunar and Planetary Laboratory. "We've spent the last year investigating Bennu's active surface, and it's provided us with a remarkable opportunity to expand our knowledge of how active asteroids behave."

Since arriving at the asteroid, the team has observed and tracked more than 300 particle ejection events on Bennu. According to the authors, some particles escape into space, others briefly orbit the asteroid, and most fall back onto its surface after being launched.

Using data collected by NASA's OSIRIS-REx mission, this video animation shows the trajectories of particles after their emission from asteroid Bennu's surface. The animation emphasizes the four largest particle ejection events detected at Bennu from December 2018 through September 2019. Additional particles, some with lifetimes of several days, that are not related to the ejections are also visible. (Credit: M. Brozovic/JPL/Caltech/NASA/University of Arizona)

The spacecraft is equipped with a sophisticated set of electronic eyes - the Touch-and-Go Camera Suite, or TAGCAMS. Although its primary purpose is to assist in spacecraft navigation, TAGCAMS has now been placed into active duty spotting any particles in the vicinity of the asteroid.

Using software algorithms developed at UArizona's Catalina Sky Survey, which specializes in discovering and tracking near-Earth asteroids by detecting their motion against background stars, the OSIRIS-REx team found the largest particles erupting from Bennu to be about 6 centimeters (2 inches) in diameter. Due to their small size and low velocities - like a shower of tiny pebbles in super slow motion - the mission team does not deem the particles a threat to the spacecraft.

"Space is so empty that even when the asteroid is throwing off hundreds of particles, as we have seen in some events, the chances of one of those hitting the spacecraft is extremely small, and even if that were to happen, the vast majority of them are not fast or large enough to cause damage," Hergenrother said.

During a number of observation campaigns between January and September 2019 dedicated to detecting and tracking mass ejected from the asteroid, a total of 668 particles were studied, with the vast majority measuring between 0.5 and 1 centimeters (0.2-0.4 inches) and moving at about 20 centimeters (8 inches) per second, about as fast - or slow - as a beetle scurrying across the ground. In one instance, a speedy outlier was clocked at about 3 meters (9.8 feet) per second.

On average, the authors observed one to two particles kicked up per day, with much of the material falling back onto the asteroid. Add to that the small particle sizes, and the mass loss becomes minimal, Hergenrother explained.

"To give you an idea, all of those 200 particles we observed during the first event after arrival would fit on a 4-inch by 4-inch tile," he said. "The fact that we can even see them is a testament to the capabilities of our cameras."

The authors investigated various mechanisms that could cause the phenomena, including released water vapor, impacts by small space rocks known as meteoroids and rocks cracking from thermal stress. The two latter mechanisms were found to be the most likely driving forces, confirming predictions about Bennu's environment based on ground observations preceding the space mission.

As Bennu completes one rotation about every four hours, boulders on its surface are exposed to a constant thermo-cycling as they heat during the day and cool during the night. Over time, the rocks crack and break down, and eventually particles may be thrown from the surface. The fact that particle ejections were observed with greater frequency during late afternoon, when the rocks heat up, suggests thermal cracking is a major driver. The timing of the events is also consistent with the timing of meteoroid impacts, indicating that these small impacts could be throwing material from the surface. Either, or both, of these processes could be driving the particle ejections, and because of the asteroid's microgravity environment, it doesn't take much energy to launch an object from Bennu's surface.

Of the particles the team observed, some had suborbital trajectories, keeping them aloft for a few hours before they settled back down, while others fly off the asteroid to go into their own orbits around the sun.

In one instance, the team tracked one particle as it circled the asteroid for almost a week. The spacecraft's cameras even witnessed a ricochet, according to Hergenrother.

"One particle came down, hit a boulder and went back into orbit," he said. "If Bennu has this kind of activity, then there is a good chance all asteroids do, and that is really exciting."

As Bennu unveils more of itself, the OSIRIS-REx team continues to discover that this small world is glowingly complex. These findings could serve as a cornerstone for future planetary missions that seek to better characterize and understand how these small bodies behave and evolve.

The KRAS oncogene is involved in at least one fifth of all human cancers: KRAS mutations are directly responsible for 32% of lung tumours and 96% of pancreatic tumours. However, after more than thirty years of research to date, there are still no effective therapeutic strategies against this oncogene. For this reason, much of the research conducted seeks to identify other molecules that display therapeutic activity along the KRAS signalling pathway. Rising to this challenge, researchers from the Experimental Oncology Group of the Spanish National Cancer Research Centre (CNIO) have achieved complete remission in 25% of lung tumours induced by this oncogene in mice following genetic inactivation of CDK4 and RAF1, which opens new venues for the development of future treatments. This finding has been published by PNAS, the journal of the American Academy of Sciences.

In this project, the CNIO team explored an approach that consists of inactivating two genes that are part of the KRAS signalling pathway: CDK4 and RAF1. "And this strategy has worked," says Monica Musteanu, one of the leading authors of the study. By working with mouse models for lung cancer caused by a combination of two mutations - activation of the KRAS oncogene and elimination of the tumour suppressor gene p53, two of the most frequently mutated genes in human cancer - they have managed to shrink 100% of the tumours, and a quarter of them have remitted completely. In addition, the researchers have confirmed in healthy mice that this therapeutic strategy does not compromise normal functioning of the body.

Even so, as is often found in clinical practice, a percentage of the tumours were able to survive in the absence of CDK4 and RAF1. However, the researchers were able to identify the molecular mechanisms that triggered this resistance and prevented total tumour remission: activation of the PI3K pathway, essential in cancer, and the silencing of several tumour suppressor genes by means of methylation. "Both mechanisms can be therapeutically neutralised: using PI3K inhibitors, on the one hand, and on the other, through the selective demethylation of tumour suppressor genes to reactivate their function", explains Laura de Esteban, the lead author of the research published by PNAS.

To carry out this study, the CNIO team used a mouse model that accurately reproduces the human disease, inducing aggressive lung tumours by activating the KRAS oncogene and deactivating the p53 tumour suppressor, a genetic combination responsible for a high percentage of human lung adenocarcinomas. Then, once the tumour has formed, genes are inactivated in the mouse systemically in the same way that a patient would receive treatment after diagnosis.

The findings shed light on the development of new treatments for tumours with KRAS mutations and indicate the importance of developing inhibitors specifically against RAF1, because the inhibitors developed so far have not made it past phase I on account of their high toxicity.

In addition, the authors also point out that another area of research to be pursued in the future would be the study of multiple resistance pathways that may arise following inactivation of therapeutic targets.

What if you could touch a loved one during a video call - particularly in today's social distancing era of COVID-19 - or pick up and handle a virtual tool in a video game?

Pending user tests and funding to commercialise the new technology, these ideas could become reality in a couple of years after UNSW Sydney engineers developed a new haptic device which recreates the sense of touch.

Haptic technology mimics the experience of touch by stimulating localised areas of the skin in ways that are similar to what is felt in the real world, through force, vibration or motion.

Dr Thanh Nho Do, Scientia Lecturer and UNSW Medical Robotics Lab director, is senior author of a study featuring the new device.

His research team featured lead author and PhD candidate Mai Thanh Thai, Phuoc Thien Phan, Trung Thien Hoang and collaborator Scientia Professor Nigel Lovell, Head of the Graduate School of Biomedical Engineering.

Dr Do said the sense of touch was something many people took for granted to perform everyday tasks.

"When we do things with our hands, such as holding a mobile phone or typing on a keyboard, all of these actions are impossible without haptics," he said.

"The human hand has a high density of tactile receptors and is both an interesting and challenging area to encode information through haptic stimulation, because we use our hands to perceive most objects every day.

"There are many situations where the sense of touch would be useful but is impossible: for example, in a telehealth consultation a doctor is unable to physically examine a patient. So, we aimed to solve this problem."

The UNSW study about the new haptic device was published in the Institute of Electrical and Electronics Engineers (IEEE) Access journal recently.

Dr Do said the researchers were so excited about their new haptic technology that they had applied to patent it.

"Our three-way directional skin stretch device (SSD), built into the fingertips of the wearable haptic glove we also created, is like wearing a second skin - it's soft, stretchable and mimics the sense of touch - and will enable new forms of haptic communication to enhance everyday activities," he said.

"What's also special about our new technology is that it's scalable and can be integrated into textiles for use in various potential applications such as telehealth, medical devices, surgical robots and training, augmented and virtual reality, teleoperation and industrial settings.

"The device aims to solve a common problem in emerging systems - such as assistive devices, remote surgery, self-driving cars and the guidance of human movements - where visual or auditory feedback can be slow, unintuitive and increase the cognitive load."

Why haptic technology needs to improve

The study's lead author Mai Thanh Thai said existing technology had great difficulty recreating the sense of touch with objects in virtual environments or located remotely.

"Visual or auditory cues are easy to replicate, but haptic cues are more challenging to reproduce. In a virtual environment, we can see objects but we are unable to feel them as if we were directly touching them," Mr Thai said.

"It is almost impossible to enable a user to feel something happening in a computer or smartphone using a haptic interface, such as commercially available smart glasses.

"Vibration is the most common haptic technology today and is built into many electronic devices, such as the Taptic Engine attached to the back of a trackpad in laptops, which simulates a button clicking.

"But haptic feedback with vibration becomes less sensitive when used continuously or when users are in motion, leading to desensitisation and impaired device functionality."

How the new haptic device works

Dr Do said the researchers' new technology overcame issues with existing haptic devices by introducing a novel method to recreate an effective haptic sensation via soft, miniature artificial "muscles".

"Our soft, wearable haptic glove enables people to feel virtual or remote objects in a more realistic and immersive way. The inbuilt soft artificial muscles generate sufficient normal and shear forces to the user's fingertips via a soft tactor, enabling them to effectively reproduce the sense of touch," he said.

"It works like this: imagine you are in Australia while your friend is in the United States. You wear a haptic glove with our integrated three-way directional SSDs in the fingertips and your friend also wears a glove with integrated 3D force sensors.

"If your friend picks up an object, it will physically press against your friend's fingers and their glove with 3D force sensors will measure these interactions.

"If these 3D force signals are sent to your haptic glove, then the integrated three-way directional SSDs will generate these exact 3D forces at your fingertips, enabling you to experience the same sense of touch as your friend."

Implications of the new technology

Dr Do said the ability to effectively reproduce the sense of touch via the new wearable haptic device would have a wide range of benefits; for example, during today's COVID-19 pandemic when people were relying on video calls to stay connected with loved ones.

"Unlike existing haptic devices, our technology is soft, lightweight, and thin and therefore, we hope users will be able to integrate it into what they're wearing to provide realistic haptic experiences in settings including rehabilitation, education, training and recreation," he said.

"Our technology could enable a user to feel objects inside a virtual world or at a distance; for example, a scientist could feel a virtual rock from another planet without leaving their lab, or a surgeon could feel a patient's organ tissues with surgical tools without directly touching them."

Dr Do estimated the new technology could become available in the next 18 months to three years - if plans to commercialise the device were realised.

"The next step is to conduct user evaluations to validate how effective our device is, because the main scope of our current research has been on the design, fabrication and characterisation of the new technology," he said.

"In addition, we plan to implement the device in various haptic applications such as haptic motion guidance, navigational assistance for older people and those with low vision, tactile textual language, and 3D force feedback display for use in surgical robots, prosthesis and virtual and augmented reality."

Arginine metabolism boosts to make a plant body complex, according to new research by a collaborative team from Exploratory Research Center on Life and Living Systems (ExCELLS), National Institute for Basic Biology (NIBB), RIKEN, Rikkyo University, Toyohashi University of Technology, Yamagata University, Chiba University, Hokkaido University, and University of Tokyo in Japan. The findings, now online in Cell Reports, might lead to a new understanding of amino acid metabolism with a specific role in plant morphogenesis.

In the ancestral lineage of land plants, the moss Physcomitrium patens has evolved to produce leafy shoots called gametophore. "Because metabolic reprogramming is necessary for this dramatic evolution in morphology to ensure the generation of sufficient biomass, we focused on gametophore formation as a model to uncover a mutual interaction between morphogenesis and metabolism" said Associate Professor Kensuke Kawade at ExCELLS/NIBB.

In the current study, they showed that arginine metabolism is a key for gametophore formation in Physcomitrium patens and identified its underlying core pathway mediated by transcriptional co-activators ANGUSTIFOLIA3/GRF-INTERACTING FACTOR1 (AN3/GIF1) family signaling. These findings have advanced our understanding of the mechanism, by which the shoot system was established via metabolic reprogramming during the evolution of plants. More generally, this study refines the emerging concept in biology that developmental and metabolic processes influence one another for chemical force that facilitates growth, morphogenesis, and maturation. "Future work to clarify what kind of metabolite is produced from arginine in gametophores promises to unravel the physiological base of this phenomenon" explained Kawade.

As California aims to provide 60% of its energy from renewable sources by 2030 and 100% by 2045, a study from California Polytechnic State University provides some good news. Offshore winds along the Central Coast increase at the same time that people start using more energy -- in the evening.

One of the challenges of moving toward fully renewable energy is matching production to demand. Though the state has high existing solar energy capacity and the potential for even more, the supply of solar power peaks in the middle of the day and ends when the sun goes down. Consumer demand, on the other hand, peaks in the evening when people return from work around or after sunset.

Because storage of solar energy on a large scale is not yet practical, other renewable sources are needed to meet the Golden State's environmental milestone of going fully renewable.

The Cal Poly research team found that offshore winds are strongest when demand is greatest, making it an ideal candidate to fill the gap left by solar and on-shore wind energy production. The team was led by research scientist Yi-Hui Wang and included biology professors Ben Ruttenberg and Crow White and physics Professor Ryan Walter.

"The alignment between potential offshore wind power production and demand highlights the important role that offshore wind energy could play in meeting California's ambitious renewable energy goals," Wang said.

Even more promising, offshore winds reach their peak during the hot summer months when state energy use is highest due to the use of air conditioning. Offshore wind energy offers several other advantages over land-based wind and solar energy, including stronger and more consistent winds and less impact on other land uses.

The greatest wind speeds, which would produce the most energy, are found farther from the coast. Most existing offshore wind farms are installed close to shore in shallow water less than 160 feet deep. However, several floating wind farms in deeper water farther from shore are now in operation in Europe, with more in the planning stages.

"Floating offshore wind farms are now a proven technology and game-changer in many respects," Walter said. "These floating platforms make offshore wind farms a new reality in many locations, with a single turbine having the potential to power more than 10,000 homes."

The Bureau of Ocean Energy Management, which funded the study, is considering the Central Coast as a location for California's first offshore wind farm and has proposed priority areas for leasing by energy companies. The Cal Poly study provides crucial information that, along with other studies on economic, cultural and environmental factors, will help guide the evaluation and planning of offshore wind energy.

"Looking at this wind data in relation to maps of fisheries, whale and seabird activity will help identify locations where offshore wind farms could add the most value and yet have the least impact on local economies and marine wildlife," White said.

The Cal Poly team is working on the next steps, which include estimating the total amount of electricity wind farms in the area could produce and how these wind farms might affect the broader economy of San Luis Obispo County.

"Ultimately, we hope this information and our ongoing work will inform the conversation, helping the policymakers and citizens of California decide if, how and where to prioritize renewable offshore wind energy," Ruttenberg said.

The particles that make up lithium-ion battery electrodes are microscopic but mighty: They determine how much charge the battery can store, how fast it charges and discharges and how it holds up over time - all crucial for high performance in an electric vehicle or electronic device.

Cracks and chemical reactions on a particle's surface can degrade performance, and the whole particle's ability to absorb and release lithium ions also changes over time. Scientists have studied both, but until now they had never looked at both the surface and the interior of an individual particle to see how what happens in one affects the other.

In a new study, a research team led by Yijin Liu at the Department of Energy's SLAC National Accelerator Laboratory did that. They stuck a single battery cathode particle, about the size of a red blood cell, on a needle tip and probed its surface and interior in 3D with two X-ray instruments. They discovered that cracking and chemical changes on the particle's surface varied a lot from place to place and corresponded with areas of microscopic cracking deep inside the particle that sapped its capacity for storing energy.

"Our results show that the surface and the interior of a particle talk to each other, basically," said SLAC lead scientist Yijin Liu, who led the study at the lab's Stanford Synchrotron Radiation Lightsource (SSRL). "Understanding this chemical conversation will help us engineer the whole particle so the battery can cycle faster, for instance."

The scientists describe their findings in Nature Communications today.

Damage both inside and out

A lithium-ion battery stores and releases energy by moving lithium ions through an electrolyte back and forth between two electrodes, the anode and the cathode. When you charge the battery, lithium ions rush into the anode for storage. When you use the battery, the ions leave the anode and flow into the cathode, where they generate a flow of electrical current.

Each electrode consists of many microscopic particles, and each particle contains even smaller grains. Their structure and chemistry are key to the battery's performance. As the battery charges and discharges, lithium ions seep in and out of the spaces between the particles' atoms, causing them to swell and shrink. Over time this can crack and break particles, reducing their ability to absorb and release ions. Particles also react with the surrounding electrolyte to form a surface layer that gets in the way of ions entering and leaving. As cracks develop, the electrolyte penetrates deeper to damage the interior.

This study focused on particles made from a nickel-rich layered oxide, which can theoretically store more charge than today's battery materials. It also contains less cobalt, making it cheaper and less ethically problematic, since some cobalt mining involves inhumane conditions, Liu said.

There's just one problem: The particles' capacity for storing charge quickly fades during multiple rounds of high-voltage charging ­- the type used to fast-charge electric vehicles.

"You have millions of particles in an electrode. Each one is like a rice ball with many grains," Liu said. "They're the building blocks of the battery, and each one is unique, just like every person has different characteristics."

Taming a next-gen material

Liu said scientists have been working on two basic approaches for minimizing damage and increasing the performance of particles: Putting a protective coating on the surface and packing the grains together in different ways to change the internal structure. "Either approach could be effective," Liu said, "but combining them would be even more effective, and that's why we have to address the bigger picture."

Shaofeng Li, a visiting graduate student at SSRL who will be joining SLAC as a postdoctoral researcher, led X-ray experiments that examined a single needle-mounted cathode particle from a charged battery with two instruments - one scanning the surface, the other probing the interior. Based on the results, theorists led by Kejie Zhao, an associate professor at Purdue University, developed a computer model showing how charging would have damaged the particle over a period of 12 minutes and how that damage pattern reflects interactions between the surface and interior.

"The picture we are getting is that there are variations everywhere in the particle," Liu said. "For instance, certain areas on the surface degrade more than others, and this affects how the interior responds, which in turn makes the surface degrade in a different manner."

Now, he said, the team plans to apply this technique to other electrode materials they have studied in the past, with particular attention to how charging speed affects damage patterns. "You want to be able to charge your electric car in 10 minutes rather than several hours," he said, "so this is an important direction for follow-up studies."

On Friday September 4, 2020 at about 6:44 PM PDT the Creek Fire began in the Big Creek drainage area between Shaver Lake, Big Creek and Huntington Lake, Calif. NASA's Suomi NPP satellite captured these images of the fire on Sep. 05 through Sep. 07, 2020. From the series of images the spread of the fire can be seen in the outward movement of the red hot spots, although the huge cloud on the 6th obscures all readings due to its size.

The huge, dense cloud created on Sep. 05 and seen in the Suomi NPP image was a pyrocumulonimbus cloud (pyroCb) and the resulting smoke plume that grew upward was spotted and confirmed on Sep. 06, 2020. A pyrocumulonimbus cloud is also called a cumulonimbus flammagenitus. The origins of the latter word are from the Latin meaning “flame” and “created from.” This perfectly describes a cloud that is caused by a natural source of heat such as a wildfire or volcano. Rising warm air from the fire can carry water vapor up into the atmosphere causing clouds. Any type of convective cloud can be created. In this case, the cumulonimbus, or thunderhead cloud, was created. Precipitation and lightning can also occur with these types of clouds creating a risk that the fire will expand due to increased wind from precipitation downdraft or by creating new fires due to lightning strikes. These are all things that fire managers must keep in mind while continuing to try to fight the fire.

“The pyrocumulonimbus cloud created aerosol index values indicate that this is one of the largest (if not the largest) pyroCb events seen in the United States,” according to Dr. Colin Seftor, Atmospheric Scientist at Goddard Space Flight Center in Greenbelt, Md.

This fast-moving fire is burning in both the Madera and Fresno districts of the Sierra National Forest. The fire began near the communities of Big Creek and Huntington Lake and moved swiftly prompting evacuations. Timber in the area has approximately 80-90 percent tree mortality from the bark beetle providing ample fuel for the fire’s spread.

Inciweb reports that the fire has grown to 135,523 acres as of Sep. 08, 2020. The cause of the fire is still under investigation. Weather concerns continue to plague firefighters as hot and very dry conditions remained over the region through Labor Day with relative humidity very low. Forecasts expect terrain driven winds with overnight temperatures between 70-75 degrees Fahrenheit and daytime temperatures between 90-95 degrees Fahrenheit.

WASHINGTON, September 8, 2020 -- N95 masks are a critical part of the personal protective equipment used by front-line health care workers. These masks achieve 95% efficiency at filtering out tiny 0.3-micron particles, while maintaining reasonable breathability, thanks to a layer of fine melt-blown polypropylene fibers incorporating electrical charges to attract particles.

Extended usage and decontamination provoked by severe supply shortages around the globe during the COVID-19 pandemic can easily remove the charges and degrade filtration efficiency.

In the journal Physics of Fluids, from AIP Publishing, researchers from India's Tata Institute of Fundamental Research and Israel's Technion-IIT share a method to restore the filtration efficiency of N95 masks to out-of-box levels -- as long as the mask is not structurally compromised.

"Today, N95 masks are being worn by health care workers for extended periods," said co-author Shankar Ghosh. "This gives rise to very humid conditions, and humidity is detrimental to electrostatics."

During use, all electrostatics-based masks slowly lose their efficiency due to humidity.

"It's much worse in a place like Mumbai during the Indian monsoon, where ambient humidity levels can reach more than 90%," Ghosh said.

The group's work exploits that, under high electric fields, the polypropylene conductivity is high, which makes introducing excess charges into the material possible by connecting it to a battery. When the charge source is switched off, the applied electrical field becomes zero, and the conductivity of the polypropylene drops effectively to zero. As a result, the added charge carriers immobilize, and the material remains charged.

The researchers discovered they could toss an N95 into a standard washing machine to clean it, which significantly reduces its filtration efficiency. They could then recharge it by sandwiching it between two electrodes at high voltage to recover its 95% efficiency.

"We've also shown a proof-of-concept construction of a battery-operated smart mask, where the lost charge gets replenished periodically by plugging the mask into a charging station -- akin to how you would charge your smartphone," Ghosh said.

The group believes its method to keep masks charged will lead to highly energy-efficient smart masks.

"Currents are in microamps, and the power requirement is extremely low, on the order of a milliwatt, so a compact and practical solution may soon be feasible," said Ghosh.

Beyond this, their method will be useful for a variety of air filtration applications, such as HVAC or industrial filters.

Restoring normal patterns of rhythmic neural activity through non-invasive electrical stimulation of the brain alleviates sound-processing deficits and improves reading accuracy in adults with dyslexia, according to a study published September 8, 2020 in the open-access journal PLOS Biology by Silvia Marchesotti and Anne-Lise Giraud of the University of Geneva, and colleagues.

Dyslexia is a frequent disorder of reading acquisition that affects up to 10% of the population, and is characterized by lifelong difficulties with written material. Although several possible causes have been proposed for dyslexia, the predominant one is a phonological deficit, i.e., a difficulty in processing language sounds. The phonological deficit in dyslexia is associated with changes in rhythmic or repetitive patterns of neural activity, specifically the so-called "low-gamma" (30-Hz) oscillations, in a sound-processing region of the brain called left auditory cortex. But a causal relationship between these oscillations and the ability to process phonemes had not been established in previous studies.

To address this question, the researchers applied transcranial alternating current stimulation (tACS) over left auditory cortex in 15 adults with dyslexia and 15 fluent readers for a period of 20 minutes. This intervention immediately improved phonological processing and reading accuracy in the dyslexia group, specifically when 30 Hz (but not 60 Hz) stimulation was used. Interestingly, the beneficial effect on phonological processing was most pronounced in those individuals who had poor reading skills, whereas a slightly disruptive effect was observed in very good readers.

According to the authors, the results demonstrate for the first time the causal role of low-gamma oscillatory activity in phonemic processing. The findings may pave the way to non-invasive therapeutic interventions aimed at normalizing oscillatory function in auditory cortex and improving phonological processing in individuals with dyslexia.

Dr. Marchesotti adds "The next steps for us are to investigate whether normalizing oscillatory function in very young children could have a long-lasting effect on the organization of the reading system, but also to explore even less invasive means of correcting oscillatory activity for instance using neurofeedback training".

What The Study Did: Survey data were used to assess changes in the use of electronic cigarettes among U.S. adults from 2016 to 2018.

Authors: Michael J. Blaha, M.D., M.P.H., of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, 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/jamainternmed.2020.2817)

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

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JAMA Internal Medicine

The use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and diclofenac, is not associated with any adverse effects in people who have tested positive for COVID-19, according to a new study published September 8 in PLOS Medicine by Anton Pottegård of the University of Southern Denmark and colleagues from Aarhus University Hospital and the Danish Medicines Agency.

During the early phases of the COVID-19 pandemic, concerns were raised that the use of the painkiller ibuprofen may lead to a more severe course of coronavirus disease. As use of ibuprofen and other NSAIDs is widespread, data on their safety is urgently needed to guide clinicians and patients. In the new study, researchers obtained data on all 9,326 Danish residents who tested positive for the SARS-CoV-2 virus between February 27, 2020 and April 29, 2020. Data were available on NSAID use, 30-day mortality, hospitalization, ICU admission, mechanical ventilation, and acute renal replacement therapy. 248 people (2.7%) had filled a prescription for NSAIDs within 30 days of their positive virus test.

The researchers found no association between any of the outcomes and NSAID use. Among NSAID users in a matched cohort who tested positive for the coronavirus, 6.3% (95% Confidence Interval [CI] 3.1-9.4) died, 24.5% (95% CI 18.6-30.4) were hospitalized and 4.9% (95% CI 2.1-7.8) were admitted to ICU. Of those who tested positive for the coronavirus but were not treated with NSAIDs, 6.1% (95% CI 4.4-7.8) died, 21.2% (95% CI 18.1-24.3) were hospitalized, and 4.7% (95% CI 3.2-6.2) were admitted to ICU. None of these differences between groups were statistically significant (mortality Risk Ratio [RR] 1.02, 95%CI 0.57-1.82, p=0.95; hospitalization RR 1.16, 95%CI 0.87-1.53, p=0.31; ICU admission RR 1.04, 95%CI 0.54-2.02, p = 0.90).

"Considering the available evidence, there is no reason to withdraw well-indicated use of NSAIDs during the SARS-CoV-2 pandemic," the authors say. "However, the well-established adverse effects of NSAIDs, particularly their renal, gastrointestinal, and cardiovascular effects, should always be considered, and NSAIDs should be used in the lowest possible dose for the shortest possible duration for all patients."