Culture

Until now, scientists believed the male fin whale sings just one song pattern, which is unique to the males in his particular group -- but new research has blown this theory out of the water. The study, published in Frontiers in Marine Science, suggests that these endangered deep-sea giants actually sing multiple different songs, which may spread to different parts of the ocean through migrating individuals. Understanding the complexity of fin whale song provides new insights into how their populations move and change over time, helping efforts to better protect and manage the world's second largest mammal.

"There is still a lot of uncertainty around the fin whale population size and structure in the North Pacific, and so learning about the song could help us understand population dynamics in this region much better", says Dr Tyler Helble of the Naval Information Warfare Center Pacific, United States. "Male fin whales in the Pacific sing just two very low notes, which are produced in different rhythms to create song. Previously, some marine mammal scientists thought that fin whales each sang a single pattern of notes, which was found only within their specific group and region. Our research indicates that fin whale song is more complex than this".

Using hydrophones (underwater microphones), the team of researchers recorded the songs and locations of 115 whale encounters near Kauai, Hawaii over six years. Dr Regina Guazzo, also of the Naval Information Warfare Center Pacific, explains, "The sound is recorded on multiple hydrophones, allowing us to triangulate on the signal and formulate a position for the animal. By showing that different song patterns were coming from the same location, we demonstrated that these were likely made by the same individual".

Five main song patterns were recorded. Some were unique to this area, but some were similar to song patterns recorded several years before in populations off the north-west coast of the US. "When a new whale song is recorded in a region, researchers often read it as a signal that a new group or individual has arrived from a different part of the world", reveals Guazzo. "However, this study suggests that these new song patterns may have been picked up by a local whale on his migratory travels, in a process of cultural transmission between groups from different regions".

To confirm whether these whales recorded in Hawaiian waters are from a single population or multiple converging populations, scientists should use additional methods of monitoring the whales. "Visual identification, genetic analyses, or long-duration tags could be used to determine where these whales go when they are not singing off Kauai", Helble recommends.

Our Galaxy may be teeming with rogue planets, gravitationally unbound to any star. An international team of scientists, led by Polish astronomers, has announced the discovery of the smallest Earth-sized free-floating planet found to date.

Over four thousand extrasolar planets have been discovered to date. Although many of the known exoplanets do not resemble those in our solar system, they have one thing in common - they all orbit a star. However, theories of planet formation and evolution predict the existence of free-floating (rogue) planets, gravitationally unattached to any star. Indeed, a few years ago Polish astronomers from the OGLE team from the Astronomical Observatory of the University of Warsaw provided the first evidence for the existence of such planets in the Milky Way. Writing in Astrophysical Journal Letters, OGLE astronomers announced the discovery of the smallest rogue planet found to date.

Exoplanets can be only rarely directly observed. Usually, astronomers find planets using observations of the light from the planet's host star. For example, if a planet crosses in front of its parent star's disk, then the observed brightness of the star periodically drops by a small amount causing so called transits. Astronomers can also measure the motion of the star caused by the planet.

Free-floating planets emit virtually no radiation and - by definition - they do not orbit any host star, so they cannot be discovered using traditional methods of astrophysical detection. Nevertheless, rogue planets can be spotted using an astronomical phenomenon called gravitational microlensing. Microlensing results from Einstein's theory of general relativity - a massive object (the lens) may bend the light of a bright background object (the source). The lens' gravity acts as a huge magnifying glass which bends and magnifies the light of distant stars.

'If a massive object (a star or a planet) passes between an Earth-based observer and a distant source star, its gravity may deflect and focus light from the source. The observer will measure a short brightening of the source star' - explains dr Przemek Mroz, a postdoctoral scholar at the California Institute of Technology and a lead author of the study. 'Chances of observing microlensing are extremely slim because three objects - source, lens, and observer - must be nearly perfectly aligned. If we observed only one source star, we would have to wait almost a million year to see the source being microlensed' - he adds.

This is why modern surveys hunting for gravitational microlensing events are monitoring hundreds of millions of stars in the Milky Way center, where the chances of microlensing are highest. The OGLE survey - led by Warsaw University astronomers - carries out one of such experiments. OGLE is one of the largest and longest sky surveys, it started operations over 28 years ago. Currently, OGLE astronomers are using a 1.3-meter Warsaw Telescope located at Las Campanas Observatory, Chile. Each clear night, they point their telescope to the central regions of the Galaxy and observe hundreds of millions of stars, searching for those which change their brightness.

Gravitational microlensing does not depend on the lens' brightness, so it enables the study of faint or dark objects such as planets. Duration of microlensing events depends on the mass of the lensing object - the less massive the lens, the shorter the microlensing event. Most of the observed events, which typically last several days, are caused by stars. Microlensing events attributed to free-floating planets have timescales of barely a few hours. By measuring the duration of a microlensing event (and shape of its light curve) we can estimate the mass of the lensing object.

The scientists announced the discovery of the shortest-timescale microlensing event ever found, called OGLE-2016-BLG-1928, which has the timescale of just 42 minutes. 'When we first spotted this event, it was clear that it must have been caused by an extremely tiny object' - says dr Radoslaw Poleski from the Astronomical Observatory of the University of Warsaw, a co-author of the study. Indeed, models of the event indicate that the lens must have been less massive than Earth, it was probably a Mars-mass object. Moreover, the lens is likely a rogue planet. 'If the lens were orbiting a star, we would detect its presence in the light curve of the event' - adds dr Poleski. 'We can rule out the planet having a star within about 8 astronomical units (the astronomical unit is the distance between the Earth and the Sun)'.

OGLE astronomers provided the first evidence for a large population of rogue planets in the Milky Way a few years ago. However, the newly-detected planet is the smallest rogue world ever found. 'Our discovery demonstrates that low-mass free-floating planets can be detected and characterized using ground-based telescopes' - says Prof. Andrzej Udalski, the PI of the OGLE project.

Astronomers suspect that free-floating planets actually formed in protoplanetary disks around stars (as "ordinary" planets) and they have been ejected from their parent planetary systems after gravitational interactions with other bodies, for example, with other planets in the system. Theories of planet formation predict that the ejected planets should be typically smaller than Earth. Thus studying free-floating planets enables us to understand the turbulent past of young planetary systems, such as our solar system.

The search for free-floating planets is one of the science drivers of the Nancy Grace Roman Space Telescope, which is currently being constructed by NASA. The observatory is scheduled to start operations in the mid-2020s.

Because of the brevity of the event, additional observations collected by the Korea Microlensing Telescope Network (KMTNet) were needed to characterize the event. KMTNet operates a network of three telescopes - in Chile, Australia, and South Africa.

Embargoed until 4 a.m. CT/5 a.m. ET Thursday, Oct. 29, 2020

DALLAS, Oct. 29, 2020 -- Computed tomography angiogram (CTA) scans may offer fast and early detection of COVID-19 in acute ischemic stroke (AIS) patients, according to new research published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

The study, titled "The Utility of Apical Lung Assessment on CTA as a COVID-19 Screen in Acute Stroke," found that in addition to patient-reported COVID-19 symptoms, routine or standard care CTA scans were an accurate screening method for faster detection of COVID-19 since they include imaging of the upper portion of the lungs.

Researchers conducted a retrospective analysis of patients treated for AIS at three hospitals in the Bronx from March 1 to April 30, 2020, the height of the COVID-19 surge in New York City. A total of 57 patients who received a CTA scan within 24 hours of hospitalization for AIS were included in the study. Researchers used CTA scans to evaluate the lung apices (the upper area of the lungs) for signs of COVID-19 pneumonia. They then analyzed the accuracy of using CTA scans for COVID-19 diagnosis alone as well as in combination with patient-reported symptoms, such as cough and/or shortness of breath.

"Every second counts when treating a person experiencing a stroke," said Charles Esenwa, M.D., M.S., lead author of the study, an assistant professor and a stroke neurologist at the Albert Einstein College of Medicine in the Bronx, New York City. "Conducting a CTA is already part of the stroke management process, and these scans provide an opportunity to assess the lungs for signs suggestive of COVID-19. Our team sought to determine if this already necessary scan could have a secondary use of identifying potential COVID-19 patients more quickly than a standard nasal swab COVID-19 test."

The study defined confirmed COVID-19 positive cases from nasal swab PCR-test results, which are the standard required by the U.S. Food and Drug Administration (FDA) for COVID-19 testing, and it can take several days for results. Of the 57 study participants, three were diagnosed with COVID-19 prior to the date when a nasal swab COVID-19 test was administered.

Researchers found that:

CTA scans in combination with patient feedback to COVID-19 symptom questions were able to diagnose COVID-19 with 83% accuracy before results were received from traditional nasal swab tests in AIS patients.

30 of the 57 patients included in the study were COVID-19 positive.

20 of the COVID-19 positive patients and 2 of the COVID-19 negative patients had findings highly suspicious for COVID-19 pneumonia on their CTA lung scans.

"In combination with symptoms, CTA scan analysis is relatively accurate in diagnosing COVID-19, even compared to the nasal swab test. Since this analysis is much faster and at no extra cost, we hope it could be incorporated as a rapid diagnosis tool for patients with acute stroke," Esenwa said. "In addition, accurately diagnosing COVID-19 within hours, rather than the sometimes days wait-time to receive the results from nasal swab tests could help protect both patients and medical professionals."

While these findings are promising, the study had some limitations. As there is no universally defined standard for diagnosing COVID-19, the study confirmed infection positivity through the nasal swab COVID-19 test (RT-PCR). Patients who did not have the RT-PCR test performed were excluded from the study. Additionally, diagnostic accuracy may have been higher because the study participants were in an area with higher geographic incidence of COVID-19, which may not be the case in an area with a lower rate of COVID-19 infections.

"Screening questionnaires alone are often inaccurate because of the absence of symptoms or the patient is unable to speak because they are suffering from an acute stroke," Esenwa said. "Early diagnosis via CT scans has helped our center protect other patients and staff through early isolation, and it has also allowed us to start early supportive care for those suspected of having stroke who are COVID-19 positive," Esenwa added.

Embargoed until 4 a.m. CT / 5 a.m. ET Thursday, Oct. 29, 2020

DALLAS, Oct. 29, 2020 -- Patients in cardiac intensive care units (CICUs) could benefit from the CICU health care team using a daily checklist to prevent infections and other common complications, according to a new American Heart Association Scientific Statement, "Prevention of Complications in the Cardiac Intensive Care Unit," published today in the Association's flagship journal Circulation. This Statement reviews evidence from general medical and surgical ICUs to identify opportunities to apply them to the care of critically ill heart patients and improve CICU outcomes.

"Patients admitted to cardiac intensive care often have serious, non-cardiovascular conditions, such as lung, kidney or liver disease, increasing their risk for complications," said Christopher B. Fordyce, M.D., M.H.S., M.Sc., chair of the writing group for the Scientific Statement, an assistant professor in the division of cardiology at the University of British Columbia and director of the cardiac intensive care unit at Vancouver General Hospital in Vancouver, Canada. "Cardiac patients require increasingly complex care, and it is important for cardiovascular health care professionals to be experts in treating both cardiovascular and non-cardiovascular conditions, and to understand ways to prevent complications in the CICU."

Coordinated care for CICU patients includes a multi-disciplinary team of health care professionals across various specialties. The use of a daily, bedside checklist during patient rounds is encouraged to provide standardized approaches to preventative care.

The checklist includes strategies to optimize care and prevent complications related to:

infections;

pain management;

ventilator complications;
l
ack of mobilization (early mobilization is recommended for the majority of patients);

gastrointestinal complications and proper nutrition;

medication use and errors;

device use; and

inclusion of the appropriate specialists for multidisciplinary care.

Hand hygiene is a mainstay of infection prevention, and CICUs should monitor for the presence of pathogens. Other preventative strategies include proper cleaning and stringent disinfection of equipment and the environment.

Monitoring and support devices used in the CICU are also a source of potential infection. These include catheters, mechanical circulatory support and ventilators. The longer that these devices are used, the higher the risk of infection for these patients. Invasive devices should be used for as short a time as possible to reduce the risk of associated infections. Special attention to intravenous access sites, catheter placement, and monitoring for infection can reduce device-related infections and complications.

In the case of mechanical ventilation, required by more than 25% of CICU patients, noninvasive, positive pressure ventilation (e.g. ventilation through a nasal mask, face mask or nasal plugs) should be considered when appropriate. Daily, spontaneous breathing trials are important to test the patient's ability to breathe with minimal or no ventilator support. This allows early identification of patients who are ready to be taken off the ventilator.

Fordyce added, "A central tenet to preventing CICU complications is to anticipate the need for invasive procedures and devices to avoid emergency procedures when possible. Rates of infections and other complications are higher in urgent procedures."

As many as one-third of critically ill cardiac patients experience ICU-acquired muscle weakness, which can be reduced with early, progressive mobilization. Mobilization protocols can help improve physical functioning, decrease time on a ventilator and shorten a hospital stay.

Routine adherence to the checklist can also help minimize gastrointestinal complications, feeding complications, medication errors and adverse drug events that are prevalent in ICU settings. Malnutrition, hyperglycemia and stress ulcers - common in the CICU - are associated with adverse outcomes, including increased length of hospital stay, readmission, infection and in-hospital mortality. In addition, using the lowest effective dose of medicines minimizes the potential adverse effects of the high-risk cardiovascular medications that are frequently prescribed in the CICU.

"Cardiac critical care is a growing field, and there is an urgent need to implement strategies to optimize care among patients admitted to the CICU," said Fordyce. "These strategies can help CICU professionals anticipate and prevent complications in this unique patient population, and we encourage critical care teams to reflect upon their current practices and consider implementing these strategies where any gaps exist."

People with dementia are more likely to go missing in areas where road networks are dense, complicated and disordered - according to new research from the University of East Anglia.

Researchers studied hundreds of 'missing person' police reports for people with dementia and compared each case to the surrounding road network.

They hope their findings could help inform future safeguarding guidelines.

Prof Michael Hornberger, from UEA's Norwich Medical School, said: "People with dementia getting lost or going missing is a problem worldwide. Around 70 percent of people with dementia may go missing at least once, with some at risk of going missing multiple times.

"Around 40,000 people with dementia go missing for the first time every year in the UK - and this figure is likely to grow with the projected increase in the dementia population.

"Unfortunately, the first event when people with dementia go missing comes completely out of the blue, when doing such routine activities as going for a walk with the dog or getting the newspaper from the local shop.

"When a person with dementia goes missing, it can have life-threatening consequences. But very little is known about what actually causes people with dementia to go missing."

The research team set out to find out whether the design of road networks could be linked to people going missing.

They looked at 210 police records of people with dementia going missing in Norfolk over three years - and compared each case to the nearby road network.

PhD student Vaisakh Puthusseryppady, also from UEA's Norwich Medical School, said: "We know that people with dementia have difficulty navigating so we wanted to see whether there was a relationship between people going missing and the outdoor environment they went missing from.

"We were particularly interested in road layouts as they determine significantly our navigation, in particular the complexity of the road network, the complexity of road intersections, and how ordered the overall layout of the road network is.

"We found that the higher the density of road intersections, the more complicated the road intersections are, and the less ordered or less grid-like the overall road network layout, the greater the risk for people with dementia to get lost.

"We think this is because each road intersection represents a point at which a person needs to make a critical navigation decision. The more intersections there are, the more complex these intersections are, and the more disorganised the overall road network is - the bigger the problem for people with dementia.

"This is because these factors can make it more likely for people with dementia to make an error and make a wrong turn, causing them to get lost and go missing.

"We hope that by identifying these environmental risk factors, our findings can potentially help identify or predict areas where people with dementia may be at higher risk of going missing from - and contribute to the development of safeguarding guidelines to prevent them from going missing in future.

"It will also inform future recommendations for dementia-friendly urban design," he added.

BOSTON - Some patients with COVID-19 have persistent skin-related symptoms long after their initial infection has cleared, according to a new analysis. The findings, presented at the 29th Congress of the European Academy of Dermatology and Venereology by investigators at Massachusetts General Hospital (MGH), point to another burden experienced by so-called "long haulers" who get better but don't seem to fully recover from COVID-19.

For the analysis, researchers established an international registry for COVID-19 skin manifestations in April 2020, in collaboration with the International League of Dermatological Societies and the American Academy of Dermatology. Clinicians were contacted in June and August to update COVID-19 laboratory test results and the duration of patients' COVID-19 skin symptoms. The team defined long haulers as anyone with skin symptoms of COVID-19 that persisted for at least 60 days.

The team evaluated almost 1,000 cases of patients with skin manifestations of COVID-19. Among 224 total suspected cases and 90 laboratory-confirmed cases of COVID-19 from 39 countries with information on symptom duration, the median duration of symptoms was 12 days. Rash-like morbilliform and urticarial eruptions lasted a median of seven days and four days, respectively, for patients with lab-confirmed COVID-19, with a maximum duration of 28 days. Papulosquamous eruptions, which are scaly papules and plaques, lasted a median of 20 days in lab-confirmed cases, with one confirmed long hauler eruption lasting 70 days. Pernio/chilblains, or redness and swelling of the feet and hands, commonly known as "COVID toes," lasted a median of 15 days in patients with suspected COVID-19 and 10 days in lab-confirmed cases. Notably, six patients with pernio/chilblains were long haulers with toe symptoms lasting at least 60 days, with two lab-confirmed patients with COVID toes lasting longer than 130 days.

"Our findings reveal a previously unreported subset of patients with long-standing skin symptoms from COVID-19, in particular those with COVID toes. This data adds to our knowledge about the long-term effects of COVID-19 in different organ systems. The skin is potentially a visible window into inflammation that could be going on in the body," said senior author Esther E. Freeman, MD, PhD, director of Global Health Dermatology at MGH. "We encourage clinicians taking care of patients with COVID-19 to ask about and evaluate any skin symptoms. Health care providers can enter information into our registry to further our understanding of the dermatologic effects of COVID-19."

LUGANO, 29 October, 2020 - Some COVID-19 patients experience long-lasting skin symptoms that vary according to type of COVID-19 skin rash, a late-breaking abstract will reveal today at the 29th EADV Congress, EADV Virtual.

Analysis of the largest registry of COVID-19 patients with dermatological symptoms has revealed a subset of patients, called 'long-haulers' or 'long COVID', who experience prolonged symptoms (lasting >60 days) on their skin (1).

Data from 990 cases from 39 countries input into the registry, a collaboration between the International League of Dermatological Societies and the American Academy of Dermatology, show an average duration of 12 days for all dermatological symptoms, with some lasting as long as >150 days (1).

Patients presented with a broad spectrum of dermatologic manifestations lasting for different lengths of time, including hives (urticaria), lasting for median 5 days, and pernio/chilblains (''COVID toes''), lasting 15 days but sometimes as long as 130-150 days, and papulosquamous eruptions, which are scaly papules and plaques, persisting for 20 days (1).

The identification of this unique subset of "COVID toes" patients with symptoms lasting long after the acute phase of COVID-19 may have implications for understanding the prolonged inflammatory response in some patients after infection.

Skin symptoms vary by COVID-19 severity. Some symptoms, such as retiform purpura, are associated with severe COVID-19, since 100% of these patients were hospitalised, while COVID toes travel with relatively mild disease, with only 16% hospitalised. Furthermore, although COVID toes often appear 1-4 weeks after initial infection, 15% were found to still be PCR positive for COVID-19.

Dr Esther Freeman, Principal Investigator of the International COVID-19 Dermatology Registry and Director, Global Health Dermatology, Massachusetts General Hospital says: "Our registry identified a previously unreported subset of patients with longstanding skin symptoms from COVID-19. We highlight patients with pernio/chilblains, also known as COVID toes, who have had symptoms for as long as 150 days. This data adds to our knowledge about how COVID-19 can affect multiple different organ systems, even after patients have recovered from their acute infection. The skin can provide a visual window into inflammation that may be going on elsewhere in the body."

At EADV 2020, COVID-19 is a key talking point and something that the world is learning more about every day. Dermatological symptoms of COVID-19 and the impact of COVID-19 on dermatology practitioners and patients is just beginning to be understood and is being explored at the Congress.

An EADV survey of 490 dermatologists has revealed that 35% saw patients presenting skin-signs of COVID-19 and that 4% of the dermatologists themselves tested positive for COVID-19 (2). These findings highlight the need for further research into the dermatological symptoms of COVID-19 and the interaction between COVID and underlying skin conditions. These data also stress the importance of using protection means such as facemasks during dermatological consultations.

Finally, Dr Asja Prohic, Medical Faculty University of Sarajevo, is presenting growing research investigating the possible association between male pattern baldness (androgenetic alopecia) and men hospitalised with COVID-19 (3).

A new analysis of federal surveys on health insurance coverage concludes that the number of uninsured Americans increased by about 2.3 million between 2016 and 2019. The analysis by researchers at Harvard Medical School and the City University of New York's Hunter College, published today in Health Affairs blog, concludes that the contraction of coverage under President Trump caused at least 3,399, and perhaps as many as 25,180, excess deaths even before the onset of the COVID-19 pandemic. 

The researchers examined results of three benchmark federal surveys that collect data on health insurance coverage -- the American Community Survey (ACS), the Current Population Survey, and the National Health Interview Survey.  All three surveys indicate that uninsurance has risen under President Trump, but the researchers cite the ACS results as the most reliable. (Changes in methodology and data collection processes since 2016 hinder interpretation of year-to-year changes in the other two federal surveys). Using the ACS-based data indicating that the number of uninsured Americans has risen by 2.3 million, the researchers calculated the number of resulting excess deaths by applying estimates of the mortal consequences of being uninsured from previous rigorous, peer-reviewed studies.

"I see that my uninsured patients often can't get the care they need, and research proves that many who lack coverage die as a result," noted study author Dr. Steffie Woolhandler, a Distinguished Professor of Urban Public Health at Hunter College and Lecturer at Harvard Medical School. "President Trump has tried at every turn to undermine the ACA and chip away at coverage. That's costing thousands of lives," she added.

"Our analysis warns that much worse is ahead if the Supreme Court overturns the ACA, as Trump's Justice Department is advocating," stated lead author Dr. Adam Gaffney, a pulmonary and critical care physician at Harvard Medical School and the Cambridge Health Alliance. "Gutting the ACA  would throw another 19.9 million Americans off of insurance, and cause up to 68,345 extra deaths each year. We need to expand insurance, not shrink it. With 30 million uninsured today, we could save thousands of lives by achieving universal coverage," he added.

ARLINGTON, VA: October 29, 2020 - As COVID-19 infections escalate, Americans across the political divide demonstrate pronounced support for public health. According to a recently-commissioned survey by Research!America on behalf of a working group formed to address our nation's commitment to science, a strong bipartisan majority of Americans place an urgent or high priority on improving our nation's public health system (78%) and, further, are willing to pay $1 more per week in taxes to support an emergency public health fund to address health threats like a pandemic (71%). Additionally, 82% of Americans agree it is important for elected leaders to listen to public health officials.

Nearly three-quarters (73%) of Americans, across the partisan divide, say the COVID-19 pandemic has revealed that major changes are needed in our public health system, including more funding. COVID-19 has also shined a bright light on the problem of health disparities in the United States, with a strong bipartisan majority of Americans saying that eliminating health disparities is an urgent or high priority (72%). In addition, 82% support research to help tackle this challenge.

A number of recent surveys report that fewer than half of Americans would agree to a COVID-19 vaccination. This newly commissioned survey reveals that the likelihood of getting the vaccine is greatly affected by who recommends it. Almost 43% of respondents said they would be very likely to get the vaccine if recommended by "your doctor"; another 43% if it was approved by the U.S. Food and Drug Administration; and 39% if recommended by the Centers for Disease Control and Prevention. By contrast, only 23% would be very likely to get the vaccine if it is recommended by a family member and even fewer, 19%, if recommended by a celebrity they trusted.

"As COVID-19 continues to wreak havoc on our communities, it's important for policymakers to know that a clear bipartisan majority of Americans place a high priority on the urgency of improving our nation's public health system," said Mary Woolley, Research!America's President and CEO and a co-chair of the working group.

"This survey tells us that, overwhelmingly, Americans recognize the crucial importance of public health. In order to meet our future challenges as a nation, we must commit to greatly increasing investment in this area, including investment in the science that drives preparedness, prevention, and response," said Keith Yamamoto, PhD, Vice Chancellor for Science Policy and Strategy at the University of California, San Francisco, a co-chair of the working group.

"Policymakers should take note of the public's sense of urgency and act quickly to assure that challenges to our health and quality of life - indeed, our safety and security as a nation -- are met and overcome," said Sudip Parikh, PhD, CEO of the American Association for the Advancement of Science, and also a working group co-chair.

Other results show:

Americans remain concerned about ongoing issues affecting the public health of the nation: 79% say ensuring a safe drinking water supply is an urgent or high priority, and 72% indicate that addressing drug and opioid abuse is an urgent or high priority.

While a strong majority of all Americans are concerned about the future impact of climate change on their health (70%), people of color report even greater concern: African Americans 74%, Hispanics 83%, and Asian Americans 82%.

Concern is also significant regarding the high number of U.S. hospitalizations from preventable causes and avoidable deaths, compared to peer nations; nearly 7 in 10 Americans say they are very or somewhat concerned about this.

COVID-19 (coronavirus) patients who were administered a novel antibody had fewer symptoms and were less likely to require hospitalization or emergency medical care than those who did not receive the antibody, according to a new study published in the The New England Journal of Medicine.

The multisite, Phase II clinical trial tested three different doses of LY-CoV555, a monoclonal antibody derived from the blood of a recovered COVID-19 patient. While the trial is ongoing, results from the interim analysis indicated a reduced viral load in outpatients with mild to moderate cases of COVID-19 at the 2,800-milligram dosage level, along with reduced rates of hospitalization and emergency medical care among patients at all dosage levels.

The study's co-first author, Peter Chen, MD, professor of Medicine and director of the Division of Pulmonary and Critical Care Medicine at Cedars-Sinai, said the results are promising.

"For me, the most significant finding was the reduction in hospitalizations," Chen said. "Monoclonal antibodies like this have the potential to reduce the severity of COVID-19 for many patients, allowing more people to recover at home."

Monoclonal antibodies work by attaching themselves to a virus and preventing it from replicating. LY-CoV555 binds to a particular protein, called a spike protein, which SARS-CoV-2, the virus that causes COVID-19, needs in order to enter human cells and replicate. By preventing the virus from replicating, the antibody slows down the viral process, allowing the patient's own immune system time to kick into gear.

"What we're doing is preventing the virus from causing too much damage early on in the process," Chen said. "We're buying the patients time, so that their bodies can start developing their own immunity to fight the virus."

Patients in the randomized, double-blind study were given intravenous doses of either 700, 2,800 or 7,000 milligrams of the antibody, or a placebo. Investigators used a nasopharyngeal swab to test patients' viral load before administering the antibody and again at several points after administering the drug. Patients in the trial were also given a questionnaire about their subsequent symptoms and treatment.

Approximately 300 patients received the treatment (100 patients per dosage level) and approximately 150 patients received the placebo. Of the three dosage levels, the 2,800-milligram dosage was shown to be effective in reducing viral load. By day 11, viral load was substantially diminished for most patients, including those in the placebo arm. Further studies will be needed to validate these results, according to the investigators.

"The publication of these data in a peer-reviewed journal adds to the growing body of evidence for the potential utility for neutralizing antibodies as therapeutics for people recently diagnosed with mild to moderate COVID-19, particularly high-risk patients," said Ajay Nirula, MD, PhD, vice president of immunology at Eli Lilly and Company and co-first author of the study. "These data show LY-CoV555 may be effective in treating COVID-19 by reducing viral load, symptoms and the risk of hospitalization in outpatients."

At day 29, hospitalization rates were only 1.6% in the antibody-treated group, compared with 6.3% in the group that received the placebo.

Importantly, the reduction in hospitalizations was seen across all demographic groups, including those in high-risk categories: adults older than 65 and those with a high body mass index (greater than 35). For high-risk patients, hospitalization rates were 4.2% in patients treated with the antibody, compared with 14.6% in placebo-treated patients. The safety profile of patients treated with LY-CoV555 was similar to that of placebo-treated patients.

"We know that COVID-19 is especially hard on the elderly, the obese and people with certain pre-existing health conditions," Chen said. "Antibody treatments like this may have the most benefits for people in these higher-risk categories."

SINGAPORE, 30 October 2020 - Mothers can pass allergies to offspring while they are developing in the womb, researchers from the Agency for Science, Technology and Research (A*STAR), KK Women's and Children's Hospital (KKH) and Duke-NUS Medical School in Singapore reported this week in the journal Science.

The study, which employed an animal model conducted according to the National Advisory Committee for Laboratory Animal Research (NACLAR) guidelines, shows that the key antibody responsible for triggering allergic reactions, immunoglobulin E (IgE), can cross the placenta and enter the foetus. When inside the foetus, the antibody binds to foetal mast cells, a type of immune cell that releases chemicals that trigger allergic reactions, from runny noses to asthma. After birth, newborn mice develop allergic reactions to the same type of allergen as their mothers at the time of first exposure - unlike adult mice, which require two exposures. Studies in the laboratory also showed that maternal IgE can bind to human foetal mast cells, indicating they might cross the placenta in humans in a similar way.

Dr Florent Ginhoux, Senior Principal Investigator at A*STAR's Singapore Immunology Network (SIgN), a senior co-author of the study, said, "There is currently a significant lack of knowledge on mast cells that are present early on in the developing foetus. Here, we discovered that foetal mast cells phenotypically mature through the course of pregnancy, and can be sensitised by IgE of maternal origin that cross the placental barrier. The study suggests that a highly allergic pregnant mother may potentially transfer her IgE to her baby that consequently develop allergic reactions when exposed to the first time to the allergen."

"Allergies begin very early in life," said Associate Professor Ashley St. John, an immunologist at Duke-NUS' Emerging Infectious Diseases Programme and a senior co-author of the study. "Infants experience allergic responses closely linked with the mother's allergic response in ways that cannot only be explained by genetics. This work emphasises one way that allergic responses can pass from the mother to the developing foetus, and shows how allergies can then persist after birth."

As part of the study, following NACLAR guidelines, researchers exposed mice to ragweed pollen, a common allergen, prior to pregnancy. Mice that developed a sensitivity to the pollen had offspring that also showed an allergic reaction to ragweed. The sensitivity is allergen-specific; the offspring did not react to dust mites, another common allergen.

Notably, the transfer of sensitivity appears to fade with time. The newborn mice had allergic reactions when tested at four weeks, but less or none at six weeks.

The experimental studies were backed up with cellular tests and imaging, which showed maternal IgE bound to fetal mast cells, triggering the mast cells to release chemicals in reaction to an allergen, a process called degranulation.

This study further showed that the IgE transfer across the placenta requires the help of another protein, FcRN. Mice with FcRN knocked out lacked maternal IgE attached to their mast cells, and did not develop allergies after birth.

The study findings potentially open new intervention strategies to limit such transfer to minimise the occurrence of neonatal allergies. Currently, between 10 to 30 per cent of the world's population are affected by allergies. This number is set to continue rising and a solution preventing allergies being passed from mother to child could potentially bring those numbers down over time.

"Our research has really exciting findings that may explain the high incidence of early onset atopic dermatitis (eczema) in children of mothers with clinically proven eczema, which parallel findings in our local birth cohort findings," said Professor Jerry Chan, Senior Consultant, Department of Reproductive Medicine at KKH, Senior National Medical Research Council Clinician Scientist, and Vice Chair of Research with the Obstetrics and Gynaecology Academic Clinical Programme at the SingHealth Duke-NUS Academic Medical Centre. "From a clinical point of view, developing a further understanding in placental transfer of IgE, and the mechanism of foetal mast cell activation would be key to developing strategies to reduce the chance of eczema or other allergies from being transferred from mother to baby."

The authors next aim to better understand the mechanism of IgE transfer through the placenta, how IgE binding to mast cells in foetal skin modulate their functions and how it could affect skin physiology after birth.

An international research team has sequenced the full genome of an ornamental variety of miscanthus, a wild perennial grass emerging as a prime candidate for sustainable bioenergy crops.

The genome project -- led by scientists at the Center for Advanced Bioenergy and Bioproducts Innovation (CABBI), a Department of Energy (DOE) bioenergy research center -- provides a road map for researchers exploring new avenues to maximize the plant's productivity and decipher the genetic basis for its desirable traits.

The study, published in Nature Communications, was supervised by CABBI researchers Daniel Rokhsar, Professor in the Department of Molecular and Cell Biology at the University of California (UC), Berkeley; and Kankshita Swaminathan, Faculty Investigator at HudsonAlpha Institute for Biotechnology, Huntsville, Ala. (pictured). The team, which included more than 40 collaborators, was led by Therese Mitros, Adam Session, and Guohong Albert Wu from Rokhsar's lab; and Brandon James from Swaminathan's lab. Mitros and James are CABBI researchers, and Session and Wu are affiliated with the DOE Joint Genome Institute (JGI), a DOE Office of Science user facility at Lawrence Berkeley National Laboratory (Berkeley Lab).

Miscanthus grasses, also used in gardens, paper production, and roofing, are a promising source of biomass, a renewable alternative to petroleum-based fossil fuels. They belong to the Andropogoneae family of grasses, which includes maize, sorghum, and sugarcane -- highly productive and globally important plants grown as a source of food, feed, and biofuels.

Miscanthus is extremely adaptable and easy to grow. It can thrive on marginal lands, requires only limited fertilization, has a high tolerance for drought and cool temperatures, and uses the more efficient C4 form of photosynthesis.

The CABBI team's sequence and genomic analysis of Miscanthus sinensis -- the first for any type of miscanthus -- provide a foundation for systematic improvements to optimize those desirable traits. The project also produced an atlas of genes that are turned on and off in different parts of the plant during its seasonal life cycle, revealing new regulators of perenniality, a desirable trait for biofuel and other crops.

"The genomic toolkit we have assembled for miscanthus will be a valuable resource for researchers studying this plant and breeding it to improve biomass and other traits," Swaminathan said. "By comparing miscanthus with sorghum, sugarcane, and other related grasses, researchers within CABBI and beyond hope to decipher the genetic basis for innovations linked to productivity and adaptability."

The study relied on extensive field collections over several growing seasons at the University of Illinois that captured the plant's full life cycle. Led by Swaminathan, scientists measured gene expression in the leaves, stems, and rhizome (the underground part of the stem). The catalog of tissue-preferred genes will provide clues for how to genetically modify the plant to improve certain processes, said Mitros, who led the computational work on genome assembly, annotation, and sequence analysis.

The study also revealed a group of genes involved in the all-important nutrient remobilization cycle. In the fall, as the plant's leaves die, nitrogen and other nutrients are sent to the rhizome, where they are stored underground over the winter; in the spring, that energy is taken up into other tissues as the plant grows instead of going back into the soil, reducing the need for fertilizer. The rhizomes also produce new stems, allowing the plant to get bigger every year, and help with carbon storage. All of that makes miscanthus more sustainable -- less costly to manage and more environmentally friendly.

Many M. sinensis lines are used as decorative grasses and grow both from the rhizome and from seed. The grass with bioenergy potential, Miscanthus x giganteus "Illinois" type, doesn't create viable seed and is thus more difficult to propagate. CABBI researchers like Erik Sacks, Associate Professor in the Department of Crop Sciences at Illinois, are working on new hybrids, crossing M. sinensis and M. sacchariflorus to create multiple giganteus varieties that would be more adaptable to different regions and produce seeds.

The genetic sequence is a platform to understand the variations within all kinds of miscanthus varieties, Rokhsar said. Miscanthus hybrids have evolved naturally in Asia, and Sacks and other breeders hope to combine the best of the populations to create varieties best suited for particular locations.

On a fundamental level, the study will help scientists tease out answers to basic questions about plant biology, such as the circuits involved in the rhizome nutrient cycle, how it works through the seasons, and how it evolved. And it will give them more information about the rules for crossing and combining miscanthus so they can produce optimal hybrids, Rokhsar said.

"The types of data presented in this study are also critical to deploy techniques like gene-editing to help decipher the function of the genes that control traits and adaptations important to the success of this high-yielding grass," Swaminathan said.

For example, the gene expression data point to a suite of genes that may be involved in the ability of miscanthus to store energy in a modified underground stem (the rhizome) over winter and bounce back each year bigger than before. Swaminathan is intrigued by what makes a stem become a storage organ in Andropogoneae grasses; she wants to understand the molecular mechanisms that direct the miscanthus rhizome to store complex carbohydrates while sugarcane and sweet sorghum stems store sugar.

Miscanthus and other plants have complex genomes, with a history of more genomic duplication than seen in animals. Having multiple copies of chromosomes allows for larger plants and more genetic diversity while providing more targets for genetic engineers. But it also made the sequencing and assembly a challenge, Rokhsar said. "We drew on lots of different technologies to make that happen."

The team's analysis determined that miscanthus is a "paleo-allotetraploid," meaning it arose by ancient hybridization of two ancestral species, rather than by doubling within a single species as happened in sugarcane. The two progenitors of miscanthus are long-extinct -- dying out after the hybridization about 2 million years ago -- but their chromosomes live on in miscanthus. Session used computational analyses to figure out the ancient origins of each chromosome and identify segments that have swapped chromosomes. He also teased apart subtle differences in the way the two chromosome sets have evolved since the duplication -- vital information for genetic engineers who want to knock out particular genes, Mitros said.

The paper is the culmination of a multi-year, interdisciplinary effort to sequence a miscanthus genome involving dozens of researchers in the U.S., Europe, and Asia. It is built on the work of scientists like Sacks, who has collected germplasm from thousands of lines of Miscanthus in Japan, Korea, and other countries.

Other instrumental researchers included Professors Stephen Moose and Matthew Hudson, University of Illinois crop scientists who were involved in the genome project when the project was under the auspices of the Energy Biosciences Institute, a BP-funded initiative at Illinois, UC Berkeley and Berkeley Lab. Professor Stephen Long, another U of I crop scientist, had been among the first to propose miscanthus as the basis for a new biofuel economy as part of a scientific team in the College of Agricultural, Consumer and Environmental Sciences. Moose led EBI's feedstocks group and pioneered the genomics work, producing chromosome maps of M. sinensis and early gene expression data sets for multiple Miscanthus lines. The JGI carried out much of the genome sequencing under the supervision of Rokhsar, who was also part of the original EBI project and has a long-standing interest in complex plant and animal genomes.

Swaminathan was a scientist on Moose's team during the EBI project. The team, which included Rokhsar and Mitros, started by trying to decipher the M. x giganteus Illinois genome, but "it was a jigsaw puzzle not coming together," she said. The researchers realized that M. x giganteus was too complicated, and turned to a double-haploid line of M. sinensis generated by Katarzyna Glowacka, then a graduate student in Poland and now a faculty member at the University of Nebraska. Using the best available data at the time, they put together a fragmented genome assembly. Swaminathan joined HudsonAlpha in 2016, bringing a freezer full of samples with her, and both James and fellow Postdoc Mohammad Belaffif started processing samples and analyzing the data.

CABBI was formed in 2017 and took on the genome project. Mitros pulled together the genomic analysis. Swaminathan's team focused on gene expression, and Sacks contributed data from his diversity collections. Researchers in Europe shared genotype data and information on the M. sacchariflorus genome, and the project grew.

"It took that concerted effort, with someone at the center pulling all the data together to make sense of it," Swaminathan said. "This would have just not happened without CABBI."

In a new study published in the Academy of Management Journal by Traci Sitzmann, an Associate Professor at the University of Colorado Denver Business School, and Elizabeth Campbell, an Assistant Professor at the University of Minnesota, provide empirical evidence and an explanation into why religion perpetuates the gender wage gap.

While studying trends in 140 countries around the world, researchers found the gender wage gap is 29 percentage points greater in the most religious countries. Women earn 46% as much as men in the most religious countries and 75% of men's wages in secular countries. This trend of a greater gender wage gap in religious cultures applies across all six major world religions--Buddhism, Christianity, Folk, Hinduism, Islam, and Judaism.

The same trend occurs in the United States--the gender wage gap is eight percentage points greater in religious than secular states.

Sitzmann and Campbell also conducted a series of experiments to demonstrate that the effect of religiosity on the gender wage gap is causal, meaning religion is the cause for the wage gap. The researchers found being exposed to religious values resulted in supervisors allocating significantly higher wages to male than female employees, even though the employees performed at the same level.

Why does religion increase the gender wage gap?

Sitzmann and Campbell's research shows that religion sets up different social expectations for men and women in three areas:

Religiosity socializes members to increase their family size, placing a heavy burden on women because men are permitted or even expected to repudiate domestic tasks. This decreases a women's career success due to the infeasibility of both working full-time and taking on most domestic responsibilities.

Believing they are protecting a women's sexuality, religious societies place restrictions on women's ability to enter public spaces, interact unchaperoned with members of the opposite sex, and freely choose their apparel. Religion is often misused to legitimize violations of women's human rights.

Religiosity advocates that men should pursue power and decision-making authority, while women should heed power and defer to men's authority. This unequal distribution of power results in women's underrepresentation in leadership positions. Indeed, Pope Francis indicated that "the door is closed" to women who wish to be ordained priests.

What are the implications?

Religious values are central to cultures around the world. In the U.S., Congress has their own chaplain to opening meetings with prayer; money is imprinted with "In God We Trust;" Supreme Court nomination hearings focus on the justice's religious values; and increasingly businesses are demonstrating religious support by providing employees with a place to pray and evoking god as an explanation for firm policies.

"The existing management literature proposes that religion is a "benign and positive force," which is in direct opposition to research on the intersection between religion and gender," said Sitzmann. "Our research is instrumental for documenting that religiosity has a systematic effect on women's wages, suggesting that businesses should toe a fine line between permitting religious freedom and ensuring that freedom does not infringe upon the rights of others. "

What is the solution?

A common notion is that the gender wage gap will resolve itself over time, but this is also contingent upon religiosity. The gender wage gap in secular U.S. states will take approximately 28 years to close, while the gap in religious states will take approximately 109 years to close, according to Sitzmann's study.

Rather than waiting 47 years for wage parity, organizational leaders and policymakers can assess whether employees are paid equitably based on the value of their work, regardless of gender. This is required for organizations in Iceland, which has helped the country maintain the smallest gender wage gap for the past nine years.

"Research has provided incontrovertible evidence that men and women's job performance is the same," said Sitzmann. "Wages should align with performance, rather than with employees' gender. I hope this research sensitizes organizational leaders to rectify cases where professional equals are compensated unequally based on gender."

Scientists have discovered that sodium bicarbonate - also known as baking soda or bicarbonate of soda - can reprogram T cells in leukemia patients to resist the immune-suppressing effects of cancer cells, which can drive leukemia relapse after stem cell transplants. The work clarifies why patients frequently relapse after transplant, and lays the foundation to test sodium bicarbonate as a safe and simple therapy to reduce relapse rates and improve treatment outcomes. Allogeneic hematopoietic cell transplantation is a form of stem cell transplant that can sometimes cure people with blood cancers such as acute myeloid leukemia (AML). However, complete response rates can be as low as 17% after 100 days, largely because the leukemia will frequently return. There is a pressing need for methods that can boost the anticancer effects of stem cell transplants, but researchers haven't fully understood why donated T cells often fail to finish off tumors. By studying mouse models of leukemia and T cells from patients before and after transplantation, Franziska Uhl and colleagues found that AML cells suppressed the metabolic activities and the spread of donated T cells by secreting lactic acid, which acidified the cellular environment and interfered with glucose metabolism. Searching for therapies, the team turned to the antacid sodium bicarbonate, and found that a clinical formulation named bicaNorm reversed these suppressive effects on T cells in 10 transplant recipients with relapsed AML. The authors call for trials with larger groups of patients to better determine the long-term benefits of sodium bicarbonate for recipients of stem cell transplants.

BOSTON - A temporary tracheostomy--an opening created in the neck to facilitate placing a tube into a person's windpipe--can be essential for allowing a critically ill patient to come off a ventilator. A new article, with an accompanying video, published in the New England Journal of Medicine by clinicians at Massachusetts General Hospital (MGH) offers valuable guidance on how to safely perform the procedure in patients with COVID-19.

"Tracheostomy facilitates ventilator weaning, decreasing the need for sedating medications and allows family members to more easily interact with their loved ones," said senior author Hugh G. Auchincloss, MD, MPH, a thoracic surgeon at MGH. "We were concerned that tracheostomy was being underutilized in the management of patients with severe disease in the setting of COVID-19 because of concern that performing the procedure would expose health care workers to the virus."

The article and video provide step-by-step instructions on how to perform a tracheostomy quickly and safely at the bedside, with modifications to prevent generating aerosols that could contain the virus that causes COVID-19. Instructions start with details on equipment, preparation and positioning before initiating the procedure. Next steps include information on the procedure itself, such as the size and location of the incision and the placement of the bronchoscope that allows the surgeon to visualize the patient's airways. The article and video also offer guidance on what to do if difficulties or complications arise, and on care that is required after the surgery.

"We hope that this video can help physicians around the world consider the modifications to percutaneous tracheostomy that can reduce the risk of procedural aerosolized transmission of COVID-19 and other viruses," said lead author Daniel Hashimoto, MD, MS, chief resident in General Surgery at MGH and associate director of research of MGH's Surgical Artificial Intelligence & Innovation Laboratory. "This work helps provide education on performing percutaneous tracheostomy for non-COVID-19 infected patients as well."