Culture

A new study from the University of Copenhagen's Department of Nutrition, Exercise and Sports demonstrates that formation of small blood vessels is impaired in the muscle tissue of postmenopausal women. The study's findings highlight the importance of physical activity for women prior to and during menopause, as a means to prevent the development of disease later in life.

The risk of developing cardiovascular disease generally increases with age. For most of their lives, women have a lower risk of cardiovascular disease than men, but the picture changes as menopause sets in. The exact reason has yet to be fully understood.

Spinning failed to stimulate blood vessel growth

A new study has demonstrated that postmenopausal women have a significantly reduced ability to form tiny blood vessels, called capillaries, in their muscles - compared to younger women. The study showed that older women were unable to increase the number of capillaries in skeletal muscle tissue after an eight-week period of spinning on stationary bikes, in contrast with what has previously been demonstrated in both younger and older men.

Capillaries are important for health as they are needed for absorbing sugar and fat into muscles. The loss of capillaries can also have an effect on insulin resistance and contribute to the development of type 2 diabetes.

Despite the absence of capillary growth, the women's health improved in a number of other ways after the eight weeks of spinning, including overall fitness.

Line Norregaard Olsen, a PhD student at the University of Copenhagen's Department of Nutrition, Exercise and Sports explains that the lack of improvement with regards to new capillary growth is most likely due to the permanent loss of estrogen after menopause:

"The study supports the idea that women benefit from being physically active prior to menopause, while their estrogen levels are high. It provides them with a better physical starting point as they enter menopause - which is important. Even though eight weeks of training of the post-menopausal women has a noteworthy effect on some parameters, it had no effect on capillary formation in muscle. A sufficient number of capillaries in muscle is important for muscle function and reduces the risk of developing type 2 diabetes."

Professor Ylva Hellsten, also of UCPH's Department of Nutrition, Exercise and Sports, and the principal investigator, elaborates on the study's potential implications: "It is important to emphasize that both men and women are greatly served by being physically active throughout life, regardless of their age. But the current study suggests that there are some crucial differences between men and women in the way that the cardiovascular system is affected by aging and physical activity. As a result, this study should lead to an adjustment of the training recommendations for women in this age group."

In future studies, the researchers will evaluate which training is most effective to develop the health of the postmenopausal women.

Facts about the study

Two groups of women participated in the study: 12 women 59-70 years of age (postmenopausal) and five women 21-28 years of age (premenopausal). Both groups had a biopsy taken from their thigh muscle. Furthermore, the older group was trained over an eight-week period, three times weekly, on spin bikes at moderate to high intensity.

The postmenopausal women took part in tests of their physical fitness and on a range of other parameters both before and after training. Both before and after the training, this group of participants had tissue samples taken from their thigh muscles, which were used to analyze the number of capillaries in their muscles, as well as to analyze several muscle-specific proteins.

After 8 weeks of aerobic exercise, in the form of spinning, the fitness of the postmenopausal women improved by 15%.

The process by which new capillaries are formed is called 'angiogenesis'. Capillaries are essential for the transport of oxygen and nutrients to the body's cells.

In the project, cells in capillaries called 'endothelial cells' were studied in the laboratory by isolating them from muscle samples obtained from the participating women. This has never been done before.

The study has ben published in the article "Angiogenic Potential is Reduced in Skeletal Muscle of Aged Women" in the renowned scientific journal 'Journal of Physiology'. 

The study is supported by Independent Research Fund Denmark and the Danish Ministry of Culture's Fund for Sports Research.

A new nationwide model of care for hip and knee joint replacements appears to reduce disparities in health outcomes for Black patients, according to new research led by Oregon Health & Science University.

Researchers examined health outcomes for about 700,000 patients who underwent joint replacement procedures through Medicare between 2013 and 2017. The study examined differences in outcomes before and after April 2016, when Medicare adopted a model called Comprehensive Care for Joint Replacement, a bundled payment model designed to reduce spending and improve outcomes for all joint replacement patients.

The review is published by the journal JAMA Network Open.

The retrospective study examined three key metrics: spending, discharges to institutional post-acute care and hospital readmission. It compared outcomes for patients self-identified as white, Black and Hispanic.

Taken together, the results showed improved outcomes for Black patients and mixed results for Hispanic patients compared with those who are white.

Although Black patients were discharged to institutional post-acute care more than white patients, the gap narrowed under the new bundled payment model. Readmission risk decreased about 3 percentage points for Black patients under the new model, and stayed roughly the same for Hispanic and white patients.

"I was surprised the readmission rate decreased for Black patients," said corresponding author Hyunjee Kim, Ph.D., a health economist with the OHSU Center for Health Systems Effectiveness. "When you combine it with lower rates of institutional post-acute care, you're seeing better overall care."

The bundled payment plan was enacted in April 2016 to reduce cost and improve care for the single most common inpatient procedure for Medicare beneficiaries. Hip and knee replacements alone account for 5% of total Medicare inpatient spending.

The OHSU-led retrospective study is the first to gauge the plan's comparative effect on Black and Hispanic patients, who have historically had worse outcomes compared with white patients.

Overall, the study found substantially reduced use of institutional post-acute care for all groups.

"These represent relative improvements, a notable finding given general concerns that value-based payment models may exacerbate care for racial/ethnic minorities," the authors concluded. "Nonetheless, racial/ethnic differences in joint replacement care still persist, indicating the need for additional and sustained efforts to create an equitable health care system."

During a special COVID-19 session at this year's online Annual Meeting of the European Association for the Study of Diabetes (EASD), Prof. Daniel J. Drucker (Lunenfeld Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, Canada) will present a new review the latest clinical findings linking diabetes to risk of infection and differential outcomes in people with COVID-19 infection.

The medications that are used to treat people with diabetes often include drugs that modulate the expression and activity of the protein ACE2, the principal receptor for SARS-CoV-2 (how the virus enters cells). Furthermore, observational data suggests that people treated with statins, a widely used class of cholesterol lowering drugs, may experience improved outcomes in the hospital.

He says: "I will review the importance of optimising management of risk factors in people with diabetes during the pandemic, and how to consider adjustment of glucose-lowering drugs in hospitalised patients with COVID-19 infection. Notably, some of the medicines, such as dexamethasone recently shown to be beneficial for severely ill people with COVID-19 may worsen blood sugar control requiring careful monitoring and preferential use of insulin in people with type 2 diabetes."

He will also discuss the reports of new onset type 1 diabetes and complications such as ketoacidosis in the context of SARS-CoV-2 biology, predisposition for viral infection of the endocrine pancreas, and the limitations of the available epidemiology so far. There continues to be controversy about whether the SARS-CoV-2 virus directly infects islets and insulin-producing beta cells, leading to insulin deficiency, and in some cases, new onset type 1 diabetes. Dr Drucker will highlight very new data in this area that illuminates our understanding of where the receptors for the virus are located in different cells within the pancreas.

Dr Drucker will underline that better control of blood sugar in people with type 1 and type 2 diabetes appears to be an important modifier of COVID-19 severity, further emphasizing the opportunity to optimise the management of diabetes in the community to mitigate the potential consequences of SARS-CoV-2 infection.

U.S. cellphone data analysis finds "hotspots" where COVID-19 social distancing levels are low, as well as revealing how demographics and governmental restrictions interact. Rajesh Narayanan and colleagues at Louisiana State University, Baton Rouge, present these findings in the open-access journal PLOS ONE on September 22.

Maintaining physical distance from others can reduce the spread of COVID-19. People may engage in social distancing voluntarily or because of governmental restrictions, or some combination of the two. Understanding the interplay of these two factors could help inform strategies to reduce disease spread.

To better understand social distancing across geographic areas, Narayanan and colleagues developed a computational model of social distancing behavior across the U.S. The model uses cell phone tracking data to indicate the amount of time spent at home--a proxy for social distancing--in counties throughout the country.

The researchers used this model to explore how stay-at-home behaviors evolved over the first 21 weeks of the spread of COVID-19 in the U.S., from late January to June, 2020. They examined how these behaviors changed in relation to governmental restrictions and demographic factors that could influence social distancing, such as population density, the presence of children in households, education, race, and income.

The analysis suggests that stay-at-home behavior increased by over nine times from late January through late March, and then decreased by about half through mid-June. Demographic factors appear to have driven these changes to a substantially greater degree, suggesting the importance of(either due to voluntary distancing or to differential compliance with mandated distancing). Importantly, there was also a tendency for behaviors to cluster, creating hotspots of counties with low social distancing.

One implication of these findings is that encouraging voluntary distancing could potentially be an effective and lower-cost alternative to governmental restrictions. Such encouragement could boost acceptance of restrictions and thus increased compliance with distancing rules, resulting in an even greater degree of distancing.

Professor Naryanan adds: "Cell phone location and mobility data reveal that social distancing in the U.S. during the Covid-19 pandemic was initially voluntary rather than a response to governmental jurisdictional restrictions. As the pandemic progressed, both effects reinforced each other, increasing social distancing far more than what could be explained by the sum of the individual effects." -

Fairy circles are one of nature's greatest enigmas and most visually stunning phenomena. An international research team led by the University of Göttingen has now, for the first time, collected detailed data to show that Alan Turing's model explains the striking vegetation patterns of the Australian fairy circles. In addition, the researchers showed that the grasses that make up these patterns act as "eco-engineers" to modify their own hostile and arid environment, thus keeping the ecosystem functioning. The results were published in the Journal of Ecology.

Researchers from Germany, Australia and Israel undertook an in-depth fieldwork study in the remote Outback of Western Australia. They used drone technology, spatial statistics, quadrat-based field mapping, and continuous data-recording from a field-weather station. With the drone and a multispectral camera, the researchers mapped the "vitality status" of the Triodia grasses (how strong and how well they grew) in five one-hectare plots and classified them into high- and low-vitality.

The systematic and detailed fieldwork enabled, for the first time in such an ecosystem, a comprehensive test of the "Turing pattern" theory. Turing's concept was that in certain systems, due to random disturbances and a "reaction-diffusion" mechanism, interaction between just two diffusible substances was enough to allow strongly patterned structures to spontaneously emerge. Physicists have used this model to explain the striking skin patterns in zebrafish or leopards for instance. Earlier modelling had suggested this theory might apply to these intriguing vegetation patterns and now there is robust data from multiple scales which confirms that Alan Turing's model applies to Australian fairy circles.

The data show that the unique gap pattern of the Australian fairy circles, which occur only in a small area east of the town of Newman, emerges from ecohydrological biomass-water feedbacks from the grasses. In fact, the fairy circles - with their large diameters of 4m, clay crusts from weathering and resultant water run-off - are a critical extra source of water for the dryland vegetation. Clumps of grasses increased shading and water infiltration around the nearby roots. With increasing years after fire, they merged more and more at the periphery of the vegetation gaps to form a barrier so that they could maximize their water uptake from the fairy circle's runoff. The protective plant cover of grasses could reduce soil-s­urface temperatures by about 25°C at the hottest time of the day, which facilitates the germination and growth of new grasses. In summary, the scientists found evidence both at the scale of the landscape and at much smaller scales that the grasses, with their cooperative growth dynamics, redistribute the water resources, modulate the physical environment, and thus function as "ecosystem engineers" to modify their own environment and better cope with the arid conditions.

Dr Stephan Getzin, Department of Ecosystem Modelling at the University of Göttingen, explains, "The intriguing thing is that the grasses are actively engineering their own environment by forming symmetrically spaced gap patterns. The vegetation benefits from the additional runoff water provided by the large fairy circles, and so keeps the arid ecosystem functional even in very harsh, dry conditions." This contrasts with the uniform vegetation cover seen in less water-stressed environments. "Without the self-organization of the grasses, this area would likely become desert, dominated by bare soil," he adds. The emergence of Turing-like patterned vegetation seems to be nature's way of managing an ancient deficit of permanent water shortage.

In 1952 when the British mathematician, Alan Turing, published his ground-breaking theoretical paper on pattern formation, he had most likely never heard of the fairy circles before. But with his theory he laid the foundation for generations of physicists to explain highly symmetrical patterns like sand ripples in dunes, cloud stripes in the sky or spots on an animal's coat with the reaction-diffusion mechanism. Now, ecologists have provided an empirical study to extend this principle from physics to dryland ecosystems with fairy circles.

Widespread fungal disease in plants can be controlled with a commercially available chemical that has been primarily used in medicine until now. This discovery was made by scientists from Martin Luther University Halle-Wittenberg (MLU) and the University of the State of Paraná in Brazil. In a comprehensive experiment the team has uncovered a new metabolic pathway that can be disrupted with this chemical, thus preventing many known plant fungi from invading the host plant. The team reported on their study in the scientific journal Phytopathology.

The fungus Colletotrichum graminicola is prevalent around the world. It infects maize, causing anthracnose, a disease that causes the plant's leaves to turn yellow at first and then ultimately to succumb to toxins. The fungus multiplies through spores that initially land on the surface of the plant. There they find rather inhospitable conditions: a lack of most of the nutrients that fungi need to develop - in particular nitrogen. "The only option they have is to break down some of their own nitrogen-containing molecules, for instance purines, the building blocks of DNA or RNA," explains plant pathologist Professor Holger Deising from MLU.

The researchers on Deising's team have found a way to impede this transitional phase which the fungus relies on. To do this, the team administered acetohydroxamic acid onto the plants, a substance also used to treat harmful bacteria in the human stomach, and which is known to inhibit the breakdown of urea. "The acid prevents the harmful fungi from penetrating into the plants and from becoming infectious," says Deising.

The team also tested whether the findings from C. graminicola and maize could be transferred to other plants and fungi. The acid was also found to be effective against numerous other pathogens which cause, for example, powdery mildew in cereal crops, late blight in potatoes, as well as corn and bean rust. "We have been able to develop a completely new approach to pathogen control that uses an existing active ingredient and thus can be quickly used commercially," says Deising.

The scientists conducted extensive experiments in order to come to their conclusions. They wanted to understand the molecular details of how the fungus manages to obtain nitrogen at the onset of the infection. First, they generated a series of random mutations in the genome of the fungus C. graminicola. "Then we inoculated the different fungal mutants onto the plants to see which ones were no longer infectious," says Deising. One of these mutants had a defect in the purine degradation pathway. In order to check whether the mutants' failure to infect the plant was actually caused by a lack of nitrogen, the researchers then applied nitrogen to the plants. "Once nitrogen was added, even the harmless mutants became infectious again," says Deising. The team was able to induce the same defect they had observed in the mutants in wildtype fungi by applying acetohydroxamic acid because it blocks the purine degradation pathway, too.

University of Warwick astronomers have shown that water vapour can potentially be detected in the atmospheres of exoplanets by peering literally over the tops of their impenetrable clouds.

By applying the technique to models based upon known exoplanets with clouds the team has demonstrated in principle that high resolution spectroscopy can be used to examine the atmospheres of exoplanets that were previously too difficult to characterise due to clouds that are too dense for sufficient light to pass through.

Their technique is described in a paper for the Monthly Notices of the Royal Astronomical Society and provides another method for detecting the presence of water vapour in an exoplanet's atmosphere - as well as other chemical species that could be used in future to assess potential signs of life. The research received funding from the Science and Technologies Facilities Council (STFC), part of UK Research and Innovation (UKRI).

Astronomers use light from a planet's host star to learn what its atmosphere is composed of. As the planet passes in front of the star they observe the transmission of the stellar light as it skims through the upper atmosphere and alters its spectrum. They can then analyse this spectrum to look at wavelengths that have spectral signatures for specific chemicals. These chemicals, such as water vapour, methane and ammonia, are only present in trace quantities in these hydrogen and helium rich planets.

However, dense clouds can block that light from passing through the atmosphere, leaving astronomers with a featureless spectrum. High resolution spectroscopy is a relatively recent technique that is being used in ground-based observatories to observe exoplanets in greater detail, and the Warwick researchers wanted to explore whether this technology could be used to detect the trace chemicals present in the thin atmospheric layer right above those clouds.

While astronomers have been able to characterise the atmospheres of many larger and hotter exoplanets that orbit close to their stars, termed 'hot Jupiters', smaller exoplanets are now being discovered at cooler temperatures (less than 700°C). Many of these planets, which are the size of Neptune or smaller, have shown much thicker cloud.

They modelled two previously known 'warm Neptunes' and simulated how the light from their star would be detected by a high resolution spectrograph. GJ3470b is a cloudy planet that astronomers had previously been able to characterise, while GJ436b has been harder to characterise due to a much thicker cloud layer. Both simulations demonstrated that at high resolution you can detect chemicals such as water vapour, ammonia and methane easily with just a few nights of observations with a ground-based telescope.

The technique works differently from the method recently used to detect phosphine on Venus, but could potentially be used to search for any type of molecule in the clouds of a planet outside of our solar system, including phosphine.

Lead author Dr Siddharth Gandhi of the Department of Physics at the University of Warwick said: "We have been investigating whether ground-based high resolution spectroscopy can help us to constrain the altitude in the atmosphere where we have clouds, and constrain chemical abundances despite those clouds.

"What we are seeing is that a lot of these planets have got water vapour on them, and we're starting to see other chemicals as well, but the clouds are preventing us from seeing these molecules clearly. We need a way to detect these species and high resolution spectroscopy is a potential way of doing that, even if there is a cloudy atmosphere.

"The chemical abundances can tell you quite a lot about how the planet may have formed because it leaves its chemical fingerprint on the molecules in the atmosphere. Because these are gas giants, detecting the molecules at the top of the atmosphere also offers a window into the internal structure as the gases mix with the deeper layers."

The majority of observations of exoplanets have been done using space-based telescopes such as Hubble or Spitzer, and their resolution is too low to detect sufficient signal from above the clouds. High resolution spectroscopy's advantage is that it is capable of probing a wider range of altitudes.

Dr Gandhi adds: "Quite a lot of these cooler planets are far too cloudy to get any meaningful constraints with the current generation of space telescopes. Presumably as we find more and more planets there's going to be more cloudy planets, so it's becoming really important to detect what's on them. Ground based high resolution spectroscopy as well as the next generation of space telescopes will be able to detect these trace species on cloudy planets, offering exciting potential for biosignatures in the future."

People with 'silent' COVID-19 infection have as much coronavirus in their noses and throats as those with symptoms, reveals research published online in the journal Thorax.

Given how many of these people there are---a fifth of those infected, the study findings show--they may have a key role in driving the spread of COVID-19, warn the researchers, who go on to suggest that this warrants extending testing provision.

People infected with SARS-CoV-2, the virus responsible for COVID-19, but who don't have symptoms, still carry potentially transmissible virus, known as the viral load.

But just how large this viral load might be, and to what extent it might contribute to the spread of the virus, isn't clear.

To try and find out, the researchers compared the viral load of 213 people, all of whom had tested positive for SARS-CoV-2, but not all of whom had symptoms of COVID-19 infection.

Following a large cluster outbreak of COVID-19 in Daegu City, South Korea, early on in the pandemic, the close contacts of this cluster (a religious group) were traced. This uncovered more than 3000 cases of COVID-19, ranging in symptom severity from none to severe.

Those with mild or no symptoms were admitted to dedicated care facilities for isolation and monitoring. The 213 participants in this study had been admitted to one such facility.

They were classified as symptomless if they had none of the following: fever; chills; muscle pain (myalgia); fatigue; runny nose (rhinorrhea); blocked nose; loss of taste or smell; sore throat; swallowing difficulties; cough; phlegm production; coughing up blood; headache; dizziness; loss of appetite; nausea; vomiting, abdominal pain; and diarrhoea.

Before the isolation period--an average of 6 days from the first swab test--around a fifth (41; 19%) people didn't developed any symptoms: 39 (95%) of them had a further nose and throat swab test, 13 days, on average, after their initial diagnosis, to measure viral load.

Of the remaining 172 (81%) with mild symptoms, 144 were retested, adding up to a total of 183 who were included in the final analysis.

Over half of those without symptoms (21; 54%) tested positive for SARS-CoV-2, as did nearly two thirds of those with mild symptoms (92; 64%). There was no significant difference in the viral load, however, between the two groups.

This is an observational study, and the researchers caution that positive swab test results don't necessarily indicate the presence of live virus.

Further studies are needed to clarify whether the persistence of viral DNA in people without any symptoms warrants precautionary quarantine measures, they say.

Most of the participants were also in their 20s and 30s so the findings might not apply to other age groups, they suggest.

Nevertheless, they point out: "Considering that most asymptomatic individuals with COVID-19 are likely to go unnoticed by healthcare workers and continue to reside within communities, such individuals may act as an essential driving force for the community spread of COVID-19 and the ongoing pandemic state."

Until such time as it becomes clear how long, and to what extent, symptomless people might be infectious, testing should be extended to certain groups as a precautionary measure, recommend the researchers.

In a linked podcast, lead author Professor Sung-Han Kim explains: "Our data add further support to the general public use of face masks, regardless of the presence of symptoms, and suggest that the scope of SARS-CoV-2 testing should be expanded to include asymptomatic individuals in high-risk settings, such as nursing homes or healthcare facilities."

Individuals from Black and Hispanic backgrounds in the United States are twice as likely to test positive for COVID-19 than their White counterparts, according to new research in PLOS Medicine.

Led by researchers at the London School of Hygiene & Tropical Medicine (LSHTM) and Yale University, and the U.S. Department of Veterans Affairs (VA), the study found this disparity even after accounting for factors such as underlying health conditions, where they live and where they receive care.

However, the study, which used the health records of approximately six million people, did not find a race/ethnicity difference in the amount of people who died 30 days after testing positive.

The researchers say the findings highlight the urgent need for improved strategies to contain and prevent further outbreaks in racial and ethnic minority communities in the US, principally focused on testing and getting individuals into care.

Previous research in the UK, led by LSHTM, found that those from Black, Asian and minority ethnic backgrounds had a substantially higher risk of in-hospital death from COVID-19, while a study in the US found that Black individuals were overrepresented in coronavirus hospitalisations and deaths in a sample of 3,481 patients.

Christopher Rentsch from LSHTM and study lead author said: "Most studies investigating racial and ethnic disparities to date have focused on hospitalised patients, or have not characterized who received testing and those who tested positive. In this study, we compared patterns of testing and test results for COVID-19 and subsequent mortality by race and ethnicity in the Department of Veterans Affairs, the largest integrated healthcare system in the United States."

The Department of Veterans Affairs comprises more than 1,200 points-of-care nationally including hospitals, medical centres, and community outpatient clinics. Around nine million individuals access VA care each year, which for most is free-of-charge. It is the closest system the US has to the NHS.

The team looked at all individuals who were in care just prior to the coronavirus epidemic in the US. They then followed them to identify who was tested, who tested positive, and who died within 30 days after testing positive for COVID-19.

At each of these three stages they then looked to see if there were differences between three groups: Black, Hispanic, and White individuals.

Between 8 February to 22 July 2020, 254,595 individuals were tested and 16,317 tested positive for COVID-19. Black (10.2% testing positive) and Hispanic (11.4%) individuals were more than two times as likely to test positive than their White counterparts (4.4%). Among those who tested positive, 1,057 died within 30 days, but there was no difference by race/ethnicity group.

Christopher Rentsch said: "Minority individuals who received a positive COVID-19 test did not appear to have worse outcomes. However, our findings suggest these communities face a substantial excess burden of COVID-19 infection."

The study also found substantial variation in the disparity between Black and White individuals in testing positive by geographic region, with stronger disparity observed in the Midwest than all other regions, and disparity most attenuated in the West.

While the disparity between Black and White individuals slightly decreased over the study period, it was highest in locations that experienced an early or resurgent outbreak of COVID-19. Interestingly, the disparity between Hispanic and White individuals in testing positive was consistent across time, geographic region, and outbreak pattern.

The team weren't able to fully explain the reasons behind the disparities in their data. Previous reports have highlighted that members of racial and ethnic minorities are more likely to live in densely populated areas or multi-generational households, and work in essential industries, including high-contact jobs.

Christopher Rentsch said: "Understanding what is driving these disparities is vital so that strategies can be tailored to curb the disproportionate epidemics in minority communities.

"Going forward, we are exploring whether racial and ethnic disparities exist at other key stages in the clinical course of COVID-19, from hospitalisation to intubation. We appeal to other researchers who have the data to do so as well. This will provide essential information to design effective interventions."

The researchers acknowledge limitations of their work, including that the study used electronic health records, which did not include detailed data on socioeconomic status (e.g., type of employment, income, number of individuals in household) that may help explain some of the disparities they identified. Also, women represented a small proportion (9%) of individuals in the sample.

A special session at this week's ESCMID Conference on Coronavirus Diseases (ECCVID, held online 23-25 September) will see a new review of the evidence presented to address the difficult issue of school closures and reopenings. The session has been co-organised with the European Centre for Disease Control and Prevention (ECDC), Stockholm, Sweden.

"Children are more likely to have mild or asymptomatic infection, meaning that infection may go undetected or undiagnosed based on testing strategies," says presenter Jonathan Suk of ECDC. (see full slide presentation link below)

He will add that decisions on control measures in schools should be made consistently with decisions on other physical distancing and public health response measures within the community as a whole, saying: "Schools are unlikely to be worse propagating environments than occupational or leisure activities with similar densities of people with proper measures in place."

He adds: "Closures of childcare and educational institutions are unlikely to be an effective single control measure for community transmission of COVID-19 and cannot be justified based on protecting the health of children, most of whom develop very mild, if any, disease from COVID-19."

However he cautions: "The infectiousness of asymptomatic children is unknown. While very few significant outbreaks of COVID-19 have been documented in schools, they do occur and may be difficult to detect due to the relative lack of symptoms in children."

In another presentation, Dr Chiara Reno of the University of Bologna, Italy, will say that "policy makers have the task of balancing the pros and cons of the school reopening strategy, taking into account psychological, educational and social consequences for children and their families." (see full slide presentation link below)

She will discuss that so far of all cases of COVID-19 reported (EU/EEA and UK, as of 26 July) only 4% were children (0-18 years), of which 24% were under 5 years of age, 32% between 5 and 11 years and 44% between 12 and 18 years.

"Children are more likely to have asymptomatic or mild infection, with better overall outcomes than adults," she explains. "Transmission potential was shown in both children and adolescents, but further research needs to be done on clinical infectiousness."

She cautions: "Infants and neonates are more vulnerable to severe COVID-19. Pre-existing medical conditions have been suggested as a risk factor for severe disease and ICU admission in children and adolescents."

In her talk, she will also discuss the negative consequences of school closures on children's health. For example, some evidence reports that children and adolescents are at high risk of depression and anxiety both during isolation from school and their friends, and even after isolation / lockdown periods end. She will also discuss the uneven behaviour of schools worldwide in lockdown, and inequitable access to online classes for schools that closed in lockdown.

"The coronavirus lockdown exposed Italy's digital divide, since one in three households does not have access to a personal computer," explains Dr Reno. "Even in Japan, only a handful of schools and other educational institutions moved their classes online. A new government project there is aiming to boost IT infrastructure and improve remote learning capabilities."

She will say that the contagion rate in educational settings is strongly correlated to the spread of the infection in the community. "Implementation of strict infection control measures is crucial (physical distancing, use of masks, proper management of indoor air, hand hygiene, respiratory etiquette, and cleaning," explains Dr Reno.

"There is no single completely effective intervention, but a mix of interventions variously combined and contextualised. Targeted strategies for different age groups will be more effective since younger children can be very different to older children and adolescents. Active surveillance activities, rapid response by public health professionals with early detection of cases and contact tracing must be put in place."

She concludes: "As we lack strong evidence on when and how schools should be closed and/or reopened, it is important to concede uncertainty. We have to contrast misinformation and create trust - social sciences have shown us that acknowledging uncertainty will actually increase trust much more than painting things as certain."

"Policy makers cannot delay their decisions... we need to form a strong alliance and effective communication channels between policy makers, researchers and community members, making the way forward for schools a shared decision-making process."

A number of studies have shown how playing video games can lead to structural changes in the brain, including increasing the size of some regions, or to functional changes, such as activating the areas responsible for attention or visual-spatial skills. New research from the Universitat Oberta de Catalunya (UOC) has gone further to show how cognitive changes can take place even years after people stop playing.

This is one of the conclusions from the article published in Frontiers in Human Neuroscience. The study involved 27 people between the ages of 18 and 40 with and without any kind of experience with video gaming.

"People who were avid gamers before adolescence, despite no longer playing, performed better with the working memory tasks, which require mentally holding and manipulating information to get a result," said Marc Palaus, who has a PhD from the UOC.

The article stems from Palaus' doctoral thesis, which was supervised by Elena Muñoz and Diego Redolar, researchers in the UOC Faculty of Health Sciences' Cognitive NeuroLab. They were co-authors of the article alongside Raquel Viejo, another researcher from the group.

The results show that people without experience of playing video games as a child did not benefit from improvements in processing and inhibiting irrelevant stimuli. Indeed, they were slower than those who had played games as children, which matched what had been seen in earlier studies.

Likewise, "people who played regularly as children performed better from the outset in processing 3D objects, although these differences were mitigated after the period of training in video gaming, when both groups showed similar levels," said Palaus.

Combining transcranial magnetic stimulation

The study lasted a month and the researchers analysed participants' cognitive skills, including working memory, at three points: before starting the training in video gaming, at the end of the training, and fifteen days later. The video game used was Nintendo's Super Mario 64.

The study also included 10 sessions of transcranial magnetic stimulation. This is non-invasive brain stimulation through the skin without the need to get to the brain tissue that temporarily changes the brain's activity.

"It uses magnetic waves which, when applied to the surface of the skull, are able to produce electrical currents in underlying neural populations and modify their activity," explained Palaus.

The researchers wanted to find out if combining video gaming and this kind of stimulation would improve cognitive performance, but that didn't turn out to be the case. There are a number of possible causes, including the experimental nature of the parameters for the stimulation.

"We aimed to achieve lasting changes. Under normal circumstances, the effects of this stimulation can last from milliseconds to tens of minutes. We wanted to achieve improved performance of certain brain functions that lasted longer than this," said Palaus.

Strengthening cognitive skills

In this case, the video game used was a 3D platform adventure, but there are many genres of video game which can influence cognitive functions differently.

According to Palaus, what most have in common is that they involve elements that make people want to continue playing, and that they gradually get harder and present a constant challenge. "These two things are enough to make it an attractive and motivating activity, which, in turn, requires constant and intense use of our brain's resources."

"Video games are a perfect recipe for strengthening our cognitive skills, almost without our noticing." Nonetheless, he stressed that these improvements only have a limited effect on performance of other activities not linked to video gaming, as is the case with most cognitive training.

A review of studies (meta-analysis) presented at this year's ESCMID Conference on Coronavirus Diseases (ECCVID, online 23-25 September) shows that 40% of healthcare workers who test positive for COVID-19 were asymptomatic, raising the risk of silent transmission in healthcare settings.

The study is by Dr Sergio Gómez-Ochoa, Cardiovascular Foundation of Colombia, Floridablanca, Colombia, Professor Oscar H Franco and Dr Taulant Muka from the Institute Of Social And Preventive Medicine (ISPM), University Of Bern, Switzerland, and colleagues, and is to be published in the American Journal of Epidemiology.

"Health care workers (HCW) are at the frontline response to the new coronavirus disease 2019 (COVID-19), exposing themselves to a higher risk of acquiring the disease, and subsequently, exposing patients and colleagues," says study co-author Professor Oscar H Franco. The authors aimed to systematically review the evidence on the prevalence, risk factors, clinical characteristics, and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCW.

Searches in Embase, Pubmed, LILACS, MedxRiv and Google Scholar databases (up to July 8th, 2020) were performed. Preprint and peer-reviewed published articles of any language reporting the prevalence of COVID-19 in HCW and evaluating the risk factors, clinical characteristics, and clinical outcomes of SARS-CoV-2 infection among HCW were included. Two reviewers independently selected the studies, extracted the data, and assessed the quality of evidence. Estimates were pooled using a random-effects meta-analysis.

A total of 97 studies, including 230,398 HCW across 24 countries, met the inclusion criteria. From the screened HCW using PCR testing and the and the presence of antibodies, the estimated prevalence of SARS-CoV-2 infection was 10% and 7%, respectively.

The study shows that 48% of those testing positive for COVID-19 were nurses, followed by physicians (25%) and other HCW (23%). Most of the COVID-19 positive medical personnel were working in regular/non-surgical/non-COVID wards during the screening (43%), followed by 24% in the operating room, 16% in the emergency room and 9% in ICU, with 29% reporting 'other' locations.

"Loss of taste and smell (anosmia), fever and muscle pain were identified as the only symptoms significantly associated with SARS-CoV-2 positivity among HCW," explains co-author Dr Taulant Muka. Pooled data from 15 studies showed, that among RT-PCR positive HCW, 40% did not show symptoms at time of diagnosis. Finally, 1 in 20 (5%) of the COVID-19 positive HCW developed severe clinical complications, and 1 in 200 (0.5%) died.

Dr Muka says: "Healthcare workers suffer a significant burden from COVID-19. A significant proportion of healthcare workers are positive for COVID-19 while asymptomatic, which leads to the silent transmission of the disease. The symptoms associated with COVID-19 in HCW could be used as an indicator for screening in settings with limited testing capacities.

Professor Franco concludes: "Because we might miss a large proportion of COVID-19 cases if screening targets only symptomatic HCW, universal screening for all exposed HCW regardless of symptoms should be the standard strategy. While more research is needed to understand specific interventions that can help reducing SARS-CoV-2 infection among healthcare personnel, it is clear that providing healthcare workers with adequate personal protective equipment and training is essential."

New research presented at this this week's ESCMID Conference on Coronavirus Diseases (ECCVID, online 23-25 September) suggests that the poor outcomes and higher death rates in cancer patients with COVID-19 could be due to them generally being older and having more underlying conditions, rather than due to the cancer itself. The study is by Dr Maria Rüthrich, Jena University Hospital, Germany, and colleagues.

In their study, the authors used data from the LEOSS (Lean European Open Survey for SARS-CoV-2 Infected Patients) Registry. The German Society of Infectious Diseases (DGI) created this registry aiming to provide scientists and doctors with reliable clinical data to enable them to answer numerous urgent questions, such as when do COVID-19 patients develop severe symptoms? what is the best possible treatment? or which measures have been successful up to now? Under the new initiative, all the collected data will be available to the scientific community for use in crowd-based analyses.

The authors retrospectively analysed a cohort of 435 patients with cancer and COVID-19 from a total of 3071 patients enrolled between March and August 2020. Baseline characteristics include socio-demographics, comorbidity according to Charlson Comorbidity Index (a measurement of number of underlying conditions) (CCI), ECOG score (measure of functional status in cancer patients) and outcome of COVID-19.

Clinical manifestation of COVID-19 was described in four phases: uncomplicated (asymptomatic/mild symptoms), complicated (need for oxygen supplementation), critical (need for life supporting therapy) and recovery (improvement/ discharge).

The median observational period was 14 days, and the median duration of hospitalisation 15 days. The most common age category was 76 - 85 (36.5%), 176 (41%) pts were female. Mean CCI was 4.65, and 44/187 (23.5%) pts had an ECOG of over 2, indicating cancer patients who are capable of limited self-care and confined to bed or chair for more than 50% of the day. Solid tumors were seen in 59% of patients, and lymphoma and leukemia in 18% and 11%, respectively.

A total of 193 patients (54%) had an active malignant disease and 96 (22%) had received anti-cancer treatment within the last 3 months before testing positive for SARS-CoV-2. At detection of SARS-CoV-2, 272 (63%) pts were in an uncomplicated phase of COVID-19 disease. Progression to complicated/ critical phases of COVID-19 was seen in 206 (55%) pts, while 119 (28%) pts received critical care. A total of 78 of these 119 pts (66%) needed mechanical ventilation. COVID-19 mortality rate was 23%, while men were twice as likely to die as women (28% vs 14%). Additionally, active cancer disease (e.g. recurrent or metastatic cancer, pts receiving anti-cancer therapy) was associated with a higher mortality attributed to COVID-19 than in patients without active cancer disease (27% vs 17%)

Compared with non-cancer patients, the distribution of age and comorbidity differ significantly. Thus, patients without cancer were younger (most frequent age category 56 - 65) and had less comorbidity (CCI 1.12 vs 1.59). Survival at 30 days was worse in cancer patients (70%) versus those without cancer (77%), and mortality rate higher (23% vs 14%). However, after adjustments for age, sex and comorbidity, survival and mortality attributed to COVID-19 were comparable to non-cancer patients.

Dr Rüthrich concludes: "Even though survival and COVID-19 mortality of both groups appeared to be comparable, after adjusting for age, sex and comorbidity, our results show that cancer patients are at higher risk of more serious disease and death due to being generally older than non-cancer patients with COVID-19, and also having more underlying conditions. It does not appear to be the cancer itself that is leading to these poor outcomes."

We process language differently depending on whether we are reading alone or in the company of another person, according to a study carried out by teachers and researchers from the Complutense University of Madrid (UCM) and the Carlos III Health Institute (ISCIII) and published in Cortex.

The results of recording electrical activity in the brain indicated that when we read in company, our language processing is more heuristic, i.e. more global, controlled, integrated and possibly more creative.

"However, when we read alone, our language processing is more algorithmic, in other words, more automatic, limited and subject to rules", explained Laura Jiménez Ortega, a researcher in the Department of Psychobiology at the UCM and the UCM-ISCIII Centre for Evolution and Human Behaviour.

To compare the effect of company and solitude on language comprehension, the researchers measured electrical brain activity using electroencephalography (EEG).

Participants read texts containing syntactic or semantic errors, half of them in solitude and the other half in company. Those reading in company showed activity in the precuneus, an area of the brain involved in social and attentional processing. In addition, their language comprehension was more global and integrated compared with that of subjects reading alone.

In the social situation, syntactic errors elicited a pattern of electrical activity characteristic of semantic processing (N400), which is considered more heuristic and integrated. However, electrical brain activity in subjects reading alone showed a LAN pattern, characteristic of early, automatic processing.

The social isolation caused by the current coronavirus pandemic has created an unprecedented opportunity, prompting researchers to change perspective and conduct more research into social aspects of behaviour and language comprehension.

"Given that company favours a more creative and integrated understanding whereas isolation leads to more detailed and systematic processing, we need to start thinking more about the impact of social interaction in research, in education and in professional settings where language comprehension is fundamental", concluded Jiménez Ortega.

Millions of ibis and birds of prey mummies, sacrificed to the Egyptian gods Horus, Ra or Thoth, have been discovered in the necropolises of the Nile Valley. Such a quantity of mummified birds raises the question of their origin: were they bred, like cats, or were they hunted? Scientists from the CNRS, the Université Claude Bernard Lyon 1 and the C2RMF (1) have carried out extensive geochemical analyses on mummies from the Musée des Confluences, Lyon. According to their results, published on 22nd September 2020 in the journal Scientific Reports, they were wild birds.

Mammals, reptiles, birds: the tens of millions of animal mummies deposited as offerings in the necropolises of the Nile Valley bear witness to an intense religious fervour, and to the practices of collecting and preparing animals that undoubtedly contributed significantly to the economy from the Old Kingdom (3rd millennium BC) to Roman Egypt (1st-3rd centuries AD). However, the origin of these animals and the methods of supply remain unknown. For some tamed species, such as the cat, breeding was probably the most efficient way of supplying large numbers of animals for mummification. But unlike cats, bird mummies cover all stages of development, from egg to adult, which may indicate more opportunistic sourcing practices.

In order to determine the origin -- breeding or hunting -- of the mummified birds, tiny fragments of feathers, bones and embalming strips were taken from 20 ibis and birds of prey mummies from the collections of the Musée des Confluences, Lyon. If these birds, which migrate in the wild, had been bred, their diet would have been homogeneous, of local origin and reflected in the uniform isotopic composition (2) of the animal remains, regardless as to whether that diet had been produced specifically or derived from that of coexisting humans.

The various tissues were therefore dated using the carbon-14 method; and the isotopic compositions of oxygen, carbon, nitrogen, sulfur and strontium were measured, interpreted in terms of food sources and compared with those of contemporaneous human mummies. However, far from being homogeneous, these isotopic compositions showed a high variability and "exotic" signatures compared to those of ancient Egyptian humans: the birds were wild, migrating seasonally out of the Nile Valley.

These results, combined with that of a genetic study carried out by another team (3), suggest the mass hunting and capture of birds as documented on certain tomb frescoes (for example on the wall of Nakht's tomb in the Theban Necropolis). Indeed, the Egyptians probably exerted a significant ecological pressure on wild bird populations long before the decline in avifauna observed today.