Culture

Infants born to women with COVID-19 showed few adverse outcomes, according to the first report in the country of infant outcomes through eight weeks of age.

The study, led by researchers at UC San Francisco, suggests that babies born to mothers infected with the virus generally do well six to eight weeks after birth, however there was a higher rate of neonatal intensive care unit (NICU) admissions reported if the mothers had COVID-19 up to two weeks prior to delivery.

Among 263 infants in the study, adverse outcomes -- including preterm birth, NICU admission, and respiratory disease -- did not differ between those born to mothers testing positive for SARS-CoV-2 and those born to mothers testing negative. No pneumonia or lower respiratory tract infection were reported through eight weeks of age.

The study is published as a prepublication accepted manuscript in Clinical Infectious Diseases.

"The babies are doing well, and that's wonderful," said lead author Valerie J. Flaherman, MD, MPH, associate professor of pediatrics and of epidemiology and biostatistics at UCSF. "When coronavirus first hit, there were so many strange and unfortunate issues tied to it, but there was almost no information on how COVID-19 impacts pregnant women and their newborns. We didn't know what to expect for the babies, so this is good news."

The prospective study is part of a national project led by UCSF called PRIORITY (Pregnancy Coronavirus Outcomes Registry), which began in March 2020, shortly after the pandemic erupted in the United States. The project is designed for pregnant women with suspected or confirmed COVID-19, with the goal of better understanding how pregnant and postpartum women and their infants are affected by the virus.

It's known that pregnant women have alterations in their immune system that may increase the risk of severe illness from influenza viruses. In past outbreaks, women who contracted flu during pregnancy have been at higher risk for hospitalization, miscarriage or stillbirth, and their babies have had an increased likelihood of having birth defects.

While studies have reported that maternal SARS-CoV-2 infection increases the risk of preterm birth and can be transmitted from the mother to the infant, overall risks for the infants were not known and almost no information is available about how COVID-19 affects infants as they grow.

The new paper reports on live births among 179 mothers with a positive test for SARS-CoV-2 and 84 mothers who had a negative test. The births occurred at more than 100 U.S. hospitals. On average, the mothers were about 31 years old. Among women testing positive, 146 (81 percent) were symptomatic; among those testing negative, 53 (63 percent) were symptomatic.

Of the 263 infants in total, 44 were admitted to a NICU but no pneumonia or lower respiratory tract infections were reported during the study. Among the 56 infants assessed for upper respiratory infection, it was reported in two infants with COVID-positive mothers, and in one with a COVID-negative mother.

Among infants born to mothers who tested positive, the estimated incidence of a positive infant SARS-CoV-2 test was low at 1.1 percent, and COVID did not appear to impact those infants, the authors said.

"Overall, the initial findings regarding infant health are reassuring, but it's important to note that the majority of these births were from third trimester infections," said senior author Stephanie L. Gaw, MD, PhD, assistant professor of obstetrics, gynecology and reproductive sciences at UCSF. "The outcomes from our complete cohort will give the full picture of risks throughout pregnancy."

Two infants born to mothers who tested positive in the third trimester were reported to have birth defects, each with multiple congenital anomalies reported (one had cardiac, vertebral, renal and pulmonary anomalies, while the other had facial, genital, renal, brain and cardiac anomalies). One mother who tested negative reported an infant with gastrointestinal, renal and cardiac anomalies.

The researchers said the findings could help inform national and international guidelines and policies, but also noted some study limitations. Among those, tests for infection might be biased by false-positive or false-negative results. They also said that Latinas and Blacks were underrepresented in the study - in May, PRIORITY launched a new project to increase enrollment of underrepresented groups - and noted that further research is needed on infant incidence following maternal infection.

Researchers suggest employees should take a cue from Jimmy Fallon's Thank You Notes segment on The Tonight Show to improve workplace behavior. A recent University of Central Florida study suggests employees who keep a gratitude journal exhibit less rude behavior and mistreatment of others in the workplace.

"Gratitude interventions are exercises designed to increase your focus on the positive things in your life. One intervention involves writing down a list of things you are thankful for each day," says management Professor Shannon Taylor, who teamed up with fellow management Professor Maureen Ambrose and doctoral student Lauren Locklear for the study. "That simple action can change your outlook, your approach to work, and the way your co-workers see you."

Workplace mistreatment is widespread and can cost organizations millions of dollars each year. Bullying, gossip, and exclusion or ostracism have been shown to negatively impact physical health, job performance and job satisfaction. Mistreatment also hurts the bottom line, as it creates costs from productivity loss, employee turnover, and litigation.

"While organizations spend quite a bit of time and money to improve employee behavior, there are not a lot of known tools available to actually make the needed changes," Locklear said. "We found the gratitude journal is a simple, inexpensive intervention that can have a significant impact on changing employee behavior for the better."

For two weeks, study participants spent a few minutes a day jotting down the things, people and events they were grateful for -- and as a result, their coworkers reported that they engaged in fewer rude, gossiping, and ostracizing behaviors.

"Gratitude exercises are becoming increasingly popular products to improve employee attitudes and well-being, and our study shows managers can also use them to foster more respectful behavior in their teams," Taylor says.

The study was recently published in the Journal of Applied Psychology. Taylor, who joined UCF in 2012, has a doctorate in organizational behavior from Louisiana State University and a bachelor's degree in finance from Bradley University. His areas of research include leadership and workplace mistreatment. Ambrose is the Gordon J. Barnett Professor of Business Ethics at UCF College of Business. Her research interests include organizational fairness, ethics and workplace deviance. Locklear studies workplace deviance and mistreatment, as well as interventions in gratitude and mindfulness, and expects to graduate in the spring.

Researchers at the National Institute of Standards and Technology (NIST) have developed a new method of 3D-printing gels and other soft materials. Published in a new paper, it has the potential to create complex structures with nanometer-scale precision. Because many gels are compatible with living cells, the new method could jump-start the production of soft tiny medical devices such as drug delivery systems or flexible electrodes that can be inserted into the human body.

A standard 3D printer makes solid structures by creating sheets of material -- typically plastic or rubber -- and building them up layer by layer, like a lasagna, until the entire object is created.

Using a 3D printer to fabricate an object made of gel is a "bit more of a delicate cooking process," said NIST researcher Andrei Kolmakov. In the standard method, the 3D printer chamber is filled with a soup of long-chain polymers -- long groups of molecules bonded together -- dissolved in water. Then "spices" are added -- special molecules that are sensitive to light. When light from the 3D printer activates those special molecules, they stitch together the chains of polymers so that they form a fluffy weblike structure. This scaffolding, still surrounded by liquid water, is the gel.

Typically, modern 3D gel printers have used ultraviolet or visible laser light to initiate formation of the gel scaffolding. However, Kolmakov and his colleagues have focused their attention on a different 3D-printing technique to fabricate gels, using beams of electrons or X-rays. Because these types of radiation have a higher energy, or shorter wavelength, than ultraviolet and visible light, these beams can be more tightly focused and therefore produce gels with finer structural detail. Such detail is exactly what is needed for tissue engineering and many other medical and biological applications. Electrons and X-rays offer a second advantage: They do not require a special set of molecules to initiate the formation of gels.

But at present, the sources of this tightly focused, short-wavelength radiation -- scanning electron microscopes and X-ray microscopes -- can only operate in a vacuum. That's a problem because in a vacuum the liquid in each chamber evaporates instead of forming a gel.

Kolmakov and his colleagues at NIST and at the Elettra Sincrotrone Trieste, in Italy, solved the issue and demonstrated 3D gel printing in liquids by placing an ultrathin barrier -- a thin sheet of silicon nitride -- between the vacuum and the liquid chamber. The thin sheet protects the liquid from evaporating (as it would ordinarily do in vacuum) but allows X-rays and electrons to penetrate into the liquid. The method enabled the team to use the 3D-printing approach to create gels with structures as small as 100 nanometers (nm) -- about 1,000 times thinner than a human hair. By refining their method, the researchers expect to imprint structures on the gels as small as 50 nm, the size of a small virus.

Some future structures made with this approach could include flexible injectable electrodes to monitor brain activity, biosensors for virus detection, soft micro-robots, and structures that can emulate and interact with living cells and provide a medium for their growth.

"We're bringing new tools -- electron beams and X-rays operating in liquids -- into 3D printing of soft materials," said Kolmakov. He and his collaborators described their work in an article posted online Sept. 16 in ACS Nano.

Using a combination of demographic and clinical data gathered from seven weeks of COVID-19 patient care early in the coronavirus pandemic, Johns Hopkins researchers today published a "prediction model" they say can help other hospitals care for COVID-19 patients -- and make important decisions about planning and resource allocations.

Brian Garibaldi, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine, led a team that published in the Annals of Internal Medicine the article that shares important lessons learned in the care of COVID-19 patients between March 4 and April 24, 2020, at five Johns Hopkins hospitals in Maryland and Washington, D.C.

During those 52 days, The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Suburban Hospital and Sibley Memorial Hospital admitted a combined 827 people age 18 or older -- 336 Black, 264 white, 135 Hispanic, 48 Asian, 2 Native American and 42 multiracial -- who tested positive for the coronavirus and had symptoms of COVID-19.

From the data those patients generated, the researchers developed a prediction model using a set of risk factors known to be associated with COVID-19 to forecast how likely a patient's disease is to worsen while being treated in a hospital and at what point in their care that might happen. Among the risk factors researchers considered as part of the model were a patient's age, body mass index (BMI), lung health and chronic disease, as well as vital signs and the severity of a patient's COVID-19 symptoms at the time of admission.

The model, called the "COVID Inpatient Risk Calculator (CIRC)," is available online. Garibaldi says the calculator is meant to help hospital physicians and other health care providers assess the risk of a patient's condition worsening.

"This is some of what we've learned in the months since we started seeing patients with COVID-19 at our hospitals," says Garibaldi. "As we continue to grapple with high numbers of COVID-19 infections across the United States, it's important to share knowledge with our colleagues at other hospitals."

Among the highlights of the study was the rapidity with which the disease can progress from mild or moderate to severe, particularly if a patient had all or some of the risk factors associated with the disease. Forty-five of the patients in the study had severe COVID-19 when they were admitted to the hospital. But 120 patients developed severe disease or died within 12 hours of being admitted. Of the 302 patients in the study who developed severe disease or died, the median time of disease progression was 1.1 days.

"Rapid progression of disease following admission [to the hospital] provides a narrow window to intervene," Garibaldi writes in the article. "Different combinations of risk factors appear to predict severe disease or death, with probabilities ranging from over 90% to as little as 5%."

For example, using the CIRC, Garibaldi and his colleagues estimate that a 60-year-old white woman with a BMI of 28, no chronic disease and no fever who is hospitalized for COVID-19 has a 10% chance of her disease worsening by day two of her hospital stay. The longer she's in the hospital, the greater that chance becomes, at 15% after four days and 16% after a week.

Conversely, the researchers considered an 81-year-old Black woman admitted to the hospital with COVID-19. The hypothetical patient has a BMI of 35, diabetes, hypertension and a fever. CIRC forecasts her probability of progressing to severe disease or even death by just the second day of her hospital stay is 89%. That percentage increases to higher than 95% by days four and seven.

By June 24, 694 of the patients in the study had been discharged from the hospital, 131 had died and seven were still hospitalized with severe COVID-19.

"We identified a few readily measurable demographic and clinical factors that, when assessed on admission to the hospital, can predict if someone has a 5% or a 90% risk of developing severe disease or dying from COVID-19," says Amita Gupta, M.D., professor of medicine at the Johns Hopkins University School of Medicine, who directs the Center for Clinical Global Health Education and is a co-author of the study. "This is incredibly useful information to have when communicating with patients and their families, as well as for informing resource allocation in the hospital."

The study's data comes from a registry of all patients treated for the novel coronavirus infection at hospitals in the Johns Hopkins system. Known as "JH-CROWN," the registry -- which is funded by InHealth, the institution's precision medicine initiative -- offers demographics, diagnoses, procedures, social histories and other data points relevant to caring for COVID-19 patients.

"The JH-CROWN data registry embodies the same teamwork and dedication that went into the care of more than 3,000 COVID-19 patients admitted to Johns Hopkins hospitals since the start of the pandemic," Garibaldi says. "We hope it can teach us more about the nature of COVID-19 and improve both patient care and research as we prepare for a second wave of infections in the fall."

Diabetic ketoacidosis (DKA), a serious but common complication of type 1 diabetes, is linked to lower IQ scores and worse memory in children with type 1 diabetes, according to a study led by UC Davis Health researchers. The study published Sept. 22 in Diabetes Care is also the first large-scale work to differentiate between DKA's impact on children with a new diagnosis and children with a previous diagnosis of type 1 diabetes.

DKA happens when diabetes goes undiagnosed or is poorly managed. With DKA, blood sugar gets very high as acidic substances called ketones build up to dangerous levels in the body. Early signs of DKA include excessive thirst, frequent urination, and nausea, abdominal pain, weakness and confusion.

"We assessed the neurocognitive effects of DKA in children with known type 1diabetes as well as in those who were just diagnosed with it," said Simona Ghetti, professor of psychology at UC Davis and the lead author on the study. "Our study uncovered that even one severe episode of DKA in children newly diagnosed with type 1 diabetes is linked to cognitive problems; and among children with a previous diagnosis, repeated DKA exposure predicted lower cognitive performance after accounting for glycemic control."

The study included 376 children with type 1 diabetes and no DKA history and 758 children with type 1 diabetes and a history of DKA. These children, ages 6-18 years, were participating in a DKA clinical trial at the Pediatric Emergency Care Applied Research Network (PECARN) sites led by two of the study's co-authors, Nathan Kuppermann and Nicole Glaser.

One severe DKA episode can hurt memory and IQ

The study found that among children newly diagnosed with type 1 diabetes, those who experienced moderate and severe DKA had lower long-term memory compared to children with diabetes and no exposure to DKA. Greater severity of DKA was also associated with lower IQ in these children.

Children with a previous diagnosis showed lower performance compared with children with new onset in measures of memory and IQ, suggesting that cognitive deficits may worsen over time.

The study's large sample allowed the researchers to capture complex associations of DKA severity, socioeconomic status and glycemic control among previously diagnosed patients. These associations revealed that patients with repeated DKA exposure and poorly controlled type 1 diabetes are at substantial risk of cognitive deficits.

"The results from the study emphasize the importance of prevention of DKA in children with known type 1 diabetes and of timely diagnosis during new onset before the development of DKA," said Glaser, professor of pediatrics at UC Davis Health and senior author of the study. "There is an opportunity to prevent DKA with proper management of the glucose level in the blood."

Wave scattering appears practically everywhere in everyday life--from conversations across rooms, to ocean waves breaking on a shore, from colorful sunsets, to radar waves reflecting from aircraft. Scattering phenomena also appear in realms as diverse as quantum mechanics and gravitation. According to Pavel Ginzburg, professor at Tel Aviv University's School of Electrical Engineering, these phenomena become especially interesting when the waves in question encounter a moving object.

The everyday Doppler effect is familiar--witnessed as the audible shift in pitch that occurs, for example, as a fire engine's siren approaches, passes, and recedes. The idea that the observed frequency of a wave depends on the relative speed of the source and the observer, a popularized aspect of Einstein's theory of relativity, entails cosmic implications for the Doppler effect, particularly for light waves. Now, it appears that between relativity and the classical (stationary) wave regime, there exists another regime of wave phenomena, where memory influences the scattering process.

Memory effect alters the Doppler wave signature

As recently demonstrated by a team of scientists led by Ginzburg, including lead author Vitali Kozlov and coauthors Sergey Kosulnikov and Dmytro Vovchuk, the Doppler effect can be dramatically altered by memories of prior wave interactions. Specifically, when rotating dipoles are arranged to retain a long memory of past interactions with an incident wave, the Doppler signature displays asymmetric peaks in the scattered spectrum. Rather than fading quickly, these long-lasting past interactions affect the present and future evolution of the system under study.

"The newly discovered memory effect is universal," observes Ginzburg, "It can emerge in a variety of wave-related scenarios--from optics, where lasers are rotating molecules, to astronomy, where rotating dipoles can approximate neutron stars." Although the effect is universal, Ginzburg notes that not every scatterer possesses a long memory. "The effect is introduced on purpose, for instance with lumped circuitry in the case of electromagnetic applications," explains Ginzburg. He speculates that the memory effect may contribute to increased efficiency of radar target identification and classification, among other applications, such as stellar radiometry.

Ginzburg's team set out to answer the question of whether there is "an overlooked interaction regime, which on the one hand does not require relativistic velocities yet on the other hand cannot be straightforwardly explained with classical stationary physics." The team chose a simple case of a rotating dipole as a mathematical model that is "capable of describing properties of many real objects, such as quasars in astronomy or rotating blades of a helicopter in radar applications," according to Ginzburg.

The researchers hope that these newly demonstrated memory effects will be used to advance our understanding of the universe around us and help give rise to new technological applications that take advantage of long-memory materials to imprint motion signatures on scattered waves.

Hospitalized patients with COVID-19 may face an increased risk for kidney injury, a dreaded complication for those suffering from infection with the novel 2019 coronavirus, an observational study led by University of Michigan researchers has found.

According to Jochen Reiser, MD, PhD, the Ralph C Brown MD professor and chairperson of Rush's Department of Internal Medicine, patients with COVID-19 experience elevated levels of soluble urokinase receptor (suPAR), an immune-derived pathogenic protein that is strongly predictive of kidney injury.

"SuPAR is a circulating factor we've seen contribute to kidney injury in thousands of patients," Reiser said. "RNA viruses such as HIV and SARS-CoV-2 (the virus that causes COVID-19) elicit a suPAR response of the innate immune system, leading to a rise in blood suPAR levels. If there is a hyperinflammatory suPAR response, kidney cells may be damaged."

Reiser is an author of the multicenter study led by Salim Hayek MD, an assistant professor of cardiology at University of Michigan, "Soluble Urokinase Receptor in COVID-19 related Acute Kidney Injury." Published online in the Journal of the American Society of Nephrology on Sept. 22, the study results show that more than a third patients with COVID-19 end up in need of dialysis and are also at much higher risk of death.

The research team tested suPAR levels of 352 study participants when they were admitted to the hospital for COVID-19 infection. A quarter of the participants developed acute kidney injury while hospitalized, and their median suPAR levels were more than 60% higher than those of the rest of the participants.

The risk of needing dialysis was increased 20-fold in patients with the highest suPAR levels. Overall, median suPAR levels for these study participants hospitalized with severe COVID-19 were almost three times higher than levels of healthy people.

"Certainly, a suPAR level at time of hospitalization of COVID-19 patients will provide an important risk stratification tool with respect to patient outcomes such as intubation or kidney failure," Hayek said. "This will help hospitals by providing proper surveillance of patients at higher risk of a severe COVID-19 course.

"Now that we know the epidemiological link of suPAR to COVID-19-associated acute kidney injury (AKI), we must study if suPAR is a cause of COVID-19 associated AKI," Reiser said. "In other words, can AKI in COVID-19 infected patients be prevented by keeping plasma suPAR levels low? This hypothesis is supported by the findings of the paper showing that COVID-19 infected study patients with a suPAR level below 4.6 ng/ml never needed dialysis. A newly developed and specific suPAR apheresis device is about to enter a clinical pilot trial where this scenario is tested."

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.

Prediction model uses patient data at admission to determine potential disease trajectory for COVID-19 patients
Older age and obesity independent risk factors for severe disease and death
Data can be used to determine resource allocation and care decisions

Data collected from participants upon hospital admission at a single health care system were used to develop a decision tool called the COVID-19 Inpatient Risk Calculator (CIRC). This prediction model proved accurate at determining potential disease trajectory, or whether a patient's disease would worsen while being treated in the hospital and at what point in their care that might happen. Older age and obesity were found to be independent risk factors for progression of COVID-19 to severe disease or death. Findings from a cohort study are published in Annals of Internal Medicine.

Researchers from Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health reviewed 827 consecutive COVID-19 admissions in five Maryland and Washington, D.C. area hospitals to determine the factors on hospital admission that are predictive of severe disease or death from COVID-19. Among the risk factors researchers considered as part of the model were a patient's age, body mass index (BMI), lung health and chronic disease, as well as vital signs and the severity of a patient's COVID-19 symptoms at the time of admission. The researchers found that 90 percent of deaths occurred in patients 60 years and older. Other risk factors included older age and living in a nursing home, especially in patients over 70. BMI, independent of age, was also associated with progression to severe disease or death. The researchers noted how quickly patients could progress to severe illnesses when patients had all or some of the risk factors.

MELBOURNE, Australia, September 22, 2020 - Is the world prepared a wave of neurological consequences that may be on its way as a result of COVID-19? This question is at the forefront of research underway at the Florey Institute of Neuroscience and Mental Health. A team of neuroscientists and clinicians are examining the potential link between COVID-19 and increased risk of Parkinson's disease, and measures to get ahead of the curve.

"Although scientists are still learning how the SARS-CoV-2 virus is able to invade the brain and central nervous system, the fact that it's getting in there is clear. Our best understanding is that the virus can cause insult to brain cells, with potential for neurodegeneration to follow on from there," said Professor Kevin Barnham from the Florey Institute of Neuroscience & Mental Health.

In a review paper published today, researchers put spotlight on the potential long-term neurological consequences of COVID-19, dubbing it the 'silent wave'. They are calling for urgent action to be taken to have available more accurate diagnostic tools to identify neurodegeneration early on and a long-term monitoring approach for people who have been infected with the SARS-CoV-2 virus.

The researchers report that neurological symptoms in people infected with the virus have ranged from severe, such as brain hypoxia (lack of oxygen), to more common symptoms such as loss of smell.

"We found that loss of smell or reduced smell was on average reported in three out of four people infected with the SARS-CoV-2 virus. While on the surface this symptom can appear as little cause for concern, it actually tells us a lot about what's happening on the inside and that is that there's acute inflammation in the olfactory system responsible for smell," explained Florey researcher Leah Beauchamp.

Inflammation is understood to play a major role in the pathogenesis of neurogenerative disease and has been particularly well studied in Parkinson's. Further research into these illnesses may prove critical for future impacts of SARS-CoV-2.

"We believe that loss of smell presents a new way forward in detecting someone's risk of developing Parkinson's disease early. Armed with the knowledge that loss of smell presents in around 90% of people in the early stages of Parkinson's disease and a decade ahead of motor symptoms, we feel we are on the right track," added Ms Beauchamp.

Clinical diagnosis of Parkinson's disease currently relies on presentation of motor dysfunction, but research shows that by this time 50-70% of dopamine cell loss in the brain has already occurred.

"By waiting until this stage of Parkinson's disease to diagnose and treat, you've already missed the window for neuroprotective therapies to have their intended effect. We are talking about an insidious disease affecting 80,000 people in Australia, which is set to double by 2040 before even considering the potential consequences of COVID, and we currently have no available disease-modifying therapies," said Professor Barnham.

The researchers hope to establish a simple, cost-effective screening protocol aiming to identify people in the community at risk of developing Parkinson's, or who are in early stages of the disease, at a time when therapies have the greatest potential to prevent onset of motor dysfunction. They plan to put the proposal forward for funding from the Australian Government's Medical Research Future Funding scheme.

Additionally, the team have developed two neuroprotective therapies currently under investigation and have identified a cohort of subjects who are ideally suited to study the treatments. Through their research they gained new evidence that people with REM sleep behaviour disorder have a higher predisposition to go on to develop Parkinson's disease.

Parkinson's disease is a significant economic burden costing the Australian economy in excess of $10 billion a year.

"We have to shift community thinking that Parkinson's not a disease of old age. As we've been hearing time and time again, the coronavirus does not discriminate - and neither does Parkinson's," said Professor Barnham.

"We can take insight from the neurological consequences that followed the Spanish Flu pandemic in 1918 where the risk of developing Parkinson's disease increased two to three-fold. Given that the world's population has been hit again by a viral pandemic, it is very worrying indeed to consider the potential global increase of neurological diseases that could unfold down track."

He added, "The world was caught off guard the first-time, but it doesn't need to be again. We now know what needs to be done. Alongside a strategized public health approach, tools for early diagnosis and better treatments are going to be key."

Before the pandemic, there wasn't any difference in the rates at which Democratic and Republican voters actually cast their ballots by mail or in-person. That may change now.

Based on nationally representative surveys conducted in the spring of 2020 and through the summer, researchers report a significantly greater preference for mail, or absentee, ballots among Democrats than among Republicans. The researchers document for the first time a partisan gap in stated preferences in April 2020. By June, that gap had doubled - from a 10% difference in April to a 20% one in June. The gap was even wider among those exposed to scientific projections about the COVID-19 pandemic, with Democrats then expressing even greater preferences for mail ballots while Republicans were unaffected.

These findings are detailed in a study published in the Proceedings of the National Academy of Sciences.

After finalizing their PNAS paper, the research team - members of the New Electorate Project from UC San Diego, UC Riverside and the University of Southern California - continued to survey America's eligible voters. The partisan gap, they say, has continued to grow: By late August, more than half of Democrats but less than a quarter of Republicans said they personally preferred to vote by mail.

"A serious partisan divide has opened up on preferences for voting by mail and has grown from a gap to a gulf over the past several months," said Thad Kousser, a UC San Diego professor of political science, who is senior author on the PNAS study and the New Electorate Project's principal investigator.

Study also finds widespread, bipartisan support for mail ballots

An encouraging finding: Personal preferences aside, there is bipartisan support for making mail ballots available to all voters who want them.

"Despite the polarization, we see support across the board for making voting more accessible," said Mackenzie Lockhart, corresponding author on the PNAS study and a political science doctoral candidate at UC San Diego.

"In all our surveys, a majority of Republicans and Democrats supported not only making vote-by-mail ballots available to anyone who wants them," Lockhart said, "but also sending ballots directly to every registered voter, regardless of how they intend to vote."

Kousser notes that policies allowing any voter who requests an absentee ballot to cast their vote this way are place in most states, including nearly every swing state in the presidential election.

Why the gap?

The researchers attribute the growth in the partisan divide to two things: signals from partisan elites in both parties and Republican partisans' distrust in science and experts.

"Republican and Democratic lawmakers have staked out very different positions on voting by mail and voters have begun to notice," Lockhart said. "But on top of that, our evidence suggests that voters' views on COVID-19 are probably also polarizing the issue. We found that scientific predictions about the COVID-19 pandemic had much smaller effects on Republicans than Democrats and contributed to a larger gap between partisans."

Will the gap matter in November?

Each of the surveys was conducted with more than 5,600 Americans of voting age. What remains an open question is whether there will now also be a partisan difference in actual voting behaviors, with Republicans turning out to vote in person at polling places at greater rates than Democrats. And will Democrats, in turn, vote at greater rates by mail ballot - which, depending on state laws, they'll then drop off at polling places or secure drop-boxes, or send through the mail?

Also an open question: Will this gap affect the outcomes of the 2020 U.S. presidential election?

"We don't know what will happen in November," Lockhart said, "and if things go smoothly with both voting methods, then the partisan differences we found might not matter. But, based on our results, if either mode of voting (in-person or by mail) ends up not running smoothly, that's when these differences in how partisans want to vote could matter."

If a spike in infection rates makes voting in-person more difficult or delays in the mail mean mail ballots arrive after the deadline, Lockhart said, how exactly partisans decide to vote could have a big effect on the election.

The study's other co-authors are Seth Hill of UC San Diego, Jennifer Merolla of UC Riverside and Mindy Romero of the University of Southern California

The New Electorate Project is funded by the UC Office of the President.

The recent deaths of George Floyd, Breonna Taylor and Ahmaud Arbery added new momentum to the Black Lives Matter social movement in the United States. But Stanford researchers have found that local news media have not treated Black and Hispanic lives as equal in value to white lives in stories.

Forrest Stuart, associate professor of sociology in Stanford's School of Humanities and Sciences, worked with University of Chicago researchers Kailey White and Shannon L. Morrissey to quantify how local news organizations cover homicide victims in minority neighborhoods.

The team focused on Chicago, Illinois, in 2016 - one of the deadliest years in the nation's third-largest city - when 762 people were killed. The study, published Sept. 17 in the journal Sociology of Race and Ethnicity, found that victims killed in predominantly Black neighborhoods - common to Chicago's West and South Sides - received less news coverage than those killed in mostly white neighborhoods - common to Chicago's North Side. The disparities extend to the city's Hispanic-majority neighborhoods, where victims received more coverage than killings in Black neighborhoods.

But both categories of victims were often not covered with "complex personhood," the researchers concluded, meaning any mention of the fullness of their lives as spouses, parents, children, siblings or community members. This is something the family of recent police shooting victim Jacob Blake, of Kenosha, Wisconsin, has talked about. "I am my brother's keeper," Blake's sister Letetra Widman said in news interviews. "And when you say the name Jacob Blake, make sure you say father, make sure you say cousin, make sure you say son, make sure you say uncle."

"We all have these universal things about us that make us human," Stuart said, "so the question very quickly becomes: Who has the privilege, who has the honor of being talked about in any of those ways?"

"We can assume that anyone who dies is a family member - they have people who are going to be mourning their death, a community that is going to be affected," Morrissey added. "So why is it that only some victims are written about in that way? What makes a reporter choose to put in the effort to track down a middle-school teacher or talk to a neighbor?"

Building an article database

The study was motivated by the 2014 police killings of Michael Brown in Ferguson, Missouri, and Laquan McDonald in Chicago. Stuart began subscribing to news alerts about homicides across Chicago and thought there was something different about the way shootings were covered on the mostly white North Side compared to other largely minority areas of the city.

"As a social scientist, I thought, 'Wouldn't it be even more powerful to quantify the value of different folks' lives from different racial identities and backgrounds in news coverage and hold those up next to each other?'" he said.

Stuart and his colleagues spent two years collecting and manually analyzing thousands of news articles. They combed through every article on every death to determine the victim's name, race and gender as well as time and location of death and then reconciled that information with police data.

The team examined 2,245 news articles about homicide victims from the Chicago Sun-Times' Homicide Watch, the Chicago Tribune's Homicide Tracker and the now-defunct DNAInfo database to determine how the individuals were covered. They looked at how much coverage each person received, considering factors like word count, and which articles recognized someone as more than a victim - as a complex, multi-dimensional human being with a family and community connections. The articles were cross-referenced with official Chicago Police Department public records.

Their analysis determined that about 35 percent of murder victims in majority-white neighborhoods are likely to be covered as a complex person - about double that of victims in majority-Black neighborhoods (17 percent) and majority-Hispanic neighborhoods (18 percent). Furthermore, homicide victims in majority-white neighborhoods received about 450 words more of text on average than those killed in majority-Black neighborhoods. The researchers found that Black victims' names were sometimes misspelled or had transposed letters in the news reports.

"Even just reading the news articles, there was a palpable difference in the way that victims and neighborhoods were talked about," said Morrissey, a doctoral student in the Department of Sociology at the University of Chicago. "This paper does well to remind us that the disparities are on a neighborhood and community level."

Disparities in news coverage

Victims across races were covered in an average of 2.8 newspaper articles, with an average of 3.8 articles for white victims, 2.8 for Black victims and 2.6 for Hispanic victims. "Not all of these articles - even for the same person - are made the same," Stuart explained. "Just because someone's name is showing up in an article doesn't mean the article has the same kind of essence."

The researchers differentiated between articles that simply listed a victim in a weekend review of homicides and more nuanced articles that tried to capture an individual's life.

"There were other articles especially about victims from majority-white neighborhoods where the reporters were doing interviews with family members, with friends, with teachers, coaches, with all sorts of people in the victim's life, and they were providing quotes," said White, a fourth-year doctoral student in the Department of Sociology at the University of Chicago. "They talked about the victim in a very different way - like this complex person who has value and who is being missed by the community, family members and friends."

The researchers acknowledged an important caveat in the study: Chicago remains deeply segregated. Only 4 percent of Chicago's 2016 murders happened to white victims and few of them were killed in majority-Black neighborhoods. Similarly, only a few Black victims were killed in mostly white neighborhoods. They also acknowledged that their study focused on one city and the results could look different in various parts of the country, as well as in suburban versus urban centers.

But in Chicago, a city that is almost a third white, a third Black and a third Hispanic, racial disparities in news coverage persist, even when controlling for each neighborhood's unique homicide rate, according to the researchers. They emphasized that their study demonstrates the importance of understanding the racialization of places at the neighborhood level and the cycle of devaluing minority lives.

"Race isn't just your phenotypical coloring," Stuart said. "Race is a series of historic, economic, symbolic and, importantly, geographical set of power relations where some people are stigmatized and rendered powerless or less powerful. These are systems of domination."

DURHAM, N.C. -- A study appearing next week in the journal Nature Communications offers some good news in the search for antiviral drugs for hard-to-treat diseases. Researchers have identified a potential new drug candidate against enterovirus 71, a common cause of hand, foot and mouth disease in infants and young children.

The compound of interest is a small molecule that binds to RNA, the virus's genetic material, and changes its 3-D shape in a way that stops the virus from multiplying without harming its human host.

There are currently no FDA-approved drugs or vaccines for enterovirus 71, which affects hundreds of thousands of children each year, particularly in Southeast Asia. While most people get better within 7 to 10 days after suffering little more than a fever and rash, severe cases can cause brain inflammation, paralysis and even death.

The work could pave the way for new treatments for other viral infections as well, says a team of scientists at Duke University, Case Western Reserve University and Rutgers University.

Traditionally, most drugs are designed to bind to proteins to block or disrupt their role in causing disease. But much of the genome in humans and their microbial pathogens doesn't code for proteins, which means that only a fraction of their genetic material is targeted by existing drugs.

"For diseases that don't have good treatments, maybe the problem is we've been targeting the wrong thing," said co-author Amanda Hargrove, associate professor of chemistry at Duke.

Instead of targeting proteins, Hargrove and others are looking for small molecules that target RNA, which most drug discovery programs have overlooked.

When a virus like enterovirus 71 (or SARS-CoV-2, the virus that causes COVID-19) infects a human cell, it injects its RNA into the cell, hijacking the internal machinery to make copies of itself that eventually burst out to infect neighboring cells.

Previous work on enterovirus 71 singled out one part of its RNA structure that helps the virus co-opt the host machinery it needs to replicate. This RNA region folds over on itself to form a hairpin, with a bulge in the middle where unpaired nucleotides balloon out to one side.

If a drug can be developed to inhibit this region, the researchers say, we might be able to block the virus before it has a chance to spread.

For the current study, Hargrove and colleagues screened a library of some 30 small molecules, looking for ones that bind tightly to the bulge and not other sites in the virus's RNA.

RNA is a wiggly molecule; when it binds to other molecules such as host proteins or small molecule drugs it takes on different 3-D shapes.

The researchers identified one molecule, dubbed DMA-135, that enters infected human cells and attaches itself to the surface of the bulge, creating a kink in this region.

This shape change, in turn, opens access to another molecule -- a human repressor protein that blocks the "reading out" of the virus's genetic instructions, stopping viral growth in its tracks.

In an experiment, the researchers were able to use the molecule to stop the virus from building up inside human cell cultures in the lab, with bigger effects at higher doses.

Hargrove says it would take at least five years to move any new drug for hand, foot and mouth disease from the lab to medicine cabinets. Before their small molecule could reach patients, the next step is to make sure it's safe and effective in mice.

In the meantime, the researchers are building on their success with enterovirus 71 and looking at whether RNA-targeting small molecules could be used to tackle other RNA viruses too, including SARS-CoV-2.

Researchers around the world are a step closer to a better understanding of the intricacies of COVID-19 thanks to two new web resources developed by investigators at Baylor College of Medicine and the University of California San Diego.
The resources are freely available through the Signaling Pathways Project (Baylor) and the Network Data Exchange (UCSD). They put at researchers' fingertips information about cellular genes whose expression is affected by coronavirus infection and place these data points in the context of the complex network of host molecular signaling pathways. Using this resource has the potential to accelerate the development of novel therapeutic strategies. The study appears in the journal Scientific Data.

"Our motivation for developing this resource is to contribute to making research about COVID-19 more accessible to the scientific community. When researchers have open access to each other's work, discoveries move forward more efficiently," said leading author Dr. Neil McKenna, associate professor of molecular and cellular biology and member of the Dan L Duncan Comprehensive Cancer Center at Baylor.

The Signaling Pathway Project

For years, the scientific community has been generating and archiving molecular datasets documenting how genes are expressed as cells conduct their normal functions, or in association with disease. However, usually this information is not easily accessible.

In 2019, McKenna and his colleagues developed the Signaling Pathways Project, a web-based platform that integrates molecular datasets published in the scientific literature into consensus regulatory signatures, or what they are calling consensomes, that rank genes according to their rates of differential expression.

In the current study, the researchers generated consensomes for genes affected by infection with three major coronaviruses, Middle East respiratory syndrome coronavirus (MERS) and severe acute respiratory syndrome coronaviruses 1 (SARS1) and 2 (SARS2, which causes COVID-19).

McKenna and his colleagues provide a resource that assists researchers in making the most out of coronavirus' datasets. The resource identifies the genes whose expression is most consistently affected by the infection and integrates those responses with data about the cells' molecular signaling pathways, in a sense getting a better picture of what happens inside a cell infected by coronavirus and how the cell responds.

"The collaboration with UCSD makes our analyses available as intuitive Cytoscape-style networks," says McKenna. "Because using these resources does not require training in meta-analysis, they greatly lower the barriers to usability by bench researchers."

Providing new insights into COVID-19

The consensus strategy, the researchers explain, can bring to light previously unrecognized links or provide further support for suspected connections between coronavirus infection and human signaling pathways, ultimately simplifying the generation of hypotheses to be tested in the laboratory.

For example, the connection between pregnancy and susceptibility to COVID-19 has been difficult to evaluate due to lack of clinical data, but McKenna and colleagues' approach has provided new insights into this puzzle.

"We found evidence that progesterone receptor signaling antagonizes SARS2-induced inflammatory signaling mediated by interferon in the airway epithelium. This finding suggests the hypothesis that the suppression of the interferon response to SARS2 infection by elevated circulating progesterone during pregnancy may contribute to the asymptomatic clinical course," McKenna said.

Consistent with their hypothesis, while this paper was being reviewed, a clinical trial was launched to evaluate progesterone as a treatment for COVID-19 in men.

COLUMBUS, Ohio - The disruptive inventions that make people go "Wow!" tend to come from research in the heart of cities and not in the suburbs, a new study suggests.

Researchers found that, within metro areas, the majority of patents come from innovations created in suburbs - often in the office parks of big tech companies like Microsoft and IBM.

But the unconventional, disruptive innovations - the ones that combine research from different technological fields - are more likely to be produced in cities, said Enrico Berkes, co-author of the study and postdoctoral researcher in economics at The Ohio State University.

These unconventional patents are ones that, for example, may blend research on acoustics with research on information storage - the basis for digital music players like the iPod. Or patents that cite previous work on "vacuum cleaning" and "computing" to produce the Roomba.

"Densely populated cities do not generate more patents than the suburbs, but they tend to generate more unconventional patents," said Berkes, who did the work as a doctoral student at Northwestern University.

"Our findings suggest that cities provide more opportunities for creative people in different fields to interact informally and exchange ideas, which can lead to more disruptive innovation."

Berkes conducted the study with Ruben Gaetani, assistant professor of strategic management at the University of Toronto. Their research was published online recently in The Economic Journal.

Previous research had shown that large metropolitan areas are where patenting activity tends to concentrate, Berkes said, suggesting that population density is an important factor for innovation.

But once Berkes and Gaetani started looking more closely at metro areas, they found that a sizable share of these patents was developed in the suburbs - the least densely populated part.
Nearly three-quarters of patents came from places that had density below 3,650 people per square mile in 2000, about the density of Palo Alto, California.

"If new technology is spurred by population density, we wanted to know why so much is happening in the least dense parts of the metro areas," Berkes said.

So Berkes and Gaetani analyzed more than 1 million U.S. patents granted between January 2002 and August 2014. They used finely geolocated data from the U.S. Patent and Trademark Office that allowed them to see exactly where in metro areas - including city centers and specific suburbs - that patented discoveries were made.

But they were also interested in determining the type of innovations produced - whether they would be considered conventional or unconventional. They did this by analyzing the previous work on which each patent was based.

The researchers tagged new patents as unconventional if the inventors cited previous work in widely different areas.

For example, a patent from 2000 developed in Pittsburgh is one of the first recorded inventions in wearable technologies and one of the precursors to products such as Fitbit. It was recognized as unconventional because it cites previous patents in both apparel and electrical equipment - two very distant fields.

After analyzing the data, the researchers found that both urban and suburban areas played a prominent role in the innovation process, but in different ways, Berkes said.

Large innovative companies, such as IBM or Microsoft, tend to perform their research in large office parks located outside the main city centers.

"These companies are very successful in taking advantage of formal channels of knowledge diffusion, such as meetings or conferences, where they can capitalize on the expertise of their scientists and have them work together on specialized projects for the company," Berkes said.

"But it is more difficult for them to tap ideas from other scientific fields because this demands interactions with inventors they're not communicating with every day or running into in the cafeteria or in the hallway."

That's where the urban cores excelled. In cities like San Francisco and Boston, researchers may meet people in entirely different fields at bars, restaurants, museums and cultural events. Any chance encounter could lead to productive partnerships, he said.

"If you want to create something truly new and disruptive, it helps if you have opportunities to casually bump into people from other scientific fields and exchange ideas and experiences and knowledge. That's what happens in cities," he said.

"Density plays an important role in the type, rather than the amount, of innovation."

These findings show the potential value of tech parks that gather technology startup companies in a variety of fields in one place, Berkes said. But they have to be set up properly.

"Our research suggests that informal interactions are important. Tech parks should be structured in a way that people from different startups can easily interact with each other on a regular basis and share ideas," he said.

Children and adults exhibit distinct immune system responses to infection by the virus that causes COVID-19, a finding that helps explain why COVID-19 outcomes tend to be much worse in adults, researchers from Yale and Albert Einstein College of Medicine report Sept. 18 in the journal Science Translational Medicine.

A widespread and dangerous immune response to the virus has been linked to acute respiratory distress syndrome, the need for ventilation, and increased mortality in adults with COVID-19. These outcomes are less common in children, which has led to speculation that immune system response to the virus is somehow suppressed. But the new study, which examined serum and cell samples obtained from pediatric and adult patients diagnosed with COVID-19, found that children actually express higher levels of two specific immune system molecules. The researchers believe this may contribute to the better outcomes.

"To our surprise, we found these particular serum cytokines were at higher levels in children than adults," said Kevan Herold, the C.N.H. Long Professor of Immunology and Internal Medicine at Yale and co-senior author of the paper.

Intriguingly, the analysis also showed that certain types of antibody responses thought to be protective were actually higher in adults, including those with severe cases, than in children, the research found.

Since the earliest days of the COVID-19 outbreak, scientists have observed that children infected with the virus tend to fare much better than adults. To determine why that is, Herold, along with his spouse, Betsy Herold, the co-senior author and a professor of pediatrics and microbiology-immunology at Albert Einstein College of Medicine, decided to study blood and cell samples collected from patients of different ages who were admitted with COVID-19 symptoms to the Montefiore Medical Center in New York City.

Specifically, they looked for variations in the types of immune system responses in patients who experienced different health outcomes from the novel coronavirus. The subjects also included children and adolescents diagnosed with multi-system inflammatory syndrome or MIS-C, a rare complication of COVID-19 infection in young people that is associated with a variety of severe health complications.

They found that levels of two immune system molecules -- interleukin 17A (IL-17A), which helps mobilize immune system response during early infection, and interferon gamma (INF-?), which combats viral replication -- were strongly linked to the age of the patients. The younger the patient, the higher the levels of IL-17A and INF-?, the analysis showed.

These two molecules are part of the innate immune system, a more primitive, non-specific type of response activated early after infection, Kevan Herold noted. Conversely, the adults showed a more vigorous adaptive immune system response including higher neutralizing antibody levels, which record signatures of pathogens and target them for elimination.

They also found that children with rare cases of MIS-C also have high levels of IL-17A and INF-?, but seldom exhibit severe damage to lung tissue that characterizes severe adult cases. These children, however, share other immune response signatures linked to more severe adult cases. The source of the IL-17A and INF-? molecules remain unknown, but its identification may shed light on cells that can be targeted to prevent severe effects from COVID-19.

Boosting certain types of immune responses may be beneficial to patients, the authors theorize.

"The suggestion is that kids have a more robust, earlier innate immune response to the virus, which may protect them from progressing to severe pulmonary disease," Betsy Herold said.