Culture

ITHACA, N.Y. - Small-scale. Short-lived. All digital. Out of public view. That's how a new form of collective worker resistance is unfolding in China's app-based food delivery economy, new Cornell University research finds.

Though highly fragmented and not always successful, "mini-strikes" by small groups of food couriers - conducted via WeChat - reflect a new form of leverage, suggest Chuxuan "Victoria" Liu and Eli Friedman, associate professor in the ILR School.

Food couriers are able to maintain complete physical invisibility, and each individual worker can 'strike' from anywhere, they write.

The scholars interviewed couriers, in-person and online, who delivered food for Ele.me, an Alibaba-owned company that controlled nearly half the nation's food-delivery market.

Platform-based delivery work has grown exponentially over the past decade. In 2020, Ele.me and Meituan, a slightly larger competitor, together had more than 8 million registered food-delivery couriers, the result of rapid growth achieved in part through exploitative working conditions, according to the researchers.

Friedman said scholars have wondered whether high levels of worker dissatisfaction seen in manufacturing would appear in this new sector. Their research determined it has - if you know where to look.

In addition to crowd sourced freelance couriers who work individually, Ele.me relies on a network of subcontractors that operate "stations" within city districts to provide restaurants with more reliable delivery services.

Like the workers themselves, the app rewards or punishes stations financially based on metrics including numbers of deliveries, worker attendance, on-time performance and customer ratings. That pressure on stations creates bargaining power for couriers who may choose to stay offline during peak lunch and dinner times.

"Simply by refusing to login to the system," they wrote, "a handful of couriers can cause considerable damage to the station's statistics."

Significantly, the government is either unable to monitor such small-scale labor resistance or tolerates it, since it causes minimal social disruption and appears apolitical.

"We've seen in the last few years that any kind of collective, coordinated action in China - for all kinds of activists - is really dangerous," Friedman said. "This refines our understanding of the way public protest can work in light of that new, highly repressive environment, and the role digital media can play in fomenting that kind of action, even on a small scale."

Strikes by food couriers are distinctive for their very small numbers, short duration and concealed nature, the authors wrote, revealing "one of the ways that labor unrest has evolved alongside shifting political, economic and technological conditions."

Newborns at risk for Type 1 diabetes because they were given antibiotics may have their gut microorganisms restored with a maternal fecal transplant, according to a Rutgers study.

The study, which involved genetic analysis of mice, appears in the journal Cell Host & Microbe.

The findings suggest that newborns at risk for Type 1 diabetes because their microbiome - the trillions of beneficial microorganisms in and on our bodies - were disturbed can have the condition reversed by transplanting fecal microbiota from their mother into their gastrointestinal tract after the antibiotic course has been completed.

Type 1 diabetes is the most common autoimmune disease in childhood.

"Our previous work has shown that exposing young animals to antibiotics perturbs the microbiome, which may change age-associated immunity and organ-specific inflammation, increasing risk of immune-mediated diseases," said co-author Martin Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers.

The study compared mice that were exposed to antibiotics between days 5 and 10 of life and given a transplant of maternal microbiota up to a week later, and those that were not. The researchers found that the mice given the transplant had their microbiome partially restored and their diabetes risk brought back to the baseline level.

"The mice that were exposed to antibiotics had the expression of indicator genes in their intestinal wall that were either too high or too low, but the transplant brought that back almost to the original levels and restored metabolic pathways," said co-author Xue-Song Zhang, an assistant research professor at the Center for Advanced Biotechnology and Medicine at Rutgers. "We were able to identify groups of genes that returned to normal after the transplant as if the mice had never received the antibiotics."

WASHINGTON, July 20, 2021 -- Surpassing the biological limitations of the brain and using one's mind to interact with and control external electronic devices may sound like the distant cyborg future, but it could come sooner than we think.

Researchers from Imperial College London conducted a review of modern commercial brain-computer interface (BCI) devices, and they discuss the primary technological limitations and humanitarian concerns of these devices in APL Bioengineering, from AIP Publishing.

The most promising method to achieve real-world BCI applications is through electroencephalography (EEG), a method of monitoring the brain noninvasively through its electrical activity. EEG-based BCIs, or eBCIs, will require a number of technological advances prior to widespread use, but more importantly, they will raise a variety of social, ethical, and legal concerns.

Though it is difficult to understand exactly what a user experiences when operating an external device with an eBCI, a few things are certain. For one, eBCIs can communicate both ways. This allows a person to control electronics, which is particularly useful for medical patients that need help controlling wheelchairs, for example, but also potentially changes the way the brain functions.

"For some of these patients, these devices become such an integrated part of themselves that they refuse to have them removed at the end of the clinical trial," said Rylie Green, one of the authors. "It has become increasingly evident that neurotechnologies have the potential to profoundly shape our own human experience and sense of self."

Aside from these potentially bleak mental and physiological side effects, intellectual property concerns are also an issue and may allow private companies that develop eBCI technologies to own users' neural data.

"This is particularly worrisome, since neural data is often considered to be the most intimate and private information that could be associated with any given user," said Roberto Portillo-Lara, another author. "This is mainly because, apart from its diagnostic value, EEG data could be used to infer emotional and cognitive states, which would provide unparalleled insight into user intentions, preferences, and emotions."

As the availability of these platforms increases past medical treatment, disparities in access to these technologies may exacerbate existing social inequalities. For example, eBCIs can be used for cognitive enhancement and cause extreme imbalances in academic or professional successes and educational advancements.

"This bleak panorama brings forth an interesting dilemma about the role of policymakers in BCI commercialization," Green said. "Should regulatory bodies intervene to prevent misuse and unequal access to neurotech? Should society follow instead the path taken by previous innovations, such as the internet or the smartphone, which originally targeted niche markets but are now commercialized on a global scale?"

She calls on global policymakers, neuroscientists, manufacturers, and potential users of these technologies to begin having these conversations early and collaborate to produce answers to these difficult moral questions.

"Despite the potential risks, the ability to integrate the sophistication of the human mind with the capabilities of modern technology constitutes an unprecedented scientific achievement, which is beginning to challenge our own preconceptions of what it is to be human," Green said.

PHILADELPHIA -- (July 20, 2021) -- Alternative polyadenylation (APA) is an RNA processing mechanism that regulates gene expression by generating different ends on RNA transcripts of the same gene. Though it affects more than half of human genes, the significance of APA was poorly understood. Now a new study by The Wistar Institute describes an important function of APA in allowing certain mRNAs to reach specific sites of protein synthesis and reveals that length, sequence and structural properties can determine the destination (and fate) of mRNAs within the cell. These findings, published online in the journal Cell Reports, shed light on the consequences of APA that may represent a paradigm shift in the mRNA metabolism field.

The laboratory of Bin Tian, Ph.D., professor and co-leader of the Gene Expression & Regulation Program at The Wistar Institute Cancer Center and senior author on the study, was among the first to discover the widespread occurence of APA using genomic and bioinformatic approaches.

Following gene transcription, messenger RNAs are chemically modified to become mature RNA molecules that can leave the nucleus and perform their functions. One of these modifications is polyadenylation, which prevents RNA degradation and favors its translation into protein.

Through APA, a gene can be polyadenylated at multiple sites, resulting in mRNAs with different coding sequences and/or regulatory regions (3'untranslated regions or 3'UTRs), called isoforms. Transcripts encoding the same protein can have different fates in the cell because of distinct 3'UTRs, which harbor regulatory elements for mRNA metabolism. This dramatically increases the complexity of our genome, so that fewer genes are needed to encode all the proteins a cell needs.

Tian and colleagues employed functional genomics methods to analyze the distribution of the APA isoforms in mouse cells. Bioinformatic analysis and machine learning approaches revealed that APA, via modulation of mRNA 3'UTRs, impacts the connection between mRNAs and the endoplasmic reticulum (ER), a network of tubes that build, package and transport proteins.

They named this mechanism translation-independent ER association (TiERA) and found that some mRNAs possess specific sequences and structures that determine their potential to undergo APA and ultimately associate with the ER.

"When mRNAs leave the nucleus and move to the cytoplasm, they need to be properly directed to reach the appropriate site of protein translation," said Tian. "The cytoplasm is a huge space for an RNA molecule: For comparison, imagine entering a baseball stadium and needing directions to reach your seat."

The team found that mRNAs with higher TiERA tend to encode for signaling proteins,which help cells communicate with each other by sending, receiving and processing signals in response to changes in the environment.

They propose that APA renders this process more efficient by anchoring certain mRNA isoforms with the ER in specific cellular locations where important signaling events happen.

"According to our model, the ER would serve as a scaffold to keep proteins 'on hand' where they are most needed," said Tian. "This would provide a platform for signaling events to happen effectively at the right place in the cell."

What The Study Did: Credit reports were analyzed to estimate the amount of medical debt in collections nationally and by geographic region and income group and its association with Medicaid expansion under the Affordable Care Act.

Authors: Neale Mahoney, Ph.D., of Stanford University in Stanford, California, is the corresponding author.

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

(doi:10.1001/jama.2021.8694)

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

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Media advisory: The full study and editorial are linked to this news release.

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For more than 20 years, Makoto Miyata from Osaka City University has been studying the gliding motility of the parasitic bacterium Mycoplasma mobile (M. mobile). It is a mechanism consisting of an external "grabbing" structure and internal "motor" - the motor having yet to be clarified on a molecular level. In collaboration with Osaka University and Kanazawa University, his research team used electron microscopy and high-speed atomic force microscopy (high-speed AFM) to reveal that the bacteria's molecular motor consists of two ATP synthase-like complexes, suggesting an unexpected evolution of the protein. Their findings were published in mBio.

Based on genetic information, researchers have suggested that the molecular motor of M. mobile evolved from a protein that synthesizes ATP, called ATP synthase, although this had yet to be confirmed. ATP is an important substance generated in the mitochondria that provides energy that a molecular motor uses for the movement of nearly all living things, including M. mobile gliding.

"It was recently hypothesized that M. mobile, unlike respiration systems in mitochondria, converts ATP energy into a gliding force with a rotary class of ATP synthase," said Makoto Miyata. "To our surprise, we discovered the motor of M. mobile to be a chain of two ATP synthases-like molecules, housed within a complex cylindrical structure," he continued - something that has never been seen before.

The discovery started with the team extracting a cell from M. mobile and isolating its protein units. Using negative-staining electron microscopy, they discovered a twin motor where each motor is structurally similar to ATP synthase. However, the clarification has not stopped here. "We need to see this dimeric ATP synthase chain in action," stated Noriyuki Kodera of Kanazawa University, "to understand how it facilitates M. mobile's gliding movement." Using the state-of-the-art technology high-speed AFM, pioneered at the Nano Life Science Institute of Kanazawa University, the team plans to confirm the rotary nature of the molecular motor during ATP hydrolysis. As the architecture of the gliding motor is like ATP synthase, "it is possible the chains share a common evolutionary origin," stated Takuma Toyonaga, a research fellow at Osaka City University.

Toyonaga continued, "This discovery of an ATP synthase created a breakthrough in our understanding of the evolution of cells and protein and has brought us closer to understanding the operating principles of motility, which is expected to serve as a basis for the development of nanoscale devices and pharmaceuticals."

In the largest study of its kind, an investigation by UC San Francisco has found no evidence that moderate coffee consumption can cause cardiac arrhythmia.

In fact, each additional daily cup of coffee consumed among several hundred thousand individuals was associated with a 3 percent lower risk of any arrhythmia occurring, including atrial fibrillation, premature ventricular contractions, or other common heart conditions, the researchers report. The study included a four-year follow up.

The paper is published July 19, 2021, in JAMA Internal Medicine.

"Coffee is the primary source of caffeine for most people, and it has a reputation for causing or exacerbating arrhythmias," said senior and corresponding author Gregory Marcus, MD, professor of medicine in the Division of Cardiology at UCSF.

"But we found no evidence that caffeine consumption leads to a greater risk of arrhythmias," said Marcus, who specializes in the treatment of arrhythmias. "Our population-based study provides reassurance that common prohibitions against caffeine to reduce arrhythmia risk are likely unwarranted."

While some professional societies suggest avoiding caffeinated products to lower the risk for arrhythmia, this connection has not been consistently demonstrated - indeed, coffee consumption may have anti-inflammatory benefits and is associated with reduced risks of some illnesses including cancer, diabetes, and Parkinson disease.

In the new study, UCSF scientists explored whether habitual coffee intake was associated with a risk of arrhythmia, and whether genetic variants that affect caffeine metabolism could modify that association. Their investigation was conducted via the community-based UK Biobank, a prospective study of participants in England's National Health Services.

Some 386,258 coffee drinkers took part in the coffee research, with an average mean age of 56 years; slightly more than half were female. It was an unprecedented sample size for this type of inquiry.

In addition to a conventional analysis examining self-reported coffee consumption as a predictor of future arrhythmias, the investigators employed a technique called "Mendelian Randomization," leveraging genetic data to infer causal relationships. As those with the genetic variants associated with faster caffeine metabolism drank more coffee, this analysis provided a method to test the caffeine-arrhythmia relationship in a way that did not rely on participant self-report and should have been immune to much of the confounding inherent to most observational studies.

With a mean four-year follow up, data were adjusted for demographic characteristics, health and lifestyle habits.

Ultimately, approximately 4 percent of the sample developed an arrhythmia. No evidence of a heightened risk of arrhythmias was observed among those genetically predisposed to metabolize caffeine differently. The researchers said that higher amounts of coffee were actually associated with a 3 percent reduced risk of developing an arrhythmia.

The authors noted limitations including the self-reporting nature of the study, and that detailed information on the type of coffee - such as espresso or not - was unavailable.

"Only a randomized clinical trial can definitively demonstrate clear effects of coffee or caffeine consumption," said Marcus. "But our study found no evidence that consuming caffeinated beverages increased the risk of arrhythmia. Coffee's antioxidant and anti-inflammatory properties may play a role, and some properties of caffeine could be protective against some arrhythmias."

PULLMAN, Wash. - When it comes to craft beer, the flavor doesn't have to be all in the hops. As a panel of amateur beer tasters at Washington State University recently demonstrated, malted barley, the number one ingredient in beer besides water, can have a range of desirable flavors too.

Researchers recruited a panel of about 100 craft beer drinkers to taste some so-called SMaSH beers--those brewed with a single barley malt and single hop. All the beers contained the same hop variety, called Tahoma, but each had a malt from a different barley genotype, or genetic makeup. Trained tasters can distinguish these easily, but even the untrained panel could taste the difference among five different barley varieties--and definitely favored some more than others.

"We found that the untrained panelists could differentiate among the barley breeding lines in the beer," said Evan Craine, a WSU doctoral student and first author on the study in the Journal of Food Science. "They did a good job of selecting attributes that revealed distinctive profiles for each of the beers."

The panel generally preferred the four barley breeding lines developed at WSU over the control, known as Copeland, a high-quality malting barley widely grown in Washington state. The panelists were able to easily identify the flavor profiles of the beers, such as one with a "fruity and sweet aromatic" flavor and another with a "citrus" profile made with a barley called Palmer, a variety recently released by WSU for commercial use.

While the untrained panel could distinguish flavors from brewed beers, they were not as adept at tasting the differences among "hot steep" samples which are made by combining hot water and ground barley malt before filtering. This creates a sweet liquid--similar to that made by brewers before yeast is added to create alcohol.

The researchers had hoped amateur beer tasters could distinguish flavor differences in the hot steep as it would shorten the testing process for new barley varieties. Corresponding author Kevin Murphy was not ready to give up on the method.

"Hot steep malt still shows a lot of promise," said Murphy, a WSU associate professor of crop and soil sciences. "The next step would be testing it with a trained panel to see if they can distinguish barley varieties. Ideally, we would just set it out to consumers because hot steep malting is great outreach. It gets people involved. They love tasting and talking about it."

While U.S. craft beer drinkers are known for their love of hop-heavy India Pale Ales, the results of this study add evidence that barley malts might be another good way to develop new beers.

For this study, Craine and Murphy worked with Scott Fisk, a faculty research assistant at Oregon State University, to create the malts and brewer Aaron Hart of Moscow Brewing Company to develop the beers, using hops only to add a little bitterness to balance the sweetness from the malt. These types of beers are called "malt-forward." They can be light or strong flavored, ranging in types from lagers and pilsners to ambers and stouts. Hart called the beers developed for this study "American Pale Ales."

More variety from malt-forward beers can potentially benefit not only beer lovers but also the environment and brewers' bottom lines, said Craine.

"In terms of sustainability, hops can be pretty resource intensive, and at least around us in Pullman, we can grow barley that's just rain fed," he said. "Hops can also be really expensive. Brewers are already buying the malt, so if we can find ways to increase the flavor contribution from the malt, hopefully, they can rely less on the hops and save money."

While the hops craze is continuing, the malt-forward beers have the potential to spur the next evolution in craft brewing, said Murphy.

"Just as craft beer flavor has evolved in the last 20 years, we can expect it to continue to change over the next 20, and the new frontier will be adding different barley flavors or barley-hop combinations," he said. "I don't know how many people knew about IPAs 20 years ago, and they exploded. Brewers are very innovative, and I am very excited to see where this goes in the future."

Tsukuba, Japan - Scientists from the department of Anatomy and Embryology at the Faculty of Medicine of the University of Tsukuba created a computer model to simulate the development of complex structures based on the Delta-Notch signaling pathway. This work may lead to a more comprehensive picture of the process that results in the formation of organs and other physiological systems.

The development of a tiny embryo consisting of undifferentiated cells into a healthy fetus with spatially defined organs depends on the complex interplay between genetic instructions and signaling molecules. For example, "Notch" genes are found in almost all animals and insects, and encode for receptor proteins that extend through a cell's membrane. This allows external signaling molecules to coordinate the cell's development by turning specific genes on or off at just the right time and location. However, there is still much we do not understand about the details of this mechanism.

Now, to better understand the role of signaling systems in organ development and cell differentiation, a team of scientists at the University of Tsukuba created a computer simulation that models the Delta-Notch signaling pathway in biliary cell differentiation. The differentiation of epithelial cells that are essential for the development of liver's bile ducts are special in that they receive signals in the form of Delta ligands from portal vein cells to ensure they are in the proper location. "A Delta ligand released by a portal vein cell can bind to a Notch receptor to regulate gene expression in the epithelial cell," first author Masaharu Yoshihara explains.

The scientists used a set of coupled differential equations to show how the concentrations of each change over time on a 20 × 20 two-dimensional matrix mimicking the planar cross-section of the liver. The diffusion of Delta molecules led to concentration differences based on the location, ensuring that epithelial differentiation occurred at only the correct places, which the authors called "fine-grained differentiation". However, even with a portal vein cell from the liver sending out Delta molecules, certain conditions resulted in no cell differentiation, showing that proper development is dependent on the rates of production of Delta ligands and Notch receptors. "This project demonstrates the ability of computer models to simulate the formation of spatial structure using complex feedback signaling pathways," senior author Professor Satoru Takahashi says. Future models may incorporate other signaling molecules, as well as cell migration.

CATONSVILLE, MD, July 20, 2021 - Uber and Lyft are popular on-demand ways to travel, but does that mean trains and buses are a thing of the past? Travelers prefer different modes of transportation at different times. So how can all these modes co-exist and do so successfully? New research in the INFORMS Journal Transportation Science has created a model and an algorithm to redistribute transit resources based on commuter preferences resulting in millions in savings.

"Based on case study experiments in New York City, our optimized transit schedules consistently lead to 0.4%-3% system-wide cost reduction. This amounts to rush hour savings of millions of dollars per day, while simultaneously reducing costs to passengers and transportation service providers," said Vikrant Vaze of Dartmouth College.

"Transit Planning Optimization under Ride-hailing Competition and Traffic Congestion," was written by Vaze alongside Keji Wei also of Dartmouth, as well as Alexandre Jacquillat of the Massachusetts Institute of Technology.

This study attempts to understand what would happen if a public transit agency were to explicitly consider commuter choice factors and what that would do to the commute when designing their schedules.

Commuters choose modes of transportation based on travel convenience, prices, travel times and traffic congestion. The authors have found that the opposite is also true - their choice in turn changes the traffic patterns and travel times.

The authors note that by considering both of these points, they can come up with a better alignment of available transportation options with passengers' preferences in mind - by redistributing public transit resources where they provide the strongest societal benefits.

"In the interest of the overall urban ecosystem, a transit operator should critically assess what kinds of trips and travel needs transit is better equipped to serve and at the same time, what are some of the areas where it might be better to cut down and let on-demand operators take up a larger proportion of trips. Such thoughtful reconfiguration can benefit diverse stakeholders simultaneously," continued Vaze, a professor in the Thayer School of Engineering at Dartmouth. "What we found is that this leads to schedules that are better for passengers, better for transportation operators and better for the city as a whole, a rare win-win-win."

Retail traders often fear that reducing the amount of urban space made available for parking private vehicles would have a negative effect on their businesses. A survey conducted by researchers from the Institute for Advanced Sustainability Studies (IASS) on two shopping streets in Berlin shows that traders have a skewed perception of their customers' mobility habits. The findings of this research will facilitate better-informed decision-making around urban land-use planning.

The researchers surveyed around 2,000 customers and 145 retailers on Kottbusser Damm (Friedrichshain-Kreuzberg district) and Hermannstraße (Neukölln district). The vast majority of shoppers - 93 per cent - had not travelled to their destination by car. 91 per cent of the revenue generated by these businesses came out of the wallets of customers who walked, cycled or used public transport to reach them. Customers that drive to the shops accounted for just 9 per cent of sales.

Just 7 per cent of customers travel to businesses by car

"The results of this survey confirm the findings of studies published in 2019 on the inner cities of Offenbach, Gera, Erfurt, Weimar and Leipzig. Studies on mobility and local economic impacts conducted in other European countries, North America, and Australia paint a similar picture. The car is less relevant for local business than is often assumed in policy processes. Pedestrians, cyclists, and transit riders are the important customer groups for local business in an urban context." says IASS researcher Dirk von Schneidemesser. Retailers in the cities surveyed overestimated the share of customers who come by car - so too in Berlin, where retailers estimated that 22 per cent of their customers used this mode of transport, when in fact it was only 7 per cent.

This misperception could be due to a human tendency to assume that others behaviour in a similar manner. The survey revealed that traders who drive to their business estimated much higher customer car use (29%) than traders that use other modes of transport (between 10% and 19%). Traders were also found to overestimate the distance that customers travel to visit their businesses. In fact, over half (51%) of the shoppers surveyed lived less than 1 kilometer from the shopping street. In contrast, traders estimated that just 13% of customers live within this range.

Better infrastructure for active mobility can benefit businesses

"The findings of this survey are in line with the growing body of literature that suggests improved active travel (i.e. for pedestrians and cyclists) and transit infrastructure is likely to benefit local business", says Dirk von Schneidemesser. Business associations should consider this evidence when weighing the benefits and disadvantages of infrastructure development in order to best represent the interests of local business.

One of the leading thinkers in nano-science has called on the energy materials community to help finally put an end to the world's reliance on fossil fuels.

In a hard-hitting editorial published by Energy and Environmental Materials, Professor Ravi Silva, Director of the Advanced Technology Institute (ATI) at the University of Surrey, argues that there are no coherent excuses left to justify the use of fossil fuels. In his paper, Professor Silva challenges the scientific community to lead the world away from a reality where fossil fuels still account for 80 per cent of the energy mix.

While the cost of clean energy generation has plummeted over recent years, Professor Silva argues that significant innovations in advanced batteries and energy storage technologies are needed to meet the International Energy Agency's goal of the planet being carbon net-zero by 2050.

For example, the transportation sector would need to see a 15-fold rise in electric vehicle sales from 10m in 2020 to 145m in 2030 - a goal entirely dependent on a leap in battery and energy storage technology, according to Professor Silva.

Professor Silva concludes that these unprecedented but much-needed goals are only possible if the scientific community usher in a new wave of energy materials that are cheap, easily deployable and have short payback times.

Professor Ravi Silva, Director of the ATI at the University of Surrey, said:

"The pandemic has been a truly horrific experience. However, one of the few positives that I can gather from the past two years is that it has allowed me to take stock and refocus on the incredible challenge of combatting climate change. It is increasingly clear that the energy materials community has a crucial role to play in weaning the world off fossil fuels.

"The cost of green energy is falling all the time - in the UK, solar and wind generation is competitive with fossil fuels. But we need to look at improvements in thin-film technologies, new polymers and other hybrid materials that can boost energy capture capabilities while reducing the cost of production if we are to have a genuine green energy revolution."

Amsterdam, July 20, 2021 - Well over six million people globally have been diagnosed with Parkinson's disease (PD), which has an enormous impact on the lives of patients, their families, and caregivers and is incurring mounting costs for society. This special supplement to the Journal of Parkinson's Disease (JPD), guest-edited by noted experts Anat Mirelman, PhD, E. Ray Dorsey, MD, MBA, Patrik Brundin, MD, PhD, and Bastiaan R. Bloem, MD, PhD, reviews how digital technology is being used to reshape research and clinical care in PD.

Digital health technology is an umbrella term that spans a diverse range of applications, including body-fixed wearable sensors, non-contactable domestic sensors, smartphone apps, and videoconferencing and other telemedicine systems that allow for direct remote interaction between patients and healthcare providers.

"Digital health technology is an important and promising field that is beginning to make a real tangible impact on persons with PD," explained Co-Guest Editor Anat Mirelman, PhD, Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center; and Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Israel. "This special supplement includes a series of succinct reviews that cover many practical and relevant aspects, such as digital monitoring, telemedicine, digital therapeutics, virtual clinical trials and digital progression biomarkers for clinical trials. All reviews offer both a view of the current state-of-the-art and informed perspectives on future directions."

"Despite the accumulating body of evidence to support the feasibility, utility, and benefits of various digital technology approaches, the use of digital technology in clinical practice has long remained scarce," added Co-Guest Editor and joint JPD Editor-in-Chief Bastiaan R. Bloem, MD, PhD, Radboud University Nijmegen Medical Center; Donders Institute for Brain, Cognition, and Behavior; Department of Neurology, Nijmegen, The Netherlands. "It has taken a contagion to make patients, physicians, and insurers pay better attention. Specifically, the limits on our ability to travel imposed by the ongoing coronavirus pandemic has led to a dramatic increase in the use of digital platforms in a matter of a few months. This change was unprecedented and has been identified as one of the few silver linings of the pandemic."

Important developments highlighted in this supplement include:

The increase in use of digital platforms is transforming neurological care, catalyzing the use of digital technology to maintain continuity of care, and impacting clinical trials. Using wearable sensors, clinicians can still monitor patients' motor symptoms while they are isolated at home and gain insights into behavioral changes and the implications of social distancing on patients' non-motor symptoms.

In clinical research, digital technologies are transforming practice and enhancing the understanding of PD. For example, assessing sleep can now be done in the home, passively, and frequently, expanding the knowledge of sleep disorders in patients with clinically manifest Parkinson's as well as individuals in early stages of the disease.

New tools may also shine a light on features of the disease that have largely been invisible, such as the appraisal of social function, expanded assessments of voice, quantification of tremor, assessment of falls, dyskinesia or freezing of gait, and objective measurement of the response to treatment. This could lead to a better understanding of the disease, its temporal pattern, variability, and impact on individuals bearing its burden.

Technological applications have the potential to reshape the way clinical research is conducted as decentralized trials will expand and even more assessments will transfer from the clinic to the home and mobile devices. Remote digital therapeutics can offer an attractive alternative for intensive interventions such as speech and language therapy, which typically requires frequent visits to clinics.

"There remain significant challenges," noted Dr. Mirelman. "These include the digital divide, the issue of privacy and security, and reimbursement, which requires health insurance companies and other payers to be persuaded by the merits of technology."

"The COVID-19 pandemic has emphasized some of the shortcomings of telemedicine or monitoring approaches, such as the undiminished need for in-person visits, especially for new patients," commented Professor Bloem. "These shortcomings raise yet another question as to what extent digital health technologies will survive when our lives get back to a new normal after this pandemic has resolved.

"We can say with certainty that the digital revolution has definitely started. We can almost be equally certain that this is only the beginning. The future of digital medicine will likely benefit both patients and healthcare in ways that are currently difficult to predict," he concluded.

Parkinson's disease is a slowly progressive disorder that affects movement, muscle control, and balance. It is the second most common age-related neurodegenerative disorder affecting about 3% of the population by the age of 65 and up to 5% of individuals over 85 years of age.

MINNEAPOLIS/ST. PAUL (07/20/2021) -- National data analyzed by University of Minnesota Medical School researchers show that nearly 40 percent of all funds used to pay for medical school are expected to come from family or personal sources and scholarships. The prevalence of these sources, however, varies widely by race and socioeconomic status.

Arman Shahriar, Varun Sagi and Lorenzo Gonzalez, all fourth-year students at the University of Minnesota Medical School, are co-lead authors of the study, which was published today in JAMA Network Open.

"Financing a four-year medical education requires upwards of a quarter-million dollars, and this amount has been rising faster than inflation since the 1960s. Prior to this study, little was known about how students pay for medical school, so we set out to shed light on this opaque subject," Shahriar said.

Their research analyzed de-identified data from more than 29,000 medical students nationwide who responded to the 2017 to 2019 Association of American Medical Colleges (AAMC) Matriculating Student Questionnaire. The study found that:

- Nearly 25 percent of all medical students come from the top five percent of household incomes (greater than $270,000 in 2019), and 37% of these high-income students will be paying for medical school primarily using family or personal funds. For comparison, only three to four percent of students from the lowest three income quintiles rely primarily on family or personal funds.

- Family or personal financing was more prevalent among Asian students and white students and was least prevalent among Black students. Shahriar says, "This may be a reflection of the widening racial wealth gap - rooted in structural racism - and may explain AAMC data indicating Black students graduate with the highest debt burden of any racial group."

- Between high- and low-income students, scholarships were distributed much more evenly than family or personal funds. The heavier reliance on loans among low-income students suggests an inadequacy of current scholarship amounts to offset the large deficit in family or personal funds that these low-income students face.

"Knowing that scholarship funds are finite, individual medical schools should work to ensure that scholarships are awarded through holistic review with ample consideration of economic background," Shahriar said. "Additionally, considering the degree to which some students are relying on family wealth, medical schools ought to be ensuring equal access to expensive resources during training, like board preparatory materials. As medicine works toward improving its socioeconomic, racial and ethnic diversity, the last thing we want is for family wealth to be influencing educational quality."

The study team is now looking at socioeconomic diversity among matriculating medical students. Shahriar says that future work on the topic of financing should better examine how financing methods have evolved over time for various subgroups, as well as link matriculant financing plans with debt and other economic outcomes at the time of graduation and beyond.

Despite the best efforts of industry to work towards sustainability, most plastics (or polymers) are still made using non-renewable fossil fuels. However, researchers have now found an economical method for producing biobased acrylate resins. The study, published in the journal Angewandte Chemie, shows how all the synthesis steps, from initial building blocks right up to polymerization, can be carried out in a single reactor (one pot), minimizing environmental impact.

Most varnishes, adhesives and paints are made from acrylate resins, which are polymers of acrylic acid esters and methacrylic acid esters. The raw materials that form these esters are acrylic or methacrylic acid, and alcohols. The alcohols give the plastics properties, such as softness or hardness, and water absorption or repulsion.

To make these polyacrylates and polymethacrylates more sustainable, Christophe Thomas and his team from the Institut de Recherche de Chimie in Paris, France, used alcohols from biobased or natural sources, rather than fossil sources. These included plant-based lauryl alcohol, menthol, tetrahydrogeraniol (a pheromone-like substance), vanillin, and ethyl lactate.

In addition to sustainability through renewable resources, the team also targeted synthesis in as few steps as possible, in other words a one-pot process. This meant they had to find catalysts that were suitable for several steps of the process, and also to finely tune all the other synthesis conditions, such as solvents, concentrations, and temperatures.

The first step in this kind of synthesis is the activation of acrylic or methacrylic acid. The researchers were able to identify catalysts from simple salts. These substances were also suitable for the next step, reacting the biobased alcohols with acrylic or methacrylic anhydride (a condensed form of the acids) to give the corresponding esters, which are the building blocks of the subsequent polymer.

"This monomer preparation step is highly efficient and allowed us to perform the polymerization in the same reactor," says Thomas. Thus, without purifying the intermediate products, the team was ultimately able to produce block copolymers, which are widely used in plastics production, from two or three different individual polymers produced separately.

The team's biobased plastics had a number of beneficial properties, depending on the monomers making them up. For example, the resin produced with a lactic acid side chain (poly(ELMA)) was hard and brittle, while the one produced with the more flexible tetrahydrogeraniol side chain (poly(THGA)) was pliable at room temperature. The authors emphasize the numerous available possibilities thanks to the wide variety of biobased alcohols at their disposal.

Aside from the versatility of the team's approach, their one-pot synthesis also helps reduce the environmental footprint. Since work-up solvents account for a large proportion of the E-factor, or environmental impact, of plastics synthesis, one-pot processes without work-up obviously greatly reduce this factor. Their most successful synthesis reduced the E-factor by three quarters, demonstrating the significance of this research.