Culture

The period preceding the emergence of behaviourally modern humans was characterised by dramatic climatic and environmental variability - it is these pressures, occurring over hundreds of thousands of years that shaped human evolution.

New research published today in the Cambridge Archaeological Journal proposes a new theory of human cognitive evolution entitled 'Complementary Cognition' which suggests that in adapting to dramatic environmental and climactic variabilities our ancestors evolved to specialise in different, but complementary, ways of thinking.

Lead author Dr Helen Taylor, Research Associate at the University of Strathclyde and Affiliated Scholar at the McDonald Institute for Archaeological Research, University of Cambridge, explained: "This system of complementary cognition functions in a way that is similar to evolution at the genetic level but instead of underlying physical adaptation, may underlay our species' immense ability to create behavioural, cultural and technological adaptations. It provides insights into the evolution of uniquely human adaptations like language suggesting that this evolved in concert with specialisation in human cognition."

The theory of complementary cognition proposes that our species cooperatively adapt and evolve culturally through a system of collective cognitive search alongside genetic search which enables phenotypic adaptation (Darwin's theory of evolution through natural selection can be interpreted as a 'search' process) and cognitive search which enables behavioural adaptation.

Dr Taylor continued, "Each of these search systems is essentially a way of adapting using a mixture of building on and exploiting past solutions and exploring to update them; as a consequence, we see evolution in those solutions over time. This is the first study to explore the notion that individual members of our species are neurocognitively specialised in complementary cognitive search strategies."

Complementary cognition could lie at the core of explaining the exceptional level of cultural adaptation in our species and provides an explanatory framework for the emergence of language. Language can be viewed as evolving both as a means of facilitating cooperative search and as an inheritance mechanism for sharing the more complex results of complementary cognitive search. Language is viewed as an integral part of the system of complementary cognition.

The theory of complementary cognition brings together observations from disparate disciplines, showing that they can be viewed as various faces of the same underlying phenomenon.

Dr Taylor continued: "For example, a form of cognition currently viewed as a disorder, dyslexia, is shown to be a neurocognitive specialisation whose nature in turn predicts that our species evolved in a highly variable environment. This concurs with the conclusions of many other disciplines including palaeoarchaeological evidence confirming that the crucible of our species' evolution was highly variable."

Nick Posford, CEO, British Dyslexia Association said, "As the leading charity for dyslexia, we welcome Dr Helen Taylor's ground-breaking research on the evolution of complementary cognition. Whilst our current education and work environments are often not designed to make the most of dyslexia-associated thinking, we hope this research provides a starting point for further exploration of the economic, cultural and social benefits the whole of society can gain from the unique abilities of people with dyslexia."

At the same time, this may also provide insights into understanding the kind of cumulative cultural evolution seen in our species. Specialisation in complementary search strategies and cooperatively adapting would have vastly increased the ability of human groups to produce adaptive knowledge, enabling us to continually adapt to highly variable conditions. But in periods of greater stability and abundance when adaptive knowledge did not become obsolete at such a rate, it would have instead accumulated, and as such Complementary Cognition may also be a key factor in explaining cumulative cultural evolution.

Complementary cognition has enabled us to adapt to different environments, and may be at the heart of our species' success, enabling us to adapt much faster and more effectively than any other highly complex organism. However, this may also be our species' greatest vulnerability.

Dr Taylor concluded: "The impact of human activity on the environment is the most pressing and stark example of this. The challenge of collaborating and cooperatively adapting at scale creates many difficulties and we may have unwittingly put in place a number of cultural systems and practices, particularly in education, which are undermining our ability to adapt. These self-imposed limitations disrupt our complementary cognitive search capability and may restrict our capacity to find and act upon innovative and creative solutions."

"Complementary cognition should be seen as a starting point in exploring a rich area of human evolution and as a valuable tool in helping to create an adaptive and sustainable society. Our species may owe our spectacular technological and cultural achievements to neurocognitive specialisation and cooperative cognitive search, but our adaptive success so far may belie the importance of attaining an equilibrium of approaches. If this system becomes maladjusted, it can quickly lead to equally spectacular failures to adapt - and to survive, it is critical that this system be explored and understood further."

Federal agencies that regulate drug pricing and healthcare insurance are concerned that an industry practice of using rebates to lower drug costs for insurers has led to increases in list prices and out-of-pockets costs for patients.

To investigate whether patients with or without insurance were paying more because of rebates to insurers, researchers led by the University of Washington examined cost and price data on more than 400 branded drugs. The study found that rebates were associated with increases in out-of-pocket costs for patients by an average of $6 for those with commercial insurance, $13 for Medicare patients and $39 for the uninsured.

"We know that list prices have been increasing quite dramatically as have rebates, but no one has looked into the association between rebates and out-of-pocket costs," said study lead author Kai Yeung, an affiliate assistant professor at the CHOICE Institute in the UW School of Pharmacy. "Increases in out-of-pocket costs are associated with rebates, however rebates also help keep premium costs down."

Consequently, said Yeung, who is also an assistant professor at Kaiser Permanente Bernard J. Tyson School of Medicine, "There has been inadequate focus on the impact the pricing mechanism has on the uninsured, who are most affected."

For the study published June 14 in JAMA, the researchers used data on 444 branded drugs without generic equivalents from national datasets involving healthcare costs and drug prices from 2007 to 2018 including the federal Medical Expenditure Panel Survey and SSR Health, a private company that collects and analyzes prescription drug pricing data.

Researchers point out that the cost increases can impact patient health, since higher costs can cause patients to take their medication less often. That, in turn, can lead to increased emergency room use and hospitalizations. People in their study who did not have insurance had the poorest health and those with lower incomes were less likely to take medication as prescribed when costs increased.

"Further," the researchers wrote, "uninsured individuals were more likely to be in racial minority groups, amplifying pre-existing disparities in healthcare access."

As a result, the authors suggest future research and policies should focus on decoupling list prices from what patients pay out of pocket, "especially for uninsured individuals."

"The biggest takeaway is understanding that the rebates work to reduce the cost of prescription drugs for insurance companies and may reduce premiums," said co-author Anirban Basu, the Stergachis Family endowed director of the CHOICE Institute and professor of health economics at the UW School of Pharmacy. "And while it's unclear how much the discounts are reducing premiums, they are definitely not translating to lower out-of-pocket costs for the patients who are using the treatment because of this structure of coinsurance and copayments tied to the list price."

Stacie Dusetzina, Vanderbilt University School of Medicine, Nashville, Tenn., is also a co-author. This research was supported in part by grant funding from the Donaghue Foundation's Greater Value Portfolio.

In 1943, two scientists named Max Delbrück and Salvador Luria conducted an experiment to show that bacteria can mutate randomly, independent of external stimulus, such as an antibiotic that threatens a bacterial cells' survival. Today the Luria-Delbrück experiment is widely used in laboratories for a different purpose--scientists use this classic experiment to determine microbial mutation rates. When performing the Luria-Delbrück experiment, scientists need efficient computer algorithms to extract reliable estimates of mutation rates from data, and they also need well-designed software tools to access these sophisticated algorithms.

Through the years, several web tools that allow researchers to more easily input and analyze data on a computer were developed to increase efficiency and efficacy of the Luria-Delbrück experiment. However, no existing web tool allows scientists to access many recently developed algorithms that can extract even more accurate estimates of microbial mutation rates from data.

Qi Zheng, PhD, professor at the Texas A&M University School of Public Health, recently developed a new web tool called webSalvador to fill several gaps left by existing web tools. In the Microbiology Resource Announcements (MRA) Journal, Zheng explains how WebSalvador offers many desirable capabilities that are vital to bacteria mutation research, including more accurate methods for constructing confidence intervals and new methods for comparing mutation rates.

The web tool also eliminates the need for scientists to learn programming and software language, which Zheng described as an "important barrier" to using the Luria-Delbrück experiment to tackle important problems in mutation research, such as the global public health headache of bacterial drug resistance.

"Learning software languages can be challenging and time consuming for most biologists," Zheng said. "With webSalvador, biologists can input data and see results easily."

Increasing the efficiency and efficacy of the Luria-Delbrück experiment is important because it can ultimately help advance mutation research, which is vital to many branches of life sciences. Zheng cites bacterial drug resistance as one of the most important applications of the Luria-Delbrück experiment, and refers to multi-drug resistant tuberculosis as an example in which advanced mutation research is vital. He calls microbial drug resistance a "wide-spread, global health problem."

Instead of looking at the reasons child welfare caseworkers leave their jobs, Oregon State University researchers examined the common factors among workers who stay in the field, and what makes them feel most satisfied in their work.

In their recent study, researchers found that quality supervisory support and strong relationships with coworkers helped caseworkers feel appreciated and understood, while having adequate technology and equipment helped them manage their workload effectively

They hope child welfare agencies can use this information to support caseworkers and reduce the field's high turnover and burnout rates, which in turn will mean better support for children and families.

"Caseworkers have very challenging jobs, but some are satisfied with the work despite its challenges, and they intend to stay," said co-author Kelly Chandler, an assistant professor in OSU's College of Public Health and Human Sciences. "If we want to improve continuity in terms of service to children and families in the community, it's important to not only minimize the job challenges that are inevitable, but also think about which employees are really thriving and what we can learn from them."

Researchers sent a confidential online survey to all social service specialist caseworkers in Oregon's Department of Human Services in 2018 and were able to use the data from 485 respondents, including 222 from Child Protective Services.

The survey posed a series of statements and asked caseworkers to rank how strongly they agreed with them. The statements covered a range of topics, from job satisfaction and intention to remain, to more specific items about job resources, such as: "My supervisor gives me clear feedback on my job performance" and "I have the technology and equipment to do my job well."

For more quantitative points about job demands, researchers examined objective agency records to measure caseload and case severity. They took a unique approach to measure case severity, basing it on the number of substantiated abuse flags in a single client family, up to a total of five per family.

Case severity was the only job demand shown to have a significant negative impact on whether an employee was a "satisfied stayer;" that is, someone who intended to stay at the agency and was satisfied in their job. They compared satisfied stayers with undecided workers and found caseworkers were 8% less likely to be in the satisfied stayer group if they had severe caseloads.

On the flip side, all three job resources studied -- supervisor quality, coworker support and work tools -- were significantly and positively associated with caseworkers feeling satisfied and wanting to stay in their jobs.

Lead author Brianne Kothari, an assistant professor at OSU-Cascades, said that while there are obvious budget and salary factors that affect caseworker retention, this study demonstrates that agencies also need to remember the value of intangible support for their workers.

"It's really about finding how we can support caseworkers to increase their job satisfaction and intention to stay at ODHS," Kothari said. "They want to feel seen and heard. It might be a pat on the back for one person; it might be something else for another person. This study demonstrates the importance of quality supervisor relationships and the need to identify specific supervisory behaviors that benefit employees. It's also important to remember that all workers, including supervisors, need support."

That kind of emotional support, both from coworkers who are "in the trenches" together, and from supervisors who see how hard caseworkers are working, can go a long way toward helping employees feel that they're not alone, Chandler said.

This study aligns with a broader effort at Oregon DHS to transform the workplace culture and employ more trauma-informed approaches to training at all levels, Kothari said. And it opens the door for further collaboration between OSU and the agency, where researchers can work together to dig into the data and help the agency solidify the best evidence-based practices.

"This is part of our effort to figure out how we can better collaborate with state agencies, which I think really falls within the OSU land grant mission," Kothari said. With ODHS, "There are ways we can think about how we as a larger community can be supportive of these workers, who are really there because they want to make a difference in these children's and families' lives."

"So, no one told you life was going to be this way.
Your job's a joke, you're broke, you're love life's DOA.
It's like you're always stuck in second gear,
When it hasn't been your day, your week, your month, or even your year..."

If you have watched TV since the 1990s, the sitcom theme song, "I'll Be There for You," has likely been stuck in your head at one point or another. New research from UC Davis suggests these experiences are more than a passing nuisance -- they play an important role in helping memories form, not only for the song, but also related life events like hanging out with friends -- or watching other people hang with their friends on the '90s television show, Friends.

"Scientists have known for some time that music evokes autobiographical memories, and that those are among the emotional experiences with music that people cherish most," said Petr Janata, UC Davis professor of psychology and co-author on a new study.

"What hasn't been understood to date is how those memories form in the first place and how they become so durable, such that just hearing a bit of a song can trigger vivid remembering," said Janata.

The paper, "Spontaneous Mental Replay of Music Improves Memory for Incidentally Associated Event Knowledge," was published online in the Journal of Experimental Psychology: General. Co-authors are Janata and Benjamin Kubit, a postdoctoral researcher in cognitive neuroscience, both of the UC Davis Department of Psychology, and Center for Mind and Brain.

This new research offers an initial glimpse into these mechanisms and, somewhat surprisingly, finds that the songs that get stuck in your head help that process of strengthening memories as they first form, the authors said. Thus, this is the first research to link two of the most common phenomena people experience with music -- earworms (having a song stuck in your head) and music-evoked remembering.

For their latest study, the researchers worked with 25 to 31 different people in each of three experiments, over three different days, spaced weeks apart. Subjects first listened to unfamiliar music, and then, a week later, listened to the music again, this time paired with likewise unfamiliar movie clips. In one instance, movies were played without music. The research subjects, all UC Davis undergraduate and graduate students, were subsequently asked to remember as many details as they could from each movie as the music played. They were also quizzed about their recollection of the associated tunes and how often they experienced each of the tunes as an earworm. None of them had formal music training.

The more the tune played, the more accurate the memory

The results: the more often a tune played in a person's head, the more accurate the memory for the tune became and, critically, the more details the person remembered from the specific section of the movie with which the tune was paired.

With only one week between when they saw the movie, and when they were asked to remember as many details from the movie as they could while listening to the movie soundtrack, the effect of repeatedly experiencing a tune from the soundtrack as an earworm resulted in near-perfect retention of the movie details. These people's memories, in fact, were as good as when they had first seen the movie. Additionally, most subjects were able to report what they were typically doing when their earworms occurred, and none of them mentioned the associated movies coming to mind at those times.

"Our paper shows that even if you are playing that song in your mind and not pulling up details of memories explicitly, that is still going to help solidify those memories," Janata said.

"We typically think of earworms as random nuisance beyond our control, but our results show that earworms are a naturally occurring memory process that helps preserve recent experiences in long-term memory," Kubit said.

Future help for memory loss?

The authors said they hope the research, which is ongoing, could eventually lead to the development of nonpharmaceutical, music-based interventions to help people suffering from dementia and other neurological disorders to better remember events, people and daily tasks.

When a fictional female journalist appears on screen, chances are she's about to sleep with one of her sources. It's a trope that infuriates actual women in news media -- and it can have real-life consequences, says University of Florida researcher Frank Waddell, Ph.D.

In shows like "House of Cards" and movies like "Thank You for Smoking," female reporters are quick to trade sex for information. Even when sex with sources has nothing to do with ambition -- such as the hookups in "Sharp Objects," "Top Five," "Trainwreck," and the "Gilmore Girls" reboot, to name a few -- it still portrays unethical behavior.

"In the past 20 to 30 years, Hollywood has really latched on to this. It's incredibly consistent," Waddell said.

At the same time, threats to female journalists have increased. A UNESCO study of 901 journalists from 125 countries shows that 73% experienced online harassment. And in a 2019 survey of women and gender non-conforming journalists in the United States and Canada, 70% experienced threats and 85% felt they had become less safe in past five years.

Waddell, an assistant professor in UF's College of Journalism and Communications, wanted to know who believes these sexist portrayals, as research shows we're most affected by media we perceive as realistic. In a study published in Journalism Studies, he was surprised to uncover no difference between men and women or liberals and conservatives, who tend to indicate lower levels of trust in mainstream media. Less surprising: People who already held sexist beliefs about women journalists found the portrayals believable. With repetition, Waddell explains, those views become more entrenched, creating a vicious cycle.

Understanding who falls for skewed portrayals of female journalists is the first step in finding solutions, he says.

"This is a very specific slice of the pie, but it's in the context of a larger conversation about declining trust in media overall," said Waddell, who is part of UF's multidisciplinary Consortium on Trust in Media and Technology.

In his original concept for the experiment, Waddell wanted to contrast reactions to sexist portrayals of women journalists in popular shows and movies with positive ones. He couldn't find any.

"I was actually struggling so badly to find positive examples that I couldn't do that part of the study," he said. ("Spotlight," the chronicle of the Boston Globe's reporting on child sex abuse in the Catholic church, is a rare exception, but Waddell was concerned that the subject matter could have skewed the data.)

Because most people have few, if any, first-hand encounters with reporters, Hollywood can have an outsized influence. Ways to counter that could include increased contact between regular folks and journalists, whether it's through town hall events, expanded social media interaction, or creative approaches to demystifying what goes on inside a newsroom, Waddell said.

"I'm also hoping that Hollywood can do a better job finding ways to dramatize the practice of journalism," he said. "People are treating women in the newsroom differently because they fail to recognize what they're seeing has nothing to do with real life."

New research from Syracuse University Newhouse School of Public Communications reveals a relationship between political biases and attitudes about sexual assault.

Authored by assistant professor Rebecca Ortiz and PhD student Andrea Smith, the article "A social identity threat perspective on why partisans may engage in greater victim blaming and sexual assault myth acceptance in the #MeToo era," was published in the peer-reviewed journal Violence Against Women.

Ortiz and Smith found that the stronger the partisan identity of Republicans and Democrats, the more likely they were to engage in victim blaming attitudes, which was then related to a lesser likelihood to perceive the #MeToo movement as having a positive impact in the United States, possibly as a way of defending their political identities in a time when many political leaders have been accused of sexual assault.

In this cross-sectional study, the researchers sent a survey to Democrats, Republicans and independents and asked them a series of questions related to how strongly they identify with their political party affiliation.

The next series of questions looked at their attitudes about sexual assault and violence against women. These questions explored how likely they were to agree with myths about sexual assault, such as believing that female victims are at least somewhat responsible. The researchers then broke down responses by political identity and gender.

"What we found is that the more Republicans and Democrats strongly identified with their party, the more likely they were to agree, or at least not strongly disagree, with these sexual assault myths and then the less likely they were to perceive the #MeToo movement as having a positive impact," said Ortiz. "As predicted, these sexual assault myth attitudes were significantly higher among Republicans than Democrats and among men than women. We also found that our participants aligned more closely by party than gender, such that Republican women more closely aligned with Republican men and Democratic men with Democratic women."

However, while the Democratic Party has championed the #MeToo movement and women's rights, the researchers' findings indicate that even strongly partisan Democrats may still be willing to, at least somewhat, question a victim's story or believe in sexual assault myths, perhaps especially when a Democratic politician is accused of harassment or assault.

This narrative has played out on both sides of the political spectrum. In 2016, former President Donald Trump was accused by several women of sexual misconduct and harassment. During the campaign, an infamous tape resurfaced of Trump making lewd remarks about women and bragging about sexually harassing women. He still won the election and enjoyed popular support from Republicans. Likewise, while many Democrats called out former President Trump for the numerous sexual assault allegations against him, some Democrats were far less willing to criticize President Biden when a similar accusation was made by a former staffer during the 2020 elections.

"It appears that both Democrats and Republicans have the potential to engage in victim blaming and acceptance of these harmful cultural myths about sexual assault survivors as a means of preserving and defending their political identities, perhaps especially when powerful members and leaders of their political group are accused of these crimes," said Ortiz.

Below please find link(s) to new coronavirus-related content published today in Annals of Internal Medicine. All coronavirus-related content published in Annals of Internal Medicine is free to the public. A complete collection is available at https://annals.org/aim/pages/coronavirus-content.

1. NFL employee and player surveillance program enabled early detection of COVID-19, even among those who were asymptomatic

Free full text: https://www.acpjournals.org/doi/10.7326/M21-0319

Frequent, routine testing within the National Football League (NFL) enabled early detection of COVID-19 infection among players and employees, even among those who were asymptomatic. The study is among the first to summarize the use of daily testing for COVID-19 surveillance. A brief research report is published in Annals of Internal Medicine.

Researchers from the NFL and IQVIA studied results for more than 600,000 tests administered to over 11,600 NFL players and staff during the 2020 football season to describe results of a rigorous, large-scale COVID-19 testing and monitoring program. Testing was conducted daily using 2 reverse transcription polymerase chain reaction (RT-PCR) platforms: a transcription mediated amplification platform, and an antigen point-of-care. Test results were reported as "positive," "negative," "presumptive positive," or "inconclusive." Cycle thresholds (Cts), which can approximate viral load, were reported where possible. In addition to routine testing, the Program included ongoing player and staff education, physical distancing and masking requirements, environmental disinfection, and contact tracing protocols to decrease risk for transmission.

That data showed that overall, frequent RT-PCR surveillance allowed for detection of new infections, including those early in the clinical course and patients who were not experiencing symptoms at the time of testing. Quantitative values proved useful for understanding test results, with Ct values signaling early infection. The researchers noted that antigen POC testing was unable to reliably rule out COVID-19 early in infection.

According to the authors, these findings may be used to inform understanding and development of population-level SARS-CoV-2 testing and surveillance strategies to mitigate spread of the virus.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. For more information or to speak with the corresponding authors, please contact Megan Grant at Megan.Grant@nfl.com.

2. Vaccination rates in urban hospital less than ideal, especially among Black and Hispanic employees

Free full text: https://www.acpjournals.org/doi/10.7326/M21-1513

A brief research report found that vaccination rates of health care system employees during the COVID-19 pandemic were less than ideal, particularly among Black and Hispanic people. Understanding SARS-CoV-2 vaccination among health care workers is important because they are at high risk for occupational exposure and may be convincing advocates for vaccination among their patients. The findings are published in Annals of Internal Medicine.

Researchers from The MetroHealth System and Case Western Reserve University studied health records for more than 7,800 employees in an urban safety-net hospital system to determine the relationship between social and demographic characteristics of health care workers and receipt of vaccination. They found sizeable disparities in vaccination rates by race/ethnicity and occupational category. Adjusted probability of vaccination among Black employees was approximately 30% and about 55% among Hispanics. This rate was highest among Asian employees at about 68% and about 65% among Whites. Physicians, dentists, and psychologists had the highest rate of vaccination (81%), while nurses (54%) and facilities staff had the lowest (35%).

According to the researchers, these findings are concerning given the high burden of COVID-19 affecting in Black and Hispanic communities. The low vaccination rate among nurses was also deemed concerning given their higher rate of occupational exposure to SARS-CoV-2 and likely higher risk for death due to COVID-19. Understanding SARS-CoV-2 vaccination among health care workers is important because they are at high risk for occupational exposure and may be convincing advocates for vaccination among their patients. Barriers to vaccination cannot explain low uptake, as availability, efficacy, and safety of the vaccines were widely publicized to all employees by e-mail, intranet, flyers posted on bulletin boards, and word of mouth and vaccination scheduling could occur at any time via patient portal or by telephone. These findings suggest that more must be done to understand and overcome barriers to vaccination among health care employees and especially for Black and Hispanic populations.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding author, J. Daryl Thornton, MD, MPH, please contact Dorsena Drakeford at ddrakeford@metrohealth.org.

3. Medicalized hotels a safe alternative to conventional hospitals for patients with noncritical COVID-19 infection

Free full text: https://www.acpjournals.org/doi/10.7326/M21-1873

A team of researchers from Hospital Clinic de Barcelona (HCB) found that medicalized hotels are a safe alternative to conventional hospitals for patients with noncritical COVID-19 infection. Their brief research report is published in Annals of Internal Medicine.

During the first wave of the pandemic in Barcelona, the Catalonia Plaza Hotel in Barcelona was medicalized to provide hospital-level care to patients with COVID-19. Staff from different HCB departments were recruited to work in the hotel hospital (HH). From March to May 2020, 2,410 patients with COVID-19 were admitted to HCB and about one fifth of those patients were transferred to the HH. The cumulative median length of stay was 15 days for the HCB and HH combined and 9 days for the HH. Just over 5% of the patients in the HH required transfer back to HCB because of clinical deterioration or other medical complications and 2 of those patients died.

According to the researchers, these finding suggest that medicalized hotels can be used to reduce pressure on hospitals, allowing them to be used for patients who are more complex and critically ill. Their report provides preliminary guidance on how to adapt of hotels for medical use and how to determine admission criteria for selecting appropriate patients.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding author, David Nicolás, MD, PhD, please contact HCB PR at premsa@clinic.cat or Ms. Núria Boutin nboutin@clinic.cat.

4. NIH panel discusses lessons learned from developing treatment guidelines during a pandemic health crisis

Free full text: https://www.acpjournals.org/doi/10.7326/M21-1647

In March 2020, the White House Coronavirus Task Force, through the Secretary of Health
and Human Services, asked the National Institutes of Health (NIH) to develop evidence-based
guidelines for the treatment of patients with COVID-19. In a new commentary published in Annals of Internal Medicine, members of the National Institutes of Health COVID-19 Treatment Guidelines Panel discuss the important lessons the process has provided for responding to an unprecedented public health emergency.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding authors, Safia Kuriakose, PharmD, and Kanal Singh, MD, MPH, please contact the NIAID Office of Communications and Government Relations at 301-402-1663 or niaidnews@niaid.nih.gov.

In a study published today in the Annals of Internal Medicine, Johns Hopkins Medicine researchers say they believe that, for the first time, there is evidence to show that three doses of vaccine increase antibody levels against SARS-CoV-2 -- the virus that causes COVID 19 -- more than the standard two-dose regimen for people who have received solid organ transplants.

"Our findings suggest clinical trials are warranted to determine if transplant recipients should receive COVID-19 vaccine booster doses as standard clinical practice, similar to what is currently done with hepatitis B and influenza vaccinations for this population," says study lead author William Werbel, M.D., an infectious diseases research fellow at the Johns Hopkins University School of Medicine.

People who receive solid organ transplants (such as hearts, lungs and kidneys) often must take drugs to suppress their immune systems and prevent rejection. Such regimens may interfere with a transplant recipient's ability to make antibodies to foreign substances, including the protective ones produced in response to vaccines.

In the first of two previous studies, the researchers showed that only 17% of the participating transplant recipients produced sufficient antibodies after one dose. Then, in the second study, they found the level improved to 54% after the second shot. In both cases, even those transplant recipients with antibodies had levels well below what has been typically seen in people with healthy immune systems.

In their latest study, the researchers evaluated 30 organ transplant recipients who received a third dose of one of three vaccines -- Johnson & Johnson/Jansen, Moderna or Pfizer/BioNTech -- between March 20 and May 10, 2021. They had previously received two doses of either the Moderna or Pfizer/BioNTech vaccine. The median age of the study participants was 57, 17 were women and one identified as non-white. No study participant reported an illness prior to vaccination or a positive test for SARS-CoV-2. All were taking multiple immunosuppressive medications to prevent rejection of their transplanted organs.

"Our findings revealed that a third of the participants who had negative antibody levels and all who had low positive levels before the booster increased their immune response after a third vaccine dose," says study senior author Dorry Segev, M.D., Ph.D., the Marjory K. and Thomas Pozefsky Professor of Surgery and Epidemiology and director of the Epidemiology Research Group in Organ Transplantation at the Johns Hopkins University School of Medicine.

A week after receiving their third vaccine dose, 23 study participants completed a questionnaire about adverse effects. Reactions were generally mild or moderate, with one participant reporting severe arm pain and another a severe headache. No participant reported fever or an allergic reaction. There was one case of mild organ rejection during the study.

"These reactions seem acceptable, considering the benefits that vaccines can confer," says Segev.

Werbel and Segev note that this study only examined antibody levels, and that future research is needed to see if the increased immune response after a third vaccine dose is associated with lower SARS-CoV-2 infection rates.

"Although the third vaccine dose appears to raise the immune response of transplant recipients to higher levels than after one or two doses, these people may still be at greater risk for SARS-CoV-2 infection than the general population who have been vaccinated," says Werbel. "Therefore, we recommend that transplant recipients and other immunocompromised people continue to wear masks, maintain physical distancing and practice other COVID-19 safety measures."

Sometimes photos cannot truly capture a scene. How much more epic would that vacation photo of Niagara Falls be if the water were moving?

Researchers at the University of Washington have developed a deep learning method that can do just that: If given a single photo of a waterfall, the system creates a video showing that water cascading down. All that's missing is the roar of the water and the feeling of the spray on your face.

The team's method can animate any flowing material, including smoke and clouds. This technique produces a short video that loops seamlessly, giving the impression of endless movement. The researchers will present this approach June 22 at the Conference on Computer Vision and Pattern Recognition.

"A picture captures a moment frozen in time. But a lot of information is lost in a static image. What led to this moment, and how are things changing? Think about the last time you found yourself fixated on something really interesting -- chances are, it wasn't totally static," said lead author Aleksander Holynski, a doctoral student in the Paul G. Allen School of Computer Science & Engineering.

"What's special about our method is that it doesn't require any user input or extra information," Holynski said. "All you need is a picture. And it produces as output a high-resolution, seamlessly looping video that quite often looks like a real video."

Developing a method that turns a single photo into a believable video has been a challenge for the field.

"It effectively requires you to predict the future," Holynski said. "And in the real world, there are nearly infinite possibilities of what might happen next."

The team's system consists of two parts: First, it predicts how things were moving when a photo was taken, and then uses that information to create the animation.

To estimate motion, the team trained a neural network with thousands of videos of waterfalls, rivers, oceans and other material with fluid motion. The training process consisted of asking the network to guess the motion of a video when only given the first frame. After comparing its prediction with the actual video, the network learned to identify clues -- ripples in a stream, for example -- to help it predict what happened next. Then the team's system uses that information to determine if and how each pixel should move.

The researchers tried to use a technique called "splatting" to animate the photo. This method moves each pixel according to its predicted motion. But this created a problem.

"Think about a flowing waterfall," Holynski said. "If you just move the pixels down the waterfall, after a few frames of the video, you'll have no pixels at the top!"

So the team created "symmetric splatting." Essentially, the method predicts both the future and the past for an image and then combines them into one animation.

"Looking back at the waterfall example, if we move into the past, the pixels will move up the waterfall. So we will start to see a hole near the bottom," Holynski said. "We integrate information from both of these animations so there are never any glaringly large holes in our warped images."

Finally, the researchers wanted their animation to loop seamlessly to create a look of continuous movement. The animation network follows a few tricks to keep things clean, including transitioning different parts of the frame at different times and deciding how quickly or slowly to blend each pixel depending on its surroundings.

The team's method works best for objects with predictable fluid motion. Currently, the technology struggles to predict how reflections should move or how water distorts the appearance of objects beneath it.

"When we see a waterfall, we know how the water should behave. The same is true for fire or smoke. These types of motions obey the same set of physical laws, and there are usually cues in the image that tell us how things should be moving," Holynski said. "We'd love to extend our work to operate on a wider range of objects, like animating a person's hair blowing in the wind. I'm hoping that eventually the pictures that we share with our friends and family won't be static images. Instead, they'll all be dynamic animations like the ones our method produces."

The eye is the first sensory organ that recognizes the presence or shape of an object. The conjunctiva is a thin mucous membrane that covers the front half of the eyeball. It protects the eye by secreting mucus and tears for lubrication, and prevents microorganisms from entering. However, since it is exposed to the air, it is susceptible to damages by microorganisms, bacteria, or dust. In fact, if fibrovascular tissues are left to propagate on its surface, they can lead to diseases like pterygium, which can cause visual deterioration. To treat such conditions, an operation to remove and regenerate the damaged conjunctiva is performed. Recently, a Korean research team has developed a new method for performing sutureless amniotic membrane transplantation using the mussel adhesive protein.

Professor Hyung Joon Cha's research team at POSTECH (Ph.D. candidate Seong-Woo Maeng, Dr. Tae Yoon Park) with the team led by Professor Woo Chan Park of the Department of Ophthalmology at Dong-A University College of Medicine (Dr. Ji Sang Min, currently at Kim's Eye Hospital of the Konyang University School of Medicine) have together applied a light-curable protein bioadhesive named FixLight to an animal model that simulated the transplantation of the amniotic membrane on an actual ocular surface. As a result, it was confirmed that the operation could be completed more than five times faster than the traditional suture method and the therapeutic effect of the conjunctival regeneration through stably bonded amniotic membranes could successfully replace the conventional procedure.

The amniotic membrane is the innermost membrane of the placenta that surrounds and protects the embryo. Since it contains many factors that promote epithelial regeneration, performing amniotic transplantation to reconstruct the ocular surface has been widely practiced. However, the current method stitches the membrane with sutures and fixes it to the surface of the eyeball, which leaves a scar. And since precise sutures are required due to the thinness of the amniotic membrane, the operation is considerably time-consuming.

To this, the POSTECH research team has developed a light-curable adhesive that exists in a liquid state when unexposed to light, but changes into a hydrogel within a few seconds when exposed to visible light of a specific wavelength. Going a step further this time, in joint effort with researchers from Dong-A University College of Medicine, the amniotic membrane was transplanted without sutures on the ocular surface of a rabbit model with conjunctiva defects using a light-curable bioadhesive.

The joint research team used a visible light-curable bioadhesive with liquid-solid photocrosslinking characteristics in the amniotic membrane transplantation surgery, focusing on the high transparency of the amniotic membrane. After evenly coating the liquid adhesive, the amniotic membrane was adhered to the defect site by crosslinking it with light of a specific wavelength. In an experiment using a rabbit conjunctiva defect model, the researchers observed stable tissue adhesion ability that showed no significant difference from suture-treated cases even on the wet surface of the eye. In addition, after epithelialization progressed over the transplanted amniotic membrane, the adhesive completely biodegraded and regenerated into an integrated epithelial tissue.

Professor Hyung Joon Cha of POSTECH explained, "We confirmed the effectiveness of a new amniotic membrane transplantation method for conjunctival reconstruction in an actual animal model using the mussel adhesive protein, an original biomaterial." He added, "It is anticipated to be highly useful as a safe bioadhesive to replace sutures in various medical fields."

FixLight - the visible light-curable protein bioadhesive - shows promise for commercialization in the near future as it has completed the technology transfer to Nature Gluetech Co., Ltd. and is awaiting clinical trials as a safe bioadhesive that can fully replace surgical sutures.

"The amniotic membrane transplantation is an important operation in ocular surface reconstruction and this visible light-curable bioadhesive enabled facile and rapid operation," remarked Professor Woo Chan Park of Dong-A University College of Medicine. "This technique shows promise to be applicable to other ophthalmological surgeries such as closing of incisions after cataract operation or other transplantations of the ocular surface, such as conjunctival autografting."

A team of scientists at Nanyang Technological University, Singapore (NTU Singapore) has developed millimetre-sized robots that can be controlled using magnetic fields to perform highly manoeuvrable and dexterous manipulations. This could pave the way to possible future applications in biomedicine and manufacturing.

The research team created the miniature robots by embedding magnetic microparticles into biocompatible polymers -- non-toxic materials that are harmless to humans. The robots are 'programmed' to execute their desired functionalities when magnetic fields are applied.

The made-in-NTU robots improve on many existing small-scale robots by optimizing their ability to move in six degrees-of-freedom (DoF) - that is, translational movement along the three spatial axes, and rotational movement about those three axes, commonly known as roll, pitch and yaw angles.

While researchers have previously created six DoF miniature robots, the new NTU miniature robots can rotate 43 times faster than them in the critical sixth DoF when their orientation is precisely controlled. They can also be made with 'soft' materials and thus can replicate important mechanical qualities -- one type can 'swim' like a jellyfish, and another has a gripping ability that can precisely pick and place miniature objects.

The research by the NTU team was published in the peer-reviewed scientific journal Advanced Materials in May 2021 and is featured as the front cover of the June 10 issue.

Lead author of the study, Assistant Professor Lum Guo Zhan from the School of Mechanical and Aerospace Engineering said the crucial factor that led to the team's achievement lie in the discovery of the 'elusive' third and final principal vector of these magnetic fields, which is critical for controlling such machines.

By contrast, previous works had only defined the applied magnetic fields in terms of two principal vectors.

"My team sought to uncover the fundamental working principles of miniature robots that have six-DoF motions through this work. By fully understanding the physics of these miniature robots, we are now able to accurately control their motions. Furthermore, our proposed fabrication method can magnetise these robots to produce 51 to 297 folds larger six-DoF torques than other existing devices. Our findings are therefore pivotal, and they represent a significant advancement for small-scale robotic technologies," explains Asst Prof Lum.

Remote-controlled miniature robots suitable for surgical, manufacturing use

Measuring about the size of a grain of rice, the miniature robots may be used to reach confined and enclosed spaces currently inaccessible to existing robots, say the NTU team, making them particularly useful in the field of medicine.

The movements of the robots can be controlled remotely by an operator, using a programme running on a control computer that precisely varies the strength and direction of magnetic fields generated by an electromagnetic coil system.

The miniature robots may also inspire novel surgical procedures for 'difficult-to-reach' vital organs such as the brain in future, the NTU team said, adding that much more work and testing still need to be accomplished before the miniature robots can eventually be deployed for their targeted medical applications.

Co-authors of the research, PhD students Xu Changyu and Yang Zilin from the School of Mechanical and Aerospace Engineering said, "Besides surgery, our robots may also be of value in biomedical applications such as assembling lab-on-chip devices that can be used for clinical diagnostics by integrating several laboratory processes on a single chip."

NTU miniature robots swim through barriers, assemble structures

In lab experiments, the research team demonstrated the dexterity and speed of the miniature robots.

Using a jellyfish inspired robot, the NTU team showed how it was able to swim speedily through a tight opening in a barrier when suspended in water. This demonstration was highly significant as it suggested that these robots were able to negotiate barriers in dynamic and uncertain environments and this could be a highly desirable ability for their targeted biomedical applications in future such as in surgical procedures for 'difficult-to-reach' vital organs such as the brain.

Demonstrating precise orientation control, the miniature robot also recorded a rotation speed of 173 degrees per second for their sixth DoF motion, exceeding the fastest rotation that existing miniature robots have achieved, which is four degrees per second for their sixth DoF motion.

With their gripper robot, the scientists were able to assemble a 3D structure consisting of a bar sitting atop two Y-shaped stilts in less than five minutes, about 20 times faster than existing miniature robots have been able to. This proof-of-concept demonstration, say the researchers, suggests that one day they may be used in 'micro factories' that build microscale devices.

Providing an independent view, Professor Huajian Gao, a Distinguished University Professor from the School of MAE at NTU, and a recipient of the prestigious 2021 American Society of Mechanical Engineers Timoshenko Medal, said, "This is a perfect example of how engineering ingenuity rooted in deep scientific understanding helps us develop advanced robotics for the benefit of mankind. This research work can have profound impact in many fields ranging from novel surgical methods to small scale assembly processes in future manufacturing."

The NTU team is now looking to make their robots even smaller, on the scale of a few hundred micrometres, and to ultimately make the robots fully autonomous in terms of control.

GAINESVILLE, Fla. --- An international research team has described a new species of Oculudentavis, providing further evidence that the animal first identified as a hummingbird-sized dinosaur was actually a lizard.

The new species, named Oculudentavis naga in honor of the Naga people of Myanmar and India, is represented by a partial skeleton that includes a complete skull, exquisitely preserved in amber with visible scales and soft tissue. The specimen is in the same genus as Oculudentavis khaungraae, whose original description as the smallest known bird was retracted last year. The two fossils were found in the same area and are about 99 million years old.

Researchers published their findings in Current Biology today.

The team, led by Arnau Bolet of Barcelona's Institut Català de Paleontologia Miquel Crusafont,
used CT scans to separate, analyze and compare each bone in the two species digitally, uncovering a number of physical characteristics that earmark the small animals as lizards. Oculudentavis is so strange, however, it was difficult to categorize without close examination of its features, Bolet said.

"The specimen puzzled all of us at first because if it was a lizard, it was a highly unusual one," he said in an institutional press release.

Bolet and fellow lizard experts from around the world first noted the specimen while studying a collection of amber fossils acquired from Myanmar by gemologist Adolf Peretti. (Note: The mining and sale of Burmese amber are often entangled with human rights abuses. Peretti purchased the fossil legally prior to the conflict in 2017. More details appear in an ethics statement at the end of this story).

Herpetologist Juan Diego Daza examined the small, unusual skull, preserved with a short portion of the spine and shoulder bones. He, too, was confused by its odd array of features: Could it be some kind of pterodactyl or possibly an ancient relative of monitor lizards?

"From the moment we uploaded the first CT scan, everyone was brainstorming what it could be," said Daza, assistant professor of biological sciences at Sam Houston State University. "In the end, a closer look and our analyses help us clarify its position."

Major clues that the mystery animal was a lizard included the presence of scales; teeth attached directly to its jawbone, rather than nestled in sockets, as dinosaur teeth were; lizard-like eye structures and shoulder bones; and a hockey stick-shaped skull bone that is universally shared among scaled reptiles, also known as squamates.

The team also determined both species' skulls had deformed during preservation. Oculudentavis khaungraae's snout was squeezed into a narrower, more beaklike profile while O. naga's braincase - the part of the skull that encloses the brain - was compressed. The distortions highlighted birdlike features in one skull and lizard-like features in the other, said study co-author Edward Stanley, director of the Florida Museum of Natural History's Digital Discovery and Dissemination Laboratory.

"Imagine taking a lizard and pinching its nose into a triangular shape," Stanley said. "It would look a lot more like a bird."

Oculudentavis' birdlike skull proportions, however, do not indicate that it was related to birds, said study co-author Susan Evans, professor of vertebrate morphology and paleontology at University College London.

"Despite presenting a vaulted cranium and a long and tapering snout, it does not present meaningful physical characters that can be used to sustain a close relationship to birds, and all of its features indicate that it is a lizard," she said.

While the two species' skulls do not closely resemble one another at first glance, their shared characteristics became clearer as the researchers digitally isolated each bone and compared them with each other. The differences were minimized when the original shape of both fossils was reconstructed through a painstaking process known as retrodeformation, conducted by Marta Vidal-García from the University of Calgary in Canada.

"We concluded that both specimens are similar enough to belong to the same genus, Oculudentavis, but a number of differences suggest that they represent separate species," Bolet said.

In the better-preserved O. naga specimen, the team was also able to identify a raised crest running down the top of the snout and a flap of loose skin under the chin that may have been inflated in display, Evans said. However, the researchers came up short in their attempts to find Oculudentavis' exact position in the lizard family tree.

"It's a really weird animal. It's unlike any other lizard we have today," Daza said. "We think it represents a group of squamates we were not aware of."

The Cretaceous Period, 145.5 to 66 million years ago, gave rise to many lizard and snake groups on the planet today, but tracing fossils from this era to their closest living relatives can be difficult, Daza said.

"We estimate that many lizards originated during this time, but they still hadn't evolved their modern appearance," he said. "That's why they can trick us. They may have characteristics of this group or that one, but in reality, they don't match perfectly."

The majority of the study was conducted with CT data created at the Australian Centre for Neutron Scattering and the High-Resolution X-ray Computed Tomography Facility at the University of Texas at Austin. O. naga is now available digitally to anyone with Internet access, which allows the team's findings to be reassessed and opens up the possibility of new discoveries, Stanley said.

"With paleontology, you often have one specimen of a species to work with, which makes that individual very important. Researchers can therefore be quite protective of it, but our mindset is 'Let's put it out there,'" Stanley said. "The important thing is that the research gets done, not necessarily that we do the research. We feel that's the way it should be."

While Myanmar's amber deposits are a treasure trove of fossil lizards found nowhere else in the world, Daza said the consensus among paleontologists is that acquiring Burmese amber ethically has become increasingly difficult, especially after the military seized control in February.

"As scientists we feel it is our job to unveil these priceless traces of life, so the whole world can know more about the past. But we have to be extremely careful that during the process, we don't benefit a group of people committing crimes against humanity," he said. "In the end, the credit should go to the miners who risk their lives to recover these amazing amber fossils."

Other study co-authors are J. Salvador Arias of Argentina's National Scientific and Technical Research Council (CONICET - Miguel Lillo Foundation); Andrej Cernansky of Comenius University in Bratislava, Slovakia; Aaron Bauer of Villanova University; Joseph Bevitt of the Australian Nuclear Science and Technology Organisation; and Adolf Peretti of the Peretti Museum Foundation in Switzerland.

A 3D digitized specimen of O. naga is available online via MorphoSource. The O. naga fossil is housed at the Peretti Museum Foundation in Switzerland, and the O. khaungraae specimen is at the Hupoge Amber Museum in China.

The specimen was acquired following the ethical guidelines for the use of Burmese amber set forth by the Society for Vertebrate Paleontology. The specimen was purchased from authorized companies that are independent from military groups. These companies export amber pieces legally from Myanmar, following an ethical code that ensures no violations of human rights were committed during mining and commercialization and that money derived from sales did not support armed conflict. The fossil has an authenticated paper trail, including export permits from Myanmar. All documentation is available from the Peretti Museum Foundation upon request.

PULLMAN, Wash. - You can take a fish out of toxic water, but its epigenetic mutations will remain for at least two generations.

A research team led by Washington State University scientists analyzed the epigenetics--molecular factors and processes that determine whether genes are turned on or off--of a group of Poecilia mexicana fish, or Atlantic molly, that live in springs naturally high in hydrogen sulfide, which is normally toxic to most organisms.

The researchers removed a sample of fish from the toxic water and bred them in freshwater. They found that the grandchildren of the sulfidic-adapted fish had more epigenetic marks in common with their wild, toxic-water-living grandparents than other Atlantic molly that had always lived in freshwater.

"After two generations in laboratory conditions, the fish generally retained their same epigenetic marks, which was really unexpected," said Joanna Kelley, WSU associate professor of evolutionary genomics and a corresponding author on the study published in Proceedings of the National Academy of Sciences. "In an evolutionary context, the study shows that these epigenetic marks are fairly stable."

Hydrogen sulfide is found in nature and as a by-product generated by many human activities, such as paper manufacturing, sewage treatment and gas exploration. For most animals, including humans, it is usually toxic at relatively low concentrations and fatal at high levels. Yet some populations of Atlantic molly have adapted to living in springs with high levels of hydrogen sulfide, while other groups of the same species have remained in freshwater. To Kelley and her colleagues, these fish presented a natural experiment to help address questions of how evolutionary adaptations occur.

For this study, Kelley collaborated with WSU environmental epigenetics and reproductive biologist Michael Skinner, to do the epigenetic analysis. The researchers raised a sample of sulfidic and non-sulfidic fish in freshwater environments. When the fish produced two generations of offspring, they measured their epigenetic similarities, specifically regions of DNA methylation, a type of chemical modification that can regulate gene expression, turning a gene on or off, without changing the DNA sequence string itself.

They found that the grand-offspring of the sulfidic fish had an 80% overlap in DNA methylation regions with the grandparent fish--even though they had been raised in freshwater. This compares to only 20% overlap with the non-sulfidic fish that had always lived in freshwater.

"It's really one of the first examples where we've taken an organism out of its normal environment and put it into a different environment and showed that the epigenetics keep being inherited going forward," said Skinner, also a corresponding author on the paper.

The study also adds to evidence from previous animal research showing that exposure to toxins has epigenetic effects that can last for generations. Skinner's lab has conducted studies on other wild species, including Darwin Finch in the Galapagos and the New Zealand mud snail as well as laboratory animals, showing that epigenetic changes resulting from environmental toxicants are passed down.

"This is not a one-off, unique species event. This has an impact on everything, including humans," said Skinner. "Although this is an animal model, it's a demonstration of how an environmental toxicant can actually shift the epigenetics, and it becomes programmed for subsequent generations."

EVANSTON, Ill. --- The human gut is more than a source of instinct.

A new Northwestern University study is the first to explicitly address the gut microbiome as a pathway to understanding how environmental inequities could lead to health disparities.

Biological anthropologist Katherine Amato, assistant professor of anthropology at the Weinberg College of Arts and Sciences at Northwestern, is the study's lead author.

Amato says, despite a rich body of literature documenting environmental impacts on the microbiome, and the microbiome's impact on human health, the links between structural discrimination, altered environments, microbiome structure and health disparities have not been comprehensively outlined.

The new study calls for a better understanding of how structural discrimination that exposes minoritized populations to 'unhealthy' environments -- from altered diets, pollution, sanitation and lack of access to green space -- impacts the human gut microbiome, which in turn affects almost every aspect of human biology and health.

"Research has implicated the microbiome in most chronic diseases, and we know that there are disparities in most chronic diseases in which higher morbidity is observed in minoritized populations," Amato said.

Prior studies have demonstrated the impact of environmental inequality on health. For example, a 2020 study showed that children who are exposed to plants and dirt daily at school have higher microbial diversity and improved immune markers, likely because the exposure to microbes in these materials are transmitted to children's bodies. The pattern suggests that minoritized populations living in neighborhoods with little access to outdoor green space are more likely to have lower microbial diversity and associated health risks.

Among its many roles, the gut microbiome contributes to protection from pathogens, nutrition and metabolism, immune function, brain development and behavior. An altered gut microbiome can also have an impact on the gestational environment and the resulting health of the next generation.

Amato's study builds on prior research that shows the environment's role may be stronger than genetics in shaping the human microbiome, and that changes to the composition and function of the microbiome are most flexible in early life.

According to Amato, more empirical and interdisciplinary research is needed to facilitate epidemiological approaches that can tease apart multiple interacting determinants of health and help isolate the factors leading to chronic disease.

An ultimate goal of the research is to be able to deliver interventions that address environmental issues and individualized therapies to restore and improve microbiome health.

"Demonstrating the potential importance of these therapies in combatting health inequities could lead to transformative policy interventions that strive for universal access to emerging health technologies, and to healthcare more generally," Amato said.