Author Archives: Nancy Cohen

About Nancy Cohen

Nancy Cohen is a writer from Cambridge, MA. She holds an MS from Columbia University Graduate School of Journalism. Her focus is on business, science, and technology.

Tokophobia in the spotlight: Experts seek grip on pathologic dread of childbirth

The fear of giving birth is not always on the common list of phobias — but maybe it should. It’s more pervasive than most people think, and it’s poorly understood.

Fear of heights. Fear of flying. Fear of spiders. Fear of germs. We know about irrational fears through popular media, armchair psychologists, journal studies, case reports. A lesser-known phobia, though, has not been given as much spotlight as others, and health professionals say it is time to pay attention. The stranger is tokophobia — so what is it?

The name of the phobia refers to a pathological fear of pregnancy and avoidance of childbirth; it can also be spelled with toc-, toco-, tok-, and toko- as combining forms, and all refer to labor or childbirth.

At first glance, it wouldn’t really seem like a big deal or a common problem. But this should not be confused with the usual concerns pregnant women may have after reading tips on what to do and not to do during pregnancy — this fear is much more intense and abrasive . Tal Slome wrote in kidspot that “It can be so debilitating that sufferers may avoid pregnancy, or, in extreme cases, choose to terminate a pregnancy or refrain from sex altogether.” She said that symptoms can include nightmares, sleeplessness, overwhelming fear of stillbirths, maternal death, birth defects.

Here is one observation published in a blog of BMJ, one of the most reputable medical journals, and a subsidiary of the British Medical Association, further detailing the issue.

“Tokophobia is an extreme fear of pregnancy and childbirth; it causes severe psychological distress and can have far reaching consequences. Despite this, tokophobia is under-researched and many healthcare professionals have never heard of it.” The author of the BMJ blog entry, Sarah-Jane Archibald, is a UK-based clinical psychologist.

Depending on where you look, tokophobia is described as fear of pregnancy and childbirth, but it is also frequently described as, primarily, a fear of childbirth. An article from authors at the University of Hull and Southern Cross University last December in The Conversation, for example, defined tokophobia as “a severe and unreasoning dread of childbirth, which is sometimes accompanied by a disgust of pregnancy.”

Discussion after discussion bears a similar lament among health professionals: As Melissa Weinberg, a therapist wrote in in February, this phenomenon is widely experienced, yet “not thoroughly researched. There are some, but not enough, comprehensive studies.” The literature mentions the problem, but there are indeed more questions than answers at this point.

Triggers vary

Tokophobia can come in two forms: primary (in women who have not had a baby before) and secondary (women who have previously had a baby).

In a study published in the in Industrial Psychiatry Journal, Manjeet Singh Bhatia and Anurag Jhanjee referred to it as “a pathological fear related to childbirth.” They explain:

“Primary is morbid fear of childbirth in a woman, who has no previous experience of pregnancy. Secondary is morbid fear of childbirth developing after a traumatic obstetric event in a previous pregnancy.”

The two authors observed that triggers for this fear can come from a number of situations. They discussed hypotheses for why a woman might fear childbirth and there’s a wide variety of reasons. Examples of what include disturbance in mechanisms regulating anxiety; the women talked with women who had already undergone traumatic births; they are afraid they will receive poor medical care (ineffective pain control, low confidence in team providing care); and factors such as traumatic memories of childhood or psychiatric disorders.

So how likely is it that you would ever know someone with tokophobia? From Australia, earlier this year, Shona Hendley wrote in Body and Soul that “tokophobia can affect anywhere between 2.5-14% of women; although some studies have identified this figure as high as 22%.”

Addressing the issue

Tokophobia has two main challenges: understanding its causes and its profiles is the first. The second is, given its complexity, figuring out effective interventions which ideally are evidence-based. Since there is such a wide variety in the way it manifests, neither will be easy.

The authors from University of Hull and Southern Cross who wrote in The Conversation said that there was “much work left to do if we are to understand and identify when standard worries deviate from expected levels to problematic levels.” Elsewhere, Weinberg noted that there was little in the way of specific treatment guidelines.

Meanwhile, the authors from University of Hull and Southern Cross University last December in The Conversation reminded readers of their new paper published in the Journal of Reproductive and Infant Psychology, which reflected on a decisive meting of researchers and clinicians to nail down what’s missing un the way tokophobia is identified and treated. That meeting’s conclusion: “Significant gaps remain within the FoC/tokophobia knowledge base.” FoC stands for fear of childbirth. The authors in The Conversation did talk about treatment options, which if simplified might be summed up as listen carefully to the woman and give her support. They said among approaches that may help was “additional midwifery support to discuss the birth, with continuity of care, which is where the same midwife and/or midwifery care team sees the woman throughout pregnancy and labor.”

The world’s fish are swimming in microplastics

Wait, what are microplastics? Small bits of plastic? Plastics in the ocean break up into very small particles, less than 5 millimeters in length (as noted by US National Ocean Service, about the size of a sesame seed). Fish and other creatures often think the microplastics are food.

The Field Museum made news recently, as it published findings from its unique library. The library, described sometimes as a bunker, an underground warehouse, or even a “library of life on Earth”, contains fish specimens preserved in jars. In their latest study, researchers from Loyola University looked at the presence of microplastics in fish.

Tim Hoellein, a professor, and grad student Loren Hou have been examining the timeline of the microplastics buildup in fish, looking to see when and how plastic started accumulating in fish — and what we can expect for the future. Their search was assisted by Caleb McMahan, a marine biologist who specializes in the field of ichthyology (study of fish). The related scientific paper is titled, “A fish tale: a century of museum specimens reveal increasing microplastic concentrations in freshwater fish,” and it appears in Ecological Applications.

Turns out, organisms’ exposure to plastic was probably happening ever since plastic was invented, Hoellein said. However, the concentration has increased at an accelerated pace in the past few decades. According to the press release from the museum, “There were no plastic particles before mid-century, but when plastic manufacturing was industrialized in the 1950s, the concentrations skyrocketed.”

Washed out to sea

In searching for plastic in fish, Hou treated the digestive tracts of the fish with hydrogen peroxide. Plastic is resistant to the process, while the tissue is not. Hou described finding plastic pieces too tiny to see with the naked eye, just looking like a yellow stain — so they had to use a microscope to help them see the shape of pieces. A separate technique was also utilized to analyze a sample’s “chemical signature.”

Hou and team noted a surprising connection between the plastic they were finding in fish and pieces of clothing. When we think of plastic litter, we think of soda bottles and objects like six-pack can rings. We don’t think of plastics that we wear on our backs. Hou said microplastics can come often from clothing that’s been washed, with little threads breaking off and getting flushed into the water supply.

But this is far from the first study to highlight the problem of plastic in our clothes.

In 2011, ecologist Mark Brown published a study (Accumulation of Microplastic on Shorelines Worldwide: Sources and Sinks) that found oceans filled with tiny plastic microfibers that come from clothing. Brown looked at 18 shorelines worldwide, and 85 percent of the sediment along these shores was composed of microfibers. How did that happen? “Laundry,” said the author of the one article, Kate Good.

“Every time a single piece of synthetic clothing is washed, it releases 1,900 plastic microfibers into the water. These microfibers are carried out of your washing machine and diverted to sewage plants or local waterways. The fibers are too small to be filtered out of the water and end up washed out to sea.”

Understandably, researchers are very concerned about this, especially since microplastics can travel and accumulate up the food chain, and easily reach humans. In fact, previous studies found that humans consume around 100,000 microplastic pieces a year, or the equivalent of a credit card every week.

Ingesting fibers that were never intended for edibles? How will that affect one’s health? Cancer? Endocrine disruption? That definitely warrants further study. An article that appeared in The Conversation addressing what research has shown on the topic of fish eating plastic stated that that there is evidence that “microplastics and even smaller particles called nanoplastics can move from a fish’s stomach to its muscle tissue, which is the part that humans typically eat. Our findings highlight the need for studies analyzing how frequently plastics transfer from fish to humans, and their potential effects on the human body,” write Authors Alexandra McInturf, University of California, Davis and Matthew Savoca, Stanford University,

There are several important takeaways. For starters, plastic ingestion by fish seems to be widespread, but it does not seem to be universal. The authors were able to predict “which species were more likely to eat plastic based on their environment, habitat and feeding behavior.” They said “sharks, grouper and tuna that hunt other fishes or marine organisms as food were more likely to ingest plastic.”

Also, the amount of plastic that fish consumed seemed to depend on how much plastic was in their environment. “Species that live in ocean regions known to have a lot of plastic pollution, such as the Mediterranean Sea and the coasts of East Asia, were found with more plastic in their stomachs.” So if we want fish to not have as much plastic inside them, we simply need to discard less plastic — either recycle more or just use less of it in the first place.

Why your allergy symptoms are getting worse

Image credits: Brittany Colette.

For those with allergies, life in the past may not have been fun but at least the pattern was predictable. Reach for the box of tissues, try not to rub your eyes — a period of suffering, and that’s that.

Those who suffered knew that allergies would arrive and leave at certain times of the year. But the allergy picture has changed. Doctors see a different pattern, and allergies stick around for more. To make matters even worse, symptoms have become more severe.

Climate woes

Massachusetts Eye and Ear, a member of Mass General Brigham and a teaching hospital of Harvard Medical School, took their Focus blog to analyze the problem. They highlight the connection between the environment (global warming in particular) and allergy symptoms. Increased temperatures and worsening air pollution are part of the story. Dr. Amanda Dilger, an instructor in Otolaryngology-Head and Neck Surgery at the Harvard Medical School, has been looking at climate change’s impact on health.

It’s not the first time this relationship has been highlighted.

Sir Andy Haines, professor at the London School of Hygiene and Tropical Medicine, notes that climate change has a lot to do with health.

“Climate change has always been framed as an environmental issue and it’s always difficult to get traction on that but researchers have been conceptualizing it as a health issue and we hope people will start to take notice,” he stated.

Similarly, Dilger and scientists at the University of Utah are among those professionals connecting the dots between climate change and health problems.

The University of Utah site had an article about climate change and longer allergy seasons and posed the question, What’s climate change got to do with it? Their answer: Quite a lot. Some numbers in a nutshell: (1) Pollen seasons start 20 days earlier, (2) are 10 days longer, and (3) feature 21% more pollen than in 1990.

Led by William Anderegg of the university’s School of Biological Sciences, the research appears in Proceedings of the National Academy of Sciences. The researchers applied statistical methods toward pollen trends in conjunction with climate models over the past three decades, underscoring the connection between climate heating and allergies.

These allergies are more than a nuisance. The University of Utah underscored how for some people allergies to pollen are tied to respiratory health problems, “with implications for viral infections, emergency room visits and even children’s school performance. More pollen, hanging around for a longer season, makes those impacts worse.”

So what can someone with allergies do to relieve their symptoms?

“Nasal sprays, topical eye drops, steroids and over-the-counter antihistamines are symptomatic medications that can alleviate swollen eyes, sneezing and congestion. If medications are ineffective, a specialist might suggest in-office allergy shots or sublingual immunotherapy, which conditions the body so that its immune system responds less adversely to an allergen over time,” Focus wrote. If “significant structural issues” affect symptoms, surgery may be considered.

Faster, greener, cheaper: Your next home may be printed instead of built

A new generation of start-ups wants to disrupt the way houses are developed — and they’re already on the market.

Image via Dezeen.

For those uninitiated in 3D printing (although years of maker sites, souvenirs, prosthetic limbs, and car parts have already shown us the wonders of 3D printing) here is a useful definition of 3D printing from Associated Press: “3D printing, also known as additive manufacturing, uses machines to deposit thin layers of plastic, metal, concrete and other materials atop one another, eventually producing three-dimensional objects from the bottom up.”

Printing in three dimensions.

You may think 3D printing is all about small objects — and for the most part, that’s true, most printers are small in size and can only produce small objects. But increasingly, 3D printers are being used for larger objects. Houses, in particular, are an attractive field for it.

The time has never been as ripe as it is now for 3D printing. Innovation is in the air; prices for 3D printers are dropping; more affordable and durable materials are being developed; and there’s a shortage of wood and other materials conventionally used for house building. All the elements have aligned to make 3D-printed structures competitive with regular materials.

In fact, many believe that 3D printed houses could not only be comparable in price to conventional houses — but they could be cheaper. The construction time could also be reduced substantially. The World Economic Forum acknowledged the significance of this industry-changer — 3D printing can raise a house within days, compared to weeks or (more often) months.

Mighty Buildings is a case in point. As reported in Sustainable Brands, the firm basically makes construction panels. These can be bolted together as building blocks for structures. They use a thermoset composite material created via 3D-printer technology and the whole process is very efficient: the material hardens immediately under UV light.

Another 3D printing company on the construction scene is ICON, leveraging advanced robotics. They can print up to three houses at a time. Fast Company looked at their capabilities and reported that, on one site, it tried printing multiple homes at once. It was an experiment and they discovered it was possible, enabling them to go faster and reduce costs. Fast Company described the Vulcan printer, at 33 feet long, as working “like a giant version of desktop 3D printers, squirting out a custom concrete mixture in layers like frosting on a cake. The process builds the walls of the house, with other parts, including the roof and windows, added later.”

But are 3D printed houses too limited a solution for a giant problem of lack of affordable housing? How is this a practical solution? The CTO answered the question with another question: “how do you eat an elephant? One bite at a time.”

Down to Earth

In Italy, meanwhile, 3D printed homes are, literally, breaking ground. If you’re yawning over structures that look like super-sized cartons and resonate with a bicycle, dog and morning newspaper on the doorstep, wait for this. WASP has delivered a startling alternative.

3D printed houses. Image credits: Wasp.
Te inside. Image credits: Wasp.

WASP is a 3D printing company that partnered with Mario Cucinella Architects to make a “TECLA” house near Bologna, Italy. It is a dome-shaped structure, a circular model that has the appearance of coming up straight from the earth under it.

Construction was based on natural materials and it was made with two printer arms running at the same time. The recipe: soil blended with water and special additives. It presents close to a net zero footprint and uses about a hundred layers of 3D-printed clay.

“Each printer has the capacity to print an area of 50 sq m (538 sq ft), making it possible to accomplishing a single housing module in a matter of days,” as per New Atlas. The house has an open living room with a kitchen, bedroom, bathroom, and wardrobe storage. A skylight brings natural light during the day and “star gazing” at night. New Atlas called TECLA a “pioneering example for low-carbon housing construction.”

At the moment, it’s still hard to say if 3D printed houses will become mainstream. But the signs are there. Already, the first 3D printed house in the US was sold — and at a price much lower than its competitors in the area. No doubt, 3D printing is just getting started and it may not be long before it starts popping up in a neighborhood near you.

Cone of light aims to cut pandemic fears by killing 99.9% of viruses with light

We’re all eager to look forward and imagine a time where vaccine-sated countries and states lift restrictions on the pandemic and we go on with our life . The question is, can we expect to shed our deep anxiety about that, too?

A new technology using light can help us in that regard.

Image credits: Edwin Hooper.

In the Netherlands, a design team wants to restore confidence with a cone-of-light design. This is being referred to as a “floating design” installation that emits specific light that kills viruses.

It’s a way of enabling people gathering outdoors to watch sports, to attend cultural events, or whatever else they may do — simply put, to enjoy the public commons safely.

This is what the Urban Sun is all about. It’s a concept that was dreamed up at Studio Roosegaarde, and their idea has made it to the list of finalists in Fast Company’s 2021 World Changing Ideas Awards.

Urban Sun’s cone of light sheds an other-worldly glow on a city plaza — that’s the gist of how it works. Dezeen explained how it works: “by being installed overhead on a system of cables, so it can shine a large cone of sanitizing light onto a space below.”

Image credits: Studio Roosegaarde.

The Urban Sun’s cone of light is reported to be able to reduce the presence of viruses, including various strains of coronavirus and influenza, up to 99.9%.

The studio started exploring the concept in 2019. Daan Roosegaarde, Urban Sun’s designer, pioneered the idea, but the project is the result of his collaboration with scientists from Italy, Japan, Netherlands, and the US. The project is based on peer-reviewed journal articles authored by scientists. “Far-UVC light (222nm) efficiently and safely inactivates airborne human coronaviruses” is one such paper, published last year in Scientific Reports. In other words, the project doesn’t aim to be flashy or interesting — it aims to work.

So, what’s the science behind it?

“Research shows that though traditional 254nm UV light is harmful, the new far-UVC light with a wavelength of 222 nanometers can actually sanitize viruses safely,” said the studio.

The tech is also referred to as “far-UVC light.” The visible cone of yellowish light is merely regular light that demarcates the edge of the Urban Sun. “The visible ring demarcates the edge of Urban Sun. Far-UVC is invisible to the human eye, so we created a means by which the space could be visualized,” explains Studio Roosegaarde.

Safe radiation

The project’s far-UVC light source is measured and calibrated by the Dutch National Metrology Institute VSL, according to the studio. Also, Urban Sun meets the safety standards of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) — which means there’s no risk of danger from the radiation itself.

“The research shows that specific ultraviolet light (far-UVC) with the wavelength of 222nm can reduce the presence of viruses, including various strains of coronavirus and influenza, up to 99.9%. Even though traditional 254nm UV light is harmful, this specific light of 222nm is considered safe for both people and animals.”

Regarding far-UVC at 222 nanometers, scientists from the Center for Radiological Research, Columbia University Irving Medical Center, had this to say in Scientific Reports last year:

“As all human coronaviruses have similar genomic sizes, far-UVC light would be expected to show similar inactivation efficiency against other human coronaviruses including SARS-CoV-2… while staying within current regulatory dose limits, low-dose-rate far-UVC exposure can potentially safely provide a major reduction in the ambient level of airborne coronaviruses in occupied public location.”

A safe(r) space

Unfortunately, some uncertainties still remain about the technology. There is limited published data about the wavelength, dose, and duration of UVC radiation required to inactivate the SARS-CoV-2 virus, the researchers say. Furthermore, an FDA report also mentiones that:

“It is important to recognize that, generally, UVC cannot inactivate a virus or bacterium if it is not directly exposed to UVC. In other words, the virus or bacterium will not be inactivated if it is covered by dust or soil, embedded in porous surface or on the underside of a surface.”

The studio, meanwhile stated its claim and its limits quite clearly in Dezeen: “Urban Sun is not intended to create a guaranteed safe space. It is intended to create a safer space.”

The studio appears to be positioning Urban Sun as a concept that can create hope, but one that should not get in the way of government regulations for safety measures.

“Urban Sun creates a space for safer human gatherings. Government regulations and advisories regarding distancing still need to occur within Urban Sun. Urban Sun reduces risk. It does not eliminate it.”

As for what’s next — the studio aims for more modeling and will explore the question of blind spots in their cone.

Cold sandwiches are calorie traps — don’t fall for it

For some reason, we tend to feel that cold food isn’t as filling as hot food, and it’s tricking us into overeating.

When you’re tempted to conclude that the human species is rational, you may want to slide over to marketing research and check out a journal called Appetite. The journal looks at sensory and other influences on people’s selections of food and drinks. It doesn’t take long to understand the selections we make don’t exactly scream common sense.

A recent research effort in the journal examines our practice of adding orders “on the side” if our main item on order is a cold sandwich. They found that customers who bought cold sandwiches were twice as likely to order a la carte extras such salty crisps and cookies, as if the sandwich, just for its being cold, could not possibly satisfy them without companion sides.

Imagine customer Raph telling the waiter what he wants. After studying his lunch menu, he pats on cold crabmeat sandwich. He wants to know, “What will it come with?” Raph looks at the sides list on the menu and taps on stuffed olives and plantain chips. Was Raph’s sandwich (580 calories and 26 grams of fat, but who’s counting) was not enough to sustain him for a few hours?

If we look at the research in focus, we know that Raph or customers standing at takeout counters think they need more than just the sandwich to complete a sit-down eating experience, because it’s just a cold sandwich, and that’s not much. They simply feel that the cold sandwich alone will not offer ample satiety.

“We show that the temperature at which foods and beverages are served impacts consumers’ complementary purchases, defined as additional foods and beverages purchased for a consumption episode.” wrote Sara Baskentli, Lauren Block, Maureen Morrin in their journal article, “The serving temperature effect: Food temperature, expected satiety, and complementary food purchases.”

Somebody cared

Anyone hunting for explanations for this behavior might remember all the family memories of steaming food on a table marking religious holidays and celebrations. A psychological add-on is that the hot food is a reminder that somebody in the household cared enough to stand, mix, pour, bake, braise, and simmer so that you could be pleased and nourished. Translation: Hot food equals caring. Cold food? Not so much.

To test the hypothesis, researchers examined customers’ café orders over a two-week period. The researchers saw 123 customers’ orders at a New York City café with sandwiches on their menu. People buying cold sandwiches were twice as likely to buy other food items. As for cold beverage orders? Calorie and money traps were evident, too.

“When a customer purchased a cold beverage, they were three times more likely to also buy food items, such as a croissant or a muffin,” said the news release from Rutgers.

The authors in their paper nailed the good news for restaurant business and the caution for the rest of us.

“Serving temperatures that increase complementary purchasing may enhance the firm’s bottom line, but could add unnecessary calories to the meal, and thus is of interest to both consumers and managers.”

In the bigger picture, this is a research discussion that indicates the important difference between appetite and hunger. Scientists like to point out the difference between the two words. Appetite is not hunger, plain and simple. According to the Aspen Clinic, for example, “appetite” involves a “conditioned response to food” and the word is more closely linked to behavior and emotional connection to food. Appetite “can increase/decrease due to hormones, emotional state, and taste preferences.”

Could gene editing help us fight chronic pain?

A CRISPR-based technique as an alternative to opioids is making news. The unlikely approach could help millions and help reduce America’s dependence on opioids, according to several new studies.

Image credits: K State Research.

For now, a current standard of care for chronic pain often involves opioids, and this has become quite a problem, as opioids pose the risk of getting addicted to them. It is ironic: the very mitigant designed to ease suffering has turned out to be in an of itself a “crisis.”

Over the past two decades, there has been a sharp rise in the use of prescription opioids in the US, with Americans consuming around 80% of the world’s strongest opioids. Researchers are also taking note of this and they’re looking for ways to offer effective pain management in a world without opioids. Now, they’re finally starting to report some good results.

The Consortium Against the overuse of Opioids in Surgery (CAOS) was established in August 2019 with the aim of reducing harmful effects from opioid use among surgical patients. CAOS wanted to inform opioid prescribing policy and to improve clinical practice via collaborative research. Members included professors and experts in fields such as molecular biology, anesthesiology, orthopaedics, and epidemiology research.

A forceful and multidisciplinary call from experts associated with CAOS came out in Frontiers in Surgery last year. “The Surgeon’s Role in the Opioid Crisis: A Narrative Review and Call to Action” called for specific action, with the authors emphasizing “a pressing need to optimize postoperative prescribing practices.”

This month, those focused on an alternative to opioids for pain will want to check out a new study published on March 10 in Science Translational Medicine. The study authors from the University of California San Diego, admit they are working on an area which has thus far delivered limited returns. But things are about to change, they say.

“Despite decades of research, the goal of achieving broadly effective, long-lasting, nonaddictive therapeutics for chronic pain has remained elusive,” the study writes.

The developed an approach they call LATER, which stands for “long-lasting analgesia via targeted in vivo epigenetic repression of NaV1.7” — an important channel in the transmission of pain. Their work is particularly promising since LATER reversed chemotherapy-induced chronic pain in mice, and may be effective for treating chronic pain of multiple origins.

A direct hit at Nav1.7

In a study published in Nature, researchers reported that they might be able to stop pain signals traveling to the brain by preventing neurons from producing Nav1.7. With CRISPR’s edge in targeting genes with precision, the researchers thought they might be able to hit Nav1.7 directly, without any “off-target” effects. In an article discussing the study for Nature, journalist Ariana Remmel notes that “mice that received doses of chemotherapy became very sensitive to pain, but lost that sensitivity after a single injection of the gene therapy.” This is an approach that represses, at least temporarily, a gene involved in sending pain, but it could last for months.

For pain sufferers and medical professionals who treat them, duration is clearly an important part of the problem. The treatment was tested at various timepoints, said the news release, and was still effective after 44 weeks in the mice with inflammatory pain– and 15 weeks in those with chemotherapy-induced pain.

Quoted in Nature, a Yale neuroscientist weighed in on information that the pain relief seemed to last, in some cases, for as long as 44 weeks after the injection. “That’s quite remarkable,” comments Sulayman Dib-Hajj at Yale, and it’s hard to disagree.

The authors of the study summed up their results thusly:

“Our results show effective repression of NaV1.7 in lumbar dorsal root ganglia, reduced thermal hyperalgesia in the inflammatory state, decreased tactile allodynia in the neuropathic state, and no changes in normal motor function in mice. We anticipate that this long-lasting analgesia via targeted in vivo epigenetic repression of NaV1.7 methodology we dub pain LATER, might have therapeutic potential in management of persistent pain states.”

NaV1.7 was also the focal point of a study led by Ana Moreno from the University of California, San Diego. Moreno recals the time she came across a paper about a genetic mutation that caused humans to feel no pain.

“This mutation inactivates a protein in pain-transmitting neurons in the spinal cord, called NaV1.7. In individuals lacking functional NaV1.7, sensations like touching something hot or sharp do not register as pain. On the other hand, a gene mutation that leads to overexpression of NaV1.7 causes individuals to feel more pain.”

Click. Moreno thought, “By targeting this gene, we could alter the pain phenotype,” she said in the UCSD news release. “What’s also cool is that this gene is only involved in pain. There aren’t any severe side effects observed with this mutation.”

So it seems to add up, and a non-opioid way to deal with pain may be just around the corner.

What’s next? The length of duration is still being tested, researchers said. Hopefully, it will be long-lasting.

*The initial version of this article was edited as it wrongly stated that a Nature study was led by Ariana Remmel, when in fact, Remmel was a journalist covering the study.

A foray into the British variant: why B.1.1.7 matters, and how worried should we be about it

Last year, the COVID-19 variant that swept across the UK drew headlines. It was more transmissible than pre-existing variants, and possibly, more likely to cause severe disease. The highly infectious B.1.1.7 variant spread to other countries, with University of Exeter researchers noting that the variant had been detected in over 50 countries worldwide, and slowly replacing the original one. A scientific team including epidemiologists has quantified the variant’s severity: Variant B.1.1.7 of COVID-19 (also called the “B.1.1.7 lineage”) is between 30 and 100% more deadly than previous strains.

Their study looked at death rates among people infected with the new variant that led to 227 deaths in 54,906 patients. That was more than the 141 deaths in the same number of patients, closely matched, who had previous strains. This variant appeared to them to be more lethal.

“We expect this to be associated with changes in its phenotypic properties because of multiple genetic mutations, and we see no reason why this finding would be specific to the UK. This development, borne out in epidemiological analyses, implies that the rate of patients with serious infection requiring hospital attention will increase.”

The researchers’ study was published in the British Medical Journal on March 10. Leon Danon, senior author of the study, said in a news release that they focused their analysis on cases that occurred between November 2020 and January 2021, identifying the B.1.1.7 variant from genomic sequencing of samples from patients with Covid-19. In England, the variant has already taken over.

“During December this new variant spread from the south east to London and the rest of the UK, with three quarters of infections being attributable to the new variant by 31 December 2020.”

There can be no rest for weary COVID-19 health monitors any time soon, and researchers are wary that new variants can emerge at any moment — in Brazil or South Africa, it’s already happening..

“SARS-CoV-2 appears able to mutate quickly, and there is a real concern that other variants will arise with resistance to rapidly rolled out vaccines. Monitoring for new variants as they arise, measuring their characteristics and acting appropriately needs to be a key part of the public health response in the future.”

Illness more severe

Meanwhile, another study about mortality in cases of SARS-CoV-2 lineage B.1.1.7 was accepted for publication in Nature. Author affiliations included the Center for Mathematical Modeling of Infectious Diseases, London School of Hygiene and Tropical Medicine. The authors estimate “a 61% (42–82%) higher hazard of death associated with B.1.1.7. Our analysis suggests that B.1.1.7 is not only more transmissible than preexisting SARS-CoV-2 variants, but may also cause more severe illness.”

By now, it’s become abundantly clear that we are all in this together. There is no real getting back to normal until the whole world goes back to normal. Otherwise, the risk of a new variant emerging — one that could invalidate all our hard work up to that point — could emerge.

The good news is that vaccines seem to be effective against the variant. The Pfizer, Moderna, AstraZeneca, and Johnson and Johnson vaccines all seem to offer robust protection against the variant. For now though, most countries are still far away from reaching any form of herd immunity. Restrictions are not behind us just yet.

For nearly 20 years, William Haseltine was a professor at Harvard Medical School and the Harvard School of Public Health. “Last winter and spring, we saw our future in Italy,” he wrote in Forbes. “When Italy reached its plateau, it started lifting restrictions. Did Italy’s numbers stay level? Not in the least. As I write, Italy is headed back into lockdown, with cases having peaked again at just over 26,000, an equivalent of roughly 146,000 cases per day in the US.”

We continue to need to drive down new infections.

“There will be time for a party, but that time is not now,” said Dr. Haseltine. “First let’s take advantage of the warmer weather to reinforce mask wearing, social distancing and outdoor gatherings only to bring down new infections closer to zero—at least under a couple thousand. Then, and only then, can we start thinking about the plan needed to restart the party.”

Can astronaut suits repel lunar dust? This team believes so

When multiple talented engineers go into the same room (or Zoom call), awesome things can happen, especially when experts in other disciplines also pitch in. Case in point: engineers and designers recently collaborated on how to protect spacesuits from lunar dust.

Moon dust can be a big problem for astronauts. Image credits: NASA.

Moondust is unlike the light powdery stuff we’re used to seeing on Earth. Earthly dust is more “well-behaved” — on your average windowsill, it obeys eviction under a soft cloth. But lunar soil is abrasive and fine-grained, and those tiny grains make it much more problematic. It sticks to everything. It can clog machinery, scratch lenses, ruin an entire mission. The long-term effects of moondust exposure are even more dangerous.

Astronauts have been aware of the dangers posed by moondust for some time. In a post-flight debriefing, Apollo 17 astronaut Eugene Cernan commented that “dust is probably one of the greatest inhibitors to a nominal operation on the Moon.” Discover magazine really laid into the problem in a 2019 wrap-up.

“Lunar dust, the Apollo astronauts learned, gets everywhere. Its jagged shape can scratch delicate spacesuit surfaces, while its dark color absorbs sunlight, overheating vital electronics. Breathing it in can even incite hay fever-like symptoms when astronauts return from moonwalks and shed their dust-covered spacesuits,” journalist Alison Klesman wrote.

A team at Stony Brook University recently examined what compounds in the lunar soil can do a lot of damage. According to a 2018 report from the university, lunar soil was toxic to human lung and mouse brain cells. Up to 90% of human lung cells and mouse neurons died when exposed to dust particles that mimic soils found on the Moon’s surface.

“We found that exposure of neuronal and lung epithelial cells in culture to several types of lunar soil simulants caused cell death and DNA damage,” said the authors of the paper, which appeared in GeoHealth.

Apollo spacesuit worn by astronaut Buzz Aldrin on Apollo 11. Image credits: NASA.

NASA, at work on the dust problem, has been very interested in what university students might offer for dust-busting solutions. NASA asked university students around the country to help address lunar dust and through its 2021 competitive Breakthrough, Innovative, and Game-changing (BIG) Idea Challenge and the Space Grant project, NASA awarded seven university teams to develop their innovative lunar dust mitigation solutions.

One such response came from Brown University and Rhode Island School of Design, titled “Tufted Electrostatic Solution to Regolith Adhesion Dilemma.” So, what’s their big idea? Protective patches on spacesuits.

Patching things up

These special patches are made of electrostatic fibers that repel dust, offering layers of protection at the suit’s vulnerable points. The solution is dubbed TEST-RAD.

NASA seemed to like the idea, noting that it involves “systematic layers of protection at a spacesuit’s most vulnerable points through implementing tufted electrostatically charged repulsion fibers and regolith catching fibers where abrasion is most likely to occur.”

Brown Space Engineering also discussed how the patch works, implementing electrostatically charged repulsion fibers and regolith-catching fibers where abrasion is most likely to occur — regolith referring to loose rock and dust that blankets a layer of solid rock. Regolith is found on earth as well as on the moon.

Essentially, a layer of stainless steel mesh generates an electric field, which propagates up through the outer layer of tufted fibers.

“The electric field repels the lunar dust particles, which themselves carry a tiny electric charge. Particles that get through the electric field are likely to be trapped dense fiber tufts. Anything that gets through the tufts will be blocked by steel mesh,” said the Brown report. The tufted fibers are made of PEDOT, a conductive polymer material.

As Brian Clegg notes for Chemistry World, PEDOT is excellent because it also fits with the rest of the technology inside space suits.

“What sets PEDOT apart from many other polymers… is that it is both a conductor and transparent. The free electrons that make, for instance, metals good conductors tend also to make for easy absorption of photons, so by far the majority of conductors are opaque. But PEDOT lets the light through, making it ideal for applications that bring light and electrical circuitry together,” Clegg explains.

So could this approach truly become a standard? NASA has included the protective patch solution as one of seven chosen for further development, and the team gets research funds to build and test a system prototype. With the grant in place, the team aims to build the prototype and test it with the help of simulated lunar soil. The teams will present the results of their research and development to a panel of NASA and industry experts.

Sun-grown coffee is no Eden for birds

Shade-grown coffee was a bird’s paradise until sun operations started stealing the show. Birds such as orioles, tanagers, warblers are missing out on trees, their very canopy for survival. Alas, many birdwatchers are clueless when it comes to the important connection between coffee-growing and birds’ survival.

A small coffee farm in Hawaii. Image credits: Clint McKoy.

Just like there are two types of coffee (Arabica and Robusta), there are two ways of growing coffee: sun-grown and shade-grown. Shade-grown coffee is the traditional approach, the way coffee grows naturally, under the forest canopy. But in the 1970s, things started to change.

A group of farmers had an idea to grow coffee in the sun as a way to increase production. It worked, in one sense: the yield really did increase, and farmers got a higher profit. But it came at a cost to the environment. In Central America, for instance, sun cultivation of coffee has led to a 2.5 million acre loss of forest, with native animals paying the price. But many consumers are completely unaware of this.

A new study reports that even among conservation-minded bird lovers seem, a large proportion are completely unaware. Researchers from the Cornell Lab of Ornithology and Virginia Tech asked birdwatchers if they drank shade-grown coffee. The team reported their findings in the British Ecological Society’s People and Nature.

You’d hope that birdwatchers, of which there are 45 million in the US alone, are well-informed about the environmental challenges faced by birds. They’re also among the group expected to be most interested in environmental certifications like Fairtrade or Rainforest Alliance. The researchers, however, found confusion among those asked about what certifications exist, where to buy bird-friendly coffee, and how coffee production impacts bird habitats.

“The highest rated constraints on buying bird‐friendly coffee were lack of awareness, cost, and lack of availability,” the researchers noted in the journal article.

Before we even dare to grind them down, however, it should not be hard to argue that many people know little to nothing about the links between birds and shade-grown coffee.

The Cornell Lab of Ornithology is more than ready to fill in the blanks.

No place to fuel

Coffee, when grown under a canopy of trees supports birds attracted to all the insects, nectar, and fruit that the trees provide. It’s not just the birds: the whole environment stands to benefit, including nearby farmers. The shade-grown farm trees prevent erosion and landslides, improve water quality, and contribute nutrients to the soil.

Now that much of the shaded coffee has been converted to sun coffee, this reduces erosion prevention, landslide prevention, and carbon storage. By 2010, only an estimated 24% of the world’s coffee was managed with traditional shade‐grown practices, the research paper noted. “Sun” coffee farms are intensively managed, said the authors, and usually associated with high use of fertilizers and pesticides.

For birds, however, these trees are particularly important. Birds need the energy to migrate and they lay down the energy in the form of fat deposits, using typically putting on a lot of fat before embarking on long flights. They also need to find high-quality habitats, said a researcher in a related video, and without the lush forests of shade-grown coffee, everything is much harder for them.

Over the years, said Amanda Rodewald, a professor and director of the Center for Avian Population Studies at the Cornell Lab, “most of the shade coffee in Latin America has been converted to intensively managed row monocultures devoid of trees or other vegetation.” Bird migration and breeding have suffered.

The bird-and-coffee research group feel that birdwatchers, by supporting more sustainable products, could be of help to these environments. Authors think that bird watchers would benefit from a better understanding of what coffee certifications are, what bird‐friendly coffee is, and the impact coffee production has on migratory bird habitats.

“We know birdwatchers benefit from having healthy, diverse populations of birds, and they tend to be conservation-minded folks,” said Assistant Professor Ashley Dayer. “We need to mobilize the estimated 45 million U.S. bird enthusiasts to help limit bird population declines. One way to do that is to encourage birdwatchers to seek out and purchase bird-friendly coffee, in stores and online.”

One case in point would be the “Bird Friendly” certification which Smithsonian scientists created. This means that one is drinking coffees grown underneath shade trees that provide bird habitats. Most Bird Friendly coffees are grown in the highlands of Latin American countries from Mexico to Peru.

Return of the cold sore

Credit: Wikimedia Commons.

The herpes simplex virus represents a sore spot in more ways than one. Without a warning, a victim’s sores might flare up with no warning, triggered by factors as light as stress and exposure to UV light. Cold sores, also known as fever blisters, are one of the most common symptoms of herpes (HSV) reactivation.

Now, new research at least tells scientists what exactly goes on when the clinical Herpes simplex virus (HSV-1), one of the forms, reactivates. UVA Today notes that “the new insights help doctors better understand what is happening in neurons and the immune system,” and that could lead to ways to prevent unwanted outbreaks, the researchers hope.

What do we mean by one of its forms? According to the World Health Organization, herpes simplex virus-1 (HSV-1) is one of two herpes simplex virus germs. The other is herpes simplex virus type 2 (HSV-2). WHO draws an important distinction between the two.

“HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes (which can include symptoms known as ‘cold sores’), but can also cause genital herpes. HSV-2 is a sexually transmitted infection that causes genital herpes. Both HSV-1 and HSV-2 infections are lifelong.”

Wait, lifelong?

Yep. According to UVA Today, the virus never really goes away. “Instead, it lurks inside neurons, waiting for the right moment to strike again, a process known as reactivation.”

In this recent effort, researchers found that when neurons harboring the virus were exposed to stimuli that induce “neuronal hyperexcitation,” the virus senses this particular change and seizes its opportunity to reactivate. In other words, when the neurons flare up, so too does the herpes.

Their investigation took place at the University of Virginia’s Department of Microbiology, Immunology, and Cancer Biology (MIC). They discussed their discovery in their paper “Neuronal hyperexcitability is a DLK-dependent trigger of herpes simplex virus reactivation that can be induced by IL-1” published in the journal eLife.

Unsurprisingly, scientists are eager to learn more about the virus: the numbers of those who have contracted it are significant. As the authors explained in their paper:

“Herpes simplex virus-1 (HSV-1) is a ubiquitous human pathogen that is present in approximately 40–90% of the population worldwide (Arvin, 2007). HSV-1 persists for life in the form of a latent infection in neurons, with intermittent episodes of reactivation.”

Interestingly, the virus hijacks an immune response in the body. Per UVA Today:

“In response to prolonged periods of inflammation or stress, the immune system releases a cytokine, Interleukin 1 beta.” This cytokine is in epithelial cells in the skin and eye and is released when these cells are damaged by ultraviolet light. The researchers discovered that “Interleukin 1 beta then increases excitability in the affected neurons, “setting the stage for HSV to flare up.”

Their model was developed using mouse neurons infected with HSV. The paper’s authors noted why this focus on reactivation matters:

“Reactivation from a latent infection and subsequent replication of the virus can cause substantial disease including oral and genital ulcers, herpes keratitis, and encephalitis. In addition, multiple studies have linked persistent HSV-1 infection to the progression of Alzheimer’s disease (Itzhaki, 2018).”

In the bigger picture, too, the research highlights how “some viruses have evolved to take advantage of what should be part of our infection-fighting machinery,” concluded Anna Cliffe, one of the researchers.

Which COVID-19 patients end up in the ICU? This new algorithm could figure it out

California researchers have created an algorithm that uses just five data inputs to predict a patient’s COVID-19 prognosis — a big improvement compared to the bad old days of last year.

In the early days of the pandemic, medical professionals reasonably collected various categories of patient data to create a snapshot picture of how ill the patient was and estimate a prognosis. In today’s complicated world of this infectious disease, a bedside tool could help a physician assess a prognosis much faster.

COVID-19 has been full of bad surprises, sending a lot of people in the hospital and the ICU — well, you know the story. Hospital resources are stretched to the maximum, both in terms of equipment and people themselves. Running out of available ICU beds has become a hospital’s worth nightmare in the pandemic, so researchers wanted a tool that would help them forecast ICU usage.

Tools that offer a real-time prognosis of patients are few and far between. For doctors, it’s very useful to know, once a person is admitted to hospital, what are the chances the person will end up in the ICU. The new algorithm does just that: it’s designed to be give medical personnel some quick answers upon the patient’s initial hospitalization.

Assad Oberai, Hughes Professor in the Department of Aerospace and Mechanical Engineering, explained how the biomarkers can tell the degree to which COVID-19 is advancing in the patient. Oberai said this is a disease that “isn’t affecting just one system in the body, but is affecting many systems. Many things are going wrong at the same time, and by focusing on these five features, you can get a picture of how the disease is progressing.”

So based on this, if we measure what is going wrong with a patient, we can forecast how the disease is likely to progress. The indicators that researchers used to derive a patient’s prognosis are:

  • respiratory distress (breathing rate and blood oxygen level of patient);
  • immune response (likelihood of sepsis);
  • circulatory system (likelihood of blood clots);
  • and inflammation.

Since the predictors rely only on quantitative data, they are less prone to errors and subjectivity, which make them scalable and applicable in all sorts of different scenarios. What is more, the model is simple and easy to use.

The team behind the algorithm are from the Viterbi School of Engineering and Keck School of Medicine at the University of Southern California. They presented their work in an article published in Scientific Reports in an article called “Machine learning based predictors for COVID‑19 disease severity.”

“Predictors of the need for intensive care and mechanical ventilation can help healthcare systems in planning for surge capacity for COVID-19,” the researchers explain in the study.

It is an old but imperative rule to be proactive rather than reactive in pandemics. In this instance, the authors called for a proactive approach towards resources such as ICU bends and ventilators.

“Given the urgency for resource allocation and optimization, we sought to identify patient-level clinical characteristics at the time of admission to predict the need for ICU care and mechanical ventilation in COVID-19 patients.”

Their study cohort comprised of 212 patients (123 males, 89 females) with an average age of 53 years, of which 74 required intensive care at some point during their stay, and 47 required mechanical ventilation. Neha Nanda, medical director of infection prevention and antimicrobial stewardship at Keck Medicine of USC, said that maybe, with time, “this proactive approach is something we can adopt universally to all emerging infectious diseases.”

However, in order for this to happen, the results would have to be validated on a much larger cohort. For now, only data obtained at the time of initial presentation was included as input to the predictive models. The need for ICU admission and mechanical ventilation at any time during hospitalization were selected as outcomes.

“The results presented in this study demonstrate that data acquired at or around the time of admission of a COVID-19 patient to a care facility can be used to make an accurate assessment of their need for critical care and mechanical ventilation,” the researchers conclude.

Studies to zoom in on links between cognitive decline and driving behavior

Image credits: Jaromír Kavan.

Hopefully, your elderly friends and family are in good driving shape. Nonetheless, age-related declines in cognitive functioning can occur. If this happens, it can affect one’s driving abilities.

“Despite dementia and other neurobiological disorders that are associated with aging, improved imaging has revealed that even into our seventies, our brains continue producing new neurons,” notes the Dana Foundation, an organization based in New York committed to advancing brain research.

As people age, their movements and reflexes can slow down. But there is little consistency in how these changes happen. Cognitive abilities show at least a small decline with age in many—but not all—healthy persons. In a recent study looking at cognitive peaks and declines, researchers found considerable variability in the changes of cognitive ability throughout life. For the sake of both drivers and pedestrians, we must pay attention to that variability.

According to the National Highway Traffic Safety Administration in the US, “research has established that drivers with dementia are at a greater risk for crashes compared to cognitively normal adults, but little research has been done regarding the effects of mild cognitive impairment on driving performance.”

Mild cognitive impairment and what it means for driving performance is being examined for decades now. Even so, we still don’t have a clear, formal diagnosis It is a state of being where there is no straightforward diagnosis of dementia.

This is what makes the ongoing research at the University of East Anglia (UEA) so interesting. They’ve launched a new study, looking at how everyday driving changes in people who are over 65.

Lost in space

Lead researcher Prof. Michael Hornberger, from UEA’s Norwich Medical School said that “surprisingly little is known on how the cognitive changes during aging impact our driving.” Dr. Hornberger has highlighted spatial disorientation and its implications in driving.

“Spatial disorientation often therefore only becomes obvious to others when the disease has more advanced, as we cannot compensate anymore our spatial deficits. It is therefore important to remember that spatial disorientation is an early symptom in Alzheimer’s disease but only seems to ’emerge’ to others later.” As for getting behind the wheel, he said that “the effect of cognitive or spatial navigation changes on car driving have – so far – been virtually unexplored, despite being very common when cognitive changes occur.”

Hornberger and colleagues are currently looking for volunteers in the study called The Driver Effect of Cognitive Impairment and Spatial Orientation and Navigation (DECISION). Volunteers must be at least 65 years, have valid driving licenses, and are currently driving.

Algorithms on the go

In Florida, meanwhile, yet another study will take off, focusing on older drivers in the United States. Researchers from Florida Atlantic University’s Christine E. Lynn College of Nursing in collaboration with FAU’s College of Engineering and Computer Science and Charles E. Schmidt College of Science received a five-year, $5.3 million grant from the National Institute on Aging of the National Institutes of Health for a project called “In-vehicle Sensors to Detect Cognitive Change in Older Drivers.”

This is where technology will play a key part. The grant will test an in-vehicle sensing system, looking to deliver early warnings of cognitive change for older drivers in the United States. How might technologies in vehicles catch signs of abnormal driving behavior that are attributable to cognitive impairment?

The project involves a battery of cognitive tests; sensors designed to detect cognitive change; developing algorithms that could translate the sensor data into behavior indices that are gender, age and vehicle-specific; and evaluating acceptability of installed systems in older drivers. The systems will include cameras, on-board diagnostics, high level GPS, motion and orientation detection, vision sensors, driver eye movements, driving scene awareness, and driving behavior tracked and recorded over time.

Just reading over what the researchers will look for has resonance for anyone encountering an older person driving sub-optimally. Researchers will track not just travel patterns but abnormal driving such as getting lost, losing focus, and near-collision events; reaction time when stopping at a stop sign or traffic light; and braking patterns such as stopping at a stop sign or traffic signal as well as ignoring traffic signals. The study design aims for the setup itself to be kept simple, minimizing complex wiring and the number of in-vehicle sensors.

As mentioned in the FAU announcement, this “could provide the first step toward future widespread, low-cost early warnings of cognitive change for this large number of older drivers in the United States.”

Medieval cemeteries tell tales of fractures, broken jaws, and a very hard life

They didn’t have Netflix, Twitter, Starbucks. But that wasn’t nearly the worst of it. Daily life in medieval Britain seems to have been a tale of broken bones and bad, violent behavior. New research from Cambridge reveals how tough it could get for men and women to keep body and mind intact between the 10th and 14th centuries.

Life in medieval Cambridge would have been very, very different than it is today. Image credits: Malgorzata Bujalska.

The level of hardship endured by Cambridge’s medieval inhabitants is chilling. University of Cambridge researchers used X-ray analysis to discover evidence of skeletal trauma in the remains of 314 individuals from three cemeteries in Cambridge, England. They used X-ray analysis.

According to a university’s press release, severe trauma was remarkably prevalent in medieval Britain.

“Severe trauma was prevalent across the social spectrum. Life was toughest at the bottom – but life was tough all over.” One friar had lived with defensive fractures on his arm and signs of blunt force trauma to his skull. “Such violence-related skeletal injuries were found in about 4 percent of the population, including women and people from all social groups.”

The investigators said life, however, took its hardest physical toll on the working poor.

“Ordinary working people had more ‘skeletal trauma,’ likely through accident and injury while laboring in agriculture and construction,” said the caption in a video posted on YouTube by the university. The findings of the team have been published in the American Journal of Physical Anthropology.

The team analyzed bones from medieval burial sites, determining the nature of the breaks and fractures, with each bone fracture cataloged. The study authors stated that “Skeletal trauma was highest in All Saints parish burial ground, indicating that the poor, whether working urban or rurally, had the highest risk of injury. The pattern and types of fractures observed suggests that males experienced more severe traumatic events than females. However, females that were routinely involved in manual labor were also at increased risk of injury.”

Marks of abuse

Researchers found different types of fractures. Some fractures suggested personal histories of violence and domestic abuse was a likely culprit. One older woman buried in the parish grounds appeared to bear marks of lifelong domestic abuse. The damage she suffered was no joke: it was so severe that it’s hard to interpret it as anything else other than abuse.

“She had a lot of fractures, all of them healed well before her death. Several of her ribs had been broken as well as multiple vertebrae, her jaw and her foot,” said Dr. Jenna Dittmar, Department of Archaeology. Addressing the jaw, for example, Dittmar added that “Today, the vast majority of broken jaws seen in women are caused by intimate partner violence.”

But although the poor suffered the brunt of the damage, the rich weren’t spared from violence. The team visited three sites that carried remains from the poorest, also, the working poor, and the wealthy. One of the three sites, for example, was a friary with rich benefactors. Wealthy donors were buried there, but there was also a graveyard for the working poor. Yet another place was a charitable hospital that buried the infirm and the destitute.

Of the three sites, the Hospital of St John the Evangelist contained the fewest fractures. Established in the 12th century, the hospital provided help to the needy, offering help and spiritual care. Many of the folks there had evidence of chronic illness and would have been unable to work. Dr. Dittmar said, “We can see that ordinary working folk had a higher risk of injury compared to the friars and their benefactors or the more sheltered hospital inmates.”

The study authors note that “The highest prevalence rate was observed on the individuals buried at All Saints by the Castle (44%, n = 37/84), and the lowest was seen at the Hospital of St John (27%, n = 42/155). Fractures were more prevalent in males (40%, n = 57/143) than females (26%, n = 25/95).” Likely risky scenarios for incidents affecting bones — men may have worked in the fields with heavy ploughs pulled by horses or oxen, or lugged blocks and beams in town.

Psychiatric research needs to start taking gender differences more seriously

When the book Men are from Mars Women are From Venus hit the shelves in the 1990s, the ground almost shook. The book sold in the millions, confirming every sitcom writer’s fantasy and triggering many endless debates. But there was more to the book’s impact than just this.

Fast forward to 2017 and consider the National Public Radio review of the book Testosterone Rex: Myths of Sex, Science, and Society. The review quoted the book’s author Cordelia Fine, who said: “Testosterone Rex misrepresents our past, present, and future; it misdirects scientific research; and it reinforces an unequal status quo.”

By “Testosterone Rex,” she refers to the over-generalized notion that women and men were essentially different. But things are not always clearly separated.

In fact, the more we look at this matter, the more we find that things are complex and there are few things that are clear. To emphasize this even more, a study from the University of Colorado Boulder addressed gender differences in the way we experience drugs for mental illness. The study findings were published in the journal eLife, and they shed new light but also raise more questions about how the minds of men and women are different.

AKT behavior

Over the years, molecular studies have led to the development of many pharmacological treatments for psychiatric illnesses. However, with all these advancements, the effectiveness of available therapies still remains limited.

The researchers said the situation may, at least in part, be due to not having enough information “about the specificity of neuromolecular signaling pathways involved in the manifestation of individual behaviors and processes associated with the symptomology of psychiatric disorders as well the specific signaling effects within different neural cell types and those impacted by sex.”

Here’s the thing: most behavioral mouse studies are carried out using only males. When a finding is successful on mice, it can then be trialed on humans eventually, but it still started from just male mice — and this is a problem. If we tailor treatments based on this, we may end up with treatments biased against women — and this is just one of the possible biases that can creep up in this sort of study. Charles Hoeffer, an assistant professor of integrative physiology at the Institute for Behavioral Genetics, and one of the study authors, explains:

“The ultimate goal is to find the kink in the armor of mental illness—the proteins in the brain that we can specifically target without impacting other organs and causing side effects.” Hoeffer maintained that personalization was key. “We need to stop hitting every mental illness with the same hammer.”

Researchers wanted to further explore gender differences in their study. The team found that “a key protein in the brain called AKT may function differently in males than females. The study also offers a closer look at where, precisely, in the brain things may go wrong, marking an important step toward more targeted and less harmful therapies.”

It wouldn’t be the first time sex-dependent differences are called out in mental health research — the matter has been amply documented before. Citing other studies, for example, this recent study notes that “Women are disproportionately impacted by affective disorders” while, in men, schizophrenia was more prevalent and yet, over the course of aging, schizophrenia impacted women at higher rates. Researchers also found that women were more responsive to available treatments for schizophrenia and in female mice, ketamine exerted more potent and rapid effects.

The study explored that “key protein in the brain called AKT,” as mentioned earlier. Quoted in CU Boulder Toay, Hoffer discussed AKT: “Let’s say you see a shark and you’re scared and your brain wants to form a memory. You have to make new proteins to encode that memory.” AKT cranks the gears up on downstream proteins in the memory factory. We can’t learn new memories without it nor extinguish old ones to make room for new, less harmful ones. The team noticed how different gendered mice responded to the loss of various AKT isoforms.

Interestingly, National Institutes of Health guidelines in the past six years began to require researchers to include both male and female animals in studies. The New York Times back in 2014: “Name a new drug or treatment, and odds are researchers know far more about its effect on men than on women. From sleeping pills to statins, women have been blindsided by side effects and dosage miscalculations that were not discovered until after the product hit the market.”

Memories in balance

The study team found that the difference between males and females was nothing to sneeze at. They found the difference between males and females to be “so great it became the focus of our work,” Hoeffer said. “It was like night and day.”

CU Boulder Today said “male mice whose AKT1 was functioning normally were much better than those missing the protein when it came to “extinction learning” – replacing an old memory, or association, that’s not useful anymore. (Imagine letting go of the memory of your favorite route home from work because you’ve moved, or disassociating a loud sound with danger).” For female mice, it didn’t make much of a difference.

AKTs include AKT2, found in star-shaped brain cells and often implicated in brain cancer. AKT3 appears to be important for brain growth and development. AKT1, in combination with AKT2 appears to be critical for learning and memory. What’s next? Beyond AKT, there may be other proteins in the brain contributing to the differences, said Hoeffer, “with different flavors serving different purposes or acting differently in men and women.”

Are we using the right language in the pandemic?

Along with all the other problems, Covid-19 communicators are up against a wall of words. Experts are doing their best, designing strategies to bring down the number of cases and employ public cooperation, but sometimes, a good strategy seems to get lost in bad words. Is “lockdown” really the best we can do? Is “social distancing” better than “physical distancing? It’s a debate that seems to fall low on the current priority list, but maybe we should pay it more attention.

Peter Sokolowski, editor-at-large of the Merriam-Webster dictionary, said that “big events have the power to change our language itself” — and of course, language also has the power to change events.

Covid-19 is a major event in recent history, and “lockdown” is one of the words to watch. According to MarketWatch in November, “Collins Dictionary recently bestowed its word-of-the-year title on ‘lockdown.’” People are being introduced to phrases and nomenclature particular to a pandemic they never saw coming. Chicago Tribune columnist Christopher Borrelli said traditional words lacked the power of living in this extraordinary time. Borrelli said that:

“Many of the words we now say and hear all day long, every day, over and over, we had never even heard. We have acquired a large new toolbox of linguistic neologisms, a fresh vocabulary…Science gets explained with epidemiological mashes, while sociological jargon takes flight overnight…at the zip of Zoom.”

Honing in on lockdowns: What did lockdown connote in a pre-Covid world? The connotation and context were all negative, unruly. It may have referred to rioters who needed to be locked down, for instance. If they were to defy a lockdown order and walk free, they would be punished by the authorities who forced them to lockdown. Is the word itself, perhaps, a part of the reason why some people reacted so violently against it?

One unsurprising reaction during Covid is to defy the order if you give a hoot about the principles of freedom, liberty and the pursuit of beach parties.

Interest for “lockdown” and “social distancing” as Google Searches. Via Google Trends.

Ism fever

We’re all being treated (or mistreated, depending on the view) to a game of language potentially subverting policy. The lockdown notions have become politically loaded in many people’s minds, especially in societies where polarization runs high. For some, disobedience to lockdowns grew to be synonymous with courageously fighting fascism, communism, socialism, or whatever ‘-ism’ was, in the eyes of the beholders, toxic. For others, it was a positive and important public health measure.

By September, Tim Harford, writing in Financial Times, apparently had his patience tested thinking about word usage like “lockdown” when talking about Covid. With all the global chatter, he said it was far from obvious what a lockdown was supposed to mean, “and the lack of clarity risks making a bad situation worse.” The most obvious risk, he added, was “people become too confused and irritated to follow the rules.” Added to the ambiguity of the word, it was becoming “yet another ideological cleavage point.”

That was last year; two months into the new year, it is quite obvious that words, like vaccines, are making a difference in how public health efforts can be derailed. Brian Castrucci, CEO of the de Beaumont Foundation, said “it’s never been more important for health leaders to understand the perceptions of Americans and modify their language accordingly.” A recent poll of Americans from Frank Luntz in partnership with the de Beaumont Foundation reflected the concern in its title, “Changing the COVID Conversation.”

Participants were 1,100 in number and their responses delivered some idea about reactions on health issues and decisions. Luntz: “The words our leaders are using need an immediate upgrade.” The poll highlighted the need to change the “pandemic lexicon” in order for people to adopt life-saving public health precautions.

Americans had a more positive reaction when rules and regulations to address COVID-19 were called “protocols” rather than “mandates,” “directives,” “controls,” or “orders.” Respondents had a more positive reaction to “a stay-at-home order” than a “lockdown” or “aggressive restrictions.”

Very small numbers

Ultimately, clarifying lockdowns is not an impossible dream. Left to scientists familiar with the rises and falls of pandemics, it can be simple. In a December interview with Dr. John Whyte, chief medical officer at WebMD, interviewers sought to clarify what was meant by ‘lockdown’. Scientist Yaneer Bar-Yam, the guest, responded and kept it simple.

“So it actually– starts with just understanding the transmission, right. We all know this by now. It transmits when somebody breathes out and someone else breathes in. And the point is that the virus dies if it doesn’t transmit. So we just have to stop it from transmitting. And the way we do that is by making sure that we’re not near other people. It’s that simple.”

He said that the idea was “we’re just going to go all-out. And it turns out that the advantage of doing this is that it goes away very fast. It actually only takes about four to six weeks for even a very large outbreak to get down to very, very small numbers if we do it all-out.” Bar-Yam asked a question to answer a question. “And so why would we want to live with this for six months, three months, six months. We’ve been living with it for a long time already. So if you’re tired of it, the solution should be to get rid of it. If there wasn’t a way to do that, then, well, there isn’t a way to do that. But it turns out that there is, and it’s been shown in multiple countries. The analysis shows it. The experience shows it. So that’s really what we want to do. We want to get rid of it.”

If words count in managing public response to this health crisis, replacements for ‘lockdown’ could be ‘free-up’, or ‘all-out’ — or even ‘all-in’.

Pandemic skirmishes: the US is lacking decisive action on viral transmission, physicist warns

Yaneer Bar-Yam uses a fire analogy. It’s a simple scenario, says the American scientist specialized in the quantitative analysis of pandemics: there’s a fire in your living room. You can go hide in the basement where you can’t smell the smoke and see the flames — or you can put the fire out.

So far there, many are headed for the basement.

We’re back to flattening the curve.

US President Biden signed an order in January mandating masks in airports and on many planes, trains, ships and intercity buses. The US was one of the very few countries where this had not been mandated, and as a nation hungry for true leadership and reasonable policies, his orders were well received.

However, those familiar with pandemics might be pulling their hairs at how slowly things have developed. Bar-Yam supports temporary lockdowns as a COVID-fighting measure — especially in regards to traveling. “If there is a way to get there, the virus will be there,” he recently tweeted. It has no preferences for direct flights or whether or not the arrivals are on the east or west sides of terminals.

Our approach to the pandemic can largely be summed thusly: we’re running on skirmishes when we should be waging a full-scale war.

What are we doing now? It seems that many authorities are showing us how to co-exist with COVID-19 instead of fighting it. As a result, people are increasingly weary and disappointed by the yo-yo behavior of closings and reopenings, and having to shut down all over again while the virus remains in the winner’s circle. This is one of the major differences between countries like New Zealand or South Korea, which have quickly squashed the virus, and the vast majority of countries, which have focused on mitigation rather than eliminating the virus. Bar-Yam summarizes this difference in a recent tweet.

“Trying to keep economic activity and travel as open as possible but perpetuating the economic harm and imposing yoyo restrictions, versus making an initial sacrifice of economic activity and travel in order to benefit from the rapid restoration of normal economic activity.”

Mitigation is also important, but good luck with passively living with a such a dangerous and constantly evolving virus with no strategy to eliminate the spread community-by-community. Then, there’s also the problem of countries not reacting quickly enough to existing scientific evidence. Kimberly Prather, PhD, an aerosol scientist and member of the Covid Action Group, recently tweeted:

“Someone just asked me how sure I am #COVIDisAirborne . My response: all evidence to date points to the fact this virus travels in infectious aerosols produced in speech which can be inhaled. There is no counter evidence. It is airborne. We must say so ASAP to protect everyone.”

Vaccines can offer protection in time and they’re a way out of the pandemic. Masks help to reduce transmission. But lockdowns can also make a real difference.

Teachable outbreaks

Supporting lockdowns as a Covid-fighting strategy is Bar-Yam, a physicist and president of the New England Complex Systems Institute (NECSI). He has been studying pandemics for 15 years and thinks we have important lessons from the past to guide us through the COVID-19 pandemic.. He contributed to response protocols for stopping Ebola in Africa in 2014, for example.

In January of 2014 he spoke at the World Health Organization in Geneva about the risk of Ebola due to increasing transportation in Africa as it developed economically.

“Two months later, in March 2014, the largest outbreak of Ebola to date began in West Africa. The number of cases increased exponentially, roughly doubling every week. The response was not sufficient, and if an outbreak is growing exponentially, being behind in the response means being completely ineffective. The outbreak become the worst Ebola epidemic to date by a factor of ten.”

Scientists who do the math on pandemic transmission patterns point to risks of responding in a Swiss-cheese pattern where only some holes are being closed up (e.g., masks and social distancing) but not all holes are closed.

Bar-Yam advocates four actions to fight the pandemic more energetically: strict lockdown, travel restrictions, massive testing, masks.

We’re doing much of those, but we’ve ignored (or delayed as much as possible) the strict lockdown part, and at what price? In regards to transportation, it’s like we’re sending invitations to the virus to do its thing. Bar Yam and his coalition partners point out that their “zone” strategy is not punitive; it is designed to protect people. The strategy involves smaller local areas protected by travel restrictions.

Pandemic math

Bar-Yam has studied transmission rates. He knows that temporary shut-downs really work. They bring down the numbers, as we’ve seen in this pandemic and previous outbreaks as well. Shutting down for a number of weeks such as five weeks is what he is talking about, not shutting down for a year.

He believes it doesn’t have to take a long time. He last month tweeted how “New Zealand’s ‘go hard and early’ Covid policy reaped economic rewards. And, he more recently tweeted good news about Western Australia with over 250 days of zero community transmission. How, he asked? Low population? No. Small cities? No. “Here is how: Strong policies with ZERO as the goal, including 14 day quarantines for incoming travelers, and interregional travel restrictions. Brilliant!”

“We are all Covid-tired,” he said elsewhere in an interview, and “we don’t want to do this for a long time; we don’t want to do this for years. So the answer is, take a deep breath. Let’s do a reset. Let’s do the right thing, get together, set it up, get to zero. We can do it in 4 to 6 weeks—with distancing, with masks, with a green zone strategy.”

Message by matrix

Back in February 2020 Chen Shen and Yaneer Bar-Yam delivered a sober wake-up call in their article “Pandemic math: Stopping outbreaks,” which was posted on the NECSI site. They wrote that

“Transmission is like matrix multiplication where each person can have the disease and be contagious or not.” They proceeded to show a list of everyone with either a “0” they are not sick or a “1” they are sick. Here there are two sick people. “The contact between people is a matrix that says who has enough contact with another person to infect them.” It’s a bit like ripping a band-aid — you have the short, five week tight lockdown that’s ripping the band-air, versus a prolonger period of months of struggles.

Shen and Bar-Yam say that the matrix is not the same from day to day because people do different things. “What is most important is that we can choose to act to change the transmission network by how we behave.” The pathogen could disappear if we were to reduce the number of sick individuals to zero; then “the matrix of connections doesn’t matter. If it is not there it can’t infect anyone.”

Bar-Yam and his coalition partners point out that their “zone” strategy is not punitive; it is designed to protect people. The strategy involves smaller local areas protected by travel restrictions. It would work like this:

  • Each zone is ranked regarding the degree of Covid-19 transmission.
  • Green zones are a Covid-19-free jurisdiction, meaning areas where there were good signs of less virus; yellow zones are a boundary area; red zones have active transmissions.
  • Non-essential travel between zones would be temporarily suspended. Isolation facilities for mild and moderate cases would prevent the infection of household members.
  • Any community showing zero could start on the path to normal.
  • Masks would continue to be required in all shared spaces. Frequent testing on a mass scale would speed the reopening process.

Nonetheless, one might ask, the vaccines look promising. Why go to all this bother over lockdowns when the vaccines have arrived? Unfortunately, vaccines won’t save us immediately — we still have a lot of work cut in the meantime.

As per a report from CNN, WHO’s Chief Scientist Dr. Soumya Swaminathan said that “even as vaccines start protecting the most vulnerable, we are not going to achieve any level of population immunity, or herd immunity in 2021 and even if it happens in a couple of pockets in a few countries, it’s not going to protect people across the world.”

What’s next?

Bar-Yam is part of the Covid Action Group. This is a network of pandemic experts, researchers and communicators. Their focus is how to eliminate the COVID-19 virus. Fields of expertise range from infectious diseases to applied probability science to environmental engineering.

“The world is in crisis with the exponential spread of the deadly COVID-19 virus and its variants, while the United States is in the midst of one of the most important political transitions in its history. Defeating the complex problem of COVID-19 requires a coordinated, multifaceted approach. The COVID Action Group has been created to offer support to the newly established national task force and to help guide the country forward.”

Until we are able to reach some level of vaccine-induced herd immunity, restrictions and masks are still our allies.

Robot baristas will now take your order

Coffee economics: Keith Tan woke up a six-axis Ella.

We’ve learned a lot about social distancing, now ponder coffee distancing. Robots take your order, make the beverage, and settle the payment. It’s a new day in PandemicLand. Or is it just the future?

No humans required: tomorrow’s coffee might come entirely from robot baristas

Pre-pandemic, it was a common feel-good activity: having a cup of Joe from your favorite local coffee hangout, greeted by a bright smile and a “What can I get you today?”

Today, it’s pretty different. Coffee hangouts are not really for hanging out and you can forget about asking the man at a table next to yours if you can take their one empty chair so your friend can sit down. There are no people to ask and the chairs are usually stacked up against the wall. Hanging around for a coffee is not what it used to be.

If ever there was a time to bring in the robot baristas then, this is it. It’s not just practical from a pandemic point of view, it offers attractive advantages in coffee shop economics.

Crown Coffee, a coffee bar in downtown Singapore, has become the poster child of this robot trend. The head of the operation, Keith Tan, is the man behind the story of Ella, the six-axis robot barista, who goes beyond showing a gee-whiz skill in picking up cups without dropping them.

  • Ella takes your order remotely via an online app.
  • Ella makes your coffee.
  • Ella tells you when it is ready.
  • Ella serves it.
  • Ella finalizes your bill and charges your card.
  • Ella can’t really make small talk though.

Intel partnered with Keith Tan and the two sides explored prototypes.

“Ella solves many of Tan’s challenges,” said an Intel news report. “First, the compact unit takes up a fraction of the space required for a traditional coffee bar, which translates into a cheaper retail footprint. Next, Tan is able to guarantee quality and consistency in every cup … Ella frees up labor, allowing Tan to reassign his staff to other in-store tasks like greeting customers or cleaning. But perhaps most important during the COVID-19 pandemic, customers are assured of safety as Ella operates in a sealed chamber. No human interacts with the product from the moment it’s made to when it’s served hot.”

Tan and his team plan to scale the solution to 40 other locations across the tech-savvy Singapore, then to Japan and the rest of the world. His location examples included kiosks at busy train stations. Tan thinks of robots’ roles in redefining retail as well as its job opportunities:

“What we are doing is transformational and will be part of the landscape of smart cities where AI-driven robots become deeply ingrained into our daily lives. Also, this is New Retail, which eases retail labor shortages while providing re-skilling employment opportunities for value-added technology and engineering people.”

But Tan isn’t the only one exploring this avenue.

Back in May, a robot barista in South Korea made news, involving Vision Semicon developers.

“After managing to contain an outbreak of the new coronavirus that infected more than 11,000 and killed 269, South Korea is slowly transitioning from intensive social distancing rules towards what the government calls ‘distancing in daily life,’” as per Reuters.

That same month, Robotics Tomorrow confirmed that:

“Coffee robot baristas are one of the latest forms of machines in the world of coffee automation. They deliver delicious cups of coffee in the most efficient manner and with almost no errors. Several companies around the world have begun to embrace this invention.”

So all in all, it seems like only a matter of time before robot baristas become a part of our lives.

What parts are at play to make a barista like Ella do tasks like make coffee according to customer choices and figure out how to process the customer’s payment? In addition to Xeon and Core processors, the Intel story reported on the technologies that make Ella run, like a vision processing unit (Movidius) and the Intel distribution of the open-source OpenVINO toolkit.

Machines can clearly get the coffee to you quickly enough and correctly enough (“No, I ordered a latte with lemon, not a lemonade” could become a slow-line reason of the past) but at what price? If “price” refers to humans who miss their encounters with human baristas, the question is if the public will welcome robots serving them coffee. No doubt, fancy, human-only cafe’s will start to pop up in this case.

Singapore’s minister of state for trade and industry, Low Yen Ling, may have a suitable answer. Quoted in, she said automation does not merely mean creating robots. In the retail context, companies that want to embark on robots have an opportunity to enhance, not kill, the customer experience:

“Ella is a good example of a digital solution that focuses on the customer experience at its core. It recognizes that customers increasingly crave for personalization and customization, and personalized customer services can now be offered with the help of technology.”

So, would you like a man-made coffee, or will a robotic hand also do the job?

Lab is exploring brain links to Parkinson’s

The National Institute on Aging considers Parkinson’s Disease (PD) is a brain disorder. Other descriptions characterize it as a progressive, neurodegenerative disorder. Scientists know there is a loss of brain cells that produce dopamine, which regulate one’s voluntary movements.

But there’s a disturbing limit to what we truly understand about this disorder. According to the NIA, “scientists still do not know what causes cells that produce dopamine to die.” One investigator with a research laboratory in the Van Andel Institute’s Department of Neurodegenerative Science wants to figure that out.

Image credits: Josh Riemer.

The lab, with its focus on PD, wants to know more about how cells and cell-to-cell communication in the brain are affected by Parkinson’s. The Chu Lab is on a mission to “identify mechanisms that contribute to progressive degeneration of midbrain dopaminergic neurons, and abnormal circuit activity that underlies the devastating motor symptoms of Parkinson’s disease.”

Even more ambitious, the goal is also to develop therapies that could modify the progression of the disease. They are looking at precision strategies, where they could target specific types of neurons or neural circuits to prevent and treat the disease.

The person behind this lab’s name is Van Andel Institute assistant professor Hong-yuan Chu. Chu received his Ph.D. in pharmacology from the Shanghai Institute of Materia Medica and did his postdoctoral training at the National Institute of Mental Health and Northwestern. In 2019, he joined Van Andel Institute’s Center for Neurodegenerative Science as an assistant professor.

Different behaviors

Specifically, Chu’s lab are analyzing the relationship between alpha-synuclein and the amygdala. Let’s break those complicated terms down.

Alpha-synuclein refers are abnormal proteins that have been linked to Parkinson’s disease . The biological function of alpha-synucleins are not fully understood, Chu says, and that abnormal aggregation that occurs “plays a mysterious role in why and how Parkinson’s disease arises.” The proteins are abundant in the brains, and smaller amounts can also be found in the hear, muscle, and other tissues.

The amygdala is a part of the brain that helps regulate emotions. This is where emotions are given meanings and associated to responses. There are two, one in each hemisphere or side of the brain.

“In our brain, there exists a network that controls our emotions and memories associated with emotion. For example, a flash of remembrance of previous holiday parties perhaps makes you feel happy, while recalling an attack by a poisonous snake provokes fearful feelings,” says Chu. He also reported a clinical observation: “…the amygdala shows high levels of alpha-synuclein clumps in people with Parkinson’s, and these people often experience different psychiatric symptoms, such as apathy, anxiety and depression-like behaviors.”

So the amygdala and these alpha-synuclein proteins seem to be connected somehow, and according to Chu, understanding this relationship is understanding “the very biology that underlies psychiatric symptoms in people with Parkinson’s.”

Hunting for the cause

Columbia University’s Department of Neurology has noted what scientists know and what they still do not know about PD, noting that there are a bunch of myths floating around Parkinson’s.

“It is a myth that Parkinson’s disease was cured after the introduction of levodopa (L-dopa) in the 1960s… With today’s medicine, we have yet to find a cure for Parkinson’s disease. However, based on the severity of the symptoms and medical profile, the doctor will establish an appropriate treatment protocol.”

Even though the specific cause of the disease is unknown, the CU department pointed out, medical experts believe the symptoms are related to a “chemical imbalance in the brain caused by brain-cell death.”

Is the environment a suspect in the cause of PD? It’s something worth considering.

“Environmental causes are being researched and the strong consistent findings are that rural living, exposure to well water, and exposure to agricultural pesticides and herbicides are related to PD,” said the CU department. “It is important to remember, however, that these factors do not guarantee the development of PD, nor does their absence prevent it.”

They went on to say that “Having one or more close relatives with PD increases one’s risk of developing the disease; however, unless there is a known genetic mutation for PD present, the increased risk is only 2 to 5 percent.”

All in all, researchers, they added, currently believe that in most the cause of PD is a combination of genetics and environmental exposure. Undoubtedly, we’ll learn more about this condition which affects 10 million people worldwide. For now, however, it’s proving a tough nut to crack.

Cancer team seeks non-invasive precision tissue sampling to reduce the number of biopsies

Illustration of a patient with a pelvic tumour. Image credits: Beer et al / Springer.

Biopsy smarter, not harder

Scientists working on diagnoses and treatments of cancer have reason to be encouraged by work at the University of Cambridge. Namely, we could see real progress in doctors able to ascertain more timely accurate diagnoses with less invasion of the patient’s body.

We are talking about the “b” word — not that one, the other one — biopsy. Most cancer patients undergo one or several biopsies to confirm the diagnosis and plan their treatment accordingly. But because this is an invasive clinical procedure, it would be better if there was a way to reduce the number of biopsies, while still maintaining the diagnosis accuracy.

So, could biopsies eventually go virtual? Not entirely, but some of them could be skipped. The enabler for “virtual” biopsies would be the technique used by the Cambridge scientists, which they discussed a study published in the journal European Radiology. They used an advanced computing technique involving routine medical scans, with the aim to enable doctors to take fewer, more accurate tumor biopsies.

“More accurate” is a key point. The technique stands up to the challenge of whether the diversity of cancer cells in a tumor can be successfully captured. Their computing technique reveals tumor heterogeneity from standard medical images, which is a step forward in “precision tissue sampling.”

This news study was led by Professor Evis Sala from the Department of Radiology and the gist of it involves combining computed tomography (CT) scans with ultrasound images. The technique offers a visual guide that can ensure a doctor sees the full complexity of a tumor. Co-first author Dr. Lucian explains:

“Our study is a step forward to non-invasively unravel tumor heterogeneity by using standard-of-care CT-based radiomic tumor habitats for ultrasound-guided targeted biopsies.” (A CT scanner uses x-rays and computing to create a 3D image of the tumor from image ‘slices’ through the body.)

A map on the image

They tested a small group of patients with advanced ovarian cancer who were due to have ultrasound-guided biopsies prior to starting chemotherapy. High grade serous ovarian (HGSO) cancer is known as a silent killer because its early symptoms can be difficult to pick up. Also, HGSO tumors tend to have that high level of tumor heterogeneity.

The patients first had a standard-of-care CT scan. Second, the team used radiomics: a process using high-powered computing methods to analyze and extract information from the images created by the scanner. That way, a scientist can identify and map areas and features of the tumor.

The tumor map is then superimposed on the ultrasound image of the tumor, and the combined image guides the biopsy procedure. This results in a more targeted biopsy, and more targeted biopsies means fewer biopsies are necessary.

The study marks an important milestone towards precision tissue sampling, which can not only make patients’ lives a bit easier, but it can also reduce the workload that doctors have to cope with. It’s still a small-scale study, however, and researchers admit that they need to test the findings on a larger clinical study.

The researchers also mention a wholesome anecdote surrounding the study. Fiona Barve (56), a science teacher who lives near Cambridge, was diagnosed with ovarian cancer in 2017 after reporting abdominal pain. She was diagnosed with stage 4 ovarian cancer. Doctors immediately recommended surgery and a course of chemotherapy, which she undertook. Since March 2019, she has been cancer free and is back to teaching three days a week.

“I was diagnosed at a late stage and I was fortunate my surgery, which I received within four weeks of being diagnosed, and chemotherapy worked for me. I feel lucky to be around,” said Barve.

“When you are first undergoing the diagnosis of cancer, you feel as if you are on a conveyor belt, every part of the journey being extremely stressful. This new enhanced technique will reduce the need for several procedures and allow patients more time to adjust to their circumstances. It will enable more accurate diagnosis with less invasion of the body and mind. This can only be seen as positive progress.”