Publisher Health

Digital health systems can tell clinicians when someone’s heart-disease risk calls for a drug to lower cholesterol or whether insulin shots are warranted for a person with type 2 diabetes.
But for millions of low-back pain sufferers, care decisions rely heavily on subjective measures of patient discomfort — often leading to expensive tests and treatments (back pain is the third-highest U.S. health care expenditure, after diabetes and heart disease) that don’t necessarily offer a permanent solution.
Ohio State University engineering and medical researchers are developing a digital health system approach designed to enhance back-pain clinical decision-making. After completing a series of studies testing precise, objective measurements they’ve perfected in the lab, the team aims to apply the data-driven practices to the assessment and repair of back problems brought on by dysfunction in the spine.
In a recent study published in Clinical Biomechanics, researchers combined self-reported pain and disability measures with data from a wearable motion-sensing system to evaluate low-back function in lumbar fusion surgery patients. While post-operative pain relief and lower disability were self-reported within six weeks, the objective metrics didn’t detect actual functional improvement in the spine for at least six months after surgery.
These precise motion-based measures, and their inclusion in a burgeoning national database of patient spine-function scores and other medical data, could form the basis of more objective clinical decision-making for surgical patients, the researchers concluded.
“You simply can’t only ask people how they feel about their back,” said senior author William Marras, executive director of the Spine Research Institute at Ohio State.

Research led by nurses at The Ohio State University Wexner Medical Center found that a new wireless sock monitoring system reduced fall rates among “fall-risk” patients hospitalized at Ohio State’s Brain and Spine Hospital. In fact, none of the patients who were on a fall-risk protocol fell while wearing the socks over 2,211.6 patient-days during the study.
The study evaluated the effectiveness of Palarum’s PUP (Patient is Up) Smart Socks and findings are published online in the Journal of Nursing Care Quality.
Data was collected on 569 patients who were hospitalized in the major academic medical center’s neurological and neurosurgical units during 13 months of the study period. These units specialize in stroke, orthopedics, neurosurgery, general neurology and epilepsy. Originally planned to enroll 2,500 patients, the study ended early because of the COVID-19 pandemic.
“Patients can fall while they are hospitalized, and this can sometimes lead to injury or death. We know that existing fall prevention measures do not work consistently,” said senior investigator Tammy Moore, Associate Chief Nurse of Ohio State’s Neurological Institute and Medical Surgical. “During our study, we observed zero falls, which was a lower fall rate among the patients wearing these socks than the historical fall rate of 4 falls per 1,000 patient-days.”
During the study period, 5,010 safety events (alarms) were associated with the system. Eleven were reported to be false alarms, indicating 4,999 of the safety events (or 99.8%) were true patient stands, Moore said.
At admission to the hospital, patients’ fall risk scores were assessed by nurses based on the hospital’s assessment tool. All patients enrolled in the study were provided with the socks until discharge or removal from the fall risk protocol, and no other fall prevention system, such as chair or bed alarms or TeleSitter was used for these patients.

A baby’s cry is a form of communication used to attract attention from adult caregivers, and every baby cries in a similar but distinct way. An international research team has studied the vocal behavior of baby mice, called pups, to determine how the age of the father affects the pups’ vocal communication and body weight development. Their study will help them better understand vocal development in human babies.
The team published their findings in the journal iScience on August 10, 2022.
Research suggests that infant crying can serve as a marker of a baby’s development. Altered crying in a baby may indicate a risk for autism spectrum disorder or other neurodevelopmental disorders. Researchers know that children with these disorders show particular crying patterns.
However, scientists do not fully understand what makes the crying patterns of these children different. Recent studies have shown that advanced paternal age is a risk factor for neurodevelopmental disorders and lower body weight in the offspring.
Wanting to better understand the connection between a father’s age and vocal behavior in their offspring, a research team led by Professor Noriko Osumi, Tohoku University Graduate School of Medicine has conducted a study, using mice, to determine how paternal aging influences the vocal behavior of offspring.
One of the team’s main findings was that the advanced paternal age causes alterations in early vocal behavior and increases the number of offspring with atypical developmental patterns. “This vocal feature of pups born to aged fathers is similar to that of pups from autism spectrum disorder model mice. Moreover, pups born to young fathers showed a rich repertoire, while those born to aged fathers exhibited a limited repertoire,” said Professor Osumi.
In recent years, scientists have studied ultrasonic vocalizations in mice to learn more about the neurobiology of vocal communication. They know that when a pup is separated from its mother and littermates, it emits ultrasonic vocalizations consisting of various sound elements. When the mother hears these sounds, she responds by coming to retrieve the pup. This type of behavior in mice is similar to that of a human infant and mother.
The Tohoku University research team conducted a series of computational analyses of ultrasound vocalizations, comparing the pups of females who mated with young males and females who mated with older males. They separated the young pups from their mother and littermates, one by one, and recorded the ultrasonic vocalizations that occurred. Then the researchers analyzed the ultrasonic vocalization sonograms using machine learning tools.
The researchers examined the ultrasonic vocalization consisting of syllables. Their analyses showed that in pups with advanced age fathers, the syllables were reduced in number and duration. The syllable composition was also altered, with a more limited syllable repertoire in the pups with advanced age fathers. In addition, they measured the body weight of the pups after they completed each ultrasound vocalization recording. Comparing the weights, the team discovered that the pups with the advanced age fathers had consistently lower body weight gain than pups with young fathers.
In modern societies where humans are marrying and giving birth at older ages, advanced paternal age may represent a risk factor for neurodevelopmental disorders. This finding reiterates the clinical evidence that advanced paternal age is a risk factor for the atypical development observed in children with neurodevelopmental disorders and suggests that the effect of advanced paternal age could be detected in early infancy. As a next step, the team will be working to identify the neural basis governing ultrasound generation and the mechanisms by which advanced paternal age affects the offspring.
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Materials provided by Tohoku University. Note: Content may be edited for style and length.

Nearly all vital functions in the human body are regulated by so-called G protein-coupled receptors on the cell surface. These receptors thus serve as attractive drug targets to treat various diseases. Researchers have now discovered that empty spaces inside these receptors are important for their activation and thus for relaying messages to the inner cell. Their approach to locate these voids may help to direct the search for novel drugs.
The G protein-coupled receptors (GPCRs) enable us to see, taste food, feel cold or warm, or respond to stress, among other things. Located on the cell surface, GPCRs sense a large variety of signals such as nutrients, light, odors or hormones. By changing their conformation, they transmit this information from the outside to the inside of the cell. The accumulated knowledge about GPCRs has tremendously affected modern medicine: about one-third of all marketed drugs target GPCRs.
Empty spaces important for receptor activation
Using cutting-edge technology, the research team led by Prof. Stephan Grzesiek, together with collaborators at the Biozentrum of the University of Basel and the Paul Scherrer Institute, has now discovered that GPCRs contain completely empty cavities which are important for their activation. Their recent, experimental approach, published in “Nature Chemistry,” may direct and speed up the search for new and more specific drug candidates with fewer side effects.
Although the 826 GPCRs within the human body respond to many different stimuli, they all share a common architecture. “Our aim is to understand at the atomic level how GPCRs transmit signals,” says Dr. Layara Abiko, who co-directed the study. “For many years, we have therefore been studying the β1-adrenergic receptor, a GPCR that prepares the body for fight or flight.” The hormone adrenaline binds to and activates the receptor which triggers a stress response, for example, causing an increase in heart rate and blood pressure.” Beta-blockers inhibit this receptor and thus are effective drugs to treat hypertension or cardiovascular diseases.
Exact localization of dry voids
“Thanks to high-pressure NMR and our experimental approach using X-ray scattering on receptor crystals that incorporated the noble gas xenon, we could further complete the picture of this highly dynamic receptor,” says Abiko. “Previously, it was assumed that the cavities inside the receptor are filled with water. We have now revealed that some of them are empty.” During activation, the conformation of the receptor changes in such a way that these dry voids get compressed and disappear. Consequently, the receptor shrinks just like when you squeeze a sponge. In case of the β1-adrenergic receptor, this conformational change is key for initiating the body’s fight-or-flight response.
The researchers have now been able to exactly localize two of such empty cavities and revealed that cholesterol — an important cell membrane component — can fill one of these. Like a wedge, cholesterol impedes the receptor from squeezing and changing to its fully active state. “Blocking this void obstructs the subtle, but essential movements required to activate the GPCR,” explains Abiko. “We think, this wedge effect could be another layer of receptor regulation.”
New routes for drug development
But why can scouting for dry voids be important? Classical drug binding sites are often similar among GPCR subclasses. A drug directed to such a site may bind to more than one receptor and therefore cause unwanted side effects. In contrast, the dry cavities differ considerably between GPCRs, even when they are from the same subclass. This makes them highly selective drug targets.
“In this way, you may design drugs that are highly specific for one receptor,” explains Abiko. The developed new approach may locate such unconventional drug binding sites which differ strongly between the receptors. This can help the screening process for new therapeutics, save time and reduce costs.
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Materials provided by University of Basel. Note: Content may be edited for style and length.

The ‘promising’ results from tests on animal brain tissues suggest it could help clinicians to better monitor both disease progression and patients’ response to treatment than is currently possible, which indicate the high potential for future diagnostic trials in humans.
People who experience a serious blow to the head, such as during road traffic accidents, can suffer traumatic brain injury (TBI) — a leading cause of death and disability worldwide that can result in long-term difficulties with memory, concentration and solving problems.
TBIs need to be continuously monitored during treatment. For this reason, intracranial probes are used in neurocritical care settings to monitor key indicators of injury progression, called biomarkers, like pressure and oxygen in the brain.
Some of these probes can measure only one biomarker at a time. Others can monitor several biomarkers, but require several tubes inserted into the brain to do so, which risks causing further tissue damage or infections.
Imperial researchers have now developed a patient monitoring system to monitor multiple biomarkers following traumatic brain injury. The device combines the ability to monitor four biomarkers at once with machine learning algorithms that use previous data to predict biomarker concentrations based on obtained data in real-time. If optimised and proven for use in humans, the device could help hospitals to more effectively monitor TBI.
Lead author Dr Yubing Hu, at Imperial’s Department of Chemical Engineering, said: “This is a promising breakthrough. Our promising results indicate both accurate biomarker monitoring and precise predictions of injury progression which, after further development, could help clinicians monitor both patients’ brain health and response to treatment.”
The research is published in Matter.

The annual U.S. survey of substance use captures the growing mainstream acceptance of cannabis and hallucinogenic compounds.Marijuana and hallucinogen use among young adults reached an all-time record last year after having leveled off during the first year of the coronavirus pandemic, according to federal survey data.The findings, part of the government’s annual survey of drug use among young Americans, also found that nicotine vaping and excessive alcohol consumption continued to climb in 2021 after a brief pause. Another worrying trend among young people, ages 19 to 30: mounting consumption of alcoholic beverages suffused with THC, the psychoactive ingredient in cannabis.But there were some bright spots in the survey. Cigarette smoking and opioid abuse among young adults dropped last year, a continuing trend that has heartened public health experts.Taken in its entirety, the report provides a mixed picture of substance use in the United States that experts say reflects a number of disparate trends affecting young Americans: the devastating mental health effects of the pandemic; the increased availability of legal marijuana; and the emerging therapeutic embrace of psychedelics to treat depression, post-traumatic stress disorder and other psychological problems.“Overall, the results are very concerning,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which publishes the annual Monitoring the Future survey. “What they tell us is that the problem of substance abuse among young people has gotten worse in this country, and that the pandemic, with all its mental stressors and turmoil, has likely contributed to the rise.”More About CannabisWith recreational marijuana becoming legal in several states, cannabis products are becoming more easily available and increasingly varied.An Aphrodisiac?: The data is scarce, but anecdotal evidence suggests that the right dose of cannabis can make a woman’s orgasms more satisfying and increase sex drive.Risks of Driving High: Research suggests that marijuana may be less likely than alcohol to lead to deadly car crashes. But experts still urge caution.Delta-8: This popular cannabis product claims to be milder than regular marijuana. But is it legal? And is it safe? Here is what you should know.Edibles and Kids: A growing number of children are inadvertently consuming marijuana-infused foods. This is what to do if it happens to the young ones in your life.The online survey of people ages 19 to 60 was conducted from April to October 2021.Substance use research experts said the mounting use of marijuana in young adults was especially notable. The survey found that 43 percent in the 19-30 age group had used cannabis 20 or more times over the previous month, up from 34 percent. In 2011, that figure was 29 percent. Daily marijuana consumption also jumped significantly, to 11 percent from 6 percent in 2011.Increases in use also occurred among people ages 35 to 50, according to the survey.Not surprisingly, the surge in marijuana use has been occurring in tandem with a rise in the number of states that have legalized recreational use — 19 in the past decade. (Another 13 states allow the medical use of cannabis.) Experts say the normalization of marijuana has helped persuade many young people that it is harmless.A similar dynamic, experts say, is also at play with psychedelics. The use of hallucinogens had been stable for decades, but in 2021, 8 percent of young adults reported using psychedelics compared with 3 percent in 2011, a record high since the category was first surveyed in 1988.Over the past few years, researchers say, increasing media coverage and social media chatter about the potential therapeutic value of ketamine, psilocybin mushrooms and ecstasy have helped chip away at long-held taboos that were fostered during the nation’s failed war on drugs.“It’s about availability, but also about peer acceptability,” said Dr. Kevin M. Gray, a professor of psychiatry and behavioral sciences at the Medical University of South Carolina. “Generally speaking, young people don’t see these substances as dangerous, but the consequences of using them are still there.”Although the risks associated with psychedelics tend to be short-lived — overdoses are rare and most compounds are not addictive — experts stress the importance of using them with professional guidance. Some states have decriminalized psilocybin, but it and other popular psychedelics remain prohibited under federal law, though the Food and Drug Administration is expected to grant approvals for some therapeutic uses in the coming years.With marijuana use, the dangers include the risks of impaired driving, the potential for addiction and the effects on mental health such as heightened anxiety, depression and temporary psychosis.Many of those risks have increased alongside the potency of THC levels in cannabis, and more so with vaping products, said Sion Kim Harris, co-director of the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital. Some vaping concentrates contain THC levels of 90 percent or higher and the increased potency, she said, has contributed to a spike in cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in heavy marijuana users.Overall, Professor Harris said she was encouraged by some of the survey’s trends, including the continued declines in tobacco use, especially among teenagers. The drop in smoking, she noted, highlighted the benefits of sustained and consistent public health messaging about the perils of tobacco. But she said the rise in drug and alcohol use among college-age individuals was worrisome, especially given the potential to form lifelong habits during those pivotal years. “Stress is a real contributor to increased substance use and it’s really been a tough time for millennials and Gen Z,” she said.Dr. Volkow, the N.I.D.A. director, agreed. Given the normalization of formerly illicit substances, she said public health experts needed to come up with more nuanced and thoughtful ways of communicating the potential dangers of recreational drugs that also have therapeutic benefits.“As a society, we tend to be very categorical about these things,” she said. “We say drugs are so bad they will fry your brains like an egg and then we undermine the evidence that they can be harmful, depending on the dose and the person who takes them. By making everything black and white, we lose all credibility.”

Scientists at the UNC School of Medicine have made the surprising discovery that a molecule called EdU, which is commonly used in laboratory experiments to label DNA, is in fact recognized by human cells as DNA damage, triggering a runaway process of DNA repair that is eventually fatal to affected cells, including cancer cells.
The discovery, published in the Proceedings of the National Academy of Sciences, points to the possibility of using EdU as the basis for a cancer treatment, given its toxicity and its selectivity for cells that divide fast.
“The unexpected properties of EdU suggest it would be worthwhile to conduct further studies of its potential, particularly against brain cancers,” said study senior author Aziz Sancar, MD, PhD, the Sarah Graham Kenan Professor of Biochemistry and Biophysics at the UNC School of Medicine and member of the UNC Lineberger Comprehensive Cancer Center. “We want to stress that this is a basic but important scientific discovery. The scientific community has much work ahead to figure out if EdU could actually become a weapon against cancer.”
EdU (5-ethynyl-2′-deoxyuridine) is essentially a popular scientific tool first synthesized in 2008 as an analog, or chemical mimic, of the DNA building block thymidine — which represents the letter “T” in the DNA code of adenine (A), cytosine (C), guanine (G) and thymine (T). Scientists add EdU to cells in lab experiments to replace the thymidine in DNA. Unlike other thymidine analogs, it has a convenient chemical “handle” to which fluorescent probe molecules will bond tightly. It thus can be used relatively easily and efficiently to label and track DNA, for example in studies of the DNA replication process during cell division.
Since 2008, scientists have used EdU as a tool in this way, as published in thousands of studies. Sancar, who won the 2015 Nobel Prize for Chemistry for his seminal work on DNA repair, is one such scientist. When his lab began using EdU, his team unexpectedly observed that EdU-labeled DNA triggered a DNA repair response even when it wasn’t exposed to DNA-damaging agents, such as ultraviolet light.
“That was quite a shock,” Sancar said. “So we decided to explore it further.”
Following up on the strange observation, the team discovered that EdU, for reasons that are still unclear, alters DNA in a way that provokes a repair response called nucleotide excision repair. This process involves the removal of a short stretch of damaged DNA and re-synthesis of a replacement strand. This is the mechanism that repairs most damage from ultraviolet light, cigarette smoke, and DNA-altering chemo drugs. The researchers mapped EdU-induced excision repair at high resolution and found that it occurs across the genome, and it apparently occurs again and again, since each new repair strand includes EdU and thus provokes the repair response anew.

Insecure income associated with nontraditional employment known as “gig work” has a negative impact on the overall health and well-being of U.S. workers, according to a new article by researchers from UTHealth Houston.
A pre-press version of the findings, which will be published in the September 2022 issue of the journal Social Science & Medicine, is now available online.
Gig work includes employment where people are paid by the piece of completed work, by the hour, or by the day, rather than a traditional employer-employee relationship. Uber, Lyft, TaskRabbit, and Handy are examples of gig companies, according to the Congressional Research Service.
Using data from the 2008-2019 IPUMS Medical Expenditure Panel Survey, UTHealth School of Public Health researchers found that insecure income from gig work contributed to poor health outcomes among the national workforce, including a sicker workforce, higher unreimbursed healthcare costs, and greater costs to the consumer.
Co-authors, led by School of Public Health alumnus Robert Thomas, PhD, JD, MBA, included Gretchen Gemeinhardt, PhD, associate professor of management policy and community health; Paula Cuccaro, PhD, assistant professor of health promotion and behavioral sciences; and John Davis, MA, from UTMB Health. Thomas is also immediate past commissioner of the Texas Workforce Commission.
Key findings included: Insecure income earners reported a 50% increase in poor overall health and psychological distress compared to salary earners. The poor health effects of piece work were somewhat eased on workers when accounting for socioeconomic factors, but the trend of increased health risks remained constant, especially for women, those with less than a college degree, financially poorer workers, and non-white-collar workers. Black and Hispanic workers earning insecure income were more likely to report poor health than their white counterparts. Higher rates of hourly pay reduced, but did not remove, the correlation between insecure income and workers’ health.The study comes at a time when gig companies are pushing to classify workers as independent contractors, rather than employees, in state courts and legislatures in California, Massachusetts, and elsewhere in the U.S.
While the paper utilized pre-COVID-19 data, the researchers say their findings suggest that COVID-era gig workers will likely see an even greater increase in poor overall health and psychological distress.
“The longer-term economic burden will ultimately be passed onto the U.S. consumer as we see increases in worker shortages, increases in prices from gig companies, and increases in unreimbursed health care utilization,” Thomas said. “It is reasonable to project that the U.S. taxpayer will pay more for uninsured chronic morbidity care of uninsured U.S. workers who are paid an insecure income.”
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Materials provided by University of Texas Health Science Center at Houston. Original written by Caitie Barkley. Note: Content may be edited for style and length.

People who use therapeutic cannabis are more likely to also use nicotine products than the general population, according to a Rutgers study.
The study, published in the American Journal on Addictions, is among the first to examine nicotine use among patients of a medical marijuana dispensary.
“Simultaneous use of cannabis and nicotine is a growing concern, but while the relationship between recreational cannabis and nicotine use is well-established, little is known about nicotine use among users of medical cannabis,” said Mary Bridgeman, a clinical professor at Rutgers Ernest Mario School of Pharmacy.
The researchers surveyed 697 patients between ages 18 and 89 at a medical marijuana dispensary on their nicotine and cannabis use, how they self-administered the cannabis (smoked, vaped) and the medical conditions that qualified them for using therapeutic cannabis.
They found that close to 40 percent of medical marijuana users also use nicotine — sharply higher than the 14 percent of U.S. adults who smoke.
Therapeutic cannabis users who also used electronic cigarettes or didn’t use nicotine at all were about four times more likely to vape, rather than smoke, cannabis than those who exclusively smoked cigarettes.
The study also found 75 percent of the respondents smoked cannabis rather than vaped and about 80 percent of the cigarette smokers reported planning to quit in the next six months.
These findings reveal that while medical cannabis dispensaries may recommend vaping rather than smoking cannabis due to the health concerns associated with combustible products, this recommendation alone may not influence patients who also smoke cigarettes,” said co-author Marc Steinberg, author of the study and a professor in the department of psychiatry at Rutgers Robert Wood Johnson Medical School.
“Between the higher rates of nicotine use in those using medical cannabis, the fact that cigarette smokers opt to smoke cannabis as well and that those people also are seeking to quit using nicotine presents a strong argument that dispensaries provide tobacco control messaging at the point-of-sale to encourage cigarette smokers to quit,” Steinberg added. “The strategy also could increase the chances that a medical cannabis user would vape the product, which is a less harmful route than smoking.”
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Materials provided by Rutgers University. Original written by Patti Verbanas. Note: Content may be edited for style and length.

The human body contains 600 to 800 lymph nodes, which are specialised organs that trigger immune responses. To be informed about infections in the body, lymph nodes are connected to the individual organs via lymph vessels. From the organs, the lymph vessels transport fluids and special immune cells to the lymph nodes. These immune cells are called dendritic cells; they carry information from the organs into the lymph nodes and pass it on to other immune cells there.
Now it is clear: the dendritic cells are not solely responsible for this important flow of information. A research team led by immunologist Professor Wolfgang Kastenmüller from Julius-Maximilians-Universität (JMU) Würzburg in Bavaria, Germany, has discovered that so-called unconventional T cells also continuously migrate from the tissue into the lymph nodes and influence the immune responses there.
This discovery has consequences — for vaccination strategies as well as for immunotherapies against cancer.
Different subtypes of unconventional T cells
“Each tissue in our body has different subtypes of unconventional T cells,” explains Wolfgang Kastenmüller. “Since these cells each migrate to the nearest lymph node, the individual lymph nodes also differ in the composition of the T cells. And that has a direct effect on the immune responses of the individual lymph nodes.”
For example, a lymph node that has been informed about an infection in the lungs triggers a different immune response than a lymph node that receives its information from the intestine or from the skin.