Publisher Health

A study published in Nature Biomedical Engineering details a novel method for imaging the placenta in pregnant patients as well as the results of a pilot clinical study. By combining optical measurements with ultrasound, the findings show how oxygen levels can be monitored non-invasively and provides a new way to generate a better understanding of this complex, crucial organ. This research was the result of a collaboration of the groups of the University of Pennsyvlania’s Arjun Yodh and Nadav Schwartz with colleagues from the Children’s Hospital of Philadelphia (CHOP) and was led by postdoc Lin Wang.
Schwartz describes the placenta as the “engine” of pregnancy, an organ that plays a crucial role in delivering nutrients and oxygen to the fetus. Placental dysfunction can lead to complications such as fetal growth restriction, preeclampsia, and stillbirth. To increase knowledge about this crucial organ, the National Institute of Child Health and Human Development launched the Human Placenta Project in 2014. One focus of the program is to develop tools to assess human placental structure and function in real time, including optical devices.
For three years, the researchers optimized the design of their instrument and tested it in preclinical settings. The process involved integrating optical fibers with ultrasound probes, exploring various ultrasound transducers, and improving the multi-modal technology so that measurements were stable, accurate, and reproducible while collecting data at the bedside. The resulting instrumentation now enables researchers to study the anatomy of the placenta while also collecting detailed functional information about placenta blood flow and oxygenation, capabilities that existing commercially devices do not have, the researchers say.
Because the placenta is located far below the body’s surface, one of the key technical challenges addressed by Wang, a postdoc in Yodh’s lab, was reducing background noise in the opto-electronic system. Light is scattered and absorbed when it travels through thick tissues, Yodh says, and the key for success was to reduce background interference so that the small amount of light that penetrates deep into the placenta and then returns is still large enough for a high-quality measurement.
“We’re sending a light signal that goes through the same deep tissues as the ultrasound. The extremely small amount of light that returns to the surface probe is then used to accurately assess tissue properties, which is only possible with very stable lasers, optics, and detectors,” says Yodh. “Lin had to overcome many barriers to improve the signal-to-noise ratio to the point where we trusted our data.”
Notably, the paper also describes the results of a pilot study where 24 pregnant patients in their third trimester were given supplemental oxygen for a short time period, creating placental hyperoxia. Using the device, the team collected measurements of the placenta’s oxygenated and deoxygenated blood concentrations before and during hyperoxia; the results demonstrated that the device could be used to study placental function in real time. The research also provided new insights into the relationship between blood flow and maternal vascular malperfusion, which occurs when blood flow into the placenta is impeded.
“Not only do we show that oxygen levels go up when you give the mom oxygen, but when we analyze the data, both for clinical outcomes and pathology, patients with maternal vascular malperfusion did not have as much of an increase in oxygen compared to patients with normal placentas,” says Schwartz. “What was exciting is that, not only did we get an instrument to probe deeper than commercial devices, but we also obtained an early signal that hyperoxygenation experiments can differentiate a healthy placenta from a diseased placenta.”
While the device is still in development, the researchers are currently refining their instrument to make it more user-friendly and to allow it to collect data faster. The team is also currently working on larger studies, including recently data from patients during their second trimester, and they are also interested in studying different regions of the placenta. “From an instrumentation perspective, we want to make the operation more user-friendly, and then we want to carry out more clinical studies,” Wang says about the future of this work. “We have lots of interesting ideas.”
And because there are many unanswered clinical questions about the placenta, for Schwartz the biggest potential of this work is in providing a way to start answering those questions. “Without being able to study the placenta directly, we are relying on very indirect science,” he says. “This is a tool that helps us study the underlying physiology of pregnancy so we can more strategically study interventions that can help support good pregnancy outcomes.”
The authors are Lin Wang, Jeffrey M. Cochran, Kenneth Abramson, Lian He, Venki Kavuri, Samuel Parry, Arjun G. Yodh, and Nadav Schwartz from Penn; Tiffany Ko, Wesley B. Baker, and Rebecca L. Linn from the Children’s Hospital of Philadelphia, and David R. Busch, previously a research associate at Penn and now at the University of Texas Southwestern Medical School.
This research was supported by National Institutes of Health grants F31HD085731, R01NS113945, R01NS060653, P41EB015893, P41EB015893, T32HL007915, and U01HD087180.

Americans aren’t turning to pharmaceutical options as often in the never-ending battle for a good night’s sleep.
The use of medication to treat sleep disturbances has fallen dramatically in the United States in recent years after several decades of climbing steeply, according to a study by a team of researchers led by a University of Florida Health scientist.
The study published July 12 in the Journal of Clinical Sleep Medicine documented a 31% decline in the use of common sleep medications between 2013 and 2018, a trend thought to be linked to a greater awareness of the potential pitfalls posed by these prescriptions. (It remains to be seen how the COVID-19 pandemic might have impacted this trend.)
The drop-off is particularly noteworthy for Americans over age 80, who are most susceptible to falls leading to injury when using sleep medications. The study showed an 86% decrease in this group.
“I was surprised and encouraged by the results because there’s been a great deal of effort to minimize the long-term use of these pharmaceutical agents,” said public health researcher Christopher Kaufmann, Ph.D., M.H.S., an assistant professor in the UF College of Medicine’s department of health outcomes and biomedical informatics and a member of the UF Institute on Aging.
“We’ve seen deprescribing initiatives,” he added. “A number of medical organizations, advocacy groups and policymakers have also strongly discouraged the use of these drugs to treat insomnia due to potential adverse outcomes associated with their use. There are highly effective behavioral treatments available that are growing in popularity.”
The study’s observed trend stands in marked contrast to the rapid rise of sleep medication use and prescribing in previous decades. An earlier study by some of the same researchers found that prescriptions for benzodiazepines, or BZDs, a class of drugs to treat anxiety and insomnia that includes diazepam (Valium) and alprazolam (Xanax), and non-BZDs, a similar class of medications including zolpidem (Ambien), climbed 69% and 140%, respectively, between 1993 and 2010.

New research published today by the University of Southampton shows new insight in how our brain develops, that can pave the way for treating neurological disorders.
For the first time, a team of international scientists led by the University’s Professor of Neuroimmunology, Diego Gomez-Nicola, have studied the development of the main immune cell population residing in the human brain, called microglia, on human tissue.
Microglial cells are vital in brain development and function, although most of the knowledge about them comes from studies in mice.
For this research, post-mortem human brain samples were sourced across several tissue banks to create the largest ever study on microglial development on human life, from embryonic development to advanced ageing.
The spatiotemporal dynamics of microglia across the human lifespan which has been published in Development Cell online, was made possible thanks to funding from the Leverhulme Trust.
Co-author, Professor Gomez-Nicola said: “We lacked the all important human data vital in exploring how the development of microglia affects how our brain works.

Electronic cigarettes have attracted media and consumer attention for claims of their addictive nature, variety of flavors, and increased use among teens, sparking regulatory oversight and policies. A Penn State College of Medicine study suggests that these devices may help people decrease their dependence on combustible cigarettes — which contain an array of harmful chemicals called toxicants — without increasing their overall nicotine dependence.
Smoking is a leading cause of death in the U.S., and despite interest in quitting and the availability of FDA-approved cessation methods, smokers still struggle to quit. Some public health experts have proposed e-cigarettes as a “reduced harm” alternative to cigarettes for those not interested or able to quit, citing reports like one from the National Academies of Sciences, Engineering and Medicine, which found that substitution of e-cigarettes for combustible cigarettes reduced users’ exposures to carcinogens and other harmful toxicants.
Jessica Yingst, assistant professor of public health sciences and Penn State Cancer Institute researcher, and colleagues at the Penn State Center for Research on Tobacco and Health study e-cigarettes and whether they can help nicotine users stop smoking or reduce their exposure to harmful toxicants found in cigarettes. Their latest study investigated a common question — whether initiation of electronic cigarette use to reduce cigarette smoking could potentially increase nicotine dependence.
“Research on this topic is conflicted because, in prior studies, participants used their own devices with unknown nicotine delivery profiles,” Yingst said. “Our study used devices with known nicotine delivery profiles, which allowed us to effectively compare how the varying levels of nicotine in a device might affect user nicotine dependence and ability to reduce cigarette consumption.”
The researchers enrolled 520 participants interested in reducing their cigarette intake but with no plans or interest to quit smoking and instructed them to reduce their cigarette consumption over the six-month study period. Participants randomly received an e-cigarette that delivered 36, 8 or 0 mg/mL of nicotine, or a cigarette substitute that contained no tobacco, as an aid in their efforts to reduce their cigarette consumption.
Participants self-reported their cigarette and e-cigarette dependence at one, three and six months using validated measures of dependence, including a Penn State-developed questionnaire that ranges from 0 (not at all dependent) to 20 (highly dependent). Urine samples were also collected throughout the study to measure cotinine, a biomarker for nicotine exposure.
At six months, all participants in the e-cigarette groups reported significant, decreased cigarette consumption, with those in the 36 mg/mL group smoking the least number of cigarettes per day. Those in the e-cigarette groups reported significantly lower dependence on the Penn State Cigarette Dependence Index than those in the cigarette substitute group.
Participants also reported their e-cigarette dependence using the Penn State E-Cigarette Dependence Index. E-cigarette dependence did not significantly change throughout the study, with the exception of participants in the 36 mg/mL group who saw significant, increased dependence over the course of the study, yet still much lower when compared with cigarette dependence. Urine cotinine levels remained consistent across all groups for the duration of the study, suggesting that there was no increase in overall exposure to nicotine during the study. The results were published in the journal Nicotine and Tobacco Research.
“Our results suggest that using e-cigarettes or a cigarette substitute to reduce cigarette consumption can result in a reduction of self-reported cigarette use and dependence,” said Yingst, who directs the College of Medicine’s Doctor of Public Health Program. “Importantly, use of the high concentration e-cigarette did not increase overall nicotine dependence, and was associated with a greater reduction in cigarette smoking compared to the cigarette substitute.”
While it has been hypothesized that the use of e-cigarettes could increase overall nicotine dependence, the research team said their study found that initiating e-cigarette use to reduce cigarette consumption resulted in reduced cigarette dependence and low e-cigarette dependence. In the future, they will evaluate the health effects of completely switching from cigarettes to e-cigarettes.
Xi Wang and Jonathan Foulds of Penn State College of Medicine; Alexa Lopez of the University of Wisconsin-Milwaukee; Alison Breland, Andrew Barnes, Megan Underwood and Melanie Crabtree of Virginia Commonwealth University; Eric Soule of East Carolina University College of Health and Human Performance; and Joanna Cohen of John Hopkins Bloomberg School of Public Health also contributed to this research. Foulds has done paid consulting for pharmaceutical companies involved in manufacturing smoking-cessation medications (e.g., Pfizer, GlaxoSmithKline, Johnson and Johnson); and has acted as a deposed and compensated expert witness on behalf of plaintiffs suing cigarette manufacturers. Other author disclosures can be read in the published manuscript.
This research was supported by the National Institute on Drug Abuse of the National Institutes of Health and the Center for Tobacco Products of the U.S. Food and Drug Administration (grant numbers P50DA036105 and U54DA036105). Data collection was supported by Penn State Clinical and Translational Science Institute (grant number UL1TR002014) and the C. Kenneth and Dianne Wright Center for Clinical and Translational Research at Virginia Commonwealth University (grant number UL1TR002649) through the National Center for Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors.
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Researchers have deciphered a signaling cascade through which inborn errors in metabolism provoke deadly neuroendocrine tumors in the adrenal glands. This discovery explains how impaired metabolism due to mutations in a key enzyme called succinate dehydrogenase B disables a normal bioenergetic sensing mechanism, triggering cells to divide uncontrollably.
This explanation of how cancer cells divide despite having a less efficient energy production opens new possibilities to treat this and other forms of cancer. The phenomenon of cancer cells’ dividing uncontrollably — while almost inexplicably shifting to an impaired metabolic state — was dubbed the Warburg effect, in honor of Otto Warburg, Ph.D., M.D., who first described it almost 100 years ago and won the Nobel Prize in physiology or medicine in 1931. Further aspects of the phenomenon relating to hypoxia have been famously described in the 2019 Nobel Prize in physiology or medicine awarded to William Kaelin Jr., M.D., and colleagues.
Now, a new study, published in the journal Cell Reports and led by University of Alabama at Birmingham researchers, shows how succinate, one of the unused metabolites of the faulty energy production, triggers a second chain of protein-to-protein interactions that turns off a key mechanism that coordinates energy sensing during a cell’s resting state. As a result, the cells escape from their normal state and invoke an aberrant cell cycle activity, a characteristic of cancer cells.
“Importantly, the discovery of this new cascade has revealed several new potential anti-cancer drug targets,” said UAB’s James Bibb, Ph.D., and first author Priyanka Gupta, Ph.D. The study also has yielded a new animal model for this form of neuroendocrine cancer, which can be used to test new treatments, including preclinical demonstration of effective experimental anti-cancer treatments.
“This paper represents a major advance in our understanding of this recalcitrant form of cancer,” Bibb said. “It also advances our understanding of how alterations in metabolism drive cancer and hopefully will allow us to bring forward more effective treatments.” Bibb is a professor in the UAB Department of Surgery, and Gupta is a research scientist in the O’Neal Comprehensive Cancer Center at UAB.
The steps of how succinate triggers a cascade of protein-to-protein interactions that turns off a key energy-sensing mechanism and causes cancer are detailed in this multi-institution study. The researchers used modern cell biology to show how succinate buildup leads to loss of control of calcium and the activation of proteases, followed by alternations in the activity of a series of protein kinases that mediate intracellular signaling networks. At the center of this cancer-causing process, a protein known as AMP kinase is inactivated, so it can no longer sense low energy levels and pass this information on to processes that block cell proliferation. The result is a default release from cell cycle checkpoints, leading to uncontrolled cell proliferation.
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Transferring the nuclear genome from one egg into the cytoplasm of a donor egg is a strategy to enable women carrying mutations in their mitochondrial DNA to have healthy babies. A new study from Wei Shang of Chinese PLA General Hospital, Beijing, Fuchou Tang of Peking University, Beijing, and colleagues, publishing August 16 in the open-access journal PLOS Biology, uses multiple “omics” techniques to show that this strategy, called spindle transfer, is likely to be safe, with little evidence of genetic or functional difference between the resulting embryos and healthy control in vitro fertilization (IVF) embryos. The results are likely to spur further adoption of spindle transfer for IVF when there is a risk of mitochondrial disease.
Mitochondria, the energy powerhouses of the cell, contain their own DNA, mutations in which can cause a variety of inherited diseases, including metabolic, muscular, and neurologic disorders. In human reproduction, only maternal mitochondria, contained in the egg, are inherited. To interrupt that inheritance, techniques have been developed to place parental nuclear DNA into cytoplasm from donor cells carrying healthy mitochondria, either just before fertilization (spindle transfer), or just after (pronuclear transfer).
The “spindle” refers to the division apparatus that holds the nuclear chromosomes in suspension until fertilization. During spindle transfer, the maternal spindle is removed from an unfertilized egg and placed into a donor egg that has had its own spindle removed. (Pronuclear transfer removes the pronucleus, containing both egg and sperm DNA, and places it in a donor embryo whose pronucleus has been removed.) Spindle transfer has been used clinically, but there remain questions about its safety.
To shed light on this question, the authors performed three different types of analyses on single cells from 23 blastocysts following spindle transfer and compared them to 23 control IVF blastocysts. (The blastocyst is the multicellular ball that forms about 5 or 6 days after fertilization, ready for implantation into the uterine wall.) They found no difference in DNA copy number, a measure of genomic integrity, between spindle transfer and control blastocysts. RNA expression profiles were also similar between the two blastocyst types, regardless of which layer of the blastocyst the cells were taken from.
The authors did find a small but significant reduction in the level of DNA demethylation in spindle transfer blastocysts in one layer, the trophectoderm, though not in two other layers. DNA demethylation is one of the processes used to increase gene expression during development, and their analysis suggested that the reduction was evidence of a slight delay in the process, rather than a permanent inability to upregulate the affected genes. “It is quite possible that after the blastocyst stage, the spindle transfer embryos can catch up to complete DNA demethylation before implantation,” Tang said.
“We conclude that spindle transfer seems generally safe and does not severely disturb embryonic development. However, given the limitation of the study, more dimensions and larger-scale evaluations are still needed to determine whether this technique can be applied to a wider set of clinical trials.”
Tang adds, “Spindle transfer can potentially be used to prevent the germline transmission of mitochondrial DNA mutation related diseases. However, its safety has not been comprehensively evaluated. This study provided the first systematic analyses of the transcriptome, DNA methylome, and genome (copy number variations) of spindle-transferred blastocysts at single-cell resolution and revealed that spindle transfer procedure seems generally safe for embryonic development with only global DNA demethylation slightly delayed in trophectoderm lineage of blastocysts.”
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The B.C.G. tuberculosis vaccine may protect against Covid-19 and other infections by broadly bolstering the immune system.In the early days of the Covid-19 pandemic, when prevention seemed light years away, several scientists launched trials to see whether a tuberculosis vaccine developed in the early 1900s might protect people by bolstering the immune system.The Bacillus-Calmette-Guerin vaccine has long been known to have broad effects on the immune system, and is still given to infants in the developing world and in countries where TB is prevalent.Scientists observed many years ago that the vaccine seems to train the immune system to respond to a variety of infectious diseases, including viruses, bacteria and parasites, and reduces infant mortality.As new threats like monkeypox and polio re-emerge and the coronavirus continues to evolve, the potential of the old vaccine to provide a measure of universal protection against infectious diseases has gained renewed interest among scientists.Now the results of clinical trials conducted during the pandemic are coming in, and the findings, while mixed, are encouraging.The latest results, published Monday in Cell Medicine Reports, come from a trial initiated before Covid-19 emerged. It was designed to see whether multiple B.C.G. injections could benefit people with Type 1 diabetes, who are highly susceptible to infection.In January 2020, as the pandemic began, the investigators started tracking Covid infections among the trial’s 144 participants. All of them had Type 1 diabetes; two-thirds had received at least three B.C.G. doses before the pandemic. The remaining one-third had received multiple placebo injections.The scientists are still evaluating the vaccine’s long-term effects on Type 1 diabetes itself. But they commissioned an independent group to look at Covid infections among the participants for 15 months, before any of them had received Covid vaccines.The results were dramatic: only one — or less than 1 percent — of the 96 people who had received the B.C.G. doses developed Covid, compared with six — or 12.5 percent — of the 48 participants who received dummy shots.Although the trial was relatively small, “the results are as dramatic as for the Moderna and Pfizer mRNA vaccines,” said Dr. Denise Faustman, the study’s lead author and director of immunobiology at Massachusetts General Hospital.Read More on the Coronavirus PandemicBoosters: Britain became the first country to authorize a coronavirus vaccine that targets two variants. Half of each dose of the Moderna-made shot will target the original variant, and the other half will target Omicron.New Guidelines: The Centers for Disease Control and Prevention loosened its Covid-19 guidance, saying those exposed to the virus no longer need to quarantine. A day later, the U.S. Food and Drug Administration recommended that people exposed to Covid who are asymptomatic take at least three at-home antigen tests, each spaced 48 hours apart, to reduce the risk of missing an infection.Parents and Pandemic Politics: They were once Democrats and Republicans. But fears for their children fueled by vaccine skepticism have turned them into single-issue voters, on the side of no vaccine mandates for their children.Coronavirus Origins: Two new studies exploring how the Covid outbreak began, concluded that the wet market in Wuhan, China, was the likely epicenter of its emergence.People with Type 1 diabetes are particularly prone to infections. “We saw a major decrease in bladder infections, less flu and fewer colds, less respiratory tract infections and less sinus infections that diabetics get a lot of,” Dr. Faustman added.The vaccine “seems to be resetting the immune response of the host to be more alert, to be more primed, not as sluggish.”Another trial of B.C.G. in 300 older Greek adults, all of whom had health problems like heart or lung disease, found that the BCG vaccine reduced Covid-19 infections by two-thirds and lowered rates of other respiratory infections, as well.Only two individuals who received the vaccine were hospitalized with Covid-19, compared with six who received the placebo shots, according to the study, published in July in Frontiers in Immunology.“We have seen clear immunological effects of B.C.G., and it’s tempting to ask if we could use it — or other vaccines that induce training effects on immunity — against a new pathogen that emerges in the future, that is unknown and that we don’t have a vaccine for,” said Dr. Mihai Netea, the paper’s co-senior author a professor at Radboud University Medical Center in the Netherlands.He called the results of the Type 1 diabetes trial “very strong,” but urged caution, noting that other trials have had disappointing results. A Dutch study of some 1,500 health care workers who were vaccinated with B.C.G. found no reduction in Covid infections, and a South African study of 1,000 health care workers found no impact of B.C.G. on Covid incidence or severity.The results of the largest trial of B.C.G., an international study that followed over 10,000 health care workers in Australia, the Netherlands, the U.K., Spain and Brazil for a year, are still being analyzed and are expected in the next few months. The study also followed health care workers after they received Covid vaccines to see if B.C.G. improved their responses.“B.C.G. is a controversial area — there are believers and nonbelievers,” said the chief investigator of that trial, Dr. Nigel Curtis, a professor of pediatric infectious diseases at the University of Melbourne in Australia and leader of Murdoch Children’s Research Institute’s Infectious Diseases Group. (Dr. Curtis calls himself “an agnostic.”)“Nobody argues that there are off-target effects, but how profound is that, and does it translate to a clinical effect? And is it confined to neonates, whose immune systems are more susceptible? These are very different questions,” Dr. Curtis said.A number of factors could explain the disparate findings. B.C.G. is composed of a live attenuated virus that has been cultivated in labs around the world for decades, introducing mutations that make for different strains.Dr. Faustman’s lab uses the Tokyo strain, which is considered particularly potent, Dr. Curtis said. His own studies used the Denmark strain, which is easiest to obtain. The number of doses may also have an effect on immunity, as many vaccines require repeated inoculations to maximize protection.Dr. Faustman said her work has shown that it takes time for the vaccine to have its maximal effect. Type 1 diabetes patients in her study had received several B.C.G. shots before the pandemic.In any case, scientists interested in B.C.G.’s potential to provide universal, broad-spectrum protection against pathogens have recast their aims. They are no longer looking at preventing Covid-19, since the current vaccines are very effective.Instead, they want to develop tools for use in the next pandemic, which could be another coronavirus, a deadly new strain of influenza or an unknown pathogen.“It is more for the future,” said Dr. Netea, who has called for conducting large clinical trials of B.C.G. and other vaccines that have demonstrated broad protective effects.“If we had known this at the very beginning of the Covid-19 pandemic, we would have been able to obtain a large protective effect on the population during the first year of the pandemic.”The Open Source Pharma Foundation, a global nonprofit that seeks to develop affordable new therapies in the areas of greatest need, is interested in repurposing off-patent vaccines for use in current and future pandemics, said its chairman and co-founder Jaykumar Menon.“Imagine if we could use existing vaccines to curb pandemics — that would change world history,” Mr. Menon said, adding that B.C.G. is not the only vaccine with wide effects on the immune system.“These narrow, very specific vaccines, like the Pfizer or Moderna mRNA vaccines, are homed in very tightly on the spike protein of the virus that causes Covid-19, but if that protein mutates — which it does — you lose efficacy,” Mr. Menon said.The alternative? “A broad universal vaccine that works on innate immunity puts up this fortified moat that repels all comers,” he said.

Adding simple statements that put vaccine side-effect risks into broader context could improve vaccine uptake, a study published today in eLife has shown.
The research could help inform public health campaigns aimed at increasing the uptake of COVID-19 booster jabs, which are currently far from target levels.
The study was conducted in the US and UK, where vaccination rates have slowed and only 63.9% and 71.3% of the respective populations are fully vaccinated. Moreover, just over 27% and 55% of adults have received their booster vaccines in the US and UK, respectively.
“Vaccine hesitancy is not the result of a single common cause and can vary for different people and populations,” explains lead author Nikkil Sudharsanan, Assistant Professor of Behavioural Science for Disease Prevention and Health Care, Technical University of Munich, Germany. “A common fear around COVID-19 vaccination is concern about side effects, heightened by widespread media coverage that did not put the very low risk of side effects in context with other risks, such as the likelihood of death from COVID-19 itself. Addressing these public concerns will be a key component of efforts to improve vaccine use in the US, UK and globally, especially with recommendations for ongoing booster doses.”
Evidence shows that the way risks are framed and presented to people can affect their perceptions of the severity of risk and, ultimately, their behaviour. The researchers therefore set out to compare different ways of framing risk for a hypothetical COVID-19 vaccine, then asked participants whether they would take the vaccine and how safe they thought it was.
They designed an online randomised controlled trial, providing vaccine information to 8,988 people aged over18 years old in the UK and US. Participants were presented with information about the hypothetical vaccine, including the risk of serious blood clots, framed in three different ways: 1) with an additional label explaining whether the risk is low or high, 2) adding a comparison risk, such as the risk of dying in a motor vehicle, and 3) whether risks were communicated as absolute (that is, the presenting the actual vaccine side-effect risk next to other common risks)or relative (presenting the vaccine side-effect risk as a multiple of other common risks).
They found that adding a simple qualitative risk level of ‘very low risk’ next to the vaccine side effect increased people’s intentions to take the vaccine by 3 percentage points. Similarly, adding a comparison to motor vehicle death rates increased intentions by 2.4 percentage points. These framing tools worked even better when used together: increasing vaccine intentions by 6.1 percentage points.
The authors also report some surprising results: comparing vaccine side-effect rates with COVID-19 death rates did not appear to influence vaccine intentions. This was unexpected because COVID-19 death rates are substantially higher than motor vehicle death rates (170 per 100,000 versus 12 per 100,000 in the US) and it is a cause of death directly associated with the purpose of COVID-19 vaccination strategies. A second surprise was that expressing risk as relative versus absolute had no apparent impact on people’s willingness to take the hypothetical vaccine.
“We believe our results can inform communication efforts aimed at increasing vaccination, especially booster vaccinations,” concludes co-author Alain Vandormael, Senior Data Scientist at the Heidelberg Institute of Global Health, Heidelberg University Hospital, Germany. “Our results are focused on vaccine intentions and not vaccination rates, so the next step is to test whether these framing efforts can increase shots in arms before translating our findings into policy action.”
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A study from RCSI University of Medicine and Health Sciences has gained new insights into changes in heart function and blood pressure in the lungs of babies born with Down Syndrome.
Heart and lung conditions are common in babies born with Down Syndrome and can contribute to the requirement for intensive care and longer hospital admissions for babies with Down Syndrome compared to babies without Down Syndrome. The findings of this work will help clinicians to better asses one in 600 babies who are born with Down Syndrome in Ireland every year.
Published in the Journal of the American Society of Echocardiography, the study is the first of its kind to follow babies with Down Syndrome over the first two years of age to investigate heart function and increased blood pressure in the blood vessels in their lungs. Seventy babies with Down Syndrome were followed in this study through collaboration between three neonatal intensive care units in Dublin, Ireland.
This research found that the babies with Down Syndrome have impaired changes in heart function and blood pressure in the lungs over the first two years of age Importantly, there were no differences in heart function between those babies with Down Syndrome who had congenital heart disease compared to those without over the study period. This is a significant finding and indicates that all babies with Down Syndrome should have their heart function and blood pressure in their lungs monitored during childhood.
Professor Afif EL-Khuffash, Clinical Professor of Paediatrics at RCSI and Consultant Neonatologist, at The Rotunda Hospital said: “Until this point, there has been a dearth of evidence to explain why babies with Down Syndrome experience these issues. The results of this study show us that babies with Down Syndrome experience changes in the heart function that leads to increased blood pressure in the lungs.”
First author on the study, Dr Aisling Smith, a Neonatology Specialist Registrar who carried out the research as part of her PhD at RCSI commented: “This study will help clinicians to better understand the mechanisms causing these problems and highlights the importance of monitoring heart function in babies with Down Syndrome over time.”
Approximately half of babies born with Down Syndrome also have congenital heart disease. In this study, 48 babies with Down Syndrome had congenital heart disease and 22 did not. The results from the babies with Down Syndrome were compared to 60 babies without Down Syndrome (controls). All babies enrolled in the study underwent a heart scan (echocardiogram) to assess heart function at six months, one year and two years of age.
The research was conducted by RCSI in collaboration with the Rotunda, Coombe and National Maternity Hospitals in Dublin; the Department of Paediatric Cardiology, Children’s Health at Crumlin Hospital, Dublin; Department of Paediatrics and Child Health, Trinity College Dublin, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA.
The study was funded by the Health Research Board Ireland and the National Children’s Research Centre.
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Researchers have identified what they believe to be robust metabolic markers of Covid, a discovery which could lead to better understanding and treatments for people that suffer from symptoms of the disease months after diagnosis.
Scientists from the University of Surrey collected blood samples of hospital patients and found that Covid-19 changed people’s metabolism. The team observed that the effects of Covid-19 changed over time, with the first wave disrupting metabolites differently from the second.
While researchers observed that many patients’ metabolites relaxed back to normal levels once they had recovered from Covid-19, a small number continued to be disrupted for several months after infection.
Dr Holly-May Lewis, lead author of the study from the University of Surrey, said:
“It is thought that around two million people suffer symptoms of Covid-19 a month after infection, and 800,000 people still experience symptoms a year later. So, it’s clear that this virus will be with us for some time and, therefore, the scientific community is duty-bound to better understand Covid-19 and why, for some, symptoms seem to linger longer than average.”
Surrey’s study analysed the blood samples of 164 hospital patients — 123 with Covid-19 and 41 who provided a negative PCR test — across the first two waves of infection. Nineteen positive patients also provided samples two to seven months after infection.
Using an artificial intelligence model, the Surrey team identified six metabolites that can be used to identify Covid-19 with 91% accuracy.
Professor Melanie Bailey, corresponding author of the study from the University of Surrey, commented:
“To our knowledge, this is the first time it has been demonstrated that Covid-19 is now affecting patients’ metabolism differently than it did in the initial wave — which we think is due to emerging variants. It is known that different Covid variants have various associated symptoms, so it makes sense that this would relate to changes in blood chemistry.
“With this in mind, we then deployed artificial intelligence to identify biomarkers characteristic of Covid-19, regardless of the Covid wave. This can help us better understand the limitations of the treatments being given and help to make better ones.”
The paper has been published in the journal Metabolites.
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