Publisher Health

Scientists today can access genomic data from Indigenous Peoples without their free, prior, and informed consent, leading to potential misuse and the reinforcement of stereotypes. Despite existing tools that facilitate the sharing of genomic information with researchers, none of those options give Indigenous governments control over how these data are used. In an article publishing in the journal Cell on July 21, authors propose a new blockchain model where researchers are only allowed to access the genomic data after the Indigenous entities have approved the research project.

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An artificial intelligence-driven device that works to detect and predict hemodynamic instability may provide a more accurate picture of patient deterioration than traditional vital sign measurements, a Michigan Medicine study suggests.
Researchers captured data from over 5,000 adult patients at University of Michigan Health with the Analytic for Hemodynamic Instability. Developed at the U-M Weil Institute for Critical Care Research and Innovation, AHI is a software as a medical device designed to detect and predict changes in hemodynamic status in real-time using data from a single electrocardiogram lead. The researchers compared the results against gold standard vital sign measurements of continuous heart rate and blood pressure measured by invasive arterial monitoring in several intensive care units to determine if the AHI could indicate hemodynamic instability in real-time.
They found that the AHI detected standard indications of hemodynamic instability, a combination of elevated heart rate and low blood pressure, with nearly 97% sensitivity and 79% specificity. The results are published in Critical Care Explorations (a Society of Critical Care Medicine journal).
The findings suggest that the AHI may be able to provide continuous dynamic monitoring capabilities in patients who traditionally have intermittent static vital sign measurements, says senior author Ben Bassin, M.D., director of the Joyce and Don Massey Family Foundation Emergency Critical Care Center, also known as EC3, and an associate professor of emergency medicine at U-M Medical School.
“AHI performs extremely well, and it functions in a way that we think may have transformative clinical utility,” Bassin said. “Most vital signs measurements are static, subject to human error, and require validation and interpretation. AHI is the opposite of that. It’s dynamic, produces a binary output of ‘stable’ or ‘unstable,’ and it may enable early martialing of resources to patients who may not have been on a clinician’s radar.”
Traditional vital signs have limitations, including limited accuracy in non-invasive monitoring and the fact that patients who are not at obvious risk for immediate deterioration may only be monitored periodically every 4-6 hours or longer. The AHI, which was approved by the United States Food and Drug Administration in 2021 and is licensed to Fifth Eye, Inc. (a U-M spinoff), was designed to address those limitations.
“The vision of AHI was born out of our continued inability to identify unstable patients and to predict when patients would become unstable, especially in settings where they cannot be intensively monitored, said co-author Kevin Ward, M.D., executive director of the Weil Institute and professor of emergency medicine and biomedical engineering at Michigan Medicine.
“AHI is ideally suited to be utilized with wearable monitors such as ECG patches, that could make any hospital bed, waiting room or other setting into a sophisticated monitoring environment. The implication of such a technology is that it has the potential to save lives not only in the hospital, but also at home, in the ambulance and on the battlefield.”
Researchers say future studies are needed to determine if AHI provides clinical and resource allocation benefits in patients undergoing infrequent blood pressure monitoring. The next phase of research will focus on how AHI is used at Michigan Medicine.
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Materials provided by Michigan Medicine – University of Michigan. Original written by Noah Fromson. Note: Content may be edited for style and length.

Published1 minute agoSharecloseShare pageCopy linkAbout sharingImage source, EPAUS President Joe Biden has tested positive for Covid-19 and is isolating at the White House.The 79-year-old, who is fully-vaccinated and has twice received booster jabs, is experiencing “very mild symptoms” and will continue to carry out all his duties, press secretary Karine Jean-Pierre said.The president is taking the antiviral medicine Paxlovid, her statement added.First Lady Jill Biden said he is “doing fine”, and she had tested negative.Consistent with White House protocol the president will continue to work in isolation until he tests negative, Ms Jean-Pierre said,He will take part in meetings via telephone and Zoom, the official said.White House Covid coordinator Dr Ashish Jha said the president was tired, with a runny nose and dry cough.He said Mr Biden went to bed feeling fine but did not sleep well and then tested positive on Thursday morning.Ms Jean-Pierre will hold a press briefing alongside Dr Jha later.The White House medical unit will inform all close contacts of the president during the day, Ms Jean-Pierre said, including any members of Congress or members of the press who were with Mr Biden during his visit to Massachusetts on Wednesday.First Lady Mrs Biden said she had spoken to her husband and he was “doing fine”.”He’s feeling good. I tested negative this morning. I’m going to keep my schedule. According to CDC guidelines, I’m keeping masked,” she said.Mr Biden, who is the oldest president in US history and turns 80 this year, last tested negative for Covid on Tuesday, the White House said.In a memo to Ms Jean-Pierre, Mr Biden’s physician Kevin O’Connor said he thought the president would respond favourably due to being fully vaccinated and twice boosted, adding that the early use of Paxlovid provided “additional protection against severe disease”.As the pandemic has unfolded, doctors have come to understand more about who is at greatest risk of getting seriously ill if they catch Covid and what care they might need. Age is a big factor – generally, the older you are the higher the risk – as well as how fit and healthy you were beforehand. Doctors will be conscious that being aged 79 puts Mr Biden at some additional risk, although he is fully vaccinated which means he already has some good protection against severe Covid.They will normally only prescribe Paxlovid to those who have a higher chance of becoming extremely ill. But he is the president after all, so you would expect him to get the Rolls Royce of medical care. Paxlovid is an antiviral medicine that helps stop the Covid virus from multiplying in the body. This keeps virus levels in the body low while the immune system gets on with the job of fighting the infection.It’s actually a course of two treatments or tablets. The patient usually takes the pills – one tablet of ritonavir and two of nirmatrelvir – twice daily, for five days.US Vice President Kamala Harris is in North Carolina for an abortion rights event and is expected to speak later.Should Mr Biden become unable to carry out his duties due to illness she would be given presidential powers.This happened briefly in November when Mr Biden was put under general anaesthetic during a regular health check.Mr Biden is not the first US president to suffer Covid after his predecessor Donald Trump had to be taken to hospital after contracting the virus in October 2020 while he was in office.More on this storyJoe Biden gets Covid-19 vaccine live on TV21 December 2020

Anticholinergics, a class of drugs frequently prescribed for depression, urinary incontinence and many other conditions common in older adults, affect the brain by blocking acetylcholine, a nervous system neurotransmitter which influences memory, alertness and planning skills.A new study from Regenstrief Institute, Purdue University College of Pharmacy and Indiana University School of Medicine researchers has found that using pharmacists as deprescribing care coordinators decreased prescription of anticholinergics by 73 percent and reduced cumulative use of these drugs by as much as 70 percent.
“Our new study is important, necessary preliminary work, enabling us to test whether deprescribing these drugs improves clinical outcomes,” said Regenstrief Institute and Purdue College of Pharmacy faculty member Noll Campbell, PharmD, M.S., who led the new study to develop pharmacist-centric delivery models to successfully switch patients to safer drugs. “Tackling deprescribing has not been easy. That pharmacist-centric deprescribing models work so well does not surprise me because pharmacists are well suited for the task. They are knowledgeable about medications, often have a close relationship with the patients and are well trained to communicate with providers.”
The researchers developed two pharmacist-focused deprescribing models. One, a face-to-face model involved pharmacists meeting with and monitoring older adult patients being seen in an aging brain care clinic. The second model, which involved pharmacist outreach via telephone to a generally older adult patient population encouraging safer medications, was less effective in diminishing exposure to anticholinergics but more effective than other methodologies, including clinician alerts in electronic health records (EHRs). Collectively, these models decreased prescription of anticholinergics by 73 percent and reduced cumulative use of these drugs by as much as 70 percent.
“Deprescribing anticholinergics in primary care older adults: Experience from two models and impact on a continuous measure of exposure” is published in the peer-reviewed Journal of the American College of Clinical Pharmacy (JACCP). Authors, in addition to Dr. Campbell are Christopher Callahan, M.D., and Malaz Boustani, M.D., MPH, Regenstrief Institute, IU School of Medicine and Eskenazi Health; Christopher Pitts, PharmD, and Parveen Chand, MHA, IU Health; Claire Corvari, PharmD, Franciscan Health;Ellen Kaehr, M.D.,IU School of Medicine; Khalid Alamer, PharmD, PhD candidate, Purdue University College of Pharmacy; Kristine Nanagas, M.D., IU Health and IU School of Medicine.
The study was supported by the National Institutes of Health’s National Institute on Aging [K23AG044440 and R01AG061452] and the Agency for Healthcare Research and Quality [P30HS2 4384].
Using the human-intensive deprescribing methodologies described in the JACCP paper, Regenstrief researchers are currently conducting R2D2 — an acronym for “Reducing Risk of Dementia through Deprescribing” to determine whether the adverse cognitive effects of anticholinergic medications are reversible. In this study, which is currently recruiting patients, clinical pharmacists are working with physicians and their patients who are using anticholinergics to identify and switch to safer alternative medications. The trial also monitors the effect of deprescribing these medications on depression, anxiety, pain, insomnia, and quality of life. Dr. Campbell leads this National Institutes of Health’s National Institute on Aging funded study.
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Materials provided by Regenstrief Institute. Note: Content may be edited for style and length.

The ancient North American city of Cahokia had as its focal point a feature now known as Monks Mound, a giant earthwork surrounded on its north, south, east and west by large rectangular open areas. These flat zones, called plazas by archaeologists since the early 1960s, were thought to serve as communal areas that served the many mounds and structures of the city.
New paleoenvironmental analyses of the north plaza suggest it was almost always underwater, calling into question earlier interpretations of the north plaza’s role in Cahokian society. The study is reported in the journal World Archaeology.
Cahokia was built in the vicinity of present-day St. Louis, beginning in about A.D. 1050. It grew, thrived for more than 300 years and was abandoned by 1400. Many mysteries surround the culture, layout and architecture of the city, in particular its relationship to water. Cahokia was built in a flood plain below the confluence of the Mississippi and Illinois rivers and would have been regularly infiltrated with flowing water, said Caitlin Rankin, a geoarchaeologist at the Illinois State Archaeological Survey who conducted the new research.
“Cahokia is the largest archaeological site in North America, but only about 1% of it has been excavated, so there’s so much about the site that we don’t know,” Rankin said.
Early in her encounters with the city’s layout, Rankin was baffled by the location and height of the north plaza.
“It’s a really strange area because it’s at a very low elevation, like the lowest elevation of the site,” she said. “And it’s in an old meander scar of the Mississippi River.”
Two creeks ran through the area, and it likely flooded whenever the Mississippi swelled after heavy rains.

Telling a child about their mother’s risk of hereditary breast and ovarian cancer does not adversely influence the offspring’s lifestyle or quality of life in the long term, according to a new study led by researchers at Georgetown Lombardi Comprehensive Cancer Center.
The finding appeared July 21, 2022, in Pediatrics.
The study looked at the mutation status of mothers’ BReast CAncer (BRCA) genes. Children inherit a copy of both BRCA1 and BRCA2 genes from each parent. Testing positive for a mutation in one of these genes (being BRCA+) can have cancer risk implications for biological relatives, including children.
The researchers enrolled mothers who had undergone BRCA genetic testing one to five years before the start of the study and whose children were between the ages of 12 and 24 years old. The mothers had obtained genetic counseling and testing at regional cancer centers in either Scarborough, Maine, Boston, Washington, D.C. or Houston. Of the children enrolled, most had mothers who tested negative for BRCA mutations, but 17% had mothers who were BRCA+. The majority of mothers were cancer survivors.
The researchers assessed offsprings’ lifestyle behaviors and found that detrimental health activities, such as tobacco and alcohol use as well as lack of physical activity, did not vary among the children, regardless of the mothers’ BRCA status. Similarly, maternal BRCA status was unrelated to children’s emotional distress about cancer.
“Our findings underscore the resilience of children of mothers who are BRCA+, especially those adolescents and young adults who have grown up around cancer in the family and learned how to cope,” says Kenneth P. Tercyak, PhD, a professor in the Departments of Oncology and Pediatrics and leader of the Cancer Prevention and Control research program at Georgetown Lombardi and the study’s senior author. “The study’s findings will help us learn how to build on young people’s cancer awareness and their interest in knowing more about their family’s health history.”
For teens and young adults who had mothers who survived cancer, they considered themselves to be at greater risk for, and were more knowledgeable about, cancer than youth of healthy mothers. Additionally, children of BRCA+ mothers were more concerned about cancer, held stronger beliefs about the role of genes in determining their health, and placed a higher value on learning about genetics.

Our immune system is essential for our survival, as our bodies are constantly being exposed to bacteria, viruses, parasites, and other pathogens. Without an immune system, we would quickly lose the war against these pathogens and succumb to these outside invaders. The immune system is made up of billions of individual white blood cells that circulate in our bloodstream and move around in our tissues, patrolling for signs of infection or tissue damage. The body’s defenses consist of numerous different types of white blood cells that include lymphocytes, monocytes, and granulocytes. Lymphocytes are in turn further subdivided into T cells, B cells, and NK cells.
Identification of each cell type is essential for understanding their specific roles and conducting research in the field of immunology. T and B lymphocytes are two major adaptive immune cells in our body’s defense systems. However, the similar size and shape of the cells make it challenging to distinguish them. Currently, distinguishing different cell types is done by staining cells using fluorescent antibodies that bind to different clusters of differentiation (CD) receptors on the cell surface.
Now, a team led by Professor CHANG Young-Tae at the Center for Self-assembly and Complexity within the Institute for Basic Science in Pohang, South Korea, successfully developed a small molecule probe CDyB (which stands for Compound of Designation yellow for B cell) that can accomplish live B cells distinction over T cells. CDyB was discovered using an unbiased fluorescence library screening called Diversity Oriented Fluorescence Library, or DOFL. By using this process, the researchers were able to screen for thousands of different molecules for their specificity to one type of immune cell over another. When applied to a mixture of T and B cells, this new probe was found to have high selectivity toward B cells.
CDyB is a new type of probe that does not require CD-specific antibodies to distinguish different cell types. Rather, it was found to be capable of entering the cell itself and staining the endoplasmic reticulum (ER) and Golgi apparatus, which are prominent organelles within the cells that are responsible for transporting materials within the cells. This is thought to be possible thanks to the molecule’s ability to easily pass through cell membranes.
After realizing that CDyB is localized within the ER / Golgi organelles, the researchers speculated that the mechanism of the B cell selectivity is based on gating. In other words, some transporter molecules must be responsible for the uptake and accumulation of the CDyB inside the organelles in some cells, but not the others. Hence they coined the new term, gating-oriented live-cell distinction (GOLD) to describe this newly discovered mechanism of distinguishing different types of cells.
Next, the researchers sought to find out why CDyB only stains the organelles of the B cells, but not T cells. The researchers further explored the mechanism of the new probe by using an SLC-CRISPR-based library, which is a platform that offers a high chance of systematic gating target elucidation. By employing SLC-CRISPRa and SLC-CRISPRi, the researchers discovered that SLC35C2 was the transporter specific for CDyB, which allows the molecule to be transported inside the organelles. The target transporter was further validated by the gene expression analysis. The researchers performed further knockout experiments and showed that deleting the transporter removed the ability of the molecule to be internalized by the ER / Golgi of the target cells, proving the role of SlC35C2 for the B cell selectivity.
Interestingly, the researchers observed that CDyB signal was stronger in mature B cells than in immature B cells. This is most likely due to the expression of SLC35C increasing according to the maturity of the B cells. The progenitor cells such as hematopoietic stem cells (HSC) and common lymphoid progenitor (CLP) express a low level of SLC35C2 and are thus minimally stained by CDyB. When they differentiate into T and NK cells, the expression of SLC35C2 remains low, hence yielding weak CDyB fluorescence. If the cells differentiate into B cell lineages, the SLC35C2 expression increases during the maturation path. The partially differentiated B-cell progenitors (Pre-Pro B, Pro B, Pre B) exhibit moderate CDyB fluorescence, and the fully matured B cells display the highest level of CDyB fluorescence.
Notably, Professor Chang’s team previously unlocked another B-cell-selective probe called CDgB (Compound of Designation green for B Cells) last year. Unlike CDyB, it distinguishes B cells over T cells using the Lipid-Oriented Live-cell Distinction (LOLD) mechanism. LOLD utilizes the small difference in membrane components, such as carbon chain length and cholesterol contents, and flexibility for cell discrimination. While CDyB showed stronger fluorescence in mature B cells, CDgB showed the brightest staining in immature B cells due to their softer membrane structure. It is hoped that utilizing both of these molecules with mechanisms together can be an effective way to distinguish different cell types in blood cells.
This study enriches the molecular probe toolbox and molecular understanding for live B cell distinction and opens the possibility of multi-dimensional cell analysis based on the orthogonal mechanism with new insight. This work was published in the Angewandte Chemie International Edition on 5th July.
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Materials provided by Institute for Basic Science. Note: Content may be edited for style and length.

Patients infected with SARS-CoV-2 develop protective immune responses, mediated by virus-specific T cells and antibodies, shortly after the infection. There is concern, however, that immunity does not persist over time, which may translate into severe COVID-19 upon re-infection.
In the July, 12 issue of Proceedings of the National Academy of Sciences (PNAS), Anna Martner and co-authors at University of Gothenburg report two main findings. First, several variants of virus-specific T cells became detectable in blood shortly after COVID-19, but strikingly disappeared after 10-12 weeks.
However, a group of highly specialized T cells, designed to facilitate elimination of infected cells, remained active in the blood of all previously SARS-CoV-2-infected patients. These T cells did not disappear or wane even at long follow-up.
The findings may explain the reduced risk of severe disease and mortality among patients who have become re-infected with SARS-CoV-2.
Scientists at the University of Gothenburg and Sahlgrenska University Hospital collected 81 blood samples from hospital staff members who had contracted mild COVID-19 in the first year of the pandemic and uninfected controls. The researchers studied T cell reactivity to an inner part of SARS-CoV-2 (the virus nucleocapsid) thus capturing T cell responses that only occur after a natural infection.
The blood samples were exposed to more than 100 peptides from the nucleocapsid portion of SARS-CoV-2 virus. The researchers then analyzed which T cell mediators (cytokines) were produced by blood cells to determine the longevity of T cell reactivity after the infection.
It was observed that a subgroup of specialized T cells (Th1 cells) that promote destruction of virus-infected cells were active for at least 20 months after natural COVID-19. The infected patients also harbored several other types of T cells that reacted with SARS-CoV-2. These latter T cells disappeared from blood approximately 2 months after recovery from infection.
“While certain subsets of T cells disappear shortly after infection, highly specialized T cells (T helper 1 cells) remain stably present in blood to suggest that a vital aspect of protective immunity is functional years after COVID-19,” says Anna Martner, Associate Professor of immunology at the Sahlgrenska Academy. These results may explain why re-infection with SARS-CoV-2 only rarely translates into severe COVID-19.
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Materials provided by University of Gothenburg. Note: Content may be edited for style and length.

A novel long-term study of how vaccine-related fears influence flu shot outcomes has found that these fears not only reduce vaccination, but also fuel symptoms of dizziness and lightheadedness at the time of the injection.
These fears can have such a hold on some people that they may get a flu shot one year, but skip it when the next season comes around, the survey results showed.
The pandemic enabled an evaluation of COVID-19 vaccine intention and uptake as well. Responses suggested that the combination of vaccine-related fears and feeling dizzy and lightheaded while getting a flu shot led some people to say they weren’t likely to get the COVID vaccine — and then not get it.
While researchers already knew these fears and symptoms exist, this study showing their impact on outcomes points to the need for interventions that address fear and potential dizziness at the time of vaccination — which hasn’t been studied very much, said study author Jennifer Kowalsky, assistant professor of psychology at The Ohio State University Newark campus.
“Interventions could be developed that help people face fears — people who want to get vaccinated but have fears holding them back,” Kowalsky said. “Beyond targeting fears, we could also improve the experience when the person is getting vaccinated to reduce the risk and severity of symptoms.”
The study was published recently in the journal Applied Psychology: Health and Well-Being.

The agency recommended that consumers avoid using the disinfection products because of high levels of radiation that could damage skin or eyes.The U.S. Food and Drug Administration is warning consumers against purchasing eight ultraviolet wands used for disinfection because of high levels of radiation that could cause injuries, the agency said on Wednesday.Some of the UV wands are said to have as much as 3,000 times the recommended amount of exposure to ultraviolet-C radiation, the F.D.A. said. The eight products are:Safe T Lite from Max-lux CorporationOttLite Rechargeable UVC Disinfecting wand, model UV10002M, from OttLite TechnologiesUVILIZER FLIP, model SG-153 from In My Bathroom LLC.Portable UV Light Wand Sterilizer, also from In My BathroomUltraviolet Sterilamp PURPLEGLOW from VanelcSharper Image UV Sanitizing Portable Wand, model 101362 from MerchSource LLCSurfaceSoap UV from PhoneSoap LLCMagic UV Light Sanitizer from Magic UV Light SanitizerUsing the products or coming near them might cause erythema, a burn-like skin reaction, or photokeratitis, an eye injury that can cause severe pain, after just a few seconds of exposure, the F.D.A. said. The products also lacked the proper safety information, the agency noted.“When a product is advertised to disinfect in seconds, it likely means that it gives off an unsafe level of UV-C radiation,” the agency wrote. “The F.D.A. recommends that consumers do not use these products and consider using safer alternative methods.”The F.D.A. sent letters to the product’s manufacturers warning them about the defect, the agency said, and it planned to work with the companies to “ensure adequate corrective actions.”Rochelle Torke, a spokeswoman for PhoneSoap, said the UV wand in question has undergone rigorous safety testing and also has a hand guard and “other features” that help prevent unsafe exposure to UV-C light.“Phonesoap takes these concerns very seriously and is actively engaged with F.D.A. to explore resolutions,” Ms. Torke wrote in a statement. “After 10 years of leadership in UV light technology, we’ve consistently put safety first with every product we’ve designed. Our UV sanitizing wand is no exception.”The other companies did not immediately respond to requests for comment.Ultraviolet tools have been used for decades to help curb the spread of bacteria, the F.D.A. said. But amid the coronavirus pandemic, interest grew in the products as people searched for solutions to kill the virus. The ultraviolent disinfection industry is projected to grow to $8.3 billion by 2027, according to a report by Reportlinker.com earlier this year.Research shows that UV radiation can kill Covid-19 bacteria but the F.D.A. says more information is needed about how effective it is and how long and how strong the dose should be.Overexposure to UV radiation can lead to serious health issues, including skin cancer, the Centers for Disease Control and Prevention said. Skin cancer is the most common type in the United States, with more than 88,000 new cases reported in 2019, the latest year for which data is available.