Publisher Health

When people feel sleepy or alert, that sensation is controlled in part by the ebb and flow of a 24-hour rhythm of their body temperature. Bioengineers at The University of Texas at Austin have developed a unique mattress and pillow system that uses heating and cooling to tell the body it is time to go to sleep.
Sleep is possible when the body temperature declines at night as part of the 24-hour rhythm. This new mattress stimulates the body to trigger the sleepy feeling, helping people fall asleep faster and improving the quality of sleep.
“We facilitate the readiness to fall asleep by manipulating internal body temperature-sensitive sensors to briefly adjust the thermostat of the body so it thinks the temperature is higher than it actually is,” said Shahab Haghayegh, a research fellow at Harvard Medical School’s Division of Sleep Medicine and Brigham and Women’s Hospital, who helped lead the development of the mattress at UT Austin while earning a Ph.D. in biomedical engineering. Haghayegh graduated in 2020.
The skin of the neck is an important bodily thermostat for humans, and it is the primary sensor the mattress targets, with a warming pillow. The mattress is designed to simultaneously cool the central areas of the body while heating up the neck, hands and feet, thereby increasing blood flow to dissipate body heat.
The researchers published a proof-of-concept study about the unique combination warming pillow plus cooling-warming, dual-zone mattress system in the Journal of Sleep Research, looking at two versions of the mattress: one that uses water and another that uses air to manipulate the core body temperature. They tested the mattresses with 11 subjects, asking them to go to bed two hours earlier than usual, some nights using the cooling-warming functions of the mattresses and other nights not.
The study found that the warming and the cooling-warming mattress helped them fall asleep faster — approximately 58% faster compared with nights when they did not use the cooling-warming function, even in the challenging setting of an earlier bedtime. Not only did lowering internal body temperature significantly shorten the amount of time required to fall asleep, it also resulted in significantly improved quality of sleep.
The project arose out of a larger goal in the lab of Kenneth Diller, a professor in the Cockrell School of Engineering and an expert in heat and temperature regulation for therapeutic devices, to find new ways to use thermal stimulation to help people sleep. The researchers published a study in 2019 that found taking a warm bath an hour or two before bed helped people fall asleep quickly and sleep better.
This project is similar but more targeted. Lowering the internal body temperature at the right circadian time sends the signal that it is time to go to sleep. Targeting the important bodily sensors in just a few areas that control heat dissipation, and thus body temperature level, made more sense than focusing on the entire body.
“It is remarkable how effective gentle warming along the cervical spine is in sending a signal to the body to increase blood flow to the hands and feet to lower the core temperature and precipitate sleep onset,” Diller said. “This same effect also enables the blood pressure to fall slightly overnight, with the benefit of allowing the cardiovascular system to recover from the stress of maintaining blood flow during daily activities, which is highly important for long-term health.”
The team has a patent for the cooling-warming mattress and pillow technology and is seeking partnerships with mattress companies to commercialize it.
Other members of the team are Sepideh Khoshnevis and Michael Smolensky of UT Austin, Ramón Hermida of the University of Vigo in Spain, Richard Castriotta of the University of Southern California and Eva Schernhammer of Harvard University.
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Materials provided by University of Texas at Austin. Note: Content may be edited for style and length.

Paramyxoviruses have the potential to trigger a devastating pandemic. This family of viruses includes measles, Nipah virus, mumps, Newcastle disease and canine distemper.
“The infectiousness of measles is unmatched by any known virus. If one person with measles coughs in a room with 100 unvaccinated people, around 90 would become infected,” says Michael Norris, Ph.D., a former postdoctoral associate at La Jolla Institute for Immunology (LJI) and current assistant professor at the University of Toronto. “Nipah virus is not as contagious, but it is incredibly lethal, with between 40 percent and 90 percent of infections causing death.”
“Just imagine if a paramyxovirus emerged that was as contagious as measles and as deadly as Nipah,” Norris adds.
It’s not hard to picture that scenario. In fact, the 2011 film Contagion was based on this exact kind of imagined paramyxovirus.
Now Norris and an international team of collaborators have published the first-ever look at a key stage in the life cycles of measles and Nipah viruses. Their new study, published as an upcoming cover story in Science Advances, reveals how future therapies might stop these viruses in their tracks.
“This work solves a long-standing mystery: how viruses assemble themselves,” says LJI Professor Erica Ollmann Saphire, Ph.D., who served as study co-senior author with Professor Robert Stahelin, Ph.D., of Purdue University. “We know that a virus’s many pieces come together at the cell membrane, but we didn’t know what the trigger was that starts that irreversible assembly process.”
“This study succeeds by identifying how paramyxoviruses are able to utilize a host cell lipid for viral spread,” says Stahelin. “This work will inform future drug discovery endeavors.”

Scientists at the Francis Crick Institute have found that using immunotherapy alongside a drug that blocks a common gene mutation in lung cancer could be a promising new combination therapy for certain types of lung tumours.
Their work, published today (20 July) in Science Advances, could help select patients for clinical trials to confirm whether this combination therapy is effective in people.
Around 1.8million people die from lung cancer each year, making it the leading cause of cancer death globally. While some people are effectively treated with immunotherapy, this does not work for most patients.
With only a quarter of people surviving more than five years after diagnosis, there is an urgent need to find new treatments or new combinations of existing drugs.
“In recent years, there has been a lot of attention on whether combining immune checkpoint blockade, a type of immunotherapy, with a KRAS-inhibitor could be effective. This inhibitor works by blocking a mutated version of KRAS, a gene that helps control cell growth and death. As the mutation is present in about one third of lung cancer cases, it is a promising therapeutic target,” explains Julian Downward, author and principal group leader and associate research director at the Crick.
In their study, the researchers studied the effects of combining immune checkpoint blockade with KRAS inhibitors, in mice. In tumours where there were already high numbers of active immune cells, so called ‘immune hot’ tumours, the treatment successfully controlled the cancer. However, in cases where the immune system was not able to mount a strong response, the combination treatment was ineffective.

An anti-inflammatory compound may have the potential to treat systemic inflammation and brain injury in patients with severe COVID-19 and significantly reduce their chances of death, according to a new study from UTHealth Houston and other institutions.
A team of researchers including UTHealth Houston faculty members Aaron M. Gusdon, MD, assistant professor in the Vivian L. Smith Department of Neurosurgery with McGovern Medical School at UTHealth Houston; H. Alex Choi, MD, associate professor in the department as well as the Department of Neurology; and Louise D. McCullough, MD, PhD, professor and Roy M. and Phyllis Gough Huffington Distinguished Chair in the Department of Neurology, conducted a multi-site, randomized, double-blind, placebo-controlled, adaptive Phase 2 trial evaluating the safety and efficacy of an anti-inflammatory compound, called OP-101, in patients with severe COVID-19. The results of the trial were published today in Science Translational Medicine.
In the trial, 24 patients classified as having severe COVID-19 across five clinical sites in the U.S. were randomized to receive a single intravenous dose of placebo or OP-101 at 2, 4, or 8 mg/kg. All patients received standard of care, including corticosteroids.
“OP-101 is a novel nanotherapeutic compound that specifically targets activated macrophages and microglia, the primary immune cell in the brain,”said Gusdon, who was first author on the study. “Due to its excellent safety profile, we were excited to offer this therapy to these critically ill patients at Memorial Hermann Hospital.”
Hyperinflammation triggered by SARS-CoV-2 is a major cause of disease severity in COVID-19. OP-101 was found to be better than a placebo at decreasing inflammatory markers, as well as better at reducing markers of neurological injury, including neurofilament light chain and glial fibrillary acidic protein.
Additionally, risk for the composite outcome of mechanical ventilation or death at 30 or 60 days after treatment was 71% for patients receiving the placebo, but just 18% for patients in the pooled OP-101 treatment arms. At 60 days after treatment, 3 of 7 patients given placebo and 14 of 17 patients treated with OP-101 survived.

In a new study, researchers at Cedars-Sinai found that antibiotics have sex-specific effects on the gut microbiome makeup of male and female laboratory rats. The findings, published in the journal Frontiers in Microbiology, could have implications for using the drugs in humans to treat or prevent bacterial infection.
“We found that giving the rats a multidrug antibiotic cocktail resulted in significant and sex-specific changes in both the stool, or large intestine, and the small bowel. For example, greater loss of the diversity of the microbes in both stool and small bowel was observed in the male rodents than in the females,” said Ruchi Mathur, MD, the study’s principal investigator.
“Changes in the diversity of the gut microbiome could have a negative impact. Previous studies of intestinal health have demonstrated that overall microbial diversity promotes vitality and resilience, often making for a healthier gut,” said Mathur, an endocrinologist.
In the controlled study, investigators from the Cedars-Sinai Medically Associated Science and Technology (MAST) Program compared the composition of the gut microbes of the male and female rats before, during and after treatment with broad-spectrum antibiotics, including vancomycin, ampicillin, metronidazole, and neomycin.
“We followed the rats for a period after the antibiotics were stopped and found that many of the sex-specific changes we observed during treatment remained. The constellation of microbes in the gut did not return to their original, pre-antibiotic compositions in either sex during the duration of the study,” said research associate Gonzalo Parodi, first author of the paper.
Some studies have identified sex-specific effects of antibiotics on the large bowel (stool) microbiome in mice. But Cedars-Sinai investigators emphasize that this is the first study to also examine changes in the small bowel microbiome induced by antibiotics and to also use male and female rats that had no significant differences in microbiome composition prior to treatment.
“It is difficult to tease out the impact of the drugs if the lab animals’ gut microbiomes are different to begin with. We used rats with similar gut profiles right out of the gate. This allowed us to pinpoint changes in the microbiomes of the male and female rats that could be attributed specifically to the impact of the antibiotics during and after exposure to the medicines,” said Mark Pimentel, MD, director of the MAST program and a co-author of the study.
More studies are needed using different combinations of antibiotics and exposure times. Investigators say if these findings hold true for humans, the research could have implications for the way antibiotics are prescribed.
“Sex is a biological variable, and like any variable, it needs to be taken into consideration in basic and medical research. Currently, we consider factors such as kidney function and weight when dosing medications for patients. Depending on the results of further research, specifically in humans, the sex of patients may one day be an important consideration when prescribing antibiotics,” said Mathur.
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SARS-CoV-2 infection is associated with an increased risk of preterm birth, but only for women infected in their final trimester, according to research published in the open access journal PLOS ONE. The study of over 5,000 pregnant women is one of the first to look at pregnancy outcomes for COVID-19 patients by trimester.
There is limited data on pregnancy and COVID-19 infection. To date, studies have been small, generally limited to patients who are hospitalized, and have often not reported outcomes depending on infection during different stages of pregnancy. Noga Fallach and colleagues from the Kahn-Sagol-Maccabi Research and Innovation Center used anonymized data captured by Maccabi Healthcare Services in Israel to match 2,753 women who were infected during pregnancy with 2,753 women without reported COVID-19 infections. Their study ran from February 21, 2020 until July 2, 2021. Of the infected women, 17.4% got COVID-19 during the first trimester, 34.2% during the second and 48.4% during the third trimester.
COVID-19 infection in the first and second trimesters was not associated with increased risk of preterm birth. However, women infected in their third trimester were 2.76 times more likely to experience preterm birth (2.76, 95% CI 1.63-4.67) — while women infected after 34 weeks of gestation were over seven times more likely to experience preterm birth (7.10, 95% CI 2.44-20.61). There was a lower rate of waters breaking before labor began in infected women (39.1%) vs non-infected women (58.3%), and proportions of caesarean sections and baby loss were similar in both groups.
Because of the increased risk of preterm birth in women infected during late pregnancy, the researchers suggest that during their third trimester, and particularly after 34 weeks of gestation, women should be advised to distance and wear masks to reduce risk of infection.
Dr. Tal Patalon, head of Kahn-Sagol-Maccabi (KSM), the research and innovation center of Maccabi Healthcare Services in Israel adds: “The results are encouraging and reassuring that COVID-19 infection during pregnancy is not associated with any type of pregnancy loss. However, it should be remembered that the research group tested the COVID pre-Delta variants, and does not refer to the dominant variant today, which is Omicron. We continue to conduct research to provide real-world data and knowledge to the public and decision-makers.”
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Materials provided by PLOS. Note: Content may be edited for style and length.

A new study by researchers at Yale, Stanford, and Dartmouth provides the first nationwide, small-area analysis of the variation in spending by the three main funders of health care in the United States: Medicare, Medicaid, and private insurers. The researchers’ goal: to see whether there are regions that have low health spending by each of the three payers simultaneously or whether distinct factors drive health spending variation among the payers.
The study, published July 20 in JAMA Network Open, analyzes spending data for more than 100 million individuals and shows that while health spending per payer varies significantly across regions, there are almost no regions that have simultaneously low spending by Medicare, Medicaid, and private insurers or that have universally high spending across all three payers. In fact, the researchers found that distinct factors appear to be driving regional variation in health spending across each payer segment of the U.S. health system.
The finding has significant public policy implications because it suggests that policymakers should focus on payer-specific interventions that target individual sources of waste rather than searching for silver-bullet interventions, according to the researchers.
“In the past, policymakers have identified particular regions as having efficient health systems based solely on care delivered through Medicare,” said study co-author Zack Cooper, an associate professor of health policy at the Yale School of Public Health and of economics in the Faculty of Arts and Sciences. “By analyzing data from all three dominant payers, we show that analysts cannot understand the overall performance of regions by studying only one payer or learn about a model for the country by studying one region.
“Our findings suggest that payer-specific factors drive health spending across and within regions, suggesting that policymakers should focus on payer-specific strategies to increase efficiency in the U.S. health care sector.”
Olivia Stiegman, a pre-doctoral fellow for Yale’s Department of Economics and Tobin Center for Economic Policy, and Chima D. Ndumele, an associate professor of public health at the Yale School of Public Health, are co-authors of the study. The other co-authors are Becky Staiger of the School of Medicine of Stanford University and Jonathan Skinner of Dartmouth College.

Racial discrimination increases the risk for physical and mental illnesses, and Black women suffer from diseases at significantly higher rates than White women. How traumatic experiences such as discrimination increase vulnerability to illness remains the topic of intense research. Now, a new study shows that the experience of racial discrimination affects the microstructure of the brain, as well as increasing the risk for health disorders.
The study, led by Negar Fani, PhD, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA, appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.
Dr. Fani said, “Here we see a pathway through which racist experiences may increase risk for health problems via effects on select stress-sensitive brain pathways. Earlier, we found that racial discrimination has a negative impact on brain white matter; now we can see that these changes may enhance risk for negative health outcomes, possibly by influencing regulatory behaviors.”
For the study, researchers recruited 79 Black women from a county hospital in Atlanta, Georgia. The women were clinically assessed for trauma and for medical disorders ranging from asthma to diabetes to chronic pain. Over half the women reported severe economic disadvantage, with a household income under $1,000 per month, for which the researchers controlled in their analysis.
The participants also underwent a brain scan using magnetic resonance imaging (MRI). The researchers measured the brain’s fractional anisotropy (FA), a reflection of water movement through brain white matter — specifically the long, fatty tracts that connect distant regions of the brain. Changes in FA can result from structural disruptions of white matter tracts.
Women who experienced more racial discrimination displayed lower FA in select brain tracts including the anterior cingulum bundle and the corpus callosum, which connects the two hemispheres of the brain. In addition, the structural integrity of these two specific tracts mediated the relationship between racial discrimination and medical disorders in these women.
“That points to a possible brain mechanism for adverse health outcomes,” Dr. Fani added.
Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the work, “These findings provide important new evidence that changes in the brain measured using MRI may occur, in association with a range of ongoing chronic health problems, in the wake of ongoing experiences of racial discrimination in African American women. Such insights may contribute to our understanding of the origins of health disparities in minoritized communities and the negative impact that racial discrimination may have on human health.”
The authors hypothesize that the burden of trauma and racial discrimination may affect brain matter integrity through the stress system. The affected tracts are involved in emotional regulation and cognitive processes, which may in turn lead to behavioral changes, such as increased consumption of drugs or foods, that increase risk for health conditions.
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Materials provided by Elsevier. Note: Content may be edited for style and length.

In a new study, Johns Hopkins Medicine researchers tested more than 100 topical cannabidiol (CBD) products available online and at retail stores, and found significant evidence of inaccurate and misleading labeling of CBD content. The study also revealed that some of these nonprescription products contained amounts of delta-9-tetrahydrocannabinol (THC), the main active ingredient in cannabis that can cause a “high,” including some products that claimed to be free of THC.
The study, published July 20 in JAMA Network Open, further found that some of the CBD products made therapeutic claims not approved by the U.S. Food and Drug Administration (FDA). To date, the FDA has only approved one prescription CBD product to treat seizures associated with rare epilepsy disorders, and two prescription THC products for nausea and vomiting associated with chemotherapy and for loss of appetite and weight loss associated with HIV/AIDS.
“Misleading labels can result in people using poorly regulated and expensive CBD products instead of FDA approved products that are established as safe and effective for a given health condition,” says study lead author Tory Spindle, Ph.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
According to the National Institutes of Health’s National Center for Complementary and Integrative Health, CBD and THC are the most commonly known compounds in the plant Cannabis sativa. A key difference between the two is that THC can produce a psychoactive “high” effect at high doses, whereas CBD doesn’t.
Under the Agriculture Improvement Act of 2018 (the Farm Bill), CBD products that contain less than 0.3% of THC are not considered federally illegal substances. This has made CBD products particularly popular and widely available to consumers virtually anywhere, but it also makes it difficult for the FDA to address unapproved claims and mislabeling. However, Spindle notes, “Recent research has shown that people who use CBD products containing even small amounts of THC could potentially test positive for cannabis using a conventional drug test.” This has not been determined for topical CBD products, but the authors are currently studying it.
For the study, the research team purchased 105 CBD topical products — including lotions, creams and patches — online and at brick-and-mortar retail locations in Baltimore, Maryland, in July and August 2020. Products were tested using a technology called gas chromatography-mass spectrometry to identify the actual amount of CBD and THC they contained.

Researchers at the Vancouver Prostate Centre have developed a new blood test that provides unprecedented insight into a patient’s cancer make-up, potentially allowing doctors to better select treatment options that will improve patient outcomes.
The technology was outlined in a study published today in Nature.
The first-of-its-kind blood test analyzes the DNA that metastatic cancers shed into the bloodstream, known as circulating tumour DNA or ctDNA. By sequencing the entire genome of this ctDNA, the test reveals characteristics that are unique to each patient’s cancer, giving physicians new tools to develop more personalized treatment plans.
“With only a few drops of blood, we can uncover critical information about a person’s overall disease and how best to manage their cancer,” says Dr. Alexander Wyatt, an assistant professor of urologic sciences at the University of British Columbia (UBC) and research scientist with the Vancouver Coastal Health Research Institute (VCHRI) and BC Cancer. “This test has the potential to help clinicians choose better tailored treatment options and to more efficiently detect treatment resistance, allowing clinicians to adjust clinical care as needed.”
For the study, the researchers examined ctDNA samples collected from patients with metastatic prostate cancer. Metastatic cancer — cancer that has spread to other organs in the body — is not often curable, and chemotherapy and newer targeted therapies may not work for all patients. Biopsies to help determine the best treatments for this type of cancer are rarely performed due to their invasive nature and the high risk of complications. This is often a major barrier in studying and treating this disease.
The researchers discovered that whole genome sequencing of ctDNA provides a host of information about the different metastases spread throughout the body. Using newly developed computer programs, the researchers were able to pinpoint the unique genetic make-up of various cancer populations in the body to gain a more comprehensive understanding of the disease.