Publisher Health

Parental smoking is a significant risk factor for developing smoking behavior and nicotine dependence in offspring. These findings suggest that parental nicotine exposure may promote addiction-like behaviors in subsequent generations. Given the significance of cigarette smoking for public health, preventing nicotine use among adolescents is critical to ending tobacco use disorder and decreasing e-cigarette use.
In a novel study, researchers from the University of Pennsylvania School of Nursing (Penn Nursing) have discovered that paternal nicotine taking is associated with addiction-like behaviors, cognitive deficits, and anxiety-like behaviors in male offspring. These heritable effects were associated with reduced expression of Satb2, a transcription factor, in the hippocampus of male offspring. Increasing Satb2 expression in the hippocampus rescued the memory deficits associated with paternal nicotine taking in male offspring.
“Understanding how voluntary nicotine-taking changes germ cells and/or seminal fluid and how these modifications translate into neuroadaptations and behavioral phenotypes in subsequent generations is necessary for understanding the heritability of parental drug taking,” says Heath D. Schmidt, PhD, Associate Professor and lead author of the article. “Findings from these studies highlight vulnerable populations at risk for developing nicotine dependence, cognitive impairments, and/or mental health disorders.”
The article “Paternal Nicotine-Taking Elicits Heritable Sex-Specific Phenotypes That Are Mediated by Hippocampal Satb2” details the study. It has been published in the journal Molecular Psychiatry and is available online. Co-authors of the article include John J. Maurer, Christopher A. Turner, Rae J. Herman, Yafang Zhang, Kael Ragnini, Julia Ferrante, and Blake A. Kimmey, all of Penn Nursing; Mathieu E. Wimmer of Temple University; Richard C. Crist, the University of Pennsylvania Perelman School of Medicine; and R. Christopher Pierce, of Rutgers University.
This work was supported by the following grants from the National Institute on Drug Abuse (NIDA): R01 DA037897, R21 DA039393 and R21 DA045792 (HDS), R01 DA033641 (RCP), T32 DA028874 (RJH and MEW), T32 GM008076 (JF), and K01 DA039308 (MEW). This study was also supported by a grant from the Pennsylvania Department of Health (HDS).
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A new study published today in Arthritis & Rheumatology led by researchers at Baylor College of Medicine reveals that walking for exercise can reduce new frequent knee pain among people age 50 and older diagnosed with knee osteoarthritis, the most common form of arthritis. Additionally, findings from the study indicate that walking for exercise may be an effective treatment to slow the damage that occurs within the joint.
“Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis,” said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor, chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper.
The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as “walkers” and those who reported less were classified as “non-walkers.”
Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.
“These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don’t have pain every day in their knees,” said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. “This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis.”
Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects.
“People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain,” advises Lo. “If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged.”
Others who participated in the research include Dr. Surabhi Vinod with Baylor; Dr. Timothy E. McAlindon, Dr. Jeffrey B. Driban and Michael J. Richard with Tufts Medical Center; Dr. Matthew S. Harkey with the Michigan State University; Dr. Andrea M. Kriska and Dr. Bonny Rockette-Wagner with University of Pittsburgh; Dr. Charles B. Eaton with Brown University Warren Alpert Medical School of Brown University and School of Public Health of Brown University; Dr. Marc C. Hochberg with University of Maryland School of Medicine; Dr. Rebecca Jackson with Ohio State University; Dr. C. Kent Kwoh with the University of Arizona in Tucson, School of Medicine; and Dr. Michael C. Nevitt with the University of California, San Francisco.
Lo was supported by K23 AR062127, an NIH/NIAMS funded mentored award; this work was supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center.
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A molecule in mosquito spit has been identified as a potential new target for vaccination against a range of diseases for which there is no protection or medicine.
University of Leeds Virus Host Interaction Team researchers have discovered that the molecule, called sialokinin, makes it easier for a number of viruses to pass from mosquitoes to human, where they can then take hold — leading to unpleasant and potentially deadly diseases.
These viruses include Yellow Fever, which causes serious illness in around 15% of people infected; dengue, which can develop into the potentially fatal disease dengue fever, and Zika, which caused a global medical emergency in 2016.
Previous research determined that sialokinin was able to alter the function of blood vessel cells grown in a lab, allowing increased blood flow and more effective feeding for the mosquito. But experts did not know what role it played in helping the virus to infect the body.
Inspecting the behaviour of sialokinin on skin cells from mice, the team discovered that the molecule causes blood vessels to become permeable, allowing contents to leak out into the skin — which inadvertently helps viruses to infect the host.
Research supervisor Dr Clive McKimmie, Associate Professor in the University of Leeds’ School of Medicine, said: “We have identified sialokinin as a key component within mosquito saliva that worsens infection in the mammalian host.

UNDER THE SKIN: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, by Linda VillarosaIn 1973, two Black girls, 14-year-old Minnie Lee Relf and her 12-year-old sister, Mary Alice, were forcibly taken from their home in Montgomery, Ala., and sterilized at a clinic funded by the federal government. Their parents — who had been displaced from rural Alabama into a cardboard shanty in the city and could not read or write — were tricked into agreeing to the procedure. Two years earlier, doctors had already begun to inject their oldest daughter, 15-year-old Katie, with the Depo-Provera contraceptive, then unapproved even for adult women, never mind teenagers.Jessie Bly, a Black social worker who had brought the Relf family to the state’s attention the year before, recalled the horror of discovering what the state’s own doctors had done to the girls. Interviewing Bly for her remarkable third book, “Under the Skin,” Linda Villarosa writes: “Even nearly half a century later, Bly has no trouble conjuring the image of the younger Relf girls in the hospital, huddled together, looking small and scared in cotton surgical gowns.” At the sight of Bly, they began to cry. Mary Alice, who was born with a developmental disability, could only say: “I just hurt so bad. I just hurt so bad, Miss Bly, help me. Help me, Miss Bly.”I am writing this review the week after the Supreme Court’s draft ruling to overturn Roe v. Wade was leaked. In the days since, some women and activists on social media have predicted that “‘The Handmaid’s Tale’ will become a reality,” conveniently forgetting that it already has been for generations of American women who are not white.How this country understands birth, personhood and privacy — why its laws even presume to dictate what happens during an individual pregnancy — is deeply rooted in slavery. A couple of hundred years ago, the reproductive health of enslaved Black people literally decided the state of this country’s economy: More Black women able to bear more Black children meant that the plantation economy could prosper. But of course, the system of slavery — and the doctrine of anti-Blackness that sprang up to philosophically justify it — was predicated on inhumane physical, sexual and emotional violence. This entanglement of incentives left a cruel legacy that continues in today’s shocking racial health disparities. Through case histories like the Relfs’ story and the better-known Tuskegee experiment, as well as her independent reporting across the country, Villarosa elegantly traces the effects of this legacy on Black health: reproductive, environmental, mental and more.Diana EjaitaVillarosa opens the book with a long personal history of her awakening to these structural inequalities. She was raised in an upwardly mobile Black family that moved from an all-Black neighborhood in Chicago to a white suburb in Colorado when she was a child. She often felt “like a fly in the buttermilk,” she writes, acutely aware of her imperative, as a representative of her race, to help other, poorer Black people. She began her career as a health journalist at the bible of Black women’s bougie ambitions, Essence magazine. The job required her to break down complex scientific and clinical reports into narratives for a general reader. That underrated skill serves Villarosa well in this book, where she repositions various narratives about race and medicine — the soaring Black maternal mortality rates; the rise of heart disease and hypertension; the oft-repeated dictum that Black people reject psychological therapy — as evidence not of Black inferiority, but of racism in the health care system.A disciple of the gospel of racial uplift, Villarosa implicates herself as one of many well-meaning professionals who assumed that the “problem” of Black health must simply be a matter of education and class. If only poor Black people paid better attention, she once assumed, they would be healthier. In 1994, Villarosa wrote “Body & Soul: The Black Women’s Guide to Physical Health and Emotional Well-Being,” pitched as an African American “Our Bodies, Ourselves.” Angela Y. Davis and June Jordan wrote the foreword to the book. They “had been involved in the civil rights and Black Power movements and understood that structural racism and health care discrimination contributed greatly to the health problems that ‘Body & Soul’ covered,” Villarosa writes. “But as a child of the generation that benefited from earlier struggles but was too young to be involved in the movements, I stayed in my sweet spots — information, education and self-help.”It is not until a 1991 encounter with Harold Freeman, the head of surgery at Harlem Hospital, that Villarosa begins to rethink this approach. Freeman had recently published a groundbreaking and explosive report in The New England Journal of Medicine that found that “Black men in Harlem lived fewer years than their counterparts in the impoverished country of Bangladesh.” Visiting Harvard during Villarosa’s fellowship there, Freeman admonished her: “If you really care about these issues and want to make a difference, you must not use race as a proxy for poverty or poverty as a proxy for race. … Look deeper, think differently.” Even as she took these words to heart, it would take decades for Villarosa to truly internalize them. This new approach finally came to a head in 2018, with Villarosa’s own groundbreaking reporting on the Black maternal health crisis, told through the experience of Simone Landrum, “a woman whose medical treatment led to the death of her baby and her own near death.” Published in The New York Times Magazine (where she has been a contributing writer since 2017), “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis” made an immediate public impact, inspiring a slew of conferences, initiatives, further articles and testimonies, and culminating in a 2020 executive order by the governor at the time, Andrew Cuomo, requiring all New York hospitals to allow “support people,” i.e. doulas, in delivery rooms. The story formed the seed of this singular and expansive book on the racism of American health care.But despite this wide influence, Villarosa felt the limits of this country’s understanding. I, along with almost every other Black woman of childbearing age I knew, read the piece and talked about it constantly. Trapped in the American narrative of individualism, I took the same ineffectual lessons from it that Villarosa had espoused at Essence: “to work within the medical system and squeeze everything you could” out of it, not to “challenge that system” but to “self-advocate for fair treatment.” I did all this during my own pregnancy, with Landrum’s story at the front of my mind. I took prenatal vitamins religiously; I followed doctor’s orders even when they suggested I should lose weight during my pregnancy; I hired a doula, and found a doctor who looked like me, and chose a hospital renowned for its low rate of cesarean sections. I still ended up in the hospital for a week before my daughter’s birth — a traumatizing time marked by painful medical interventions that I sometimes feel I am still coming to terms with. I had done everything, had “cared enough” in the face of everyone telling me Black mothers didn’t care. Instead of recognizing the external factors of my suffering, I internalized it into shame.“Under the Skin” offers an alternative understanding of this suffering, for which there is a long history. Black pain is not, and has never been, the fault of the individual, but a result of the structural racism embedded in the practice of medicine in this country. Many doctors avoid confronting this truth. Hearing Villarosa’s account of Landrum’s harrowing delivery, a group of white Midwestern doctors only questioned why Villarosa was allowed in the delivery room at all. “That was your takeaway?” she replied. “The denial of racial bias can be so extreme that no one believes you even when you have the evidence.”In this eminently admirable book, there are no easy answers or platitudes. Even as Villarosa meticulously outlines the myriad ways Black people have fought for their own health, from social workers to doulas to community organizers, she stays focused on the nature of a structural problem, which cannot be changed through individual choices. In 1992, Villarosa asked Audre Lorde if she agreed that racism in America was “dying out.” In response, Lorde “warned me that when something dies, it doesn’t just fade away; it fights to the death, desperately clinging to life, and goes out ugly.” If racial bias in medicine is receding, Villarosa concludes, it’s certainly “going out ugly.”UNDER THE SKIN: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, by Linda Villarosa | 269 pp. | Doubleday | $30Kaitlyn Greenidge is the features director at Harper’s Bazaar and the author, most recently, of the novel “Libertie.”

The spread of Covid-19 in passenger ships is exacerbated when a cabin door is left open to let in fresh air, according to new research led by Cranfield University.
High performance simulations were developed to show how infected particles from a person’s mouth were distributed onboard small passenger ships. The key finding was that keeping the cabin door shut led to a shorter area spread of particles.
The research aims to aid the post-pandemic recovery of the maritime industry — which saw a reduction of 43% in passenger vessel operations due to Covid-19. The results will advance on-board protection measures against future viruses — reducing the economic and social impact of pandemics on seafarers, passengers and the shipping industry.
Maritime industry hit hard by pandemic
Passenger transportation across the world has been significantly affected by the Covid-19 pandemic, with the time passengers spend confined together creating a risk to health and spreading the virus.
Although research of how the virus spreads in hospitals and other settings such as cars is extensive, equivalent studies into Covid-19 on ships have been limited.

Reducing the excess prevalence of low birthweight, preterm birth or small-for-gestational-age birth in low- and middle-income countries may lead to substantial long-term human capital gains when it comes to both long-term schooling and lifetime income gains, according to a new study published this week in the open-access journal PLOS Global Public Health by Mia Blakstad of Harvard TH Chan School of Public Health, U.S.A., and colleagues.
Globally, it is estimated that 14.6% of all live births are low birthweight, 10.6% are preterm and 27.0% are small-for-gestational-age. While the global contribution of adverse birth outcomes to child morbidity and mortality is well documented, the potential long-term schooling and economic consequences have been less well studied.
In the new study, the researchers used previously collected data on birth outcomes and population demographics from a number of open-access sources and previous studies. They modeled the potential impact of reducing adverse birth outcomes to theoretically possible minimums across 121 low- and middle-income countries.
The team calculated that, across the 121 countries, reducing low birthweight to the theoretical minimum of 3.2% could lead to an additional 20.3 million school years (95% CI: 6.0,34.8) and US$ 68.8 billion (95% CI: 20.3,117.9) in lifetime income gains per birth cohort. Reducing preterm birth to 5.5% could lead to estimated gains of 9.8 million school years (95% CI: 1.5,18.4) and US$ 41.9 billion (95% CI: 6.1,80.9) in lifetime income. And reducing small-for-gestational age births to 10% could contribute 39.5 million (95% CI: 19.1,60.3) school years and US$ 113.6 billion (95% CI: 55.5,174.2) in lifetime income gained. Gains varied between regions, with some of the largest gains in both educational attainment and lifetime earnings seen in South Asia and Sub-Saharan Africa.
The authors conclude that the impacts of interventions to improve birth outcomes have far-reaching effects beyond the more immediate benefits on child mortality, growth and development, and could provide substantial population-level human capital returns.
The authors add: “We found that global investment to reduce the number of babies born too soon or too small today may return billions of dollars in workforce earnings in the future.”
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As U.S. cities rethink the role of law enforcement in nonviolent 911 emergencies, new Stanford research uncovers the strongest evidence yet that dispatching mental health professionals instead of police officers in some instances can have significant benefits.
The study of a pilot 911 response program in Denver, in which mental health specialists responded to calls involving trespassing and other nonviolent events, finds a 34% drop in reported crimes during the six-month trial. The study by Stanford scholars Thomas Dee and Jaymes Pyne also shows that the direct costs of the alternative 911 approach were four times lower than police-only responses.
“We provide strong, credible evidence that providing mental health support in targeted, nonviolent emergencies can result in a huge reduction in less serious crimes without increasing violent crimes,” says Dee, the Barnett Family Professor at the Stanford Graduate School of Education and a senior fellow at the Stanford Institute for Economic Policy Research (SIEPR).
“In our politically divisive times,” Dee says, “this first-responder innovation provides a rare opportunity for consensus on meaningfully improving public safety and health.”
The analysis — published June 8 in Science Advances — comes at a pivotal time in broader national discussions around the performance of police officers who often serve as first responders. Public attention to the challenges of providing humane and effective policing has increased dramatically since George Floyd was killed in 2020 by a Minneapolis police officer after a 911 call over an alleged counterfeit bill, as well as in the wake of concerns over the police responses to school shootings in Parkland, Florida, and, most recently, Uvalde, Texas.
This public discourse has also included growing awareness of the possibly counterproductive — and sometimes tragic — consequences of having police as the first responders to nonviolent situations involving individuals in mental-health or substance-abuse crises. Today, a small but growing number of cities around the country are piloting programs that embed mental health care and other social services in their first-responder procedures.

New research offers evidence that getting a second or third dose of the COVID-19 vaccine in the final stages of pregnancy offers protection for infants against SARS-CoV-2 infection (the virus that causes COVID-19 illness).
Co-author, Dr. Deshayne Fell helped conduct the register-based cohort study of all live-born infants in Norway born between Sept. 1, 2021 and Feb. 28, 2022. The study published in JAMA Internal Medicine is one of only two studies published that quantifies a reduction in COVID-19 infection risk in babies during the first four months of life if their mother was vaccinated during pregnancy.
“Young infants are at higher risk of severe COVID-19 compared with older children, and there is no approved COVID-19 vaccine for this age group. Getting fully vaccinated against COVID-19 during pregnancy helps protect young infants from potential SARS-CoV-2 infection when they are born,” said Dr. Fell, Scientist at the CHEO Research Institute and Associate Professor in the University of Ottawa’s Faculty of Medicine.
Of 21,643 newborns included in the study, 9,739 (45%) were born to women who received a second or third dose of a COVID-19 mRNA vaccine during the last two trimesters of pregnancy. Infants of mothers vaccinated during pregnancy had a lower incidence of confirmed SARS-CoV-2 infection compared with infants of unvaccinated mothers. The effectiveness of vaccination during pregnancy against infant infection was greater during the Delta variant-dominated period (before Jan. 1, 2022) compared with the Omicron period (starting Jan. 1, 2022).
“It is not unexpected that maternal COVID-19 vaccination during pregnancy could reduce infant infection, as similar protective benefits against infant infection have been observed for pertussis and influenza vaccination during pregnancy in randomized clinical trials and observational studies,” said Dr. Fell, whose recent study published in JAMA found that receiving a COVID-19 vaccine during pregnancy does not lead to increases in the frequency of complications around the time of childbirth.
Pregnant women are recommended to receive COVID-19 vaccination to reduce their risk of severe COVID-19. This new study suggests that vaccination during pregnancy additionally provides protection to their newborns in the first few months after birth.
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Several years ago, a promising therapeutic using stem cell factor (SCF) emerged that could potentially treat a variety of ailments, such as ischemia, heart attack, stroke and radiation exposure. However, during clinical trials, numerous patients suffered severe allergic reactions and development of SCF-based therapeutics stopped.
A research team led by engineers at The University of Texas at Austin has developed a related therapeutic that they say avoids these major allergic reactions while maintaining its therapeutic activity. The keys to the discovery, published recently in Nature Communications, were the use of a similar, membrane-bound version of SCF delivered in engineered lipid nanocarriers.
“We envision this as something you can inject where you have lack of blood flow and it could induce blood vessels to grow in that area,” said Aaron Baker, a professor in the Cockrell School of Engineering’s Department of Biomedical Engineering, and one of the leaders on the project.
Stem cell factor is a cytokine, a type of soluble protein that can stimulate regeneration in the body and growth of stem cells. Its ability to help stem cells grow, especially in critical places like bone marrow, makes it very promising for many therapeutic applications. But when delivered to the body in clinical trials related to strokes, it caused mast cell growth, which activated the immune system’s defenses and led to the allergic reactions.
The new therapeutic uses transmembrane stem cell factor, a version of the cytokine that tethered to a cell membrane. In the body, the transmembrane form can be cleaved off into to the soluble form, which travels around the body.
“We found this transmembrane stem cell factor has all the necessary therapeutic properties and without activating the immune system and causing allergic reaction,” said Eri Takematsu, a former member of Baker’s lab who is now a postdoctoral researcher at Stanford and was the first author on the paper.
The big problem with the transmembrane SCF is that, because it’s not soluble, it tends to just clump together in solution. So, the team developed lipid nanocarriers to help it say in solution and to tailor its activity towards different cell type. They looked specifically at using a liposomes (lipid bubbles) and lipid nanodiscs as carriers for transmembrane SCF.
“This type of nanodisc is something people haven’t explored very much developing therapeutics before,” Baker said. “It makes a little island of lipid around the transmembrane SCand holds it together with a ring of proteins, kind of like a lariat.”
The researchers have patented their method, and the next step would be clinical trials. In order to do that, however, they need approval from the U.S. Food and Drug Administration to classify the therapeutic as an investigational new drug. In addition, they are continuing to fine-tune important details like correct dosage for patients.
Other team members on the project include Miles Massidda, Jeff Auster, Po-Chih Chen, ByungGee Im, Sanjana Srinath, Sophia Canga, Aditya Singh, Marjan Majid and Andrew Dunn from the Department of Biomedical Engineering; Michael Sherman from the Department of Biochemistry & Molecular Biology, University of Texas Medical Branch, Galveston; and Annette Graham and Patricia Martin of the Department of Biological and Biomedical Sciences at Glasgow Caledonian University in Scotland. The research was funded through grants from the American Heart Association, National Institutes of Health and the U.S. Department of Defense’s Congressionally Directed Medical Research Programs.
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A new study from the University of Michigan describes one of the first entirely new drug delivery microencapsulation approaches in decades.
Microencapsulation in biodegradable polymers allows drugs such as peptide therapeutics to be released over time in the body.
Peptides are molecules in the body that are composed of short chains of amino acids, and include messengers, growth factors and well-known hormones such as insulin. Because of their larger size and structure, peptide drugs are rarely given by mouth and must be injected. Microencapsulation is one way to decrease the time needed between injections.
One slow-release delivery method for peptide drugs is to encapsulate them within the type of resorbable polymers often used as dissolving sutures, said study co-author Steven Schwendeman, professor of pharmaceutical sciences and biomedical engineering.
However, development of polymer dosage forms for delivery of certain peptide drugs has been difficult because the currently available methods to microencapsulate the peptide molecules in the polymer require organic solvents and complex manufacturing.
“The Schwendeman group discovered about 10 years ago that peptides can bind and enter the polymer spontaneously from water to microencapsulate the peptide very simply without organic solvent,” Schwendeman said.
At that time, the group showed that the concept potentially worked, but it was not yet commercially useful, he said.
“This paper demonstrates that this concept can be performed to efficiently create equivalent or even improved injectable biodegradable polymer particles relative to existing commercial products, which slowly release several different peptides for more than one month, providing one of the first entirely new microencapsulation approaches in decades,” Schwendeman said.
Schwendeman and colleagues discovered that if they made the polymer first and equilibrated the peptide with the polymer microspheres in water under certain conditions, they could achieve a very similar result as the conventional organic-solvent based method of drug encapsulation.
In the current study, the researchers found that leuprolide encapsulated in this way released peptides for over 56 days in the lab and suppressed testosterone production in rats in an equivalent manner as the one-month Lupron Depot injection. Leuprolide injections are used to treat prostate cancer, endometriosis and other conditions.
This encapsulation method works with several other peptide drugs on the market and for others that have recently been approved or in development, Schwendeman said.
The group is now expanding the ability to encapsulate different types of peptides and other large molecular drugs, delivering the drugs over longer time periods, and developing a second technique to remotely load drugs into the polymer, which is focused on fragile proteins.
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