Publisher Health

A new study reveals that 68 percent of COVID-19 deaths during the first year of the pandemic were adults in low socioeconomic positions (SEP) employed in labor, service and retail jobs that require on-site attendance and prolonged close contact with others.
University of South Florida epidemiologist Jason Salemi’s research confirmed associations between COVID-19 mortality rates and socioeconomic position, gender, ethnicity and race.
In collaboration with a team of epidemiologists from the COVKID Project, Salemi, an associate professor in USF’s College of Public Health, launched a national investigation into COVID-19 deaths in 2020 with data released by the U.S. National Center for Health Statistics.
The study, published in the International Journal of Environmental Research and Public Health, analyzed nearly 70,000 adults, ages 25 to 64, who died from COVID-19.
Salemi’s research shows: The mortality rate of low SEP adults is five times higher when compared to high SEP adults, and the mortality rate of intermediate SEP adults is two times higher. White women make up the largest population group considered high SEP. In contrast, nearly 60 percent of Hispanic men are in a low SEP. When compared, the mortality rate of low SEP Hispanic men is 27 times higher than high SEP white women.”The degree to which it takes a toll on communities is very unevenly distributed and we wanted to call attention to that issue,” Salemi said.

Dr. Marco Ajelli and other researchers in both China and the U.S. issue grim predictions if China abandons Zero-COVID policies.
Dr. Marco Ajelli of the Indiana University School of Public Health-Bloomington is one of several authors of “Modeling transmission of SARS-CoV-2 Omicron in China,” published recently in Nature Medicine. The paper states that if China rescinds Zero-COVID policies, the country’s healthcare system will almost certainly be overwhelmed.
The authors assert that the highly contagious omicron variant of COVID-19 would — in the absence of existing, strict protective measures — likely kill 1.5 million people in China within a very short period.
“Our study shows that a COVID outbreak of this size will overwhelm the Chinese healthcare system, particularly the intensive care units,” Ajelli says. “This does not account for other illnesses that also require beds. If there is a bed shortage due to a sharp increase in COVID cases, people with other infections will not have access to necessary care, further increasing the number of likely deaths.”
Ajelli notes that only about half the people in China over the age of 80 are vaccinated against COVID-19. He states that improving vaccination rates, especially in the elderly; access to antiviral therapies; masking; and other non-pharmaceutical interventions are critical to slowing the pandemic, regardless of whether China eliminates zero-COVID practices.
“As scientists, our job is to provide evidence and numbers,” he adds. “We do not make policy recommendations or dispense advice. We provide important data so that leaders in China can make the most informed decisions possible for their country and their people.”
“It is vitally important that Chinese leaders communicate and educate their citizens regarding the value of protection against COVID,” says Dr. Philip Eskew, professor emeritus in the IU School of Medicine. “In this paper, Dr. Ajelli and his colleagues provide a great deal of evidence to consider with respect to the wellness of the most vulnerable people in their country.”
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Patients newly diagnosed with cancer typically focus on one question, eclipsing all others: “What is my prognosis?”
Determining a cancer patient’s prognosis — the likely course and outcome of their disease — typically involves staging the lymph nodes, a process that examines factors such as the lymph node’s size, location and how far the cancer has extended beyond the node. Lymph node staging, however, currently is highly variable, depending on the cancer site, said Zachary S. Zumsteg, MD, assistant professor of Radiation Oncology at Cedars-Sinai Cancer. Because staging helps determine which treatments patients receive, getting it right should be consistent, accurate and universal, which is not always the case, he added.
A study co-led by Zumsteg, recently published in the Journal of the National Cancer Institute,has confirmed the effectiveness of a universal lymph node staging process that potentially may do just that.
“Count the number of metastatic lymph nodes,” Zumsteg said. “We found that this simple process is much better for determining prognoses for solid tumors than all the other factors used today. It should be the backbone of nodal staging because it is the best predictor of mortality, irrespective of the disease site.”
To test their hypothesis that metastatic nodal counting could be used to generate objective and reproducible nodal classification systems for all solid tumors, the researchers performed a retrospective analysis of nearly 1.3 million patients from the National Cancer Database who were diagnosed between 2004 and 2015. The researchers also used data from an additional 2 million patients from the Surveillance, Epidemiology, and End Results registry.
Their findings, validated across 16 of the most common solid cancers in the United States, confirmed that the number of cancerous lymph nodes is a dominant predictor of cancer death. Investigators also found that consistently, across disease sites, patient mortality risk increased continuously with the increasing number of metastatic lymph nodes.

A smartphone app that identifies severe jaundice in newborn babies by scanning their eyes could be a life-saver in areas that lack access to expensive screening devices, suggests a study co-authored by researchers at UCL (University College London) and the University of Ghana.
The app, called neoSCB, was developed by clinicians and engineers at UCL and was used to screen for jaundice in over 300 newborn babies in Ghana, following an initial pilot study on 37 newborns at University College London Hospital (UCLH) in 2020.
For the large-scale study, published in Paediatrics, the team tested over 300 babies with the app, which analyses images taken on a smartphone camera to quantify the yellowness of the white part of the eye (sclera) — a sign of neonatal jaundice. Analysing the yellowness of the eye just by looking is unreliable, and the neoSCB app can give early diagnosis of neonatal jaundice requiring treatment.
The study compared the effectiveness of the neoSCB app with conventional screening methods. Of the 336 babies tested by the app, 79 were severely jaundiced newborns, and the app correctly identified 74 of them. This is in line with the accuracy of the most common conventional screening method, a non-invasive device known as a transcutaneous bilirubinometer, which correctly identified 76.
The transcutaneous bilirubinometer works by measuring the yellow pigment under the newborn’s skin to give a measure of jaundice levels. All screening results are then followed up by blood tests to determine the type of treatment required.
Dr Terence Leung (UCL Medical Physics & Biomedical Engineering) who developed the technology behind the app, said: “The study shows that the neoSCB app is as good as commercial devices currently recommended to screen for severely jaundiced newborns, but the app only requires a smartphone which costs less than a tenth of the commercial device. We hope that, once rolled out widely, our technology can be used to save the lives of newborns in parts of the world that lack access to expensive screening devices.”
Study lead Dr Christabel Enweronu-Laryea (University of Ghana Medical School) said: “The neoSCB method was acceptable to mothers in urban and rural communities where the study was conducted. Mothers easily devised ways to keep the baby’s eye open, most often by initiating breastfeeding.”

On the way from the place of production to the consumer’s plate, about one third of all food worldwide spoils. One reason is unfavorable storage conditions along production and supply chains, including suboptimal storage at home. Researchers at Empa’s Biomimetical Membranes and Textiles laboratory in St. Gallen have been working for some time on digital solutions that could reduce this food waste. Now, together with researchers from the University of Bern and South Africa’s Stellenbosch University, the team has developed digital twins of citrus fruits and published the results in the journal Nature Food.
Plate instead of trash bin
The 17 Sustainable Development Goals of the United Nations’ 2030 Agenda include food security and sustainable agriculture. The Food and Agriculture Organization (FAO) also sees sustainable digital solutions and innovations as a means of achieving these goals. The team led by Chandrima Shrivastava and Thijs Defraeye is now relying on digital information for the virtual doppelgangers of citrus fruits, which they were able to determine by “upcycling,” i.e., upgrading data that was hardly used. “Every container in the world is now equipped with one or more temperature sensors,” explains Empa’s Defraeye. Until now, however, the diverse information hidden in these measurement data has not yet been exploited.
By mathematically evaluating the physical processes, the team was able to use the data sets to track crucial properties of the fruit over time, thereby revealing and even predicting quality losses and marketing problems. To do this, the researchers tracked the temperature development in 47 container loads of citrus fruits over the entire transport route and used computer simulations to determine the probability of corresponding damage, such as decay, moisture loss, cold damage, mold or desirable changes like mortality of fruit fly larvae, in the digital twins.
The result was a wide range of transport conditions and corresponding quality losses. “In our study, half of all shipments were outside the optimal conditions for transport,” Defraeye says. The consequences: decay, cold damage, spoiled goods. At the end of their 30-day journey, some of the remaining citrus fruits had a shelf life of only a few days.
Optimum conditions
The solution to the problem, however, is not simply to refrigerate the food. Rather, a precise adjustment of the transport conditions in the form of a compromise is necessary. If, for example, the lemon travels too cool, pests such as fruit flies or other quality impairments are kept at bay. On the other hand, the fruit is damaged by the cold, which may make it unsalable.
Using digital twins, the team has now been able to determine optimal conditions in which relevant risks such as fly infestation, visual defects and cold damage are weighed against each other. Further developments are still needed before the technology can be applied, but the goal is clear: Along their production and supply chains, companies should be able to integrate the virtual fruits into their processes in order to optimize storage conditions in reality and reduce food losses.
Fruit spies on the move
Empa researchers are also working on biophysical twins of fruits and vegetables to reduce food waste. Here, the properties of the crops are perfectly simulated by polymer models. In addition, the biophysical twins are equipped with sensors that measure the temperature and moisture content as they exist on the skin and in the flesh of the real food. In this way, the “spy” among the products reports precise data to optimize conditions during storage and transport — unlike conventional measuring methods.
Most recently, the researchers have expanded the range of existing sensor fruits, apple and mango, to include potatoes and avocados in various sizes, as well as improving materials and the manufacturing process.

Combination chemoimmunotherapy with the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib demonstrated improved progression-free survival over standard chemoimmunotherapy for previously untreated mantle cell lymphoma (MCL) in patients 65 and over, researchers from The University of Texas MD Anderson Cancer Center reported today at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting. The study results also were published today in the New England Journal of Medicine.
The randomized Phase III SHINE clinical trial was conducted at 183 sites in 28 countries since 2013. The double-blinded study evaluated treatment with bendamustine-rituximab and rituximab maintenance plus either ibrutinib or placebo. The primary endpoint was progression-free survival (PFS) assessed by the investigators.
The median PFS was 80.6 months with the ibrutinib combination versus 52.9 months in the control arm. The complete response rate was 65.5% in the ibrutinib arm and 57.6% in the placebo arm. Median overall survival had not been reached in either treatment arm at the time of data cutoff.
“The majority of mantle cell lymphoma patients who are diagnosed over age 65 are not able to receive intensive chemotherapy or stem cell transplantation due to the excessive toxicities from treatment,” said Michael Wang, M.D., professor of Lymphoma and Myeloma and lead investigator of the study. “These results provide evidence that an ibrutinib-based combination front-line treatment regimen provides a significant progression-free survival benefit and may be a new treatment opportunity for this patient population who previously had few options.”
MCL is a rare and incurable subtype of B-cell lymphoma, accounting for 7% of all non-Hodgkin lymphoma cases. Single agent ibrutinib has transformed the care of patients with relapsed or refractory MCL with durable activity, particularly when used at first relapse, but patients inevitably develop resistance, generally within one to two years. Ibrutinib received accelerated approval from the U.S. Food & Drug Administration to treat MCL patients who have previously received at least one line of therapy.
The SHINE study randomized 523 patients to the two treatment arms. Median age was 71 years, 65.6% of patients had low or intermediate prognostic risk factors on the mantle cell lymphoma international prognostic index (MIPI), and 8.6% had blastoid/pleiomorphic histology. Patients could not have received prior therapies for their disease. Trial participants were representative of the racial breakdown of patients with newly diagnosed MCL, where majority were white (77%).
Ibrutinib treatment was administered during induction and during rituximab maintenance for two years, continuing indefinitely until disease progression or intolerance. Fifty-two (19.9%) and 106 (40.5%) patients received subsequent anti-lymphoma therapy in the ibrutinib and placebo arms, respectively, while 41 of 106 (38.7%) received a second-line BTK inhibitor in the placebo arm.
Grade 3 or 4 treatment-related adverse events occurred in 81.5% of patients in the ibrutinib group and 77.3% in the placebo group. Atrial fibrillation was reported in 13.9% of patients in the ibrutinib arm and 6.5% of patients who received the placebo. The safety profile was consistent with the known profiles of the individual drug, and patients rated their health-related quality of life similarly across both treatment arms.
“This study shows that the ibrutinib combination significantly improved progression-free survival with manageable toxicities,” Wang said. “I am encouraged that moving ibrutinib to the front-line setting will improve outcomes in these patients and should change the standard of care for elderly patients with mantle cell lymphoma.”
The patients in this study continue to be followed to evaluate differences in overall survival between treatment arms. Future research may investigate chemotherapy-free or time-limited ibrutinib combinations.
The study was funded by Janssen Pharmaceuticals NV, part of the Janssen Pharmaceutical Companies of Johnson & Johnson and Pharmacyclics LLC, an AbbVie Company. Wang has worked in a consulting/advisory role for and received research support from Janssen and Pharmacyclics.
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A multi-center study of more than 3,000 people with high blood pressure and brain aneurysms found that the use of RAAS inhibitors, a class of blood pressure lowering medications, reduced the risk of an aneurysm rupture by 18%, according to new research published today in Hypertension, a peer-reviewed journal of the American Heart Association.
An aneurysm is a bulging or weakening in the wall of an artery. When this happens in an artery in the brain, it is called an intracranial aneurysm. If an intracranial aneurysm ruptures, it spills blood around the brain and cuts off oxygen to an affected area, which can cause a hemorrhagic stroke, coma and death. These strokes account for 3-5% of all strokes, but a larger proportion of morbidity and mortality than other types of strokes. Each year, approximately 30,000 adults in the United States have intracranial aneurysms that rupture, according to the National Institute of Neurological Disorders and Stroke. Additionally, stroke is a leading cause of disability in the United States.
The body’s renin-angiotensin-aldosterone system (RAAS) includes hormones that affect blood pressure regulation, and dysregulation of the RAAS can lead to the development of high blood pressure. Two components of RAAS have been shown to be involved in the development of intracranial aneurysms, and previous research has found that dysregulation of RAAS may also contribute to aneurysm rupture. RAAS inhibitors, medications that block the effects of the RAAS, are often used to treat high blood pressure.
“Approximately half of patients with intracranial aneurysms have high blood pressure, which can cause vascular inflammation and increase the risk of aneurysm rupture,” said the study’s senior author Qinghai Huang, M.D., Ph.D., professor of neurosurgery at Changhai Hospital, Second Military Medical University in Shanghai, China. “Given that one-third of patients with ruptured aneurysms die and another third remain dependent for daily life activities, there is a need to identify modifiable risk factors to prevent aneurysm rupture.”
This multi-center study analyzed data collected from 2016 to 2021 at 20 medical centers in different regions across China, collected pre- and post-rupture, to evaluate the association among the use of RAAS inhibitors and other blood pressure medications, including beta-blockers and diuretics, on the risk of aneurysm rupture.
More than 3,000 adults with high blood pressure and intracranial aneurysms were included. The study sample was one-third men and two-thirds women, with an average age of 61 years old. Participants’ hypertension status was categorized as controlled (normal blood pressure with the use of antihypertensive medications) or uncontrolled (high blood pressure, defined as 140/90 or above, with the use of antihypertensive medications), and was determined by blood pressure measurements taken at one point in time, three months before they were hospitalized for aneurysm.

A compound, developed by a team including scientists from The University of Texas Health Science Center at San Antonio, kills a range of hard-to-treat cancer types in petri dishes and animal models by targeting a previously unexploited vulnerability, a new study reports. The findings, published in Nature Cancer, could eventually lead to new drugs to fight these cancers, which currently have few effective treatments.
“We identified a critical vulnerability in multiple cancers and have validated our findings in multiple cancer cell types and animal models,” said study leader Ratna Vadlamudi, PhD, professor of obstetrics and gynecology at UT Health San Antonio and a member of the Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center. “The range of cell lines and xenografts in which the compound has been shown to work is compelling and indicates that it is targeting a fundamental vulnerability in cancer cells.” Xenografts are human tumors grown in mouse models for research purposes.
The Vadlamudi lab studies breast and ovarian cancer progression, including in therapy resistance, with a goal to developing small-molecule inhibitors for therapy-resistant cancers. In 2017, he and his colleagues identified a compound called ERX-11 that targets the estrogen receptor (ER), a protein that drives the vast majority of breast cancers. From a screen of chemical analogs of ERX-11, the researchers identified that a compound called ERX-41 not only killed ER-positive cancers in petri dishes, but also readily killed triple-negative breast cancers (TNBCs), including more than 20 distinct TNBC cell lines. TNBC is a cancer subtype lacking receptors for estrogen, progesterone and human epidermal growth factor 2, and for which there is a paucity of targeted treatments.
The researchers expanded these studies to show ERX-41 had activity against a large number of human tumors grown from several of these cell lines in mouse models. In addition, ERX-41 was potent against patient-derived xenografts, as well, causing shrinkage of these human tumors grown in mouse models without affecting normal breast cells or causing any discernible toxicity in these animals. “The safety profile and high therapeutic index of this compound is particularly notable and bodes well for clinical translation,” Dr. Vadlamudi said.
Other experiments showed that in addition to ER-positive breast cancers and TNBC, ERX-41 is also effective against other cancer types with elevated endoplasmic reticulum stress, including pancreatic, glioblastoma and ovarian cancers, which all have few effective treatments. The endoplasmic reticulum is a structure in many cell types that performs assorted functions, including manufacture of proteins.
This work was performed in collaboration with scientists at UT Dallas (led by Dr. JungMo Ahn) and UT Southwestern Medical Center at Dallas (led by Dr. Ganesh Raj). ERX-41 and the related portfolio have been licensed to Dallas-based EtiraRx, which plans to move these drugs into clinical trials in early 2023.
Other researchers from UT Health San Antonio who contributed to this study include Drs. Suryavathi Viswanadhapalli, Mengxing Li, Gangadhara R Sareddy, Uday P Pratap, Zexuan Liu, Hui Yan, Zhenming Xu, Susan E Weintraub and Rajeshwar Rao Tekmal.
This research was funded by grants from the National Institutes of Health (CA223828-01 and NIH-NCI P30 CA054174).
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Materials provided by University of Texas Health Science Center at San Antonio. Original written by Will Sansom. Note: Content may be edited for style and length.

Mechanisms associated with a particular diabetes drug can also help to protect against Alzheimer’s disease, a study by researchers at Karolinska Institutet in Sweden and published in Neurology reports. The results indicate that the drug’s target protein can be an interesting candidate for the treatment of Alzheimer’s disease.
Alzheimer’s disease is becoming increasingly common, but there are no drugs to affect the course of the disease and the development of new drugs is a slow, costly and complex process.
An alternative strategy is therefore to find already approved drugs that can prove efficacious against the disease and give them a new area of application. Diabetes drugs have been put forward as possible candidates, but so far the studies that have tested diabetes drugs for Alzheimer’s disease have not produced convincing results.
In the present study, researchers from Karolinska Institutet used genetic methods to study this more closely.
“Genetic variants within or nearby the genes that encode a drug’s target proteins can cause physiological changes similar to the effects of the drug,” says the study’s first author Bowen Tang, doctoral student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “We utilise such variants to test the repurposing potential of already approved drugs.”
The researchers began by identifying genetic variants that mimic the pharmacological effect of diabetes drugs, namely lowering blood glucose. This was done through an analysis of data from over 300,000 participants in the UK Biobank register.
The analysis identified variants in two genes that together code for the target protein of a class of diabetes drug called sulphonylureas. The researchers validated these variants by showing their association with, amongst other phenomena, higher insulin release, lower type 2 diabetes risk and higher BMI, which is consistent with the drug’s effects.
The researchers then examined the link between the identified genetic variants and the risk for Alzheimer’s disease. They did this by analysing data collected previously from over 24,000 people with Alzheimer’s disease and 55,000 controls. They found that the genetic variants in the sulphonylurea genes were linked to a lower risk of Alzheimer’s disease.
“Our results suggest that the target protein of sulphonylureas, the KATP channel, may be a therapeutic target for the treatment and prevention of Alzheimer’s disease,” says the study’s last author Sara Hägg, docent at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “This protein is expressed in the pancreas, but also in the brain, and further studies are needed to fully understand the underlying biology.”
The method of analysis applied in the study is called Mendelian randomisation which uses knowledge of genetic variants in individuals as a kind of natural randomisation, not unlike a randomised clinical study. Individuals born with certain protective variants that mimic the effect of a certain drug can therefore be studied for their association to a disease.
The study was financed by the Swedish Research Council, a KI-NIH doctoral grant, Karolinska Institutet Foundation, Karolinska Institutet’s grant for the Strategic Research Area in Epidemiology (SFOepi), King Gustaf V and Queen Victoria’s Foundation of Freemasons and the National Institutes of Health.
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Researchers from McGill University and the US National Cancer Institute (NCI) have made some surprising discoveries about our immune system. By using mathematical modelling to look at specific aspects of immune responses in mice and humans, their data-driven approach, described in a recent article in Science, reveals that immune responses may exist on a finer spectrum than had previously been believed. The results also suggest that in the battle between a body’s defenses and intruders, the messengers are key. These findings could advance cancer and other immunotherapy treatments.
Fever, cough, sore throat — symptoms in the spotlight in the era of COVID-19 — are just some of the tell-tale signs of our body’s immune system kicking into action against an unwanted intruder. Whether triggered by an infection, an allergen, or a vaccine, immune responses are driven by a complex array of cellular processes that can play out over several days or even weeks.
A lot is known about the overarching processes at play in immune responses. But because of the sheer numbers of variables involved, pinpointing what to focus on to develop treatments or vaccines proves very much like looking for a needle in a haystack. This may now change thanks to a new study by researchers from McGill University and the US National Cancer Institute (NCI), published recently in Science.
It focused on a fundamental process in the immune system: the role of proteins called cytokines in signalling and kickstarting a body’s responses.
The crucial role of the messengers
Our immune system is often characterized as a battle. Certain critical white blood cells (called T cells) travel through the bloodstream and lymphatic systems and into tissues, searching for traces of microorganisms and other invaders known as antigens. To avoid attacking healthy cells indiscriminately, T cells circulate until they recognize a specific antigen; only then do they send out messengers in the form of cytokines to activate an alert system and signal that all is not well.