Publisher Health

Follow-up care after an asthma-related visit to the emergency department (ED) may help prevent future ED visits for children, a new study led by UC San Francisco researchers found.
Past studies on the relationship between asthma-related ED visits and follow-up found either no protective effect, or that follow-up was paradoxically associated with increased ED use, possibly because sicker patients in the ED were more likely to get follow-up but were also more likely to have severe asthma and subsequent visits, the researchers said.
If follow-up were in place for all visits, around 72,000 subsequent ED revisits could be prevented and millions of dollars could be saved, the researchers said.
In the current study, patients 3 to 21 years old who received follow-up care within two weeks of an asthma-related ED visit were 12% less likely to return to the ED for asthma within 60 days, and 13% less likely to revisit for asthma in the next year.
The paper was published online by Academic Pediatrics.
Only 23% of patients in the current study received follow-up care, although clinical practice guidelines recommend all patients be referred for follow-up within a month after an ED visit for asthma. The patients who received it were younger and more likely to have commercial insurance, complex chronic conditions and known asthma from prior ED visits.

In the course of Alzheimer’s disease, two proteins called “amyloid” and “tau” accumulate in the brain. A DZNE study with more than 200 participants now provides insights into the interaction of these pathological phenomena. The data suggest that tau load in the brain impairs memory functions only when amyloid burden is also high. These findings therefore support therapeutic approaches aimed at removing amyloid from the brain in the early stages of Alzheimer’s disease. A research team led by Prof. Emrah Düzel reports on this in the journal Brain.
“It has long been known that deposits of tau proteins in the so-called hippocampus and in neighboring brain areas impair memory. In the case of amyloid, on the other hand, no clear relationship to memory performance has been found to date. For this reason, among others, it is debated whether it makes sense at all to target amyloid therapeutically. Our current results suggest that this could indeed be helpful for memory function in the early stages of the disease,” says brain researcher Emrah Düzel, speaker of the DZNE’s Magdeburg site and director of the Institute of Cognitive Neurology and Dementia Research of Otto-von-Guericke University Magdeburg. “The crucial aspect is that you don’t look at tau in isolation, but together with amyloid pathology. This is where a link becomes apparent when you study a larger number of individuals and accordingly have solid statistics.”
Data Acquisition at Several Sites
The data now evaluated come from a DZNE long-term study (DELCODE) in collaboration with university hospitals in which ten study centers across Germany are participating. The current investigations included data from 235 subjects over 60 years of age. This group included not only cognitively normal adults, but also individuals with memory problems that were either mild (“mild cognitive impairment”) or only subjectively perceived — i.e. common testing methods could not detect memory impairment. Data from individuals with dementia were not considered, because the focus was on early stages of Alzheimer’s disease. Düzel’s team analyzed the cerebrospinal fluid (CSF) of the study subjects and examined their memory and brain activity using functional magnetic resonance imaging (fMRI).
Levels of amyloid and tau proteins in CSF are commonly used indicators for assessing the burden of these proteins on the brain. Since amyloid and tau proteins also occur in the CSF of cognitively healthy individuals, the study participants were grouped according to established thresholds into those with pathological, i. e. abnormal readings, and those with levels in the normal range. To assess memory by fMRI, study participants were given the task of memorizing photographic images while brain activity in the hippocampus — the switchboard for memory — was simultaneously registered. “Using this task fMRI, we found that hippocampal activation to new images decreased with increasing tau load, and so did memory performance, only when amyloid load was high. In other words, high load by both proteins was the likely cause of memory impairment,” Düzel says. “This relationship has not been demonstrated in previous studies. The necessary technical harmonization across all study sites is very complex. Such studies require the kind of infrastructure that DZNE has established over the years.”
Backing for Anti-Amyloid Therapies
“Our data show several relevant associations. If amyloid levels are beyond the pathological threshold, and only then, we see that the higher the tau levels in the CSF, the worse the memory performance and the more pronounced the reduction in hippocampal activation,” Düzel continues. “And we also see that if you compare study participants with similar tau data, memory performance is more impaired in those with abnormal amyloid levels than in those with amyloid levels in the normal range.” The causes of the interaction of amyloid and tau pathology are still largely unclear, Düzel acknowledges, but concludes: “Our data show that it might be useful to reduce tau load if amyloid burden is also high. However, our findings also suggest that it might help to reduce or keep amyloid burden low in the early stages of the disease, even if tau load remains the same. One can infer from our results that memory could benefit from this.”
This is where anti-amyloid therapies using “monoclonal antibodies” come in that are currently undergoing clinical trials and of which the drug “Aducanumab” (brand name: Aduhelm) is the first to have been approved in the USA. However, the approval is controversial. Düzel: “Regardless of how well this particular drug is clinically effective, our study results provide additional support for the general concept of targeting amyloid. This approach should continue to be considered in therapy development.”
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A new study has found that women’s health research remains disproportionately focused on the reproductive years — particularly on pregnancy — with few articles on the major causes of illness and death in women.
Despite growing awareness of differences in how women experience medical conditions and the impact this can have on diagnosis and treatment, this research gap has widened over the last ten years, researchers found.
Lead author Laura Hallam from The George Institute for Global Health said that the focus on so-called ‘bikini medicine’ stemmed from the mistaken belief that women’s health only differs from men’s in the parts of the body that a bikini would cover.
“Historically, women’s health research has focused on reproductive health. However, noncommunicable diseases are now the leading cause of death and disability for women in most countries, particularly low- and middle-income countries,” she said.
“Sex and gender bias in research and health care can lead to poorer health outcomes for women, particularly in conditions not recognised as women’s health issues.”
George Institute researchers analysed the main health content of articles published in six women’s health journals and five leading general medical journals in 2010 and 2020, categorising the main medical area topics and the life stage under study. They then compared these findings with the leading causes of disease in women according to the well-established Global Burden of Disease study.

Mycobacteria are a group of pathogenic bacteria that cause diseases like leprosy and tuberculosis in humans. Now, a new study by scientists at Hiroshima University finds that mycobacteria are associated with red blood cells at lung infection sites, an interaction that has escaped scientific notice for 140 years since the discovery of the organism causing tuberculosis.
The new research, published on March 16 in Microbiology Spectrum, illuminated the interaction of mycobacteria with red blood cells and its role in lung disease.
Discovery of mycobacteria
In 1882, German doctor Robert Koch isolated the disease agent that causes tuberculosis (TB) — a bacteria later named Mycobacterium tuberculosis. His work validated French doctor Jean-Antoine Villemin’s earlier evidence that tuberculosis was transmissible. While the use of streptomycin to treat TB would wait another 65 years, Koch’s discovery of the bacterial culprit paved the way for its treatment.
M. tuberculosis and other mycobacteria implicated in lung disease are now known to live in macrophages — white blood cells that engulf and kill pathogens. Mycobacteria turn up in blood and sputum coughed up by sick patients. Says lead study author and associate professor Yukiko Nishiuchi, “Pathogenic mycobacteria, such as Mycobacterium tuberculosis, Mycobacterium avium subsp. hominissuis (MAH), and Mycobacterium intracellulare, cause pulmonary infections as intracellular parasites of macrophages.” The mycobacteria grow inside macrophages.
Red blood cells, although also found in the sputum of tuberculosis patients, have not been specifically studied in disease progression.

The global bio-health research community is making a tremendous effort to generate knowledge relating to COVID-19 and SARS-CoV-2. In practice, this effort means a huge, very rapid production of scientific publications, which makes it difficult to consult and analyse all the information. That is why experts and decision-making bodies need to be provided with information systems to enable them to acquire the knowledge they need.
This is precisely what has been explored in the VIGICOVID researchers project run by the UPV/EHU’s HiTZ Centre, the UNED’s NLP & IR group, and Elhuyar’s Artificial Intelligence and Language Technologies Unit, thanks to Fondo Supera COVID-19 funding awarded by the CRUE. In the study, under the coordination of the UNED research group they have created a prototype to extract information through questions and answers in natural language from an updated set of scientific articles on COVID-19 and SARS-CoV-2 published by the global research community.
“The information search paradigm is changing thanks to artificial intelligence,” said Eneko Agirre, head of the UPV/EHU’s HiTZ Centre. “Until now, when searching for information on the internet, a question is entered, and the answer has to be sought in the documents displayed by the system. However, in line with the new paradigm, systems that provide the answer directly without any need to read the whole document are becoming more and more widespread.”
In this system, “the user does not request information using keywords, but asks a question directly,” explained Elhuyar researcher Xabier Saralegi. The system searches for answers to this question in two steps: “Firstly, it retrieves documents that may contain the answer to the question asked by using a technology that combines keywords with direct questions. That is why we have explored neural architectures,” added Dr Saralegi. Deep neural architectures fed with examples were used: “That means that search models and question answering models are trained by means of deep machine learning.”
Once the set of documents has been extracted, they are reprocessed through a question and answer system in order to obtain specific answers: “We have built the engine that answers the questions; when the engine is given a question and a document, it is able to detect whether or not the answer is in the document, and if it is, it tells us exactly where it is,” explained Dr Agirre.
A readily marketable prototype
The researchers are satisfied with the results of their research: “From the techniques and evaluations we analysed in our experiments, we took those that give the prototype the best results,” said the Elhuyar researcher. A solid technological base has been established, and several scientific papers on the subject have been published. “We have come up with another way of running searches for whenever information is urgently needed, and this facilitates the information use process. On the research level, we have shown that the proposed technology works, and that the system provides good results,” Agirre pointed out.
“Our result is a prototype of a basic research project. It is not a commercial product,” stressed Saralegi. But such prototypes can be modelled easily within a short time, which means they can be marketed and made available to society. These researchers stress that artificial intelligence enables increasingly powerful tools to be made available for working with large document bases. “We are making very rapid progress in this area. And what is more, everything that is investigated can readily reach the market,” concluded the UPV/EHU researcher.
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Eating two or more servings of avocado weekly was associated with a lower risk of cardiovascular disease, and substituting avocado for certain fat-containing foods like butter, cheese or processed meats was associated with a lower risk of cardiovascular disease events, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Avocados contain dietary fiber, unsaturated fats especially monounsaturated fat (healthy fats) and other favorable components that have been associated with good cardiovascular health. Clinical trials have previously found avocados have a positive impact on cardiovascular risk factors including high cholesterol.
Researchers believe this is the first, large, prospective study to support the positive association between higher avocado consumption and lower cardiovascular events, such as coronary heart disease and stroke.
“Our study provides further evidence that the intake of plant-sourced unsaturated fats can improve diet quality and is an important component in cardiovascular disease prevention,” said Lorena S. Pacheco, Ph.D., M.P.H., R.D.N., lead author of the study and a postdoctoral research fellow in the nutrition department at the Harvard T.H. Chan School of Public Health in Boston. “These are particularly notable findings since the consumption of avocados has risen steeply in the U.S. in the last 20 years, according to data from the U.S. Department of Agriculture.”
For 30 years, researchers followed more than 68,780 women (ages 30 to 55 years) from the Nurses’ Health Study and more than 41,700 men (ages 40 to 75 years) from the Health Professionals Follow-up Study. All study participants were free of cancer, coronary heart disease and stroke at the start of the study and living in the United States. Researchers documented 9,185 coronary heart disease events and 5,290 strokes during more than 30 years of follow-up. Researchers assessed participants’ diet using food frequency questionnaires given at the beginning of the study and then every four years. They calculated avocado intake from a questionnaire item that asked about the amount consumed and frequency. One serving equaled half of an avocado or a half cup of avocado.
The analysis found: After considering a wide range of cardiovascular risk factors and overall diet, study participants who ate at least two servings of avocado each week had a 16% lower risk of cardiovascular disease and a 21% lower risk of coronary heart disease, compared to those who never or rarely ate avocados. Based on statistical modeling, replacing half a serving daily of margarine, butter, egg, yogurt, cheese or processed meats such as bacon with the same amount of avocado was associated with a 16% to 22% lower risk of cardiovascular disease events. Substituting half a serving a day of avocado for the equivalent amount of olive oil, nuts and other plant oils showed no additional benefit. No significant associations were noted in relation to stroke risk and how much avocado was eaten.The study’s results provide additional guidance for health care professionals to share. Offering the suggestion to “replace certain spreads and saturated fat-containing foods, such as cheese and processed meats, with avocado is something physicians and other health care practitioners such as registered dietitians can do when they meet with patients, especially since avocado is a well-accepted food,” Pacheco said.
The study aligns with the American Heart Association’s guidance to follow the Mediterranean diet — a dietary pattern focused on fruits, vegetables, grains, beans, fish and other healthy foods and plant-based fats such as olive, canola, sesame and other non-tropical oils.
“These findings are significant because a healthy dietary pattern is the cornerstone for cardiovascular health, however, it can be difficult for many Americans to achieve and adhere to healthy eating patterns,” said Cheryl Anderson, Ph.D., M.P.H., FAHA, chair of the American Heart Association’s Council on Epidemiology and Prevention.
“We desperately need strategies to improve intake of AHA-recommended healthy diets — such as the Mediterranean diet — that are rich in vegetables and fruits,” said Anderson, who is professor and dean of the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego. “Although no one food is the solution to routinely eating a healthy diet, this study is evidence that avocados have possible health benefits. This is promising because it is a food item that is popular, accessible, desirable and easy to include in meals eaten by many Americans at home and in restaurants.”
The study is observational, so a direct cause and effect cannot be proved. Two other limitations of the research involve data collection and the composition of the study population. The study analyses may be affected by measurement errors because dietary consumption was self-reported. Participants were mostly white nurses and health care professionals, so these results may not apply to other groups . .
The study was funded by the National Institutes of Health, the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health and the Harvard Chan Yerby Fellowship at Harvard T.H. Chan School of Public Health.

Researchers at the University of Colorado Anschutz Medical Campus and their international collaborators have discovered that a protein critical in the embryonic stages of life is reactivated in certain cases of mesothelioma, offering clues into the origin of this aggressive cancer.
The study published today in the journal Nature Communications.
“Together with our basic research and clinical collaborators, we have discovered that in numerous mesothelioma tumors, the Hand2 protein has been turned back on, possibly altering the cells of the tumor,” said Christian Mosimann, PhD, lead author of the study and associate professor of pediatrics in the section of developmental biology at the University of Colorado School of Medicine on the CU Anschutz Medical Campus. “Now we’re investigating what causes this and what makes such mesothelioma tumors different from tumors that do not have Hand2 present.”
Mesothelioma is an aggressive cancer that occurs in a thin layer of tissue called the mesothelium, which covers most internal organs. Its primary cause is exposure to asbestos.
The Hand2 protein, Mosimann said, binds to genes at the beginning of life to control them during cellular development. It usually goes dormant in many tissues after an embryo fully develops. The discovery that the protein reactivates in some cases of mesothelioma offers the chance to possibly manipulate it to influence the course of the disease.
Mosimann and his team are using zebrafish to study how different cell types form because their translucent nature helps them observe the entire course of cell development rapidly due to how fast the fish grow. Specifically, they have been observing the mesothelium, a membrane that already develops in the embryonic stage and covers the heart, abdomen, intestines and inner organs, such as the lungs in humans. Mosimann described the mesothelium as a protective shrink wrap that protects the inner organs.

An algorithm which can predict how long a patient might spend in hospital if they’re diagnosed with bowel cancer could save the NHS millions of pounds and help patients feel better prepared.
Experts from the University of Portsmouth and the Portsmouth Hospitals University NHS Trust have used artificial intelligence and data analytics to predict the length of hospital stay for bowel cancer patients, whether they will be readmitted after surgery, and their likelihood of death over a one or three-month period.
The intelligent model will allow healthcare providers to design the best patient care and prioritise resources.
Bowel cancer is one of the most common types of cancer diagnosed in the UK, with more than 42,000 people diagnosed every year.
Professor of Intelligent Systems, Adrian Hopgood, from the University of Portsmouth, is one of the lead authors on the new paper. He said: “It is estimated that by 2035 there will be around 2.4 million new cases of bowel cancer annually worldwide. This is a staggering figure and one that can’t be ignored. We need to act now to improve patient outcomes.
“This technology can give patients insight into what they’re likely to experience. They can not only be given a good indication of what their longer-term prognosis is, but also what to expect in the shorter term.

Face masks are important for slowing the spread of COVID-19 and protecting against smoke. Per- and polyfluoroalkyl substances (PFAS) are added to many products to repel fluids, but their presence in face masks hasn’t been thoroughly studied. Now, researchers reporting in ACS’ Environmental Science & Technology Letters found that most face masks tested contain low or negligible levels of PFAS, except for one marketed to firefighters, which could pose health risks in certain situations.
Manufacturers design face masks to not only prevent inhalation of particles and pathogens but also to repel fluids, so some companies could be adding PFAS coatings to their products. During the current pandemic, people have been wearing face masks for long periods, which could expose them to PFAS through inhalation, skin exposure or accidental ingestion. In addition, used masks end up in landfills, where the compounds might leach out into the environment. Ivan Titaley at Oregon State University and colleagues wanted to measure PFAS in different types of face masks and analyze the implications for human exposure and the environment.
The researchers used mass spectrometry to measure nonvolatile and volatile PFAS in nine types of face masks: one surgical, one N95, six reusable cloth and a heat-resistant fabric mask advertised to firefighters. Surgical and N95 masks had the lowest levels, whereas the firefighting mask had the highest amount. Next, the team estimated the dose of PFAS that could cause health problems from chronic exposure, based on prior animal studies. According to the calculations, regular wear of the surgical, N95 and cloth masks would not pose a risk. However, the higher PFAS levels in the firefighter mask exceeded the dose considered safe, but only when worn for a full day (10 hours) at a high activity level, such as exercising or working in ways that boost the wearer’s respiration. Next, the researchers analyzed the environmental impact of PFAS from surgical and N95 masks (which comprise over 99% of masks discarded in landfills). They estimated that even if everyone in the U.S. over age 5 threw away one mask per day (90 billion masks per year), masks would be only a minor source of PFAS in landfill leachates and domestic water.
According to the researchers, this study should encourage the public to continue wearing face masks, especially during a pandemic. It could also help people make informed decisions about what type of masks to wear and encourage manufacturers to consider the chemicals used in masks, they explain.
The authors acknowledge funding or support from the National Science Foundation, National Institutes of Health, Environmental Protection Agency, Department of Agriculture and the North Carolina Policy Collaboratory.
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Although SARS-CoV-2 has taken the world by storm, it’s not the only coronavirus that can infect humans. But unlike SARS-CoV-2, common human coronaviruses (HCoVs) generally cause only mild disease. Now, researchers reporting in ACS Infectious Diseases have shown that infections with two different HCoVs don’t generate antibodies that effectively cross-react with SARS-CoV-2. So, prior infection with HCoVs is unlikely to protect against COVID-19 or worsen a SARS-CoV-2 infection through antibody-dependent enhancement (ADE), the researchers say.
Because SARS-CoV-2 shares significant sequence similarity with its HCoV cousins, researchers have wondered if the immune system might recognize the new coronavirus from prior bouts with HCoVs. This could re-activate memory B cells, causing them to produce antibodies that helped the person overcome previous HCoV infections, and might also help fight COVID-19. On the other hand, if the antibodies against HCoVs recognize SARS-CoV-2, but not strongly enough to generate an immune response, they could cause ADE. In this rare condition, sub-optimal antibodies actually help some viruses attach to and enter host cells, making the infection worse. Sebastien Fiedler, Tuomas Knowles and colleagues wanted to compare the strength and concentration of antibodies against HCoVs and SARS-CoV-2 in the sera of nine recovered COVID-19 patients and in three pre-pandemic sera.
The researchers used a technique called microfluidic antibody-affinity profiling, which unlike the traditionally used enzyme-linked immunosorbent assay (known as ELISA), can measure both antibody affinity and concentration independently. They found that all nine recovered COVID-19 sera samples contained moderate amounts of antibodies with high affinity to the SARS-CoV-2 spike protein. In contrast, none of the pre-pandemic sera contained high-affinity antibodies for SARS-CoV-2. All 12 sera contained low amounts of very high-affinity antibodies against two common HCoVs, indicating previous infections. Other experiments showed that these antibodies did not bind to SARS-CoV-2. The results suggest that there is no significant cross-reactivity of antibodies against common HCoVs and SARS-CoV-2, and therefore, no expected protective or adverse effects of antibody cross-reactivity for these coronaviruses, the researchers say.
The authors acknowledge funding from the University of Zurich, the University Hospital of Zurich, the NOMIS Foundation, the European Research Council, the National Institute for Health Research, the P.I. Terasaki Scholar program, and the Biotechnology and Biological Sciences Research Council.
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