Publisher Health

A new statistical analysis supports beliefs that COVID-19 became more lethal in the U.K. in late 2020, while also suggesting that multiple factors — not just the alpha variant of the virus that causes COVID-19 — were to blame. Patrick Pietzonka of the University of Cambridge, UK, and colleagues present these findings in the open-access journal PLOS ONE on Nov. 24, 2021.
Studying how the lethality of COVID-19 has changed over time in different regions could help guide continued efforts to address this disease. While simple, preliminary evaluations of infection and mortality data suggest that COVID-19 may have become more lethal in the UK in late 2020, more rigorous analyses have been lacking.
To explore whether COVID-19 indeed became more lethal in late 2020, Pietzonka and colleagues employed a statistical approach known as Bayesian inference. This enabled them to draw statistically stronger conclusions about lethality from weekly data on the number of cases and the number of deaths due to COVID-19 in the U.K. Specifically, they used Bayesian inference to compare predictions from different mathematical simulations of COVID-19 spread and deaths, some of which incorporated increased lethality.
This analysis suggests that, in late autumn of 2020 in the U.K., COVID-19 did indeed become more lethal — meaning that the probability that an infected person would die from the disease increased.
Prior speculations hold that this increase in lethality was driven by the alpha variant (B.1.1.7) of the SARS-CoV-2 virus, which was more infectious than previously widespread variants in the U.K. However, the new analysis suggests that lethality increased to a greater degree than the alpha variant would have accounted for, and that the increase in lethality began before the alpha variant became widespread.
These findings suggest that, while the alpha variant contributed to increased lethality in late 2020, other factors were also in play. Further research will be needed to identify those factors, but the authors suggest they may include increased strain on health care services and seasonality — a seasonal cycle in the severity of a virus that is commonly seen for other respiratory diseases like the common cold and the flu.
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An experimental compound reduced complications of type 1 and type 2 diabetes in mice — not by lowering blood sugar — but by countering its consequences: cell death, inflammation, and organ damage.
Published online in Science Translational Medicine on November 24, the study reported that a new class of compounds blocked the ability of a protein called RAGE to pass on inflammatory signals that injure the heart and kidneys in diabetes, and that slow the healing of diabetic wounds.
The results revolve around the body’s immune system, which recognizes and destroys invading bacteria and viruses. This system’s activation causes inflammation, responses like swelling and pain that result from the homing in by immune cells into sites of infection or injury. Many diseases — including diabetes — include misplaced inflammation that damages tissues.
Experiments in human cells and mouse models found that the lead study compound, RAGE229, significantly reduced short- and long-term complications of diabetes.
“Our results establish the molecular backbone of RAGE229 as the foundation for a new approach that targets intracellular RAGE actions to counter diabetic tissue damage,” says lead study author Ann Marie Schmidt, MD, the Dr. Iven Young Professor of Endocrinology at NYU Grossman School of Medicine. “With further refinements, RAGE229 and its descendants have great potential to fill gaps in treatment, including that most current drugs work only against type 2 diabetes.”
Picking a Lead
Most narratives of diabetes say that diet and age (Type 2) or genetic differences (Type 1) reduce action or production of the hormone insulin, which keeps blood sugar levels in check after meals supply the body with energy. While high blood sugar causes inflammatory damage, past work has also established that mechanisms occurring later in, and common to, both types of diabetes could be targeted separately by novel drug candidates.

Hospitals in Massachusetts will cut back on nonurgent scheduled procedures starting on Monday because of staffing shortages and longer patient hospital stays, according to the state’s health authorities.Coronavirus cases have been rising in Massachusetts for several weeks, but hospitalizations have risen at a lower rate. The pressure on hospitals relates to other consequences of the coronavirus pandemic, the authorities said.The staffing shortage, largely driven by the pandemic, has contributed to the loss of approximately 500 medical, surgical and I.C.U. hospital beds in Massachusetts, according to the state. And hospitals are seeing an influx of patients who need more complex treatment for health issues because they delayed visiting the doctor when Covid cases were higher.

For most of us, exercise impacts our hunger and weight in unexpected and sometimes contradictory ways.Does being active make us ravenous afterward and prone to eating more than we perhaps should? Or does it blunt our appetites and make it easier for us to skip that last, tempting slice of pie?A new study provides timely, if cautionary, clues. The study, which involved overweight, sedentary men and women and several types of moderate exercise, found that people who worked out did not overeat afterward at an enticing buffet lunch. However, they also did not skip dessert or skimp on portions. The findings offer a reminder during the holidays that while exercise has countless health benefits, helping us eat less or lose weight may not be among them.For most of us, exercise affects our weight and hunger in unexpected and sometimes contradictory ways. According to multiple scientific studies, few people who start to exercise drop as many pounds as the number of calories they burn working out would foretell.Some recent research suggests this occurs because our bodies stubbornly try to hang on to our fat stores, an evolutionary adaptation that protects us against (unlikely) future famines. So, if we burn calories during exercise, our bodies might nudge us to sit more afterward or reallocate energy from some bodily systems to others, reducing our overall daily energy expenditure. In this way, our bodies unconsciously compensate for many of the calories we burn exercising, reducing our chances of dropping pounds by working out.But that caloric compensation happens slowly, over the course of weeks or months, and involves energy expenditure. It has been less clear whether and how exercise influences our energy intake — that is, how many servings of food we consume — especially in the hours immediately after a workout.The evidence so far has been mixed. Some studies indicate that exercise, especially if it is strenuous and prolonged, tends to blunt people’s appetites, often for hours or into the next day. This phenomenon prompts them to take in fewer calories at subsequent meals than they would had they not exercised. But other studies suggest the opposite, finding that some people feel hungrier after workouts of any kind, and soon replace the calories they expended — and then some — with an extra helping or two at their next meal.Many of those studies, though, relied on healthy, fit and active young men and women as subjects, since those groups tend to be in ready supply among students in exercise science departments at universities. Fewer experiments have looked at how exercise might immediately affect appetite and eating in older, overweight, sedentary adults, and even fewer have studied the effects of resistance training as well as aerobic exercise.The new study was published in October in Medicine & Science in Sports & Exercise. Scientists at the University of Utah in Salt Lake City, the University of Colorado Anschutz Medical Campus in Aurora and other institutions advertised for volunteers in Colorado willing to exercise and eat, for the sake of science.Winnowing hundreds of replies, they wound up with 24 men and women, ranging in age from 18 to 55, who were overweight or obese and generally inactive. They invited everyone to visit the lab first thing in the morning, fed them breakfast, and then, on separate days, had them sit quietly, walk briskly on a treadmill or lift weights for about 45 minutes.Before, during and for three hours afterward, the researchers drew blood to check for changes in hormones related to appetite and asked people how hungry they felt. They also let everyone help themselves to an open buffet lunch of lasagna, salad, rolls, soda and poundcake with strawberries, while unobtrusively monitoring how much food people consumed.Then the researchers compared hormones, hunger and actual eating and found odd disconnects. In general, people’s hormones shifted after each exercise session in ways that could be expected to reduce their appetites. But the study’s participants did not report feeling less hungry — nor did they report feeling hungrier — after their workouts compared with when they had sat. And at lunch, they ate about the same amount, about 950 calories worth of lasagna and the other buffet foods, whether they worked out or not.The upshot of these results suggests that, at the very least, brisk walking or light weight lifting may not affect our subsequent eating as much as “other factors,” such as the aroma and oozing gustatory delights of lasagna (or buttery rolls or pie), said Tanya Halliday, an assistant professor of health and kinesiology at the University of Utah, who led the new study. People’s appetite hormones may have dropped a bit after their workouts, but those drops did not have much effect on how much they ate afterward.Still, exercise burned some calories, she said — about 300 or so each session. That was less than the nearly 1,000 calories the volunteers consumed on average at lunch, but hundreds more than when they sat. Over time, this difference might help with weight control, she said.Of course, the study has obvious limitations. It looked at a single session of moderate, brief exercise by a couple dozen out-of-shape participants. People who work out regularly, or who do more strenuous workouts, might respond differently. Researchers will need to conduct more studies, including those with more diverse groups and those that take place over a longer time period.But even now, the findings have a gentle, apple-pie allure. They suggest “people shouldn’t be afraid that if they exercise, they will overeat,” Dr. Halliday said. And, she said, “Thanksgiving is just one day” and will not affect your weight in the long term. So, eat what you want at the feast and enjoy. Dr. Halliday also recommended going for a walk or join a Turkey Trot with your family and friends beforehand, if you can — not to blunt your appetite, but to boost your social bonds and to be thankful to be moving forward together.

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesWomen who experience bleeding in early pregnancy and have had at least one miscarriage should be treated with the hormone progesterone.The new guidance, from the health watchdog NICE, is based on research suggesting the treatment could lead to 8,450 more births each year in the UK. The more miscarriages a woman had, the more effective progesterone was, the trial found.The naturally occurring hormone helps prepare the womb for the growing baby. After five miscarriages, Josie is now 15 weeks into her sixth pregnancy.It is her longest so far – and while it is impossible to know for sure whether her progesterone treatment is the reason, it makes a big difference to how she feels.”If this is what is going to make it OK for us… it’s just miraculous,” she says.”All we’ve ever wanted is to become parents. “So to actually get this far and to have the opportunity and have the progesterone, it gives us incredible hope.” Bleeding continuesAbout one in five women experience bleeding, or spotting as it is sometimes called, in the first 12 weeks of pregnancy. It often causes no problems but they are advised to have it checked out with their doctor or midwife to be sure. Some may experience a “threatened miscarriage”, where bleeding continues along with the pregnancy. Most are told to go home and wait and see what happens next.The new National Institute for Health and Care Excellence (NICE) guidance recommends inserting progesterone pessaries into the vagina twice a day. Doctors at the Birmingham Women’s Hospital prescribed it for Josie. A trial carried out by researchers at the Tommy’s National Centre for Miscarriage Research which the new guidance is based on, found that progesterone didn’t make much of a difference for women who just had bleeding and no previous miscarriages. But the more miscarriages a woman had suffered, the more effective progesterone was. Best treatmentsOne of those behind the Tommy’s National Centre for Miscarriage Research research, Prof Arri Coomarasamy, from the University of Birmingham, said: “This is a very significant moment. “We have an intervention that works that can stop a miscarriage. “This gives hope to thousands of couples throughout UK.”But it’s really important to appreciate that only some miscarriages can be prevented by progesterone. “There are other causes for miscarriages. “We still need to study them.”We need to find other effective treatment.”About one in four pregnancies ends in miscarriage – the vast majority in the first few months or trimester.Royal College of Obstetricians and Gynaecologists president Dr Edward Morris said: “It is positive that NICE has acknowledged the latest evidence. “We do, however, still have a way to go before understanding the best treatments for women experiencing unexplained pregnancy loss and would welcome further research in this area.”Professor Gillian Leng, NICE’s chief executive, said the research evidence “is clear that progesterone will not be able to prevent every miscarriage”.But she said it would be “of benefit to some women, and as an inexpensive treatment option, can be made available to women on the NHS from today”.Follow Tulip on Twitter.NICEThe Miscarriage AssociationTommy’sThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesNew Zealand has unveiled its plans to reopen borders and will allow foreigners to enter next year.Fully vaccinated visitors can enter from 30 April, and will have to self-isolate for seven days upon arrival.More New Zealanders will be allowed to travel home from early next year as well, under similar rules.The move eases strict curbs that have locked out many citizens and tourists since borders were slammed shut at the start of the Covid pandemic.Covid-19 Response Minister Chris Hipkins outlined the staged re-opening plans on Monday, calling it “the safest approach to ensure risk is carefully managed”.What do the new rules say?In the first phase of the re-opening, fully vaccinated New Zealand citizens and residents who are currently in Australia will be allowed to return from 16 January onwards.New Zealanders who are in all other countries will be allowed to enter from 13 February.Foreign travellers will be the last group to be granted entry into the country, from 30 April. All travellers must be fully vaccinated, will have to self-isolate for seven days, and will be tested for Covid upon arrival.”This (phased approach) reduces any potential impacts on vulnerable communities and the New Zealand health system,” Mr Hipkins said. Currently, only citizens and permanent residents of New Zealand are allowed to enter the country, and they must stay for seven days in government-managed quarantine hotels. As these have limited spaces, the rules have effectively kept out many New Zealanders wishing to return.New Zealand was one of the first countries in the world to shut its borders early in the pandemic, as part of a highly-praised tough approach to Covid that managed to keep deaths to a minimum. Besides the travel curbs, it quashed earlier outbreaks with rapid, strict lockdowns.However, the country has struggled to beat back the highly-infectious Delta strain of the virus, forcing Prime Minister Jacinda Ardern to switch from a total Covid elimination strategy to pushing for higher vaccination rates and treating the virus as endemic. It had established a travel bubble with Australia earlier this year, but had to suspend it months later following outbreaks in both countries. You may also be interested in:New Zealanders rejoice at being able to reunite with their friends and family in May 2020, following easing of coronavirus restrictions within the country that allowed a maximum of 10 people to meet and businesses to reopen. This video can not be playedTo play this video you need to enable JavaScript in your browser.

Switching from a restricted diet to eating as much as you like could be beneficial for reproduction in later life, according to new research from the University of East Anglia.
Researchers studied the eating and mating habits of the small fruit fly Drosophila melanogaster.
They found that females that consumed less food for their entire lives lived longer, however they didn’t reproduce as well as their better-fed counterparts.
But those that switched from a restricted diet to unlimited food, started mating and reproducing more. These flies produced three times more offspring than those that were kept on a restricted diet.
Meanwhile their survival was similar to females that had been fully-fed their whole lives.
Lead researcher Dr Zahida Sultanova, from UEA’s School of Biological Sciences, said: “Dietary restriction is associated with longer life and better health in many organisms, including humans.

She studied the impact of AIDS on women and explored the effects of famine and poverty on health with an “unwavering commitment to social justice.”Dr. Zena Stein, a South African-born epidemiologist whose influential work encompassed the effects of famine on children, the health of entire communities afflicted by poverty and the impact of the AIDS crisis on women in Africa, died on Nov. 7 at her home in Coatesville, Pa. She was 99.Her daughter Ida Susser confirmed her death.Dr. Stein came of age in South Africa during World War II and started her career in the early years of institutionalized apartheid. Those backdrops shaped her approach to epidemiology: She aimed to identify the social, economic and political conditions that can affect the health of a population as well as individuals, an approach known as social medicine or community-based medicine.Dr. Stein’s research focused closely on women’s health at a time when the bulk of scientific study spotlighted men. She was also well known for her research on child development and on mental illness.She and her husband, Dr. Mervyn Susser, worked as a team and conducted hundreds of studies, many of which shaped the field of epidemiology and community health care. Dr. Stein is listed as the author or co-author of 270 academic articles and several books, including “Eras in Epidemiology: The Evolution of Ideas” (2009), which she wrote with Dr. Susser.Early in their careers, the couple ran a clinic in the South African township of Alexandra, near Johannesburg, with another husband-and-wife medical team. In one of their first articles, written with collaborators and appearing in the scientific journal The Lancet, they demonstrated that melding medical care and social support made people healthier. The clinic taught patients and family members, for example, how to care for illnesses at home and pregnant women how to improve nutrition. Varieties of the treatment plans Dr. Stein helped develop are still in use today.In a tribute to her and Dr. Susser in the journal Pediatric and Perinatal Epidemiology, the researchers Richard Neugebauer and Nigel Paneth wrote that the Lancet article “presages enduring themes” in the couple’s work.“On the scientific level, it reflects their commitment to an analysis of human health centered both on the immediate environment and larger society,” they wrote, adding, “On a deeper level of conscience and morality, it signals their unwavering commitment to social justice.”Dr. Stein often spoke of her most treasured accomplishment: a seminal study in 1972 on a nine-month stretch of famine in the Netherlands during World War II. The study was based on government data assembled and examined by Dr. Stein and Dr. Susser. In a finding that countered the accepted wisdom, they showed that babies born during a famine were no more likely to experience cognitive deficiencies than babies raised with plentiful food. (Later research, however, showed possible links between prenatal famine exposure and congenital nervous system problems.)The Dutch famine data had implications for research on prenatal nutrition. Further studies by other scientists using the data pointed to folate, or the various forms of vitamin B9, as a key nutrient during pregnancy, and led the U.S. government to recommend daily folic acid supplements during gestation.The large data set is still in use today, including by Dr. Stein’s son, Dr. Ezra Susser, a former chairman of Columbia University’s epidemiology department.Dr. Stein later turned her attention to the effects of the H.I.V./AIDS crisis on women, who made up a minority of patients and were often overlooked. She was a proponent of a female condom for AIDS prevention, particularly in South Africa, where treatment options were more limited. Securing institutional funding for her work, her daughter Ms. Susser said, presented a perennial challenge: Medical authorities did not place great value on AIDS research focused on women. But Dr. Stein was not cowed and found ways to publish nonetheless.As she told The New York Times in 1990, “If we’re serious about preventing H.I.V. infection in women, then we’re going to have to empower women.”Dr. Stein was a proponent of the female condom as a way to protect women from H.I.V. infection. Columbia University has materials on the subject from her papers.Columbia University LibrariesZena Athene Stein was born on July 7, 1922, in Durban, South Africa, to a family of Lithuanian Jewish immigrants. Her mother, Lily (Rolnick) Stein, was a homemaker. Her father, Philip Stein, was a mathematics professor at Natal Technical College, which became the Durban University of Technology.She attended the University of Cape Town for her bachelor’s and master’s degrees in history, and earned her medical degree in 1950 from the University of Witwatersrand. Dr. Susser also studied medicine there, and the two married in 1949. While in medical school, they organized a protest over the treatment of Black students, who were barred from observing autopsies of white cadavers.The couple, part of a leftist social set in Johannesburg, started their work at the clinic in Alexandra Township in 1952. They worked there for three years, until, in 1955, the clinic’s board threatened to fire Dr. Susser if he went ahead with a scheduled appearance on a panel sponsored by the anti-apartheid African National Congress. He and Dr. Stein, staunch supporters of the A.N.C., resigned in protest.The couple had helped write guidelines for health care in South Africa’s Freedom Charter, the 1955 statement of principles by the A.N.C. and its allied parties.Dr. Stein and Dr. Susser, along with their three children, emigrated to Britain in 1958. They initially lived in boardinghouses and worried about money; Dr. Stein worked nights in a mental hospital. After a year, Dr. Susser found work at the University of Manchester, and Dr. Stein followed suit; she was a researcher there from 1959 to 1965.The family went to the United States in 1965, and Dr. Susser shortly received a job offer from Columbia University. Dr. Stein began teaching there as well, first as an associate professor of epidemiology, then earning a full professorship and assuming administrative positions in what is now the Mailman School of Public Health. Her work included research on developmental disorders in children.She and Dr. Susser were founding members of Columbia’s Gertrude H. Sergievsky Center, which originally studied disorders of the nervous system.In 1987, she founded the H.I.V. Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University. The center embarked on the first major effort to draw attention to women living with AIDS. It is now one of the largest centers of its kind in the world, employing about 100 investigators and staff members in the study H.I.V. using different disciplines, including psychology, psychiatry, public health, anthropology, sociology and social work.Dr. Stein retained her South African roots, corresponding with Nelson Mandela, returning to her home country for conferences and speaking out for racial equity in the post-apartheid era.After retiring from full-time work in 2003, she continued to write articles with her husband, her daughter and other researchers. Dr. Susser died in 2014. In addition to their daughter and son, Dr. Stein is survived by another daughter, Ruth King; her brother, Wilfred Stein; eight grandchildren; and six great-grandchildren.In a remembrance on the Sergievsky Center’s website, a former student of Dr. Stein’s, the Columbia professor Dr. Louise Kuhn, wrote of her teacher’s relentless pursuit of knowledge.“She always wanted me to go further and deeper into understanding issues,” Dr. Kuhn wrote. “Is that all you can conclude?” she quoted Dr. Stein as saying. “Where does that take us? Can’t you do more?”

Life-threatening bacteria are becoming ever more resistant to antibiotics, making the search for alternatives to antibiotics an increasingly urgent challenge. For certain applications, one alternative may be a special type of laser.
Researchers at Washington University School of Medicine in St. Louis have found that lasers that emit ultrashort pulses of light can kill multidrug-resistant bacteria and hardy bacterial spores. The findings, available online in the Journal of Biophotonics, open up the possibility of using such lasers to destroy bacteria that are hard to kill by other means. The researchers previously have shown that such lasers don’t damage human cells, making it possible to envision using the lasers to sterilize wounds or disinfect blood products.
“The ultrashort-pulse laser technology uniquely inactivates pathogens while preserving human proteins and cells,” said first author Shaw-Wei (David) Tsen, MD, PhD, an instructor of radiology at Washington University’s Mallinckrodt Institute of Radiology (MIR). “Imagine if, prior to closing a surgical wound, we could scan a laser beam across the site and further reduce the chances of infection. I can see this technology being used soon to disinfect biological products in vitro, and even to treat bloodstream infections in the future by putting patients on dialysis and passing the blood through a laser treatment device.”
Tsen and senior author Samuel Achilefu, PhD, the Michel M. Ter-Pogossian Professor of Radiology and director of MIR’s Biophotonics Research Center, have been exploring the germicidal properties of ultrashort-pulse lasers for years. They have shown that such lasers can inactivate viruses and ordinary bacteria without harming human cells. In the new study, conducted in collaboration with Shelley Haydel, PhD, a professor of microbiology at Arizona State University, they extended their exploration to antibiotic-resistant bacteria and bacterial spores.
The researchers trained their lasers on multidrug-resistant Staphylococcus aureus (MRSA), which causes infections of the skin, lungs and other organs, and extended spectrum beta-lactamase-producing Escherichia coli (E. coli), which cause urinary tract infections, diarrhea and wound infections. Apart from their shared ability to make people miserable, MRSA and E. coli are very different types of bacteria, representing two distant branches of the bacterial kingdom. The researchers also looked at spores of the bacterium Bacillus cereus, which causes food poisoning and food spoilage. Bacillus spores can withstand boiling and cooking.
In all cases, the lasers killed more than 99.9% of the target organisms, reducing their numbers by more than 1,000 times.
Viruses and bacteria contain densely packed protein structures that can be excited by an ultrashort-pulse laser. The laser kills by causing these protein structures to vibrate until some of their molecular bonds break. The broken ends quickly reattach to whatever they can find, which in many cases is not what they had been attached to before. The result is a mess of incorrect linkages inside and between proteins, and that mess causes normal protein function in microorganisms to grind to a halt.
“We previously published a paper in which we showed that the laser power matters,” Tsen said. “At a certain laser power, we’re inactivating viruses. As you increase the power, you start inactivating bacteria. But it takes even higher power than that, and we’re talking orders of magnitude, to start killing human cells. So there is a therapeutic window where we can tune the laser parameters such that we can kill pathogens without affecting the human cells.”
Heat, radiation and chemicals such as bleach are effective at sterilizing objects, but most are too damaging to be used on people or biological products. By inactivating all kinds of bacteria and viruses without damaging cells, ultrashort-pulse lasers could provide a new approach to making blood products and other biological products safer.
“Anything derived from human or animal sources could be contaminated with pathogens,” Tsen said. “We screen all blood products before transfusing them to patients. The problem is that we have to know what we’re screening for. If a new blood-borne virus emerges, like HIV did in the ’70s and ’80s, it could get into the blood supply before we know it. Ultrashort-pulse lasers could be a way to make sure that our blood supply is clear of pathogens both known and unknown.”
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Materials provided by Washington University School of Medicine. Original written by Tamara Bhandari. Note: Content may be edited for style and length.