Publisher Health

A team of health equity researchers from several institutions has leveraged a complex web of data to test a hypothesis: That structural racism is associated with resources and structures at the neighborhood level that are closely associated with poor health. What they found in an analysis of highly localized, community level data illustrates how racism is deeply interrelated with poor health outcomes.
Dinushika Mohottige, MD, MPH, Assistant Professor of Population Science and Policy, and Medicine (Nephrology), at the Icahn School of Medicine at Mount Sinai, served as first author of a paper published today in the journalJAMA Network Open that details the study.
Dr. Mohottige and her senior author and long-time mentor, L. Ebony Boulware, MD, MPH, Dean of Wake Forest University School of Medicine, describe in detail how neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hypertension are strongly associated with an increased burden of structural racism indicators.
The research team conducted an observational cross-sectional study in Durham County, North Carolina, using public data sources and deidentified electronic health records to explore how a comprehensive collection of data points associate the presence of structural racism and the neighborhood prevalence of these three chronic health conditions.
“It was important to look at these three conditions because they are interconnected and highly associated with heart disease, as well as quality and length of life. Importantly, Black people share a disproportionate burden of these three illnesses,” said Dr. Mohottige, a member of Icahn Mount Sinai’s Institute for Health Equity Research who specializes in kidney health equity and formerly practiced at Duke University with Dr. Boulware. They collaborated with colleagues from Duke, the University of North Carolina at Chapel Hill, North Carolina State University, and the Feinstein Institutes for Medical Research.
The authors explain that structural racism is defined as how societies foster discrimination through a series of systems that are reinforcing, such as housing, education, and unemployment. “These systems cascade into discriminatory beliefs, values, and the distribution of resources,” says Dr. Boulware.
“Dr. Mohottige and I agreed it was important to tap the unusual data assets available in Durham to learn how we can improve the health of communities and individuals by identifying the factors that may affect their health the most. Our goal was to use the data to help us identify possible interventions,” says Dr. Boulware. “Data which measure health outcomes such as kidney disease and diabetes — and which also measure social determinants of health, including information on the built environment and reported neighborhood violence — help us understand how the conditions where people live affect their well-being. This is especially true for groups that, because of their race or ethnicity, historically experience worse health outcomes when compared to others.”
The result of their work, incorporating thousands of data points related to where people live at the most localized level, says Dr. Boulware, is a first-of-its-kind observational study of associations of structural racism constructs with the health of individuals residing in these neighborhoods. “This study fills an important evidence gap and helps us identify factors which might be targeted to address community health inequities,” says Dr. Mohottige.

The researchers studied data of aggregate estimates of prevalence of chronic conditions for each of 150 residential neighborhoods in Durham using the Durham Neighborhood Compass, a unique data asset created by public health officials; a corresponding website, Durham Community Health Indicators Project, provides a user-friendly interface in lay language.
Along with the uniquely detailed and comprehensive Compass data, the researchers pulled data from two main buckets. Through global/composite indicators such as the area deprivation index, they gleaned data revealing the extent of Durham’s stark neighborhood advantage and disadvantage. The discrete indicators they drew upon revealed downstream factors widely thought to represent sociopolitical manifestations of structural racism, including reported crime, evictions, police shootings, and election participation. “Very limited evidence exists to tie together these structural racism constructs with the aggregate health of individuals in a given neighborhood using electronic health data and rigorous assessments of chronic conditions,” says Dr. Mohottige.
The team found that: Residential neighborhoods with the highest prevalence of CKD, diabetes, and hypertension, tended to be in neighborhoods with the lowest proportions of White residents, and vice versa. Neighborhoods with the highest prevalence of CKD, diabetes, and hypertension tended to be in areas with the lowest income and higher area deprivation. They also had the lowest rates of college education. A greater burden of most discrete indicators of structural racism (examples include reported violent crime, eviction rates, election participation, income, and poverty) was associated with greater neighborhood prevalence of the three diseases.

Researchers at Nagoya University’s Graduate School of Bioagricultural Sciences and the National Institute of Physiological Sciences in Japan have demonstrated how a specific type of neuron in the brain affects the release of hormones that control ovarian function, such as follicular development and ovulation in females. These findings, published in the journal Scientific Reports, could help researchers understand and treat reproductive disorders in both animals and humans.
Kisspeptin neurons in the brain regulate the release of hypothalamic gonadotropin-releasing hormone (GnRH) and pituitary follicle-stimulating hormone/luteinizing hormone (LH). This process is important for reproduction, as pituitary hormones stimulate the ovaries to perform their reproductive functions. Examples include follicular development and ovulation in all mammals, including humans.
There are two main areas of the brain involved in the process: the arcuate nucleus (ARC), in which kisspeptin neurons maintain the regular rhythmic (pulsatile) secretion of GnRH/LH that maintains normal follicular development and sex steroid production; and the anteroventral periventricular nucleus (AVPV), in which kisspeptin neurons trigger a surge of GnRH/LH that leads to ovulation.
The researchers focused on the fact that kisspeptin neurons in the ARC produce and respond to dynorphin, an inhibitory substance. “Kisspeptin neurons in the ARC express both dynorphin and its receptor, whereas those in the AVPV express the receptor only, suggesting a particular role of such kisspeptin neurons in fertilization,” Mayuko Nagae, a postdoctoral fellow, and Yoshihisa Uenoyama, an associate professor at Nagoya University in Japan and corresponding author of the paper, explained in a joint statement. “However, the exact role of dynorphin and its receptor in the regulation of kisspeptin neurons was not clearly understood.”
To investigate this, the researchers genetically modified female rats to delete Kiss1, a gene that codes for kisspeptin, only in neurons that expressed the dynorphin receptor. They found that the genetically modified rats with deleted Kiss1 in dynorphin receptor-expressing cells had only 3% of kisspeptin neurons in the ARC and 50% in the AVPV. The rats were still fertile, but they had a longer estrous cycle, lower ovarian weight, and fewer pups than normal rats.
The results indicate that kisspeptin neurons with dynorphin receptors are important for normal female rat reproduction, as they allow proper hormone secretion and ovulation. “This is the first report to show that kisspeptin neurons receiving direct input of dynorphin are needed to fully generate the GnRH/LH pulse and surge in female rats,” says Professor Hiroko Tsukamura from Nagoya University, the principal investigator of the research group and another corresponding author of the paper.
Professor Tsukamura is excited about the prospect of more studies to understand the molecular mechanism that controls kisspeptin neuronal activity. She says, “Our findings can help our understanding of the central mechanism underlying reproduction and have applications in the treatment of ovarian disorders in livestock and infertility in humans.”

Crop damage in agriculture and the transmission of vector-borne diseases by insect pests have become a worldwide threat. Chemical treatments such as insecticides and repellents have been a major strategy against insect pests for centuries. Due to limited understanding of mechanisms of insect avoidance behavior, however, development of insect repellents has been delayed. To discover compounds that effectively repel insect pests, it is important to focus on key molecules associated with sensory, particularly aversive, responses. In this study, researchers identified a compound that induces robust aversive responses through multiple sensory pathways in the fruit fly, Drosophila melanogaster.
Among sensory receptors, Transient Receptor Potential (TRP) cation channels play a key role in nocifensive behaviors to various stimuli in many insect species. Particularly, TRPA1 channel has been extensively studied as it is activated by various hazardous chemicals. Therefore, insect TRPA1 stimulants are promising leads for novel repellents with a broad spectrum. Takaaki Sokabe and his colleagues at the National Institute for Physiological Sciences/the Exploratory Research Center on Life and Living Systems (ExCELLS) found that 2-methylthiazoline (2MT), an analog of a volatile compound found in fox urine, repels flies effectively, and revealed the molecular and cellular mechanisms of 2MT-induced aversions in the fly. They recently published their findings in Frontiers in Molecular Neuroscience.
“2MT is reported to evoke innate fear responses in mice via TRPA1, therefore we expected that the chemical possibly have an aversive effect on insects,” Sokabe says. “And it worked terrifically more than our expectation.”
Fly’s avoidance behaviors revealed that 2MT stimulates multiple sensory modalities: 2MT vapor acts on odorant receptors (ORs) in an olfactory pathway, and direct contact to 2MT activates TRPA1 in taste and nociceptive pathways. This resulted in apparent escaping from chemical source of male flies and avoidance of egg laying of female flies. Furthermore, The researchers demonstrated that TRPA1 is activated by 2MT through the direct interaction of 2MT to specific two amino acids in TRPA1.
“The action of 2MT on multiple sensory pathways seems to be a key for its high effectiveness,” says Takaaki Sokabe. “Because the amino acids essential for TRPA1 activation are highly conserved across a wide range of insect species, including agricultural pests and disease vectors, it will be important to test 2MT on many other insect pests to evaluate the spectrum.”
This new work could promote the development of novel insect repellents by focusing on TRP channels and other types of receptors as promising targets.

Antibiotic-resistant bacteria have become a rapidly growing threat to public health. Each year, they account for more than 2.8 million infections, according to the U.S. Centers for Disease Control and Prevention. Without new antibiotics, even common injuries and infections harbor the potential to become lethal.
Scientists are now one step closer to eliminating that threat, thanks to a Texas A&M University-led collaboration that has developed a new family of polymers capable of killing bacteria without inducing antibiotic resistance by disrupting the membrane of these microorganisms.
“The new polymers we synthesized could help fight antibiotic resistance in the future by providing antibacterial molecules that operate through a mechanism against which bacteria do not seem to develop resistance,” said Dr. Quentin Michaudel, an assistant professor in the Department of Chemistry and lead investigator in the research, published Dec. 11 in the Proceedings of the National Academy of Sciences (PNAS).
Working at the interface of organic chemistry and polymer science, the Michaudel Laboratory was able to synthesize the new polymer by carefully designing a positively charged molecule that can be stitched many times to form a large molecule made of the same repeating charged motif using a carefully selected catalyst called AquaMet. According to Michaudel, that catalyst proves key, given that it has to tolerate a high concentration of charges and also be water-soluble — a feature he describes as uncommon for this type of process.
After achieving success, the Michaudel Lab put its polymers to the test against two main types of antibiotic-resistant bacteria — E. coli and Staphylococcus aureus (MRSA) — in collaboration with Dr. Jessica Schiffman’s group at the University of Massachusetts Amherst. While awaiting those results, the researchers also tested their polymers’ toxicity against human red blood cells.
“A common issue with antibacterial polymers is a lack of selectivity between bacteria and human cells when targeting the cellular membrane,” Michaudel explained. “The key is to strike a right balance between effectively inhibiting bacteria growth and killing several types of cells indiscriminately.”
Michaudel credits the multidisciplinary nature of scientific innovation and the generosity of dedicated researchers across the Texas A&M campus and country as factors in his team’s success in determining the perfect catalyst for their molecule assembly.

“This project was several years in the making and would not have been possible without the help of several groups, in addition to our UMass collaborators,” Michaudel said. “For instance, we had to ship some samples to the Letteri Lab at the University of Virginia to determine the length of our polymers, which required the use of an instrument that few labs in the country have. We are also tremendously grateful to [biochemistry Ph.D. candidate] Nathan Williams and Dr. Jean-Philippe Pellois here at Texas A&M, who provided their expertise in our assessment of toxicity against red blood cells.”
Michaudel says the team will now focus on improving the activity of its polymers against bacteria — specifically, their selectivity for bacterial cells versus human cells — before moving on to in vivo assays.
“We are in the process of synthesizing a variety of analogs with that exciting goal in mind,” he said.
The team’s paper, which features Michaudel Lab member and Texas A&M chemistry Ph.D. graduate Dr. Sarah Hancock ’23 as first author, can be viewed online along with related figures and captions. Other key contributors from the Michaudel Lab are chemistry graduate student An Tran ’23, postdoctoral scholar Dr. Arunava Maity and former postdoctoral scholar Dr. Nattawut Yuntawattana, who is now an assistant professor of materials science at Kasetsart University in Thailand.
This research was funded primarily by Michaudel’s National Institutes of Health Maximizing Investigators’ Research Award (MIRA) through the National Institute of General Medical Sciences.
A native of La Rochelle, France, Michaudel joined the Texas A&M Chemistry faculty in 2018 and holds a joint appointment in the Department of Materials Science and Engineering. In addition to an NIH MIRA in 2020, his career honors to date include a 2022 National Science Foundation Faculty Early Career Development (CAREER) Award, a 2022 American Chemical Society Polymeric Materials: Science and Engineering (PMSE) Young Investigator Award and a 2021 Thieme Chemistry Journals Award.

There does not appear to be any profound differences between so-called exposure-based CBT and traditional CBT in the treatment of fibromyalgia, according to a study led by researchers at Karolinska Institutet. Both forms of treatment produced a significant reduction in symptoms in people affected by the disease. The study is one of the largest to date to compare different treatment options for fibromyalgia and is published in the journal PAIN.
About 200,000 people in Sweden currently live with fibromyalgia, a long-term pain syndrome that causes great suffering for patients through widespread pain, fatigue, and stiffness in the body. There is no cure for fibromyalgia. Existing drugs often have insufficient effect, raising the need for more effective treatment methods. Cognitive behavioral therapy (CBT) has shown some effect, but there is a lack of trained CBT practitioners. There is also a lack of knowledge about which form of CBT is most effective. The study compared two different forms of internet-delivered cognitive behavioral therapy in terms of how well they reduce the symptoms and functional impact of fibromyalgia.
In brief, exposure-based CBT involves the participant systematically and repeatedly approaching situations, activities, and stimuli that the patient has previously avoided because the experiences are associated with pain, psychological discomfort, or symptoms such as fatigue and cognitive problems.
In traditional CBT, the participant is presented with several different strategies to work on during treatment, such as relaxation, activity planning, physical exercise, or strategies for managing negative thoughts and improving sleep.
The study showed that traditional CBT was by and large equivalent to the newer treatment form of exposure-based CBT.
“This result was surprising because our hypothesis, based on previous research, was that the new exposure-based form would be more effective. Our study shows that the traditional form can provide an equally good result and thus contributes to the discussion in the field,” says Maria Hedman-Lagerlöf, licensed psychologist and researcher at the Center for Psychiatry Research at the Department of Clinical Neuroscience, Karolinska Institutet.
The randomized study involved 274 people with fibromyalgia, who were randomly assigned to be treated with traditional or exposure-based CBT. The treatments were delivered entirely online and all participants had regular contact with their therapist.

Participants answered questions about their mood and symptoms before, during, and after treatment. After the 10-week treatment, 60 percent of those who received exposure-based CBT and 59 percent of those who received traditional CBT reported that their treatment had helped them.
“The fact that both treatments were associated with a significant reduction in the participants’ symptoms and functional impairment and that the effects were sustained for 12 months after completion of the treatment, indicates that the internet as a treatment format can be of great clinical benefit for people with fibromyalgia,” says Maria Hedman-Lagerlöf. “This is good news because it enables more people to access treatment.”
The study is the second largest to compare different psychological treatment options for fibromyalgia, according to the researchers.
“Our study is also one of the first to compare with another active, established psychological treatment,” says Maria Hedman-Lagerlöf.

The deal is a bet on the growing market for psychiatric and neurological drugs.Bristol Myers Squibb, the global pharmaceutical giant, said on Friday that it would acquire Karuna Therapeutics, which makes drugs to treat schizophrenia and Alzheimer’s, in an all-cash deal valued at $14 billion as it looks to strengthen its pipeline of neuroscience drugs.Bristol Myers said in a statement that it would pay $330 per share in cash, a premium of roughly 53 percent to Karuna’s share price on Thursday.An increasing prevalence of schizophrenia, driven in part by an aging population, has led to a push to make more drugs to treat it. The market for such therapies is estimated to grow to $12.6 billion by 2032, according to the research firm Market.Us. Earlier this month, the biomedical company AbbVie bought Cerevel Therapeutics, which develops drugs to treat psychiatric and neurological disorders including schizophrenia and Parkinson’s disease for about $8.7 billion.Karuna’s big bet on schizophrenia is the drug KarXT, which the Food and Drug Administration has accepted for review. The company said it expected to begin marketing the drug in September 2024, pending regulatory approval.“We expect KarXT to enhance our growth through the late 2020s and into the next decade,” Christopher Boerner, the chief executive of Bristol Myers Squibb, said in a statement.The boards of both companies unanimously approved the deal. Shares of Bristol Myers Squibb rose 2.5 percent in early trading, while Karuna’s stock jumped nearly 50 percent.Bristol’s other schizophrenia drugs have included the drug Abilify. In recent years, it has also been doubling down on developing cancer drugs, and to that end acquired Celgene, a maker of the blockbuster Thalomid and Revlimid cancer medicines, for $74 billion in 2019.

Published19 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Sophie HutchinsonBBC NewsLandais Alzheimer, in south-west France, is a village with a difference – all the villagers have dementia.The shop in the main square supplies simple groceries such as the all-important baguette but does not take money, so no-one has to remember their wallet.Ex-farmer Francis is collecting his daily newspaper there – and I suggest we go for a coffee next door, in the restaurant that serves as the social heart of the village.I ask Francis what it was like when the doctor told him he had Alzheimer’s. He nods, taking himself back to that time, and, after a pause, says: “Very hard.” ‘Keep going’His father also had Alzheimer’s – but Francis remains unafraid.”I’m not afraid of dying, because that will happen one day,” he says. “Meanwhile, I will live my life despite the disease.”I am here to live, even though it’s not the same. “If you surrender, you’ve had it. So you keep going, to the best of your ability.” As well as the shop and restaurant, villagers are encouraged to attend the theatre – and join in activities.Philippe and Viviane tell me they continue to live as normal a life as they can following their double dementia diagnosis. “We go on walks. We walk,” Philippe says, looking into the distance. And when I ask if they are happy, he instantly turns his head and, with a glowing smile, says: “Yes we are – truly.” Then, having finished their coffee and bundled up in warm clothes, the couple head back out into the park.Time passes differently here, my guide at the village says. There are no set hours for appointments, shopping and cleaning – just a gentle rhythm coaxing and cajoling villagers, to give them as much freedom as possible.The village is being closely monitored – and Prof Hélène Amieva says early results suggest it is actually influencing the course of the disease. “What we used to see when people enter an institution is an accelerated cognitive decline – that is not observed in this institution,” she says. “We see a kind of very smooth evolution. “We have some reasons to believe these kinds of institutions can influence the trajectory of clinical outcomes.”They have also seen a “drastic reduction” in families’ feelings of guilt and anxiety.Motioning to her mother, Mauricette, 89, sitting in her bedroom, Dominique says: “I have peace of mind, because I know she has peace of mind and is safe.” Filled with family photos, paintings and the family’s furniture, the room has a large window on to the garden. With no visiting hours, people come and go as they please. And Dominique says she and her sisters never expected the care to be so good.”When I leave her, I am relieved. When I arrive, it’s like I am just at her house – I am at home with my mum,” she says.Each of the single-storey chalets houses about eight residents, with a communal kitchen, sitting and dining rooms.While villagers pay a contribution, the running costs – similar to an average care home – are mainly covered by the regional French government which paid £17m ($22m) to set up the village. When it opened, in 2020, it was the second village of its kind – and the only one to be part of a research project. And there still are thought to be fewer than a dozen like it in the world. But it has attracted worldwide interest, from those looking for a solution to the predicted exponential growth in dementia.In the village hairdressers, Patricia, 65, who has just finished having her hair blow-dried, says Landais Alzheimer has given her her life back.”I was at home – but I was getting bored,” she says. “I had a lady to cook for me. I was tired. I was not feeling well. I knew that Alzheimer’s wasn’t easy and I was scared. “I wanted to be somewhere where I could help too. “Because in other care homes, it’s like this, like that – but they don’t do anything. “Whereas here, it’s real life. When I say real, I mean real.”So often, dementia can isolate people. But here, there seems to be a strong sense of community, with people genuinely interested in seeing each other and joining in activities. And researchers say this social element may be part of the key to living a happier, and potentially healthier, life with dementia.There are about 120 villagers and the same number of healthcare professionals, with volunteers on top. There is, of course, a cruel inevitability because there is no cure. But as each villager’s disease progresses, they are given support they need. And while this may be the winter of these villagers’ lives, staff here believe it comes more slowly with more joy along the way.Some contributors asked that their surnames be withheldMore on this storyBrain power of over-50s dropped during Covid – studyPublished2 NovemberNew drugs for Alzheimer’s hailed as turning pointPublished17 JulyFiona Phillips: How common is early Alzheimer’s?Published5 JulyNew Alzheimer’s drug slows disease by a thirdPublished3 MayAlzheimer’s drug hailed as momentous breakthroughPublished30 November 2022Related Internet Linksvillagealzheimer.landes.fr-en-the-establishmentThe BBC is not responsible for the content of external sites.

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Winston, an older silverback, is getting enviable medical treatment. Now his keepers must confront an issue that vexes doctors and older humans, too: How much intervention is too much?This month, as the patient lay anesthetized on a table, a cardiologist made a half-inch incision through the skin of his chest. She removed a small implanted heart monitor with failing batteries and inserted a new one.The patient, like many older males, had been diagnosed with cardiac disease; the monitor would provide continuing data on heart rate and rhythm, alerting his doctors to irregularities.Closing the incision required four neat stitches. In a few hours, the patient, a gorilla named Winston, would rejoin his family in their habitat at the San Diego Zoo Safari Park.“Winston, at 51, is a very old male gorilla,” said Dr. Matt Kinney, a senior veterinarian at the San Diego Zoo Wildlife Alliance who led the medical team through the procedure. With improved health care, new technology and better nutrition, “we see animals living longer, and they’re healthier for longer, too,” he said.In “human-managed care” (the term “in captivity” doesn’t fly at zoos anymore), gorillas may live two decades beyond the 30- to 40-year life spans that are common in the wild, and longer than zoo gorillas did in decades past.As with their human relatives, however, aging also brings chronic illnesses that require testing, diagnosis and treatment. Gorillas are prone to heart disease, the leading cause of death for them as for us.So now the questions for Winston’s caregivers resemble those that doctors and older human patients confront: How much treatment is too much? What is the trade-off between prolonged life and quality of life?Geriatric wildlife care “has gotten more and more sophisticated,” said Dr. Paul Calle, the chief veterinarian of the Wildlife Conservation Society, based at the Bronx Zoo. “The medical and surgical knowledge of people can be directly applied.”It looks more like human geriatric care. To keep gorillas healthy, zoo veterinarians not only turn to technologies and drugs developed for humans, but also consult with medical specialists like cardiologists, radiologists, obstetricians and dentists.Winston, for instance, takes four common heart drugs that people also take, though at different dosages. (He weighs 451 pounds.) The heart monitor he received, smaller than a flash drive, is implanted in humans as well. Winston received his annual flu shot this fall, and he is undergoing physical therapy for arthritis. “We’re looking to provide comfort to these animals later in life,” Dr. Kinney said.That doesn’t come cheaply: There were nearly 20 doctors, technicians and other staff in the operating room when Winston received his new monitor. But the San Diego Zoo Wildlife Alliance, parent organization for the zoo and the safari park, covers Winston’s care through its annual operating budget. Donors and partners offset some additional expenses.“None of our animals have insurance, and they never pay their bills,” Dr. Kinney noted. Several of Winston’s longtime caregivers, called wildlife care specialists, have retired. But Winston, who has achieved silverback status with age, remains on the job, managing his “troop” of five gorillas, keeping the peace and intervening in squabbles when needed.“He’s such a gentle silverback, an incredibly tolerant father,” said Jim Haigwood, the curator of mammals at the San Diego Zoo Safari Park. “His youngest daughter, he’ll still allow her to take food out of his mouth.”The zoo has twice introduced females with sons to the troop, which in the wild might lead to infanticide. But Winston’s caregivers believed he would be accepting, and he was.“He raised those males as though they were his own sons,” Mr. Haigwood said. (Once they became rambunctious teenagers, however, they were resettled in their own habitat, an option that human parents might occasionally envy.)Winston, a western lowland gorilla native to Central Africa, arrived at the San Diego Zoo in 1984. He enjoyed robust health until 2017, when his caregivers noticed “a general slowing down,” said Dr. Kinney, who arranged Winston’s first echocardiogram.Winston during a procedure at the Paul Harter Veterinary Medical Center, next to the San Diego Zoo Safari Park, in 2021.San Diego Zoo Wildlife AllianceThe test showed only “a couple of subtle changes, nothing alarming,” Dr. Kinney said. Everyone was relieved. Normal aging.Then in 2021, the whole troop contracted the coronavirus, probably transmitted by a human. As in human patients, age mattered.“Winston was the most severely affected,” Dr. Kinney said. “He had a cough, pretty significant lethargy, lack of appetite.” He began holding on to objects as he walked.After an infusion of monoclonal antibodies, Winston recovered. Now the whole troop has been vaccinated and boosted against the virus.But while Winston was being treated, the veterinarians and human doctors ran other tests that found concerning health issues. Winston’s heart had begun pumping less efficiently; that led to a daily regimen of blood pressure and heart drugs hidden in his food, and to the implanted monitor. He also takes ibuprofen and acetaminophen for arthritis in his spine, hips and shoulders.More worrying was a CT scan and biopsy showing a cancerous tumor damaging Winston’s right kidney. That prompted the kind of risks-versus-benefits conversation that should inform decisions about invasive treatment for older patients, but that is often skipped for humans.“Do we do a surgical procedure?” Dr. Kinney recalled wondering. “The big concern was, what would the recovery look like?” After considering Winston’s age and life expectancy, and determining that the tumor wasn’t growing, “we were comfortable with continuing to monitor him,” he said.For now, “we’re at a good balance,” he said. That is not entirely a medical issue, but reflects Winston’s ability to lead his troop — including a female, Kami, with whom he has had “a very devout partnership” for 25 years, Mr. Haigwood said.Some aspects of healthy aging might come more easily for zoo primates than for people; their keepers provide only healthy choices. “They’re not smoking,” said Marietta Danforth, the director of the Great Ape Heart Project, a research effort at the Detroit Zoo. “They’re not eating cheeseburgers.”Winston’s vegetarian diet consists primarily of tree branches and root vegetables. The half-acre Gorilla Forest where he lives, with its hills and pond and climbing structures, promotes exercise.Still, geriatric care necessarily involves end-of-life decisions. Winston could die a natural death one day like Ozzie, a gorilla who died at Zoo Atlanta two years ago at 61, or Colo, who was 60 when he died at the Columbus Zoo in Ohio in 2017.But if his quality of life declines, if he stops interacting with the troop and his caregivers or begins suffering, parallels with human care end. Even in California, with its medical aid in dying law, euthanasia remains illegal for humans. It is an option for Winston.“It’s a privilege in veterinary medicine,” Dr. Kinney said. “It also comes with great responsibility.”If Winston’s doctors, specialists and caregivers conclude, after extensive discussion, that a painless death would be preferable to a diminished life, “it’s a very calm process,” Dr. Kinney said. After an overdose of anesthesia, he said, “within minutes, there is cardiopulmonary arrest.”About 350 gorillas — and 930 great apes in total, including bonobos, orangutans and chimpanzees — live in U.S. zoos, Dr. Danforth said. However well cared for they are, some animal rights activists and primatologists argue that they don’t belong in zoos. But even People for the Ethical Treatment of Animals, whose position is that wild animals belong in the wild, acknowledged in an email that zoos like San Diego’s, accredited by the Association of Zoos & Aquariums, meet high standards of animal care. Winston “has had high-quality years,” Dr. Kinney said. The gorilla has also become a beloved media personality. San Diego will mourn his loss, whenever and however it happens.For now, “we want to be sure Winston is living a good life, that he’s fulfilled,” Dr. Kinney said. “We have a good understanding of what makes Winston Winston.”

New research, publishing December 21 in the open access journal in PLOS Biology, shows that tears from women contain chemicals that block aggression in men. The study led by Shani Agron at the Weizmann Institute of Science, Israel, finds that sniffing tears leads to reduced brain activity related to aggression, which results is less aggressive behavior.
Male aggression in rodents is known to be blocked when they smell female tears. This is an example of social chemosignaling, a process that is common in animals but less common — or less understood — in humans. To determine whether tears have the same affect in people, the researchers exposed a group of men to either women’s emotional tears or saline while they played a two-person game. The game was designed to elicit aggressive behavior against the other player, whom the men were led to believe was cheating. When given the opportunity, the men could get revenge on the other player by causing them lose money. The men did not know what they were sniffing and could not distinguish between the tears or the saline, which were both odorless.
Revenge-seeking aggressive behavior during the game dropped more than 40% after the men sniffed women’s emotional tears. When repeated in an MRI scanner, functional imaging showed two aggression-related brain regions — the prefrontal cortex and anterior insula — that became more active when the men were provoked during the game, but did not become as active in the same situations when the men were sniffing the tears. Individually, the greater the difference in this brain activity, the less often the player took revenge during the game. Finding this link between tears, brain activity, and aggressive behavior implies that social chemosignaling is a factor in human aggression, not simply an animal curiosity.
The authors add, “We found that just like in mice, human tears contain a chemical signal that blocks conspecific male aggression. This goes against the notion that emotional tears are uniquely human.”