Publisher Health

Homelessness has become an increasingly worrisome crisis in our nation over the past several years, but a new study from the University of Notre Dame shows that efforts to prevent homelessness work.
The issue has reached such proportions in California, for example, that mayors of several major cities have declared a state of emergency on homelessness. In response, leaders in California have invested billions in homelessness programs, including some that target prevention.
Prevention efforts, however, have led to questions — even from organizations committed to addressing homelessness — as to whether such programs are effective, due to the difficulty of targeting assistance to those with the greatest risk of becoming homeless. To test the impact of providing financial assistance to those susceptible to losing their housing, researchers at Notre Dame conducted a randomized controlled trial to evaluate the effect of emergency financial assistance (EFA) on families receiving support through the Santa Clara County Homelessness Prevention System, which is co-led by Destination: Home, a nonprofit organization dedicated to ending homelessness in Silicon Valley.
David Phillips, a research professor in the Wilson Sheehan Lab for Economic Opportunities (LEO) within Notre Dame’s economics department, and James Sullivan, a professor of economics and co-founder of LEO, found that people offered EFA were 81 percent less likely to become homeless within six months of enrollment and 73 percent less likely within 12 months, as reported in their study recently published by The Review of Economics and Statistics.
The study evaluated individuals and families at imminent risk of being evicted or becoming homeless who were allocated EFA between July 2019 and December 2020, with the average household receiving nearly $2,000. Recipients were chosen from among a larger group of people eligible for the program based on their vulnerability to homelessness and on a randomized system set up by LEO and Destination: Home. This temporary financial assistance helped pay rent, utilities or other housing-related expenses on their behalf.
A common approach to fighting homelessness is to provide shelter to those who are already homeless, but the researchers argued that once a family or individual becomes homeless, they face even more difficulties — such as finding permanent housing, basic necessities and health care. They are also more likely to become involved in the criminal justice system and experience frequent hospital visits. LEO’s study found that a preventive approach focusing directly on helping those who are on the brink of homelessness can also be effective.
“Our estimates suggest that the benefits to homelessness prevention exceed the costs,” the researchers said. They estimated that communities get $2.47 back in benefits per net dollar spent on emergency financial assistance.
“Policymakers at all levels are struggling to make really hard decisions about how to allocate scarce resources to address this pervasive problem,” Sullivan said. “But this study shows that you can actually target the intervention to those at risk, which moves the needle on homelessness enough to justify making the investment.”
Phillips added that while homelessness prevention programs are not a panacea to other problems often associated with the most visible forms of homelessness — such as health and substance abuse issues — it is still an effective way to help people.
“Every person who ends up homeless is a little different from the next, and the reasons they’re there are different, but it’s the kind of help they need at the moment they need it, before everything falls apart,” Phillips said.
One of LEO’s main tenets is to take a rigorous approach to fighting poverty by helping service providers apply scientific evaluation methods to better understand and share effective poverty interventions. Said Sullivan, “A big part of LEO’s mission is to create evidence that helps improve the lives of those most vulnerable. Because we have far greater needs than we have resources to address them, we have a real incentive to allocate those resources to the programs that are most effective. This evidence helps shape the decisions of those on the front lines fighting homelessness and poverty.”
Jennifer Loving, chief executive officer of Destination: Home, said the LEO study has implications both locally and nationally. “This could inspire other jurisdictions to stand up their own homelessness prevention systems, using this research as a model or starting point for how to do that on their own — as well as justification to policymakers for funding,” Loving said.

Published56 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, PerrigoBy Madeline HalpertBBC News, New YorkThe US government has approved the first-ever over-the-counter birth control pill. The Food and Drug Administration announced on Thursday birth control pill Opill will be available without a prescription for women of all ages. In a statement, the agency said the move would help reduce women’s barriers to accessing contraception. The manufacturer of Opill has said it will most likely be available over the counter in early 2024.Doctors say that the progestin-only pill – often known as the “minipill” – is a particularly safe form of contraception because it does not contain oestrogen, meaning it has fewer side effects and health risks. The most common side effects of Opill include irregular bleeding, headaches, dizziness and nausea. The US joins more than 100 countries around the world that have made the birth control pill available over the counter, including most countries in Latin America, as well as India, China and the United Kingdom. “When used as directed, daily oral contraception is safe and is expected to be more effective than currently available nonprescription contraceptive methods in preventing unintended pregnancy,” said Dr Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research. The approval comes after an FDA expert advisory panel in May unanimously voted to recommend the pill be available over the counter. Panel backs first US over-the-counter birth controlDuring the hearing, some scientists had raised concerns about whether young people and those with limited literacy could understand the directions, including not taking the prescription if they had a history of breast cancer. But committee members concluded women with breast cancer were already likely to be in contact with their doctors and aware that they should not take hormonal contraception. Ultimately, the panel found that Opill – first approved by the FDA in 1973 – had a history of safety and efficacy in preventing pregnancies. Experts say women – and in particular, teenagers – encounter a number of barriers to accessing reproductive health services, including a lack of health insurance and difficulty finding transportation to doctor’s appointments. Women also sometimes face stigma and shame from health care providers and parents when trying to obtain the pill, experts added. Dyvia Huitron is one of these people. She has struggled for three years to access the birth control pill. Growing up in a predominately Hispanic, religious community in the border town of McAllen, Texas, the 19-year-old first tried to get a prescription when she started having sex at age 16. But her parents, who had her when they were teenagers, denied her the required permission because they worried the contraceptive would make her engage in more sexually risky behaviour. Then, at age 18, Ms Huitron went to college in Alabama, where the age of adulthood is 19, meaning her parents would still be able to review her medical information, forcing her to wait one more year.”Because I came from teen parents, that was one of my biggest fears,” she told the BBC. “I wanted to do everything to prevent that same outcome … But I had to jump through so many hoops.”Doctors and activists have argued making birth control available without a prescription will have a host of health benefits for women and teenagers like Ms Huitron, including reducing unintended pregnancies. In the US, some studies have found as many as nearly half of all pregnancies are unintended. For the most part, the debate on whether to make contraception more readily available has not sparked the same controversy as the conversation around abortion access. In statements to the BBC, several anti-abortion groups, including National Right to Life and Susan B Anthony Pro Life America, said they do not take a stance on birth control. The FDA decision was lauded by several medical and advocacy groups on Thursday, including Advocates for Youth, a nonprofit organisation pushing for reproductive health rights, which called the approval “long overdue”. The group says the price of the pill remains a concern, especially for young people. The organisation plans to advocate for insurance companies to consider covering the over-the-counter purchases. It is unclear exactly how much Opill will cost at pharmacies, but the Biden administration said the pill’s manufacturer, Perrigo, will determine its price. More on this storyUS considers over-the-counter birth control pillsPublished12 July 2022Panel backs first US over-the-counter birth controlPublished10 May

The price of the pill, which has not been announced, will determine how affordable it will be when it becomes available in early 2024.The Food and Drug Administration on Thursday approved a birth control pill to be sold without a prescription for the first time in the United States, a milestone that could significantly expand access to contraception.The medication, called Opill, will become the most effective birth control method available over the counter — more effective at preventing pregnancy than condoms, spermicides and other nonprescription methods. Experts in reproductive health said its availability could be especially useful for young women, teenagers and those who have difficulty dealing with the time, costs or logistical hurdles involved in visiting a doctor to obtain a prescription.The pill’s manufacturer, Perrigo Company, based in Dublin, said Opill would most likely become available from stores and online retailers in the United States in early 2024.The company did not say how much the medication would cost — a key question that will help determine how many people will use the pill — but Frédérique Welgryn, Perrigo’s global vice president for women’s health, said in a statement that the company was committed to making the pill “accessible and affordable to women and people of all ages.” Ms. Welgryn has also said the company would have a consumer assistance program to provide the pill at no cost to some women.Since the Supreme Court overturned the national right to an abortion last year, the accessibility of contraception has become an increasingly urgent issue. But long before that, the move to make a nonprescription pill available for all ages had received widespread support from specialists in reproductive and adolescent health and groups like the American Medical Association, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians.In a survey last year by the health care research organization KFF, more than three-quarters of women of reproductive age said they favored an over-the-counter pill, primarily because of convenience. Nearly 40 percent said they would be likely to use it. Those most likely to opt for the product included women already taking birth control pills, women without health insurance and Hispanic women, the survey found.And strikingly, at a time of fierce divisions over abortion, many anti-abortion groups have declined to criticize over-the-counter birth control. Opposition appears to come primarily from some Catholic organizations and Students for Life Action.In May, a panel of 17 independent scientific advisers to the F.D.A. — including obstetrician-gynecologists, adolescent medicine specialists, a breast cancer specialist and experts in consumer health behavior and health literacy — voted unanimously that the benefits of making a birth control pill available without a prescription vastly outweighed the risks. The panel cited the long history of safety and efficacy of Opill, which was approved for prescription use 50 years ago. The over-the-counter pill will be identical to the prescription version, which is 93 percent effective at preventing pregnancy with typical use. Several panelists said there was a pressing public health need for an over-the-counter option in a country where nearly half of all pregnancies are unintended.“The evidence demonstrates that the benefits clearly exceed the risks,” said one advisory committee member, Kathryn Curtis, a health scientist with the Centers for Disease Control and Prevention’s division of reproductive health. She added: “I think Opill has the potential to have a huge positive public health impact.”For proponents of over-the-counter pills, the main issue is affordability.The Affordable Care Act requires heath insurance plans to pay for prescription contraception, but not over-the-counter methods. Some states have laws mandating coverage of over-the-counter birth control, but most states do not. The KFF survey found that 10 percent of women would not be able or willing to pay any out-of-pocket cost for contraception. About 40 percent would pay $10 or less per month, and about a third would pay $20 or less.Under a recent executive order by President Biden, the federal government could soon take steps toward requiring insurers to cover over-the-counter birth control. And Senate Democrats have reintroduced legislation to require such coverage.“We need to make it affordable and available,” Senator Patty Murray, a Democrat from Washington State and a co-sponsor of the bill, said in an interview in May. “Let’s provide women what they need and make sure it’s affordable so there’s equity, and women who are low-income, women who for whatever reason are struggling don’t have to be forced to not have any birth control simply because they can’t afford it today,” she added.Opill is known as a “mini pill” because it contains only one hormone, progestin, in contrast to “combination” pills, which contain both progestin and estrogen. A company that makes a combination pill, Cadence Health, has also been in discussions with the F.D.A. about applying for over-the-counter status.The F.D.A. analysts who evaluated the data Perrigo submitted in its application for a nonprescription Opill had raised concerns about whether women with medical conditions that should preclude them from taking birth control pills — primarily breast cancer and undiagnosed vaginal bleeding — would follow the warnings and avoid the product. The F.D.A. analysts also raised questions about whether younger adolescents and people with limited literacy could follow the directions.Several advisory committee members said patients with breast cancer, the main medical condition that precludes taking hormonal contraception, typically have doctors who would advise them to avoid birth control pills. They also said that Opill might actually be safest for adolescents because they are very unlikely to have breast cancer. And because young people often start off with contraception they can buy over-the-counter, it is especially important for them to have easy access to a method more effective than condoms and other birth control products available in retail stores, the panelists said. Perrigo reported that participants in a study took Opill on 92.5 percent of the days they were supposed to take it. Most participants who missed a pill reported that they had followed the label’s directions to take mitigating steps, such as abstaining from sex or using a condom, Dr. Stephanie Sober, the company’s U.S. medical liaison, said at the advisory committee hearing. She said that among 955 participants, only six became pregnant while using Opill.Most people who said they had missed doses attributed that to running out of pills before they could get to one of the study’s resupply sites, results that, Dr. Sober said, “illustrate precisely the barriers to adherence that could be lessened” by making the pill available over the counter.

Published1 hour agoShareclose panelShare pageCopy linkAbout sharingImage source, ReutersBy Guy Hedgecoe in Madrid, Sofia Bettiza in Rome & James Gregory in LondonBBC NewsA heatwave is sweeping across parts of southern Europe and north-west Africa, with potential record-breaking temperatures in the coming days.Temperatures are expected to surpass 40C (104F) in parts of Spain, France, Greece, Croatia and Turkey.In Italy, temperatures could reach as high as 48.8C (119.8F). A red alert warning has been issued for 10 cities, including Rome, Bologna and Florence.On Tuesday, a man in his forties died after collapsing in northern Italy.Italian media reported that the 44-year-old worker was painting zebra crossing lines in the town of Lodi, near Milan, before he collapsed from the heat. He was taken to hospital where he later died. “We are facing an unbearable heatwave,” Italian politician Nicola Fratoianni tweeted. “Maybe it’s the case that in the hottest hours, all the useful precautions are taken to avoid tragedies like the one that happened today in Lodi.”People have been advised to drink at least two litres of water a day and to avoid coffee and alcohol, which are dehydrating. One group of tourists on the streets of Rome told the Reuters news agency they were using sprinklers and thermal water as part of efforts to keep themselves cool. “We’re trying to survive,” said Mariko Desso, who was visiting from the southern city of Bari.Several visitors to the country have already collapsed from heatstroke, including a British man outside the Colosseum in Rome. Why this summer has been so hotA simple guide to climate changeIs climate change causing droughts, heatwaves, wildfires and floods? In pictures: Cerberus heatwave hits parts of EuropeThe Cerberus heatwave – named by the Italian Meteorological Society after the three-headed monster that features in Dante’s Inferno – is expected to bring extreme conditions in the next few days. Spain has been sweltering for days in temperatures of up to 45C and overnight temperatures in much of the country did not drop below 25C. Parts of Majorca on Wednesday were as high as 37C at 04:00.The Andalusian regional government has started a telephone assistance service for people affected by the heat which has received 54,000 calls since it opened in early June. On the Spanish island of Majorca, the emergency health hotline has had to deal with more than one case of heatstroke every day since May.A satellite image recorded by the EU’s Copernicus Sentinel mission revealed that the land temperature in the Extremadura region had hit 60C on Tuesday.Image source, European Union, Copernicus Sentinel-X imagery”It is true that the temperatures have risen, but much, much higher than in other years,” Madrid resident Alejandrina Coy told Reuters.”I see that this is affecting everyone a lot.””The weather is becoming less and less linear, there is less difference between the seasons,” said Paz Llanes, another resident. The Met Office says temperatures will peak on Friday, and BBC Weather says large swathes of southern Europe could see temperatures in the low to mid 40s – and possibly higher. The heat is likely to continue into the weekend, and in Prague, the Czech capital, temperatures could reach as high as 36C (96.8F) on Saturday, according to BBC Weather – well up from averages of 24C (75.2F) in July. But as Cerberus dies out, Italian weather forecasters are warning that the next heatwave, dubbed Charon after the ferryman who delivered souls into the underworld, will push temperatures back up towards 43C in Rome and a possible 47C on the island of Sardinia.Europe’s hottest-ever temperature of 48.8C (119.8F) was recorded near Syracuse on the Italian island of Sicily in August 2021.A new study says 61,672 people died in Europe as a result of the heat last year. ISGlobal Institute in Barcelona said Italy had most deaths that could be attributable to the heat, with 18,010, while Spain had 11,324 and Germany 8,173.The fear is that this heatwave could cause many more deaths this summer. ISGlobal’s research shows that that the cities in Spain with the highest risk of deaths caused by the heat are Madrid, Barcelona, Valencia, Sevilla, Málaga, Murcia, Palma de Mallorca and Bilbao.A heatwave is a period of hot weather where temperatures are higher than is expected for the time of year.Experts say periods of exceptionally hot weather are becoming more frequent and climate change means it is now normal to experience record-breaking temperatures. The European Centre for Medium-Range Weather forecasts said that globally, this June was the hottest on record.More on this storyThe new normal – why this summer has been so very hotPublished4 days ago

A new talking therapy for depression has shown encouraging early signs of being more effective and cheaper to deliver than the current best practice of Cognitive Behavioural Therapy (CBT).
A pilot trial from the University of Exeter, funded by the National Institute of Health and Care Research (NIHR) and published in Lancet EClinical Medicine, has found Augmented Depression Therapy (ADepT) could be a significant advance in depression care.
A core feature of depression is anhedonia (reduced interest or pleasure) and wellbeing deficits, but current depression psychotherapies like CBT fail to adequately target these components. ADepT has been developed to pay just as much attention to building wellbeing as it does reducing depressive symptoms.
Professor of Clinical Psychology, Barney Dunn, from the University of Exeter led the trial and said: “Depression is widespread and a significant contributor to global disability, resulting in extensive social and economic costs. Only around 60 percent of people will recover during our current best treatments like CBT and about half of those will relapse within two years. In ADepT, we encourage clients to take a new perspective to their difficulties, aiming to learn to live well alongside depressed mood. The primary goal is to help clients identify what is important to them in key life areas, take steps towards living a life in a way that is consistent with these values, and to take opportunities and manage challenges while they do so that they can experience wellbeing and pleasure.”
Katie has lived experience of ADepT and said: “I’ve got a fairly long history of using mental health services and that’s almost become my identity over the years. My focus in treatment before had always been on trying to eliminate symptoms of mental illness. ADepT has changed my outlook to help me take steps to gain wellbeing, as well as allowing me to be more authentic and act in a way more aligned to my values. ADepT is helping me make decisions which feel right and giving me more of an identity outside of mental illness, which is amazing. I’ve learnt to be able to enjoy the good things in life that give me pleasure, even when I am having a difficult week. It really has changed things for me.”
This is the first pilot randomised controlled trial evaluating the effects of ADepT. 82 adults with moderate to severe depression and exhibiting features of anhedonia took part and were primarily recruited from NHS Talking Therapy (formerly known as Improving Access to Psychological Therapy) service waiting lists in Devon, UK. Participants were randomly assigned to either 20 individual sessions of ADepT or CBT, delivered in the University of Exeter AccEPT clinic and supported by Devon Partnership NHS Trust, Exeter Collaboration for Academic Primary Care (APEx), and University of Exeter Psychology Department. Participants were assessed by researchers at the beginning of the pilot, as well as after six, 12, and 18 months.
Results suggested that ADepT was definitely not worse than, and showed potential to be better than, CBT at building wellbeing and reducing depression at the end of treatment and over longer-term follow-up. Results also suggested ADepT was cost-effective, costing the same amount to deliver as CBT but resulting in greater gains in quality of life. If these findings can be replicated in a subsequent definitive trial, it would suggest that ADepT can have both clinical and economic benefits in healthcare settings. ADepT has also been designed so that existing CBT therapists will be able to deliver it with minimal additional training.

Researchers at University of Michigan developed a method to produce artificially grown miniature brains — called human brain organoids — free of animal cells that could greatly improve the way neurodegenerative conditions are studied and, eventually, treated.
Over the last decade of researching neurologic diseases, scientists have explored the use of human brain organoids as an alternative to mouse models. These self-assembled, 3D tissues derived from embryonic or pluripotent stem cells more closely model the complex brain structure compared to conventional two-dimensional cultures.
Until now, the engineered network of proteins and molecules that give structure to the cells in brain organoids, known as extracellular matrices, often used a substance derived from mouse sarcomas called Matrigel. That method suffers significant disadvantages, with a relatively undefined composition and batch-to-batch variability.
The latest U-M research, published in Annals of Clinical and Translational Neurology, offers a solution to overcome Matrigel’s weaknesses. Investigators created a novel culture method that uses an engineered extracellular matrix for human brain organoids — without the presence of animal components — and enhanced the neurogenesis of brain organoids compared to previous studies.
“This advancement in the development of human brain organoids free of animal components will allow for significant strides in the understanding of neurodevelopmental biology,” said senior author Joerg Lahann, Ph.D., director of the U-M Biointerfaces Institute and Wolfgang Pauli Collegiate Professor of Chemical Engineering at U-M.
“Scientists have long struggled to translate animal research into the clinical world, and this novel method will make it easier for translational research to make its way from the lab to the clinic.”
The foundational extracellular matrices of the research team’s brain organoids were composed of human fibronectin, a protein that serves as a native structure for stem cells to adhere, differentiate and mature. They were supported by a highly porous polymer scaffold.

The organoids were cultured for months, while lab staff was unable to enter the building due to the COVID 19-pandemic.
Using proteomics, researchers found their brain organoids developed cerebral spinal fluid, a clear liquid that flows around healthy brain and spinal cords. This fluid more closely matched human adult CSF compared to a landmark study of human brain organoids developed in Matrigel.
“When our brains are naturally developing in utero, they are of course not growing on a bed of extracellular matrix produced by mouse cancer cells,” said first author Ayse Muñiz, Ph.D., who was a graduate student in the U-M Macromolecular Science and Engineering Program at the time of the work.
“By putting cells in an engineered niche that more closely resembles their natural environment, we predicted we would observe differences in organoid development that more faithfully mimics what we see in nature.”
The success of these xenogeneic-free human brain organoids opens the door for reprogramming with cells from patients with neurodegenerative diseases, says co-author Eva Feldman, M.D., Ph.D., director of the ALS Center of Excellence at U-M and James W. Albers Distinguished Professor of Neurology at U-M Medical School.
“There is a possibility to take the stem cells from a patient with a condition such as ALS or Alzheimer’s and, essentially, build an avatar mini brain of that patients to investigate possible treatments or model how their disease will progress,” Feldman said. “These models would create another avenue to predict disease and study treatment on a personalized level for conditions that often vary greatly from person to person.”

Older people who have little social contact with others may be more likely to have loss of overall brain volume, and in areas of the brain affected by dementia, than people with more frequent social contact, according to a study published in the July 12, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.
The study does not prove that social isolation causes brain shrinkage; it only shows an association.
“Social isolation is a growing problem for older adults,” said study author Toshiharu Ninomiya, MD, PhD, of Kyushu University in Fukuoka, Japan. “These results suggest that providing support for people to help them start and maintain their connections to others may be beneficial for preventing brain atrophy and the development of dementia.”
The study involved 8,896 people with an average age of 73 who did not have dementia. They had MRI brain scans and health exams. To determine social contact, people were asked one question: How often are you in contact with relatives or friends who do not live with you (e.g., meeting or talking on the phone)? The choices for answering were every day, several times a week, several times a month and seldom.
The people with the lowest amount of social contact had overall brain volume that was significantly lower than those with the most social contact. The total brain volume, or the sum of white and grey matter, as a percentage of the total intracranial volume, or the volume within the cranium, including the brain, meninges, and cerebrospinal fluid, was 67.3% in the lowest contact group compared to 67.8% in the highest contact group. They also had lower volumes in areas of the brain such as the hippocampus and amygdala that play a role in memory and are affected by dementia.
The researchers took into account other factors that could affect brain volume, such as age, diabetes, smoking and exercise.
The socially isolated people also had more small areas of damage in the brain, called white matter lesions, than the people with frequent social contact. The percentage of intracranial volume made up of white matter lesions was 0.30 for the socially isolated group, compared to 0.26 for the most socially connected group.
The researchers found that symptoms of depression partly explained the relationship between social isolation and brain volumes. However, symptoms of depression accounted for only 15% to 29% of the association.
“While this study is a snapshot in time and does not determine that social isolation causes brain atrophy, some studies have shown that exposing older people to socially stimulating groups stopped or even reversed declines in brain volume and improved thinking and memory skills, so it’s possible that interventions to improve people’s social isolation could prevent brain volume loss and the dementia that often follows,” Ninomiya said.
Since the study involved only older Japanese people, a limitation is that the findings may not be generalizable to people of other ethnicities and younger people.
The study was supported by the Japan Agency for Medical Research and Development and Suntory Holdings Limited.

A new study suggests that eye drops developed by Columbia University researchers could be a more effective-and comfortable-therapy for a common eye disease currently treated with injections into the eye.
Retinal vein occlusion (RVO), an eye disease that affects up to 2% of people over age 40, occurs when a vein in the eye’s retina becomes blocked, leading to swelling in the eye, inflammation, damage to the retina, and vision loss.
Standard therapy involves injecting into the eye a vascular endothelial growth factor inhibitor (anti-VEGF) that reduces swelling. The therapy can improve vision but patients with significant retinal damage due to impaired blood flow often have poor outcomes.
“Anti-VEGF therapy has helped a lot of people with RVO, but the fear factor — having to get a needle in the eye — causes many people to delay treatment, which can lead to retinal damage,” says Carol M. Troy, MD, PhD, professor of pathology & cell biology and of neurology at Columbia University Vagelos College of Physicians and Surgeons. “There’s an opportunity to help more people with this disease that is a leading cause of blindness worldwide.”
The study found that an experimental eye drop treatment was twice as effective as the standard injection therapy at reducing swelling and improving blood flow within the retina of mice with RVO. The eye drops also prevented neurons (photoreceptors) in the retina from deteriorating and preserved visual function over time, whereas the standard injections had no effect on either.
Eye drops target ‘death enzyme’
The eye drops contain an experimental drug that blocks caspase-9, an enzyme that triggers cell death, and was found by Troy’s lab to be overactive in blood vessels injured by RVO.

“We think the eye drops improve the health of blood vessels in the retina, which then decreases the toxic signaling that damages the retina’s neurons and leads to vision loss,” says Maria I. Avrutsky, PhD, the study’s first author who conducted the research as a postdoc in the Troy lab.
Future studies are aimed at preparing to test the eye drops in human clinical trials and identifying additional therapeutic targets.
“Finding the root cause of RVO is the holy grail, but if we can at least provide better symptomatic relief that doesn’t distress patients, it would be a really good start,” Troy says.
More information
The study, “Caspase-9 inhibition confers stronger neuronal and vascular protection compared to VEGF neutralization in a mouse model of retinal vein occlusion,” was published online in Frontiers of Neuroscience.
All authors: Maria I. Avrutsky (Columbia, now at Character Biosciences), Claire W. Chen (Columbia), Jacqueline M. Lawson (Columbia), Scott J. Snipas (Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA) Guy S. Salvesen (Sanford Burnham Prebys), and Carol M. Troy (Columbia).
The study was supported by a sponsored research agreement with Opera Therapeutics and grants from the National Institutes of Health (R01NS091333 and T32EY013933) and the Department of Defense Army/Air Force.
Carol Troy and Maria Avrutsky are inventors on patent applications filed by Columbia University related to the therapeutic use of caspase-9 inhibitors. Maria Avrutsky received consulting income from Opera Therapeutics.

Physical activity is a crucial component of a healthy lifestyle, yet only one in three adults in the United States meets the weekly recommendation for exercise. The struggle to stay fit is complicated even further for parents, who often prioritize their children’s needs over their own.
A new study, titled “The Association between Adult Sport, Fitness, and Recreational Physical Activity and Number and Age of Children Present in the Household,” reveals that adults with multiple young children engage in significantly less vigorous physical activity compared to those with fewer or no children. The findings have important implications for adults who aspire to be more physically active but struggle to find the time due to their caregiving responsibilities.
Published in the International Journal of Environmental Research and Public Health, the study is based on an analysis of data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007-2016, and included 2,034 adults aged 22 to 65.
The researchers examined the association between moderate and vigorous physical activities and the number and age of children in their household. Among the findings, adults with two or more children aged 0-5 reported 80 fewer minutes of weekly vigorous physical activity compared to those with no children or just one child in this age group. Similarly, adults with three or more children aged 6-17 reported 50 fewer minutes of weekly vigorous physical activity compared to those with no children, one or just two kids in the household. However, there were no significant differences in weekly moderate physical activity regardless of the number of children in the household.
“Parents often face numerous challenges in finding the time and energy to engage in regular physical activity while caring for their children. By understanding these barriers, we can develop targeted interventions to help parents lead healthier and more active lives,” said study co-author Bettina Beech, Chief Population Health Officer at the University of Houston, and clinical professor of population health at the Tilman J. Fertitta Family College of Medicine.
The lead author of the study is Jerraco Johnson, an assistant professor of kinesiology, health promotion and recreation at the University of North Texas.
“Parents typically serve as the primary role models of health behaviors for their children. Finding ways to increase parents’ physical activity could potentially influence the health trajectories these young children begin on, especially for those parents with multiple kids,” he said.
Other researchers include Ailton Coleman, James Madison University; Jamila Kwarteng, Medical College of Wisconsin; Ahondju Holmes, University of Oklahoma; Dulcie Kermah, Charles R. Drew University of Medicine and Science; and Marino Bruce, University of Houston.
The implications of these findings are significant for interventions and policies aimed at promoting physical activity among parents with multiple children. The study highlights the need for family based physical activity interventions to expand their focus beyond parent-child dyads or triads. Including multiple children in these interventions may have a more significant impact on overall physical activity levels, according to the researchers.
“Workplace wellness programs have been shown as effective avenues for intervention,” said study co-author Marino Bruce, director of UH Population Health Collaboratories and associate dean of research at the Fertitta Family College of Medicine. “Parents often spend a majority of their time outside of parenting in the workplace, making it an ideal setting to promote physical activity. By offering incentives, feedback mechanisms and short bouts of physical activity throughout the workday, employers can support parents in achieving their activity goals and overcoming time-related barriers.”
Interestingly, the study also found that the impact of children on physical activity did not significantly differ between mothers and fathers, despite previous studies which suggested that mothers might be more affected by parental responsibilities. This discrepancy could be attributed to the differing measurements of physical activity used in the studies, with the current research relying on self-reported sport, fitness and recreational activities.
The researchers note that further research is needed to explore this relationship among parents with children of various ages. The study’s findings underscore the importance of addressing the specific needs of parents with multiple children to promote a healthier and more active population.

The majority of individuals with multiple sclerosis (MS) treat the chronic and progressive neurological disorder with oral medications, likely because of many factors, including convenience, consumer advertising and approval by health insurers, according to Rutgers researchers.
“While two injectable therapies known as platform injectables, were once the mainstay of multiple sclerosis treatment, our study showed oral therapies became the predominate treatment for multiple sclerosis by 2020,” said Mackenzie Henderson, a postdoctoral researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) and the lead author of the study. “Our investigation offers an important step in understanding the evolving treatment landscape for MS among U.S. adults and children.”
The study, published in JAMA Neurology, examined a large and diverse sample of commercially insured adults and children in the United States to evaluate trends in uptake of therapies between 2001 and 2020 for patients with MS, a chronic and progressive neurological disorder and the leading cause of nontraumatic disability among young and middle-aged adults.
In 2000, there were two medications approved for MS treatment in the U.S., but over the past 20 years, more than 10 new medications have been approved, according to researchers.
Research on how these approvals have changed clinical practice has been limited. The Rutgers study shows injectable therapies accounted for nearly 100 percent of medications for MS patients in 2001, but by 2020 that decreased to about 25 percent, with oral therapies rising sharply after their introduction in 2010.
Using commercial claims data from more than 100,000 patients with MS between 2001 and 2020, researchers analyzed injectable, infusion and oral treatment trends. They found that oral medications increased sharply in popularity to become the preferable treatment for MS patients over infusion and injectable treatments. Infusion therapies remained low in uptake, accounting for about 8 percent of therapy initiations in 2020, and platform injectable therapy use declined almost 74 percent throughout the study period, according to researchers.
“Despite the availability and efficacy of infusion therapies for multiple sclerosis, we found that their utilization remained relatively low throughout the study period,” said Chintan Dave, a faculty member at the Center for Pharmacoepidemiology and Treatment Science (PETS) at IFH, an assistant professor with Rutgers Ernest Mario School of Pharmacy and a senior author of the study. “This may be due to several factors contributing to this treatment decision by patients and clinicians, including the preference for more convenient oral therapies, the relatively recent introduction of infusion options, and considerations of safety and cost.”
Researchers said this investigation offers a crucial step in understanding the evolving treatment landscape for MS patients and future research should evaluate the impact of new therapies as they emerge.
Coauthors of the study include Daniel Horton of PETS, Rutgers Robert Wood Johnson Medical School and the Rutgers School of Public Health; Greta Bushnell of PETS and the Rutgers School of Public Health; and Vikram Bhise and Gian Pal of Rutgers Robert Wood Johnson Medical School.