Publisher Health

Researchers led by Lund University in Sweden have assisted microbiologists in Ukraine in investigating bacterial resistance among the war-wounded patients treated in hospitals. The results, which were recently published in TheLancet Infectious Diseases, reveal that many of the patients were affected by bacteria that exhibited an extremely high level of antibiotic resistance.
“I am quite thick-skinned and have witnessed numerous situations involving patients and bacteria. However, I must admit that I have never encountered bacteria as resistant as this before,” says Kristian Riesbeck, professor of Clinical Bacteriology at Lund University.
There was never any doubt about helping out when Dr. Oleksandr Nazarchuk, a microbiologist at a university in Vinnytsia, Ukraine, got in touch, says Kristian Riesbeck. Help was needed in Ukraine to assess the extent of antibiotic resistance in bacteria among severely injured patients in hospital.
In addition to all the human suffering caused by the war in Ukraine, another battle is being fought — an invisible war against resistant bacteria. This became evident when Kristian Riesbeck and his research colleagues analysed patient samples from seriously wounded patients, many of whom had burn injuries, in Ukraine. The patients had acquired infections while in hospital, primarily due to the overwhelmed wards and destroyed infrastructure.
Samples were collected from a total of 141 war victims, 133 adults who sustained injures during the war and eight infants diagnosed with pneumonia. These patients were admitted to three different hospitals in Ukraine, where they received emergency surgeries and intensive care to address their conditions.
“We observed that several the Gram-negative bacteria exhibited resistance to broad-spectrum antimicrobial agents, including newly developed enzyme-inhibiting antibiotics that are not yet available in the market. Moreover, nearly ten per cent of the samples contained bacteria that demonstrated resistance even to “our last-resort” antibiotic, colistin. While we have encountered similar cases in India and China before, nothing compares to the extent of resistance observed in this study. As much as six per cent of all the samples contained bacteria resistant to every antibiotic we tested,” says Kristian Riesbeck.
He emphasizes that this clearly highlights the challenges posed by resistant bacteria in times of war. In particular, Kristian Riesbeck expresses concern regarding the resistance displayed by Klebsiella pneumoniae bacteria, as they have the potential to cause illness in individuals with a healthy and well-functioning immune system.
“This makes me very worried. It’s rare to encounter Klebsiella with such high levels of resistance, and it was not what we anticipated. While isolated cases have been documented in China, the magnitude of this situation surpasses anything we have seen before. While many countries are providing military aid and resources to Ukraine, it is equally crucial to assist them in addressing this ongoing situation. There is an evient risk of further spread of resistant bacteria, and this threatens the entire European region,” remarks Kristian Riesbeck.

A new machine learning model uses electrocardiogram (ECG) readings to diagnose and classify heart attacks faster and more accurately than current approaches, according to a study led by University of Pittsburgh researchers that published today in Nature Medicine.
“When a patient comes into the hospital with chest pain, the first question we ask is whether the patient is having a heart attack or not. It seems like that should be straightforward, but when it’s not clear from the ECG, it can take up to 24 hours to complete additional tests,” said lead author Salah Al-Zaiti, Ph.D., R.N., associate professor in the Pitt School of Nursing and of emergency medicine and cardiology in the School of Medicine. “Our model helps address this major challenge by improving risk assessment so that patients can get appropriate care without delay.”
Among the peaks and valleys of an electrocardiogram, clinicians can easily recognize a distinct pattern that indicates the worst type of heart attack called STEMI. These severe episodes are caused by total blockage of a coronary artery and require immediate intervention to restore blood flow.
The problem is that almost two-thirds of heart attacks are caused by severe blockage, but do not have the telltale ECG pattern. The new tool helps detect subtle clues in the ECG that are difficult for clinicians to spot and improves classification of patients with chest pain.
The model was developed by co-author Ervin Sejdic, Ph.D., associate professor at The Edward S. Rogers Department of Electrical and Computer Engineering at the University of Toronto and the Research Chair in Artificial Intelligence for Health Outcomes at North York General Hospital in Toronto, with ECGs from 4,026 patients with chest pain at three hospitals in Pittsburgh. The model was then externally validated with 3,287 patients from a different hospital system.
The researchers compared their model to three gold standards for assessing cardiac events: experienced clinician interpretation of ECG, commercial ECG algorithms and the HEART score, which considers history at presentation — including pain and other symptoms — ECG interpretation, age, risk factors — such as smoking, diabetes, high cholesterol — and blood levels of a protein called troponin.

The model outperformed all three, accurately reclassifying 1 in 3 patients with chest pain as low, intermediate or high risk.
“In our wildest dreams, we hoped to match the accuracy of HEART, but we were surprised to find that our machine learning model based solely on ECG exceeded this score,” said Al-Zaiti.
According to co-author Christian Martin-Gill, M.D., M.P.H., chief of the Emergency Medical Services (EMS) division at UPMC, the algorithm will help EMS personnel and emergency department providers identify people having a heart attack and those with reduced blood flow to the heart in a much more robust way compared with traditional ECG analysis.
“This information can help guide EMS medical decisions such as initiating certain treatments in the field or alerting hospitals that a high-risk patient is incoming,” Martin-Gill added. “On the flip side, it’s also exciting that it can help identify low-risk patients who don’t need to go to a hospital with a specialized cardiac facility, which could improve prehospital triage.”
In the next phase of this research, the team is optimizing how the model will be deployed in partnership with City of Pittsburgh Bureau of Emergency Medical Services. Al-Zaiti said that they’re developing a cloud-based system that integrates with hospital command centers that receive ECG readings from EMS. The model will analyze the ECG and send back a risk assessment of the patient, guiding medical decisions in real-time.
Other authors who contributed to this research were Zeineb Bouzid, Stephanie Helman, M.S.N., R.N., Nathan Riek, Karina Kraevsky-Phillips, M.A., R.N., Gilles Clermont, M.D., Murat Akcakaya, Ph.D., Susan Sereika, Ph.D., Samir Saba, M.D., and Clifton Callaway, M.D., Ph.D., all of Pitt; Jessica Zègre-Hemsey, Ph.D., R.N., of the University of North Carolina; Ziad Faramand, M.D., of Northeast Georgia Health System; Mohammad Alrawashdeh, Ph.D., of Harvard Medical School; Richard Gregg, M.S., of Philips Healthcare; Peter Van Dam, of University Medical Center Utrecht; Stephen Smith, M.D., of Hennepin Healthcare and the University of Minnesota; and Yochai Birnbaum, M.D., of Baylor College of Medicine.
This research was supported by the National Heart, Lung, and Blood Institute, the National Center for Advancing Translational Sciences and the National Institute for Nursing Research through grants R01HL137761, UL1TR001857, K23NR017896 and KL2TR002490.

Humans contain multitudes. Each person on the planet contains enough DNA to stretch to Pluto — several times.
Studying how all this genetic material works, and especially how genes influence human behavior, is an enormously complicated undertaking — one that’s being made easier by the emergence of massive banks of genetic data and complex data science analysis techniques to parse that data.
Robbee Wedow, an assistant professor of sociology and data science in Purdue University’s College of Liberal Arts, an adjunct assistant professor of medical and molecular genetics in the Indiana University School of Medicine, and Purdue’s inaugural faculty-in-residence at AnalytiXIN/16 Tech in Indianapolis, maps those miles of genes for insights into how genetics interacts with social forces and environments. He uses genetic databases to study how tiny bits of genes called single nucleotide polymorphisms, or SNPs, affect complex, overarching traits including sexual behavior, educational attainment, socioeconomic status, health behaviors and more.
“We know that social forces like socioeconomic status play a role in influencing a person’s life and life outcomes,” Wedow said. “But we also know there is a genetic component to every behavior. What we don’t understand yet is how these biological forces interact with the environment and what these sorts of interactions might mean for social science — and what we think we know about social science research to date. We are using well-powered genetic data to do more accurate and replicable social science and to explore what might be possible at the intersection of genetic and behavioral science.”
When scientists sequenced the first human genome in 2003, the true scale of genetics started to become apparent. Early geneticists thought that finding a gene for each trait was simply a matter of looking in the right place.
However, DNA bases and genes are not simply keys on a massive piano upon which human lives are played like masterpieces. Instead, DNA operates more like a pipe organ, where stops, switches and pedals can change the way notes sound, mute them or increase their volume. Environment, nutrition, pollution, life experiences and other circumstances can change when and how genes matter for certain outcomes, and even change which places in the genomes matter for those outcomes altogether. There isn’t a single gene for a behavioral outcome. Biology isn’t destiny: It may lay out the musical score, but musicians are free to improvise and interpret as they play.

The idea, Wedow stresses, is not that these genes control a person’s life or destiny. Each SNP, in fact, has a very small effect on an overall outcome like educational attainment. No “Gattaca”-level reading of one’s destiny from their genes — in the style of the dystopian 1990s movie — is on the horizon. Rather, being able to clarify the genetics of certain behaviors can help scientists understand the nuances of human behavior.
“People think that genetics is always about biology, but in the case of sociogenomics it’s more about using the advantages of this new, well-powered data to better understand the outcomes themselves, or about allowing researchers to do more accurate social science and behavioral research,” Wedow said. “The social sciences have recently struggled with replicating studies. Oftentimes the sample sizes are too small for rigorous estimates and certainty. That’s where the potential of using these huge banks of genetic data for the social sciences comes in. They help us get a much clearer, more certain look at what’s really going on.”
Analyzing the genetics is only the first step. An American geneticist in the early 1800s could have correlated genetics with educational mastery and concluded that anyone with two X chromosomes tended to have less education. That is not because the chromosomes had anything at all to do with education. Rather, the correlation reflected social and gender biases present in the culture at the time. Similar insights lurk in Wedow’s research.
“Sociogenomics isn’t necessarily about biology, like some might think,” Wedow said. “When someone studies cancer genetics, they are studying it because they want to elucidate the biology of cancer; they want to figure out ways to better diagnose it, track it and treat it. But researchers in the field of sociogenomics want to study the genetics in order to do better social science. No one would ever study sociology without considering socioeconomic status and environment. We want to be able to take genetics into account in the same way.”
In a study in volume 7, No. 7 of the journal Nature Human Behaviour, Wedow, his co-corresponding author Andrea Ganna from the University of Helsinki, and his other co-authors looked at 109 survey questions in over 300,000 individuals to examine the ways that people’s genes correlated with whether they answered certain questions or left them blank in surveys answered in the UK Biobank. That may sound fairly abstruse, but it fills a gap that the field of sociology has struggled with for decades.
“How do you know what you don’t know or how someone might have answered a question if they choose not to answer it?” Wedow said. “It turns out that the genetics of people who either answer the survey question, or do not, overlaps with the genetics of other outcomes like education, income or certain health behaviors.”
That means that scientists can use this type of data to get a better understanding of how people who choose not to answer questionnaires might also share similar responses to questions about health or social behaviors. Geneticists can also use the results of this study to correct for bias in genetic studies of any behavioral, psychiatric or medical outcomes.
“We can’t parcel out the signal from the noise yet or causally tease apart the effects of environment from the effects of biology,” Wedow said. “We know the genetics correlate with certain outcomes, but we are not at a point where we can say any specific gene causes any one outcome. The effect of each individual gene is small. It’s only in large data sets that we start to get the statistical power to get meaningful, reproducible results. We are using these new exciting, emerging data and tools to revolutionize social science.”

Overheating of wearable skin-like electronic devices increases the risk of skin burning and results in performance degradation. A research team led by City University of Hong Kong (CityU) invented a photonic material-based “soft, ultrathin, radiative-cooling interface” that greatly enhances heat dissipation in devices, with temperature drops more than 56°C, offering an alternative for effective thermal management in advanced wearable electronics.
“Skin-like electronics are an emerging development in wearable devices,” said Dr Yu Xinge, Associate Professor in the Department of Biomedical Engineering (BME) at CityU, who co-led the research. “Effective thermal dissipation is crucial for maintaining sensing stability and a good user experience. Our ultrathin, soft, radiative-cooling interface, made of dedicatedly designed photonic material, provides a revolutionary solution to enable comfortable, long-term healthcare monitoring, and virtual and augmented reality (VR/AR) applications.”
In electronic devices, heat can be generated from both internal electronic components, when an electric current passes through a conductor, a process known as Joule heating, and external sources, such as sunlight and hot air. To cool down the devices, both radiative (i.e. thermal radiation — emitting heat energy from the device surface) and non-radiative (i.e. convection and conduction — losing heat to the layer of still air around the device and through direct contact with a cold object) heat-transfer processes can play a role.
However, the current technologies rely mostly on non-radiative means to dissipate the accumulated Joule heat. Moreover, the materials are usually bulky and rigid and offer limited portability, hindering the flexibility of wireless wearable devices.
To overcome these shortcomings, the research team developed a multifunctional composite polymer coating with both radiative and non-radiative cooling capacity without using electricity and with advances in wearability and stretchability.
The cooling interface coating is composed of hollow silicon dioxide (SiO2) microspheres, for improving infrared radiation, and titanium dioxide (TiO2) nanoparticles and fluorescent pigments, for enhancing solar reflection. It is less than a millimetre thick, lightweight (about 1.27g/cm2), and has robust mechanical flexibility.

When heat is generated in an electronic device, it flows to the cooling interface layer and dissipates to the ambient environment through both thermal radiation and air convection. The open space above the interface layer provides a cooler heat sink and an additional thermal exchange channel. The interface also exhibits excellent anti-ambient-interference capability due to its lower thermal conductivity, making it less susceptible to environmental heat sources that would affect the cooling effect and performance of the devices.
To examine its cooling capacity, the cooling interface layer was conformally coated onto a metallic resistance wire — a typical component causing a temperature rise in electronics. With a coating thickness of 75 μm, the temperature of the wire dropped from 140.5°C to 101.3°C, compared with uncoated wire at an input current of 0.5 A, and dropped to 84.2°C with 600 μm thickness, achieving a temperature drop of more than 56°C.
“It is necessary to keep the device temperature below 44°C to avoid skin burns,” said Dr Yu. “Our cooling interface can cool down the resistance wire from 64.1°C to 42.1°C with a 150 μm-thick coating.”
With the efficient passive radiative cooling capacity and the sophisticated nonradiative thermal design, the performance of several skin electronic devices developed by the team significantly improved, including the efficiency of wireless power transfer to light emitting diodes (LEDs) and the signal stability of a skin-interfaced wireless sensor under environmental obstructions (e.g. sunlight, hot wind and water).
“The intrinsically flexible nature of the cooling interface allows the electronic devices to undergo stable cooling even under extreme deformation, such as bending, twisting, folding and stretching many times,” said Dr Lei Dangyuan, Associate Professor in the Department of Materials Science and Engineering (MSE) at CityU, another co-leader of the study.
For example, their cooling-interface-integrated stretchable wireless-based epidermal lighting system showed higher illumination intensity and maintained stable performance even upon stretching from 5% to 50% 1,000 times.
The team submitted a US patent application for the invention. They won a Gold Medal, one of 36 awards won by CityU teams, the highest number of awards among local institutions at the 48th International Exhibition of Inventions Geneva, with their project named “Cooling Technology for Epidermal Electronics.”
Next, the research team will focus on practical applications of the cooling interfaces for advanced thermal management of wearable electronics in the healthcare monitoring, wireless communications and VR/AR fields.

CRISPR gene editing is a breakthrough that has been used to treat diseases such as sickle cell anemia, leukemia and genetic disorders, but it has challenges that limit its broad utility.
Identifying the root of those issues led a research team at Duke Health to find an improved approach to gene editing that expands its functionality.
In work appearing online June 29 in the journal Cell Chemical Biology, the researchers lay out a new way to identify diverse CRISPR RNA variants that can specifically home in on challenging areas of DNA to target for editing. The new approach opens up more of the genome for editing, enabling the repair of mutations associated with more diseases.
“CRISPR is great, but there are a lot of places within the human genome that can’t be edited well,” said senior author Bruce Sullenger, Ph.D., the Joseph W. and Dorothy W. Beard Distinguished Professor of Experimental Surgery at Duke University School of Medicine. Sullenger is also a professor in the departments of Pharmacology and Cancer Biology, Neurosurgery, Cell Biology and Biomedical Engineering.
“This work started from ground zero to understand and address that issue using large libraries of different CRISPR RNAs as well as informatics to see if we could get these editing tools to more places in the genome so that they can be edited and repaired as needed,” Sullenger said.
Sullenger and colleagues — notably first author Korie Bush, Ph.D., who launched the study as a graduate student in Sullenger’s lab — sought to improve the process CRISPR relies on to guide RNA to the right location on DNA and facilitate the deletion or repair in that region.

More often than not, the guide, which is an RNA molecule, presents a problem — it may not fold exactly right or it’s otherwise corrupted, so the editing or deletion process cannot occur. Typically when that happens, the guide RNA must be swapped out for a new one and the genome cannot be targeted in the right spot.
The Duke team instead found a way to salvage a dysfunctional guide RNA, which actually has two components that have to work well together: an RNA sequence that recognizes the DNA target site and a scaffolding sequence that holds the enzyme in place to cleave the DNA at the right juncture.
They found multiple RNA sequences that revived the integrity of the scaffolding, demonstrating that CRISPR gene editing technology is much more adaptable than previously believed.
“We found lots of ways to change the system that yield combinations with enhanced editing efficiencies at various target sites,” Bush said. “The process is more malleable than we thought — we made hundreds of thousands of guide RNAs. If you need two pieces for the process to work well and you have so many more options to choose from, you can find a combination that works best.”
Sullenger said the finding should lead to safer and more effective ways of applying CRISPR technology as a therapy.
“This is like an improvement in word processing that enables you to easily find and edit any error in the text, rather than only being able to edit certain portions of a text effectively,” Sullenger said. “Especially when coupled with informatics, it should lead to an acceleration of breakthroughs for treating diseases.”
In addition to Sullenger and Bush, study authors include Giulia Corsi, Amy C. Yan, Keith Haynes, Juliana M. Layzer, Jonathan H. Zhou, Telmo Llanga, and Jan Gorodkin.
The research received support from the National Institutes of Health (UG3 TR002852), the Independent Research Foundation Denmark (9041-00317B) and the Novo Nordisk Foundation (NNF21OC0068988).

Water fasts — where people consume nothing but water for several days — might help you lose weight, but it’s unclear how long you’ll keep it off, according to research from the University of Illinois Chicago. And the other metabolic benefits of water fasts, such as lower blood pressure and improved cholesterol, seem to disappear soon after the fast ends, the researchers found.
However, there do not appear to be any serious adverse effects for those who do a water fast or a similar kind of fast where people consume a very small number of calories a day, said Krista Varady, professor of kinesiology and nutrition, who led the research, which is published in Nutrition Reviews.
“My overall conclusion is that I guess you could try it, but it just seems like a lot of work, and all those metabolic benefits disappear,” Varady said. She stressed, however, that no one should undertake one of these fasts for more than five days without medical supervision.
Varady, an expert on intermittent fasting, said she wanted to study water fasting because she suddenly started getting contacted by journalists last fall who wanted to hear what she thought about it. She figured if she was going to comment, she should investigate the existing research.
The new paper is a literature review of eight studies on water fasting or Buchinger fasting, a medically supervised fast that is popular in Europe where people consume only a tiny amount of juice and soup a day. Varady’s team looked at the results from each of those papers to see what story they cumulatively tell about the fasts’ impact on weight loss, as well as a number of other metabolic factors.
Fasting did seem to spur noticeable short-term weight loss, the researchers found. People who fasted for five days lost about 4% to 6% of their weight; those who fasted for seven to 10 days lost about 2% to 10%, and those who fasted for 15 to 20 days lost 7% to 10%.

Only a few of the studies in the review tracked whether participants gained back the weight they had lost once the fast ended. In one of those, people gained back all they had lost in a five-day water fast within three months. In two other studies, only a small amount of the lost weight returned, but those studies encouraged participants to restrict their calorie intake after the fasts ended.
In contrast, it was clear that the metabolic benefits of the fasts disappeared soon after the fasts ended. Improvements to blood pressure, cholesterol and blood sugar levels were short-lived, returning to baseline levels quickly after participants started eating again.
Some of the studies included participants with Type 1 and Type 2 diabetes, who suffered no ill effects from the fasting, though they were monitored closely and had their insulin doses adjusted while fasting.
The most common side effects of these prolonged fasts were similar to those from intermittent fasting, Varady said, such as headaches, insomnia and hunger. There were no serious negative effects in the studies, such as metabolic acidosis or death.
She did note that the participants in these prolonged fasts lost about two-thirds of their weight in lean mass and one-third in fat mass. This is the opposite of what happens most of the time during weight loss, where more fat is lost than muscle. It makes sense that these extreme fasts would have this result, she said, because “your body needs a constant intake of protein. If it doesn’t have that, then it draws from muscles.”
Varady’s research into intermittent fasting has looked at how well the regime works for weight loss, as well as at specific questions, such as whether intermittent fasting affects fertility — she found it does not.
Varady said she would encourage someone hoping to lose weight to try intermittent fasting instead of a water fast, “because there’s a lot more data to show it can help with weight management,” she said.
The other UIC researchers in the study are Sofia Cienfuegos, Shuhao Lin, Vasiliki Pavlou and Kelsey Gabel, as well as Mark Ezpeleta, a former UIC student.

Published17 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy James GallagherHealth and science correspondentThe sweetener aspartame – found in a variety of foods – is set to be officially labelled as “possibly carcinogenic to humans”, reports claim. The classification frequently causes confusion and does not tell us how risky consuming aspartame actually is.Other “possibly carcinogenic” substances include aloe vera, diesel and pickled Asian vegetables. The BBC understands the International Agency for Research on Cancer (IARC) will make an announcement on 14 July. What has aspartame in it?Aspartame is 200 times sweeter than sugar, so it gives the taste without the calories. You will find it on the ingredients list of many diet or sugar-free foods including diet drinks, chewing gums and some yoghurts. The sweetener has been used for decades and approved by food safety bodies, but there has been a swirl of controversy around the ingredient.IARC, the cancer research arm of the World Health Organization, has been reviewing about 1,300 studies on aspartame and cancer. The Reuters news agency says it has spoken to sources close to the process, and aspartame will be classified “possibly carcinogenic”.The BBC understands official announcements will be made by IARC and a separate expert committee on food additives – alongside a publication in the Lancet Oncology medical journal on 14 July. IARC uses four possible classifications: Group 1 – Carcinogenic to humansGroup 2A – Probably carcinogenic to humansGroup 2B – Possibly carcinogenic to humansGroup 3- Not classifiable However, this is where it can get confusing. “The IARC categorisation won’t tell us anything about the actual level of risk from aspartame, because that’s not what IARC categorisations mean,” says Kevin McConway, professor of statistics at the Open University.IARC tells us how strong the evidence is, not how risky a substance is to your health. The “possibly” category is used when there is “limited” evidence in people or data from animal experiments. It includes diesel, talc on the perineum, nickel, aloe vera, Asian pickled vegetables and a host of chemical substances. “I emphasise though that the evidence that these things could cause cancer is not very strong or they would have been put in group 1 or 2A,” added Prof McConway. The IARC classifications have caused confusion in the past, and have been criticised for creating unnecessary alarm. When processed red meat was categorised as carcinogenic, it led to reports equating it to smoking. But the risk of giving 100 people an extra 1.7oz (50g) of bacon – on top of any they already eat – every single day for the rest of their lives would lead to one case of bowel cancer.We do not have the equivalent numbers for aspartame, however, the Joint World Health Organization and Food and Agriculture Organization’s Expert Committee on Food Additives is due to report in July. Its stance since 1981 has been a daily intake of 40 milligrams, per kilogram of your body weight, per day was safe. That works out at between 12 and 36 cans of diet drinks (depending on the exact ingredients) a day for a 60 kg (nine-and-a-half stones) adult.The International Council of Beverages Associations’ executive director Kate Loatman said public health authorities should be “deeply concerned” by the “leaked opinion”, and also warned it “could needlessly mislead consumers into consuming more sugar, rather than choosing safe no-and low-sugar options”.Rick Mumford, the deputy chief scientific adviser to the UK’s Food Standards Agency, said the body would “closely study” the reports, but “our view is that the safety of this sweetener has been evaluated by various scientific committees and it is considered safe at current permitted use levels”.A study in the early 2000s linked it to cancer in mouse and rat experiments, but the findings were criticised and other animal studies have not found a cancer risk. Last year a study of 105,000 people compared people who consumed no sweeteners with those who consumed large amounts. High levels of sweeteners – including aspartame – were linked to a higher risk of cancer, but there are many differences in the health and lifestyles between the two groups. There are some people who cannot safely consume aspartame. These are people with an inherited disease called phenylketonuria or PKU.People with PKU are unable to metabolise a component of aspartame.Follow James on Twitter.

One morning in the summer of 2020, Jade Dass woke up and vomited. She assumed she was hung over; she’d been depressed lately and sometimes self-medicated with too much wine. But then a woman in her online counseling group suggested that she might be pregnant. Dass looked in the mirror and realized she was probably right.Listen to This ArticleFor more audio journalism and storytelling,

An international team of researchers has developed a new method to deliver drugs into the inner ear. The discovery was possible by harnessing the natural flow of fluids in the brain and employing a little understood backdoor into the cochlea. When combined to deliver a gene therapy that repairs inner ear hair cells, the researchers were able to restore hearing in deaf mice.
“These findings demonstrate that cerebrospinal fluid transport comprises an accessible route for gene delivery to the adult inner ear and may represent an important step towards using gene therapy to restore hearing in humans,” said Maiken Nedergaard, MD, DMSc, senior author of the new study, which appears in the journal Science Translational Medicine.
Nedergaard is co-director of the Center for Translational Neuromedicine at University of Rochester and the University of Copenhagen. The study was the product of a collaboration between researchers at the two universities and a group led by Barbara Canlon, Ph.D. in the Laboratory of Experimental Audiology at the Karolinska Institute in Stockholm, Sweden.
The number of people worldwide predicted to have mild to complete hearing loss is expected to grow to around 2.5 billion by mid-century. The primarily cause is the death or loss of function of hair cells found in the cochlea — which are responsible for relaying sounds to the brain — due to mutations of critical genes, aging, noise exposure, and other factors.
While hair cells do not naturally regenerated in humans and other mammals, gene therapies have shown promise and in separate studies have successfully repaired the function of hair cells in neo-natal and very young mice. However, as both mice and humans age, the cochlea, already a delicate structure, becomes enclosed in temporal bone. At this point, any effort to reach the cochlea and deliver a gene therapy via surgery risks damaging this sensitive area and altering hearing.
In the new study, the researchers describe a little understood passage into the cochlea called the cochlear aqueduct. While the name conjures images of monumental stone architecture, the cochlear aqueduct is thin boney channel no larger than a single strand of hair. Suspected to play a role in balancing pressure in the ear, new study shows that that the cochlear aqueduct also acts as a conduit between the cerebrospinal fluid found in the inner ear and the rest of the brain.
Scientists are developing clearer picture of the mechanics of glymphatic system, the brain’s unique process of removing waste first described by the Nedergaard lab in 2012. Because the glymphatic system pumps cerebrospinal fluid deep into brain tissue to wash away toxic proteins, researchers have been eyeing it as a potentially new way to deliver drugs into the brain, a major challenge in developing drugs for neurological disorders.
Researchers have also discovered that the complex movement of fluids driven by the glymphatic system extend to the eyes and the peripheral nervous system, including ear. The new study represented an opportunity to put the drug delivery potential of the glymphatic system to the test, while at the same time targeting a previously unreachable part of the auditory system.
Employing a number of imagining and modeling technologies, the researchers were able to develop a detailed portrait of how fluid from other parts of the brain flows through cochlear aqueduct and into the inner ear. The team then injected an adeno-associated virus into the cisterna magna, a large reservoir of cerebrospinal fluid found at the base of the skull. The virus found its way into the inner ear via the cochlear aqueduct, delivered a gene therapy that expresses a protein called vesicular glutamate transporter-3, which enable the hair cells to transmit signal and rescued hearing in adult deaf mice.
“This new delivery route into the ear may not only serve the advancement of auditory research, but also prove useful when translated to humans with progressive genetic-mediated hearing loss,” said Nedergaard.
Additional co-authors of the study include: Barbara Mathiesen, Leo Miyakoshi, Peter Bork, Natalie Hauglund, Ryszard Stefan, Yuki Mori, and Kjeld Mollgard with the University of Copenhagen; Christopher Cederroth, Evangelia Tserga, Corstiaen Versteegh, Niklas Edvall, and Barbara Canlon with the Karolinska Institute; and Jeffery Holt with Harvard University. The research was supported with funds from the Lundbeck Foundation, the Novo Nordisk Foundation, the National Institute of Neurological Disorders and Stroke, the Knut and Alice Wallenberg Foundation, the Karolinska Institute, the Tysta Skolan Foundation, Hörselforskningsfonden, the European Union’s Horizon 2020 Research and Innovation Programme, the Danish Society for Neuroscience, the U. S. Army Research Office, the Human Frontier Science Program, the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation, Simons Foundation, the Jeff and Kimberly Barber Fund, and Foundation Pour L’Audition.

The Russian writer and philosopher Leo Tolstoy may have been onto something when he wrote the opening line of Anna Karenina: “Happy families are all alike; every unhappy family is unhappy in its own way.”
A recent study published in Psychological Science and led by a scholar now at the USC Dornsife College of Letters, Arts and Sciences, suggests that when it comes to their brains processing information, people who are not lonely are all alike, but every lonely person processes the world in their own, idiosyncratic way.
Copious research shows that loneliness is detrimental to well-being and is often accompanied by self-reported feelings of not being understood by others. A recent report from the United States Surgeon General’s office referred to loneliness as a public health crisis in reaction to the growing number of adults suffering from this condition. Even before the onset of the COVID-19 pandemic, approximately half of U.S. adults reported experiencing measurable levels of loneliness.
Loneliness is idiosyncratic
While she was a postdoctoral fellow at UCLA, Elisa Baek, assistant professor of psychology at USC Dornsife, sought to better understand what contributes to such feelings of disconnection and being misunderstood. Baek and her team used a neuroimaging technique called functional magnetic resonance imaging (fMRI) to examine the brains of 66 first-year college students while they watched a series of video clips. The videos ranged in topic from sentimental music videos to party scenes and sporting events, providing a diverse array of scenarios for analysis.
Before being scanned, the participants, who ranged in age from 18 to 21, were asked to complete the UCLA Loneliness Scale, a survey that measures a person’s subjective feelings of loneliness and feelings of social isolation.

Based on the survey results, the researchers separated the participants into two groups: lonely and “nonlonely” (those not experiencing loneliness). They then scanned each participant’s brain using fMRI as the participant watched the videos.
Comparing the brain imaging data between the two groups, the researchers discovered that lonelier individuals exhibited more dissimilar and idiosyncratic brain processing patterns than their non-lonely counterparts.
This finding is significant because it reveals that neural similarity, which refers to how similar the brain activity patterns of different individuals are, is linked to a shared understanding of the world. This shared understanding is important for establishing social connections. People who suffer from loneliness are not only less similar to society’s norm of processing the world, but each lonely person differs in unique ways, as well. That uniqueness may further impact the feelings of isolation and lacking social connections.
Baek said, “It was surprising to find that lonely people were even less similar to each other.” The fact that they don’t find commonality with lonely or nonlonely people makes achieving social connection even more difficult for them.
“The ‘Anna Karenina principle’ is a fitting description of lonely people, as they experience loneliness in an idiosyncratic way, not in a universally relatable way,” she added.

Loneliness isn’t about having or not having friends
So, does idiosyncratic processing in lonely individuals cause loneliness, or is it a result of loneliness?
The researchers observed that individuals with high levels of loneliness — regardless of how many friends or social connections they had — were more likely to have idiosyncratic brain responses. This raised the possibility that being surrounded by people who see the world differently from oneself may be a risk factor for loneliness, even if one socializes regularly with them.
The study also suggests that because social connections or disconnections fluctuate over time, it may influence the extent to which an individual processes the world idiosyncratically.
Looking forward, Baek said she is interested in examining people who have friends and are socially active but still feel lonely. In addition, the researchers are looking at what particular situations lonely individuals process differently. For example, do lonely people show idiosyncrasies when processing unexpected events or ambiguous social contexts in which things can be interpreted differently?