October 5, 2020

Science Daily/University of California - Davis Health

A UC Davis MIND Institute study of pregnant mice found that high amounts of folic acid during pregnancy harmed the brain development of embryos. Researchers say the findings indicate that more investigation is needed about the best recommended dosage for pregnant women.

"We believe there's a Goldilocks effect with folic acid. Too little is not good, too much is not good; you have to get it just right," said Ralph Green, UC Davis distinguished professor of pathology and medicine and a corresponding author of the study.

The research, published Sept. 30 in Cerebral Cortex, involved pregnant mice who were given either a normal amount of folic acid, 10 times the recommended amount, or none. The offspring of the mice that received the largest amount showed significant brain changes.

"It's not subtle. It's substantial," said Konstantinos Zarbalis, associate professor in the Department of Pathology and Laboratory Medicine and also a corresponding author of the research. "It makes a marked difference in brain structure if you take very high amounts of folic acid."

Paradoxically, changes in the brain due to too much folic acid mimicked those associated with a deficiency of folic acid. "This, to me, was an even more important insight," said Zarbalis, who is also on the UC Davis MIND Institute faculty. He noted that in humans, research shows that impaired folate uptake into the brain can cause cerebral folate deficiency, a syndrome that is often associated with the development of autism.

Folic acid and pregnancy

Folic acid (the synthetic form of vitamin B9, or folate) supplementation is widely recommended for women of child-bearing age. It has been shown to substantially reduce the risk of neural tube defects, such as spina bifida, in children. Research, including studies at the MIND Institute, has also shown that prenatal vitamins that include folic acid have a protective effect against the development of autism and other disorders.

Green was on the panel with the National Academy of Sciences and the Institute of Medicine (now called the National Academy of Medicine) that determined the recommended daily intake of folic acid (400 mcg) and the maximum daily safe upper limit (1000 mcg). He was also on the Food and Drug Administration (FDA) panel that recommended adding folic acid to foods, which led to the fortification of all cereals and grains with folic acid mandated by the Federal Government in 1998.

"Addition of folic acid to the diet was a good thing, and I've supported fortification, but there is a 'best amount' of folic acid, and some people may be getting more than is optimal," said Green.

Women who have given birth to a child with neural tube defects or who have certain conditions like epilepsy and take anticonvulsants, have generally been advised to take much higher doses of folic acid.

"In animal models, we have indications that very high amounts of folic acid can be harmful to brain development of the fetus, and the clinical community should take this indication seriously, to support research in this area to reevaluate the amount of folic acid that is optimal for pregnant women," said Zarbalis.

Zarbalis and Green suspect that the problem lies in the way folic acid is metabolized by the body and have plans to investigate the phenomenon further.

https://www.sciencedaily.com/releases/2020/10/201005170836.htm

October 5, 2020

Science Daily/Johns Hopkins University Bloomberg School of Public Health

Children appear to be at greater risk of having high blood pressure when their mothers had the high blood pressure condition called preeclampsia during pregnancy -- but this adverse association may be reduced or even eliminated for children who were exposed to higher levels of vitamin D in the womb, according to a study from researchers at Johns Hopkins Bloomberg School of Public Health.

The findings, based on an analysis of data on 754 mother-child pairs in Massachusetts, suggest that higher vitamin D levels in pregnancy may help protect children born to preeclamptic women from developing high blood pressure. High blood pressure in childhood is associated in turn with hypertension and heart disease in adulthood.

The study was published online October 5 in JAMA Network Open.

"There is increasing evidence that cardiovascular disease risk is, to a great extent, programmed in the womb, and we now see that it may be vitamin D that alters this programming in a beneficial fashion," says study senior author Noel Mueller, PhD, an assistant professor in the Department of Epidemiology at the Bloomberg School.

Preeclampsia, which can lead to strokes and/or organ failure, is a major cause of illness and death for pregnant women, and also is associated with a greater risk of stillbirth and preterm birth. Researchers have estimated that preeclampsia occurs in 2-8 percent of pregnancies worldwide. It is associated with maternal obesity, and the rate of severe preeclampsia in the U.S. has risen sharply since the 1980s.

At the same time, the rate of high blood pressure among children in the U.S. has risen by about 40 percent between 1988 and 2008. Studies have suggested that maternal preeclampsia may be a factor in that increase.

Studies also have linked maternal vitamin D deficiency to a higher risk of preeclampsia, and have suggested that lower levels of vitamin D in adulthood or even early in life bring a greater risk of hypertension.

"We wanted to know if vitamin D levels in the womb would modify this association between maternal preeclampsia and hypertension in childhood," says study first author Mingyu Zhang, a PhD candidate in Mueller's research group.

To investigate this question, the team analyzed data that had been gathered on 754 mother-child pairs from 1998 to 2018 in a large epidemiological study conducted at the Boston Medical Center in Massachusetts. The dataset included information on preeclampsia during pregnancy, tests on blood from the umbilical cord at birth, and the children's blood pressure from age 3 to 18.

About 62 percent of the mothers in the study group were Black, and 52 percent were overweight or obese. Previous studies suggest that mothers who were Black or overweight or obese were at higher risk for preeclampsia. Darker-skinned people living in higher latitudes also are more likely to be deficient in vitamin D -- a cholesterol-derived molecule that is present in some foods but also is synthesized in skin with the help of ultraviolet light.

Roughly ten percent of the women in the study group had preeclampsia, and the analysis revealed that their children on average had higher systolic blood pressure than the children born to non-preeclamptic mothers -- about 5 percentile points higher, when all the blood pressure readings were arranged on a 0 to 100 percentile scale.

Cord-blood vitamin D levels clearly modified these associations, and in a dose-related manner. Children in the lowest 25 percent range of vitamin D levels (lowest "quartile") were about 11 percentile points higher in blood pressure, on average, if their mothers had had preeclampsia, compared to children of non-preeclamptic mothers.

For children in the highest vitamin D quartile, there appeared to be no difference in average blood pressure if their mothers had had preeclampsia -- in other words, the results suggest that having relatively high vitamin D levels at birth, which could be achieved through dietary supplements, may completely mitigate the risk brought by preeclampsia.

"If other epidemiological studies confirm these findings, then randomized trials would be needed to determine conclusively if higher vitamin D in mothers at risk of preeclampsia protects against childhood high blood pressure," Mueller says.

https://www.sciencedaily.com/releases/2020/10/201005144631.htm

October 1, 2020

Science Daily/Norwegian University of Science and Technology

New brain research shows that writing by hand helps children learn more and remember better. At the same time, schools are going more and more digital, and a European survey shows that Norwegian children spend the most time online of 19 countries in the EU.

Professor Audrey van der Meer at NTNU believes that national guidelines should be put into place to ensure that children receive at least a minimum of handwriting training.

Results from several studies have shown that both children and adults learn more and remember better when writing by hand.

Now another study confirms the same: choosing handwriting over keyboard use yields the best learning and memory.

Van der Meer and her colleagues have investigated this several times, first in 2017 and now in 2020.

In 2017, she examined the brain activity of 20 students. She has now published a study in which she examined brain activity in twelve young adults and twelve children.

This is the first time that children have participated in such a study.

Both studies were conducted using an EEG to track and record brain wave activity. The participants wore a hood with over 250 electrodes attached.

The brain produces electrical impulses when it is active. The sensors in the electrodes are very sensitive and pick up the electrical activity that takes place in the brain.

Handwriting gives the brain more hooks to hang memories on

Each examination took 45 minutes per person, and the researchers received 500 data points per second.

The results showed that the brain in both young adults and children is much more active when writing by hand than when typing on a keyboard.

"The use of pen and paper gives the brain more 'hooks' to hang your memories on. Writing by hand creates much more activity in the sensorimotor parts of the brain. A lot of senses are activated by pressing the pen on paper, seeing the letters you write and hearing the sound you make while writing. These sense experiences create contact between different parts of the brain and open the brain up for learning. We both learn better and remember better," says Van der Meer.

She believes that her own and others' studies emphasize the importance of children being challenged to draw and write at an early age, especially at school.

Today's digital reality is that typing, tapping and screen time are a big part of children's and adolescents' everyday lives.

A survey of 19 countries in the EU shows that Norwegian children and teens spend the most time online. The smartphone is a constant companion, followed closely by the PC and tablet.

The survey shows that Norwegian children ages 9 to16 spend almost four hours online every day, double the amount since 2010.

Kids' leisure time spent in front of a screen is now amplified by schools' increasing emphasis on digital learning.

Van der Meer thinks digital learning has many positive aspects, but urges handwriting training.

"Given the development of the last several years, we risk having one or more generations lose the ability to write by hand. Our research and that of others show that this would be a very unfortunate consequence" of increased digital activity, says Meer.

She believes that national guidelines should be put in place that ensure children receive at least a minimum of handwriting training.

"Some schools in Norway have become completely digital and skip handwriting training altogether. Finnish schools are even more digitized than in Norway. Very few schools offer any handwriting training at all," says Van der Meer.

In the debate about handwriting or keyboard use in school, some teachers believe that keyboards create less frustration for children. They point out that children can write longer texts earlier, and are more motivated to write because they experience greater mastery with a keyboard.

"Learning to write by hand is a bit slower process, but it's important for children to go through the tiring phase of learning to write by hand. The intricate hand movements and the shaping of letters are beneficial in several ways. If you use a keyboard, you use the same movement for each letter. Writing by hand requires control of your fine motor skills and senses. It's important to put the brain in a learning state as often as possible. I would use a keyboard to write an essay, but I'd take notes by hand during a lecture," says Van der Meer.

"The brain has evolved over thousands of years. It has evolved to be able to take action and navigate appropriate behaviour. In order for the brain to develop in the best possible way, we need to use it for what it's best at. We need to live an authentic life. We have to use all our senses, be outside, experience all kinds of weather and meet other people. If we don't challenge our brain, it can't reach its full potential. And that can impact school performance," says Van der Meer.

https://www.sciencedaily.com/releases/2020/10/201001113540.htm

Science Daily/Karolinska Institutet

Researchers at Karolinska Institutet in Sweden have identified a protein in the brain that is important both for the function of the mood-regulating substance serotonin and for the release of stress hormones, at least in mice. The findings, which are published in the journal Molecular Psychiatry, may have implications for the development of new drugs for depression and anxiety.

After experiencing trauma or severe stress, some people develop an abnormal stress response or chronic stress. This increases the risk of developing other diseases such as depression and anxiety, but it remains unknown what mechanisms are behind it or how the stress response is regulated.

The research group at Karolinska Institutet has previously shown that a protein called p11 plays an important role in the function of serotonin, a neurotransmitter in the brain that regulates mood. Depressed patients and suicide victims have lower levels of the p11 protein in their brain, and laboratory mice with reduced p11 levels show depression- and anxiety-like behaviour. The p11 levels in mice can also be raised by some antidepressants.

The new study shows that p11 affects the initial release of the stress hormone cortisol in mice by modulating the activity of specific neurons in the brain area hypothalamus. Through a completely different signalling pathway originating in the brainstem, p11 also affects the release of two other stress hormones, adrenaline and noradrenaline. In addition, the tests showed that mice with p11 deficiency react more strongly to stress, with a higher heart rate and more signs of anxiety, compared to mice with normal p11 levels.

"We know that an abnormal stress response can precipitate or worsen a depression and cause anxiety disorder and cardiovascular disease," says first author Vasco Sousa, researcher at the Department of Clinical Neuroscience, Karolinska Institutet. "Therefore, it is important to find out whether the link between p11 deficiency and stress response that we see in mice can also be seen in patients."

The researchers believe that the findings may have implications for the development of new, more effective drugs. There is a great need for new treatments because current antidepressants are not effective enough in many patients.

"One promising approach involves administration of agents that enhance localised p11 expression, and several experiments are already being conducted in animal models of depression," says Per Svenningsson, professor at the Department of Clinical Neuroscience, Karolinska Institutet, who led the study. "Another interesting approach which needs further investigation involves developing drugs that block the initiation of the stress hormone response in the brain."

https://www.sciencedaily.com/releases/2020/10/201002105749.htm

Science Daily/Yale University

Researchers at Yale and elsewhere previously identified a host of genetic risk factors that help explain why some veterans are especially susceptible to the debilitating symptoms of post-traumatic stress disorder (PTSD).

A new Yale-led study published Oct. 1 in the journal Biological Psychiatry has now identified a social factor that can mitigate these genetic risks: the ability to form loving and trusting relationships with others.

The study is one of the first to explore the role of nurture as well as nature in its investigation of the biological basis of PTSD.

"We exist in a context. We are more than our genes," said Yale's Robert H. Pietrzak, associate professor of psychiatry and public health, and senior author of the study.

Pietrzak is also director of the Translational Psychiatric Epidemiology Laboratory of the Clinical Neurosciences Division of the U.S. Department of Veterans Affairs National Center for PTSD.

Like many genetic studies on mental disorders such as depression, anxiety, and schizophrenia, PTSD studies have revealed numerous genetic risk factors that contribute to the severity of the disorder. For instance, a previous study of more than 165,000 U.S. military veterans led by Yale's Joel Gelernter, the Foundations Fund Professor of Psychiatry and professor of genetics and of neuroscience, found variants in eight separate regions of the genome that help predict who is most likely to experience the repeated disturbing memories and flashbacks that are hallmark symptoms of PTSD.

In the new study, Pietrzak, Gelernter, and colleagues looked at psychological as well as genetic data collected from the National Health and Resilience in Veterans Study, which surveyed a national sample of U.S. military veterans, and is supported by the National Center for PTSD. The researchers specifically focused on a measure of attachment style -- the ability or inability to form meaningful relations with others -- as a potential moderator of genetic risk for PTSD symptoms.

Individuals with a secure attachment style perceive relationships as stable, feel that they are worthy of love and trust, and are able to solicit help from others. Those with an insecure attachment style report an aversion to or anxiety about intimacy with others, and have difficulty asking for help from others.

They found that the ability to form secure attachments essentially neutralized the collective effects of genetic risk for PTSD symptoms. The impact was particularly pronounced in a variant of the IGSF11 gene, which has been linked to synaptic plasticity or the ability of the brain to form new connections between brain cells.

Pietrzak noted that deficits in synaptic plasticity have also been linked to PTSD, depression, and anxiety, among other mental disorders. The findings illustrate the importance of integrating environmental and social as well as genetic factors in the study of PTSD and related disorders, the authors said.

"Social environmental factors are critical to informing risk for PTSD and should be considered as potential moderators of genetic effects," he said. "The ability to form secure attachments is one of the strongest protective factors for PTSD."

The findings, which will help predict who is at greater risk of experiencing severe symptoms of PTSD, also suggest that psychological treatments targeting interpersonal relationships may help mitigate PTSD symptoms in veterans with elevated genetic risk for this disorder, he said.

https://www.sciencedaily.com/releases/2020/10/201001113705.htm

Science Daily/University of Chicago Press Journals

In the United States, the average American sleeps less than the minimum seven hours of sleep per night recommended by the Center for Disease Control, and nearly half of Americans report negative consequences from insufficient sleep. This problem appears to be especially prevalent in men, who report getting significantly less sleep, on average, than women.

A cultural complication is the notion that getting less than the recommended amount of sleep signals something positive about an individual. For example, US President Donald Trump has boasted about getting less than four hours of sleep per night and regularly derogates his political opponent Joe Biden as "Sleepy Joe."

"The Sleep-Deprived Masculinity Stereotype," a new paper in the Journal of the Association for Consumer Research, examines a possible stereotype connecting sleep and masculinity along with its underlying mechanisms and its social implications.

Authors Nathan B. Warren and Troy H. Campbell conducted 12 experiments involving 2,564 American participants to demonstrate that a sleep-deprived masculinity stereotype exists. In one experiment, participants were asked to imagine seeing a man shopping for a bed. Then, a salesperson asked the man, "How much do you normally sleep?" The results found that the mean masculinity rating for participants in the lots of sleep condition was significantly lower than the mean masculinity rating for participants in the little sleep condition.

In another experiment, participants were asked to ascribe different attributes to a male character, assigned to either a "very masculine and manly" man or a "not very masculine and not very manly" man. Participants in the masculine condition described their character sleeping 33 minutes less sleep per night than the characters described in the not masculine condition. A final experiment showed that participants who imagined stating they sleep more than average felt significantly less masculine than participants who imagined stating they sleep less than average.

Collectively, the experiments found that men who sleep less are seen as more masculine and more positively judged by society. The same patterns were not consistently observed for perceptions of women.

"The social nature of the sleep-deprived masculinity stereotype positively reinforces males who sleep less, even though sleeping less contributes to significant mental and physical health problems," the authors write. This may be particularly detrimental because men frequently have significantly more negative attitudes towards seeking psychological help. "Unfortunately, the problems created by the sleep-deprived masculinity stereotype may reach beyond individuals and into society, as men who sleep less are found to be more aggressive and violent." This is an example of the restrictive and toxic characteristics of masculinity, "which can be harmful to men's health and society at large."

The bright side of this research, the authors say, is that "as society continues to challenge traditional definitions of masculinity, attitudes toward sleep may become more positive, and all people might enjoy more nights full of healthy sleep."

https://www.sciencedaily.com/releases/2020/09/200929173412.htm

Since the advent of civilization, humankind has always turned towards the healing powers of the plants. Tribal and folk medicines mainly focused on deriving healing concoctions from the plants. One of the most popular among all is essential oils (EO). 

 EOs are immensely popular all over the world for their aroma-therapeutic properties. People have shown intense interest in EOs due to their benefits over mental, physical, and emotional well-being. 

 What are essential oils?

 EOs are high concentrated extracts made from plants, seeds, flowers, roots, and barks. The liquid extracts are derived from various beneficial plants through different manufacturing processes. These oils have a much stronger aroma and bioactive chemical compounds than the plants they come from.  

 Bioactive components of essential oils

 Generally, EOs parts into two groups of chemical components. They are hydrocarbons and oxygenated compounds. The hydrocarbons are mostly terpenes, and oxygenated compounds are mainly aldehyde, ketones, esters, alcohols, phenols, and oxides.  Here are examples of the most sought-after EOs and their clinical efficacy.  

 1.    CBD Oil

 CBD oil might not sound like essential oil, but it is one. The oil derives from the hemp plant, a non-psychotic plant, unlike its sister marijuana species. CBD, short for Cannabidiol, is the most common bioactive compound found in a cannabis plant. 

Highly studied properties –

●      Anti-seizure effects – In the last two decades, dozens of studies have reported that CBD oil Canada has anti-seizure activity. Recently, the FDA approved the one and only CBD medication Epidiolex for epileptic seizures.

●      Neuroprotective Effects – CBD oils are well-known to have neuroprotective properties in various neurodegenerative diseases like Alzheimer’s, Parkinson’s, multiple sclerosis (MS), and stroke. Nabiximols is the medication approved for spasticity in MS patients derived from CBD.

●      Analgesic effects – CBD oil helps as a pain-relieving agent. A range of studies, including animal models, cell cultures, and few clinical trials, suggest CBD oil effectively treats chronic pain, arthritis pain, cancer treatment pain, and migraine. 

2.    Tea Tree Oil (TTO)

TTO is acquired from the leaves of Melaleuca alternifolia or narrow-leaved paperbark. Tea tree essential oil was part of Aborigine folk medicine for centuries. They used oil for treating cough and skin problems. 

Highly studied properties –

●      Antibacterial effects – TTO’s antibacterial effects have gained much attention due to its susceptibility towards a range of bacteria. Few have proven that TTO has been found effective against antibiotic-resistant bacteria, MRSA. 

 ●      Antifungal effects – TTO was investigated in susceptibility against Candida albicans. Candida is the most common cause of fungal infections in people. Investigation proved that TTO was able to inhibit the growth and occurrence of candida infections.  

 ●      Anti-acne – There was a meticulous study on TTO treating acne. The study found that TTO could reduce acne without causing any side effects concerning acne medications.  

 3.    Lavender Oil (LEO)

Lavender has played a significant role in ancient medicine. The medical properties of the plant are studied specifically on mental and emotional well-being. 

 

Highly studied properties –

●      Anti-anxiety and anti-depression effects – The clinical trials investigated the several effects of oral lavender oil preparation (Silexan). Investigations suggest that LEO significantly reduced symptoms of anxiety disorders. Other clinical trials on depression disorders found that LEO was useful to alleviate mood and reduce psychological distress.  

●      Sedative effects – Since ancient times, lavender has thought to be an excellent natural remedy for insomnia and improving the quality of sleep. Randomized trials found that smelling LEO improved the sleep quality of individuals. 

●      Analgesic effects – There are reports suggesting lavender is useful for people with chronic pain. One such study with ICU patients found that massaging LEO on patients’ feet helps lower blood pressure, heart rate, and pain.    

4.    Peppermint Oil (PEO) 

PEO is obtained from the leaves of the peppermint, a mint plant variety. PEO is used in a variety of extracts, food flavoring agents, and dietary capsules globally. 

 Highly studied properties –

 ●      Irritable bowel syndrome (IBS) – The most extensive research of PEO centered on IBS. A meta-analysis of clinical trials examined the efficacy of PEO capsules and found that the oil relieved symptoms of IBS and abdominal pain.

 ●      Antiemetic effects – A small study examined the effects of PEO aromatherapy on postoperative and pregnancy nausea. It reports implied that PEO helped to lower the levels of nausea. 

 ●      Digestive effects – Few studies and tons of anecdotal reports suggest that PEO helps in giving relief from indigestion symptoms.

5.    Eucalyptus Oil (EEO)

 EEO has been used to treat symptoms of cough, nasopharyngeal infections, and decongestants since old ages. There are several EEO remedies available over-the-counter. 

  

Highly studied properties –

●      Analgesic effects – Several clinical trials investigated EEO for its analgesic properties. One study found that inhaling EEO was highly effective in reducing pain and blood pressure among the subjects who had a total knee replacement. 

●      Anti-asthmatic effects – Clinical trials on bronchial asthma treatment investigated effects of EEO. Examinationsfound that EEO was successful in improving lung function significantly.

●      Dental health – Cell studies show that EEO exhibits antibacterial activity against periodontal bacteria; the same effect was seen in a human clinical trial. The study found that chewing EEO containing gum promoted periodontal health.  

 Conclusion 

There are around 90 types of EOs, and l has its unique smell and potential health benefits. They are often beneficial as an alternative therapy and are harmless when used in small quantities. However, on a note - there is no evidence suggesting that EOs heal any severe health condition.

 References -

https://www.abundanthealth4u.com/essential-oils-constituents#:~:text=In%20general%2C%20pure%20essential%20oils,alcohols%2C%20phenols%2C%20and%20oxides.

 https://archives.drugabuse.gov/testimonies/2015/biology-potential-therapeutic-effects-cannabidiol

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360273/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612440/#:~:text=There%20is%20growing%20evidence%20suggesting,and%20neuroprotective%20properties%20for%20lavender.

 https://www.researchgate.net/publication/237842903_A_REVIEW_ON_PEPPERMINT_OIL

 https://www.medicalnewstoday.com/articles/266580

 https://www.sciencedirect.com/science/article/pii/S2221169115001033#sec1

October 1, 2020

Science Daily/American Osteopathic Association

A mindfulness-based stress reduction (MBSR) course was found to benefit patients with chronic pain and depression, leading to significant improvement in participant perceptions of pain, mood and functional capacity, according to a study in the Journal of the American Osteopathic Association. Most of the study respondents (89%) reported the program helped them find ways to better cope with their pain while 11% remained neutral.

Chronic pain is a common and serious medical condition affecting an estimated 100 million people in the United States, which correlates with annual costs of approximately $635 billion. The small-scale study was conducted in a semi-rural population in Oregon where issues of affordability, addiction and access to care are common. Participants received intensive instruction in mindfulness meditation and mindful hatha yoga during an eight-week period.

"Many people have lost hope because, in most cases, chronic pain will never fully resolve," says Cynthia Marske, DO, an osteopathic physician and director of graduate medical education at the Community Health Clinics of Benton and Linn County. "However, mindful yoga and meditation can help improve the structure and function of the body, which supports the process of healing."

Healing and curing are inherently different, explains Dr. Marske.

"Curing means eliminating disease, while healing refers to becoming more whole," Dr. Marske says. "With chronic pain, healing involves learning to live with a level of pain this is manageable. For this, yoga and meditation can be very beneficial."

The study found mindful meditation and yoga led to significant improvements in patients' perceptions of pain, depression and disability. Following the course, Patient Health Questionnaire (PHQ-9) scores, a standard measure of depression, dropped by 3.7 points on a 27-point scale. According to Dr. Marske, some patients experience a similar drop from the use of an antidepressant.

"Chronic pain often goes hand-in-hand with depression," says Dr. Marske. "Mindfulness-based meditation and yoga can help restore both a patient's mental and physical health and can be effective alone or in combination with other treatments such as therapy and medication."

Study participants received instruction in MBSR, a systematic educational program based on training people to have an awareness of the self in the present moment and a nonjudgmental manner. The findings bolster other evidence that MBSR can be a useful adjunctive treatment for chronic pain while improving perceived depression.

"The bottom line is that patients are seeking new ways to cope with chronic pain and effective non-pharmaceutical treatments are available," says Dr. Marske. "Our findings show meditation and yoga can be a viable option for people seeking relief from chronic pain."

https://www.sciencedaily.com/releases/2020/10/201001133227.htm

Science Daily/Penn State

Can't stop checking social media for the latest COVID-19 health information? You might want to take a break, according to researchers at Penn State and Jinan University who discovered that excessive use of social media for COVID-19 health information is related to both depression and secondary trauma.

"We found that social media use was rewarding up to a point, as it provided informational, emotional and peer support related to COVID-19 health topics," said Bu Zhong, associate professor of journalism, Penn State. "However, excessive use of social media led to mental health issues. The results imply that taking a social media break may promote well-being during the pandemic, which is crucial to mitigating mental health harm inflicted by the pandemic."

The study, which published online on Aug. 15 in the journal Computers in Human Behavior, included 320 participants living in urban districts of Wuhan, China. In February 2020, the team gave the participants an online survey that investigated how they accessed and shared health information with family members, friends and colleagues on social media, specifically WeChat, China's most popular social media mobile app.

The team used an instrument created to measure Facebook addiction to assess participants' use of WeChat. Using a 5-point Likert-type scale, ranging from strongly disagree to strongly agree, the survey assessed participants' views of WeChat in providing them with informational, emotional and peer support. The survey also assessed participants' health behavior changes as a result of using social media.

Statements related to informational support included, "I use WeChat to gain information about how to manage the coronavirus epidemic," and "If I have a question or need help related to the coronavirus epidemic, I can usually find the answers on WeChat." Statements related to emotional support included, "My stress levels go down while I'm engaging with others on WeChat," and "The health information on WeChat helps me alleviate feelings of loneliness." Statements related to peer support included, "I use WeChat to share practical advice and suggestions about managing the coronavirus epidemic," and "I have used some of the information I learned from WeChat friends as part of my management strategies for coping with the coronavirus epidemic."

The survey also investigated participants' health behavior changes related to the use of WeChat, asking them to rate statements such as, "The health information on WeChat has changed many of my health behaviors, such as but not limited to wearing face masks, using sanitizer, or washing hands."

To assess depression, the researchers used a 21-item Depression Anxiety Stress Scale in which participants rated statements such as, "I couldn't seem to experience any positive feeling at all," and "I felt that life was meaningless."

According to Zhong, secondary trauma refers to the behaviors and emotions resulting from knowledge about a traumatizing event experienced by a significant other. Using the Secondary Trauma Stress Scale, the researchers asked respondents to rate statements such as, "My heart started pounding when I thought about the coronavirus epidemic," and "I had disturbing dreams about the coronavirus epidemic."

"We found that the Wuhan residents obtained tremendous informational and peer support but slightly less emotional support when they accessed and shared health information about COVID-on WeChat," said Zhong. "The participants also reported a series of health behavior changes, such as increased hand washing and use of face masks.

More than half of the respondents reported some level of depression, with nearly 20% of them suffering moderate or severe depression. Among the respondents who reported secondary trauma, the majority reported a low (80%) level of trauma, while fewer reported moderate (13%) and high (7%) levels of trauma. None of the participants reported having any depressive or traumatic disorders before the survey was conducted.

"Our results show that social media usage was related to both depression and secondary trauma during the early part of the COVID-19 outbreak in Wuhan," said Zhong. "The findings suggest that taking a social media break from time to time may help to improve people's mental well-being during the COVID-19 pandemic."

https://www.sciencedaily.com/releases/2020/09/200929152149.htm

August 25, 2020

Science Daily/University of California - Davis

Rare research on the effects of a pandemic undertaken during an ongoing disaster shows that COVID-19 has severely affected people's daily emotional lives and mental health, increasing their stresses the longer lockdowns, fear of getting sick and financial strains continue.

Having a lower education level and speaking English as a second language further reduced resilience and hindered people's ability to cope, suggests new University of California, Davis, research based on surveys that began in April -- just a few weeks after lockdowns started in the United States.

"This is some of the first information we have on resilience in the face of COVID-19," said Clare Cannon, assistant professor in the Department of Human Ecology at UC Davis and co-author on the study. "Our hypothesis, for our continuing research, is that it's getting worse. The longer this goes on, the less resilient we are going to be."

Cannon and researchers at Tulane University surveyed 374 people online, using social media, websites and other outlets, mostly in the United States, over a 10-week period beginning in April. More research is planned as the pandemic progresses.

Those surveyed were asked about previous disaster experience, their resilience, their perceived stress, their current situation as it relates to COVID-19, and personal and household demographics. The online Qualtrics survey took an estimated 10 minutes to complete.

Respondents in the current study had filled out questionnaires before masks were mandatory, before closures were prolonged, before large job losses had occurred and prior to full realization that the world was experiencing a global economic recession and deadly public health crisis, she added. Additionally, fewer people, at the time of the survey, had experienced family illness and loss to COVID-19 as would be the case now and in future surveys, Cannon said.

The study's authors sought to look at the role of perceived stress, assess demographic variables and add to the literature on disasters, infectious disease and resilience. Their article was published this month in the journal Sustainability.

Contact with others is stressful

Historically, in environmental disasters (such as hurricanes), people find comfort in asking for and getting help from neighbors and friends. However, this kind of dependence and interaction increased stress for people in the survey, Cannon said. That's because in a pandemic, contact with others increases their risks and fears of getting sick, she said.

"There seems to be a real fear of contagion," Cannon said. "There's something unique about it being an infectious disease in that people pose a risk to each other. If we need things from other people, it increases our stress."

"The more that people perceive stress the less resilient they are."

Research on pandemics and their effects on people is scant, given that it's been a century since a pandemic the size of COVID-19 has occurred. Additionally, very little research has taken place during a pandemic, researchers said.

A population facing uncertainty

The findings showed that just 28 days, on average, into the pandemic two-thirds of survey respondents reported moderate to high levels of stress. Most of the respondents were female (75 percent), well-educated, white and employed at the time.

"It begs the question," researchers wrote in their article, "of whether populations with less social capital and fewer financial resources would be reporting even higher levels of stress and lower levels of resilience."

The authors said the research points to the need for solutions for a population facing so much uncertainty.

"Given the findings from the study, governments must mitigate the associated risks of a pandemic by providing the needed resources for individuals, households, and communities to maintain resilience over a long period of time," the authors concluded. "The uncertain end of COVID-19 requires governments to offer a buffer against the pandemic impact and to ultimately reduce stress to create optimal health and well-being for citizens facing adversity."

https://www.sciencedaily.com/releases/2020/08/200825110606.htm

Science Daily/DZNE - German Center for Neurodegenerative Diseases

Contrary to what has been generally assumed so far, a severe course of COVID-19 does not solely result in a strong immune reaction -- rather, the immune response is caught in a continuous loop of activation and inhibition. Experts from Charité -- Universitätsmedizin Berlin, the University of Bonn, the German Center for Neurodegenerative Diseases (DZNE), the Helmholtz Centre for Infection Research (HZI) and the German Center for Infection Research (DZIF), along with colleagues from a nationwide research network, present these findings in the scientific journal Cell.

Most patients infected with the coronavirus SARS-CoV-2 show mild or even no symptoms. However, 10 to 20 percent of those affected develop pneumonia during the course of COVID-19 disease, some of them with life-threatening effects. "There is still not very much known about the causes of these severe courses of the disease. The high inflammation levels measured in those affected actually indicate a strong immune response. Clinical findings, however, rather tend to indicate an ineffective immune response. This is a contradiction," says Joachim Schultze, professor at the University of Bonn and research group leader at the DZNE. "We therefore assume that although immune cells are produced in large quantities, their function is defective. That is why we examined the blood of patients with varying degrees of COVID-19 severity," explains Leif Erik Sander, Professor of Infection Immunology and Senior Physician Charité's Medical Department, Division of Infectious Diseases and Respiratory Medicine.

High-precision methods

The study was carried out within the framework of a nationwide consortium -- the "German COVID-19 OMICS Initiative" (DeCOI) -- resulting in the analysis and interpretation of the data being spread across various teams and sites. Joachim Schultze was significantly involved in coordinating the project. The blood samples came from a total of 53 men and women with COVID-19 from Berlin and Bonn, whose course of disease was classified as mild or severe according to the World Health Organization classification. Blood samples from patients with other viral respiratory tract infections as well as from healthy individuals served as important controls.

The investigations involved the use of single-cell OMICs technologies, a collective term for modern laboratory methods that can be used to determine, for example, the gene activity and the amount of proteins on the level of single, individual cells -- thus with very high resolution. Using this data, the scientists characterized the properties of immune cells circulating in the blood -- so-called white blood cells. "By applying bioinformatics methods on this extremely comprehensive data collection of the gene activity of each individual cell, we could gain a comprehensive insight of the ongoing processes in the white blood cells," explains Yang Li, Professor at the Centre for Individualised Infection Medicine (CiiM) and Helmholtz Centre for Infection Research (HZI) in Hannover. "In combination with the observation of important proteins on the surface of immune cells, we were able to decipher the changes in the immune system of patients with COVID-19," adds Birgit Sawitzki, Professor at the Institute of Medical Immunology on Campus Virchow-Klinikum.

"Immature" cells

The human immune system comprises a broad arsenal of cells and other defense mechanisms that interact with each other. In the current study, the focus was on so-called myeloid cells, which include neutrophils and monocytes. These are immune cells that are at the very front of the immune response chain, i.e. they are mobilized at a very early stage to defend against infections. They also influence the later formation of antibodies and other cells that contribute to immunity. This gives the myeloid cells a key position.

"With the so-called neutrophils and the monocytes we have found that these immune cells are activated, i.e. ready to defend the patient against COVID-19 in the case of mild disease courses. They are also programmed to activate the rest of the immune system. This ultimately leads to an effective immune response against the virus," explains Antoine-Emmanuel Saliba, head of a research group at the Helmholtz Institute for RNA-based Infection Research (HIRI) in Würzburg.

But the situation is different in severe cases of COVID-19, explains Sawitzki: "Here, neutrophils and monocytes are only partially activated and they do not function properly. We find considerably more immature cells that have a rather inhibitory effect on the immune response." Sander adds: "The phenomenon can also be observed in other severe infections, although the reason for this is unclear. Many indications suggest that the immune system stands in its own way during severe courses of COVID-19. This could possibly lead to an insufficient immune response against the corona virus, with a simultaneous severe inflammation in the lung tissue."

Approaches to therapy?

The current findings could point to new therapeutic options, says Anna Aschenbrenner from the LIMES Institute at the University of Bonn: "Our data suggest that in severe cases of COVID-19, strategies should be considered that go beyond the treatment of other viral diseases." The Bonn researcher says that in the case of viral infections one does not actually want to suppress the immune system. "If, however, there are too many dysfunctional immune cells, as our study shows, then one would very much like to suppress or reprogram such cells." Jacob Nattermann, Professor at the Medical Clinic I of the University Hospital Bonn and head of a research group at the DZIF, further explains: "Drugs that act on the immune system might be able to help. But this is a delicate balancing act. After all, it's not a matter of shutting down the immune system completely, but only those cells that slow down themselves, so to speak. In this case these are the immature cells. Possibly we can learn from cancer research. There is experience with therapies that target these cells."

Nationwide team effort

In view of the many people involved, Schultze emphasizes the cooperation within the research consortium: "As far as we know, this study is one of the most comprehensive studies to date on the immune response in COVID-19 based on single cell data. The parallel analysis of two independent patient cohorts is one of the strengths of our study. We analyzed patient cohorts from two different sites using different methods and were thus able to validate our findings directly. This is only possible if research data is openly shared and cooperation is based on trust. This is extremely important, especially in the current crisis situation."

https://www.sciencedaily.com/releases/2020/08/200806111822.htm

Science Daily/University of Leeds

Researchers have identified a pattern of longer-term symptoms likely to be experienced by people who were hospitalised with the COVID-19 infection.

They include fatigue, breathlessness, psychological distress -- including problems with concentration and memory -- and a general decline in quality of life.

Some patients, particularly those who had been in intensive care, had symptoms associated with cases of PTSD (post-traumatic stress disorder).

The findings provide the first detailed insight into problems facing patients recovering from COVID-19 in the UK.

Dr Manoj Sivan, Associate Clinical Professor at the University of Leeds and a Consultant in Rehabilitation Medicine at Leeds General Infirmary, supervised the research project. He said: "COVID-19 is a new illness and we have very little information on longer term problems in individuals after discharge from hospital."

"The emerging evidence is that for some, the road to recovery may take months and it is vital specialist rehabilitation is on hand to support them. This research gives an important insight into patient needs, and that will help shape services in the community."

The findings -- Post-discharge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation -- have been published in the Journal of Medical Virology.

Dr Stephen Halpin, Senior Research Fellow at the University of Leeds and Consultant with Leeds Teachings Hospitals NHS Trust, said: "This research follows our previous work of predicting COVID-19 patients' long-term needs based on previous coronavirus outbreaks of SARS in 2002 and MERS in 2012. The health problems are similar but on a larger scale given the number of people affected."

The research team -- involving multidisciplinary specialists from the University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds Community Healthcare NHS Trust and Leeds Beckett University -- followed 100 people recovering from COVID-19, four-to-eight weeks after being discharged from hospital in Leeds.

The COVID-19 survivors were divided into two groups: those who had become critically ill and needed intensive care -- 32 people were in this category; and those who were treated on a ward without needing intensive care -- 68 people were in this category.

Patients were contacted by a member of the hospital's rehabilitation team and asked a series of questions about their recovery and symptoms they were still experiencing.

Results

The most prevalent symptom was fatigue. More than 60 percent of people who had been treated on a ward reported fatigue, and one-third of them described it as moderate or severe. For patients who had been in intensive care, 72 percent reported fatigue. Of those, more than half said it was moderate or severe.

The second most common symptom was breathlessness. People in both groups said they had feelings of breathlessness which had not existed before they contracted COVID-19. This was higher in the group that had been the most ill, the intensive care group versus those who had been treated in a ward -- 65.6 percent versus 42.6 percent.

The third most prevalent symptoms were neuropsychological. The research survey found that almost one quarter of the people who had been on a ward and just under a half of the people who had been in intensive care had some of the symptoms of PTSD.

Writing in the paper, the researchers said: "PTSD symptoms are a well-recognised component of post- intensive care unit syndrome caused by a variety of factors including fear of dying, invasive treatment, pain, delirium, inability to communicate, weakness, immobility, and sensory problems and sleep deprivation."

More than two-thirds (68.8 percent) of patients in the intensive care group and just under half (45.6 percent) of the other group said their overall quality of life had deteriorated.

The researchers say the rehabilitation needs of patients who did not require hospital care need to be further investigated and they are working on understanding this in future research.

https://www.sciencedaily.com/releases/2020/08/200806122820.htm

July 30, 2020

Science Daily/Ann & Robert H. Lurie Children's Hospital of Chicago

A study from Ann & Robert H. Lurie Children's Hospital of Chicago discovered that children younger than 5 years with mild to moderate COVID-19 have much higher levels of genetic material for the virus in the nose compared to older children and adults.

Findings, published in JAMA Pediatrics, point to the possibility that the youngest children transmit the virus as much as other age groups. The ability of younger children to spread COVID-19 may have been under-recognized given the rapid and sustained closure of schools and daycare during the pandemic.

"We found that children under 5 with COVID-19 have a higher viral load than older children and adults, which may suggest greater transmission, as we see with respiratory syncytial virus, also known as RSV," says lead author Taylor Heald-Sargent, MD, PhD, pediatric infectious diseases specialist at Lurie Children's and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "This has important public health implications, especially during discussions on the safety of reopening schools and daycare."

Dr. Heald-Sargent and colleagues analyzed 145 cases of mild to moderate COVID-19 illness within the first week of symptom onset. They compared the viral load in three age groups -- children younger than 5 years, children 5-17 years and adults 18-65 years.

"Our study was not designed to prove that younger children spread COVID-19 as much as adults, but it is a possibility," says Dr. Heald-Sargent. "We need to take that into account in efforts to reduce transmission as we continue to learn more about this virus."

https://www.sciencedaily.com/releases/2020/07/200730141324.htm

Science Daily/University of Pennsylvania School of Medicine

Black and Hispanic pregnant women in Philadelphia are five times as likely as white and Asian women to have been exposed to the novel coronavirus, according to a new study led by Scott Hensley, PhD, an associate professor of Microbiology in the Perelman School of Medicine at the University of Pennsylvania, and Karen Marie Puopolo, MD, PhD, an associate professor of Pediatrics and neonatologist at the Children's Hospital of Philadelphia. The study was published today in Science Immunology.

"Pregnant women are fairly representative of community exposure, and these data provide more evidence, on top of what we already know with COVID-19, that health and socio-economic equity are inextricably linked," Hensley said, "Hopefully, this will help lead to policies that address these inequities."

The research team measured levels of SARS-CoV-2 antibodies to estimate rates of exposure to the novel coronavirus in pregnant women cared for at two Philadelphia hospitals. They found that, overall, 6.2 percent of these women possessed antibodies to the virus, but with significant variation across racial and ethnic groups -- 9.7 percent in Black women, 10.4 percent in Hispanic/Latina women, 2.0 percent in White/Non-Hispanic women, and 0.9 percent in Asian women.

Researchers said these data can inform clinical practice and care for pregnant women during the coronavirus pandemic, and be used to better understand the prevalence of the virus in the community, and how socio-economic factors and inequities may affect its spread.

"Identifying the disparity in virus exposure will ideally help lead to the discovery of what is causing these differences, including factors rooted in systemic racism, and inform public health measures aimed at preventing further infections," Puopolo said.

As of June 2020 -- the time period encompassed in this study -- there were 23,160 confirmed cases of COVID-19 in the city of Philadelphia, which has a population size of nearly 1.6 million people. This suggests an infection rate of approximately 1.4 percent, which is more than 4 times lower than the estimates based on the research team's serological data.

Researchers analyzed 1,293 women who gave birth between April and June at Pennsylvania Hospital and the Hospital of the University of Pennsylvania, which combined represent 50 percent of live births during that time in Philadelphia. The research team's serological test utilized a SARS-CoV-2 spike protein receptor binding domain antigen and a modified ELISA protocol. Researchers used samples stored at the Penn Medicine Biobank collected from 834 people prior to the pandemic and 31 people who recovered from known Covid-19 infections to test the efficacy of their antibody test. The researchers also tested samples from 140 pregnant women collected before the pandemic. Based on these data, the overall false positive rate is ~1.0 percent in the serological assay used for this study.

The researchers caution that the clinical meaning of the detected antibody remains unknown. Additionally, estimates of virus prevalence need to be interpreted carefully until studies directly comparing pregnant women and the general population are completed.

https://www.sciencedaily.com/releases/2020/07/200729151652.htm

Science Daily/Stanford University

Like the legendary falling apple that hit Isaac Newton and led to his groundbreaking insight on the nature of gravity, COVID-19 could provide unintended glimpses into how complex Earth systems operate, according to a new Stanford-led paper. The perspective, published July 29 in Nature Reviews Earth & Environment, hypothesizes outcomes of unprecedented changes in human activity wrought by worldwide sheltering orders, and outlines research priorities for understanding their short and long-term implications. Getting it right could revolutionize how we think about issues as broad as greenhouse gas emissions, regional air quality, and the global economy's connection to poverty, food security and deforestation, according to the researchers. It could also help ensure an economically, socially and environmentally sustainable recovery from the coronavirus pandemic while helping prevent future crises.

"Without distracting from the most important priority -- which is clearly the health and well-being of people and communities -- the current easing of the human footprint is providing a unique window into the impacts of humans on the environment, including a number of questions that are critical for effective public policy," said lead author Noah Diffenbaugh, the Kara J Foundation Professor at Stanford's School of Earth, Energy & Environmental Sciences.

For example, the question of how much electrifying the vehicle fleet will improve air quality has until now relied heavily on theoretical arguments and computer models. The scale of recent emissions reductions, however, provides an opportunity to use atmospheric observations to check just how accurate those models are in simulating the impact of pollution-reduction interventions such as electric vehicle incentives.

Predicting pandemic outcomes

The researchers note that although many of the initial impacts of COVID sheltering, such as clear skies resulting from reduced pollutant emissions, could be perceived as beneficial to the environment, the longer-term impacts -- particularly related to the economic recession -- are less clear. To understand the impacts across both short and long timescales, they propose focusing on cascading effects along two pathways: (1) energy, emissions, climate and air quality; and (2) poverty, globalization, food and biodiversity.

Given the complex interactions along these pathways, the researchers emphasize the need for techniques that can bring together multiple lines of evidence to reveal causes and effects. This includes bolstering and expanding coordinated efforts to study the impacts of the pandemic, including safe deployment of environmental sensors that can track changing conditions, computer models that simulate Earth's response to the sheltering measures and solutions-oriented research trials that lend insight into human behavior and decision making. The authors also call for a coordinated data repository where many different kinds of data can be made openly available to the public in a uniform format.

"Almost overnight, people across the world had to change the way they live, the way they work -- with many facing loss of income -- commute, buy food, educate their children and other energy-consuming behaviors," said Inês Azevedo, an associate professor of energy resources engineering in Stanford's School of Earth, Energy & Environmental Sciences. "It's critical for us to better understand how future societal disruptions and catastrophes could affect interactions among energy systems and other systems that serve society."

Understanding the human response

A key factor in understanding how the pandemic's effects play out is its influence on human behavior and decision making.

"Human behavior contributes to, but is also affected by, changes in the Earth system, and COVID-19 is creating new challenges for ensuring people and corporations act to protect the planet," said co-author Margaret Levi, the Sara Miller McCune Director of Stanford's Center for Advanced Study in the Behavioral Sciences and a professor of political science. "While government was not a central focus in this paper, it clarifies the roles that laws, regulations and investments play in the safety of the food supply and food workers, emissions controls and many other aspects of the health of the Earth and its inhabitants."

Some of the pandemic's most lasting impacts on climate and air quality could occur via insights it provides into the calculation of policy parameters that measure the value that individuals and society place on different environmental trade-offs. The COVID-19 crisis is making these tradeoffs more explicit, the researchers point out. This is because governments, communities and individuals are making historic decisions reflecting underlying preferences for current and future consumption, as well as the tradeoff between different types of economic activity and individual and collective risk.

These decisions can help quantify the parameters that are routinely used in environmental policymaking (such as the cost of human lives lost to air pollution or of climate change associated with carbon dioxide emissions). As those updated parameters are incorporated into actual policy decisions, they will have lasting effects on the regulations that impact the long-term trajectory of climate and air quality.

Studying policy interventions designed to prevent socio-environmental damage -- such as the role of poverty in driving deforestation -- could also help vulnerable people weather poverty shocks from COVID-19 by providing a deeper understanding of how and where poverty and environmental degradation are most tightly linked. The researchers propose using the kinds of solution-oriented research trials that were awarded this year's Nobel Prize in Economics to study whether interventions such as payments for protection of natural resources are effective in staving off deforestation, over-fishing and other environmental damages.

"COVID-19 poses some of the biggest challenges we have faced in the last century," said paper co-author Chris Field, the Perry L. McCarty Director of the Stanford Woods Institute for the Environment and Melvin and Joan Lane Professor for Interdisciplinary Environmental Studies. "With every challenge, there are opportunities for learning, and this paper provides a map for expanding the set of opportunities."

https://www.sciencedaily.com/releases/2020/07/200729114809.htm

Science Daily/NYU Langone Health / NYU School of Medicine

While data and news reports show that Black and Hispanic communities are disproportionately affected by the 2019 Coronavirus Disease (COVID-19) pandemic, the role that neighborhood income plays in COVID-19 deaths is less clear. New analyses by a team of researchers at NYU Grossman School of Medicine examine the interplay between race/ethnicity and income on COVID-19 cases and related deaths in 10 major U.S. cities. The researchers found that non-white counties had higher cumulative incidences and deaths compared to predominantly white counties -- and this was true for both low-income and high-income communities.

The findings -- recently published online in JAMA Network Open -- suggest that racial disparities in COVID-19 cases and deaths exist beyond what can be explained by differences in poverty rates. The researchers found that even among communities with higher median income, predominantly non-white communities still bore a greater burden of the virus -- almost three times the incidence and deaths -- compared to neighborhoods that identified as majority white. Yet income also plays an important contributing role. Indeed, the starkest racial/ethnic contrast between majority non-white and predominantly white counties was found when restricted to low-income counties only, where residents from predominantly non-white communities died from COVID-19 at nine times the rate as those living in predominantly white counties.

"While we expected to see greater numbers of COVID-19 cases and deaths in predominantly non-white, low-income communities, we were surprised that this relationship still held even after we accounted for poverty rates," said Samrachana Adhikari, PhD, assistant professor, Department of Population Health, NYU Grossman School of Medicine, and lead author of the study. "Given our findings, we believe that structural racism may explain these racial disparities in number of cases and deaths noted in Black counties."

How the Study was Conducted

Using publicly available data from the 2018 U.S. Census Small Areas Income and Poverty Estimates program, the Centers for Disease Control, and state health departments, the researchers examined cumulative COVID-19 cases and deaths per 100,000 across 158 urban counties (accounting for 64 percent of confirmed COVID-19 cases) spanning 10 large U.S. cities: New York City, Boston, New Orleans, Detroit, Los Angeles, Atlanta, Miami, Chicago, Philadelphia, and Seattle. Using the census data, the team linked median income and proportion of non-white residents in each county and used statistical analysis to identify differences in cumulative incidents and death, and their association with neighborhood race/ethnicity and poverty levels. All data analyzed included COVID-19 cases and deaths observed through May 10, 2020.

"We have known for decades that racism kills. Racism is a public health issue which has been implicated in the racial gap in mortality and in health outcomes," says Gbenga Ogedegbe, MD, MPH, professor of Population Health and Medicine at NYU Langone and one of the study's co-authors.

"Because the differences in COVID-19 cases and mortality cannot be explained by poverty alone, our findings give credence to our hypothesis that structural racism underlies the disproportionately higher rates of COVID-19 infections and alarmingly high rates of deaths in predominantly Black communities. The fact that non-white residents died from the virus at higher rates than white residents in both wealthier and poorer communities should be a major alarm bell to policymakers at the national and local government levels, academic medical centers, and the country at large," says Ogedegbe.

One of the study's limitations, according to Adhikari, is that it covers only large metropolitan areas and that the data analyzed are aggregated at the county level. More granular data at the individual level, as well as a breakdown of residents by race and ethnicity, would provide greater insight into the drivers of this troubling association, as well as expose most affected neighborhoods in need of more robust public health interventions, says Adhikari.

https://www.sciencedaily.com/releases/2020/07/200728113539.htm

Science Daily/Penn State

By reconstructing the evolutionary history of SARS-CoV-2, the virus that is responsible for the COVID-19 pandemic, an international research team of Chinese, European and U.S. scientists has discovered that the lineage that gave rise to the virus has been circulating in bats for decades and likely includes other viruses with the ability to infect humans. The findings have implications for the prevention of future pandemics stemming from this lineage.

"Coronaviruses have genetic material that is highly recombinant, meaning different regions of the virus's genome can be derived from multiple sources," said Maciej Boni, associate professor of biology, Penn State. "This has made it difficult to reconstruct SARS-CoV-2's origins. You have to identify all the regions that have been recombining and trace their histories. To do that, we put together a diverse team with expertise in recombination, phylogenetic dating, virus sampling, and molecular and viral evolution."

The team used three different bioinformatic approaches to identify and remove the recombinant regions within the SARS-CoV-2 genome. Next, they reconstructed phylogenetic histories for the non-recombinant regions and compared them to each other to see which specific viruses have been involved in recombination events in the past. They were able to reconstruct the evolutionary relationships between SARS-CoV-2 and its closest known bat and pangolin viruses. Their findings appear today (July 28) in Nature Microbiology.

The researchers found that the lineage of viruses to which SARS-CoV-2 belongs diverged from other bat viruses about 40-70 years ago. Importantly, although SARS-CoV-2 is genetically similar (about 96%) to the RaTG13 coronavirus, which was sampled from a Rhinolophus affinis horseshoe bat in 2013 in Yunnan province, China, the team found that it diverged from RaTG13 a relatively long time ago, in 1969.

"The ability to estimate divergence times after disentangling recombination histories, which is something we developed in this collaboration, may lead to insights into the origins of many different viral pathogens," said Philippe Lemey, principal investigator in the Department of Evolutionary and Computational Virology, KE Leuven.

The team found that one of the older traits that SARS-CoV-2 shares with its relatives is the receptor-binding domain (RBD) located on the Spike protein, which enables the virus to recognize and bind to receptors on the surfaces of human cells.

"This means that other viruses that are capable of infecting humans are circulating in horseshoe bats in China," said David L. Robertson, professor of computational virology, MRC-University of Glasgow Centre for Virus Research.

Will these viruses be capable of jumping directly from bats into humans or will an intermediate species be required to make the leap? According to Robertson, for SARS-CoV-2, other research groups incorrectly proposed that key evolutionary changes occurred in pangolins.

"SARS-CoV-2's RBD sequence has so far only been found in a few pangolin viruses," said Robertson. "Furthermore, the other key feature thought to be instrumental to SARS-CoV-2's ability to infect humans -- a polybasic cleavage site insertion in the Spike protein -- has not yet been seen in another close bat relative of the SARS-CoV-2 virus. Yet, while it is possible that pangolins may have acted as an intermediate host facilitating transmission of SARS-CoV-2 to humans, no evidence exists to suggest that pangolin infection is a requirement for bat viruses to cross into humans. Instead, our research suggests that SARS-CoV-2 likely evolved the ability to replicate in the upper respiratory tract of both humans and pangolins."

The team concluded that preventing future pandemics will require better sampling within wild bats and the implementation of human disease surveillance systems that are able to identify novel pathogens in humans and respond in real time.

"The key to successful surveillance," said Robertson, "is knowing which viruses to look for and prioritizing those that can readily infect humans. We should have been better prepared for a second SARS virus."

Boni added, "We were too late in responding to the initial SARS-CoV-2 outbreak, but this will not be our last coronavirus pandemic. A much more comprehensive and real-time surveillance system needs to be put in place to catch viruses like this when case numbers are still in the double digits."

https://www.sciencedaily.com/releases/2020/07/200728113512.htm

Science Daily/University of Cambridge

Existing limited evidence suggests that wearing face coverings to protect against COVID-19 does not lead to a false sense of security and is unlikely to increase the risk of infection through wearers foregoing other behaviours such as good hand hygiene, say researchers from the University of Cambridge and King's College London.

Writing in BMJ Analysis, the researchers say that the concept of 'risk compensation' is itself the greater threat to public health as it may discourage policymakers from implementing potentially effective measures, such as wearing face coverings.

Wearing face coverings, particularly in shared indoor spaces, is now mandated or recommended in more than 160 countries to reduce transmission of SARS-CoV-2, the virus that causes COVID-19. Worn correctly, face coverings can reduce transmission of the virus as part of a set of protective measures, including maintaining physical distance from others and good hand hygiene.

While it is not clear how much of an effect face coverings have, scientists have urged policymakers to encourage the wearing of face coverings because the risks are minimal while the potential impact is important in the context of the COVID-19 pandemic.

However, early in the pandemic, the World Health Organization warned that wearing face coverings could "create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices." This type of behaviour is known as 'risk compensation'.

A team led by Professor Dame Theresa Marteau at the Behaviour and Health Research Unit, University of Cambridge, has examined the evidence for risk compensation to see whether concerns might be justified in the context of face coverings to reduce transmission of SARS-CoV-2.

The idea behind risk compensation is that people have a target level of risk they are comfortable with and they adjust their behaviour to maintain that level risk. At an individual level, risk compensation is commonplace: for example, people run for longer to offset an eagerly anticipated indulgent meal and a cyclist may wear a helmet to cycle at speed.

At a population level, evidence for risk compensation is less clear. A commonly-cited example is the mandated wearing of bike helmets purportedly leading to an increase in the number of bike injuries and fatalities. Another often-cited example is the introduction of HIV pre-exposure prophylaxis (PrEP) and HPV vaccination purportedly leading to an increase in unprotected sex.

Professor Marteau and colleagues say the results of the most recent systematic reviews -- a technique that involves examining all available evidence on a topic -- do not justify the concerns of risk compensation for either of these examples. In fact, for HPV vaccination, the opposite effect was found: those who were vaccinated were less likely to engage in unprotected sexual behaviour as measured by rates of sexually transmitted infection.

At least 22 systematic reviews have assessed the effect of wearing a mask on transmission of respiratory virus infections. These include six experimental studies, involving over 2,000 households in total -- conducted in community settings that also measured hand hygiene. While none of the studies was designed to assess risk compensation or looked at social distancing, their results suggest that wearing masks does not reduce the frequency of hand washing or hand sanitising. In fact, in two studies, self-reported rates of hand washing were higher in the groups allocated to wearing masks.

The team also found three observational studies that showed people tended to move away from those wearing a mask, suggesting that face coverings do not adversely affect physical distancing at least by those surrounding the wearer. However, they say that as none of these studies have been peer-reviewed, they should be treated with caution.

"The concept of risk compensation, rather than risk compensation itself, seems the greater threat to public health through delaying potentially effective interventions that can help prevent the spread of disease," said Professor Marteau.

"Many public health bodies are coming to the conclusion that wearing a face covering might help reduce the spread of SARS-CoV-2, and the limited evidence available suggests their use doesn't have a negative effect on hand hygiene," added co-author Dr James Rubin from the Department of Psychological Medicine, King's College London.

In their article, the team argue that it is time to lay risk compensation theory to rest. Professor Barry Pless from McGill University, Montreal, Canada, once described it as "a dead horse that no longer needs to be beaten." The authors go further, saying "this dead horse now needs burying to try to prevent the continued threat it poses to public health, from by slowing the adoption of more effective interventions."

https://www.sciencedaily.com/releases/2020/07/200727114706.htm

Science Daily/Vanderbilt University Medical Center

The ongoing disruptive changes from efforts to reduce the spread of COVID-19 are having a substantial negative impact on the physical and mental well-being of parents and their children across the country, according to a new national survey published today in Pediatrics.

Families are particularly affected by stressors stemming from changes in work, school and day care schedules that are impacting finances and access to community support networks, according to the five-day survey of parents across the U.S. run June 5-June 10 run by Monroe Carell Jr. Children's Hospital at Vanderbilt and Ann & Robert H. Lurie Children's Hospital of Chicago.

Top line results showed:

• 27% of parents reported worsening mental health for themselves

• 14% reported worsening behavioral health for their children

• 24% of parents reported a loss of regular child care

The impact of abrupt, systemic changes to employment and strain from having access to a limited social network is disrupting the core of families across the country. Worsening physical and mental health were similar no matter the person's race, ethnicity, income, education status or location. However, larger declines in mental well-being were reported by women and unmarried parents.

"COVID-19 and measures to control its spread have had a substantial effect on the nation's children," said Stephen Patrick, MD, MPH, director of the Vanderbilt Center for Child Health Policy and a neonatologist at Children's Hospital in Nashville. "Today an increasing number of the nation's children are going hungry, losing insurance employer-sponsored insurance and their regular child care. The situation is urgent and requires immediate attention from federal and state policymakers."

Parents with children under age 18 were surveyed to measure changes in their health, insurance status, food security, use of public food assistance resources, child care and use of health care services since the COVID-19 pandemic began.

Since March, more families are reporting food insecurity, and more reliance on food banks, and delaying children's visits to health care providers. With COVID-19 cases and deaths on the rise around the country, families may continue to experience higher levels of need and disruption.

• The proportion of families with moderate or severe food insecurity increased from 6% to 8% from March to June.

• Children covered by parents' employer-sponsored insurance coverage decreased from 63% to 60%.

Strikingly, families with young children report worse mental health than those with older children, pointing to the central role that child care arrangements play in the day-to-day functioning of the family.

"The loss of regular child care related to COVID-19 has been a major shock to many families," says Matthew M. Davis, MD, MAPP, interim chair of the Department of Pediatrics at Northwestern University Feinberg School of Medicine and senior vice-president and chief of Community Health Transformation at Ann & Robert H. Lurie Children's Hospital of Chicago. "In almost half of all cases where parents said that their own mental health had worsened and that their children's behavior had worsened during the pandemic, they had lost their usual child care arrangements. We need to be aware of these types of stressors for families, which extend far beyond COVID-19 as an infection or an illness."

https://www.sciencedaily.com/releases/2020/07/200724104155.htm