Month: February 2021

Categories : COVID Immune SystemTags :

COVID Tracking in Space Company Employees Yields Antibody Clues

On By ModernMedia

SpaceX, an aerospace manufacturing company currently providing satellite launch services as well as transport of crew  to the International Space Station, collaborated with researchers from MIT to monitor the spread of COVID amongst its employees. 

Unusually, the paper included SpaceX CEO Elon Musk as a byline author. The technology entrepreneur is known to be quite hands-on in his company’s projects. However, he has also courted controversy by openly questioning COVID tests and saying he and his family would not take COVID vaccines, saying that achieving herd immunity naturally was a better strategy.

SpaceX was seeking data-driven methods to safeguard its essential workforce. The collaboration allowed the researchers to track the emergence of mild and asymptomatic cases in a cohort of adults as early as April, when data for such cases were rare.

“Essentially, this study indicates that it’s not simply the presence or absence of antibodies that matter; rather, the amount and type of antibodies may play a defining role in the development of a protective immune response,” said Professor Galit Alter, Harvard Medical School and Immunologist, Division of Infectious Diseases, Massachusetts General Hospital. 

The study was originally aimed at measuring antibody levels over time, but when reinfections began to be reported, the team realised their samples had some valuable information.

“In early spring, we weren’t sure if asymptomatic infection could drive long-lived antibodies,” said Prof Alter, “nor whether they possessed the capability to neutralise or kill the virus.”

The researchers knew that 120 participants had mild or asymptomatic COVID infections, resulting in their bodies producing antibodies. Using sophisticated techniques to analyse those antibodies, they found that individuals with stronger symptoms in mild COVID, had a larger number of antibodies and developed immune functions associated with natural immune protection. 

The study found that although the presence of antibodies was sufficient to determine whether an individual had experienced a COVID infection, they did not automatically mean that individual is protected against the virus in the long term.

Antibody effector functions (on the ‘long arm’ of the antibody) linked to long-term protection, such as T cell activation and virus neutralisation were only seen in certain immune responses. These involved high levels of antibodies targetting a part of the virus known as the receptor binding domain.

“Once you hit a certain threshold of these antibodies, it’s like a switch turns on and we can observe antibody effector functions,” said first author Yannic Bartsch, PhD. “These functions were not observed in individuals with lower antibody binding titers, and the level of protection from reinfections is uncertain in these individuals.”

Source: News-Medical.Net

Journal information: Bartsch, Y. C., et al. (2021) Discrete SARS-CoV-2 antibody titers track with functional humoral stability. Nature Communications. doi.org/10.1038/s41467-021-21336-8.

Categories : Diseases, Syndromes and ConditionsTags :

Russia Reports Bird Flu Transmission to Humans

On By ModernMedia

On Saturday, Russia announced that it had detected the first case of the H5N8 strain of bird flu in humans.

The head of Russia’s health watchdog Rospotrebnadzor, Anna Popova, made the announcement in televised remarks. Scientists at the Vektor laboratory had identified the strain in seven workers at a Southern Russia poultry farm which had experienced an outbreak among the birds in December. No serious health consequences among the workers had been reported, and they are believed to have contracted the virus from the birds on the farm. The World Health Organization had already been alerted to the situation soon before the announcement.

Humans can contract bird flu A(H5N1) and A(H7N9) and swine flu subtypes such as A(H1N1). The bird flu subtype H5N1 is particularly dangerous as it has a 60% mortality rate in humans. According to the WHO, direct transmission between humans of such diseases is limited, and that most transmission comes when humans are in close contact with animals.

Influenza viruses are known to evolve “quite quickly” said Gwenael Vourc’h, head of research at France’s National Institute for Agriculture, Food, and Environment.

She added that there were likely cases outside Russia, saying to the FTP that this “is probably the tip of the iceberg.”

However, Francois Renaud, a researcher at the French National Centre for Scientific Research (CNRS), said that he was “not particularly worried” at this stage as the COVID pandemic had taught countries to react quickly, and that “draconian measures” will be taken to curb the outbreak.

He added that the coronavirus pandemic had taught countries to react quickly to potential health threats. “Draconian measures will be taken to immediately stop the outbreak,” he said.

Avian flu has raged in several European countries including France, where hundreds of thousands of birds have been culled to stop the infection.

The Vektor State Virology and Biotechnology Centre, which picked up the transmission to the poultry farm workers, also developed one of Russia’s coronavirus vaccines. The lab once conducted secret bioweapons research in the Soviet era, and still maintains stockpiles of viruses ranging from Ebola to smallpox.

Vektor chief Rinat Maksyutov said the lab was ready to begin the development of test kits to detect H5N8 in humans, and also to commence working on a vaccine.

Source: Medical Xpress

Categories : Paediatrics TransplantsTags :

Novel Transplant Technique Yields More Donor Hearts for Children

On By ModernMedia

Two hospitals in the UK have reported great success in a new heart transplant technique, resulting in a record number of children receiving heart transplants in 2020.

Royal Papworth Hospital in Cambridge and Great Ormond Street Hospital (GOSH) have collaborated on a new procedure which has enabled a much larger supply of donor hearts for children, who have had to wait two and a half times as long as adults for a donation.

Royal Papworth Hospital was the first in Europe to harvest non-beating hearts from adult patients whose life support had been withdrawn, and then been restarted for transplantation, instead of waiting for brain death with a still-beating heart.

By using a special device called the organ care system, surgeons can effectively restart the heart and keep it healthy until transplantation. The first non-beating heart transplant was performed in Australia in 2014. Since February last year, the two hospitals have been offering the service to children.

The use of non-beating hearts had previously been ruled out for transplantation until recently, due to tissue damage from lack of oxygen. The new organ care system, which supplies the heart with oxygenated blood and nutrients, can be used to keep the heart alive and pumping outside the body for up to 12 hours. This is long enough for checks to be performed prior to the transplant procedure, or even transferred to another hospital.

GOSH and Freeman Hospital are the only two centres in the UK with paediatric heart transplant units. In the past five years, 39 children died while waiting for donors.

“Some patients will just not survive the wait,” said Jacob Simmonds, a transplant surgeon at GOSH. “There is also a risk that while waiting they could damage other organs, particularly the lungs.” 

Last year, six paediatric heart transplants were carried out in the UK using the new procedure, and only four elsewhere in the world. The organs came from adult donors, as the organ care system is designed to accommodate hearts from people weighing over 50kg. Development is being carried out on a system which could allow harvesting organs from children. This would increase the available transplants for infants and babies, who have a critical lack of donors.

Source: BBC News

Categories : Medical IndustryTags :

Failure of Joint Corporate Medical Insurance Betrays a Greater Problem

On By ModernMedia

The failure of a joint corporate medical insurance venture to cover the employees of three corporate giants nevertheless holds lessons for the future, its former CEO revealed.

Headed by author, innovator, and surgeon Atul Gawande, MD, Haven was created by Berkshire Hathaway, Amazon, and JP Morgan Chase to provide revolutionary healthcare insurance for their 150 000 employees, delivering high quality at an affordable price. More than just a healthcare system, it was aimed to provide an example for the rest of the United States to follow. Its team of experts created a system of coverage with no co-insurance, no deductibles, 60 critical drugs at no cost, and low-cost mental health services and primary care.

Yet, less than three years after its inception, it is soon to shut down. Dr Gawande had already stepped down as chairman in May 2020, and in a ‘grand rounds’ discussion with Robert Wachter, MD, chair of the University of California San Francisco’s department of medicine he explained the problems behind it. He said that, simply put, the system is fatally flawed — a weakness that was laid bare by the enormous job losses of the COVID pandemic.

“We have an employer-based system. A job-based system is a broken system in a world where people are moving every couple of years to different roles and many, many, kinds of jobs,” Dr Gawande said.

“The pandemic has really brought this out in spades,” he said. The lockdowns cost many workers their jobs and the benefits that came with them. At the end of 2020, there were 9.4 million fewer jobs in the US.

“The vulnerability we have of tying your healthcare to your job, that remains still a big hill to climb, and the government has to solve it. That is a public core issue that we still have not faced up to,” Dr Gawande said.

He explained that a job-based healthcare system cares only about costs this year, not over the worker’s lifetime. “That’s why we have fights over whether we’ll pay for a hepatitis C treatment that costs $50 000 and up but avert $1 million in costs over the course of a life. We need that life-course commitment and view, and we have not aligned around that,” he said.

But that wasn’t the only reason behind Haven’s dissolution; it proved extremely difficult to make an insurance plan that worked across three different companies with different organisational cultures and employees in different cities, with different populations.

“Once that became clear, then Haven threatens to become a very expensive think tank,” Dr Gawande said. Originally, Haven was supposed to assume benefits management responsibility at the three companies, he explained. But it eventually became clear that “didn’t have the potential to say we’ll take over all of the benefits and running of the insurance for all you three organisations and then add more and more and more and more.”

However, Dr Gawande doesn’t think Haven was a failure. “It definitely did not become what we thought it would be,” he confessed. But the experience enabled him to start called CIC Health, a new venture which launched COVID testing efforts in the Boston area last fall and now has major COVID vaccination efforts underway with more coming.

Source: MedPage Today

Categories : Ageing GastrointestinalTags :

Gut Microbiome Changes are Linked to Ageing and Longevity

On By ModernMedia

Ageing in humans is marked by compositional changes in the gut microbiome that become more unique later in life.

Researchers from the Institute for Systems Biology (ISB) analysed gut microbiome, phenotypic and clinical data from over 9000 people across three independent cohorts. Health and survival outcomes were tracked from longitudinal data from a cohort of over 900 community-dwelling older individuals (78-98 years old).

The researchers found that, starting in mid-to-late adulthood, gut microbiomes became increasingly unique as individuals aged, corresponding with a steady decline in the abundance of core bacterial genera common across humans.

Strikingly, while microbiomes became increasingly unique to each individual in healthy aging, the metabolic functions the microbiomes were carrying out shared common traits. Gut microbiome uniqueness was highly correlated with several microbially-derived metabolites in blood plasma. One of them, tryptophan-derived indole, has been shown to extend lifespan in mice. Another metabolite, phenylacetylglutamine, showed the strongest association with uniqueness, and is known to be highly elevated in the blood of people over 100.

“This uniqueness signature can predict patient survival in the latest decades of life,” said study leader Dr Tomasz Wilmanski, who led the study. Healthy individuals aged around 80 showed continued microbial drift toward a uniqueness, but this drift was not seen in less healthy individuals of the same age.

“Interestingly, this uniqueness pattern appears to start in mid-life—40-50 years old—and is associated with a clear blood metabolomic signature, suggesting that these microbiome changes may not simply be diagnostic of healthy aging, but that they may also contribute directly to health as we age,” Wilmanski said. Indoles are known to reduce inflammation in the gut, for example, and chronic inflammation is believed to drive age-related morbidities.

“Prior results in microbiome-aging research appear inconsistent, with some reports showing a decline in core gut genera in centenarian populations, while others show relative stability of the microbiome up until the onset of aging-related declines in health,” said co-corresponding author, microbiome specialist Dr Sean Gibbons. “Our work, which is the first to incorporate a detailed analysis of health and survival, may resolve these inconsistencies. Specifically, we show two distinct aging trajectories: (1) a decline in core microbes and an accompanying rise in uniqueness in healthier individuals, consistent with prior results in community-dwelling centenarians, and (2) the maintenance of core microbes in less healthy individuals.”

This analysis highlights the fact that the adult gut microbiome continues to develop with advanced age in healthy individuals, but not in unhealthy ones, and that microbiome compositions associated with health in early-to-mid adulthood may not be compatible with health in late adulthood.

Source: Medical Xpress

Journal information: Gut microbiome pattern reflects healthy ageing and predicts survival in humans, Nature Metabolism (2021). DOI: 10.1038/s42255-021-00348-0

Categories : Skeletal SystemTags :

NASA Awards Grant for Bone Loss Research

On By ModernMedia


The US space agency NASA has awarded a US$750 000 grant to conduct research into how bone weakening in the absence of mechanical loading, as in zero gravity, can be reduced.

Dr Meghan E McGee-Lawrence, biomedical engineer in the Department of Cellular Biology and Anatomy at the Medical College of Georgia, the recipient of the grant, will use the money to better understand how bone loss occurs in space from lack of gravity and also from disuse here on Earth.

“It’s a problem for the astronauts who are on the International Space Station for long periods of time, and it’s going to continue to be a problem for eventually trying to send astronauts to Mars,” Dr McGee-Lawrence said. It is also a problem in patients with spinal cord injuries, undergoing prolonged bedrest or physical inactivity.

“If we can find a way to make bone more sensitive to mechanical loading, then we would be able to increase bone mass with less effort. That is a long-term goal,” she says.

Her focus is the natural sensors of mechanical loading on the bone called osteocytes, and her lab found that tears, called plasma membrane disruptions, occur in osteocytes from mechanical loading, resulting in repair. They showed that these disruptions from loads happen in under a minute, and set off changes like letting in extra calcium, influencing osteoblast and osteoclast activity. If there are few tears from mechanical loading, osteoblasts are not needed and so osteoclasts will resorb some bone matrix. Even walking around has been shown to cause plasma membrane disruptions, something not possible for bedrest patients or astronauts in space.

With this in mind she posed the question, “can we do anything to reverse those processes. Can we do something to the osteocytes to make them either more likely to experience tears or more likely to repair those tears and then, accordingly, make it so there is less bone loss during disuse.”

Fewer tears seem to be not good, and she and her team want to further investigate what happens to the repair rate with disuse. They also want to know the best healing rate; slow for better osteocyte survival, or does osteocyte survival enable faster repair?

“The good news is we can dial it in either direction,” she says. However, they believe faster repair is not better because the calcium influx is linked to the cell’s response.

“Think of a membrane disruption as a doorway into the cell. If you slam the door too quickly, then there is not enough time for the cell to sense that tear and initiate the signaling to respond,” she explained.

She believes that proteins involved in repairing membrane tears, like PRKD1, are logical targets for genetic and pharmacological methods to either increase tears or speed up repair.

“The ultimate goal is can we come up with a way, whether it’s a drug therapy or a different type of regimen that can make these processes work better in astronauts and people on earth who are subjected to disuse as well,” she said.

Even with resistive exercises, astronauts lose bone mass in space. Bisphosphonates are only really effective with age-related bone loss and not loss from inactivity or lack of gravity. With the current most advanced exercise device on the International Space Station, astronauts come back to Earth fitter than when they left but still lose some bone mass. On a three-year voyage to Mars, many astronauts could return with osteoporosis. “That is really a problem. Not only are they losing bone actively while they are in space, at some point they have to come back to gravity… and then what happens?” she says. Recovering bone strength on Earth is a long and difficult process for astronauts. She and her research team are also finding that osteocytes are less likely to repair and survive tears after a long period of disuse.

There are effective therapies, like bisphosphonates, that can help age-related bone loss, but they have not been shown to be effective when disuse is the primary driver. “That is why we need to come up with better targets, more effective targets, to try to prevent disuse-induced bone loss,” she said. While it has long been clear that mechanical load also translates to stronger bones, just how remains a question, she says. She suspects the plasma membrane tears are key.

“We think the formation of these tears is important for how the bone cells know they are being exposed to that level of loading,” she said, with high-impact loading from running and jumping being particularly important. “Cells need a way to know what is going on outside their cell membrane. This is one way to do that.”

Source: News-Medical.Net

Categories : COVID General InterestTags :

Confusion Results in Vaccine Priority for ‘6.2cm’ Tall UK Man

On By ModernMedia

As a result of an error at his GP surgery, a healthy man aged 32 was offered an early COVID vaccination because his height was recorded as 6.2cm – giving him a calculated Body Mass Index (BMI) of 28 000.

Liam Thorp, political editor at The Liverpool Echo’s, said he was left “really confused” after he was offered the vaccine ahead of the government’s rollout, sharing the “frankly surreal” experience in a Twitter thread.  Vaccinations are not expected to begin until later in the year for the UK’s under-50s without underlying health conditions, perhaps as soon as March.

Manchester Evening News politics and investigations editor, Jennifer Williams, replied: “Should they not have been in touch before to see how the man the size of a thumb was getting on?” And palliative care doctor Rachel Clarke said: “This, for me, is the single best tweet of the entire pandemic, Liam. And may I please commend your decency in not exploiting your remarkable BMI to jump the queue?”

Despite being “on the chunky side”, Thorp didn’t think of his himself as obese. He said he was “uneasy”, thinking that he still ought to accept the invitation for vaccination, he contacted his GP about the situation whereupon he learned of the error which resulted in his height being recorded as 6.2cm – a mixup of his height as 6ft 2in (188cm). This resulted in his bizarre BMI of 28 000.

“If I had been less stunned, I would have asked why no one was more concerned that a man of these remarkable dimensions was slithering around south Liverpool. But he was very apologetic and really nice and I think he was just relieved that I found it so funny,” recalled Thorp.

Dr Fiona Lemmens, chair of NHS Liverpool clinical commissioning group, said: “I can see the funny side of this story but also recognise there is an important issue for us to address.”

Source: The Guardian

Categories : UrogenitalTags :

Dialysis Crisis from Texas Ice Storm

On By ModernMedia

Widespread power outages and water supply issues have created a dialysis crisis in Texas, following an onslaught of snow, ice, and sub-freezing temperatures.

“To say we’re stressed is an understatement. Almost all outpatient dialysis units closed due to power outages. Trying desperately to do as many as we can inpatient. To make matters worse some of our hospitals lost water today (so no HD [haemodialysis]). Truly a nightmare,” tweeted Tessa Novick, MD, a nephrologist at the University of Texas at Austin.
Half of Texas’ dialysis centres, serving 54 000 people, were unable to operate in the wake of the severe ice storm that has caused widespread damage in Texas and other parts of the US. Some patients had been without dialysis for four to five days, causing risk of potentially life-threatening potassium and fluid problems.

The large storm system, unofficially called Winter Storm Uri, dropped snow and ice over Texas on February 14 and 15, resulting in widespread power failures as lines were damaged. Few clinics have generators. Water pipes have also frozen, and this is a further problem as dialysis needs clean water to prepare concentrates and dialysate, and to reprocess the machines for following patients.

Fresenius Kidney Care said that around half of its Houston area centres have been impacted by a lack of water, “with the other centres either fully operational or operating on generators.” Water truck deliveries will allow other centres to reopen.

Tiffany Jones-Smith, CEO of the Texas Kidney Foundation, pointed out that there were some bright spots, such as eight clinics in San Antonio that brought water in and have been day and night to dialyse patients from any closed clinic regardless of affiliation. Other clinics were following suit, and Jones-Smith said patients were being given Uber and Lyft coupons to reach their dialysis centres. “We’re just kind of banding together and figuring out what needs to be done,” she said.

Looking ahead to when the crisis had cleared, Jones-Smith said, “We can’t let this go, because we need to be prepared for the next time, not just reacting to chaos, which is what we’re doing right now. … There’s no getting around we’ve had an epic failure.”

Climate change is predicted to increase the frequency and severity of such extreme events in the future, requiring better preparation.

Source: MedPage Today

Categories : COVIDTags :

COVID in Zambia More Widespread Than Believed

On By ModernMedia

A new study from Zambia has found almost a fifth of recently-deceased people in mid-2020 tested positive for COVID. 

The study, from the Boston University School of Public Health (BUSPH) study in Zambia, upends the notion that Africa somehow ‘dodged’ the worst of the COVID pandemic. Rather, the low reported rates are merely reflective of a lack of testing ability.

“Our findings cast doubt on the assumption that COVID-19 somehow skipped Africa or has not impacted the continent as heavily,” said study co-author Dr Lawrence Mwananyanda, a BUSPH adjunct research assistant professor of global health based in Lusaka. “This study shows that with proper diagnostics and testing, we can begin to identify the scale of COVID-19 in African countries such as Zambia. I hope this study will encourage African governments to look closer at the rollout of COVID-19 testing, as well as empower Africans to take proactive steps–such as wearing masks, physically distancing, and skipping handshakes–to protect themselves from COVID-19.”

The findings have important implications for global policy makers, who will need to ensure access to vaccines worldwide, along with monitoring.

The University Teaching Hospital morgue sees roughly 80% of people who die in Lusaka pass through it. From June to September, polymerase chain reaction tests detected COVID in 70 out of 364 recently-deceased people. A peak of 31% positive results was observed in July. Unlike the typical pattern of COVID deaths elsewhere, most of the deceased people who tested positive in this study were under 60 years old, including seven children. Given how rare paediatric COVID deaths are elsewhere, this is surprising, the researchers noted.

The researchers sought information about the symptoms of the 70 who tested positive. “In nearly all cases where we had those data, we found typical symptoms for COVID-19, yet only 6 had been tested before death,” Gill said. Of 75% of deaths outside hospital, none had been tested.

Monitoring COVID is not a simple task, especially in a country with limited resources. Zambia’s Ministry of Health has been very proactive and supportive of this and other COVID studies, the researchers said.

“They’re really grateful that we can provide them this data, and they can make informed decisions moving forward with this epidemic,” said Dr Mwananyanda.

The researchers were well-positioned to track COVID in Zambia, having conducted the ongoing Zambia Pertussis/RSV Infant Mortality Estimation Study (ZPRIME) at the morgue.

“Building studies such as this from scratch can take time and resources that can be difficult in the time needed to tackle the COVID-19 pandemic. We invested a lot of time and money and human resources to building infrastructure that allowed for that extensive surveillance,” said co-author Rachel Pieciak, a research fellow at BUSPH. “So, what we’ve done was repurpose ZPRIME study capacity to focus on enrolling all deaths across all ages and testing for COVID-19.”

The researchers expressed hope that similar studies could be repurposed for the COVID fight.

Source: News-Medical.Net

Journal information: Mwananyanda, L., et al. (2021) Covid-19 deaths in Africa: prospective systematic postmortem surveillance study. BMJ. doi.org/10.1136/bmj.n334.

Categories : Diseases, Syndromes and Conditions Medical Research & TechnologyTags :

Novel Magnetic Technique Detects Malaria in Blood

On By ModernMedia

A new magnetic method has been developed that can detect malaria, leading to faster, accurate and cheap diagnosis of the deadly disease.

An international study field-tested this new tool in Papua New-Guinea, in the hopes of helping the fight against this disease, which had 229 million reported cases in 2019, with 700 000 deaths a year.

“Malaria is easily treated but it is actually hard to diagnose, and because of that there can be over-treatment, which we have seen can lead to the spread of drug-resistant malaria,” said Dr Stephan Karl, a Senior Research Fellow in Malaria and Vector Biology at James Cook University’s Australian Institute of Tropical Health and Medicine.

“Improving malaria diagnosis, especially through the development of practical methods for resource-limited places, is important and timely,” he said.

An international team including the University of Augsburg’s Professor Istvan Kezsmarki, with the PNG Institute of Medical Research and the Burnet Institute, came up with the magnetic detection method, called rotating-crystal magneto-optical detection (RMOD).

When malaria parasites break down blood, the haeme molecules are aggregated by the parasites into biocrystals called haemezoin, which contain magnetic iron. This iron can is detectable by the RMOD method.

“I’ve studied the magnetic properties of malaria infected blood since 2006, and we engaged with Professor Kezsmarki’s team in 2013 to demonstrate the sensitivity of this test using human malaria parasites,” Dr Karl said.

A field study was successfully conducted, involving almost 1000 suspected malaria patients in a high-transmission area of Papua New-Guinea.

“After years of in-lab optimisation of the device, in collaboration with Dr. Karl we demonstrated the great potential of RMOD in fast and reliable malaria field tests performed in Papua New-Guinea,” Prof Kezsmarki said.

“We showed that RMOD performs well in comparison to the most reliable existing method..It’s very promising, as RMOD testing can be conducted after a short training session and provides test results within 10 minutes. From a funding perspective the cost is very low since no expensive reagents are used,” said Dr Karl.

Dr Karl said the aim was to refine the design until a test could be done by a simple button push.

Source: Medical Xpress

Journal information: L. Arndt et al, Magneto-optical diagnosis of symptomatic malaria in Papua New Guinea, Nature Communications (2021). DOI: 10.1038/s41467-021-21110-w