Steep decline in organ transplants amid COVID-19 outbreak

France and the United States, two countries hit hard by the novel coronavirus, have experienced a tremendous reduction in the number of organ donations and solid organ (kidney, liver, heart, and lung) transplant procedures since the onset of the COVID-19 pandemic, according to a new study. By early April, transplant centers in both countries were conducting far fewer deceased donor transplants compared to just one month earlier, with the number of procedures dropping by 91 percent in France and 50 percent in the United States.

The international team of transplant scientists, including experts from the Perelman School of Medicine at the University of Pennsylvania and Paris Transplant Group, attribute much of the overall decline to a steep reduction in the number of kidney transplants specifically. However, they also reported a substantial drop in the number of heart, lung and liver transplants. The analysis was published today in The Lancet.

“Our findings point to the far-reaching and severe ripple effects of the COVID-19 outbreak on health care, including life-saving organ transplants,” said study co-author Peter Reese, MD, MSCE, an associate professor of Medicine and Epidemiology at Penn. “Organs from deceased donors represent a time-limited opportunity, as they must be procured and used rapidly. However, in order to protect the safety of their patients, centers must now carefully vet all donors to ensure there is minimal risk of COVID-19.”

The steep reduction in organ donations and transplant procedures exacerbates the worldwide shortage of transplantable organs and need for transplants. In the United States, there are more than 112,000 people on the national transplant waiting list. While the number of living donor kidney and liver transplants continues to increase, the vast majority of organ transplant procedures involve organs from deceased donors. Of the nearly 40,000 transplants performed in the United States in 2019, more than 32,000 involved organs from deceased donors.

Many transplant centers, including the Penn Transplant Institute (PTI), continue to perform many life-saving organ transplants during the pandemic, but the outbreak has posed unique challenges for both organ procurement and transplantation. A number of centers nationwide, including the PTI, are not using organs from deceased donors with evidence of recent infection or exposure.

To quantify the impact of the COVID-19 outbreak on organ donation and transplantation, investigators analyzed validated national data from three federal agencies, including the United Network for Organ Sharing (UNOS), to study trends in France and the United States.

The team observed a strong link between the surge of COVID-19 infections and significant decline in donated organs and overall solid organ transplants. In the United States, the number of recovered organs dropped from more than 110 a day on March 6 to fewer than 60 per day on April 5, investigators found. During the same timeframe, the number of transplanted kidneys dropped from nearly 65 a day to about 35 per day. Researchers also observed that regions with fewer COVID-19 cases, or limited exposure to the disease, also experienced a significant reduction in transplant rates—suggesting a global and nationwide effect beyond the local infection prevalence.

The investigators hypothesize that France may have experienced a larger drop in transplants because of a coordinated national effort to reduce clinical and commercial activity. Whereas, in the United States, individual states had discretion to impose restrictions and hospital practice may have varied to a greater degree.

“These international comparisons of transplant activity will be very important as the COVID-19 pandemic evolves,” said co-author Alexandre Loupy, MD, Ph.D., a nephrologist at the Department of Nephrology and Kidney Transplantation at Necker Hospital in Paris and Head of the Paris Transplant Group. “Some transplant systems may develop best practices to support organ procurement and transplant that can be shared across borders. We have a lot of work ahead to restore our invaluable infrastructure of donation and transplant surgery.”

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Emergency departments slow to adopt proven opioid use disorder therapy

A new study by Yale researchers looking at nearly 400 clinicians at four urban academic emergency departments found that, despite scientific evidence supporting the benefits of buprenorphine for opioid use disorder, just 21% of emergency department clinicians indicated readiness to offer it to patients in need.

The study, which appears in the May 11 issue of JAMA Network Open, involved emergency departments at Mt. Sinai Hospital in Manhattan, the Johns Hopkins Hospital in Baltimore, Harborview Medical Center in Seattle, and University of Cincinnati Medial Center.

The study is the first installment in Project ED Health, an implementation study funded by the National Institute on Drug Abuse Clinical Trials Network to support strategies for increasing buprenorphine prescriptions in emergency departments. Buprenorphine, a partial opioid agonist—a drug that activates opioid receptors in the brain to a lesser degree than oxycodone and morphine—is safe to administer, relieves withdrawal symptoms, and can prevent overdose, according to years of established medical research. An implementation study reveals barriers to adopting research findings.

Project ED Health is led by two Yale physician-researchers, Dr. Gail D’Onofrio, professor and chair of the department of emergency medicine and Dr. David Fiellin, professor of internal medicine and director of the Yale Program in Addiction Medicine.

“This study provides a baseline evaluation of what care emergency departments are providing to patients with opioid use disorder,” said lead author Dr. Kathryn Hawk, assistant professor in emergency medicine and attending physician in the Yale New Haven Hospital Emergency Department.

Despite barriers, clinicians are willing to give buprenorphine to patients in the emergency department, provided that they receive sufficient support and training, the study found.

“The willingness of emergency department providers to take on a new treatment is changing drastically,” said Hawk.

Researchers conducted the study between April 2018 and January 2019. A team of addiction medicine physicians met with providers at the hospitals, including doctors, advance practice providers (APPs), and emergency medicine residents. Providers participated in a web-based anonymous survey that collected data about their demographics, training, experiences with ED-initiated buprenorphine, and readiness to administer buprenorphine for opioid use disorder on a scale of one to 10. Providers then rated their work culture, clinical experience, and perceived patient needs. Later, the study team ran focus groups to better understand factors impacting buprenorphine prescribing in the ED.

The researchers found that barriers to providing buprenorphine included lack of formal training, limitations on time, limited knowledge of local treatment resources, absence of local protocols and referral networks, and perceptions that initiating buprenorphine therapy falls outside the scope and practice of emergency medicine.

One resident physician quoted in the study said: “Trying to suss out which of those patients might be appropriate for initiating some therapy and which aren’t is a skill that I don’t have. I don’t think that it’s a skill that we’re necessarily being trained for right now.”

There was also confusion about required waivers. Just 3% of providers interviewed had DATA 2000 (x-waiver) training for buprenorphine. Providers need the waiver, which requires eight hours of approved training for physicians and 24 hours for APPs, to write a prescription for buprenorphine to be filed at a pharmacy. Emergency providers can give buprenorphine in the ED without the special waiver, said Hawk, but added that they “needed clarification around what they can and can’t do.”

Historically, emergency departments have not been thought of as places where patients are treated for opioid use disorder, she said. Typically, those patients were referred to outpatient clinics for treatment.

“The opioid epidemic has really changed that,” Hawk said.

In 2015, Yale researchers published a landmark study in JAMA that found that patients admitted to emergency departments for opioid use disorder who were treated with buprenorphine along with medical management in primary care were twice as likely than patients not given buprenorphine to remain in addiction treatment one month later.

“The big message of that study was that initiating treatment in the ED setting was very effective,” said D’Onofrio, “but true adoption lagged. So now we’re trying to understand why that is, and how we can improve implementation of this best practice.”

This latest study found that in order to improve adoption of ED-initiated buprenorphine there needs to be more education and training, established protocols, and enhanced communication across different stakeholder groups.

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New York City had 24,000 'excess deaths', CDC report finds

Coronavirus blamed for 75% of New York City’s 24,000 ‘excess deaths’ as fatalities tripled the usual rate at the height of the outbreak, CDC report finds

  • Between March 11 and May 2, a total of 32,107 deaths were reported in New York
  • Researchers found that 24,172 were ‘excess’, three times the typical number of 7,935 usually reported during this time
  • The excess deaths included about 14,000 confirmed COVID-19 deaths and 5,048 probable COVID-19 deaths
  • The CDC says the high number of excess deaths may be linked to people with pre-existing conditions or those who waited to seek life-saving medical care
  • Here’s how to help people impacted by Covid-19

The number of people who died in New York City during the height of the coronavirus pandemic is more than triple what would be expected in a normal year, a new report finds.   

Between March 11 and May 2, there were more than 24,000 ‘excess deaths’, compared to years prior, researchers from the Centers for Disease Control and Prevention (CDC) revealed on Monday. 

That means, in a typical year, there are about 8,000 deaths during the same period.

More than three-quarters of those deaths were associated with COVID-19, the highly-infectious disease caused by the virus.  

Between March 11 and May 2, a total of 32,107 deaths were reported in New York and 24,000 were found to be ‘excess,’ a new CDC report reveals (pictured)

The excess deaths included about 14,000 confirmed COVID-19 deaths and 5,048 probable COVID-19 deaths.Pictured: Ventilator tubes attached to a coronavirus patient in the ICU of the Veterans Affairs Medical Center in New  York, NY, April 24

The CDC says the high number of excess deaths may be linked to people with pre-existing conditions or those who waited to seek life-saving medical care. Pictured: A COVID-19 patient, in a medically induced coma, is connected to life-sustaining devices at Mount Sinai South Nassau Hospital in Oceanside, NY, April 14

Excess deaths are defined as over and above the number of people that would have died anyway – the typical mortality rate of a population.  

For the report, the researchers looked at mortality data from January 1, 2015 through May 2, 2020. 

Next, the team calculated the difference between the seasonal number of expected deaths and the number of all deaths.

A total of 32,107 deaths were reported to New York Department of Health and Mental Hygiene over the study period. 

Of that number, 24,172 were found to ‘excess’, three times the typical number of 7,935 that usually occur during the two-month window.  

The excess deaths included nearly 14,000 laboratory-confirmed COVID-19-associated deaths and 5,048 probable COVID-19–associated deaths. 

According to the CDC, the high number of excess deaths might be due to the added risk of coronavirus in people with pre-existing conditions, such as diabetes.

Additionally, the researchers say that due to social distancing measures and the increasing demand place on hospitals, people may have delayed seeking life-saving medical care. 

The 5,000 deaths not linked to the virus are likely from other pathogens circulating during the 2019-20 flu season. 

‘Tracking excess mortality is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions,’ the authors concluded. 

The report comes on the heels of a joint investigation by Yale University and The Washington Post, which found there were 15,400 ‘excess deaths’ that occurred between March 1 and April 4. 

According the study, pre-printed on medRxiv.org, there were 280,016 total deaths  over the five-week period.

Of those, 15,400 were deemed excess deaths due to pneumonia and influenza.

The researchers say the preliminary findings suggest many more Americans may have died of coronavirus than previously believed.  

In the US, there are currently more than 1.3 million confirmed cases of the virus and more than 80,000 deaths. 

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Britain faces ‘calamitous consequences’ as expert warns UK faces more deaths than in WW2

A new study – the first of its kind – shows that chasing an infection target of below 1 will force Britons into long term social distancing and more lockdowns. 

It shows that without a vaccine, it would take until December 2024 to see off the virus using social distancing.

But the economic cost of these measures would be so grave it would kill more people than WWII, Philip Thomas, a Professor of Risk Management at the University of Bristol has found.

The study estimated that 150,000 people will die from Covid-19 over five years under intermittent lockdown or semi-lockdown conditions that would be necessary to keep infection rates at the government goal close to below 

The analysis, shortly to be published in the Scientific Journal Nanotechnology Perceptions, was based on projected death rates linked to the virus, together with the economic impact of social distancing or lockdown and that of previous recessions. It shows “calamitous” long term consequences leading to large scale loss of life.

It reveals a move out of lockdown slow enough to avoid a strain on the NHS due to a surge in cases is likely to cause a drop of 23.5 percent to the economy in 2020 and still further in 2021. The study also reveals the economy would not return to pre-lockdown levels until the end of 2024. This would cause a dramatic cost to health and an associated loss of an extra 675,000 lives due to poor healthcare and impoverishment, as well as a relaxation of safety regulations.

This is higher than the UK’s loss of life over the six years of the Second World War which equated to approximately 525,000 civilian and military personnel, dwarfing the number of lives saved by lockdown.

Professor Thomas said: “It is not enough to look at the epidemiology, the spread of Covid-19, in isolation. You need to look just as much as the effect on the economy because a nation’s economy and its health are so strongly linked that at some point they become inseparable. Poverty kills just as surely as the coronavirus. The only reason we have good health and live a long time in the UK is because we are one of the wealthiest nations in the world. The policy of coming out of lockdown gradually, over five years – which will be necessary if we are to keep the infection rate close to or below 1 – will reduce the toll on life from the coronavirus but incur a far greater loss of life through the impoverishment of the nation. The net loss of life is likely to be of the order of 675,000 lives.

“The initial pandemic response to lockdown as a device for gaining time to build defences and make sure our health service was not overwhelmed was a reasonable response. But our society cannot remain under siege forever and we need to find a way of returning towards normality.

“I think we can more or less justify a lockdown of two months based on the ill effects to the economy but three months is too long. We now have to realise if we do go so slowly and continue with the aim to keep the infection rate close to or below one then the number of deaths from the prolonged lockdown will be far worse and we will be condemning people to significant impoverishment, permanent loss of wealth and more deaths than lives saved and we have to ask ourselves: “What are we doing?”

He added: “We are faced with a bad situation where there are no easy wins. We cannot just gamble on waiting for a vaccine as we cannot rely on this. This is not just a question of saving people’s money versus saving people’s lives. It is comparing life versus life.”

He also pointed out that the case against coming out of the lockdown slowly was even stronger if, as various studies have pointed out, the number of people who have already had infections is far higher than current estimates which would mean the virus is less lethal than previously thought.

Professor Thomas said he supported the less draconian social distancing measures followed by Sweden which he said were “broadly sensible.”

He added: “Lockdown doesn’t do much and does not get rid of the virus – it only gives you time.”

His comments follow criticism of the UK lockdown system by former chief scientist at the European Centre for Disease Control, Professor Johan Giesecke. Professor Giesecke, who has been advising the Swedish Agency for Public Health said in a recent article in The Lancet: “Everyone will be exposed to severe acute respiratory syndrome coronavirus and most people will become infected. COVID-19 is spreading like wildfire in all countries, but we do not see it – it almost always spreads from younger people with no or weak symptoms to other people who will also have mild symptoms. This is the real pandemic, but it goes on beneath the surface, and is probably at its peak now in many European countries. There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in 1 year from now, the figures will be similar, regardless of measures taken.”

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Individualized mosaics of microbial strains transfer from the maternal to the infant gut

Microbial communities in the intestine—also known as the gut microbiome—are vital for human digestion, metabolism and resistance to colonization by pathogens. The gut microbiome composition in infants and toddlers changes extensively in the first three years of life. But where do those microbes come from in the first place?

Scientists have long been able to analyze the gut microbiome at the level of the 500 to 1,000 different bacterial species that mainly have a beneficial influence; only more recently have they been able to identify individual strains within a single species using powerful genomic tools and supercomputers that analyze massive amounts of genetic data.

Researchers at the University of Alabama at Birmingham now have used their microbiome “fingerprint” method to report that an individualized mosaic of microbial strains is transmitted to the infant gut microbiome from a mother giving birth through vaginal delivery. They detailed this transmission by analyzing existing metagenomic databases of fecal samples from mother-infant pairs, as well as analyzing mouse dam and pup transmission in a germ-free, or gnotobiotic, mouse model at UAB, where the dams were inoculated with human fecal microbes.

“The results of our analysis demonstrate that multiple strains of maternal microbes—some that are not abundant in the maternal fecal community—can be transmitted during birth to establish a diverse infant gut microbial community,” said Casey Morrow, Ph.D., professor emeritus in UAB’s Department of Cell, Developmental and Integrative Biology. “Our analysis provides new insights into the origin of microbial strains in the complex infant microbial community.”

The study used a strain-tracking bioinformatics tool previously developed at UAB, called Window-based Single-nucleotide-variant Similarity, or WSS. Hyunmin Koo, Ph.D., UAB Department of Genetics and Genomics Core, led the informatics analysis. The gnotobiotic mouse model studies were led by Braden McFarland, Ph.D., assistant professor in the UAB Department of Cell, Developmental and Integrative Biology.

Morrow and colleagues have used this microbe fingerprint tool in several previous strain-tracking studies. In 2017, they found that fecal donor microbes—used to treat patients with recurrent Clostridium difficile infections—remained in recipients for months or years after fecal transplants. In 2018, they showed that changes in the upper gastrointestinal tract through obesity surgery led to the emergence of new strains of microbes. In 2019, they analyzed the stability of new strains in individuals after antibiotic treatments, and earlier this year, they found that adult twins, ages 36 to 80 years old, shared a certain strain or strains between each pair for periods of years, and even decades, after they began living apart from each other.

In the current study, several individual-specific patterns of microbial strain-sharing were found between mothers and infants. Three mother-infant pairs showed only related strains, while a dozen other infants of mother-infant pairs contained a mosaic of maternal-related and unrelated microbes. It could be that the unrelated strains came from the mother, but they had not been the dominant strain of that species in the mother, and so had not been detected.

Indeed, in a second study using a dataset from nine women taken at different times in their pregnancies showed that strain variations in individual species occurred in seven of the women.

To further define the source of the unrelated strains, a mouse model was used to look at transmission from dam to pup in the absence of environmental microbes. Five different females were given transplants of different human fecal matter to create five unique humanized-microbiome mice, which were bred with gnotobiotic males. The researchers then analyzed the strains found in the human donors, the mouse dams and their mouse pups. They found four different patterns: 1) The pup’s strain of a particular species was related to the dam’s strain; 2) The pup’s strain was related to both the dam’s strain and the human donor’s strain; 3) The pup’s strain was related to the human donor’s strain, but not to the dam’s strain; and, importantly, 4) No related strains for a particular species were found between the pup, the dam and the human donor. Since these animals were bred and raised in germ-free conditions, the unrelated strains in the pups came from minor, undetected strains in the dams.

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Heart attack: Worst food group which significantly raises your risk

Heart attacks occur when the supply of blood to the heart is suddenly blocked. A lack of blood to the heart may seriously damage the heart muscle and can prove deadly. When it comes to one’s diet, aiming for five portions of fruits and vegetables will help to keep the heart healthy. When it comes to a food which does the opposite, there is one that should be avoided as much as possible.

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When a heart attack occurs, it can disrupt a person’s normal heart rhythm, potentially stopping it altogether.

When the heart stops getting a supply of blood during a heart attack, some of the tissue can die.

This can weaken the heart and later cause life-threatening conditions such as heart failure.

Heart attacks can affect the heart valve and cause leaks.

Keeping healthy and active are some of the best methods to reduce having a heart attack and spotting early signs is also crucial.

When it comes to being healthy and reducing your risk of serious conditions, eating bacon should be avoided.

More than half of bacon’s calories come from saturated fat.

Saturated fat raises the low-density lipoprotein (LDL) or bad cholesterol and boost the chance of a heart attack or stroke.

Bacon also contains high amounts of salt which bumps up the blood pressure and makes the heart work harder.

High amounts of sodium can lead to stroke, heart disease and heart failure.

Bacon’s added preservatives are linked to these issues as well.

A study of almost 30,000 people followed for up to three decades found those who regularly consumed processed meat such as bacon were more prone to premature death.

In particular, having red or processed meat every seven days was linked to a three percent to seven percent higher risk of cardiovascular disease.

Senior author of the study, Norrina Allen, professor of preventative medicine at Northwestern University, Chicago said: “It is a small difference, but it’s worth trying to reduce red meat and processed meat like pepperoni and deli meats.

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Red meat includes beef, lamb, pork, veal and venison.

Processed is bacon, sausages, hot dogs, salami and corned beef.

The study published in JAMA Internal Medicine included self-reported diets over the previous year or month of 29,682 men and women with an average age of 53.

Lead author Dr Victor Zhong said: “Modifying intake of these animal protein foods may be an important strategy to help reduce the risk of cardiovascular disease and premature death at a population level.”

The National Heart, Lung and Blood Institute said: “The major risk factors for a heart attack include smoking, high blood pressure, high cholesterol, overweight and obesity, an unhealthy diet, lack of routine physical activity, high blood sugar due to insulin resistance or diabetes.

“Some of these risk factors such as obesity, high blood pressure and high blood sugar tend to occur together.

“When they do, it’s called metabolic syndrome. In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn’t have metabolic syndrome.”

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How does the brain link events to form a memory? Study reveals unexpected mental processes

A woman walking down the street hears a bang. Several moments later she discovers her boyfriend, who had been walking ahead of her, has been shot. A month later, the woman checks into the emergency room. The noises made by garbage trucks, she says, are causing panic attacks. Her brain had formed a deep, lasting connection between loud sounds and the devastating sight she witnessed.

This story, relayed by clinical psychiatrist and co-author of a new study Mohsin Ahmed, MD, Ph.D., is a powerful example of the brain’s powerful ability to remember and connect events separated in time. And now, in that new study in mice published today in Neuron, scientists at Columbia’s Zuckerman Institute have shed light on how the brain can form such enduring links.

The scientists uncovered a surprising mechanism by which the hippocampus, a brain region critical for memory, builds bridges across time: by firing off bursts of activity that seem random, but in fact make up a complex pattern that, over time, help the brain learn associations. By revealing the underlying circuitry behind associative learning, the findings lay the foundation for a better understanding of anxiety and trauma- and stressor-related disorders, such as panic and post-traumatic stress disorders, in which a seemingly neutral event can elicit a negative response.

“We know that the hippocampus is important in forms of learning that involve linking two events that happen even up to 10 to 30 seconds apart,” said Attila Losonczy, MD, Ph.D., a principal investigator at Columbia’s Mortimer B. Zuckerman Mind Brain Behavior Institute and the paper’s co-senior author. “This ability is a key to survival, but the mechanisms behind it have proven elusive. With today’s study in mice, we have mapped the complex calculations the brain undertakes in order to link distinct events that are separated in time.”

The hippocampus—a small, seahorse-shaped region buried deep in the brain—is an important headquarters for learning and memory. Previous experiments in mice showed that disruption to the hippocampus leaves the animals with trouble learning to associate two events separated by tens of seconds.

“The prevailing view has been that cells in the hippocampus keep up a level of persistent activity to associate such events,” said Dr. Ahmed, an assistant professor of clinical psychiatry at Columbia’s Vagelos College of Physicians and Surgeons, and co-first author of today’s study. “Turning these cells off would thus disrupt learning.”

To test this traditional view, the researchers imaged parts of the hippocampus of mice as the animals were exposed to two different stimuli: a neutral sound followed by a small but unpleasant puff of air. A fifteen-second delay separated the two events. The scientists repeated this experiment across several trials. Over time, the mice learned to associate the tone with the soon-to-follow puff of air. Using advanced two-photon microscopy and functional calcium imaging, they recorded the activity of thousands of neurons, a type of brain cell, in the animals’ hippocampus simultaneously over the course of each trial for many days.

“With this approach, we could mimic, albeit in a simpler way, the process our own brains undergo when we learn to connect two events,” said Dr. Losonczy, who is also a professor of neuroscience at Columbia’s Vagelos College of Physicians and Surgeons.

To make sense of the information they collected, the researchers teamed up with computational neuroscientists who develop powerful mathematical tools to analyze vast amounts of experimental data.

“We expected to see repetitive, continuous neural activity that persisted during the fifteen-second gap, an indication of the hippocampus at work linking the auditory tone and the air puff,” said computational neuroscientist Stefano Fusi, Ph.D., a principal investigator at Columbia’s Zuckerman Institute and the paper’s co-senior author. “But when we began to analyze the data, we saw no such activity.”

Instead, the neural activity recorded during the fifteen-second time gap was sparse. Only a small number of neurons fired, and they did so seemingly at random. This sporadic activity looked distinctly different from the continuous activity that the brain displays during other learning and memory tasks, like memorizing a phone number.

“The activity appears to come in fits and bursts at intermittent and random time periods throughout the task,” said James Priestley, a doctoral candidate co-mentored by Drs. Losonczy and Fusi at Columbia’s Zuckerman Institute and the paper’s co-first author. “To understand activity, we had to shift the way we analyzed data and use tools designed to make sense of random processes.”

Ultimately, the researchers discovered a pattern in the randomness: a style of mental computing that seems to be a remarkably efficient way that neurons store information. Instead of communicating with each other constantly, the neurons save energy—perhaps by encoding information in the connections between cells, called synapses, rather than through the electrical activity of the cells.

“We were happy to see that the brain doesn’t maintain ongoing activity over all these seconds because, metabolically, that’s not the most efficient way to store information,” said Dr. Fusi, who is also a professor of neuroscience at Columbia’s Vagelos College of Physicians and Surgeons. “The brain seems to have a more efficient way to build this bridge, which we suspect may involve changing the strength of the synapses.”

In addition to helping to map the circuitry involved in associative learning, these findings also provide a starting point to more deeply explore disorders involving dysfunctions in associative memory, such as panic and pos-ttraumatic stress disorder.

“While our study does not explicitly model the clinical syndromes of either of these disorders, it can be immensely informative,” said Dr. Ahmed, who is also a member of the Losonczy lab at Columbia’s Zuckerman Institute. “For example, it can help us to model some aspects of what may be happening in the brain when patients experience a fearful association between two events that would, to someone else, not elicit fright or panic.”

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COVID-19 activity levels begin to rebound

Activity levels during lockdown in Britain’s busiest regions including Greater London, Greater Manchester and the West Midlands have begun to rebound following successive week-by-week declines, according to new UCL analysis of geographical data.

Combining in-app mobile data with demographic indicators, the researchers found that activity levels—defined as the number of unique mobile devices used per hour in each study area—declined during the first five weeks of lockdown, but have ticked up since the 19th April.

Professor James Cheshire, UCL Geography and deputy director of the ESRC Consumer Data Research Centre, said: “Our analysis suggests that people have been adhering to the lockdown rules and taking them very seriously over the first month or so. But by early May, we’ve started to see a shift with more activity in recent days. It may be that people have started to increase their movements in anticipation of the government announcement expected this weekend for easing lockdown.”

The data was supplied by Huq Industries and the UCL analysis shows that across the busiest UK regions between 16-22 March, there was roughly a 20% decline in activity compared to the week before lockdown; by 23-30 March, there was a 36% decline; and by the 13th of April, almost a 50% decline in activity. Activity began to increase from the 20th April and is now back to roughly 60% of pre-lockdown levels.

London had seen the biggest reduction in activity, with levels down 70% between the 13th and 19th April rebounding slightly to a smaller reduction of 63% in the week ending 3rd May. The week of the 13th was also quietest for Greater Manchester and the West Midlands with 46% and 50% reductions in normal activity respectively. Both have seen a rise in activity levels and now report reductions of only 30% compared to those pre-lockdown.

Regional activity levels have declined the most in areas dominated by workplaces of professionals, the financial sector, leisure and tourism. Today activity levels are highest in areas dominated by routine occupations, construction, domestic workers, manual helpers, and others employed in the health sectors.

Professor Cheshire said: “The findings further highlight a divide between those in jobs that can be done from home and those with jobs that must be carried out on site, with activity levels suggesting that those working in financial services in particular are in a better position to work remotely. This will have important implications for transport planning as operators seek staggered working hours mixed with homeworking where possible to reduce peak demand.”

The research also reveals for the first time that traditional high streets and local shopping areas have seen lower relative declines in activity compared to major centers and out of town areas.

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A new plant-based system for the mass production of allergens for immunotherapy

Allergies can significantly affect health and quality of life. While allergen immunotherapy provides long-lasting therapeutic relief to people suffering from environmental allergies, the therapy can last several years and requires large amounts of allergen. Now, researchers from the University of Tsukuba developed a novel system that enables the mass production of the major birch pollen allergen Bet v 1 in plant leaves in just a matter of days. In a new study published in Frontiers in Plant Science, they showed that their system not only produces large amounts of Bet v 1, but the purified protein was also highly reactive towards the IgE antibodies in sera from individuals with birch pollen allergy.

“The idea of allergen immunotherapy is to desensitize the body’s response to the allergen by exposing patients to it in gradually increasing amounts,” says corresponding author of the study Professor Kenji Miura. “Because a significant drawback is the difficult, expensive and low-yield production of allergens, our goal was to develop a new system that allows for the rapid and massive production of allergens that can be used in the clinical setting.”

To achieve their goal, the researchers turned to their previously established “Tsukuba system,” which makes use of a method called agroinfiltration. They first introduced the gene for Bet v 1 into a specific type of bacteria called Agrobacterium tumefaciens and let them grow. They then immersed leaves of the plant Nicotiana benthamiana into the bacterial solution to bring the bacteria into close contact with the plant, so the bacteria could transfer the Bet v 1 gene to plant cells, which in turn started producing the protein. To test the quality of their product, the researchers also produced the protein in Brevibacillus brevis, which is a standard bacterial host for protein production.

“We were able to purify 1.2mg of Bet v 1 protein from 1g leaves in just 5 days,” explains Professor Miura. “This is a relatively large amount that is otherwise difficult to achieve using standard methods. Our next goal was to test whether our protein was immunogenic, which is a prerequisite for immunotherapy.”

The researchers isolated sera from individuals with birch pollen allergy and mixed them with Bet v 1 protein purified from plants and bacteria. In both cases, the researchers were able to show that Bet v 1-specific IgE from the patients’ sera, which is the antibody causing the allergy, was strongly reactive to their proteins.

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Can't sleep? Try these acupressure techniques to help you drift off

When you’re tossing and turning and sleep just won’t come, you’ll try anything – fancy pillow sprays, herbal remedies, hypnotherapy apps, desperately ringing up a pal and asking them to tell you a bedtime story.

In these dire situations, it’s worth giving acupressure a go, mostly because it’s free, easy to do, and if it doesn’t work you haven’t lost anything.

And actually, it just might work. Then you’ll get to drift off into rest and everything will be dreamy.

We chatted to Renata Nunes, a physiotherapist, massage therapist, and acupuncturist, who shared her guide to simple acupressure techniques you can do on yourself at home to help you get some sleep.

‘Chinese medicine understands insomnia as disharmony between Yin and Yang,’ Renata explains.

‘The energy between Yin and Yang must be harmonious and must flow into each other in a daily cycle. Yang energy should flow during the day and Yin energy at night.

‘Yang is brilliant energy, the sun, the day, occurs intensely, Yin is passive energy, at night, it occurs in a timid way. Someone with insomnia has a greater Yang tendency than Yin.

‘Treatment must find the balance between Yin and Yang, fire and water. In this case, fire is represented by the heart and water is represented by the kidney.

‘The ideal would be to make an assessment to check the disharmonies of each patient. However, in this time of isolation, we can work with some points to help calm the mind and sleep better.’

Don’t get put off by the Yin and Yang talk – you don’t necessarily need to buy into all of that to see benefits from acupressure techniques.

Ready? Let’s try these.

Yintang – to calm the mind

Yintang describes the point right between the eyebrows.

Renata says: ‘Make a very gentle massage between the inner ends of the two eyebrows in a circular motion clockwise.

Also you can tap the point with your fingertip.

‘As you apply the pressure allow all the muscles of your forehead to relax. This is a good point to calm the mind and insomnia.’

GV 20 – to dispel negative thoughts

This is at the top of the head, in the middle of the line that connects the apex of the two ears. You can press the point down and back.

Try making circular movements counterclockwise direction.

Renata says this technique can also help to relieve headaches.

Heart 7

Applying pressure to this area is said to help relieve insomnia, irritability, and chest pain.

‘Draw a vertical line between your fourth and fifth finger and stop at the crease of the wrist,’ Renata explains. ‘The point is at the height of the wrist crease next to the tendon.

‘You can press the point and make circular movements in a clockwise direction. Also, you can rub the whole wrist.’

Kidney 6 – to nourish kidney Yin

This is the spot on the inner side of the foot, in the depression below the ankle .

Renata recommends pressing this point, making circular movements in a clockwise direction, and tapping it, to help ‘calm the mind, open the chest, and invigorate the kidney’.

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