Immunotherapy may be effective for some prostate cancers

prostate cancer

In recent years, cancer immunotherapy has been effective in treating patients with immunogenic, or so-called “hot” tumors with increased levels of inflammation and the presence of immune cells in and around the tumors. Prostate cancer, however, is considered a “cold” tumor, with few immune cells recognizing and infiltrating prostate malignancies. Accordingly, prostate cancer has been found to respond poorly to the class of immunotherapies known as immune checkpoint inhibitors.

In previous work, a team led by medical oncologists at Beth Israel Deaconess Medical Center (BIDMC) identified a subset of prostate cancers that exhibited characteristics more typical of hot cancers. Now, in a paper appearing in the journal Clinical Cancer Research, researchers report that about a quarter of localized prostate cancers may demonstrate these immunologic traits, suggesting that a substantial number of patients with prostate cancer may, in fact, benefit from immunotherapies.

“We were surprised to find all the features of more traditionally immunogenic cancers in these prostate cancers, and that this is not a rare subtype, observed in about a quarter of high risk tumors,” said co-corresponding author David J. Einstein, MD, a medical oncologist at BIDMC and an assistant professor of medicine at Harvard Medical School (HMS). “We’re interested in whether there is a subset of patients with localized prostate cancer, especially more aggressive ones, whose cancers might be more recognized by the immune system and therefore more treatable with immunotherapies. These would also be some of the patients at greatest risk for relapse and metastatic spread.”

Einstein and colleagues, including co-corresponding author Steven Balk, MD, Ph.D., a physician at BIDMC, focused on two characteristics that make traditionally immunogenic cancers susceptible to immunotherapy: PD-L1 expression and T cell infiltration. PD-L1 is a protein involved in tumor evasion of the immune system. T cells are the sentinels of the immune system, patrolling the body for potential pathogens or disease.

The researchers identified prostate cancers that had been removed from patients, looking for those that had areas of high PD-L1 expression and then looked for the presence of infiltrating T cells. Next, the team compared the T cell landscape in the more immunogenic prostate cancers to that of more typical prostate cancers, as well as to kidney cancer, one of the most immunogenic tumor types. Finally, the team used DNA sequencing to compare the genetic profiles from these immunologically hot areas to that of the so-called cold areas in the same tumors, as well as to the genomic landscape of immunogenic cancers in general.

The scientists were surprised to learn how many more T cells infiltrated the immunogenic prostate cancers compared with more typical prostate cancers, and to observe all the features of more traditionally immunogenic cancers like kidney cancer in these more immunogenic prostate cancers. They also noted significantly more loss of some key tumor suppressor genes in these immunogenic prostate cancers compared with typical prostate cancer, a difference that could potentially serve as markers to find cancers more treatable with immunotherapies.

“We’re hoping to be able to identify patients with immunogenic tumors in advance of treatment, so that we can develop clinical trials for this subset of patients and offer a more personalized strategy than treating all-comers the same way,” said Balk, who also a professor of medicine at HMS.

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Should COVID vaccines be compulsory for care home staff? Experts debate

care home

The UK government has announced that COVID-19 vaccination will become mandatory for staff working in care homes for older people in England. Staff will be given 16 weeks to get the vaccine. If they don’t get the jab, they will be redeployed from frontline care or lose their job.

Mandating vaccination would increase vaccine uptake in care home workers, but it would be a significant intrusion into individual freedom. Is it ethically justifiable?

Yes—Professor Dominic Wilkinson

In the early phase of the pandemic, some of the most medically vulnerable people ended up catching coronavirus from those caring for them; 40,000 patients in England are said to have caught COVID while in hospital. Some patients and care home residents died from infections that they caught from their caregivers. We must do everything possible to avoid repeating this tragic and distressing situation.

First, we should ensure that all those who are at a high risk of dying from COVID have access to the vaccine. About 10% of older adult care home residents have still not had a second dose of the vaccine.

Second, those who work in the frontline with vulnerable high-risk patients have an ethical obligation to take all reasonable measures to prevent the spread of the virus to those they are caring for. They must follow the guidance on things like hand washing and PPE. They should take part in lateral flow testing schemes. And they should be vaccinated.

Mandating vaccination can be ethical if it is both necessary and proportionate. A mandate is not necessary if there are less intrusive means of effectively increasing uptake, such as persuasion and incentives. The problem is that less intrusive means may be much less effective.

Persuasion has so far failed. There is strong evidence to suggest that vaccine mandates are the most effective way to increase uptake.

A mandate could be proportionate if the public health benefit of increasing uptake among staff would outweigh the harms. Given the considerable vulnerability of care home residents, this seems to be the case. Care home residents can’t choose who cares for them. Some remain only partly protected after vaccination. The risks of vaccination for workers are exceptionally low.

However, if vaccines are made mandatory for care home workers (or healthcare workers), they should be able to choose from available vaccines. Every effort possible should be made to address any concerns that they have about the vaccines.A conditional vaccination policy would be ethical.

Care home workers—and NHS staff—who have not had the COVID vaccine should be redeployed to areas other than frontline care. In the absence of a medical exemption, COVID vaccination should be a condition of employment in the same way that hepatitis B vaccination is currently for some health professionals.

No—Professor Julian Savulescu

Mandatory vaccination policies can sometimes be ethical. But the proposal to make vaccination mandatory for care home workers is muddle-headed.

There are rare but serious risks of vaccination: blood clots for AstraZeneca and probable myocarditis in Pfizer. COVID-19 deaths are predominantly in the elderly, while rare side-effects are mostly in the young.

For most, these small risks won’t change the risk-benefit ratio. But for some, the risk-benefit ratio looks very different.

Imagine a 20-year-old care worker on a zero-hours contract, like 24% of her colleagues, who worked through the pandemic and gained natural immunity from becoming infected. She, and those in her care, have little to gain from her undergoing vaccination to gain additional immunity.

A Public Health England study compared vaccine and natural immunity and found “equal or higher protection from natural infection, both for symptomatic and asymptomatic infection.” But under this scheme, our care worker would still be exposed to the additional risks of vaccination. Moreover, if she has to take time off sick with the common side-effects, thanks to her zero-hours contract, she won’t be eligible for sick pay for four days—and perhaps not then.

This won’t be the case for everyone. But it should be up to the individual who will suffer the outcome to make an informed choice. That is perhaps the most basic tenet of medical ethics: respect for autonomy.

It is true that autonomy is not always decisive in public health and that care workers have professional responsibilities to those in their care. But to justifiably override autonomy and remove someone’s livelihood, we need to know that doing so will be an effective measure and that it is necessary.

Increasing vaccine uptake may only have a limited effect in preventing transmission. The very limited data available suggests only a limited effect (as low as 35% and up to 50%). There are also confirmed reports of breakthrough infections, and even outbreaks, among fully vaccinated staff and patients.

Vaccination will confer some protection. But, at best, mandatory vaccination won’t stop family and friends from transmitting the virus while visiting care homes. Singling out one group for the coercive measure will be divisive and may lead many staff to leave the already-understaffed profession.

The policy is also unnecessary. Half of care homes have hit the target level of staff vaccination through voluntary means. Staff could be offered incentives to be vaccinated.

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Inflammation could be a core feature of depression

inflammation

People with depression have higher levels of inflammation in their bodies than those without depression, regardless of socioeconomic background, ill health or unhealthy behaviors, a study by King’s College London finds.

C-reactive protein (CRP), a marker for inflammation in the body, was found in higher levels in depressed people compared to non-depressed people in the largest ever study into the genetic, environmental, lifestyle, medical pathways leading to inflammation in major depressive disorder (MDD).

The effect was reduced but remained significant when factors known to be related to increased inflammation such as smoking, body mass index (BMI) and trauma were taken into account, adding to the body of evidence that there may be a direct biological link between inflammation and depressive disorders. The study was conducted by researchers funded by the NIHR Maudsley Biomedical Research Center and NARSAD (National Alliance for Research on Schizophrenia & Depression) and it was published in the American Journal of Psychiatry.

Largest study of its kind

In any given week in England 3 in 100 people will have depression. The economic costs of mental illness in England have been estimated at £105.2 billion each year by the government which includes direct costs of services, lost productivity at work and reduced quality of life.

This study used the largest ever community-based sample with information on mental health, inflammation, genome-wide association study (GWAS) data linking genes to certain diseases, environment, lifestyle and physical health with approximately 86 thousand participants.

Researchers analyzed blood samples, genetic data and physical and mental health questionnaires collected by UK Biobank, the large-scale biomedical database and research resource with over half a million UK participants who were recruited between in 2006-2010. Of the 86,000 participants included in the study just under a third (31%) were classified as having major depressive disorder. This percentage is similar to estimates found by other studies on the global prevalence of depression occurring during a person’s lifetime.

The study showed that depressed participants had raised C-reactive protein (CRP) levels in their blood compared to non-depressed participants, and were more likely to have low-grade inflammation, defined as CRP levels in the blood of over 3 mg per liter. Inflammation is a biological response which is predominantly directed to fight infection but also has an important role in regulating behavior. CRP is one marker for inflammation.

Further analysis showed that this increased inflammation in depression is only partially explained by clinical and sociodemographic factors including age, sex, body mass index (BMI) smoking, alcohol consumption, exposure to early life trauma, socio-economic status and self-reported health status.

Genetics x environment

The study found that the greater the genetic risk for depression, the greater the level of inflammation.

The polygenic risk score gives an estimate of how likely an individual is to have a given trait based only on genetics. The researchers calculated polygenic risk score in participants for major depression was strongly associated with levels of CRP. However, this association was no longer present when BMI and smoking were taken into account. In contrast, polygenic risk scores for three immune disorders—biliary cirrhosis, Crohn’s disease and rheumatoid arthritis- are all positively associated with CRP levels even after controlling for BMI and smoking.

First author Maria Pitharouli, Research Associate at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London said: “Our study provides the most conclusive evidence to date that people with depression have proteins in their blood indicating activation of the inflammatory system. Furthermore, through in-depth analysis of data from over 86,000 people we have discovered more about the mechanisms that may be behind the relationship between inflammation and depression.”

Joint senior author, Professor Cathryn Lewis who leads the Social, Genetic and Developmental Psychiatry Center at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London said: “Our study highlights how genetics can be used as a tool for dissecting mental health disorders. Here we’ve shown that the genetic contribution to inflammation in depression comes mostly from eating and smoking habits. That finding is important to help us understand depression better—and one further piece in the jigsaw puzzle towards improving care for people with depression.”

Joint senior author, Professor Carmine Pariante from the National Institute for Health Research Maudsley Biomedical Research Center says: “Our large-scale analysis of data removed socioeconomic background, ill health, unhealthy habits as well as genetic predisposition to immune dysfunction as the only explanations for the relationship between depression and inflammation. By this process of elimination, we show that there may be a core biological process that is behind the association between depression and increased inflammation. If we can identify this process and uncover more detail about its role in the development of depression, we can pave the way for trialing new treatments for this widespread mental health disorder.”

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Pfizer CEO says a THIRD Covid vaccine may be needed

BREAKING NEWS: Pfizer CEO says a THIRD Covid vaccine dose will be needed as soon as six months after someone receives two shots – and then be vaccinated annually

  • Pfizer CEO Albert Bourla said it is ‘likely’ people will need a booster shot of the COVID-19 vaccine
  • The potential booster shot will be given within 12 months of someone being fully vaccinated
  • Bourla said it is possible that people will need to be immunized against the novel coronavirus annually

Pfizer Inc’s CEO says he believes people will ‘likely’ need a third dose of the COVID-19 vaccine. 

During a panel discussion hosted by CNBC in conjunction with CVS Health taped on April 1, Albert Bourla said a potential booster shot would be administered six to 12 months of being fully vaccinated.  

Bourla added that he thinks it is possible that people will need to be immunized against coronavirus annually.    

‘There are vaccines that are like polio that one dose is enough…and there are vaccines like flu than you need every year,’ he said in the segment, aired on Wednesday.

‘The Covid virus looks more like the influenza virus than the polio virus.’  

Pfizer CEO Albert Bourla said it is ‘likely’ people will need a booster shot of the COVID-19 vaccine

Pfizer and its German partner BioNTech began studying a third dose of their vaccine in late February.

The booster shot is aimed at protecting against future variants, which may be better at evading antibodies from vaccine than earlier strains of the virus.

About 144 volunteers will be given the third dose, mostly those who participated in the vaccine’s early-stage U.S. testing last year.

The vaccine uses part of the pathogen’s genetic code called messenger RNA, or mRNA, to get the body to recognize the coronavirus and attack it if a person becomes infected.

In the jab, known as BNT162b2, the mRNA encodes for all of the spike protein found on the outside of the virus that it uses to enter and infect cells.

It was authorized for emergency use by the U.S. Food and Drug Administration (FDA) after a clinical trial involving 44,000 volunteers found the shot was 95 percent effective at preventing symptomatic COVID-19. 

Real-world data six months later showed that the vaccine offered 91 percent protection six months later. 

However, the company’s current two-dose regimen produced a weaker immune response against the South African variant.

This is a breaking news story and will be updated.

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Why women may be better equipped to fight COVID

covid

When it comes to COVID-19, women seem to be the stronger sex, suffering severe disease at about half the rate as men, but the reason for this has been elusive.

Now, a chance experiment by an ophthalmology researcher at Duke Health has led to an insight: Women have more of a certain type of immune cell that fights infections in mucosal tissue, and these immune cells amass in the lungs, poised to attack the COVID virus.

“Better armed with these specialized immune cells, women appear to be more equipped to fight some of the most severe impacts of COVID-19, notably the respiratory infections that can become life-threatening,” said Daniel Saban, Ph.D., an associate professor in Duke’s Department of Ophthalmology and in the Department of Immunology.

Saban, who led the study that appears online in the Cell Press journal Med, said the investigation began last spring as COVID first spread and he was sidelined from his normal caseload studying eye diseases. A piece of equipment in his lab—a device that can perform 36-color flow cytometry—was sitting idle, so he decided to use it to examine blood samples from COVID patients.

“We didn’t start with a hypothesis,” Saban said. “It was a completely unbiased approach, where we asked our colleagues to provide blood and tissue samples from COVID patients as well as healthy people. We had no idea what we would find, if anything.”

Saban and the members of his lab, including Chen Yu, Ph.D. and Sejiro Littleton, quickly saw that a white blood cell called mucosal associated invariant T cells, or MAIT cell, circulated more abundantly in the blood from healthy women compared to healthy men. MAIT cells are highly specialized white blood cells that contribute to immune defenses in mucosal organs and tissues.

Among COVID patients, however, there were few MAIT cells circulating in the blood, even among women, where the population of MAIT cells radically fell off, leading the researchers to question where these cells had gone.

They found their answer in tissue samples from the lungs of COVID patients. Overall, there were an abundance of MAIT cells in the lung tissue of people with COVID, but upon closer inspection, they found night-and-day differences between the sexes.

“We first found this dichotomy in healthy blood,” Saban said. “Circulating MAIT cells in women expressed genes indicative of a robust profile poised for fighting an infection, but this was not the case in males. Then we looked in the tissue and were able to find evidence of this same pattern by sex.”

Saban said there are numerous examples of sexual differences in the immune responses to infections, noting those differences have been prevalent all along with COVID-19.

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How You Should Really Be Cleaning Your Toothbrush

Do you run your toothbrush under hot water every once in a while as a way to sanitize it? If you have, you likely know that it’s important to keep your toothbrush clean, but you might not know the best way to do it. Every time you use your brush, you slough off plaque, bacteria, and other microorganisms — it’s wise to have a hygienic routine for this utensil.

For people who have used the hot water trick, this may be a worthwhile method. Healthline explains that you can sanitize the brush by running it underneath the water both before and after use. Make sure that the water is as hot as possible — the outlet suggests ensuring that the water temperature generates steam to effectively rid your brush of germs. This can help burn off any clung-on bacteria, which is especially important since germs from your toilet can even make their way onto your bristles, Insider notes. Apparently, the moving water sends bacteria into the air which can settle directly on your toothbrush. Make sure to keep your brush far from the toilet and sanitize it often to counteract this effect. 

The way that you store your brush also can make or break its cleanliness. It should always stand in an upright position after use because air kills off most of the bacteria present on the bristles. Rather than tossing your brush in a drawer, find a holder that keeps your brush separated from anyone else’s in your household and allows it to stay vertical.

You can use hydrogen peroxide to clean your toothbrush

If you’re looking for a cleaning agent, you can likely find a viable option in your medicine cabinet. Insider suggests using hydrogen peroxide to do the dirty work by killing off germs and microorganisms — especially if your toothbrush needs a deep clean. You can also use a mouthwash that contains alcohol for a powerful rinse that will sweep any lingering particles out from the bristles.

The outlet even cites a study finding that toothbrushes soaked in 3 percent hydrogen peroxide or an alcohol-based mouthwash came out 100 percent germ-free. Simply pour enough of the liquid into a cup and soak the head of your brush for 15 minutes. Rinse with hot water and enjoy your squeaky clean bristles.

Tools that clean your brush for you are also on the market, and they usually use UV rays to do the work. Healthline explains that this technology is extremely effective in sanitizing your toothbrush — you can find an apparatus online. They do carry a hefty price tag so make sure that you’re ready to use it often to get the most out of it. 

Of course, replacing your toothbrush every three-four months is the best way to keep it free from bacteria. If you notice the bristles fanning out or just a lower quality of clean, it’s best to pick up a new one.

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Metabolic derangements caused by a high-fat diet may be possible to eliminate

high fat

Intake of a high-fat diet leads to an increased risk for obesity, type 2 diabetes, cardiovascular diseases and fatty liver. A study in mice from Karolinska Institutet in Sweden shows that it is possible to eliminate the deleterious effects of a high-fat diet by lowering the levels of apolipoprotein CIII (apoCIII), a key regulator of lipid metabolism. The study is published in the journal Science Advances.

Increased levels of the protein apoCIII are related to cardiovascular diseases, insulin resistance and type 2 diabetes. Researchers at the Rolf Luft Research Center, Karolinska Institutet, have previously shown that apoCIII increases in the hormone secreting part of the pancreas, the islets of Langerhans, in parallel with the development of insulin resistance and diabetes.

The same researchers have now studied two groups of mice who were fed a high-fat diet from the age of 8 weeks, and a control group of mice on a normal diet. One of the groups on a high-fat diet received so-called antisense (ASO) treatment after 10 weeks on the diet to decrease apoCIII levels, and the other group had already been treated with ASO from the start thereby preventing an increase in apoCIII.

“After a period of 10 weeks, all of the mice in the first group were obese, insulin resistant and had liver steatosis. However, after ASO treatment, still being on the high-fat diet, there was a normalization of glucose metabolism, weight and liver morphology,” says Ismael Valladolid-Acebes, assistant professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet, and first author of the study.

In the group that was treated with ASO directly from start, the development of metabolic derangements was prevented, and the animals had the same body composition and metabolism as the control mice on a normal diet. The mechanisms underlying the effects of the apoCIII-lowering treatment involve increased lipase enzyme activity and receptor-mediated uptake of lipids to the liver. Fatty acids were transferred by fatty acid oxidation to the biochemical process in the liver called the ketogenic pathway and then converted to ketones that were used for heat production in brown adipose tissue.

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Spina bifida can be caused by uninherited genetic mutations

genetic

Genetic mutations which occur naturally during the earliest stages of an embryo’s development can cause the severe birth defect spina bifida, finds a new experimental study in mice led by UCL scientists.

The research, published in Nature Communications, explains for the first time how a ‘mosaic mutation’ – a mutation which is not inherited from either parent (either via sperm or egg cell) but occurs randomly during cell divisions in the developing embryo—causes spina bifida.

Specifically the scientists, based at UCL Great Ormond Street Institute of Child Health, found that when a mutation in the gene Vangl2 (which contains information needed to create spinal cord tissue) was present in 16% of developing spinal cord cells of mouse embryos, this was sufficient to produce spina bifida.

Researchers say the findings add to scientists’ understanding of how and why mosaic mutations can affect and disrupt cell function, including those of neighbouring cells, helping cause birth defects.

For parents, the findings may help reduce the burden felt by those who believe their child inherited spina bifida from them via genes, and believe future children could also inherit the condition. This is often discussed during genetic counselling.

Spina bifida and current knowledge

Spina bifida is one of a group of birth defects called neural tube defects, affecting the brain or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. People born with this condition suffer nerve damage because part of their spinal cord remains exposed while in the womb. Advances in recent years now allow surgeons in a few centres around the world, including at Great Ormond Street Hospital and University College London Hospital, to perform surgery on foetuses in the womb to reduce the neurological consequences of their condition*.

Some neural tube defects can be prevented by taking folic acid supplements before and during early pregnancy, yet these conditions continue to affect around one in every thousand pregnancies globally. Researchers say they do not fully understand why mosaic mutations occur—though environmental factors may be involved—and cannot yet draw a link with taking (or not) folic acid during pregnancy. Notwithstanding this they say folic acid is known to help embryonic cells make DNA and encourage all expectant mothers to add folic acid to their diets from before conception.

Commenting on the potential causes, Principle Investigator, Dr. Gabriel Galea (UCL Great Ormond Street Institute of Child Health), said: “Some environmental factors are known to increase the risk of these conditions occurring and very few affected individuals or their parents receive a meaningful genetic diagnosis. The discovery that mosaic mutations, which cause spina bifida, may not be inherited from either parent, and are not necessarily present in blood or saliva commonly used for genetic testing, may explain why.”

Genetic mutations

Genetic mutations happen in every cell throughout development. In order to grow from a fertilised egg cell into a foetus, each of our cells must replicate and divide in order to increase in number and grow. Cells must copy their DNA every time they divide, but mistakes can happen which change the DNA sequence in the daughter cells. These DNA code mistakes, called mutations, are then inherited by all cells derived from that cell. If these mutations happen in germ cells—the egg and sperm cells—they are inherited from parent to offspring. Many mutations do not happen in germ cells, but rather in cells which give rise to specific tissue types. These are known as mosaic mutations.

Experimental study approach

In humans with spina bifida a number of gene mutations have been identified, but in many cases it had not been known whether they could cause spina bifida.

In this experimental study, researchers caused a specific mutation, which inactivates a single gene called Vangl2 in mouse embryos. This gene is part of a cellular signalling pathway which tells cells which way they are facing within a tissue. Mutations in this pathway had been identified in people who have neural tube defects, and recent reports from the U.S. and China previously found mosaic Vangl2¬-pathway mutations in 15% of human foetuses with spina bifida. For the cellular signalling pathway to function normally, cells must interact with their neighbours in order to communicate directional information.

For the study, researchers induced this mutation of Vangl2 in a small proportion of cells which form the developing spinal cord of mice. This was done in a number of mouse embryos. Researchers then counted the proportion of spinal cells which harboured this mutation in those which had successfully covered their spinal cord with skin (ie had developed normally), versus those which had an exposed spinal cord (had spina bifida).

Researchers found that when the mutated Vangl2 gene was present in just 16% of developing spinal cord cells, spina bifida occurred.

They say, these results show that the cellular signalling process is surprisingly vulnerable to the uninheritable mosaic mutations. Each mutant cell stops each of its neighbouring cells from functioning to promote spinal cord development. And each cell has six neighbouring cells on average, massively amplifying the effects of each mutant cell.

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U.K. COVID variant may be more lethal, and could become dominant U.S. strain by March

U.K. COVID variant may be more lethal, and could become dominant U.S. strain by march

(HealthDay)—Even as efforts to vaccinate Americans gain steam, more evidence has emerged that suggests a coronavirus variant already known to spread faster is also likely to be more deadly.

The B.1.1.7 variant, which is thought to have originated in Britain, is already firmly entrenched in America and could soon become the dominant strain, according to Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention.

Speaking Sunday on CBS’ “Face the Nation,” she said “we know now that, or we estimate now that about 4% of disease in this country is related to B.1.1.7,” she said. “And we have projections that it may be the dominant strain by the end of March.”

Her warning came on the heels of research released by British scientists that shows B.1.1.7 might be more likely to trigger more lethal cases of COVID-19.

As reported Saturday by The New York Times, the new study was posted Friday on a U.K. government website. The scientists stressed that, as has always been the case, the vast majority of COVID-19 cases are not fatal, and their new research is based on only a small proportion of deaths in Britain.

Still, “the overall picture is one of something like a 40 to 60 percent increase in hospitalization risk, and risk of death,” Neil Ferguson, an epidemiologist and scientific adviser to the British government, told the Times on Saturday.

B.1.1.7 is known to have spread to at least 82 countries and is thought to be transmitted between 35 and 45 percent more easily than other variants of coronavirus already found in the United States, the Times said.

Newer data

The British team first signaled more than a month ago that they thought there was a “realistic possibility” that B.1.1.7 might also be more lethal, based on a small amount of preliminary data. With more data now in hand, they say they have a 55 to 75 percent degree of confidence in the latest finding.

Exactly why the variant causes more death isn’t clear. It could cause higher viral loads within the body, making treatment tougher. Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government, told the Times the variant may also “transmit disproportionately in settings with frailer people,” such as nursing homes, because it is more transmissible.

Vaccines already being distributed in the United States are believed to be effective against B.1.1.7, so Walensky said it’s imperative that the massive rollout already underway continues. At the same time, and in the face of other new variants, other steps are underway, she told CBS.

Pharmaceutical companies are tweaking their research to fight the B.1.1.7 variant, she said, and the CDC is monitoring how people who’ve already gotten the Pfizer or Moderna vaccines are faring.

“But we’re not waiting for that,” she said. “We’re doing the science to scale up different vaccines in case we either need bivalent vaccines, that is a vaccine that has two different strains, or booster vaccines. Both are happening.”

In the meantime, she said, Americans need to continue with tried-and-true ways of curbing viral spread such as social distancing and mask-wearing.

“So what I would say is now is the time to not let up our guard. Now is the time to double down, still with 100,000 cases a day, still with over two and a half times the cases we had over the summer,” Walensky said.

Big boost in vaccine supply

The United States will have enough COVID-19 vaccines to inoculate 300 million Americans by summer, President Joe Biden announced Thursday.

During a tour of the National Institute of Health’s Viral Pathogenesis Laboratory, where the Moderna COVID-19 vaccine was created, Biden said his administration had secured the delivery of 600 million doses of the Moderna and Pfizer vaccines over the next five months, the Associated Press reported.

“We’re now on track to have enough supply for 300 million Americans by the end of July,” he announced.

The country is already on pace to exceed Biden’s goal of administering 100 million vaccine doses in his first 100 days in office, with more than 26 million shots delivered during his first three weeks in office, the AP reported.

“That’s just the floor,” Biden said. “Our end goal is beating COVID-19.”

If a third coronavirus vaccine, from drugmaker Johnson & Johnson, is approved for emergency use by the U.S. Food and Drug Administration at the end of February, the pace of vaccinations should accelerate even further.

Biden emphasized that his administration is doing everything possible to increase vaccine supply and the country’s capacity to deliver injections into arms.

To date, the Biden administration has deployed active-duty troops to man mass vaccination sites in several states, as it looks to lay the groundwork for increasing the rate of vaccinations once more supply is available.

On the NIH tour, Biden was shown the lab bench where researchers sequenced the coronavirus and developed the precursor of the Moderna vaccine, the AP reported.

Just days after Chinese scientists shared the genetic blueprint of the new coronavirus in January of last year, the NIH had sent instructions to Moderna to brew up doses and scientists were already setting up the key lab and animal tests that would eventually prove they were on the right track, the AP reported.

All Americans could get vaccine by April: Fauci

Any American will be able to start getting vaccinated by April, the nation’s leading infectious diseases expert predicted earlier this month.

During an interview on the “Today Show,” Dr. Anthony Fauci said that month will be “open season” for vaccinations, as increased supplies of the vaccines will allow most people to get shots to protect against COVID-19.

Fauci, who serves as science adviser to President Joe Biden, added that the rate of vaccinations will greatly accelerate in the coming months. Why? He credited forthcoming deliveries of the two approved vaccines, the potential approval of a third vaccine and measures taken by the Biden administration to increase capacity to deliver doses.

“By the time we get to April,” it will be “open season, namely virtually everybody and anybody in any category could start to get vaccinated,” Fauci noted.

Despite that good news, he cautioned it will take “several more months” to actually deliver shots to Americans, but herd immunity could be achieved by late summer. As of Monday, more than 70 million doses have been distributed, while nearly 53 million Americans have been vaccinated. More than 14 million people have gotten their second shot.

Meanwhile, fully vaccinated Americans can now skip quarantines if they are exposed to someone infected with COVID-19, new federal guidelines say.

“Fully vaccinated persons who meet criteria will no longer be required to quarantine following an exposure to someone with COVID-19,” the U.S. Centers for Disease Control and Prevention said in updated guidance posted Wednesday on its website.

There was one caveat: At least two weeks must have passed since the second shot, because it takes that long to build full immunity. But the CDC says it’s not known how long protection lasts, so people who had their last shot three months ago or more should still quarantine if they are exposed or show symptoms, the agency added.

“This recommendation to waive quarantine for people with vaccine-derived immunity aligns with quarantine recommendations for those with natural immunity,” the CDC said. People who have been vaccinated should still watch for symptoms for 14 days after they have been exposed to someone who is infected, the agency added.

That doesn’t mean vaccinated people should stop practicing social distancing, the CDC noted.

“At this time, vaccinated persons should continue to follow current guidance to protect themselves and others, including wearing a mask, staying at least 6 feet away from others, avoiding crowds, avoiding poorly ventilated spaces, covering coughs and sneezes, washing hands often, following CDC travel guidance, and following any applicable workplace or school guidance, including guidance related to personal protective equipment use or SARS-CoV-2 testing,” the agency said.

A global scourge

By Monday, the U.S. coronavirus case count passed 27.6 million while the death toll passed 485,000, according to a Times tally. On Monday, the top five states for coronavirus infections were: California with nearly 3.5 million cases; Texas with more than 2.5 million cases; Florida with over 1.8 million cases; New York with more than 1.5 million cases; and Illinois with over 1.1 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was nearly 10.9 million by Monday, a Johns Hopkins University tally showed. Brazil had over 9.8 million cases and more than 239,000 deaths as of Monday, the Hopkins tally showed.

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Child brain tumors can be classified by advanced imaging and AI

Child brain tumors can be classified by advanced imaging and AI

Diffusion weighted imaging and machine learning can successfully classify the diagnosis and characteristics of common types of pediatric brain tumors a UK-based multi-center study, including WMG at the University of Warwick has found. This means that the tumor can be characterized and treated more efficiently.

The largest cause of death from cancer in children are brain tumors in a particular part of the brain, called the posterior fossa. However, within this area, there are three main types of brain tumor, and being able to characterize them quickly and efficiently can be challenging.

Currently, a qualitative assessment of MRI by radiologists is used; however, overlapping radiological characteristics can make it difficult to distinguish which type of tumor it is, without the confirmation of biopsy. In the paper, “Classification of pediatric brain tumors by diffusion weighted imaging and machine learning,” published in the journal Scientific reports, led by the University of Birmingham including researchers from WMG, University of Warwick. The study found that tumor diagnostic classification can be improved by using non-invasive diffusion weighted imaging, when combined with machine learning (AI).

Diffusion weighted imaging involves the use of specific advanced MRI sequences, as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast in MR image. One can then extract an Apparent Diffusion Coefficient (ADC) map, analyzed values of which can be used to tell you more about the tumor.

The study involved 117 patients from five primary treatment centers across the UK with scans from twelve different hospitals on a total of eighteen different scanners, the images from them were then analyzed and region of interests were drawn by both an experienced radiologist and an expert scientist in pediatric neuroimaging. Values from the analysis of Apparent Diffusion Coeffcient maps from these images’ regions have been fed to AI algorithms to successfully discriminate the three most common types of pediatric posterior fossa brain tumors, non-invasively.

Professor Theo Arvanitis, director of the Institute of Digital Health at WMG, University of Warwick and one of the authors of the study explains:

“Using AI and advance Magnetic Resonance imaging characteristics, such as Apparent Diffusion Coefficient (ADC) values from diffusion weighted images, can potentially help distinguish, in a non-invasive way, between the main three different types of pediatric tumors in the posterior fossa, the area of the brain where such tumors are most commonly found in children.

“If this advanced imaging technique, combined with AI technology, can be routinely enrolled into hospitals it means that childhood brain tumors can be characterized and classified more efficiently, and in turn means that treatments can be pursued in a quicker manner with favorable outcomes for children suffering from the disease.”

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