The Bystander Effect Explains Why Some People Don't Help When Others Are In Danger-Here's How to Fight Against It

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The data is clear: Hate crimes against Asian Americans have skyrocketed since the pandemic began. Anti-violence organization Stop AAPI Hate reported nearly 3,800 incidents against Asian Americans and Pacific Islanders from March 2020 to February 2021, and New York City alone had an 867% increase in Asian hate crime victims in 2020 compared to the previous year.

What's most shocking? Some of these crimes have happened right in front of other people—who haven't stepped in to help. In a video that's now gone viral, a 65-year-old Asian American woman can be seen being thrown to the ground and repeatedly assaulted in full view of security guards in a building nearby. The security guards look out and clearly see what's going on, as one of them closes the door on her.

Plenty of people online have expressed shock and outrage that something like this could happen right in front of others, with no one rushing to help. But this kind of thing happens more often than you'd think. In fact, it's a social phenomenon with a name. It's called the bystander effect, and it's been well documented for decades. Here's what you need to know.

What exactly is the bystander effect?

The bystander effect is a social psychology theory that says that a person is less likely to offer help to a victim when more people are around, Todd Lucas, PhD, a social and health psychologist at Michigan State University, tells Health. "It's an irony of human behavior," he says.

The term was first coined in the 1960s by psychologists Bibb Latané and John Darley who analyzed the 1964 murder of a woman named Kitty Genovese in New York City. Genovese was stabbed to death outside of her apartment, but none of her neighbors reacted to help her, even though they were aware of what was going on.

"It's really a classic example of unhelpful behavior," Victoria Banyard, PhD, associate director for the Center on Violence Against Women and Children at the Rutgers School of Social Work, tells Health.

Why does the bystander effect happen?

There are a few possible reasons for this. One is what Lucas calls "diffusion of responsibility." Meaning, the more people there are around, the less any single person feels responsible for helping in any situation.

People are also "social creatures" and we tend to react to social cues from those around us, Banyard says. "We want to fit in and, if other people seem to think this isn't serious, we tend to react the same way," she says.

Experts say this is potentially damaging on so many levels. On a very basic—but important—level, the bystander effect increases the odds that someone will get hurt. "There may be a chance to keep something from escalating and prevent someone from being harmed if people actually intervene," Banyard says.

But the bystander effect isn't just harmful on a physical level—it's damaging on a mental level for the victim, too. "It sends a message to the victim that people don't think they're worth helping," Banyard says.

What you can do to stop the bystander effect

It's easy to think you wouldn't fall victim to the bystander effect, but it's a common social phenomenon that has impacted plenty of others. If you notice something seems off in a crowd but no one else is reacting, Lucas recommends listening to your gut. "Be confident in your values and assessment of the situation," he says. "If you think somebody needs help, recognize that might be correct. Even if no one else is acting, it may be appropriate to act."

One person taking action can create a domino effect, where others recognize that there is a problem and step in to help, too, Lucas says. "You don't need to be the person that fixes the situation entirely—you just need to be the person who starts the chain reaction," he says.

If you're a victim in a crowd and no one is helping you, Lucas recommends singling out a particular person or looking for someone who seems like they could be helpful and appealing directly to them. "You can better overcome a bystander effect that way," he says.

Even simply being aware that the bystander effect is a thing can be helpful, Banyard says. Organizations like Hollaback and Step Up also have courses you can take to learn more about the bystander effect and strategies for intervening in different situations.

And, of course, if you see someone being victimized, do your best to intervene. "Take action," Banyard says. "It's simple."

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Get the COVID vaccine that’s available to you—and don’t forget your flu shot

Yes, COVID vaccines are front and centre. But don't forget about your flu shot

As the nights begin to close in and the temperatures cool, it’s clear winter is approaching again.

With the winter season comes the risk of the usual winter lurgies, most of which result from respiratory infections. Some of the usual suspects include rhinoviruses (the common cold), RSV (respiratory syncytial virus), and influenza.

This year, of course, we’re also contending with the possibility that SARS-CoV-2 (the virus that causes COVID-19) could escape from its quarantine status and circulate alongside these other viruses.

We don’t know yet how the winter season will play out in terms of respiratory viruses. But one important way we can prepare for it is by getting a flu vaccine.

What will winter bring?

In 2020 there was a paucity of seasonal winter viruses. Only rhinoviruses circulated widely, while the others were either vastly reduced (for example, we saw a very minimal flu season) or very delayed (RSV circulated later than usual in some states until spring or even summer).

So what’s going to happen in 2021? Will it be similar to 2020, or will it be like 2019, which saw very high levels of influenza? Or perhaps something completely different?

We simply don’t know for sure. With COVID-related restrictions having eased in all Australian states and territories—albeit to varying degrees—people are free to move around, come together in crowds, and attend schools, universities and offices.

These activities promote the transmission of respiratory viruses, which explains why we saw such different trends in the usual winter lurgies last year, when we were mixing much less.

But the virus circulation needs to start from somewhere. While some viruses are happy to circulate domestically, like rhinoviruses and adenoviruses, others, like influenza, are largely transported into the country each year. So it’s possible that if Australia’s international borders remain closed through winter, we may again have a less serious flu season in 2021.

On the other hand, if borders are opened and the flu does take hold, people might have reduced immunity to the viruses given the missed season last year, and be more susceptible.

A vaccine is your best bet

In the face of this uncertainty, the usual adage prevails: “prevention is better than cure.” The best measure we can take is to get our influenza vaccine.

The flu vaccines available in Australia in 2021 under the National Immunization Program are:

  • for children aged six months to five years—Vaxigrip Tetra (Sanofi) and Fluarix Tetra (GSK)
  • for children and adults aged five to 64 years—Vaxigrip Tetra, Fluarix Tetra and Afluria Quad (Seqirus)
  • for adults aged 65 and over—Vaxigrip Tetra, Fluarix Tetra, Afluria Quad and Fluad Quad (Seqirus).

The Fluad Quad vaccine, which is slightly different and more potent than the others, is the preferred vaccine for the over-65 age group. It contains a component called an adjuvant, which helps boost the immune response in elderly people.

This season’s flu vaccines are made up of four different viruses—two influenza A types and two influenza B types. The 2021 vaccines have two changes (both in the influenza A types) from the 2020 influenza vaccines.

It’s very hard to predict in advance which strains will circulate, but the World Health Organization provides guidance on this every year, and recommends which components of the vaccine should be updated accordingly.

All the influenza vaccines used in Australia are inactivated virus vaccines, meaning the virus contained in the vaccine doesn’t replicate, so you can’t get the flu from the vaccination.

In addition to the flu vaccines under the National Immunization Program, a new vaccine called Flucelvax Quad (Seqirus) is available through retail outlets, like pharmacies, for people aged nine years and older.

This vaccine is the first influenza vaccine available in Australia which has been produced entirely in cell culture, rather than chickens eggs. This new vaccine may have some benefits over the traditional egg-based vaccines for certain people, for example those with severe egg allergies.

How effective are flu vaccines?

Flu vaccines are only moderately effective at preventing infection with influenza. On average, they offer around 60% protection across the population, although rates can often be higher in children.

While this is lower than we’d like, it’s the best measure we currently have to protect us from influenza infections. There’s also evidence it reduces the more severe consequences of being infected, such as being hospitalized or dying.

Scientists are continuing to work on new flu vaccines that may offer greater protection.

The practicalities

This year’s vaccines are already becoming available through pharmacies and some GP clinics, and will be available under the National Immunization Program from GPs and other providers, such as workplace immunization programs, in April.

The flu season generally starts in earnest around June, so it’s reasonable to get your vaccine any time between now and then.

Under the National Immunization Program, some groups are eligible to receive the influenza vaccine for free. These include:

  • adults 65 and older
  • all Aboriginal and Torres Strait Islander Australians six months and older
  • children aged six months to five years
  • pregnant women
  • people with certain medical conditions.

For people who don’t fall into these groups, the vaccine costs as little as A$14.99.

Influenza vaccines are being rolled out this year alongside the COVID-19 vaccines. With both programs operating at the same time, there may be some confusion and logistical challenges.

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Borderline personality disorder: Don’t ignore it

adolescent

For many years, clinicians have been hesitant to diagnose adolescents with Borderline Personality Disorder (BPD), believing it was a mental health “death sentence” for a patient because there was no clear treatment. Carla Sharp, professor of psychology and director of the Developmental Psychopathology Lab at the University of Houston, begs to differ.

And her new research, published in Journal of Abnormal Child Psychology backs her up.

“Like adult BPD, adolescent BPD appears to be not as intractable and treatment resistant as previously thought,” reports Sharp. “That means we should not shy away from identifying BPD in adolescents and we shouldn’t shy away from treating it.”

Borderline Personality Disorder is marked by patterns of varying moods, self-image and behavior, and it results in impulsive actions, problems in relationships and a tendency to think in purely black and white. People with BPD may experience intense episodes of anger, depression and anxiety that can last from a few hours to days.

Sharp said Borderline Personality Disorder is treatable, therapy helps, and early intervention for adolescents is of critical importance.

“We ignore Borderline Personality Disorder at our peril, because compared with other mental disorders, BPD is among the leading causes of suicidal behaviors and self-harm in young people,” she said. Up to 10% of BPD patients will die by suicide.

Sharp’s research is the first study to show that adolescent borderline pathology follows a similar downward course after discharge from inpatient treatment previously demonstrated for adults. Her conclusions come after examining data collected from 500 adolescent inpatients and following them every six months over an 18-month follow-up period to measure their symptoms of BPD.

The results showed a significant downward trend of BPD features across all time points and across both parent-and adolescent self-reporting which mirrors the reduction in BPD symptomology reported for adults with BPD. Interestingly, the teens Sharp studied were not undergoing specialized treatment for BPD and yet they still improved.

“It sends a message to clinicians: ‘Don’t put your head in the sand!’ If the pathology is there, diagnose it and treat it with your best evidence-based treatment,” said Sharp emphatically. The standard therapies for BPD in adults and adolescents currently are dialectical behavior therapy and mentalization-based therapy. But even if clinicians are not trained in those specialized treatments, it would be ethically appropriate to make use of best available scientific evidence to inform practice, consistent with practice-based evidence recommendations from the American Psychological Association, she said.

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People eventually adopt healthy behaviors – but it can take time we don’t have during a pandemic

Why do we do things that are bad for us—or not do things that are good for us—even in light of overwhelming evidence?

As someone with a long career in pharmacy, I have witnessed some pretty dramatic shifts in public health behavior. But I won’t sugarcoat it. It generally takes years—or even decades—of dragging people, kicking and screaming, to finally achieve new and improved societal norms.

This plodding time course seems to be an innate human defect that existed long before the current-day pandemic mask and social distancing conundrums. Historically, people aren’t fond of being told what to do.

Notable victories

Attitudes toward smoking have undergone dramatic changes over the past 50 years. Although there has been a gradual decline in smoking, from 42% of the American population in 1965 to the low teens today, there still are a lot of smokers in the U.S. – and premature deaths due to smoking. Even health care workers fall prey to this unhealthy and highly addictive habit.

There was a strongly held view that smoking was a personal decision that do-gooders and the government should keep their noses out of—until the issue was framed differently by studies showing harm caused by secondhand smoke. You are welcome to do what you want to yourself, but it becomes a horse of a different color when it affects others.

Today, public smoking restrictions have become commonplace. But this change in societal behavior didn’t happen overnight or without painful discourse. The journey from the initial 1964 surgeon general’s report on smoking and health to the 2006 surgeon general’s report on secondhand smoke to today was a fractious one.

Another about-face has been the adoption of seat belts. Seat belts save lives. And most people now use them as a result of the nagging warning alarm, the marketing of automobile safety, the law and the data.

This change in behavior, however, followed a rocky road over many years. In my earlier days, I can remember more than one occasion when I hopped into a friend’s car, put on my seat belt and was then chastised for having so little faith in my friend’s driving ability.

Seat belts were required to be installed in new cars starting in 1964 and New York enacted the first seat belt use law in 1984. In the U.S., seat belt use rose from 14% in 1983 to 90% in 2016.

Continuing challenges

In the medical arena, much effort has been expended in promoting healthy behaviors—diet, exercise, sleep hygiene, adherence to prescribed drugs and immunizations. Frankly, the success has been mixed.

Studies have suggested many possible variables associated with not following accepted medical advice: age, gender, race, education, literacy, income, insurance copays, level of physician and pharmacist care—and plain old stubbornness. But there is no single, easily addressable cause of nonadherence to healthy behaviors.

For example, properly prescribed cholesterol-lowering drugs called statins literally add years to patients’ lives by reducing heart attacks and strokes. Even in people with insurance coverage and minimal side effects, 50% of patients discontinue statin therapy within one year of receiving their first prescription.

Vaccines and immunization offer another window into the puzzle of human behavior. Life expectancy in the U.S. rose from 40 years in 1860 to 70 years in 1960. These gains resulted largely from decreased infant and child mortality due to infectious diseases. A better understanding of infectious diseases along with scientific advances, vaccines and antibacterial drugs were the primary factors for this profound increase in life expectancy.

Common sense alone makes the value of vaccines abundantly clear; how many people do you know who are suffering from polio or smallpox? Yet some intelligent, thoughtful friends, family and neighbors are convinced vaccines are not helpful and are even harmful. Some believe wearing a mask is nothing more than a “feel good” placebo. I believe these contrarian beliefs make better press and are therefore more frequently reported than mainstream ones, but clearly there is reason for concern.

The current crisis

Historically, changes in societal behavior that benefit public health occur in fits and starts—and never fast enough for the individuals who fall victim before society comes around.

The urgency imposed by the coronavirus has actually resulted in comparatively swift behavioral changes (masks, hand-washing, distancing) in the U.S. – as scientists learned how the coronavirus is spread, how dangerous it can be and which groups are more susceptible. But these behavioral changes were not as complete or as fast as they should—or could—have been when judged by far better outcomes in other countries.

I am discouraged by the battle between the scientific method and political ideology when it comes to public health. Ideology never seems to change and is therefore more comforting to some—while science evolves as new findings debunk old ideas or confirm new ones. It is clear to all who want to listen: controlling the virus and maintaining the economy is not an either/or choice—they are interdependent.

At the same time, I am buoyed that the tide seems to be turning. As a better understanding of treating COVID-19 has emerged and with more than one highly effective vaccine on the horizon, the “idiot scientists” are gaining ground, both in the lab and at the bedside. Even the most prominent ideologues run to the hospital to get the best treatments science can offer when the effect of their maskless behavior rears up to bite them.

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Patients on ACE inhibitors, ARBs, don’t have higher COVID-19 risk

While the COVID-19 pandemic left the world searching for answers during the earliest stages of the pandemic, one immediate healthcare concern regarded the use of certain antihypertensives—and whether they posed increased risks to patients with hypertension.

A new study by global collaborators within the Observational Health Data Sciences and Informatics (OHDSI) community found that there was no increased risk of COVID-19 diagnosis, hospitalization, or subsequent complications for users of either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) among an international cohort of more than 1.1 million patients using antihypertensives.

The study was published today in The Lancet Digital Health.

This real-world evidence, generated through open-science approaches, support recent regulatory and clinical recommendations that patients should not discontinue ACE inhibitor or ARB therapy due to concerns of increased COVID-19 risk.

“People with hypertension have worse COVID-19 outcomes, and there remains speculation that some anti-hypertensive medications may be detrimental,” says corresponding author Marc A. Suchard, a professor at UCLA and research team leader. “The clear answer is that ACE inhibitors and ARBs pose no increased risk as compared to other treatments.”

While other studies have generated similar findings recently, this study is the most comprehensive to date of COVID-19 susceptibility risks for antihypertensive users. OHDSI researchers examined electronic health records from a trio of data sources from the United States and Spain (Columbia University Irving Medical Center, the Department of Veteran Affairs and the Information System for Research in Primary Care) to conduct a systematic cohort study of ACE, ARB, calcium channel blocker (CCB) and thiazide diuretic (THZ) users.

The findings also showed no clinical reason to switch from an ARB to an ACE inhibitor to minimize COVID-19 risk.

“Based on our results, if there is a risk difference, it’s marginal and would be very challenging to further refine outside such a large-scale international study,” Suchard said.

Powered by open-source tools, state-of-the-art analytical methods and global collaboration within the OHDSI community, these findings provide robust and reproducible real-world evidence. The study design was specifically cited by the European Medicines Agency in the latest version of The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Guide on Methodological Standards in Pharmacoepidemiology following its release on a preprint server:

Morales et al. supported the reproducibility of their study by publishing the study protocol in the EU PAS Register ahead of time, providing a start-to-finish executable code, facilitating the sharing and exploration of the complete result set with an interactive web application and asking clinicians and epidemiologists to perform a blinded evaluation of propensity score diagnostics for the treatment comparisons.

“By comparing people exposed to ACE inhibitor and ARBs against people taking other antihypertensives, either alone or in combination, using two methods across three database the study generated 1280 comparisons to assess the safety of these drugs, producing highly consistent results,” says lead author Daniel Morales, Wellcome Trust Clinical Research Fellow at the University of Dundee.

The International COVID-ACE Receptor Inhibition Utilization and Safety (ICARIUS) protocol, code, and results are all available for further exploration at https://github.com/ohdsi-studies/COVID19Icarius.

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Astrologer Explains Why You Don’t Relate To Your Sun Sign

Are you a skeptic who thinks horoscopes are nonsense because the description of your sign isn’t even close to your personality? Well, before you dismiss the entire concept of astrology, Phoenix Knor’malle, a psychic advisor at MysticSense.com, explained that there’s actually a very logical reason why your sun sign might not ring true.

“Occasionally, I hear people stating that they do not relate at all to their sun sign,” Knor’malle said in an interview with The List. “Typically, these people relate more to their moon or rising placements more than the sun placement,” which make up the “big three” of your astrological chart. If you don’t relate to your sun sign, moon sign, or your rising sign, Knor’malle conceded, “It is easy to question if astrology is even real!” She went on to add, “However, there is a good reason why some people do not relate to their sun sign … The cause for this disconnection lies in the houses.”

Explaining that “the first house in astrology represents the identity and sense of self,” Knor’malle noted, “The signs that fall into this house will typically be the ones that you ‘resonate with’ on a personal level. In situations where you do not identify with your sun sign, there is probably a good chance that your sun sign is not in the first house.” This isn’t the only reason why your sun sign might not seem to fit your personality, though.

If you're born on the cusp of two signs, your sun sign might not run true

If your birthday is on the last day of one sun sign, it’s possible that the sun sign the day after will be a better fit for your personality. Or, if your birthday is on the first day of when a sun sign begins, you might have more in common with the star sign that ended the day before you were born, according to Phoenix Knor’malle. 

“Cusps are born on or near the transition date of two zodiac signs,” the MysticSense.com psychic advisor explained. “Cusps can lean more heavily towards one sign than the other, or they can be a balance of both.” In fact, this is a pretty common phenomenon for cusp babies. “Many times, I hear people saying that they are a cusp between X and Y signs and their birthday is in Y, but they feel more like X sign,” Knor’malle continued. “It is possible that being on a cusp of two signs minimizes the traits of one, making it harder to relate to. “

What if your personality is the opposite of your star sign profile?

It’s one thing if your sun sign doesn’t really match your personality, but what if the description of your star sign literally sounds like the opposite of you? For example, Virgos are known for being organized — but you’re a mess. There’s actually an astrological explanation for that, as well. 

“It is possible that a retrograde may influence how the energy of your sun sign is manifesting in your life,” Phoenix Knor’malle explained. “Retrograde means that a planet appears to be moving in the opposite direction, thus affecting how the astrological qualities of that planet manifest themselves during the retrograde period.”

So, how can you tell whether you’re a retrograde baby? A reading with a professional astrologer can help you understand the position of the planets when you were born. “If you happened to be born when your sun’s ruling planet was in retrograde, there is a chance that this altered the way the qualities of that sign manifest in your personality,” Knor’malle said. “I like to think of a retrograde in astrology a bit like reading a reversed tarot card; it is the same basic meaning, but with a very different emphasis.”

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Researchers find face masks don’t hinder breathing during exercise

A new University of Saskatchewan (USask) study has found that exercise performance and blood and muscle oxygen levels are not affected for healthy individuals wearing a face mask during strenuous workouts.

Questions have been raised as to whether mask wearing during vigorous exercise might compromise oxygen uptake or increase the rebreathing of carbon dioxide, leading to a condition (hypercapnic hypoxia) whereby increased carbon dioxide displaces oxygen in the blood.

But the study, published Nov. 3 in the research journal International Journal of Environmental Research and Public Health, did not find evidence to support these concerns.

“Our findings are of importance because they indicate that people can wear face masks during intense exercise with no detrimental effects on performance and minimal impact on blood and muscle oxygenation,” the researchers state.

“This is important when fitness centers open up during COVID-19 since respiratory droplets may be propelled further with heavy breathing during vigorous exercise and because of reports of COVID-19 clusters in crowded enclosed exercise facilities.”

The study evaluated use of a three-layer cloth face mask—the type recommended recently by Dr. Theresa Tam, Canada’s Chief Public Health Officer. “Results using a single-layer cloth mask may differ,” the researchers note.

The study, involving 14 physically active and healthy men and women, controlled for the effects of diet, previous physical activity, and sleep during the 24 hours prior to the test.

“If people wear face masks during indoor exercise, it might make the sessions safer and allow gyms to stay open during COVID,” said Phil Chilibeck, a professor in the USask College of Kinesiology, who was a co-author of the study. “It might also allow sports to continue, including hockey, where transmission of COVID-19 appears to be high.”

Participants were required to do a brief warm-up on a stationary bike. The exercise test involved a progressive increase in the intensity on the bike while they maintained a required pedal rate. Once they could not sustain the pedal rate the test was over.

“Usually a participant reaches exhaustion on this test in six to 12 minutes depending on their fitness level,” said Chilibeck.

The team assessed the participants, who did the test three times each, once wearing a surgical face mask, once wearing a cloth face mask and once with no face mask. The team recorded the participants’ blood oxygen levels and muscle oxygen levels throughout the test using non-invasive measurement tools.

Chilibeck notes the study is timely, as Saskatchewan has recently issued new public health orders that go into effect this week making masks mandatory in indoor public spaces in Regina, Saskatoon and Prince Albert to help curb the spread of COVID-19.

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Sperm don’t swim anything like we thought they did, new study finds

Under a microscope, human sperm seem to swim like wiggling eels, tails gyrating to and fro as they seek an egg to fertilize. 

But now, new 3D microscopy and high-speed video reveal that sperm don’t swim in this simple, symmetrical motion at all. Instead, they move with a rollicking spin that compensates for the fact that their tails actually beat only to one side. 

“It’s almost like if you’re a swimmer, but you could only wiggle your leg to one side,” said study author Hermes Gadêlha, a mathematician at the University of Bristol in the U.K. “If you did this in a swimming pool and you only did this to one side, you would always swim in circles. … Nature in its wisdom came [up] with a very complex, ingenious way to go forward.” 

Strange swimmers

The first person to observe human sperm close up was Antonie van Leeuwenhoek, a Dutch scientist known as the father of microbiology. In 1677, van Leeuwenhoek turned his newly developed microscope toward his own semen, seeing for the first time that the fluid was filled with tiny, wiggling cells. 

Under a 2D microscope, it was clear that the sperm were propelled by tails, which seemed to wiggle side-to-side as the sperm head rotated. For the next 343 years, this was the understanding of how human sperm moved. 

“[M]any scientists have postulated that there is likely to be a very important 3D element to how the sperm tail moves, but to date we have not had the technology to reliably make such measurements,” said Allan Pacey, a professor of andrology at the University of Sheffield in England, who was not involved in the research. 

The new research is thus a “significant step forward,” Pacey wrote in an email to Live Science. 

Gadêlha and his colleagues at the Universidad Nacional Autónoma de México started the research out of “blue-sky exploration,” Gadêlha said. Using microscopy techniques that allow for imaging in three dimensions and a high-speed camera that can capture 55,000 frames per second, they recorded human sperm swimming on a microscope slide. 

“What we found was something utterly surprising, because it completely broke with our belief system,” Gadêlha told Live Science. 

The sperm tails weren’t wiggling, whip-like, side-to-side. Instead, they could only beat in one direction. In order to wring forward motion out of this asymmetrical tail movement, the sperm head rotated with a jittery motion at the same time that the tail rotated.The head rotation and the tail are actually two separate movements controlled by two different cellular mechanisms, Gadêlha said. But when they combine, the result is something like a spinning otter or a rotating drill bit. Over the course of a 360-degree rotation, the one-side tail movement evens out, adding up to forward propulsion.

“The sperm is not even swimming, the sperm is drilling into the fluid,” Gadêlha said. 

The researchers published their findings today (July 31) in the journal Science Advances.

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Asymmetry and fertility

In technical terms, how the sperm moves is called precession, meaning it rotates around an axis, but that axis of rotation is changing. The planets do this in their rotational journeys around the sun, but a more familiar example might be a spinning top, which wobbles and dances about the floor as it rotates on its tip. 

“It’s important to note that on their journey to the egg that sperm will swim through a much more complex environment than the drop of fluid in which they were observed for this study,” Pacey said. “In the woman’s body, they will have to swim in narrow channels of very sticky fluid in the cervix, walls of undulating cells in the fallopian tubes, as well have to cope with muscular contractions and fluid being pushed along (by the wafting tops of cells called cilia) in the opposite direction to where they want to go. However, if they are indeed able to drill their way forward, I can now see in much better clarity how sperm might cope with this assault course in order to reach the egg and be able to get inside it,” Pacey said

Sperm motility, or ability to move, is one of the key metrics fertility doctors look at when assessing male fertility, Gadêlha said. The rolling of the sperm’s head isn’t currently considered in any of these metrics, but it’s possible that further study could reveal certain defects that disrupt this rotation, and thus stymy the sperm’s movement. 

Fertility clinics use 2D microscopy, and more work is needed to find out if 3D microscopy could benefit their analysis, Pacey said. 

“Certainly, any 3D approach would have to be quick, cheap and automated to have any clinical value,” he said. “But regardless of this, this paper is certainly a step in the right direction.”

Originally published in Live Science.

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‘Stay at home but don’t stay still,’ researchers recommend

The adverse side effects of the social isolation measures implemented to combat COVID-19 include an increase in sedentary behavior and physical inactivity, which can contribute to a deterioration in cardiovascular health even in the short term. Older people and people with chronic diseases tend to be most affected.

The warning comes from a review article published in the American Journal of Physiology by researchers at the University of São Paulo’s Medical School (FM-USP) in Brazil. According to the authors, the slogan “Stay at home” broadcast by governments and chief medical officers is unquestionably valid under the present circumstances but should be coupled with another: “Don’t stay still.”

“You need at least 150 minutes of moderate to vigorous physical activity per week to be considered active by the World Health Organization [WHO] and medical associations. Gyms, fitness centers and sports facilities will be open to a limited extent in the months ahead, even after confinement and quarantine measures are lifted. Physical activity in the home is a worthwhile alternative,” said Tiago Peçanha, first author of the article. Peçanha has a postdoctoral research scholarship from FAPESP.

The article reviews the scientific literature to compile evidence for the effects of short periods of physical inactivity on the cardiovascular system. Some of the studies cited show that between one and four weeks of bed rest can lead to cardiac atrophy and significant narrowing of peripheral blood vessels. Peçanha stressed that this is an aggressive model and does not reflect what happens during social confinement or quarantine. “However, other experiments reviewed in the article are a good match,” he said.

In one of these experiments, volunteers were asked to reduce their physical activity so that they took less than 5,000 steps in a week instead of more than 10,000 steps as usual. At the end of the period, the researchers observed a reduction in the diameter of the brachial artery (the main blood vessel in the arm), loss of blood vessel elasticity, and damage to the endothelium (the inner cell lining of all veins and arteries).

In other experiments, volunteers stayed seated for periods varying between three and six hours. This amount of inactivity was sufficient to cause vascular alterations, an increase in inflammation markers, and a rise in postprandial blood sugar.

“This first group of alterations observed in the studies have to do with functionality. In healthy volunteers, the heart and blood vessels function differently in response to inactivity,” Peçanha said. “In an extended period of inactivity, the alterations tend to become structural and are harder to reverse.”

Prolonged inactivity is particularly harmful for people with cardiovascular diseases and other chronic health problems, such as diabetes, hypertension, obesity or cancer. In older people, it can also aggravate loss of muscle mass (sarcopenia) and increase the risk of falls, fractures and other injuries. The FM-USP group recently published an article on this topic in the Journal of the American Geriatrics Society.

“These groups that are more vulnerable to the effects of inactivity are also high-risk groups for COVID-19 and will be staying at home for months. Ideally, they should find ways of staying active, such as doing housework, going up and down stairs, taking short walks, playing with children, or dancing in the living room,” Peçanha said. “The scientific evidence shows that getting exercise in the home is safe and effectively helps control blood pressure, reduces blood lipids, and improves body composition, quality of life and sleep.”

For high-risk groups, especially people who are not habitually active, Peçanha recommends supervision by health professionals, which can be performed remotely using cameras, smartphone apps and other electronic devices. “Studies show that an online environment favoring social support and interaction tends to motivate people to keep fit,” he said.

Fresh evidence

Data published in recent months by companies that sell smartwatches and exercise tracking apps suggest that the number of daily steps taken by users since the start of confinement has fallen.

“For example, Fitbit’s blog presents data for 30 million users showing a 7%-38% decline in daily step counts during the week ending March 22,” Peçanha said. “In Brazil, an internet survey by Raphael Ritti-Dias involving over 2,000 volunteers showed more than 60% saying they reduced their physical activity after the start of confinement or lockdown. All this evidence is preliminary, but studies are in progress to measure the effects on health of physical inactivity during social restrictions.”

One of these studies is being conducted at FM-USP as part of the Thematic Project “Reducing sedentary time in clinical populations: the Take A Stand For Health Study”. The principal investigator is Bruno Gualano, a co-author of the American Journal of Physiology article.

“We’re working with clinical groups associated with the Thematic Project, such as women with rheumatoid arthritis, patients submitted to bariatric surgery, and elderly subjects with mild cognitive impairment. They’re encouraged to take more exercise in the form of daily activities such as walking the dog or getting off the bus two stops prior to their destination. The effects on their health are being studied,” Peçanha said.

Since the implementation of social restrictions to contain the pandemic, the researchers have monitored a group of female rheumatoid arthritis patients more closely to measure their level of physical activity and compare it with the pre-pandemic level. “The patients are wearing accelerometers [electronic devices that measure physical activity and distance covered in a set period] at home,” Peçanha said. “We call them frequently to ask about quality of life and diet. A few researchers visit them at home to measure body weight, body composition and blood pressure and to take blood samples.”

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