When early humans began to travel out of Africa and spread into Eurasia over a hundred thousand years ago, a fertile region around the eastern Mediterranean Sea called the Levant served as a critical gateway between northern Africa and Eurasia. A new study, published in Geology, shows that the existence of that oasis depended almost entirely on something we almost never think about: dust.

Our bodies frequently heal wounds, like a cut or a scrape, on their own. However patients with diabetes, vascular disease, and skin disorders, sometimes have difficulty healing. This can lead to chronic wounds, which can severely impact quality of life. The management of chronic wounds is a major cost to healthcare systems, with the U.S alone spending an estimated 10-20 billion dollars per year. Still, we know very little about why some wounds become chronic, making it hard to develop effective therapeutics to promote healing. New research from Jefferson describes a novel way to sample the cells found at wounds — using discarded wound dressings. This non-invasive approach opens a window into the cellular composition of wounds, and an opportunity to identify characteristics of wounds likely to heal versus those that become chronic, as well as inform the development of targeted therapies.

•  Cerebral venous thrombosis (CVT) is a rare kind of stroke that is, however, on the rise
• CVT affects veins, rather than arteries in the brain
• The incidence of CVT is higher in young women and African Americans

Most strokes strike when an artery in the brain suddenly becomes blocked, but new research shows a rarer cause of strokes is becoming more common.

It’s called cerebral venous thrombosis (CVT), and it happens when a vein in the brain is clogged. While CVT is estimated to cause less than 1% of all strokes, scientists discovered it is now more prevalent and affecting a different demographic than previously thought.

Study author Dr Fadar Otite and his colleagues pored over years of hospital records from New York and Florida to find out how many cases of CVT occurred in these states between 2006 and 2016. Otite is an assistant professor of neurology at SUNY Upstate Medical University in Syracuse, New York.

Most common in young women

Based on the data they analysed, the researchers estimated that the number of CVT cases in the United States rose from around 14 cases per million in 2006 to 20 cases per million in 2014.

“We still find that the incidence of CVT is less than 1% of all strokes, even across our study period, but the incidence increased by 70% over time,” Otite said. “In 2006, the proportion of all strokes that were CVT was 0.47%. At the end of our study, which was in 2016, that proportion increased to 0.80%.”

CVT causes blood clots to form in the veins of the brain. These veins drain blood that has already been used by brain cells, sending it back to the heart to be replenished with oxygen. If a clot forms in one of these veins, it may leak into the surrounding brain tissue and could cause a stroke, the researchers explained.

While CVT is still most common in young women – about two-thirds of all CVT hospitalisations included in the study were in females – the researchers found that the number of cases among this demographic did not increase over the 10-year study period. Instead, they saw increases in CVT among men and older women.

“Part of the message is that we agree that CVT is still more common in women, but because of the diverse clinical presentation of CVT, when other symptoms that may be attributable to CVT are present in other demographics, we should take them with more seriousness,” Otite said.

Higher in African Americans

Another major finding was that CVT incidence in African American people was significantly higher than in other races. But why that is the case remains unknown. “We have no clear explanation, because this is truly the first study to ever relate the incidence of CVT between races,” he added.

Several factors may put one at a higher risk of developing CVT, including pregnancy and taking hormonal birth control pills, which may be why it is more common in younger women, the researchers noted.

And many of the risk factors for CVT – like blood clotting disorders or medications that cause clotting, severe dehydration, infections of the ear, face or neck, head trauma, obesity and cancer – are somewhat different from the triggers typically associated with stroke.

It is important for clinicians to be aware of this rise in CVT incidence because the condition can easily be confused with something else, Otite said. Patients with CVT may have unspecific complaints such as headaches, blurry vision or seizures.

Around 3% of patients in a prior study who had CVT and went to the hospital were diagnosed with something else and sent home, according to Otite. “So, it’s important to recognise this from the start, because by the next time the clinical condition may be worse,” he said.

A specific treatment

CVT can be treated with medication to thin the blood and help prevent further clotting, which may not be prescribed if the condition isn’t properly diagnosed, he added.

Dr Jose Biller, chair of the neurology department at Loyola University Medical Center in Hines, Illinois, said the takeaway from this study is that more attention should be paid to CVT.

“I think that there should be an increased awareness of cerebral venous thrombosis because, by and large, when people think about stroke, they don’t think about it,” Biller said. “There should be an increasing level of awareness because this is a condition that has a specific treatment.”

The study was published online on 26 August in the journal Neurology.

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• Prostate cancer is the second most common type of cancer in American men
• This kind of cancer usually grows slowly and doesn’t need aggressive treatment
• Men over 55 should consider being screened for prostate cancer

About one in nine men will be diagnosed with prostate cancer, but experts say early detection can be a lifesaver.

“Prostate cancer that is detected early, typically while it is still within the prostate gland, has a better chance of being successfully treated,” explained Dr Alexander Kutikov, chief of the Division of Urologic Oncology at Fox Chase Cancer Center in Philadelphia.

“Some types of prostate cancer are aggressive. However, most cancers are quite slow-growing, and a significant portion can be monitored without aggressive treatment,” he said in a Fox Chase news release.

Men aged 55–69 should consider prostate cancer screening, the American Urological Association says.

No symptoms in early stages

“Much debate has centred around screening for prostate cancer. Given the risks and benefits of screening, not every man should be screened for prostate cancer,” Kutikov said. “Men should talk to their health care provider about their risk factors, options and preferences. Together, they can make a decision.”

In the early stages, prostate cancer usually causes no symptoms. More advanced prostate cancer may cause: difficulty urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night; blood in urine or semen; pain or burning during urination; discomfort in the pelvic area; bone pain, or trouble getting an erection.

“Many of these symptoms can be caused by something other than prostate cancer. However, you should let your healthcare provider know if you show any signs so the cause may be determined and treated, if needed,” Kutikov said.

September is National Prostate Cancer Awareness month. Prostate cancer is the second most common type of cancer in American men, according to the American Cancer Society. It says there will be about 191 000 new prostate cancer cases and more than 33 000 prostate cancer deaths in the United States in 2020.

Risk factors for prostate cancer include: older age (about 60% of prostate cancers are diagnosed in men over 65); race/ethnicity (Black men and Caribbean men of African ancestry have higher prostate cancer rates than men of other races), and a family history of prostate cancer.

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• Asphalt heated by the sun contributes to air pollution
• Paved surfaces and rooftops constitute a majority of the exposed surface of urban areas
• The volatile organic compounds released by heated asphalt are harmful to humans and potentially carcinogenic

Asphalt baking in the summer sunshine is no fun for tender feet, but a new study suggests it’s not doing your lungs any favours either.

As it heats up, asphalt releases chemical compounds that contribute to air pollution. And its emissions double as its temperature increases from 104 to 140 degrees Fahrenheit (40 to 60 degrees Celsius), researchers found.

Sunlight plays a key role in these asphalt emissions, with even moderate levels of sunshine tripling the release of air pollutants, according to the study published on 2 September in the journal Science Advances.

The problem is likely to only grow worse as global warming increases, said lead researcher Drew Gentner, an associate professor of chemical and environmental engineering at the Yale School of Engineering and Applied Science, in New Haven, Connecticut.

Paved surfaces and rooftops

“Megacities are likely to see urban temperature increases driven by climate change and urban heat island effects, thus enhancing [asphalt’s] relative impact on urban air quality over time,” Gentner said. Urban heat islands are metropolitan areas that are a lot warmer than their rural surroundings because of human activity.

The United States typically goes through 27 million metric tons of petroleum-based liquid asphalt each year in paving, roofing and construction, the researchers said in background notes.

Paved surfaces and rooftops constitute a majority of the exposed surface of urban areas, they noted. At least 45% of urban areas are paved, and another 20% are covered by roofs.

In-use pavement usually gets as hot as between 117 and 153 degrees Fahrenheit (between 47 and 67 degrees Celsius) in the summer, while roofs can reach 167 degrees (75 degrees Celsius), the study authors said.

As the major contributors to air pollution get cut back – for example, through cleaner vehicle emissions – passive pollution sources like these will have a growing influence on the air we breathe, said Peter DeCarlo, an associate professor and air pollution expert with Johns Hopkins University, in Baltimore.

More volatile organic compounds

“In doing that reduction, we are discovering these new sources that are now playing a more prominent role in our air pollution issues,” DeCarlo said.

For the new study, Gentner and his colleagues gathered asphalt samples during road paving in New Haven and Pittsburgh, and from roofing products like asphalt shingles and sealant.

In the lab, the researchers exposed the samples to heat and sunlight in sealed chambers, and monitored the emissions coming off the asphalt.

The asphalt samples tended to produce more volatile organic compounds as they got hot, especially when exposed to sunlight, the investigators found.

Emissions doubled when the asphalt surface temperature increased from 104 to 140 degrees Fahrenheit (40 to 60 degrees Celsius) – temperatures that “occur in hot summertime conditions in many locations”, Gentner said. They then climbed by an average of 70% for every additional increase of 68 degrees Fahrenheit (20 degrees Celsius), the findings showed.

Potentially carcinogenic

“Temperature and solar radiation are key environmental factors that influence emissions, since they influence the evaporation and emission pathways related to solar exposure,” Gentner said.

On their own, volatile organic compounds are harmful to humans and potentially carcinogenic, according to the US National Institutes of Health.

They also contribute to urban smog, which forms when sunlight bakes volatile organic compounds combined with nitrogen oxides, DeCarlo explained.

“Summertime is when we have our biggest air pollution problems in urban areas,” DeCarlo said. “That’s when we have high ozone, it’s when we have the highest particulate matter, so this as a source of particulate matter is just another potential problem.”

Asphalt probably contributes most to air pollution when it’s freshly laid, DeCarlo added.

‘Cool pavement’ technology

During the paving process, asphalt is heated to as much as 248 to 320 degrees Fahrenheit (120 to 160 degrees Celius), the researchers said.

“If you’ve ever been around people laying asphalt, you smell it. It’s clear something is getting into the air when that happens,” DeCarlo said. But asphalt likely continues to emit air pollutants even after it’s aged, when sunlight bakes the material, he noted.

Switching to concrete for paving would help reduce emissions, he said, but concrete is not an ideal paving material in all locales.

Another possible solution might be the application of “cool pavement” technology, where coloured sealants are applied to paved surfaces so they reflect more solar energy and become less likely to heat up, Gentner said.

Emissions might also vary with different asphalt application methods and different formulations of the paving product, Gentner suggested.

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Hospital bosses warn that a lack of coronavirus tests for workers is putting services at risk.

• Plasma, which is a component of blood, helps people with immune deficiencies
• It supplies patients with the antibodies their immune system doesn’t produce naturally
• By donating plasma, we give someone with Primary Immunodeficiency a chance to live a normal life

Tens of thousands of people with immune system deficiencies could benefit from plasma donations, but there is a drastic shortage of plasma, allergists say.

That means that many people who need plasma have to skip treatments or go without, which can be potentially fatal, they added.

“Plasma, which is one component of blood, is a bit of a miracle cure,” said Dr J. Allen Meadows, allergist and president of the American College of Allergy, Asthma and Immunology (ACAAI).

Highly vulnerable to infections

“Allergists around the country treat a condition called Primary Immunodeficiency with a therapy made from plasma. Primary Immunodeficiency is a group of inherited immune deficiencies that leave those affected unable to produce antibodies, making them highly vulnerable to infections,” Meadows explained in an ACAAI news release.

“Immune globulin (IG) infusions, made from plasma, give those with immune deficiencies the antibodies their immune system does not produce naturally. That helps protect them from infections,” he said.

Did you know:

• It takes 130 plasma donations or more per year to treat one patient with Primary Immunodeficiency. Ten to 40 donations make up a single dose of gamma globulin. There are 1 500 to 50 000 units of plasma in one batch.
• Plasma donations are not like blood donations, which are mostly used for surgery. The need for plasma is constant.
• It’s possible to get some plasma from a blood donation, but plasma-only donation gives about twice as much. You can donate plasma more often than whole blood.
• Donating plasma is safe.

“Plasma donation is a gift of life,” Meadows said. “When you donate plasma, you are giving a patient with Primary Immunodeficiency a chance to ward off infections and live a normal life.”

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• People with inflammatory forms of arthritis aren’t more likely to be hospitalised as a result of Covid-19 
• Many with autoimmune diseases, however, take immunosuppressant drugs 
• A new study has found, though, that immunosuppressant therapy doesn’t increase one’s risk of being hospitalised due to Covid-19

People with lupus aren’t at increased risk of hospitalisation from Covid-19 due to steroidal medications they take to reduce immune system activity, a new study finds.

And a related study found that people with inflammatory forms of arthritis – such as rheumatoid arthritis – aren’t more likely to be hospitalised with Covid-19 than people without arthritis.

Both studies were led by researchers at NYU Grossman School of Medicine, in New York City.

Autoimmune diseases

The findings “should reassure most patients, especially those on immunosuppressant therapy, that they are at no greater risk of having to be admitted to hospital from Covid-19 than other lupus or arthritis patients,” Dr Ruth Fernandez-Ruiz, co-author of the studies, said in an NYU Langone news release.

“People with lupus or inflammatory arthritis have the same risk factors for getting seriously ill from Covid-19 as people without these disorders,” said Fernandez-Ruiz, a postdoctoral fellow in rheumatology.

Lupus and conditions like rheumatoid arthritis, psoriatic arthritis and spondyloarthritis are autoimmune diseases in which the immune system mistakenly attacks a person’s own tissues. This causes inflammation in the joints, skin, kidneys and other parts of the body.

The researchers found that lupus patients taking immune-suppressing medications – such as mycophenolate mofetil (CellCept) and azathioprine (Imuran) – had no greater risk of hospitalisation (15 out of 24) than lupus patients not using the medications (nine of 17).

Dangers of glucocorticoids

In addition, the Covid-19 hospitalisation rate for people with inflammatory arthritis (26%) was similar to that of New York City residents overall (25%).

Another finding was that patients taking biologic drugs for arthritis, such as adalimumab (Humira) and etanercept (Enbrel), or the antiviral hydroxychloroquine, had no greater or lower risk of Covid-19 hospitalisation than those not taking the drugs.

But patients who took steroids called glucocorticoids, even in mild doses, had a 10 times higher risk of Covid-19 hospitalisation than those who didn’t take steroids. Although the finding is statistically significant, the study’s small size may overestimate the actual risk, the researchers noted.

The studies were recently published online in the journal Arthritis and Rheumatology.

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