Health24.com | ‘Aerosol boxes’ meant to protect Covid health teams might harm them

  • Aerosol containment methods may not be protecting health workers against SARS-CoV-2 as touted
  • The effectiveness of such devices was never properly tested
  • It was found that the aerosol box actually increases exposure to virus particles – by up to five times 

Aerosol boxes meant to protect health care workers when they intubate Covid-19 patients may actually increase their exposure to airborne virus particles, an Australian study warns.

Intubation is done when patients are placed on a ventilator.

Aerosol boxes have been touted as a quick, simple way to protect workers, but their effectiveness and safety were never clinically tested. No international guideline on personal protective equipment has endorsed their use.

Even though experts have raised concern that the devices may put health care workers at risk, they are in use worldwide.

Increased exposure to virus particles

In this study, researchers tested the effectiveness of five aerosol containment methods (aerosol box; sealed box with and without suction; vertical drape; and horizontal drape) compared with no intervention.

Volunteers held a bottle of harmless fluid just under their mouth, and coughed every 30 seconds. Detection devices were used to count different-sized airborne particles and assess particle spread for five minutes.

Compared with using no containment device, exposure to airborne particles of all sizes was higher when an aerosol box was used, the study found.

If Covid-19 particles act the same way as the fluid used in this simulation, the results suggest the aerosol box increases exposure to virus particles – in some cases by a factor of five times or more, according to findings published on in July in the journal Anaesthesia.

The investigation was conducted by a team at Intensive Care and Anaesthesia Specialists at Eastern Health in Melbourne. Peter Chan and Joanna Simpson, who led the effort, said the research team was surprised by the findings.

Minimal to no benefit

“Spikes of airborne particles were clearly seen, coinciding with patient coughing. We believe that these represent particles escaping from the arm access holes in the aerosol box,” the researchers reported.

The race to provide protective equipment has resulted in a variety of devices, but evidence of their safety and effectiveness has been lacking, the study authors said.

“This study demonstrates that devices such as the aerosol box we tested – which is typical of designs used worldwide – confer minimal to no benefit in containing aerosols during an aerosol-generating procedure and may increase rather than decrease airborne particle exposure,” the authors concluded.

In a journal news release, Chan said if the aerosol box were sold as a product and regulated, it would probably need to be recalled immediately due to the potential infection risk for healthcare workers.

“Unfortunately, because these devices have been donated and are not regulated in any way, healthcare workers might be continuing to increase their exposure to Covid-19 while thinking they are protecting themselves,” he added.

Image credit: Getty Images

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Health24.com | Gynaecological cancers not a risk for severe Covid-19

  • Women with gynaecological cancer may fear that they are more susceptible to Covid-19
  • A new study, however, revealed that these women were not more affected than those who only had Covid-19
  • The study could change the theory that cancer patients face worse odds when infected with Covid-19

Despite rampant fears that cancer patients are at higher risk of having severe cases of Covid-19, a new study suggests gynaecologic cancers do not boost the chances of hospitalisation or death.

“Our study should be reassuring for women with gynaecologic cancers who are worried that having cancer increases their risk of becoming seriously ill if they go to the hospital because of Covid-19,” said lead investigator Olivia Lara, an oncology fellow at NYU Langone’s Perlmutter Cancer Center.

For the study, Lara’s team reviewed the medical records of 121 women, aged 51 to 63, being treated simultaneously for gynaecologic cancers and Covid-19 in New York City between March and April.

The results, published online in July in the journal Cancer, revealed that these women had similar hospitalisation rates and death as those who only had Covid-19.

Only a mild form of the disease

More than half of the study patients required hospitalisation, and among those hospitalised one-quarter died, amounting to a 14% death rate.

The death rate among this sample is comparable to the 21% death rate identified in another study, which included 5 700 hospitalised Covid-19 patients in the city, the study authors noted.

The study could potentially alter the theory that cancer patients face worse odds when infected with Covid-19.

A full 75% of the women with gynaecological cancer experienced only a mild form of the disease, according to the report.

The women’s risk of dying from Covid-19 did not increase even if they had late-stage cancer, cancer surgery or high-dose chemotherapy, the study authors said in a New York University news release.

Sample size too small

Still, one risk factor related to cancer treatment seemed to increase the odds of death.

Women receiving immunotherapy – treatment that uses a person’s own immune system to fight cancer – were three times more likely to die than women who received standard cancer treatments such as radiation, surgery or chemotherapy.

But only eight out of the 121 participants included in the study were treated with immunotherapy, prompting the study authors to stress that the sample was too small to make any conclusions based on this finding.

The results do underscore the importance of receiving cancer screenings and treatments, despite Covid-19 fears.

“The basic rules of cancer care have not changed during the pandemic,” study senior investigator Dr Bhavana Pothuri said in the news release. “Early detection, screening and care lead to more people surviving what remains a leading cause of death among American women.”

Image credit: Getty Images

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Differing diets of bonobo groups may offer insights into how culture is created

Human societies developed food preferences based on a blend of what was available and what the group decided it liked most. Those predilections were then passed along as part of the set of socially learned behaviors, values, knowledge, and customs that make up culture. Besides humans, many other social animals are believed to exhibit forms of culture in various ways, too.

In fact, according to a new study led by Harvard primatologists Liran Samuni and Martin Surbeck, bonobos, one of our closest living relatives, could be the latest addition to the list.

The research, published today in eLife, is the result of a five-year examination of the hunting and feeding habits of two neighboring groups of bonobos at the Kokolopori Bonobo Reserve in the Democratic Republic of Congo. They looked at whether ecological and social factors influence those habits. Four of those years were spent tracking the neighboring groups of great apes using GPS and some old-fashioned leg work to record each time they hunted.

Analyzing the data, the scientists saw many similarities in the lives of the two bonobo groups, given the names the Ekalakala and the Kokoalongo. Both roam the same territory, roughly 22 square miles of forest. Both wake up and fall asleep in the bird-like nests they build after traveling all day. And, most importantly, both have the access and opportunity to hunt the same kind of prey. This, however, is precisely where researchers noticed a striking difference.

The groups consistently preferred to hunt and feast on two different types of prey. The Ekalakala group almost always went after a type of squirrel-like rodent called an anomalure that is capable of gliding through the air from tree to tree. The Kokoalongo group, on the other hand, favored a small to medium-sized antelope called a duiker that lives on the forest floor.

“The idea is that if our closest living relatives, chimpanzees and bonobos, both have some cultural traits, then [it’s likely] our ancestors already had some capacity for culture.” — Liran Samuni

Out of 59 hunts between August 2016 and January 2020, the Ekalakala captured and ate 31 anomalure, going after duikers only once. Kokoalongo ate 11 duikers in that time and only three gliding rodents.

“It’s basically like two cultures exploiting a common resource in different ways,” said Samuni, a postdoctoral fellow in Harvard’s Pan Lab and the paper’s lead author. “Think about two human cultures living very close to each other but having different preferences: one preferring chicken more while the other culture is more of a beef-eating culture. … That’s kind of what we see.”

Using statistical modeling, the scientists found this behavior happens independent of factors like the location of the hunts, their timing, or the season. They also found the preference wasn’t influenced by hunting party size or group cohesion. In fact, the researchers’ model found that the only variable that could reliably predict prey preference was whether the hunters were team Ekalakala or team Kokoalongo.

The researchers make clear in the paper that they didn’t investigate how the bonobo groups learned this hunting preference, but through their analysis they were able to rule out ecological factors or genetic differences between the two groups. Basically, it means all evidence points toward this being a learned social behavior.

“It’s the same population, and it’s neighboring communities,” said Surbeck, an assistant professor in the Department of Human Evolutionary Biology and the paper’s senior author. He founded and directs the Kokolopori Bonobo Research Project. “These two communities basically live in the same exact forest. They use the exact same places, but, nevertheless, they show these differences.”

The paper amounts to what’s believed to be the strongest evidence of cultural behavior in this primate species.

The researchers believe this paper is only the tip of the iceberg and are already planning the next part of the work: looking at how the bonobo groups learned these behaviors.

One of the main goals driving this work is helping characterize the cultural capabilities of the last common ancestor between humans and our two closely related great ape cousins.

“The idea is that if our closest living relatives, chimpanzees and bonobos, both have some cultural traits, then [it’s likely] our ancestors already had some capacity for culture,” Samuni said.

Bonobos can play a special role in this mystery. Like chimpanzees, which they are often mistaken for, bonobos share 99 percent of their DNA with humans. Bonobos are often seen as less aggressive and territorial, however, favoring sex in various partner combinations over fighting. Chimp groups, on the other hand, sometimes battle when they meet in the wild, occasionally to the death.

Different Bonobo population groups are known to interact and even share meals, which along with their socio-sexual behavior has earn them the moniker “hippie apes.” It’s those free love and peace traits that make them prime for this type of study since scientists can observe two neighboring bonobo groups to distinguish whether a behavior that differs between two groups that interact regularly comes about because of some sort of a learning mechanism (or social preference) or because the environment dictates it, the researchers said.

The authors of the paper were not much surprised by their findings.

They had noticed this hunting preference anecdotally, and it’s already believed that bonobos have subtle cultural traits. After all, a number of social animals display cultural behavior, especially when it comes to feeding habits. Chimps teach their young to use sticks to fish for termites. Dolphin mothers teach offspring to fit marine sponges to their noses to protect them as they forage on the seafloor.

What excites the researchers about this discovery, however, is that it shows the value of studying this often-overlooked endangered species and diving into its culture.

“They’re like the missing puzzle piece,” Surbeck said.

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Study tracks human milk nutrients in infant microbiome

A new study in mice helps explain why gut microbiomes of breastfed infants can differ greatly from those of formula-fed infants.

The study, “Dietary Sphinganine Is Selectively Assimilated by Members of the Mammalian Gut Microbiome,” was published in July in the Journal of Lipid Research.

Sphinganine from milk Johnson Lab/Provided A new technique allows researchers to track specific nutrients as they are taken up by gut microbes in a mouse’s digestive tract. The image shows certain microbes (red) taking in a nutrient common in human milk called sphinganine; blue microbes have not taken it in.

The paper describes an innovative technique developed at Cornell to track the fate of metabolites — nutrients formed in or necessary for metabolism — through a mouse’s digestive tract and identify how they interact with specific gut microbes.

“We think the methods are expandable to many different microbiome systems,” said senior author Elizabeth Johnson, assistant professor of nutritional sciences in the College of Agriculture and Life Sciences. She noted that researchers investigating effects of a high-fat vs. low-fat diet, or a keto diet, might use the technique to track metabolites.

The methodology could reveal how specific metabolites promote specific bacteria. This could allow nutritionists to prescribe that patients eat foods containing specific metabolites to intentionally change the composition of their microbiomes, Johnson said.

Human milk and many other foods contain a class of lipid metabolites called sphingolipids. Previous research suggested that these metabolites help shape an infant’s microbiome, but it was not known if they actually interact with the microbiome.

The study identified two types of gut microbes, Bacteroides and Bifidobacterium, that use sphingolipids for their own metabolism.

While very little is known about the specific roles of gut microbes in human health, Bacteroides have been implicated in both beneficial and not-so-beneficial effects, depending on context. They are generally associated with microbiomes of healthy breastfed infants. Bifidobacterium, shown for the first time in this study to process dietary sphingolipids, are considered the quintessential beneficial bacteria, comprising up to 95% of breastfed infants microbiome.

They’re also a highly popular over-the-counter probiotic.

“Our lab is very interested in how the diet interacts with the microbiome in order to really understand how you can best modulate it to have positive effects on health,” Johnson said. “In this study, we were able to see that yes, these dietary lipids that are a big part of [breastfed] infants diets, are interacting quite robustly with the gut microbiome.”

Sphingolipids originate from three main sources: diet; bacteria that can produce them; and most host tissues.

Johnson, along with first author Min-Ting Lee, a doctoral student, and Henry Le, a postdoctoral researcher, both in Johnson’s lab, created a technique to specifically track dietary sphingolipids as they passed through the mouse gut.

“We custom synthesized the sphingolipid we added to the diet,” Johnson said. “It is almost identical to ones derived from breast milk but with a small chemical tag so we could trace the location of the sphingolipid once it was ingested by the mice.”

Lee then used a fluorescent label that attached to cells or microbes that absorbed the tagged lipid, such that any bacteria that had taken up sphingolipids lit up red. Microbes from the mice’s microbiomes were then isolated and analyzed. Populations with red microbes were separated from the others, and these were then genetically sequenced to identify the species of bacteria.

With further investigation, Le was able to identify the metabolites that Bacteroides and Bifidobacterium produce when exposed to dietary sphingolipids. Further investigations are underway to determine whether these microbially-produced metabolites are beneficial for infant health.

Johnson recently received a five-year, $1.9 million Maximizing Investigators’ Research Award from the National Institutes of Health (NIH) to expand on this work, to better understand how lipid-dependent host-microbe interactions affect human health..

The study was supported by seed funds from the Genomics Facility of the Biotechnology Resource Center at Cornell’s Institute of Biotechnology.

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Materials provided by Cornell University. Original written by Krishna Ramanujan. Note: Content may be edited for style and length.

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Small fish populations accumulate harmful mutations that shorten lifespan

Population bottlenecks contribute to the accumulation of several harmful mutations that cause age-related illnesses in killifish — a finding that may help answer a key question about aging.

The study, published today in eLife, reveals why killifish accumulate harmful mutations that cause age-related conditions such as cancer or neurodegenerative diseases that shorten lifespan. This may help scientists better understand how lifespan evolves among populations and may lead to new insights on human aging.

The very short lives of turquoise killifish — between three and nine months — make them an ideal model for studying aging. Killifish live in temporary ponds in Africa that dry up for part of the year, meaning they must hatch, mature and reproduce before this happens. Their eggs survive the dry periods in a hibernation-like state and hatch when rains fill the pond again, starting a new generation.

“Different wild turquoise killifish populations have varying lifespans, and we wanted to explore the reasons behind this,” explains lead author David Willemsen, Postdoctoral Research Fellow at the Max Planck Institute for Biology of Ageing, Cologne, Germany.

For their study, Willemsen and senior author Dario Riccardo Valenzano carried out field work in savanna pools in Zimbabwe to catch and collect genome samples from the killifish for sequencing and analysing in the lab. The team then compared the genomes of killifish living in the driest environments, which have the shortest lives, with the genomes of killifish from wetter environments, which live for months longer.

The short-lived killifish have very small, often isolated populations, leading to so-called population bottlenecks which, the team found, result in harmful mutations accumulating in their populations. By contrast, the longer-lived killifish have larger populations and new fish with new genetic material frequently join their populations. Over time, these larger populations make it more efficient for natural selection to remove harmful mutations.

“Limited population sizes caused by habitat fragmentation and repeated population bottlenecks increase the chance for harmful mutations to accumulate in the population,” Willemsen says. “Our work may help answer a key question about aging by suggesting that population dynamics, rather than evolutionary selection for or against specific genes, contribute to this accumulation of harmful mutations that result in aging and shorter life.”

The results support a model where, given the brief rainy seasons, killifish are under strong selective constraints to survive in the absence of water as dormant embryos and to rapidly reach sexual maturation and reproduce before the water completely evaporates. However, the team believes that killifish are not selected to be short-lived. Instead, harmful mutations that affect late-life survival and reproduction (together causing aging in the killifish) accumulate over generations without being constrained by selection.

“Harmful mutations passively accumulate in killifish populations, and this is even more prominent in smaller populations which happen to live in drier environments,” says senior author Dario Riccardo Valenzano, Group Leader at the Max Planck Institute for Biology and Ageing, and Principle Investigator at CECAD, the Cluster of Excellence for Ageing Research at the University of Cologne, Germany. “Our findings highlight the role of demographic constraints in shaping lifespan within species and could potentially be expanded to provide new insights on aging within other animal and human populations.”

Story Source:

Materials provided by eLife. Note: Content may be edited for style and length.

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Will You Ring the Bell?

During Navy SEALs training, which is really tough, recruits can quit by ringing a bell three times. Then they get a shower and a hot meal, and they’re done with the struggle.

No more physical ordeals. No more being wet and sandy. No more sleep deprivation.

And no more opportunity to be part of a SEAL team.

Afterwards the recruits who quit can offer up any reasons they want, but it doesn’t matter in terms of results. They’ve demonstrated that they will give up on the team, so the team grows stronger when they leave.

SEAL training, especially hell week, is a filter. It separates the quitters from the committed. It separates those who align with the team from those who don’t.

The SEALs have a sense of the giant pumpkins they’re looking for, including people who won’t mentally or emotionally quit no matter what, so their training tries to filter for people with the qualities they want. It isn’t perfect, but it does filter out of a lot of people who wouldn’t be good matches for the SEALs.

While you could say that these are values-based filters, they’re really behavioral filters. It doesn’t matter why someone rings the bell – only that they ring it. It doesn’t matter why someone refuses to quit – only that they never ring the bell. Ringing the bell is a simple binary behavioral test. Quit or don’t quit.

The SEALs don’t need to do complex testing for values alignment. They can just have a simple test to see who quits and who doesn’t. They let the quitters go, and they invest in those who stay. This way they end up with a fairly aligned group – a group full of people who resist quitting.

Throughout the rest of the training, there are many more tests. At each point people either pass or they don’t. The training could be seen as a series of binary challenges.

I share this because I invite you to think of this as a lens or frame for considering some of your real-life challenges. I don’t recommend using this as your one-and-only frame, but it’s a nice one for simplifying the way you look at complex problems and cutting to the core issues quickly.

How many challenges can you reduce to binary pass-or-fail tests?

Fill in the blank: You either ______, or you rang the bell.

  • started your own business
  • asked for the date
  • wrote the book
  • took the trip
  • completed the project
  • completed the 30-day challenge
  • did the workout
  • spoke your truth
  • unfriended the Trump supporter
  • finished the song
  • seized the opportunity
  • built the website
  • launched the course
  • earned the degree

Think of a goal or challenge you’re currently facing. How does it look when you reduce it to a binary challenge? Get it done, or ring the bell. Does this help you see what kind of commitment you’ll need to avoid ringing the bell?

My 365-day blogging challenge can be reduced to a binary, pass-or-fail test. All I have to do to succeed is not ring the bell any day this year. Every day the choice is simple: create or quit. Either I ring the bell, or I don’t.

Is it always bad to ring the bell? No, sometimes it’s the right move. You just have to consider how you’ll feel about it afterwards. What meaning will you assign to it?

Ringing the bell can mean years of regret, or it could mean something very positive. You have to consider ringing the bell in the context of your big picture framing.

After six years in Toastmasters, I rang the bell and quit. To me that represented a graduation. It was a success. I had invested six years in the club and went from 7-minute speeches to designing and delivering 3-day workshops on the Vegas Strip. So that particular bell produced a glorious ringing sound to celebrate the journey and what it meant to me.

Ringing the bell on my computer games business after 10 years gave me mixed feelings. It was part joy and part sadness – the death of the old and the birth of the new. It was still a positive meaning overall but very different from leaving Toastmasters.

Note also that some people will view your bell ringing differently than you do – and differently from each other. When I left the computer games field, some people treated it like a failure while others congratulated me for making the change.

One interesting way to think about your personal relationships is to ask: What kind of person will never ring the bell on you? Who is capable of being your true, long-term friend?

This loops back to the recent article on Fragile vs Resilient Relationships. A fragile relationship will lead to someone ringing the bell and quitting. A resilient relationship is one where no one will ring the bell.

Truthfully you will have to ring the bell sometimes. You have to quit the misaligned, so you can find what’s truly commitment-worthy for you. You could see life as a process of discovering those deeper commitments where ringing the bell is simply not an option.

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Coronavirus: Bolton asks for restrictions to remain after spike

Bolton Council says the infection rate means tighter measures should remain in place.

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Tens of thousands of Scottish pupils absent from school

More than 100,000 pupils are not in class – mostly for non-Covid reasons, official figures show.

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Health24.com | Stressful days, worse blood sugar control for people with diabetes

  • Stress can make the management of diabetes a lot harder
  • This is because stress causes the secretion of cortisol, which pushes up blood sugar levels and lowers insulin
  • It is all part of the body’s ‘fight or flight’ response

When something as routine as grocery shopping might lead to a deadly Covid-19 infection, stress is inevitable – and that extra tension can make it harder for people with diabetes to manage their disease.

The reason? The stress hormone cortisol is linked to higher blood sugar levels, according to a new study.

Under stress, the body releases cortisol, which leads to an increase in blood sugar and a decrease in insulin (the hormone that helps process that sugar).

Cortisol levels naturally fluctuate

“This is all part of the fight-or-flight response. You need sugar if you want to run from, let’s say, a bear. To prepare for that, your body needs to make energy, so it releases cortisol,” explained study author Dr Joshua Joseph. He’s an endocrinologist at the Diabetes and Metabolism Research Center at The Ohio State Wexner Medical Center, in Columbus.

Cortisol levels naturally fluctuate. They’re highest in the morning as you rise, and usually fall at night, Joseph said. But in people with diabetes, cortisol levels stayed steadier throughout the night, his team found.

The researchers noted that past studies have linked stress and depression to a steadier cortisol level.

The study included data from more than 2 000 participants, aged 45 to 84, who were followed over six years. The investigators found that people with diabetes who had steadier cortisol levels (indicating stress) tended also to have higher blood sugar (glucose) levels.

“Cortisol is driving glucose changes, and it does make diabetes much harder to control. Naturally, cortisol levels should be going lower in the evening. But people with stress have higher cortisol levels and blood sugar at night. Cortisol also makes you want to eat, and when you’re stressed, you’re not reaching for the carrots and broccoli – you’re reaching for high-carbohydrate, high-sugar foods,” Joseph said.

Inability to use insulin effectively

Over time, higher blood sugar levels can lead to serious complications of diabetes, such as vision problems, heart disease and kidney disease. Joseph said it also appears that constant higher blood sugar levels might make people more susceptible to complications from a Covid-19 infection, though there aren’t yet studies to prove it.

Dr Akankasha Goyal, an endocrinologist at NYU Langone Health in New York City, reviewed the new study findings. She described cortisol as a “double whammy”.

“It increases glucose production, and it decreases insulin from the pancreas,” she said. “And, in patients with type 2 diabetes, at baseline, their bodies are unable to use insulin effectively and their glucose levels are higher.”

Goyal said the study is proof of what many patients already knew: that stress can worsen blood sugar control. The findings may help motivate people to take steps to control their stress, she added.

“Stress relief is medication without side effects,” Goyal said. “Exercise if you can. Walk, yoga, tai chi or lift some dumbbells. Do mindful activities, paint, read a book – anything that slows down and quiets the mind.”

Ease your stress

Joseph and other researchers at Ohio State are recruiting diabetes patients for a study to see if mindfulness practices improve blood sugar management. People with diabetes need to focus on stress relief as part of managing their disease, he said.

“To ease stress, maintain healthy social support, get regular exercise, sleep seven to eight hours a night, practise mindfulness, meditation, yoga, listen to music and eat a healthy diet,” Joseph suggested.

The study was published online in July in the journal Psychoneuroendocrinology.

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Shake diet offered on NHS to fight type 2 diabetes

Thousands more people in England will be encouraged to try the weight loss plan.

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