Two studies analyze survivors exposed to radiation after the Chernobyl accident, and their children

AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE

Research News

 

Children whose parents had been exposed to radiation from the Chernobyl Nuclear Power Plant accident in 1986 had no excess germline mutations, a new whole-genome sequencing study shows. "This is one of the first studies to systematically evaluate alterations in human mutation rates in response to a man-made disaster, such as accidental radiation exposure," say the authors. Effects of radiation exposure from the Chernobyl nuclear accident, which occurred at a power plant in Ukraine in April 1986, remain a topic of interest. To date, there have been several studies examining transgenerational risks of radiation exposure from events such as this, but the results have been inconclusive. What's more, no large comprehensive effort has explored germline de novo mutations genome-wide in children born from parents exposed to moderately high amounts of ionizing radiation, even as possible genetic effects from such events have remained a concern for radiation-exposed populations like the Fukushima evacuees. To examine whether rates of germline de novo mutations are elevated in children born to parents exposed to ionizing radiation, Meredith Yeager et al. analyzed the genomes of 130 children and parents from families where one or both parents had experienced gonadal radiation exposure related to the Chernobyl accident and where the children were conceived after the accident - and born between 1987 and 2002. The authors did not find an increase in new germline mutations in this population. The incidence of germline de novo mutations was comparable to that reported in the general population, they say. "[O]ur study does not provide support for a transgenerational effect of ionizing radiation on germline DNA in humans," they conclude.

In a second study examining the effects of radioactive fallout on survivors of the Chernobyl nuclear accident, researchers provide more insights into the process of radiation-induced papillary thyroid cancers - one of the most frequent cancers observed after the Chernobyl event. "These findings substantially extend preliminary reports of radiation-related human tumor characteristics by integrating data from multiple platforms with large sample size and detailed radiation dose data," the authors say. Exposure to radioactive fallout increases the risk of cancer, particularly papillary thyroid carcinoma (PTC). However, a detailed molecular understanding of these tumors is still lacking, and there are no established markers of radiation-induced cancers. Lindsay Morton et al. analyzed thyroid tumors, normal thyroid tissue, and blood from hundreds of survivors of the Chernobyl nuclear accident and compared them to those of unexposed patients. While no unique radiation-related biomarker was identified, the results reveal radiation dose-related increases in DNA double-strand breaks in human thyroid cancers developing after the Chernobyl accident. Radiation-related genomic alterations were more pronounced for those younger at exposure, the authors say. Their results suggest that thyroid tumor development following radiation exposure results from DNA double-strand breaks in the genome. The authors say their results have implications for radiation protection and public health, particularly for low dose exposure.

NEWS RELEASE 22-APR-2021

International research teams explore genetic effects of Chernobyl radiation

NIH/NATIONAL CANCER INSTITUTE

Research News

 

In two landmark studies, researchers have used cutting-edge genomic tools to investigate the potential health effects of exposure to ionizing radiation, a known carcinogen, from the 1986 accident at the Chernobyl nuclear power plant in northern Ukraine. One study found no evidence that radiation exposure to parents resulted in new genetic changes being passed from parent to child. The second study documented the genetic changes in the tumors of people who developed thyroid cancer after being exposed as children or fetuses to the radiation released by the accident.

The findings, published around the 35th anniversary of the disaster, are from international teams of investigators led by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health. The studies were published online in Science on April 22.

"Scientific questions about the effects of radiation on human health have been investigated since the atomic bombings of Hiroshima and Nagasaki and have been raised again by Chernobyl and by the nuclear accident that followed the tsunami in Fukushima, Japan," said Stephen J. Chanock, M.D., director of NCI's Division of Cancer Epidemiology and Genetics (DCEG). "In recent years, advances in DNA sequencing technology have enabled us to begin to address some of the important questions, in part through comprehensive genomic analyses carried out in well-designed epidemiological studies."

The Chernobyl accident exposed millions of people in the surrounding region to radioactive contaminants. Studies have provided much of today's knowledge about cancers caused by radiation exposures from nuclear power plant accidents. The new research builds on this foundation using next-generation DNA sequencing and other genomic characterization tools to analyze biospecimens from people in Ukraine who were affected by the disaster.

The first study investigated the long-standing question of whether radiation exposure results in genetic changes that can be passed from parent to offspring, as has been suggested by some studies in animals. To answer this question, Dr. Chanock and his colleagues analyzed the complete genomes of 130 people born between 1987 and 2002 and their 105 mother-father pairs.

One or both of the parents had been workers who helped clean up from the accident or had been evacuated because they lived in close proximity to the accident site. Each parent was evaluated for protracted exposure to ionizing radiation, which may have occurred through the consumption of contaminated milk (that is, milk from cows that grazed on pastures that had been contaminated by radioactive fallout). The mothers and fathers experienced a range of radiation doses.

The researchers analyzed the genomes of adult children for an increase in a particular type of inherited genetic change known as de novo mutations. De novo mutations are genetic changes that arise randomly in a person's gametes (sperm and eggs) and can be transmitted to their offspring but are not observed in the parents.

For the range of radiation exposures experienced by the parents in the study, there was no evidence from the whole-genome sequencing data of an increase in the number or types of de novo mutations in their children born between 46 weeks and 15 years after the accident. The number of de novo mutations observed in these children were highly similar to those of the general population with comparable characteristics. As a result, the findings suggest that the ionizing radiation exposure from the accident had a minimal, if any, impact on the health of the subsequent generation.

"We view these results as very reassuring for people who were living in Fukushima at the time of the accident in 2011," said Dr. Chanock. "The radiation doses in Japan are known to have been lower than those recorded at Chernobyl."

In the second study, researchers used next-generation sequencing to profile the genetic changes in thyroid cancers that developed in 359 people exposed as children or in utero to ionizing radiation from radioactive iodine (I-131) released by the Chernobyl nuclear accident and in 81 unexposed individuals born more than nine months after the accident. Increased risk of thyroid cancer has been one of the most important adverse health effects observed after the accident.

The energy from ionizing radiation breaks the chemical bonds in DNA, resulting in a number of different types of damage. The new study highlights the importance of a particular kind of DNA damage that involves breaks in both DNA strands in the thyroid tumors. The association between DNA double-strand breaks and radiation exposure was stronger for children exposed at younger ages.

Next, the researchers identified the candidate "drivers" of the cancer in each tumor -- the key genes in which alterations enabled the cancers to grow and survive. They identified the drivers in more than 95% of the tumors. Nearly all the alterations involved genes in the same signaling pathway, called the mitogen-activated protein kinase (MAPK) pathway, including the genes BRAF, RAS, and RET.

The set of affected genes is similar to what has been reported in previous studies of thyroid cancer. However, the researchers observed a shift in the distribution of the types of mutations in the genes. Specifically, in the Chernobyl study, thyroid cancers that occurred in people exposed to higher radiation doses as children were more likely to result from gene fusions (when both strands of DNA are broken and then the wrong pieces are joined back together), whereas those in unexposed people or those exposed to low levels of radiation were more likely to result from point mutations (single base-pair changes in a key part of a gene).

The results suggest that DNA double-strand breaks may be an early genetic change following exposure to radiation in the environment that subsequently enables the growth of thyroid cancers. Their findings provide a foundation for further studies of radiation-induced cancers, particularly those that involve differences in risk as a function of both dose and age, the researchers added.

"An exciting aspect of this research was the opportunity to link the genomic characteristics of the tumor with information about the radiation dose -- the risk factor that potentially caused the cancer," said Lindsay M. Morton, Ph.D., deputy chief of the Radiation Epidemiology Branch in DCEG, who led the study.

"The Cancer Genome Atlas set the standard for how to comprehensively profile tumor characteristics," Dr. Morton continued. "We extended that approach to complete the first large genomic landscape study in which the potential carcinogenic exposure was well-characterized, enabling us to investigate the relationship between specific tumor characteristics and radiation dose."

She noted that the study was made possible by the creation of the Chernobyl Tissue Bank about two decades ago -- long before the technology had been developed to conduct the kind of genomic and molecular studies that are common today.

"These studies represent the first time our group has done molecular studies using the biospecimens that were collected by our colleagues in Ukraine," Dr. Morton said. "The tissue bank was set up by visionary scientists to collect tumor samples from residents in highly contaminated regions who developed thyroid cancer. These scientists recognized that there would be substantial advances in technology in the future, and the research community is now benefiting from their foresight."

###

About the National Cancer Institute (NCI): NCI leads the National Cancer Program and NIH's efforts to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI website at cancer.gov or call NCI's contact center, the Cancer Information Service, at 1-800-4-CANCER (1-800-422-6237).

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.gov

 ALL CAPITALISM IS STATE CAPITALISM

COVID-19 vaccine development built on >$17 billion in NIH funding for vaccine technologies

Broad foundation of NIH-funded research for enabling technologies prior to pandemic provided a tool kit for rapid development of COVID vaccines

BENTLEY UNIVERSITY

Research News

    SHARE

 PRINT  E-MAIL

IMAGE: ANNUAL PROJECT YEARS AND PROJECT COSTS ASSOCIATED WITH NIH-FUNDED PMIDS 2000-2019 view more 

CREDIT: © CENTER FOR INTEGRATION OF SCIENCE AND INDUSTRY AT BENTLEY UNIVERSITY

The unprecedented development of COVID-19 vaccines less than a year after discovery of this virus was enabled by more than $17 billion of research on vaccine technologies funded by the NIH prior to the pandemic, according to new research from Bentley University's Center for Integration of Science and Industry. The article, titled "NIH funding for vaccine readiness before the COVID-19 pandemic," demonstrates the critical role this broad foundation of government-funded research plays in ensuring vaccine readiness.

The report, published today in the journal Vaccine, examined the maturation of research and NIH funding for ten technologies that were applied in candidate COVID-19 vaccines as of July 2020. The maturation of these technologies was described in 51,530 published research papers from 2000-2019, of which 8,420 (16%) acknowledge NIH funding totaling $17.2 billion. Some of these technologies have been employed successfully in vaccines since the mid-20th century. Others, such as the viral vectors employed in the Johnson & Johnson and AstraZeneca vaccines, emerged from genetic engineering in the 1980s, and were found to be established prior to 2010. Still others, including the mRNA technologies employed by Pfizer/BioNTech and Moderna, only recently reached an established point.

"Rapid development of COVID vaccines was only possible because companies had access to a tool kit of established technologies," said Dr. Fred Ledley, Director of the Center for Integration of Science and Industry. "Some of the most recent technologies, including mRNA and viral vectors, proved to be particularly suitable for COVID-19 and the timelines required to combat this pandemic. The substantial public sector investments over the past 20 years that went into the maturation of these technologies needs to be considered in the pricing of these products and their availability to the public."

"This study also found surprisingly little NIH-funded, published research on vaccines for recognized pandemic threats, such as coronavirus, Zika, Ebola, or dengue virus," said Dr. Anthony Kiszewski, lead author of the study and Associate Professor of Natural & Applied Science at Bentley University. "Mechanisms need to be developed for funding research on vaccine technologies that accelerate vaccine development against emergent threats and preempt future pandemics."

###

Dr. Anthony Kiszewski was the lead author on this work along with Dr. Ekaterina Galkina Cleary, Dr. Matthew Jackson and Dr. Fred Ledley. This work was supported by a grant from the National Biomedical Research Foundation.

"NIH funding for vaccine readiness before the COVID-19 pandemic" DOI: https://doi.org/10.1016/j.vaccine.2021.03.022. It is published in Vaccine, Volume 39 (2021) published by Elsevier.

THE CENTER FOR INTEGRATION OF SCIENCE AND INDUSTRY at Bentley University focuses on advancing the translation of scientific discoveries to create public value. The Center is an environment for thought leadership and interdisciplinary scholarship spanning basic science, data analytics, business and public policy. For more information, visit http://www.bentley.edu/sciindustry and follow us on Twitter @sciindustry.

BENTLEY UNIVERSITY is more than just one of the nation's top business schools. It is a lifelong-learning community that creates successful leaders who make business a force for positive change. With a combination of business and the arts and sciences and a flexible, personalized approach to education, Bentley provides students with critical thinking and practical skills that prepare them to lead successful, rewarding careers. Founded in 1917, the university enrolls 4,200 undergraduate and 1,000 graduate and PhD students and is set on 163 acres in Waltham, Massachusetts, 10 miles west of Boston. For more information, visit bentley.edu. Follow us on Twitter @BentleyU #BentleyUResearch.

About Vaccine

Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society and The Japanese Society for Vaccinology and is published by Elsevier http://www.elsevier.com/locate/vaccine

AUSTRALIA WILDFIRES

Burns victims struggling to pay

Indigenous families face multiple barriers in hospital

FLINDERS UNIVERSITY

Research News

 

Living away from community and country, Aboriginal families of children with severe burns also face critical financial stress to cover the associated costs of health care and treatment, a new study shows.

An Australian study, led by Flinders researchers Dr Courtney Ryder and Associate Professor Tamara Mackean, found feelings of crisis were common in Aboriginal families with children suffering severe burns, with one family reporting skipping meals and others selling assets to reduce costs while in hospital.

The economic hardship was found to be worse in families who live in rural areas - some households travelling more than five hours for treatment, creating undue financial strain.

Participants included families from SA, NSW and Queensland who are already part of the larger-Australia-wide Coolamon study on burns injuries in Aboriginal and Torres Strait Islander children.

Their children had sustained severe burns that required at least one night in hospital and follow up care.

So far, the Coolamon study has explored the health inequity of burns incidents and severity in Aboriginal children, with hospitalisation rates found to be 2-3 times greater than other Australian children.

This research conducted by Flinders University in conjunction with The George Institute for Global Health and UNSW School of Population Health also found Aboriginal and Torres Strait Islander children spent five times longer in hospital.

Dr Courtney Ryder, from Flinders University's College of Medicine and Public Health, says out-of-pocket health expenditure are costs not covered by Medicare or health insurance, and could include gap payments, pharmaceutical costs, and travel costs such as transport, car parking, food, and accommodation.

She says results were "astounding" with some families reaching credit card limits, not paying other bills or even selling assets to get by.

"Even though we have Medicare, there are always additional out-of-pocket expenses for health care, and I don't think it's understood the depth or breadth of cost for those Aboriginal families who have a child with an acute burns injury," Dr Ryder says.

"Burns injuries are quite intensive, very invasive and require a lot of follow up. While the expenses might be as simple as sterilised water and bandages, quite often there are additional expenses such as costs associated with travelling away from home.

"One family spoke about having to spend $700 each time they went to town, and they were even staying with family close to the tertiary setting."

Participants also reported not being made aware of government initiatives, such as the Patient Assisted Travel Scheme (PATS), aimed at South Australians who need to travel more than 100km to access medical services.

Dr Ryder says a review of PATS is needed, as Aboriginal and Torres Strait Islanders often face barriers in accessing the scheme, including families who still live in regional areas but within the 100km range.

"There was one family who, because of where they were located, couldn't get assistance through PATS," she says.

"They were having to travel for an hour or more every day to the hospital, then there were parking costs and time spent away from work, so it was still significant."

Despite the stress and financial burden reported by participants, they often commented on the significant role their family networks played in helping and keeping them away from significant financial burden.

###

This research is supported by a National Health and Medical Research Council (NHMRC) project grant, while Dr Courtney Ryder was supported by an NHMRC postgraduate scholarship.

Ryder, C., Mackean, T., Hunter, K., Coombes, J., Holland, A.J. and Ivers, R. (2021), Yarning up about out?of?pocket healthcare expenditure in burns with Aboriginal families. Australian and New Zealand Journal of Public Health. https://doi.org/10.1111/1753-6405.13083

 DISARM, DEFUND, DISBAND

Law professor argues for removing police from traffic enforcement

A new legal framework could enhance public safety and equal treatment by eliminating 'pretextual' traffic stops, which have been tied to cases of police abuse and injustice

UNIVERSITY OF ARKANSAS

Research News

   

IMAGE: JORDAN BLAIR WOODS, UNIVERSITY OF ARKANSAS view more 

CREDIT: UNIVERSITY OF ARKANSAS

University of Arkansas law professor Jordan Blair Woods challenges the conventional wisdom that only police can enforce traffic laws.

In "Traffic Without Police," to be published in Stanford Law Review, Woods articulates a new legal framework for traffic enforcement, one that separates it from critical police functions, such as preventing and deterring crime, conducting criminal investigations and responding to emergencies.

If not the police, who then would enforce traffic laws? As Woods explains, jurisdictions would delegate most traffic enforcement to newly created traffic agencies. These public offices would operate independently from police departments and would hire their own traffic monitors to conduct and oversee traffic enforcement, including stops. Police officers would become involved in traffic stops only for serious violations that are a criminal offense or public threat.

"Traffic stops are the most frequent interaction between police and civilians today," Woods said. "And because we know traffic enforcement is a common gateway for funneling over-policed and marginalized communities into the criminal justice system, these stops are a persistent source of racial and economic injustice."

Previous research has shown that Black and Latinx motorists are disproportionately stopped by police for traffic violations. Compared to white motorists, these minority groups are also disproportionately questioned, frisked, searched, cited and arrested during traffic stops.

Many of these stops and intrusions are considered "pretextual," according to legal definition, meaning that they enable officers to initiate contact with motorists and to then search for evidence of non-traffic crime without reasonable suspicion or probable cause. In this sense, the traffic stop has functioned as a gateway unfairly targeting Black and Latinx motorists. Pretextual stops sometimes also lead to police mistreatment and abuse.

So far, there is one example of the reorganization that Woods articulates. In July 2020, as part of a comprehensive plan to make structural police reforms, the city of Berkeley, California, voted in favor of a proposal that removes police from conducting traffic stops. The proposal directs the city to create a transportation department staffed by unarmed civil servants who would be in charge of enforcing traffic laws. Other municipalities are considering similar reforms that would remove police from traffic enforcement to varying degrees.

In addition to the social benefits mentioned above, especially for minority communities, removing police from traffic enforcement and adopting traffic law reforms that Woods proposes could put an end to unfair and often subjective reliance on traffic ticket revenue to fund state and local budgets. Likewise, such reform could reduce or eliminate financial and professional incentives that contribute to aggressive and biased traffic enforcement, namely prohibiting the issuing of traffic tickets as a measure of professional performance.

###

Woods' study can be downloaded at SSRN.

Woods is the faculty director of the Richard B. Atkinson LGBTQ Law & Policy Program at the University of Arkansas School of Law.

Firearms laws curb rates of gun violence across United States

Number of firearm laws significantly predicted suicide and homicide rates, Rutgers study finds

RUTGERS UNIVERSITY

Research News

 

States with stricter firearms laws reported lower suicide and homicide rates, according to a Rutgers study.

The study, conducted by the New Jersey Gun Violence Research Center, the Rutgers School of Public Health, the Rutgers University-Newark Department of Psychology, the Rutgers School of Criminal Justice, the Rutgers New Jersey Medical School and the Rutgers-Newark Department of Social Work, was published in the Journal of Public Health and examined the association between firearm laws and suicide and homicide rates.

Firearm violence is a major public health concern in the United States, with firearm suicide and homicide accounting for the majority of gun deaths. In 2017, 66,683 people died by suicide and homicide with a majority of the deaths resulting from a firearm: 48 percent for suicide and 74 percent for homicide.

Using the State Firearm Law Database, the Rutgers researchers compared suicide and homicide rates across the United States from 1991 to 2017 with the number of firearm laws in each state. The study found that even with several factors, such as unemployment and overall gun ownership rates, taken into account, the total number of firearm laws in a state was a significant predictor of suicide and homicide rates.

"As states' strictness increased, their suicide and homicide rates decreased," said lead author John F. Gunn III, a postdoctoral researcher at the Rutgers School of Public Health and New Jersey Gun Violence Research Center.

The researchers, who were the first to focus on the impact of the total number of firearms regulations in each state, utilized a general index of states' overall approach to firearms regulation by aggregating the total number of gun laws. This index broadly defined states as restrictive or lenient towards firearms.

"With close to 40, 000 deaths annually from firearm violence, regulations that can limit access to firearms appear to reduce state-level mortality," says senior study author Bernadette Hohl, an assistant professor at Rutgers School of Public Health. "Evidence-based implementation of firearm regulations across the whole of the United States has the potential to significantly reduce the toll of firearm violence."

Previous research supports associations between state suicide and homicide rates and specific gun laws, such as waiting periods and universal background checks, with most work finding that the presence of specific firearm laws is associated with reductions in gun mortality.

Future research is required to continue to holistically examine the relationship between firearm laws and suicide and homicide rates. "Assessing the implications of law changes, regulation enforcement and if there is a correlation with violent crime decline will be necessary," Gunn said.

###

Link to study: https://academic.oup.com/jpubhealth/advance-article-abstract/doi/10.1093/pubmed/fdab047/6225077?redirectedFrom=fulltext

DWP: DUM WHITE PEEPLE

Individuals in lower-income US counties or high support for former President Trump continue to be less likely to socially distance

A new nearly yearlong study in the American Journal of Preventive Medicine finds that lower-income and Republican-leaning communities are less likely to socially distance than other communities during the COVID-19 pandemic

ELSEVIER

Research News

 

IMAGE: COUNTY-LEVEL DISTANCE TRAVELED HAS BEEN AVERAGED BY MONTH AND NORMALIZED TO PRE-COVID-19 LEVELS. NEGATIVE VALUES REPRESENT GREATER PHYSICAL DISTANCING. DATES RANGE FROM MARCH 9, 2020 TO JANUARY 17, 2021. BASED... view more 

CREDIT: AMERICAN JOURNAL OF PREVENTIVE MEDICINE

Ann Arbor, April 22, 2021 - Using nearly a year of anonymous geolocation data from 15-17 million cell phone users in 3,037 United States counties, investigators have found that individuals with lower income per capita or greater Republican orientation were associated with significantly reduced social distancing throughout the study period from March 2020 through January 2021. Their findings are reported in the American Journal of Preventive Medicine, published by Elsevier.

The associations persisted after adjusting for a variety of county-level demographic and socioeconomic characteristics. Other county-level characteristics, such as the share of Black and Hispanic residents, were also associated with reduced distancing at various points during the study period.

"We started this project in April 2020 because we wanted to understand the social, economic, and political factors that drive people to engage in social distancing. We ended up tracking these factors for almost a year," explained lead investigator Nolan M. Kavanagh, MPH, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

"A year is a long time to prepare policy responses and educate the public," he said. "Yet, the same kinds of communities that struggled to physically distance early on continue to struggle now."

To measure social distancing, the investigators used county-level averages of distance traveled per person using cell phone location data. They looked at the percentage change in average movement from the start of the pandemic relative to four pre-COVID-19 reference weeks. Statistical analysis was used to estimate the association between a variety of county-level demographic, socioeconomic, and political characteristics. Socioeconomic status was based on income per capita, and political orientation was based on the 2016 vote share for President Trump. Other county-level characteristics examined included the percentage of males, Black and Hispanic residents; share of residents over age 65; share of foreign-born residents; share of the workforce in industries most affected by COVID-19, such as retail, transportation and health, educational and social services; and the share of rural residential plots. These county-level characteristics were chosen based on their expected contribution to a community's ability to physically distance.

Investigators found a sharp reduction in average movement among US counties at the start of the COVID-19 pandemic and declaration of a national emergency in March 2020. Social distancing was greatest from late March to early June and then returned to baseline levels by June 2020. Distancing began to increase again in early September. However, even as a national trend evolved, the investigators found substantial variability in social distancing across counties.

While the share of racial and ethnic minorities, immigration, rurality, and employment in transportation were correlated with changes in average movement on many days, the single most consistent predictor of engagement in distancing across the study was higher per capita income. The single most consistent predictor of lack of engagement with distancing across the study was share of vote for President Trump.

Other county level-characteristics varied over time in their degree of association with physical distancing. During the early months of the study, counties with greater shares of Black and Hispanic residents were less likely to engage in social distancing. These adjusted racial and ethnic differences closed during the summer months before re-emerging in the fall. Similarly, rural counties were less likely to engage in distancing early on; by the end of the summer, rurality became the strongest negative predictor of physical distancing.

The investigators suggest a number of barriers that may underlie these findings. For example, lower-income or gig jobs may be incompatible with working from home, and lower income households may not have the necessary liquidity to shop in bulk, requiring more trips for groceries and essential household items. They observe that partisanship has dramatically shaped the government and public response to COVID-19 in the US. These findings show that political differences have continued to shape social distancing behavior, months into the pandemic and extending beyond the 2020 general election. As a result, both low-income and Republican-leaning communities are at greater risk for COVID-19.

"These results suggest that policy responses to the pandemic have failed to level the playing field," said Mr. Kavanagh. "We have not addressed the challenges to physical distancing faced by low-income Americans, such as working from home. And messages by political and public health leaders have not reached populations who may have different beliefs about disease risk. Analyses such as this study that monitor disparities over time can help us target public health and economic interventions to the communities that need them the most."

Romantic relationships mitigate effects of trauma on alcohol use among college students

VIRGINIA COMMONWEALTH UNIVERSITY

Research News

 

Students who have been exposed to interpersonal trauma —  physical assault, sexual assault or unwanted sexual experiences — prior to college are more likely to engage in risky alcohol use. But romantic relationships mitigate these effects of trauma on a student’s drinking behavior, according to a new study led by Virginia Commonwealth University researchers.

The study investigates whether romantic relationships might play a role in mitigating or exacerbating the effects of trauma exposure on alcohol use among college students. It found that students who experienced interpersonal trauma during college consumed more alcohol than those without interpersonal trauma exposure, and that their drinking was more pronounced for those in a relationship with a partner with higher levels of alcohol use. It also found that a student’s satisfaction in their romantic relationship did not change the association between interpersonal trauma and alcohol use.

Previous research has found that college students who have been exposed to interpersonal trauma are more likely to engage in risky alcohol use. Yet not everyone who experiences interpersonal trauma goes on to misuse alcohol, raising questions about what factors might play a role in the interaction of trauma and drinking.

The study, “A Longitudinal Study of the Moderating Effects of Romantic Relationships on the Associations Between Alcohol Use and Trauma in College Students,” will be published in a forthcoming issue of the journal Addiction. It explores whether three aspects of romantic relationships — relationship status, relationship satisfaction and partner alcohol use — change the associations between interpersonal trauma and alcohol use.

“These findings are important because they help elucidate the ways that romantic relationships can improve or undermine health habits, particularly concerning alcohol consumption,” said lead author Rebecca Smith, a doctoral student in the Department of Psychology in the College of Humanities and Sciences. “A better understanding of the ways that social relationships can influence health behaviors might encourage people to carefully consider the people with whom they spend time. Moreover, these findings help us better understand alcohol use risk and protective factors across the lifespan, which can be used to inform prevention and treatment programs.”

Jessica Salvatore, Ph.D., an assistant professor in the Department of Psychology and the senior author on the study, said the findings “underscore the double-edged role that relationships and partners have on health behaviors in college.”

“On the one hand, we found that involvement in a committed relationship buffered the effects of interpersonal trauma exposure on students’ alcohol use,” she said. “On the other, we found that involvement with a heavier drinking partner amplified the association between exposure and alcohol use.”

Smith said she was surprised that relationship satisfaction was not a significant moderator of the associations between interpersonal trauma and alcohol use.

“Based on previous research suggesting that involvement in satisfying relationships is protective against stress and problematic drinking, we had hypothesized that high relationship satisfaction would buffer against the effects of interpersonal trauma on alcohol use,” she said.

The study relied on data collected through Spit for Science, a universitywide project at VCU in which student volunteers provide information on alcohol, substance use, emotional health and more, and contribute DNA samples that provide insight into the role of genetics. The study involved nearly 9,000 students who participated in Spit for Science between 2011 and 2014.

Participants completed baseline assessments during the fall of their freshman year and were invited to complete follow-up assessments every spring thereafter. Participants were included in the study if they completed surveys at baseline and at least one follow-up assessment.

“Each year, participants answered questions about stressful life events they may have experienced, their quantity and frequency of alcohol consumption, and their romantic relationships,” Smith said. “This allowed us to look at the interplay between interpersonal trauma, alcohol use and romantic relationship characteristics over time.”

The study’s findings could be valuable for efforts to increase awareness and education for college students about the ways in which our social ties can promote or undermine health behaviors, like alcohol use, Smith said.

Additionally, she said, the findings could be applied as part of treatment to reduce unsafe drinking.

“We know from previous research that exposure to interpersonal trauma is associated with risky alcohol use, so romantic partners can be included in treatment planning and aftercare to help trauma survivors cope with traumatic events in healthier ways and reduce engagement in risky drinking behaviors,” she said.

In addition to Smith and Salvatore, the study’s co-authors include Danielle Dick, Ph.D., Distinguished Commonwealth Professor in the Departments of Psychology and Human and Molecular Genetics at VCU; Ananda Amstadter, Ph.D., associate professor in the Virginia Institute for Psychiatric and Behavioral Genetics at VCU; Nathaniel Thomas, a doctoral student in the Department of Psychology; and the Spit for Science Working Group.

Urgent shortage of evidence for safe withdrawal from antidepressants

UNIVERSITY OF SOUTHAMPTON

Research News

 

A new study has highlighted that while much is known about the ever increasing uptake of antidepressant medications around the world, there is very little evidence on safe and effective approaches to discontinuing treatment.

In 2020 there were 78 million prescriptions for antidepressants in England and about half of patients treated have taken them for at least two years. Guidelines typically recommend that antidepressants be taken for up to 6 to 12 months after improvement, or for up to two years in people at risk of relapse, but many people take antidepressants for much longer. Surveys of antidepressant users suggest that up to a half of people on long-term antidepressant prescriptions have no clear medical reason to keep taking them. Long-term use can put people at risk of adverse events such as sleep disturbance, weight gain, sexual dysfunction, bleeding, and gastrointestinal problems, as well as feeling emotionally numb and unable to deal with problems in life without their medication.

In this new study for Cochrane, an international research team, including Professor Tony Kendrick from the University of Southampton, looked at the findings from 33 randomised control trials that included 4,995 participants who were prescribed antidepressants for 24 weeks or longer. In 13 studies, the antidepressant was stopped abruptly; in 18, it was stopped over a few weeks (known as 'tapering'); in four, psychological therapy support was also offered; and in one study, stopping was prompted by a letter to GPs with guidance on tapering. Most tapering schemes lasted four weeks or less and none of the studies used very slow tapering schemes beyond a few weeks - in contrast to new guidelines from the UK Royal College of Psychiatrists that recommend tapering over months or years to safely stop.

The authors were unable to make any firm conclusions about effects and safety of the approaches studied and did not have confidence in the results due to the low certainty of evidence they provided.

'We know the rise in long-term antidepressant use is a major concern around the world,' says lead author Dr Ellen Van Leeuwen from the University of Ghent, Belgium. 'As a GP myself, I see first-hand the struggles many patients have coming off antidepressants. It's of critical concern that we don't know enough about how to reduce inappropriate long-term use or what the safest and most effective approaches are to help people do this. For example, there are over 1,000 studies looking at starting antidepressants, yet we found only 33 trials around the world that examined stopping them. It's clear that this area needs urgent attention.'

Co-author Tony Kendrick, Professor of Primary Care at the University of Southampton is leading the REDUCE trial, testing online and psychologist telephone support for patients withdrawing from long-term antidepressants. He says "More than one in ten adults in England are now taking antidepressants but surveys of long-term users suggest that between a third and a half of these have no evidence-based reason to continue taking them, and they are associated with increasing side effects in the longer term."

A key issue identified by the research team is that previous studies have not distinguished between symptoms of a return of depression and withdrawal symptoms from the medication.

The difficulty of distinguishing between these symptoms presents a real challenge for patients, doctors and researchers alike - often resulting in inappropriate continuation of antidepressant medication and uncertain evidence on which to base healthcare decisions.

Dr Kendrick continues, "Antidepressants are often difficult to stop due to withdrawal symptoms. More research is needed to establish the incidence of withdrawal symptoms in patients, and large randomised controlled trials are needed to test different tapering strategies.

"Ultimately we really need more deprescribing studies - especially in primary care given that's where most prescribing takes place - before we can make more definitive conclusions. In the meantime, we hope this review provides a starting point to help GPs openly discuss continuing or stopping antidepressants with their patients. We also want to raise awareness that withdrawal symptoms from antidepressants are common and can be mistaken for relapse of the underlying condition. Experiencing withdrawal symptoms isn't a sign that the patient has relapsed - it might be that they need to taper more gradually down to much lower doses instead, before eventually stopping."

WTF

Cannabis use disorder rate rose among pregnant women between 2001-2012

Study finds resulting adverse outcomes for infants: preterm births, low birth weight and small size

UNIVERSITY OF CALIFORNIA - SAN DIEGO

Research News

 

A study of almost 5 million live births in California by researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego reports that babies born to mothers diagnosed with cannabis use disorder were more likely to experience negative health outcomes, such as preterm birth and low birth weight, than babies born to mothers without a cannabis use disorder diagnosis.

The findings are published online in the April 22, 2021 issue of the journal Addiction. The National Institute on Drug Abuse, part of the National Institutes of Health, funded the study.

Cannabis use disorder is a diagnostic term with specific criteria that defines continued cannabis use despite consequent, clinically significant impairments. The research team, led by first author Yuyan Shi, PhD, associate professor at The Herbert Wertheim School of Public Health, conducted a retrospective cohort study of 4.83 million mothers who delivered live, single births in California from 2001 to 2012.

They identified 20,237 women who were discharged after delivery with a diagnosis of cannabis use disorder. Not all people who use cannabis meet the criteria for cannabis use disorder. The study authors stated the actual incidence of cannabis use disorder is likely higher than reported numbers.

The researchers found that diagnoses of cannabis use disorder, based on medical records at time of delivery, rose from 2.8 to 6.9 per 1000 deliveries from 2002 to 2012. Compared to a matched control group of 40,474 mother-infant pairs, infants born to women with cannabis use disorder were more likely to be born preterm, have a low birth weight and be small for their gestational age -- all factors that can require greater or more intense medical care or presage later health issues.

Additionally, researchers found that, though rare overall (less than 1 percent), the risk of infant mortality was greater for infants born to women with cannabis use disorder. These infants were 35 percent more likely to die within a year of birth than infants in the control group. Conversely, these infants were also less likely to be hospitalized within the first year of life than control group infants.

"Because we are looking only at medical records, there is a lot we don't know about the mothers and infants in this study," said first author Shi, "but our analysis supports the recommendation that health professionals screen for and address cannabis use disorders in their pregnant clients -- to protect both their health and potentially the health of their infants."

Currently, screening for cannabis use or related disorders is not standard practice during pregnancy health care, though marijuana is the illicit drug most commonly used by pregnant women, typically to self-treat depression, anxiety, stress, pain, nausea and vomiting, often during the first trimester. It is also not standard of care to provide counsel on the lack of safety data around cannabis use during pregnancy. Both strategies may be helpful, as well as encouraging patients to discontinue use of cannabis during pregnancy and while breastfeeding and referring to treatment when appropriate.

According to a 2018 published study, approximately 7 percent of pregnant women self-reported marijuana use, with rates as high as 10 percent among women ages 18 to 25. Rates based on urine toxicology were even higher, with 19 percent of pregnant women ages 18 to 25 screening positive for marijuana use.

Previous research has found that tetrahydrocannabinol (THC), the psychoactive compound in cannabis, can reach fetuses and infants through the placenta and breastmilk, respectively. THC disrupts the normal function of the endocannabinoid system, which has been shown to play a key role in pregnancy, including implantation of the embryo in the uterus and maintenance of the placenta.

###

Co-authors include: Bin Zhu, UC San Diego; and Di Liang, UC San Diego and Fudan University, China.

Immune system, not COVID virus, may pose greatest risk to pregnant women

YALE UNIVERSITY

Research News 

For reasons not yet clear, pregnant women infected with the virus that causes COVID-19 are more likely to experience preterm births, pre-eclampsia, and other neonatal problems than non-infected women.

A team of Yale scientists decided to investigate whether the virus could be affecting placental tissue of infected expectant mothers. Their analysis found that while evidence of the virus in the placenta is rare, the placenta in infected mothers tended to exhibit a much higher level of immune system activity than those of non-infected pregnant women, they report April 22 in the journal Med.

"The good news is the placenta is mounting a robust defense against an infection that is far distant, in lungs or nasal tissue," said Shelli Farhadian, assistant professor of internal medicine (infectious diseases) and neurology at Yale and co-corresponding author. "On the other hand, the high level of immune system activity might be leading to other deleterious effects on the pregnancy."

The team headed by Farhadian and Akiko Iwasaki, the Waldemar Von Zedtwitz Professor of Immunobiology at Yale, analyzed blood and placental tissue in 39 infected and as well as COVID-free expectant mothers at different stages of pregnancy. While they found evidence of the virus in only two samples of placental tissue, they did find ACE2 receptors -- which the SARS-CoV-2 virus uses to enter cells -- in the placentas of most women during the first trimester of pregnancy. Those receptors had largely disappeared in healthy women at later stages of pregnancy.

"It is very important to closely monitor expectant mothers who become infected early in pregnancy," Farhadian said.

Immune system activity in the placenta during infections like COVID-19 has not been extensively studied and it is not known whether other types of infections would behave similarly to SARS-CoV-2, she said.

###

Alice Lu-Culligan is lead author of the study, which was primarily funded by the National Institutes of Health and the Emergent Ventures Fund at the Mercatus Center at George Mason University.