Study identifies nearly 600 genetic loci associated with anti-social behavior, alcohol use, opioid addiction and more

The study, published today in the journal Nature Neuroscience, is one of the largest genome-wide association studies ever conducted

Peer-Reviewed Publication

VIRGINIA COMMONWEALTH UNIVERSITY

RICHMOND, Va. (Aug. 26, 2021) — An analysis of data from 1.5 million people has identified 579 locations in the genome associated with a predisposition to different behaviors and disorders related to self-regulation, including addiction and child behavioral problems.

With these findings, researchers have constructed a genetic risk score — a number reflecting a person’s overall genetic propensity based on how many risk variants they carry — that predicts a range of behavioral, medical and social outcomes, including education levels, obesity, opioid use disorder, suicide, HIV infections, criminal convictions and unemployment.

“[This study] illustrates that genes don’t code for a particular disorder or outcome; there are no genes ‘for’ substance use disorder, or ‘for’ behavior problems,” said joint senior author Danielle Dick, Ph.D., Commonwealth Professor of Psychology and Human and Molecular Genetics at Virginia Commonwealth University. “Instead, genes influence the way our brains are wired, which can make us more at risk for certain outcomes. In this case, we find that there are genes that broadly influence self-control or impulsivity, and that this predisposition then confers risk for a variety of life outcomes.”

The study, “Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction,” was published today in the journal Nature Neuroscience and was conducted by a consortium of 26 researchers at 17 institutions in the United States and the Netherlands.

It was led by Dick; Philipp Koellinger, Ph.D., professor of social science genetics at the University of Wisconsin Madison and Vrije Universiteit Amsterdam; Kathryn Paige Harden, Ph.D., professor of psychology at the University of Texas at Austin; and Abraham A. Palmer, Ph.D., professor of psychiatry at the University of California, San Diego.

The study is one of the largest genome-wide association studies ever conducted, pooling data from an effective sample size of 1.5 million people of European descent. The researchers’ genetic risk score has one of the largest effect sizes — a measurement of the prediction power — of any genetic risk score for a behavioral outcome to date.

“It demonstrates the far-reaching effects of carrying a genetic liability toward lower self-control, impacting many important life outcomes,” said Dick, a professor in the Department of Psychology in the College of Humanities and Sciences and the Department Human and Molecular Genetics in the School of Medicine at VCU. “We hope that a greater understanding of how individual genetic differences contribute to vulnerability can reduce stigma and blame surrounding many of these behaviors, such as behavior problems in children and substance use disorders.”

The identification of the more than 500 genetic loci is important, the researchers said, because it provides new insight into our understanding of behaviors and disorders related to self-regulation, collectively referred to as “externalizing” and that have a shared genetic liability.

“We know that regulating behavior is a critical component of many important life outcomes — from substance use and behavioral disorders, like ADHD, to medical outcomes ranging from suicide to obesity, to educational outcomes like college completion,” Dick said.

Characterizing the genetic contributions to self-regulation can be helpful in myriad ways, she said.

“It allows us to better understand the biology behind why some people are more at risk, which can assist with medication development, and it can allow us to know who is more at risk, so we can put early intervention and prevention programs in place,” she said. “Identifying genetic risk factors is a critical component of precision medicine, which has the goal of using information about an individual’s genetic and environmental risk factors to deliver more tailored, effective intervention specific to that individual’s risk profile.”

The researchers noted, however, that having a higher risk profile isn’t necessarily a bad thing.

“For example, CEOs, entrepreneurs and fighter pilots are often higher on risk taking,” Dick said. “DNA is not destiny. We all have unique genetic codes, and we’re all at risk for something; but understanding one’s predisposition can be empowering — it can help individuals understand their strengths, and their potential challenges, and act accordingly.”

For more information about the study and its findings, please visit this FAQ.

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About VCU and VCU Health

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls nearly 30,000 students in 238 degree and certificate programs in the arts, sciences and humanities. Twenty-three of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 11 schools and three colleges. The VCU Health brand represents the VCU health sciences academic programs, the VCU Massey Cancer Center and the VCU Health System, which comprises VCU Medical Center (the only academic medical center in the region), Community Memorial Hospital, Tappahannock Hospital, Children’s Hospital of Richmond at VCU, and MCV Physicians. The clinical enterprise includes a collaboration with Sheltering Arms Institute for physical rehabilitation services. For more, please visit vcu.edu and vcuhealth.org.

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JOURNAL

Nature Neuroscience

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction

ARTICLE PUBLICATION DATE

26-Aug-2021

 WHO SEZ SEND BOOSTERS TO POOR COUNTRIES

Don't get COVID-19 booster vaccine too soon

by Dana Sparks

Credit: Pixabay/CC0 Public Domain

Amid reports of waning COVID-19 immunity, the Food and Drug Administration (FDA) is expected to officially approve a third dose of messengerRNA vaccines for the general public. Moderna and Pfizer are mRNA vaccines.

The FDA has already approved a third COVID-19 vaccine dose for those who have compromised immune systems, as part of their primary vaccine series. That third vaccine is not considered a booster.

However, Mayo Clinic experts say the pending FDA approval for a booster vaccine does not mean the general public should go out and get a third dose of vaccine, whenever they think they need it. The timing for a booster is important and designed to give extended immunity protection. Sooner is not necessarily better and these experts have other concerns.

"We're certainly aware of news reports that people, on their own, are going out and getting a third dose," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "I would urge caution about that. We don't have a lot of data on that and we want to do this in a manner that offers the most benefit and the least risk."

Dr. Melanie Swift, co-chair of the Mayo Clinic COVID-19 Vaccine Allocation and Distribution Work Group, agrees.

"There are some things we don't know about that," says Dr. Swift. "One is that they could develop more side effects and are at more risk of adverse reactions. We don't think so, but we would have to actually study that or follow the population to find out."

She adds, "Secondly, while we have an adequate vaccine supply to meet this current booster recommendation we don't have a limitless supply of vaccine," says Dr. Swift. She explains that boosters are anticipated for the population that's already been vaccinated, but vaccines to be authorized for children over the coming months need to be anticipated, too.

"We don't want people just going out and getting vaccinated, soaking up the available supply," says Dr. Swift. "If they have a healthy immune system and got their full first series, they should expect to be covered for at least eight months after that series so they don't need to go out and get an early booster."

"We're in this unusual situation where we've got a group of people we can't convince to get the first dose, despite all the data," adds Dr. Poland. "And then a group of people where we don't yet have the data that are going out on their own and getting third, fourth and fifth doses. We have no idea what the consequences of that might be yet."

Finally, Drs. Swift and Poland encourage people to follow the science and talk with their health care providers.

What you need to know about COVID-19 booster shots

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©2021 Mayo Clinic News Network.
Distributed by Tribune Content Agency, LLC.

 

Female hummingbirds avoid harassment by looking as flashy as males

Peer-Reviewed Publication

CELL PRESS

 

IMAGE: THIS IMAGE SHOWS A MALE-LIKE FEMALE WHITE-NECKED JACOBIN HUMMINGBIRD BEING RELEASED AFTER CAPTURE AND TAGGING. view more 

CREDIT: IRENE MENDEZ CRUZ

Much like in human society, female hummingbirds have taken it into their own hands to avoid harassment. By watching white-necked Jacobin hummingbirds in Panama, researchers discovered that over a quarter of females have the same brightly colored ornamentation as males, which helps them avoid aggressive male behaviors during feeding, such as pecking and body slamming. This paper appears August 26 in the journal Current Biology.

“One of the ‘aha moments’ of this study was when I realized that all of the juvenile females had showy colors,” says first author Jay Falk (@JJinsing), who is now a postdoc at the University of Washington but led the research as a part of the Cornell Lab of Ornithology and Smithsonian Tropical Research Institute. “For birds that’s really unusual because you usually find that when the males and females are different the juveniles usually look like the adult females, not the adult males, and that's true almost across the board for birds. It was unusual to find one where the juveniles looked like the males. So it was clear something was at play.”

Male white-necked Jacobin hummingbirds are known to have bright and flashy colors, with iridescent blue heads, bright white tails, and white bellies. Female Jacobins, on the other hand, tend to be drabber in comparison, with a muted green, gray, or black colors that allow them to blend into their environment. Falk and his team, however, found that around 20% of adult females have showy colors like males.

As juveniles, all females have the showy colors, but this 20% of females doesn’t change to the muted color as they age. It is not clear whether this phenomenon is genetic, by the choice of the hummingbird, or due to environmental factors. However, the researchers found that it is probably the result of the female hummingbirds trying to evade harassment, including detrimental aggression during mating or feeding.

“Hummingbirds are such beloved animals by many people, but there are still mysteries that we haven’t noticed or studied,” says Falk. “It’s cool that you don’t have to go to an obscure unknown bird to find interesting and revealing results. You can just look at a bird that everyone loves to watch in the first place.”

To learn why some female hummingbirds kept their showy colors, the researchers set up a scenario with stuffed hummingbirds on feeders and watched as real hummingbirds interacted with them. They found that hummingbirds harassed mainly the muted colored female hummingbirds, which is in favor of the hypothesis that the showy colors are caused by social selection. Furthermore, most females had showy colors during their juvenile period and not during their reproductive period. This means that the only time they had showy colors is precisely during the period when they're not looking for mates. In combination with other results from the study, this indicates that it is not sexual selection causing the phenomenon.

In the future studies, Falk and his team hope to use the results of the variation between female white-necked Jacobins to understand how the variation between males and females in other species may evolve.

Jacobin and data-logging feede [VIDEO] | EurekAlert! Science News Release 

This video shows a white-necked Jacobin of an unknown gender visits a data-logging feeder in Gamboa, Panama installed by the researchers.

The authors received financial support from the Smithsonian Tropical Research Institute, the National Science Foundation, the Cornell Lab of Ornithology, the Cornell Department of Neurobiology and Behavior, the Society for the Study of Evolution, the American Society of Naturalists, and the Sigma Xi Society

Current Biology, Falk et al.: “Male-like ornamentation in female hummingbirds results from social harassment rather than sexual selection” https://www.cell.com/current-biology/fulltext/S0960-9822(21)01033-2

Current Biology (@CurrentBiology), published by Cell Press, is a bimonthly journal that features papers across all areas of biology. Current Biology strives to foster communication across fields of biology, both by publishing important findings of general interest and through highly accessible front matter for non-specialists. Visit http://www.cell.com/current-biology. To receive Cell Press media alerts, contact press@cell.com.

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JOURNAL

Current Biology

DOI

10.1016/j.cub.2021.07.043 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Male-like ornamentation in female hummingbirds results from social harassment rather than sexual selection

ARTICLE PUBLICATION DATE

26-Aug-2021

   

Some hummingbird females look like

males to evade harassment

New study finds females that look like males get more food

Peer-Reviewed Publication

CORNELL UNIVERSITY

 

IMAGE: THE LEFT AND CENTER IMAGES SHOW ADULT FEMALE AND ADULT MALE PLUMAGES, RESPECTIVELY. RIGHT IMAGE SHOWS JUVENILE PLUMAGE. view more 

CREDIT: ARTWORK BY JILLIAN DITNER, CORNELL LAB OF ORNITHOLOGY.

Ithaca, NY—New research on the glittering White-necked Jacobin hummingbird reveals nearly 20% of the species’ adult females have male-like plumage. This strategy is all about dodging bullies and getting better access to food. The findings were published today in the journal Current Biology. [LINK]
 
"What's interesting about the White-necked Jacobin is that all the juveniles start out with male-like plumage," explains lead author Jay Falk. "Among most other bird species, juvenile plumage looks more like the female's, presumably to be less obvious to predators." Falk did this work while a Ph.D. student with the Cornell Lab of Ornithology and is currently at the University of Washington.

As the birds mature, all the jacobin males retain the fancier plumage but so do nearly 20% of the females among the population Falk studied in Panama. The remaining 80% of females still develop the muted green and white coloration of a typical adult female. Though plumage ornamentation is usually attributed to sexual selection and attracting a mate, researchers ruled out that explanation for this species after field experiments.

Funding for this research was provided by the Cornell Lab of Ornithology, the Smithsonian Tropical Research Institute, the National Science Foundation, the Society for the Study of Evolution, the American Society of Naturalists, and the Sigma Xi Society. 
 
Scientists observed the reactions of live jacobin hummingbirds toward stuffed mounts placed on nectar feeders during breeding season. The mounts were stuffed specimens of adult White-necked Jacobin males, typical adult females, and female adults that looked like males.

"If females having male-like plumage is the result of sexual selection, then the males would have been drawn to the male-plumaged females," says Falk. "That didn’t happen. The male White-necked Jacobins still showed a clear preference for the typically plumed adult females."
 
So, what's the benefit to females of this species when they look like a male? To get to the root of that puzzle, Falk and his assistants put radio frequency ID tags on birds and set up a circuit of 28 feeders wired to read the tags. By tracking the number and length of visits, they honed in the answer.
 
"Our tests found that the typical, less colorful females were harassed much more than females with male-like plumage," Falk says. "Because the male-plumaged females experienced less aggression, they were able to feed more often—a clear advantage."

CAPTION

Both male and female White-necked Jacobins fan their tails during courtship or aggressive interactions. Because this bird also has its wings partially raised it's likely an aggressive stance.

CREDIT

Photo by Brian Sullivan/Macaulay Library at the Cornell Lab of Ornithology.

The researchers found that the male-like females got to feed longer than the typical adult female—about 35% longer at feeders filled with high-sugar nectar. That can make a big difference because hummingbirds have the highest metabolic rate of any vertebrate. They need to eat constantly in order to survive. 

Bottom line: female White-necked Jacobins retain the male-like plumage of their youth for social reasons—they avoid the bullies by looking like them. It is still not clear whether male-like females behave just as aggressively as the males. The actual physical mechanism that allows females to retain male-like plumage is also not known.
 
The White-necked Jacobin is hardly alone when it comes to having some females that look like males. Falk says studies have found that 25% of the world’s 350+ hummingbird species also have some females that look like males.

CAPTION

Field assistant Pedro Luis Castillo-Caballero glues antennas to feeders for radio frequency ID experiment in Gamboa, Panama.

CREDIT

Photo by Jay Falk.

Editors: Download images, artwork, and video. The use of this material is protected by copyright. Use is permitted only within stories about the content of this release. Redistribution or any other use is prohibited without express written permission of the Cornell Lab of Ornithology or the copyright owner.

 

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JOURNAL

Current Biology

DOI

10.1016/j.cub.2021.07.043 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Male-like ornamentation in female hummingbirds results from social harassment rather than sexual selection

ARTICLE PUBLICATION DATE

26-Aug-2021

 WHEN ARE WE GETTING THE 100% SAFE MALE CONTRACEPTIVE

Carolina scientists developing contraceptive that stops sperm in its tracks

University of North Carolina Eshelman School of Pharmacy engineers antibodies as option for affordable, non-hormonal female contraception

Peer-Reviewed Publication

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

 

IMAGE: A SCANNING ELECTRON MICROGRAPH OF HUMAN SPERM STUCK TOGETHER AND IMMOBILIZED BY AN ANTISPERM ANTIBODY. view more 

CREDIT: UNIVERSITY OF NORTH CAROLINA CHAPEL HILL/ B. SHRESTHA

Scientists at the University of North Carolina at Chapel Hill are using the precision targeting of monoclonal antibodies for a new type of female contraception.

Monoclonal antibodies are known for their ability to fight off invading germs and are used to treat and prevent everything from cancer to COVID-19. Scientists are now looking at a new mission for antibodies: immobilizing sperm before it can reach an egg.

Carolina researchers have engineered ultra-potent antibodies that, during animal testing, effectively trapped and blocked more than 99.9% of human sperm. The promising study results published in Science Translational Medicine suggest contraceptives based on antibodies may offer women a non-hormonal option to prevent pregnancy.

“Many women avoid hormonal contraception because of real and perceived side effects,” said Samuel Lai, professor in the Division of Pharmacoengineering and Molecular Pharmaceutics at the UNC Eshelman School of Pharmacy.

These effects can include irregular bleeding, nausea, depression, weight gain and migraines. And for some women estrogen-based hormonal contraception can be harmful.

“There’s a major unmet need for alternative, non-hormonal contraceptives for women,” said Lai.

Antibodies as line of defense

Nearly half of all pregnancies in the United States are unintended, and Lai is among scientists across the country who are advancing the idea of using anti-sperm antibodies for contraception.

“We were inspired by infertility that occurs in some women who develop antibodies against their partner’s sperm,” said study first author Bhawana Shrestha, a doctoral student in the Department of Microbiology and Immunology at the UNC School of Medicine and graduate research assistant at the school of pharmacy.  

The antibody they’re testing was isolated from an infertile woman and targets a unique surface antigen present on human sperm. When it’s added to sperm, the sperm quickly clump together.

“Using our highly multivalent IgG platform, we engineered antibodies that were more than 10 to 16 times more potent at agglutinating sperm and reducing sperm permeation through mucus than the best-known antibody,” she said. 

Researchers explored the effect of antibodies in sheep, which have reproductive tracts similar to human females. At a high dose of 333 micrograms of antibody, both naturally occurring antibodies and the newly engineered antibodies, effectively stopped all human sperm motility, and at a low dose of 33.3 micrograms, the modified antibodies, but not the original ones, trapped 97% to 99% of sperm.

Next step: clinical trials

But monoclonal antibodies are known as expensive drugs, which puts their usefulness as an affordable contraceptive up in the air.

However, researchers believe that by increasing the potency, much lower doses of the multivalent antibodies may be needed for effective contraception.   

“We think these second-generation molecules will provide not only greater potency but will translate to lower costs that make the approach cost-effective,” said Lai.

Mucommune, a startup spun out of the Lai Lab, has licensed the molecule for development of an antibody-based contraceptive. The company will focus on safety and manufacturing to prepare for human clinical trials that could start in 2023.

The team is working on incorporating the antibodies into an intravaginal ring that steadily releases the antibodies, or a dissolvable film placed in the vagina where it spreads antibodies before sex.

“By avoiding exogenous hormones and creating a women-controlled contraceptive method, we believe the antibodies developed here could meet the contraceptive needs for millions of women, help to reduce the number of unintended pregnancies and alleviate the health care costs of unintended pregnancies which some estimate to be in excess of $20 billion a year,” Lai said.

The study team includes researchers from the UNC-Chapel Hill, University of Texas Medical Branch, Boston University School of Medicine and Mucommune, LLC.

The National Institutes of Health, Eshelman Institute of Innovation, the Packard Foundation for Science and Engineering, the National Science Foundation and the PhRMA Foundation funded the study.

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JOURNAL

Science Translational Medicine

DOI

10.1126/scitranslmed.abd5219 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Engineering sperm-binding IgG antibodies  for the development of an effective nonhormonal  female contraception

ARTICLE PUBLICATION DATE

11-Aug-2021

 

More efficient electricity distribution thanks to new insulation material

Peer-Reviewed Publication

CHALMERS UNIVERSITY OF TECHNOLOGY

 

IMAGE: THE BASIS OF THE NEW MATERIAL IS POLYETHYLENE, WHICH IS ALREADY USED FOR INSULATION IN EXISTING HVDC CABLES. NOW, BY ADDING VERY SMALL AMOUNTS – 5 PARTS PER MILLION – OF THE CONJUGATED POLYMER KNOWN AS POLY(3-HEXYLTHIOPHENE), THE RESEARCHERS WERE ABLE TO LOWER THE ELECTRICAL CONDUCTIVITY BY UP TO THREE TIMES. view more 

CREDIT: YEN STRANDQVIST/CHALMERS UNIVERSITY OF TECHNOLOGY

High-voltage direct current cables which can efficiently transport electricity over long distances play a vital role in our electricity supply. Optimising their performance is therefore an important challenge. With that aim in mind, scientists from Chalmers University of Technology, Sweden, present a new insulation material up to three times less conductive, offering significant improvements to the properties and performance of such cables.

If we are to transition to a world powered by renewable energy, efficient long-distance transport of electricity is essential, since the supply – renewable energy sources such as wind and solar farms, as well as hydroelectric dams – is often located far from cities, where most of the demand exists. High voltage direct current cables, or HVDC cables, are the most efficient means of transporting electricity over long distances. HVDC cables with an insulation layer can be buried underground or laid on the seabed, allowing for considerable expansion of networks, and many projects are currently underway to connect different parts of the world. In Europe, for instance, the NordLink project will connect southern Norway and Germany, and HVDC cable projects form a significant part of the energiewende, Germany's overarching plan to move to a more environmentally sustainable energy supply.

“For us to handle the rapidly increasing global demand for electricity, efficient and safe HVDC cables are an essential component. The supply of renewable energy can fluctuate, so being able to transport electricity through long distance networks is a necessity for ensuring a steady and reliable distribution," says Christian Müller, leader of the research and Professor at the Department of Chemistry and Chemical Engineering at Chalmers University of Technology.

During transport, as little energy as possible should be lost. One way to reduce transmission losse such as this is by increasing the direct current voltage level.

"However, an increase in the transmission voltage adversely affects the insulation of an HVDC cable," explains Xiangdong Xu, research specialist at the Department of Electrical Engineering at Chalmers University of Technology.

"The resulting higher electric field stresses could be handled if the electrical conductivity of the insulation material was reduced sufficiently.”

The researchers now present a novel way to reduce the conductivity of an insulation material.

A material that gives the cables three times lower conductivity

The basis of the new material is polyethylene, which is already used for insulation in existing HVDC cables. Now, by adding very small amounts – 5 parts per million – of the conjugated polymer known as poly(3-hexylthiophene), the researchers were able to lower the electrical conductivity by up to three times

The additive, also known as P3HT, is a widely studied material, and given the tiny amounts required, opens up new possibilities for manufacturers. Other possible substances that have previously been used to reduce the conductivity are nanoparticles of various metal oxides and other polyolefins, but these require significantly higher quantities.

“In materials science, we strive to use additives in as small quantities as possible, in order to increase the potential for them to be used in industry and for better recycling potential. The fact that only a very small amount of this additive is required to achieve the effect is a big advantage,” says Christian Müller.

A discovery that could lead to a new research field

Conjugated polymers, such as P3HT, have been used in the past to design flexible and printed electronics. However, this is the first time they have been used and tested as an additive to modify the properties of a commodity plastic. The researchers therefore believe that their discovery could lead to numerous new applications and directions for research.

“Our hope is that this study can really open up a new field of research, inspiring other researchers to look into designing and optimising plastics with advanced electrical properties for energy transport and storage applications," says Christian Müller.

For more information, contact:

Christian Müller, Professor at the Department of Chemistry and Chemical Engineering, Chalmers University of Technology
+46 31-77227 90
christian.muller@chalmers.se

More about the research:

The research study is part of a project funded by the Swedish Foundation for Strategic Research. It was led by Christian Müller and his research group at Chalmers and was carried out in collaboration with colleagues active in both Sweden and internationally. It was recently reported in the scientific journal Advanced Materials.

The scientific article Repurposing Poly (3-hexylthiophene) as a Conductivity-Reducing Additive for Polyethylene-Based High-Voltage Insulation has been published in the journal Advanced Materials and is written by Amir Masoud Pourrahimi, Sarath Kumara, Fabrizio Palmieri, Liyang Yu, Anja Lund, Thomas Hammarström, Per-Ola Hagstrand, Ivan G. Scheblykin, Davide Fabiani, Xiangdong Xu, and Christian Müller. The researchers are active at Chalmers University of Technology, University of Bologna, Lund University and Borealis AB.

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JOURNAL

Advanced Materials

DOI

10.1002/adma.202100714 

ARTICLE TITLE

Repurposing Poly(3-hexylthiophene) as a Conductivity-Reducing Additive for Polyethylene-Based High-Voltage Insulation

ARTICLE PUBLICATION DATE

27-May-2021

THIRD WORLD USA

Study finds drop in breast cancer screening rates in low-income communities during the pandemic

Peer-Reviewed Publication

AMERICAN CANCER SOCIETY

ATLANTA – AUGUST 26, 2021 – A new study finds breast cancer screening rates (BCSR) declined among women aged 50 to 74 years within 32 community health centers that serve lower-income populations during the COVID-19 pandemic in the United States. The report, appearing in the journal, CANCER, suggests that breast cancer screening rates within community clinics in low-income communities declined by 8% from July 2019-2020, reversing an 18% improvement between July 2018-2019.

This is one of the first studies to examine BCSRs among lower-income populations during the pandemic. Investigators led by Stacey Fedewa, PhD of the American Cancer Society, examined BCSRs among 32 community health centers that provide healthcare services to communities of color and lower income populations and received grant funding from the American Cancer Society (ACS) to improve their BCSRs.

“This study is important because these populations have long-standing barriers to accessing care, lower breast screening rates, higher breast cancer mortality rates, and are especially vulnerable to healthcare disruptions,” said Dr. Fedewa.

Findings show that if 2018 to 2019 BCSR trends continued through 2020, 63.3% of women would have been screened for breast cancer in 2020 compared to the 49.6% of women that did get screened. This data translates to potentially 47,517 fewer mammograms and 242 missed breast cancer diagnoses.

It is not yet known how negative outcomes will be distributed, and if breast cancer mortality disparities will widen. It is also not known how breast cancer screening services fared in community health centers nationwide as the clinics included in this study were part of an ACS grant funded by the National Football League to improve breast cancer screening rates. Authors note that it’s possible that interventions established before and continued through 2020 may have mitigated the pandemic’s effects on breast cancer screening services.

“Declining breast cancer screening rates in clinics serving communities with lower-incomes that already have barriers to accessing healthcare and have higher breast cancer mortality rates means there is a need for additional policies to support and resources to identify women in need of screening,” said the authors. “These actions will be critical as communities and clinics return to screening with hopes of reaching pre-pandemic breast cancer screening rates in the communities they serve.”

Article: Fedewa SA, Cotter MM, Wehling K, Wysocki K, Killewald R, Makaroff L. Changes in breast cancer screening rates among 32 community health centers during the COVID-19 pandemic.  CANCER, 2021. doi: 10.1002/cncr.0038.

URL upon embargo: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.0038

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JOURNAL

Cancer

DOI

10.1002/cncr.0038 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Changes in breast cancer screening rates among 32 community health centers during the COVID-19 pandemic

ARTICLE PUBLICATION DATE

26-Aug-2021

PANDEMIC NATION

One in three Americans had COVID-19 by the end of 2020

Undocumented infections accounted for estimated three-quarters of infections last year

Peer-Reviewed Publication

COLUMBIA UNIVERSITY'S MAILMAN SCHOOL OF PUBLIC HEALTH

A new study published in the journal Nature estimates that 103 million Americans, or 31 percent of the U.S. population, had been infected with SARS-CoV-2 by the end of 2020. Columbia University Mailman School of Public Health researchers modeled the spread of the coronavirus, finding that fewer than one-quarter of infections (22%) were accounted for in cases confirmed through public health reports based on testing.

The study is the first to comprehensively quantify the overall burden and characteristics of COVID-19 in the U.S. during 2020. The researchers simulated the transmission of SARS-CoV-2 within and between all 3,142 U.S. counties using population, mobility, and confirmed case data.

Infections were more widespread in some areas of the country. In areas of the upper Midwest and Mississippi valley, including the Dakotas, Minnesota, Wisconsin and Iowa, more than 60 percent of the population is estimated to have been infected by the end of 2020. In five metropolitan areas the researchers examined, 48 percent of residents of Chicago, 52 percent of Los Angeles, 42 percent of Miami, 44 percent of New York City, and 27 percent of people in Phoenix, had been infected in the same timeframe.

Testing picked up on a growing number of infections but offered an incomplete picture. The portion of confirmed cases reflected in the study’s estimates, i.e. the ascertainment rate, rose from 11 percent in March to 25 percent in December, reflecting improved testing capacity, a relaxation of initial restrictions on test usage, and increasing recognition, concern, and care-seeking among the public. However, the ascertainment rate remained well below 100 percent, as individuals with mild or asymptomatic infections, who could still spread the virus, were less likely to be tested.

“The vast majority of infectious were not accounted for by the number of confirmed cases,” says Jeffrey Shaman, PhD, professor of environmental health sciences at Columbia University Mailman School of Public Health. “It is these undocumented cases, which are often mild or asymptomatic infectious, that allow the virus to spread  quickly through the broader population.”

One in 130 Americans was contagious at year’s end. Roughly 1 in 130 Americans (0.77%) was contagious with SARS-CoV-2 on December 31, 2020. A similar percentage (0.83%) was estimated to be latently infected, i.e. infected but not yet contagious. In some metropolitan areas, the percentage of individuals who was contagious at year’s end was much higher.

Fatality rates fell with strengthening treatments and public health measures. The percentage of people with infections who died from COVID-19 fell from 0.8 percent during the spring wave to 0.3 percent by year’s end. Urban areas like New York City that peaked in the spring saw the worst numbers for reasons that include delays in testing availability and masking mandates, overwhelmed hospitals, and lack of effective treatments.

Cities peaked at different times of the year. New York and Chicago experienced strong spring and fall/winter waves but little activity during summer; Los Angeles and Phoenix underwent summer and fall/winter waves; and Miami experienced all three waves. Los Angeles County, the largest county in the U.S. with a population of more than 10 million people, was particularly hard-hit during the fall and winter and had a community infection rate of 2.4 percent on December 31.

A new pandemic landscape for 2021. Looking ahead, the authors write that several factors will alter population susceptibility to infection. The virus will continue to spread to those who haven’t yet been infected. While vaccines protect against severe and fatal disease, breakthrough infections, including those that are mild or asymptomatic, will contribute to the spread of the virus. The current study does account for the possibility of reinfection, although there is evidence of waning antibodies and reinfection. New more contagious variants make reinfection and breakthrough infections more likely.

“While the landscape has changed with the availability of vaccines and the spread of new variants, it is important to recognize just how dangerous the pandemic was in its first year,” concludes Sen Pei, PhD, assistant professor of environmental health sciences at Columbia University Mailman School of Public Health.  

Additional authors include Teresa K. Yamana, Sasikiran Kandula, and Marta Galanti at Columbia Mailman School.

The study was supported by funding from the National Science Foundation (DMS-2027369) and a gift from the Morris-Singer Foundation. Human mobility data was provided by SafeGraph. Shaman and Columbia University disclose partial ownership of SK Analytics. Shaman discloses consulting for Business Network International (BNI).  

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JOURNAL

Nature

DOI

10.1038/s41586-021-03914-4 

METHOD OF RESEARCH

Computational simulation/modeling

ARTICLE TITLE

Burden and characteristics of COVID-19 in the United States during 2020

ARTICLE PUBLICATION DATE

26-Aug-2021

COI STATEMENT

Shaman and Columbia University disclose partial ownership of SK Analytics. Shaman discloses consulting for Business Network International (BNI).