Non-drug interventions for patients with Alzheimer’s are both effective and cost-effective, study shows

A Brown-led research team used a computer simulation to show that compared to usual care, four dementia-care interventions saved up to $13,000 in costs, reduced nursing home admissions and improved quality of life.

Peer-Reviewed Publication

BROWN UNIVERSITY

PROVIDENCE, R.I. [Brown University] — While new drugs to treat Alzheimer’s disease tend to receive the most public attention, many well-researched ways to care for people with dementia don’t involve medication. A new evaluation compared the cost-effectiveness of four non-drug interventions to the usual care received by people with dementia and found that the interventions not only resulted in a better quality of life, but also saved money.

In a study published April 6 in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, researchers used a computer simulation model to show that the four dementia-care interventions saved between $2,800 and $13,000 in societal costs, depending on the type of intervention, and all reduced nursing home admissions and improved quality of life compared to usual care.

Alzheimer’s drugs hold great promise, but they still need additional research and improvement, said lead study author Eric Jutkowitz, an associate professor at Brown University’s School of Public Health. In the meantime, he said, a number of non-drug interventions have been shown to be effective in clinical trials in improving quality of life for people with dementia and helping them stay safely at home longer.

“Now that we can show that these effective interventions can also save money, it just makes sense to find ways to make them available to more families,” Jutkowitz said. “These interventions can be used to help people with dementia starting today.”

The four interventions studied included the following: Maximizing Independence at Home, an at-home, care coordination intervention that consists of care planning, skill-building, referrals to services and care monitoring; New York University Caregiver, which is implemented in an outpatient clinic and provides caregivers with six counseling sessions over four months plus lifetime ad-hoc support and access to weekly support groups; Alzheimer’s and Dementia Care, in which a health care system provides people living with dementia and their caregivers a needs assessment, individual care plans and round-the-clock access to a care manager; and Adult Day Service Plus, which augments adult day care services with staff providing face-to-face caregiver support, disease education, care management, skill-building and resource referrals.

Nonpharmacological interventions like these provide family caregivers with knowledge, skills and support tailored to their care challenges. They have been shown to improve quality of life for the caregiver and the person living with dementia, as well as to reduce nursing home admissions, and they are not associated with adverse events such as hospitalizations and mortality. For these reasons, nonpharmacological interventions are recommended as first-line therapies for the management of Alzheimer’s and dementia.

While non-drug interventions are well-studied, Jutkowitz said they haven't been widely implemented in clinical care centers. He added that there isn’t currently an infrastructure in place to support these methods of care — for example, there are limited mechanisms for providers to be reimbursed for these types of interventions.

To conduct the study, the researchers used a computer simulation to model the likelihood of nursing home admission for four evidence-based Alzheimer’s and dementia nonpharmacological interventions compared to usual care. For each, the study evaluated societal costs, quality-adjusted life-years and cost-effectiveness. The inputs in the simulation were based on data from Medicare, clinical trials and national surveys with families of people with dementia.

Jutkowitz noted that the researchers benefited not only from Brown University computing resources that could handle intensive analytic tasks, but also access to data from the government’s Centers for Medicare and Medicaid Services, which was crucial to the analysis.

In addition to finding that the interventions were cost-effective from a societal perspective, the researchers also found that from a health care payer perspective, the interventions involved little to no additional cost, compared to usual care, while increasing patient quality of life.

Based on the study findings, the authors concluded that health insurance policies should find ways to incentivize providers and health systems to implement nonpharmacological interventions.

The importance of understanding the cost-effectiveness of non-drug Alzheimer’s and dementia interventions is further highlighted by changes in Medicare payment models and emerging Alzheimer’s therapeutics, the researchers noted. The Centers for Medicare and Medicaid Services is in the process of determining coverage for new Alzheimer’s and related dementia drugs.

“As the Centers for Medicare and Medicaid Services determine coverage for new Alzheimer’s and related dementia drugs, we strongly believe that CMS should also consider the benefits of nonpharmacologic interventions,” Jutkowitz said.

While this study focused on non-drug interventions that reduce nursing home admissions, a future analysis will look at similar interventions that reduce or maintain functional decline and challenging behaviors. The researchers are also working on designing a trial that would test the interventions with patients in a health care setting.

Additional Brown contributors included Peter Shewmaker and Gary Epstein-Lubow.

This research was supported by the National Institute on Aging (1R21AG059623-01, 1R01AG060871-01, 1RF1AG069771, R01AG049692).

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DOI

10.1002/alz.12964 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Cost effectiveness of non-drug interventions that reduce nursing home admissions for people living with dementia

COI STATEMENT

Katherine M. Prioli conducted the research while at Rutgers University and is now an employee of OPEN Health. All authors report no conflicts of interest. Author disclosures are available in the supporting information.

Activating adult-born neurons through deep brain stimulation alleviates Alzheimer’s symptoms in rodent models

Peer-Reviewed Publication

CELL PRESS

 

IMAGE: ACTIVATION OF HYPOTHALAMIC-ENHANCED ADULT-BORN NEURONS RESTORES COGNITIVE AND AFFECTIVE FUNCTION IN ALZHEIMER’S DISEASE view more 

CREDIT: CELL STEM CELL/LI ET AL.

People with Alzheimer’s disease develop defects in cognitive functions like memory as well as problems with noncognitive functions that can lead to anxiety and depression. In a paper published April 6 in the journal Cell Stem Cell, investigators used mice to study a process through which new neurons are generated in adulthood, called adult hippocampus neurogenesis (AHN). The research showed that deep brain stimulation of new neurons helped restore both cognitive and noncognitive functions in mouse models of Alzheimer’s disease.

“We were surprised to find that activating only a small population of adult-born new neurons was enough to make a significant contribution to these brain functions,” says senior author Juan Song, an associate professor at the University of North Carolina at Chapel Hill. The neurons were modified by deep brain stimulation of the suprammamillary nucleus (SuM), which is located in the hypothalamus. “We are eager to find out the mechanisms that underlie these beneficial effects,” Song says.

This research used two distinct mouse models of Alzheimer’s. The investigators used optogenetics to stimulate the SuM and enhance AHN in Alzheimer’s mice. Their earlier research had shown that stimulation of the SuM could increase the production of new neurons and improve their qualities in normal adult mice. In the new study, the investigators showed that this strategy was also effective in the Alzheimer’s mice, leading to the generation of new neurons that made better connections with other parts of the brain.

However, having more improved new neurons is not enough to improve memory and mood. Behavioral improvement in Alzheimer’s mice were seen only when these improved new neurons were activated by chemogenetics. The researchers used memory tests as well as established assessments to look for anxiety-like and depression-like behavior to confirm these improvements. The results suggested that multi-level enhancement of new neurons—enhancement in number, properties, and activity—is required for behavioral restoration in Alzheimer's brains.

To further understand the mechanism, they also analyzed the protein changes in the hippocampus of Alzheimer’s mice in response to activation of SuM-modified adult-born new neurons. They found several well-known protein pathways activated inside cells, including those known to be important for improved memory performance, as well as those that allow clearance of the plaques related to Alzheimer’s.

“It was striking that multilevel enhancement of such a small number of adult-born new neurons made such a profound functional contribution to the animals’ diseased brains,” Song says. “We were also surprised to find that activation of SuM-enhanced neurons promoted the process that can potentially remove plaques.”

Future efforts of the team will focus on developing potential therapeutics that mimic the beneficial effects mediated by activation of SuM-modified new neurons. “We are hoping these drugs could exert therapeutic effects in patients with low or no hippocampal neurogenesis,” Song says. “Ultimately, the hope is to develop first-in-class, highly targeted therapies to treat Alzheimer’s and related dementia.”

###

This work was supported by the NIH, Alzheimer’s Association, Brain & Behavior Research Foundation, NIH- NINDS Neuroscience Center, NIH- NICHD Intellectual and Developmental Disabilities Research Center, and a UNC Pharmacology Curriculum predoctoral T32 training grant.

Cell Stem Cell, Li et al. “Activation of hypothalamic-enhanced adult-born neurons restores cognitive and affective function in Alzheimer’s disease” https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(23)00043-7

Cell Stem Cell (@CellStemCell), published by Cell Press, is a monthly journal that publishes research reports describing novel results of unusual significance in all areas of stem cell research. Each issue also contains a wide variety of review and analysis articles covering topics relevant to stem cell research ranging from basic biological advances to ethical, policy, and funding issues. Visit: http://www.cell.com/cell-stem-cell. To receive Cell Press media alerts, contact press@cell.com.

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JOURNAL

Cell Stem Cell

DOI

10.1016/j.stem.2023.02.006 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Activation of hypothalamic-enhanced adult-born neurons restores cognitive and affective function in Alzheimer's disease

Random matrix theory approaches the mystery of the neutrino mass!

Peer-Reviewed Publication

OSAKA METROPOLITAN UNIVERSITY

 

IMAGE: THE HORIZONTAL AXIS SHOWS THE ORDINARY LOGARITHM OF THE NEUTRINO MASS SQUARED DIFFERENCE RATIO, WHILE THE VERTICAL AXIS SHOWS THEIR PROBABILITY DISTRIBUTION. EACH HISTOGRAMS REPRESENT THE PROBABILITY DISTRIBUTIONS FOR THE SEESAW MECHANISMS OF THE CORRESPONDING COLOR. THE VERTICAL RED AND BLUE LINES REPRESENT THE EXPERIMENTAL VALUES (1Σ AND 3Σ ERRORS) OF THE ORDINARY LOGARITHM OF THE NEUTRINO MASS SQUARED DIFFERENCE RATIO. THE PROBABILITY DISTRIBUTION FOR THE SEESAW MODEL WITH THE RANDOM DIRAC AND MAJORANA MATRICES IN ORANGE HAS THE HIGHEST PROBABILITY OF REPRODUCING THE EXPERIMENTAL VALUE. view more 

CREDIT: NAOYUKI HABA, OSAKA METROPOLITAN UNIVERSITY

When any matter is divided into smaller and smaller pieces, eventually all you are left with—when it cannot be divided any further—is a particle. Currently, there are 12 different known elementary particles, which in turn are made up of quarks and leptons each of which come in six different flavors. These flavors are grouped into three generations—each with one charged and one neutral lepton—to form different particles, including the electron, muon, and tau neutrinos. In the Standard Model, the masses of the three generations of neutrinos are represented by a three-by-three matrix.

A research team led by Professor Naoyuki Haba from the Osaka Metropolitan University Graduate School of Science, analyzed the collection of leptons that make up the neutrino mass matrix. Neutrinos are known to have less difference in mass between generations than other elementary particles, so the research team considered that neutrinos are roughly equal in mass between generations. They analyzed the neutrino mass matrix by randomly assigning each element of the matrix. They showed theoretically, using the random mass matrix model that the lepton flavor mixings are large.

“Clarifying the properties of elementary particles leads to the exploration of the universe and ultimately to the grand theme of where we came from!” Professor Haba explained. “Beyond the remaining mysteries of the Standard Model, there is a whole new world of physics.”

After studying the neutrino mass anarchy in the Dirac neutrino, seesaw, double seesaw models, the researchers found that the anarchy approach requires that the measure of the matrix should obey the Gaussian distribution. Having considered several models of light neutrino mass where the matrix is composed of the product of several random matrices, the research team was able to prove, as best they could at this stage, why the calculation of the squared difference of the neutrino masses are closest with the experimental results in the case of the seesaw model with the random Dirac and Majorana matrices. 

“In this study, we showed that the neutrino mass hierarchy can be mathematically explained using random matrix theory. However, this proof is not mathematically complete and is expected to be rigorously proven as random matrix theory continues to develop,” said Professor Haba. “In the future, we will continue with our challenge of elucidating the three-generation copy structure of elementary particles, the essential nature of which is still completely unknown both theoretically and experimentally.”

Their findings were published in Progress of Theoretical and Experimental Physics.

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About OMU 

Osaka Metropolitan University is a new public university established by a merger between Osaka City University and Osaka Prefecture University in April 2022. For more science news, see https://www.omu.ac.jp/en/, and follow @OsakaMetUniv_en, or search #OMUScience.

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JOURNAL

Progress of Theoretical and Experimental Physics

DOI

10.1093/ptep/ptad010 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Neutrino mass square ratio and neutrinoless double beta decay in random neutrino mass matrices

Understanding inflorescence architecture in woodland strawberry provides tools for crop improvement

Peer-Reviewed Publication

UNIVERSITY OF HELSINKI

 

IMAGE: RESEARCHERS DEMONSTRATED HOW STRAWBERRY INFLORESCENCE DEVELOPMENT IS DICTATED BY THE SMALL GROWING POINTS, CALLED MERISTEMS. view more 

CREDIT: MIKOLAJ CIESLAK JA PRZEMYSLAW PRUSINKIEWICZ.

Researchers from the University of Helsinki, in collaboration with their Canadian colleagues, have demonstrated how strawberry inflorescence development is dictated by the small growing points, called meristems. This research provides tools for plant breeding based on genetic information and for improving yields of the more genetically complex cultivated strawberry.

Woodland strawberry is a familiar plant for many of us. It is also a very convenient model plant for biological research – it is easy to cultivate in greenhouses, and its small genome is fully known. Researchers at the Department of Agricultural Sciences, University of Helsinki, have focused on exploring the genetic mechanisms that regulate inflorescence  architecture in woodland strawberry. With the help of transgenic strawberry plants, they have identified gene functions that affect the complexity of inflorescences.  

“Our aim is to understand the mechanisms behind the diversity of plant structures and forms in nature. In this research, we explored how the level of branching varies in strawberry inflorescences and consequently affects the berry yield of the plant,” says Professor Timo Hytönen, the corresponding author of the study.

Researchers demonstrated how strawberry inflorescence development is dictated by the small growing points, called meristems. Strawberry meristems, located at the tips of the shoots, may either terminate into a flower or produce new meristems to form a branch. The timing of these events affects the branching iterations, the final number of flowers, and eventually the number of berries in the inflorescences.

Interestingly, strawberry inflorescences combine two branching systems – a monopodial primary axis and sympodial lateral branches – and are botanically known as thyrses. The development of thyrse architecture has not been previously explored in any other plant.

“Firstly, our discovery shows how the thyrse architecture in strawberry emerges from geometrically distinct meristems, and secondly, we provide molecular data showing how two antagonistically functioning genes regulate the fate of these meristems,” explains doctoral researcher Sergei Lembinen.

In collaboration with computer scientists at the University of Calgary, the molecular data was integrated into a computational model to create virtual strawberry plants. Together with experimental data, the model helps us to understand the complex interactions and mechanisms that affect inflorescence architecture. The model explains and captures the extensive variability of inflorescence architectures in strawberry, documented by the botanist George McMillan Darrow almost a century ago.

“By exploring the diversity of plant species, and the specific features in their development, we gain a basic understanding of how genetic mechanisms governing plant development have been modified during evolution. Moreover, this research provides us with tools for genomics-based plant breeding in the genetically more complex cultivated strawberry,” summarizes Professor Hytönen.

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JOURNAL

The Plant Cell

DOI

10.1093/plcell/koad086 

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

Diversity of woodland strawberry inflorescences arises from heterochrony regulated by TERMINAL FLOWER 1 and FLOWERING LOCUS T

Simple, environmentally friendly coating can improve battery performance

Peer-Reviewed Publication

CHINESE ACADEMY OF SCIENCES HEADQUARTERS

 

IMAGE: MOLECULAR FERROELECTRIC COATING INHIBITS THE SPACE CHARGE LAYER AND ENHANCES THE LI+ TRANSPORT AT THE CATHODE/ELECTROLYTE INTERFACE view more 

CREDIT: LI WENRU AND MA JUN

Lithium-ion batteries are currently the gold standard of battery technology, but as the demand for safe and effective batteries increases, researchers are racing to find what's next.

All-solid-state lithium batteries could be an alternative to current lithium-ion battery technology, but improvements in their capacity are needed.

A new study led by researchers from the Qingdao Institute of Bioenergy and Bioprocess Technology (QIBEBT) of the Chinese Academy of Sciences details how ferroelectric cathode coatings boost the capacity of all-solid-state lithium batteries.

The study was published in Advanced Functional Materials on March 28.

Ferroelectric materials possess an inherently polarized electric field that is widely used to accelerate the separation and transfer of charges in many electrochemical types of research.

"In the field of all-solid-state lithium batteries, it is widely accepted that the ferroelectric polarization induces the built-in electric field at the electrode/solid-state electrolytes interface, which could suppress the space charge layer and boost lithium transportation," said Dr. LI Wenru, first author of the study. "However, the construction mechanism of the ferroelectric built-in electric field in these batteries is poorly understood. Revealing this construction mechanism becomes a critical challenge."

To understand more about how the ferroelectric material improves battery function, the researchers covered the lithium cobalt oxide cathode in a coating layer made from an organic-inorganic hybrid ferroelectric material called guanidinium perchlorate. Guanidium perchlorate coatings were found to possess a single-domain state, meaning the inner ferroelectric dipoles point to one same direction. This behavior finally generates the downward built-in electric field at the cathode/electrolyte interface. By the way, guanidium perchlorate can be made by evaporating solvents like ethyl alcohol, making it an inexpensive and environmentally friendly option for battery manufacturing.

The researchers found out that the capacities of the all-solid-state lithium batteries with the ferroelectric coating on the cathode are nearly the same as current liquid lithium-ion battery, which is much higher than the all-solid-state lithium batteries using the uncoated cathode.

They also analyzed how the active particles interacted with the electrolyte in the cathode with and without the coating. A space charge layer, which interferes with the movement of electrons through the battery, forms when the lithium cobalt oxide meets the solid-state electrolyte. The space charge layer restricts the transport of the lithium and reduces the capacity of the battery. When the coatings were coated onto the cathode, the effective ferroelectric built-in electric field made the lithium move more fluently through the cathode/electrolyte interface, improving the capacity of the battery despite the space charge layer.

"We found that the flexoelectric effect caused by the lattice mismatch is the primary factor for the self-polarization effect of the coatings. Our study not only designs the all-solid-state lithium batteries with excellent electrochemical performance, but also discovers the scientific theoretical guidance for constructing the ferroelectric coating layers in promoting performances of electrochemical energy storage," said Dr. LI.

Looking ahead, the researchers will look at different combinations of materials to expand the possibilities for all-solid-state lithium batteries. "We hope to expand this research idea to different combinations of cathode and ferroelectric materials in future work, and obtain experimental rules for optimal battery performance," said Prof. CUI Guanglei, corresponding author and the group leader of Solid Energy System Technology Center at QIBEBT. "The ultimate goal is to have a universal strategy improving lithium battery performance in practical applications."

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JOURNAL

Advanced Functional Materials

DOI

10.1002/adfm.202300791 

ARTICLE TITLE

Self-Polarized Organic–Inorganic Hybrid Ferroelectric Cathode Coatings Assisted High Performance All-Solid-State Lithium Battery

Providing critical insights for animal development - HKU biologists determine the evolutionary age of individual cell types

Peer-Reviewed Publication

THE UNIVERSITY OF HONG KONG

A research team led by Dr Chaogu ZHENG from the School of Biological Sciences at the University of Hong Kong (HKU) has made a significant discovery about the evolutionary age of different type of cells in a small animal called Caenorhabditis elegans (C. elegans). By using single-cell transcriptomic data and refined phylostratigraphy, the team determines the transcriptomic age of individual cells, which means they are able to estimate the evolutionary origin of different cells based on the age of the genes expressed in the cells.

Their findings shed light on the cellular basis of the ‘hourglass’ pattern of animal development, revealing significant variation in the transcriptome age of different cell types. These results also provide insights into the varying contribution of different cells and tissues to adaptation, and the evolutionary relationship among cell types. These findings offer new perspectives on the genetic mechanisms that drive the evolution of species and have been published in the leading multidisciplinary journal PNAS.

Insights from Molecular Studies on Hourglass Model
The embryos of all animals share similar morphology at the middle stage of embryonic development while having larger morphological divergence at earlier and later stages. This pattern is often referred to as the ‘hourglass’ pattern of development, meaning that all animal development experiences an evolutionarily conserved phase during mid-embryogenesis.

Recent molecular studies have shown that embryos at the middle stage of embryogenesis express the oldest transcriptome, which means that the oldest and most conserved genes are used at this stage during gene expression. In contrast, younger genes are expressed in the earlier and later stages of embryonic development. This was discovered by analysing gene expression of the embryos in different developmental stages using a technique called phylostratigraphy, a method used to determine gene ages by comparing their sequences across different species.

However, these studies are limited in that they could only determine the transcriptome age of the entire organism throughout development but not in individual cells or tissue. This limitation is significant because obtaining information about the age of genes expressed in specific cells and tissue is crucial for gaining a more detailed understanding of the evolution of developmental patterns among species, as well as the genetic mechanisms driving it. Additionally, it can shed light on how individual tissue and cells contribute to the ‘hourglass’ pattern, which is a crucial aspect of understanding how different organs and tissues contribute to the evolution and adaptation of the overall developmental process in animals.

From Whole-Organism to Single-Cell Analysis
To fill this knowledge gap, the research team studies the transcriptome age of the nematode C. elegans at the single cell level using RNA sequencing. They look at RNA expression from both whole embryos (or organism) and individual cells to gain a comprehensive understanding of how different genes are used during embryonic and larval development.

The team first identifies a period of the oldest transcriptome during C. elegans mid-embryogenesis, which starts after gastrulation, a process that forms different germ layers in the embryo and continues into the early development of an organ. More importantly, the research team finds that in early embryos, certain cells used older genes than other cells. For example, cells that would later become the germline (which is responsible for passing on genetic information to offspring) use older genes than somatic tissues in the body. Similarly, cells that would later become the endoderm (which gives rise to the digestive tract) use older genes compared to other cell types during early development. Among differentiated cells, muscles appear to have the oldest transcriptome than other cell types.

It is also observed that the variation in transcriptome ages among the cell and tissue types remain small in early embryonic stages and grow bigger at late embryonic and larval stages as cells differentiate. Tracking the dynamics of transcriptome age along lineages identifies certain tissues, such as the skin, that contribute to the rise of the transcriptome age in late embryos.

Further analysis of the variation in transcriptome ages among the 128 different types of neurons in C. elegans nervous system reveals that a specific group of chemosensory neurons and their downstream interneurons express very young transcriptomes, which may have contributed to adaptation in recent evolution, as many newly evolved young genes are associated with sensing environmental factors. Finally, by analysing the variation in transcriptome age among the different neuron types, as well as the age of the genes that regulate their development (fate regulators), the research team is able to hypothesize about the evolutionary history of some of these 128 neuron types.

‘Using C. elegans as an example, we showcase how the transcriptome age at the single-cell level can provide insight into the cellular basis of developmental innovation and help understand the functional diversity and evolutionary origin of cell types,’ said Dr Fuqiang MA, a Postdoctoral Fellow of HKU School of Biological Sciences and the first author of the paper.

Dr Zheng, the supervisor of the research project, highlighted that ‘this study serves as an example of using the cutting-edge single-cell transcriptomics to study old problems in evolutionary biology.’ Dr Zheng envisions that the possibility of determining the evolutionary age of individual cell types at the transcriptome level can open up new research directions and advance our understanding of the genetic mechanisms that drive the evolution of species.

About the research paper:
Ma F, Zheng C. Transcriptome age of individual cell types in Caenorhabditis elegans. Proc Natl Acad Sci U S A. 2023 Feb 28;120(9):e2216351120. doi: 10.1073/pnas.2216351120.

The journal paper can be accessed from here: 
www.pnas.org/doi/10.1073/pnas.2216351120

This work is supported by funding from the National Science Foundation of China, the Research Grant Council of Hong Kong, and The University of Hong Kong.

Images download and captions: https://www.scifac.hku.hk/press

For media enquiries, please contact Ms Casey To, External Relations Officer (Tel: 3917-4948; email: caseyto@hku.hk) and Ms Cindy Chan, Assistant Communications Director of Faculty of Science (Tel: 3917-5286; email: cindycst@hku.hk).

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JOURNAL

Proceedings of the National Academy of Sciences

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

Transcriptome age of individual cell types in Caenorhabditis elegans

People with obesity due to genetic predisposition have lower risk of cardiovascular disease

Peer-Reviewed Publication

KAROLINSKA INSTITUTET

The risk of developing cardiovascular disease is lower in people with obesity who have a genetic predisposition for high BMI than people with obesity influenced mainly by environmental factors such as lifestyle, researchers from Karolinska Institutet report in eClinicalMedicine.  

There has been a global increase in the incidence of overweight and obesity over the past few years. Almost one third of the world’s population now lives with overweight or obesity.  

“The figure is alarming since it is well-established that a high BMI in middle-age increases the risk of developing cardiovascular disease and other conditions,” says Ida Karlsson, assistant professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. 

However, according to this new study, the risk of developing cardiovascular diseases varies widely among people with obesity. The researchers used data from over 15,000 twins from the Swedish Twin Registry, gathering information about their BMI and their genetic predisposition for high BMI. They also used data from medical registries to establish the incidence of cardiovascular disease in this group.  

By analysing this information, the researchers were able to study how overweight and obesity as a result of genetic versus environmental and lifestyle factors influenced the risk of cardiovascular disease.  

“The link between obesity and cardiovascular disease was twice as strong in those with a genetic predisposition to a low BMI as it was in those with obesity driven by genetic factors,” says the study’s last author Ida Karlsson.  

Dr Karlsson stresses that a healthy lifestyle is always important for everyone, and that the risk of cardiovascular disease was higher in all people with overweight or obesity compared to people with a healthy weight. However, the findings also indicate that obesity mainly driven by genetic factors might not have the same adverse impact on health as obesity driven by other factors, such as lifestyle.  

“Obesity is a complex common disease that can have many different causes,” she says. “Since it’s so stigmatised, the results can help us understand that its effects on health differ from one individual to the next.” 

She continues: “Even though we all know that it takes more than exercise and diet to combat obesity, there’s still a large stigma attached to it. I think much could be gained by focusing on what has caused the obesity and what we can do to reduce the risk of comorbidities in each individual instead of mainly focusing on BMI.”

The next step of Dr Karlsson’s research is to examine how individuals with overweight and obesity caused, respectively, by genetic and lifestyle factors differ as regards to blood glucose levels, cholesterol and inflammation markers.  

The study was mainly financed by the Swedish Research Council for Health, Working Life and Welfare (Forte) and the Strategic Research Area in Epidemiology and Biostatistics at Karolinska Institutet. The researchers report no conflicts of interest.  

Publication: “Genetically and environmentally predicted obesity in relation to cardiovascular disease: a nationwide cohort study”. Elsa Ojalehto, Yiqiang Zhan, Juulia Jylhävä, Chandra A. Reynolds, Anna K. Dahl Aslan, Ida K. Karlsson. eClinicalMedicine, online 6 April 2023, doi: 10.1016/j.eclinm.2023.101943

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JOURNAL

EClinicalMedicine

DOI

10.1016/j.eclinm.2023.101943 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Genetically and environmentally predicted obesity in relation to cardiovascular disease: a nationwide cohort study

Establishing the boundaries of ethics in science journalism in Latin America

The results of a survey mapping the views of science journalists on science journalism in Latin America and the Caribbean were released during the 12th World Conference of Science Journalists in Medellín, Colombia

Reports and Proceedings

WORLD FEDERATION OF SCIENCE JOURNALISTS

The results of a survey mapping the views of science journalists on science journalism in Latin America and the Caribbean were released during the 12th World Conference of Science Journalists in Medellín, Colombia. 

The report, Science Journalism In Latin America and the Caribbean 2022, probes ethical topics, such as the legitimacy of establishing the ethical priorities of science journalism, knowledge of professional associations and codes of ethics, and ethical protections and violations. The survey was conducted by the World Federation of Science Journalists (WFSJ) in partnership with the National Institute of Public Communication of Science and Technology in Brazil, with the support of The Kavli Foundation. 

The survey was carried out using a questionnaire containing 32 questions over two weeks in February 2022, and obtained 179 responses from professionals across Latin America and the Caribbean in 18 countries in the region. The survey was distributed in Spanish, Portuguese and English. Key findings include:

• Most respondents say that there is a science journalism association in their country (73%), but only about half of them are unaware of the existence of a code of ethics (55%)
• About one-third of respondents consider the main roles of a science journalist are to inform (32%) and to explain science (32%), with others that feel their role is to promote science (16%) or be a public watchdog (9%)
• Three-quarters (75%) use the most prominent scientists in the field as sources and just over half (52%) seek to have gender balance
• The majority think that scientific findings should not be reported as certainties (74%)
• Most respondents agree that fraud (80%), retractions (72%) and errors (75%) should always be reported
• Latin American science journalists are evenly divided on whether they can be neutral on the subjects they cover, with the proportion of those who do not believe in this neutrality being slightly higher (49%) than the proportion of those who believe in it

These responses prompted the WFSJ to probe further with an extended global survey, asking the same set of questions to science journalists globally. The results of this survey will be released in the coming months. The Federation is also working to develop a set of Guiding Principles of Science Journalism for the global science journalism community.

Journalist respondents were primarily full- or part-time staff (44%) and freelance full- or part-time (40%). The majority of overall respondents were from Mexico, Brazil, and Chile (55%), followed by Argentina and Colombia (20%), and the remaining quarter (25%) other distributed among the countries in the region. Women were the predominant respondents at 60% and 40% for men. Respondent age groups were evenly distributed between 25 to 54, with 35 to 44 years at 33%, 45 to 54 years at 27% and 25 to 34 years at 23%. Those over 54 made up 16% and 18 to 24 at 2%. Most respondents have a university degree in journalism/communication (75%) and some others in science (13%).

Luisa Massarani, a co-author of the report and a science communicator and researcher at the National Brazilian Institute of Public Communication of Science and Technology and the Oswaldo Cruz Foundation (Fiocruz), in Rio de Janeiro said: “This is the first survey that I am aware of in Latin America that addresses the issue of the ethics in science journalism. Thanks to the high engagement of the science journalism associations, we have a clear snapshot of the ethical priorities, protections, and violations of science journalism in the region as well as insights into attitudes toward coverage neutrality, scientific controversies, uncertainties, fraud, errors, and retractions.” 

The WFSJ, a nonprofit Canadian organisation incorporated in 2005, is made up of 67 member associations in 60 countries and has an extended membership of some 10,000 people who work in various areas of science journalism and science communication.

Notes to editors

The report, Science Journalism In Latin America and the Caribbean 2022 was authored by 

• Luisa Massarani, National Institute of Public Communication of Science and Technology and House of Oswaldo Cruz/Oswaldo Cruz Foundation (Brazil) 
• Luiz Felipe Fernandes Neves, Federal University of Goiás and PhD candidate at the Oswaldo Cruz Foundation (Brazil) 
• Tim Lougheed, World Federation of Science Journalists (Canada) 
• Nicolás Bustamante Hernández, independent science journalist (Colombia) 

It was published by the World Federation of Science Journalists and the Brazil’s National Institute of Public Communication of Science and Technology, Casa de Oswaldo Cruz/Fiocruz 

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METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Science Journalism In Latin America and the Caribbean 2022

Significant step in fight against drug resistance in TB

Peer-Reviewed Publication

UNIVERSITY OF OTAGO

University of Otago researchers have discovered new ways to treat antibiotic-resistant strains of  tuberculosis (TB), opening the door to new approaches for tackling the disease that kills about 4,000 people a day.

Led by PhD candidate Natalie Waller and Senior Author Dr Matthew McNeil, of the Department of Microbiology and Immunology, researchers were able to identify antibiotics that could rapidly kill drug resistant strains of TB and when combined could stop drug resistance from occurring altogether.

TB is a major global cause of infectious disease morbidity and mortality, second only to COVID-19 and is one of the hardest infections to treat. Ten million people develop the disease every year and it kills about 4,000 people a day. About 300 cases of TB are diagnosed in New Zealand each year. 

Adding to the challenge, is that drug-resistant strains of the disease – that are very hard to treat and have limited treatment options – are spreading at an “alarming rate”.

“We need not only new drugs, but better drug combinations that can improve treatment success and prevent the further spread of antibiotic resistance,” Dr McNeil says.

Typically, antibiotic resistance leads to reduced sensitivity, but in some cases becoming resistant to one antibiotic can make a pathogen more sensitive to other completely unrelated antibiotics, he says. However, this phenomenon -  collateral sensitivity – has largely been unexplored in TB, until now.

“It is very hardy, resilient and hard to study in the lab because it is a dangerous pathogen that grows extremely slowly.

“To overcome this, our study used a weakened non-virulent strain of Mycobacterium tuberculosis that cannot cause disease or survive outside of the lab to generate strains that were resistant to different antibiotics,” he says.

Researchers then determined if the drug-resistant strains of the bacterium had either increased or reduced sensitivity to other antibiotics.

“We wanted the results of our work to have the greatest chance for clinical impact. For this reason, our study placed an emphasis on drugs that are either clinically approved or in pre-clinical development,” Dr McNeil says.

“Excitingly this work identified a number of instances in which a particular drug-resistant strain was more sensitive to antibiotics that targeted a completely unrelated pathway. We then showed we could use these specific drugs to rapidly kill drug resistant strains as well as design unique drug combinations that prevented the emergence of drug resistance.

“Put simply, this work demonstrates that drug resistant strains of M. tuberculosis have unique weaknesses, that if we can identify them, can be targeted to greatly reduce treatment times and prevent the emergence of drug resistance.”

Dr McNeil says work will now need to focus on further extending these findings into in animal studies.

“There is still work to do, but this is certainly a significant step in the fight again anti-microbial resistance.”

The research was funded through the Royal Society of New Zealand Marsden Fund and the Maurice Wilkins Centre.

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JOURNAL

Nature Communications

DOI

10.1038/s41467-023-37184-7 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Lab-produced tissue samples

ARTICLE TITLE

The evolution of antibiotic resistance is associated with collateral drug phenotypes in Mycobacterium tuberculosis