New findings from Emory study offer potential breakthrough in HIV cure research

Emory’s Gavegnano Group demonstrates ability to remove key barrier to an HIV cure

Reports and Proceedings

EMORY HEALTH SCIENCES

 

IMAGE: EMORY RESEARCHER PRESENTING FINDINGS AT THE INTERNATIONAL AIDS SOCIETY CONFERENCE IN BRISBANE, AUSTRALIA view more 

CREDIT: EMORY UNIVERSITY

The results of a novel study presented by Emory researchers during the International AIDS Society (IAS) Conference in Brisbane, Australia, have revealed exciting findings in the pursuit of an HIV cure. The study, led by Monica Reece, a PhD candidate in Emory’s Microbiology and Genetics Program, and directed by Christina Gavegnano, PhD, demonstrates the potential of Jak inhibitors, specifically ruxolitinib, to significantly decay the viral reservoir in people with HIV, offering a novel pathway toward long-term remission or a cure.

The HIV viral reservoir, essentially a small number of immune cells containing dormant virus integrated into the genomes of individuals who have suppressed viral replication with HIV treatment, has posed a major impediment to achieving an HIV cure. These cells are completely undetectable by the immune system because the virus is dormant. But as soon as treatment stops, the virus reactivates.

“The barrier to an HIV cure is that the virus hides inside the DNA of cells,” says Gavegnano, director of the Gavegnano Drug Discovery Program and senior author on the study. “The brass ring is an agent that can eliminate these‘reservoir cells,’ which would ultimately eliminate HIV from a person’s body.”

While Gavegnano and her Emory colleagues have shown that Jak inhibitors (Janus kinase inhibitors) could reverse the immune dysfunction caused by HIV since their discovery in 2010, questions about their impact on the HIV reservoir and the exact mechanism contributing to the immunologic improvements have remained unanswered, until now.

The data presented at IAS represented secondary results from a Phase 2a clinical trial centered on investigating ruxolitinib’s effects on viral reservoirs in people with HIV during a five-week regimen, specifically in a subset of individuals with high viral reservoir levels at baseline.

The study measured integrated proviral DNA, which is the genetic material of a virus as incorporated into, and able to replicate with, the genome of a host cell, and examined changes in total, intact only, and defective proviral DNA copies over time. Based on a linear model of decay, the researchers estimated an astonishing 99.99% clearance of the peripheral HIV-1 reservoir in less than three years. These data provide optimism for the use of Jak inhibitors as a backbone for cure-based eradication strategies in the battle against HIV.

Reece, lead author of the study says, “These data suggest that our Jak inhibitors can not only reverse the immune dysfunction that prevents HIV-1 cure, but also significantly decay the reservoir in people living with HIV. Collectively our trial demonstrates a mechanism by which ruxolitinib, or other Jak inhibitors such as baricitinib, also extensively studied by our group, decay the reservoir, which underscores potential for cure-based therapies.”

The profound impact of Ruxolitinib treatment was not limited to reservoir reduction. The study also shed light on several significant biomarkers that were altered by the drug primarily related to:

• Immune activation: Ruxolitinib exhibited the potential to modulate immune activation, which is crucial in controlling viral replication and maintaining immune health in individuals with HIV.
• Cell survival: Ruxolitinib demonstrated the ability to impact cell survival, influencing the lifespan of reservoir cells and potentially limiting viral reservoir longevity.
• Immune dysregulation: The study identified ruxolitinib’s impact on immune dysregulation, offering hope for mitigating the chronic inflammation and immune dysfunction often observed in individuals with HIV.

It is important to note that the study focused on the peripheral viral reservoir and may not fully represent the entire viral reservoir within the body, including sanctuary sites where HIV can persist despite treatment.

Regardless, the findings from Emory University’s study offer hope and renewed enthusiasm for efforts to unravel the complexities of HIV persistence and ultimately find a cure.

“These data are valuable because they show that Jak inhibitors can contribute to a long-term cure strategy for HIV, but they can also be used to slow the inflammatory process caused by other infectious diseases,” says Vincent Marconi, MD, professor of medicine and global health at Emory University School of Medicine.

Marconi, who led the initial phase 2a trial, has already been investigating the efficacy of Jak inhibitors, like ruxolitinib and baricitinib, in patients with acute COVID and now long COVID. He continues, “using an anti-inflammatory drug to treat the effects of a virus could be revolutionary.”

In addition to the data presented by Reece and Gavegnano, another presentation at IAS has shown how ruxolitinib administered to a patient following a stem cell transplant led to an undetectable viral load 20 months after stopping antiretroviral therapy, highlighting the different mechanisms in which these class of drugs could be valuable in HIV care and treatment.  

Further research and clinical trials will be needed to fully understand the effects of Jak inhibitor use in HIV and other immune-suppressing conditions. Emory researchers have an extensive history of working with Jak inhibitors. Gavegnano and researcher Raymond Schinazi are listed on the issued patents as sole inventors, and they, alongside their co-investigators, have built a roadmap for tackling a variety of immunosuppressive viruses with these drugs.  

Gavegnano emphasizes, “The safety and efficacy outcomes we observed in this study provide a strong foundation for further research on cure-based interventions containing a Jak inhibitor, and we hope to bring this therapy one step closer to helping people living with HIV.”

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METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

COI STATEMENT

N/A

 

Residents must have a voice in ocean conservation

University of Miami Rosenstiel School researchers Daniel Suman and Claire B. Paris-Limouzy are co-authors of a recent journal article that outlines ways to achieve greater equity in ocean governance and science in the global tropics.

Peer-Reviewed Publication

UNIVERSITY OF MIAMI

 

IMAGE: FISHERMEN WHO LIVE IN COASTAL COMMUNITIES MUST BECOME PART OF THE DECISION-MAKING PROCESS FOR LAWS THAT IMPACT THEIR LIVELIHOOD, ACCORDING TO A JOURNAL ARTICLE WRITTEN BY ROSENSTIEL SCHOOL RESEARCHERS AND OTHERS. view more 

CREDIT: PHOTO COURTESY OF VANESSA CROOKS/OFFICE OF COMMUNICATIONS, SMITHSONIAN TROPICAL RESEARCH INSTITUTE

For the coastal residents in Sri Lanka, Southern India, and Thailand who survived the 2004 Indian Ocean tsunami that killed more than 200,000 people, the nightmare was just starting. After the disaster, their communities—and with them, their way of life—were permanently relocated inland, clearing the way for tourism development. 

Today, people in another part of the world are also facing the threat of displacement. Thousands of villagers who live along the banks of Mozambique’s Zambezi River and depend on the waterway for their livelihood could be forced from their lands if a $4.2 billion mega dam project goes forward in their community. 

While differing in the reason for displacement, both cases are prime examples of how poor, Indigenous people in tropical regions are excluded from the decision-making processes that affect the use of their lands. 

“The tropics are a biodiversity storehouse, and the majority of people who are directly ocean-dependent live there,” said Daniel Suman, a professor of environmental science and policy at the University of Miami Rosenstiel School of Marine, Atmospheric, and Earth Science. “Those residents can be described as the ‘tropical majority.’ Yet, the laws and policies that affect the oceans and waterways in their countries are often made by international organizations, international financial institutions like the World Bank, and global environmental groups in richer countries located in temperate zones.” 

Suman and Rosenstiel School biological oceanographer Claire B. Paris-Limouzy are two of 25 authors—80 percent of whom call the tropics home and three of whom are University of Miami alumni—who recently published a paper in the journal Ocean Sustainability that calls on policymakers to address inequities in ocean science and governance. 

“We need to give a voice to the tropical majority,” said Suman, describing the problem as an “environmental justice issue” rife in many tropical countries, particularly in Latin American nations such as Honduras and Ecuador.

“People who live in or near mangroves there and have used those mangroves traditionally but don’t have property title to them have, in many cases, lost access to those mangroves because they have been privatized, or wealthier groups have come in and gotten concessions, legally or illegally, to build shrimp ponds, displacing locals,” explained Suman, who holds an adjunct appointment in the University’s School of Law. 

To ensure the tropical majority can play a leading role in maintaining ocean sustainability and ecosystems, policymakers must center equity in ocean governance, reconnect people and the ocean, redefine ocean literacy, and decolonize ocean research, the authors agree. 

“From many of the international agreements that come out of high-level United Nations meetings, specific goals related to issues such as sustainable fisheries or marine protected areas are already established,” Suman said. “Specific goals about equity, about fairness to people, about the inclusion of the rights of traditional peoples who rely on the oceans must also be incorporated. And it needs to be solid, actionable goals, not just words.” 

Policymakers, Suman added, must incorporate into new laws the indigenous knowledge coastal residents have about the areas in which they live. “That knowledge must be respected just as much as the scientific information developed largely by scientists in wealthier countries,” he said. “Fishermen and poorer people know a lot about the environment. Even though they may not have received a formal education, they know about weather, and they know where the fish are. They know weather patterns, and their knowledge should be respected and included in ocean management. 

“And recognizing that traditional users can be good stewards and good protectors of the environment by using their local knowledge is the most effective way to reconnect people and the ocean,” Suman continued. “The hope is that our journal article will help raise awareness about these issues.” 

The idea for the article, “Engaging the tropical majority to make ocean governance and science more equitable and effective,” started at the eighth Our Ocean Conference held in Panama last March. Lead authors and Oregon State University researchers Ana K. Spalding and Kirsten Grorud-Colvert, who both earned graduate degrees from the Rosenstiel School, assembled a team of multidisciplinary scientists from around the global tropics to discuss actionable solutions for ocean conservation. 

While the group, which included Suman and Paris-Limouzy, discussed the most pressing problems affecting the ocean, they also quickly realized that inequity in ocean governance and ocean science was a matter that required just as much attention. 

“The thought was that an article like this might encourage the inclusion of equity in international ocean governance meetings and agreements,” Suman said. 

It will be a challenge to accomplish that goal, he admitted. 

“Among the biggest challenges is how to include traditional ecological knowledge within the decision-making process. There must be more inclusion and recognition by decision-makers of the need to include local users and invite those people to the table.” Suman said. “And it will certainly be a multiyear effort to make that happen.”

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JOURNAL

Nature

DOI

10.1038/s44183-023-00015-9 

ARTICLE TITLE

Engaging the tropical majority to make ocean governance and science more equitable and effective

 

UBC researchers recover vital resources from wastewater sludge

New technique can extract and recycle phosphorous from municipal waste

Peer-Reviewed Publication

UNIVERSITY OF BRITISH COLUMBIA OKANAGAN CAMPUS

If you were ever to see sewage sludge up close, you might be hard-pressed to find any redeemable value; however, researchers at UBC’s Bioreactor Technology Group see it another way.

Using a combination of heat, water and phase separation, UBC researchers have developed a cost-effective method to concentrate phosphorous—which can be efficiently recovered by extraction—from wastewater sludge.

“Phosphorous is a non-renewable, but essential, element for life and has many industrial uses,” explains Huan Liu, a doctoral student with UBCO’s School of Engineering and lead author of a new study investigating this method.

Phosphorus is a natural mineral crucial for human health and essential to food security as a commercial fertilizer; however, it's also listed as a critical raw material because many countries rely on imports.

“The uneven distribution of phosphate rock has created political and economic risks,” he says. “On the other hand, phosphorus discharge from waste sources, such as wastewater, is a major contributor to aquatic eutrophication, causing severe environmental challenges including algae blooms and dead zones in lakes.”

Liu and his supervisor, principal investigator Dr. Cigdem Eskicioglu, are investigating a promising process that integrates hydrothermal liquefaction.

The process converts organic components of the municipal wastewater sludge into a petroleum-like bio-crude and concentrates the phosphorous into a solid residue called hydrochar. The hydrochar can have 100 times higher total phosphorus than raw sludge, making it comparable to the phosphate rock used in commercial fertilizers.

Liu describes the extraction process as mirroring what happens when you mix minerals and acids. “We were able to identify, for the first time, the kinetic reactions of phosphorus leaching from hydrochar to optimize the recovery of useful materials, such as what is needed for fertilizer,” says Liu.

According to Dr. Eskicioglu, their latest findings are essential for wastewater utilities aiming to develop a process to recover usable nutrients from the system.

“At a time when we are seeking to be more sustainable and looking for alternative fuels, extruding useable materials from waste is essential,” she says. “Recovery and recycling is the solution that also provides the double benefit of providing a secondary source of phosphorus that can be globally distributed and also help with environmental conservation.”

This latest study appears in the journal Water Research and was funded by the Natural Sciences and Engineering Research Council of Canada and the Metro Vancouver Industrial Research Chair Program in Advanced Resource Recovery from Wastewater. Liu also conducted six months of studies in France in collaboration with Dr. Ange Nzihou’s team at the Research Centre for Particulate Solids, Energy and Environment at the IMT Mines Albi-Carmaux engineering school.

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JOURNAL

Water Research

DOI

10.1016/j.watres.2023.120138 

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Phosphorus recovery from municipal sludge-derived hydrochar: Insights into leaching mechanisms and hydroxyapatite synthesis

 

A new vision for US health care

In her latest book, “We’ve Got You Covered,” Amy Finkelstein prescribes a complete overhaul of our health insurance system.

Book Announcement

MASSACHUSETTS INSTITUTE OF TECHNOLOGY

 

IMAGE: “WE’VE GOT YOU COVERED,” A BOOK CO-AUTHORED BY MIT ECONOMIST AMY FINKELSTEIN, DESCRIBES A WAY TO REVAMP HEALTH CARE IN THE UNITED STATES. view more 

CREDIT: ©PORTER GIFFORD PHOTOGRAPHY

It’s not exactly what he’s best known for, but Alexander Hamilton helped develop the first national, compulsory health insurance policy in the world: a 1798 taxpayer-financed plan Congress approved to cover sick and disabled seamen. 

“The interests of humanity are concerned in it,” Hamilton wrote. 

And they still are, as MIT Professor Amy Finkelstein notes in a new book. The U.S. has repeatedly tried to provide medical care for those who need it and cannot afford it. These efforts may have started with Hamilton, but they have continued through modern times, with policies that have mandated emergency-room care for all, and have extended insurance to those with certain serious illnesses.  

Then again, no policy has fully addressed the needs of the U.S. population. About 30 million U.S. citizens lack health insurance. Even for the insured, costs routinely exceed a plan’s benefits. Americans have $140 billion in unpaid medical debt, more than all other personal debt combined, and three-fifths of it is incurred by people with health insurance. 

That’s why Finkelstein is calling for a total overhaul of the U.S. health insurance system, in a new book with economist Liran Einav of Stanford University, “We’ve Got You Covered: Rebooting American Health Care,” published by Portfolio. In it, the scholars envision an approach with one layer of free and automatic health insurance for everyone, and another layer of private insurance for those seeking additional care amenities.  

“In the U.S., we have always had a commitment to do something when people are ill, so we might as well do it effectively and efficiently,” says Finkelstein, the John and Jennie S. MacDonald Professor in MIT’s Department of Economics. “I don’t think anyone would argue we have a wonderful, well-functioning health care system.”

Patchwork programs

Finkelstein has won the John Bates Clark Medal and received a MacArthur fellowship for empirical studies of health insurance and health care — including work on Medicaid and Medicare, the financial impact of being hospitalized, geographic variation in medical costs, and more. Finkelstein and Einav are also co-authors, with Ray Fisman, of the 2023 book, “Risky Business,” about the insurance industry.

Through two decades of intensive research, Finkelstein and Einav have also never advocated for specific health care policies — until now.

“We feel we do have something to say to the wider public about the problems, and also about the solution,” Finkelstein says. “We emphasize the problems of the insured, not only the uninsured.”

Indeed, around 150 million Americans rely on private employer-provided insurance. Yet they risk losing that insurance if they lose or change their job. Those with public health insurance, like Medicaid, face nearly the opposite problem. If a family member earns enough money to lift a household above the poverty line, they can lose eligibility. The net result: About one in four Americans under the age of 65 will be uninsured at some point in the next two years.

Many of them will actually be eligible for free or heavily discounted coverage. About 18 million Americans who are eligible for public health insurance remain unenrolled due to a lack of information and complicated signup procedures. And even Medicare, the workhorse public insurance program for many seniors, has out-of-pocket expenses with no cap. A quarter of people on Medicare spend a quarter of their income on health care. 

Some reforms have brought better coverage to more people. As the scholars note, the Affordable Care Act of 2010 (which MIT economist Jonathan Gruber helped develop) has allowed 10 million formerly uninsured Americans to gain coverage. But it didn’t change the risk of losing insurance coverage or of incurring large medical debt due to highly incomplete coverage.

The book contends the U.S. has used a long series of piecemeal policies to try to fix problems with health coverage in the U.S. One long-standing approach has been to create disease-specific care subsides, starting with a 1972 law extending Medicare to everyone with end-stage kidney disease. More recently, similar programs have been passed to cover patients with tuberculosis, breast and cervical cancer, sickle cell anemia, ALS, HIV/AIDS, and Covid-19. 

Finkelstein and Einav are skeptical of this approach, however, due to its patchwork nature. Passing separate laws for different illnesses will always leave holes in coverage. Why not just automatically include everyone? 

“When you think about covering all the gaps, that’s what universal basic coverage is,” Finkelstein says. 

Land of the free

As “We’ve Got You Covered” notes, the current U.S. approach to health insurance is hardly etched in concrete: Employer-provided health care really only dates to the 1950s. And, the authors emphasize, the way the U.S. keeps instituting policies to make basic care available to anyone — open emergency rooms, subsidies for severe disease treatments — is telling us that the country has a bottom-line expectation of providing humane care when most needed. 

“The reason why we have all these patches is that, hard as it is to believe, in the United States there is in fact a strong social norm, an unwritten social contract, that we don’t let people die in the streets,” Finkelstein says. “When people are in dire medical situations and don’t have resources, we inevitably as a society feel compelled to try to help them. The problems of the insured and the uninsured represent failures to achieve our commitments, not the lack of those commitments.”

To Finkelstein and Einav, then, the solution is to provide free, basic health care for everyone. No sign-up woes; enrollment would be automatic. No charges for basic care. No losing insurance if you leave your job. No falling off the public-insurance ranks if you climb above the poverty line. 

At the same time, they envision, the U.S. would have another layer of private health insurance, covering health care amenities — private hospital rooms, say, or other elective elements of medical care. “You can pay to upgrade,” Finkelstein says. 

That would not lead to the system of absolutely equal, universal care that some envision, but Finkelstein still believes it would improve the status quo.

“We have inequality in all aspects of our lives, and this is another,” Finkelstein says. “The key is to provide essential basic coverage.”

Could the U.S. afford a system of free, basic, automatic-enrollment health care? The book’s surprising answer is: Yes, absolutely. In the U.S., 18 percent of GDP is spent on health care. Half of that goes to public health care, and half on private care. As it happens, 9 percent of GDP is how much European countries spend on their public-care health systems. 

“We’re already paying for universal coverage in the United States, even though we’re not getting it,” Finkelstein says. “We’re already spending 9 percent of GDP on publicly financed health care. We certainly could do it at the same price tag as all these other countries.”

“We’ve Got You Covered” even comes out against modest co-pays (despite studies showing they reduce visits to doctors), finding them “in conflict with the rationale for universal coverage, namely, access to essential medical care without regard to [financial] need,” as Finkelstein says. 

Until the impossible becomes inevitable

If the Finkelstein-Einav health insurance system makes sense on the merits, though, does it have any chance of existing? 

“One thing that makes me, if not optimistic, then at least not unduly pessimistic, is that this is an argument that will and does appeal to people across the political spectrum,” Finkelstein contends. Expanding health insurance is usually associated with progressive politicians, but the book points to a series of conservatives who, even into the 21st century, have supported universal coverage.

Even if a change to a free system of basic care is not immediately in the offing, Finkelstein and Einav suggest in the book that their role, in writing “We’ve Got You Covered,” is something economist Milton Friedman suggested: Develop ideas and keep them in the public sphere until “the politically impossible becomes the politically inevitable.” 

And in the meantime, Finkelstein and Einav firmly suggest people take more seriously the way U.S. health care policy implicitly assumes we should help everyone. And for the same reasons Hamilton wanted to help seamen, namely, “to protect from want and misery” in their lives.

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Written by Peter Dizikes, MIT News

Book: “We’ve Got You Covered: Rebooting American Health Care”

https://www.penguinrandomhouse.com/books/690632/weve-got-you-covered-by-liran-einav-and-amy-finkelstein/

 

Reduced likelihood of gabapentin prescription in U.S. adults receiving chiropractic spinal manipulation for low back pain

Peer-Reviewed Publication

UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER

CLEVELAND -  A new study conducted by researchers at University Hospitals (UH) Connor Whole Health sheds light on potential benefits of chiropractic care for adults with radicular low back pain (i.e., sciatica). The study, published in BMJ Open, entitled "Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using U.S. data," investigated the relationship between chiropractic spinal manipulative therapy (CSMT) and the prescription of gabapentin, an off-label treatment for radicular low back pain.

The researchers hypothesized that adults under 50 years of age receiving CSMT for newly diagnosed radicular low back pain would have reduced odds of being prescribed gabapentin over a one-year follow-up period. Using a retrospective cohort study design, the research team analyzed data from a large U.S. healthcare network comprising millions of patient records. The CSMT cohort had significantly lower odds of receiving a gabapentin prescription compared to the usual medical care cohort. The odds ratio was 0.53 (p<0.0001), indicating a meaningful reduction in gabapentin use among patients who received chiropractic care for radicular low back pain.

"We are excited by the implications of our findings, which suggest that chiropractic care could offer benefits to managing low back pain and lead to greater concordance with clinical practice guidelines with respect to medication prescribing," said lead author Robert J Trager, DC, from UH Connor Whole Health. "While chiropractic spinal manipulation is already recommended for low back pain, this study re-affirms its utility and sheds light on its other potential pain management benefits."

As the medical community continues to seek ways to improve patient care, studies like this one contribute valuable insights into the potential benefits of CSMT for low back pain. With this study, the authors build on their previous work, which showed that recipients of CSMT were less likely to be prescribed a benzodiazepine, and other studies, which showed a similar finding with opioids.

You can read “Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data” in BMJ Open by clicking here.

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About UH Connor Whole Health

UH Connor Whole Health is part of University Hospitals (UH), a comprehensive health system with annual revenues in excess of $5.0 billion, 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices located throughout 16 counties. UH’s goal is to be the most trusted health care partner in Northeast Ohio and UH Connor Whole Health furthers this objective by working to strengthen relationships between patients and providers to improve outcomes. The Whole Health approach prioritizes compassionate care centered on the patient’s entire well-being. The health care provider’s goal is to equip and empower each patient to take charge of their physical, mental, and spiritual health in order to live a full and meaningful life. Linking the patient’s larger purpose and life goals to their lifestyle allows clinical services, integrative medicine, and well-being programs to be delivered in a way that increases collaboration, motivation, and adherence to self-care and clinical needs. UH Connor Whole Health services include acupuncture, art therapy, chiropractic, expressive therapy (art, dance, and music), guided imagery, integrative medicine/lifestyle medicine consultations (adult and pediatric), massage therapy, meditation, mindfulness, osteopathic sports rehabilitation, stress management and resilience training workshops and yoga. For more information, visit UH Hospitals.org/ConnorWholeHealth. Follow UH Connor Whole Health on LinkedIn.

About University Hospitals / Cleveland, Ohio

Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 21 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, the Technion Israel Institute of Technology and . National Taiwan University College of Medicine. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.

 

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JOURNAL

BMJ Open

DOI

10.1136/bmjopen-2023-073258 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data

COI STATEMENT

RJT reports he has received royalties as the author of two texts on the topic of sciatica.

 

Spurge purge: Plant fossils reveal ancient South America-to-Asia ‘escape route’

Climatic and continental changes likely drove a well-known group of spurge plants out of southern South America to southeast Asia and beyond, as evidenced by newly identified fossils found in Argentina

Peer-Reviewed Publication

PENN STATE

 

IMAGE: A 52-MILLION-YEAR-OLD COMPOUND INFRUCTESCENCE FOSSIL SHOWING PRESERVED FRUITS AND SEEDS ATTACHED TO BRANCHES, COLLECTED BY THE LATE RODOLFO MAGÍN CASAMIQUELA FROM LAGUNA DEL HUNCO, CHUBUT PROVINCE, ARGENTINA. THE PLANT'S CHARACTERISTICS — SUCH AS THE TERMINAL FRUIT (TF), AXILE SEEDS (SD) AND PLUMOSE STIGMA (ST) — ARE ONLY FOUND TODAY IN THE MACARANGA-MALLOTUS CLADE OF THE SPURGE FAMILY. view more 

CREDIT: COURTESY OF PETER WILF

UNIVERSITY PARK, Pa. — Anyone who has taken a long road trip or bike ride has used a product of the spurge plant family — rubber. The spurge family, or Euphorbiaceae, includes economically valuable plants like the rubber tree, castor oil plant, poinsettia and cassava. Newly identified fossils found in Argentina suggest that a group of spurges took a trip of their own tens of millions of years ago. Driven by climatic changes and land movements over millennia, a group of spurges relocated thousands of miles from ancient South America to Australia, Asia and parts of Africa, according to research led by Penn State.

Reported in the American Journal of Botany, the findings suggest that the spurge family’s Macaranga-Mallotus clade (MMC), encompassing a common ancestor and all its descendants and long considered to have Asian origins, may have first appeared in South America when it was still part of Gondwana — the supercontinent that encompassed South America, Antarctica and Australia — before spreading around the globe.

“Our study provides the first direct fossil evidence of spurges in Gondwanan South America,” said Peter Wilf, professor of geosciences at Penn State and lead author of the current study, noting that the finding contrasts with the prevailing idea that the MMC evolved in Asia. “But if they evolved in Asia, how in the world would they have gotten to where we found them, in Argentine rocks 50 million years old? Instead, we think these spurges tracked the moving continents from South America to Asia, to the other side of the world. You can’t go much farther than that without leaving the planet. We’ve seen this pattern in many other plant groups we’ve found as fossils in South America like kauris, Asian chinkapin and yellowwood trees. Altogether it is the most dramatic evolutionary biogeography story I’ve ever seen.”

According to Wilf, Euphorbiaceae have adapted well to evolutionary challenges in different environments.

“They’re common in tropical rainforests in Africa, South America and most notably in Asia, where if you count the number of trees in a plot, they’re usually the second most common type,” he said. “They make up much of the understory habitat that is structurally important to the rainforest and its animal life. The MMC is well known in the Asian tropics and is highly visible along roadsides and in burned areas. Its plants often have large, umbrella-like leaves that provide abundant shade, and they provide nutritious seeds for animal forage.”

The spurge family comprises more than 6,000 species, found mostly in the tropics but also in deserts and cold temperate zones, and there are about 400 species in the MMC alone. Given their prevalence in southeast Asia and 23-million-year-old fossils previously found in New Zealand, scientists have considered the MMC an “Old World” plant group likely with Asian origins. The current study, based on fossils more than twice as old as the New Zealand specimens, provides the first evidence of “New World” origins for MMC spurges and adds two new species to the plant family, according to the scientists.

Wilf and his colleagues at Argentina’s Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) in Bariloche and the Museo Paleontológico Egidio Feruglio (MEF), and Cornell University examined 11 leaf fossils and two compound infructescence fossils, or fossils that show preserved fruits and seeds attached to branches. The fossils came from a site in Chubut, Argentina called Laguna del Hunco, where the researchers have collected fossils for decades. Dating of volcanic rocks at this site places the fossils at 52 million years old, a globally warm time immediately preceding the final separation of Gondwana.

The scientists studied the detailed characteristics of the leaves and fruits and compared them with living specimens. They also took CT scans of the infructescences at the Penn State Center for Quantitative Imaging. The scans picked up density changes in the rock and rendered them into three-dimensional images that the researchers used to study the fruits’ features, including tiny paired seeds inside the fruits that were barely visible at the surface.

The researchers found that the characteristics of the fossil fruits and leaves are only found today in MMC spurges, identifying them as two new species. They named the infructescences after the late Rodolfo Magín Casamiquela, an Argentine vertebrate paleontologist and anthropologist who collected one of the specimens, perhaps as early as the 1950s, and the leaf species after Kirk Johnson, paleobotanist and Sant Director of the Smithsonian National Museum of Natural History who had discovered the first of the leaf fossils in the 1990s.

“The MMC is widely distributed, but prior to this research they’ve never been found growing naturally in the Americas,” Wilf said. “This is the first time that the MMC has been reliably documented anywhere in the Western Hemisphere past or present.”

The fossils tell a story about environmental changes, plate tectonics and biogeography, or the distribution of plants and animals around the world, Wilf said. The plants likely originated and evolved in Gondwana and began retreating as the climate grew drier and colder over millions of years, suffering extinction in Antarctica and South America but apparently surviving in Australia, he said. At the same time, plate tectonics were pulling apart the Gondwanan supercontinent. Australia broke away from Antarctica more than 40 million years ago and collided with southeast Asia 25 million years ago, bringing the water-demanding plants to New Guinea and the southeast Asian rainforest, the researchers said.

 “We’ve seen over and over again that we can trace a significant number of Australian and Asian rainforest plants all the way to Argentina and Western Gondwana,” Wilf said. “These fossils tell us how plants respond to environmental changes. If you give them time and an escape route, like Australia as it moved from the Antarctic latitudes to Asia, they can move around the world following their preferred environment and thrive. Deforestation and environmental changes today, including in southeast Asia where our Gondwanan survivor trees live, are occurring 100 to 1000 times faster than they did millions of years ago, and escape routes have been converted into cities and agriculture. These fossils serve as a warning from the deep past, that the natural world that we rely on is extremely resilient but cannot keep up with us. It is not too late to act and avoid the worst outcomes.”

Also contributing to the study were Ari Iglesias, CONICET, and María Gandolfo, Cornell University and the MEF.

The National Science Foundation and National Geographic Society supported this work.

Fossil leaves with characteristics identical to several Macaranga species.

A compound infructescence fossil showing preserved fruits and seeds attached to branches. The 52-million-year-old fossil fruits and leaves that the researchers identified as belonging the the Macaranga-Mallotus clade (MMC) of the spurge family suggest that the MMC, long considered to have Asian origins, may have first appeared in Gondwanan South America before spreading around the globe.

A CT scan of a fossil infructescence showing fruits and tiny paired seeds inside the fruits. The CT scan picked up density changes in the rock and rendered them into three-dimensional images.

CREDIT

Courtesy of Peter Wilf

JOURNAL

American Journal of Botany

DOI

10.1002/ajb2.16169 

ARTICLE TITLE

The first Gondwanan Euphorbiaceae fossils reset the biogeographic history of the Macaranga-Mallotus clade

 

AI as a leader? A conversation we need to have!

Peer-Reviewed Publication

KÜHNE LOGISTICS UNIVERSITY

 

IMAGE: PROF. DR. NIELS VAN QUAQUEBEKE PROFESSOR OF LEADERSHIP AND ORGANIZATIONAL BEHAVIOR HEAD OF DEPARTMENT OF LEADERSHIP AND MANAGEMENT view more 

CREDIT: KLU

How can an AI become the boss? Already during the COVID-19 pandemic, we have seen how crucial digital technologies have become for leadership. Without Microsoft Teams, Zoom, and related programs, leaders would not have been able to reach their employees easily. These tools continue to enjoy a secured place in the office today.

There is no surprise there. Anything that can be considered a competitive advantage will be utilized as such, and digital options are often quicker, more cost-efficient, or simply more convenient. Indeed, in the future, leadership as a whole is going to make giant leaps toward digitalization. The next phase is therefore only logical: digitally supported leadership, that is AI assisting human managers (e.g., for the preparation of strategic decisions or analyzing employee behavior). And the phase after that is also already on the horizon:  AI substituting human leadership as opposed to merely supporting it.

Forget any romantic notions you may have about leadership

“Stop!” we hear some of you shouting. “‘Real’ leadership needs real people! How is AI supposed to motivate employees or instill in them any sense of enthusiasm for the company’s goals?” You may not like our answer: Forget any romantic notions you have about leadership. AI will likely do an even better job than (average) leaders today do. If we maintain our romantic point of view, we are going to be woefully underprepared when reality comes knocking.

How AI can be the better leader

How is it that AI, in the future, will be accepted as a leader? The AI leader of the future will most likely not be a mere chat program. It will sit on your devices with natural speech functionality (just as Siri and Alexa do now) and perhaps present itself as a human, or rather an avatar, visible through the use of VR goggles.

How effective an AI will be in its role as a true leader will be contingent on how deeply the AI used can understand the three basic psychological needs of its employees. Humans long for belonging, mastery, and autonomy – because truly fantastic leaders are good at addressing these needs. But let’s be honest for a moment: How many truly fantastic bosses have you had across your career? Many leaders are stressed out, overworked, inattentive, unwittingly unfair, or simply not very empathetic. Future AI, with the ability to record and regard any important details, would be an advantage in many situations here.

Already today, man and machine interact with one another in harmony, for instance in the field of online therapy. In fact, many people are less hesitant to open up to a computer, and some programs are so sophisticated that their communication is barely indistinguishable from humans. Why shouldn’t that apply to the field of leadership?

Don’t let your worry get in the way of constructive co-creation

Of course, regardless of all the potential benefits, this idea alone could spark fear in us. But we should have an open dialogue about this rather than fearing the worst! What does this development mean for leadership? Which leadership roles will people be able to (or need to) take on in the future? What needs to change in leadership research and education in order to help shape the ethical aspects of such man-to-machine interaction?

The way we see things? Yes, there is still a need for human leaders. But in the future, they will need to understand both what makes people tick and how AI works. Their main responsibility will be leading computers that, in turn, lead humans. In this capacity, they will have to decide upon the rules that machines will follow. We better talk about these now before machines make up their own.

More details on this topic:

• Van Quaquebeke, N., & Gerpott, F. H. (2023). The Now, New, and Next of Digital Leadership: How Artificial Intelligence (AI) Will Take Over and Change Leadership as We Know It. Journal of Leadership & Organizational Studies, online first. doi.org/10.1177/15480518231181731

About KLU
Kühne Logistics University – Wissenschaftliche Hochschule für Logistik und Unternehmensführung (KLU) – is a private university located in Hamburg’s HafenCity. The independent, state-certified university’s major research areas are Sustainability, Digital Transformation, Entrepreneurship & Value Creation in the fields of Transport, Global Logistics, and Supply Chain Management.

KLU is one of very few private universities in Germany entitled to confer their own PhDs.

With one BSc and three MSc degree programs, a structured doctoral program, and a part-time Executive MBA, KLU offers its 400 full-time students a high level of specialization and excellent learning conditions. KLU has an international team of around 30 professors who teach in English. In open, tailor-made management seminar series, industry specialists and managers alike benefit from the application of academic findings to practical issues.

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► More Information: www.the-klu.org

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JOURNAL

Journal of Leadership & Organizational Studies

ARTICLE TITLE

The Now, New, and Next of Digital Leadership: How Artificial Intelligence (AI) Will Take Over and Change Leadership as We Know It