Saturday, August 12, 2023

 

Playing football may increase the risk for Parkinson’s disease


New study shows risk increases with more years of play, even in high school and college players

Peer-Reviewed Publication

BOSTON UNIVERSITY SCHOOL OF MEDICINE




(Boston)—Identification of risk factors for Parkinson’s disease (PD) is essential for early diagnosis. Dating back to the 1920s, Parkinson’s disease and parkinsonism—an umbrella term that refers to motor symptoms found in Parkinson’s disease and also other conditions—have long been described in boxers. Repetitive head impacts from tackle football can also have long-term neurological consequences like chronic traumatic encephalopathy (CTE). But research on the association between participation in tackle football and PD is limited.

 

In the largest study to describe the association between participation in football and the odds for having a reported diagnosis of PDresearchers from the BU CTE Center used a large online data set of people concerned for having PD and found participants with a history of playing organized tackle football had a 61% increased odds of having a reported parkinsonism or PD diagnosis.

In this study, the researchers evaluated 1,875 sport participants — 729 men who played football, predominantly at the amateur level, and 1,146 men who played non-football sports who served as the control group. Participants were enrolled in Fox Insight, a longitudinal online study of people with and without PD sponsored by The Michael J. Fox Foundation for Parkinson’s Research.

 

Notably, researchers found a link between playing football and increased odds for having a parkinsonism or PD diagnosis even after accounting for known risk factors for PD. Additionally, the data revealed that players who had longer careers and played at higher levels of competition experienced increased odds for having a reported diagnosis of parkinsonism or PD. Football players who played at the college or professional level were at 2.93 increased odds for having a PD diagnosis compared with those who just played at the youth or high school level. Age of first exposure to football was not associated with odds for having a reported parkinsonism or PD diagnosis.

“Playing tackle football could be a contributing risk factor to PD, particularly among people already at risk due to other factors (e.g., family history). However, the reasons for this relationship are not clear and we also know that not everyone who plays tackle football will develop later-life neurological conditions, meaning many other risk factors are at play,” says corresponding author Michael L. Alosco, PhD, associate professor of neurology at Boston University Chobanian & Avedisian School of Medicine.

The researchers also emphasized that they compared the football players to another group of athletes, a noteworthy strength of the study. Furthermore, most of the participants played tackle football only at the amateur level, which is contrast to most of the research to date that has focused on professional athletes.

“Previous research has focused on the association between American football and risk for CTE. However, similar to what has historically been seen in boxers, American football might also affect risk for other neurodegenerative conditions such as PD,” says Hannah Bruce, MSc, first author and research specialist at Boston University Chobanian & Avedisian School of Medicine.

The researchers acknowledge several limitations to their findings and caution that the work is still preliminary. It was a convenience sample of people enriched for having PD who were mostly white, thereby limiting the generalizability of the findings. Diagnosis of PD was also self-reported by participants through online assessments and objective in-person evaluations were not conducted.

This work was in collaboration with The Michael J. Fox Foundation for Parkinson’s Research, the sponsor of Fox Insight. The Fox Insight study was used to collect and aggregate data used in this manuscript. Grant funding was also from NINDS (U54NS115266; K23NS102399).

Note to Editors:

Several authors are staff members at The Michael J. Fox Foundation for Parkinson’s Research, the sponsor of Fox Insight. CHA consulted for Avion, CND Life Sciences, Jazz, and Precon Health. RAS is a paid consultant to Biogen (Cambridge, MA, USA). He is a member of the Board of Directors of King-Devick Technologies, Inc. (Chicago, IL, USA), and he receives royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. (Lutz, FL, USA). He is a member of the Medical Science Committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Chris Nowinski is a volunteer member of the Mackey-White Committee of the NFL Players Association and compensated advisor to Oxeia Biopharmaceuticals. Ann C. McKee is a member of the Mackey-White Committee of the NFL Players Association. MLA has received honorarium from The Michael J Fox Foundation for services unrelated to this study. He also receives royalties from Oxford University Press. The remaining authors have no conflicts of interest to disclose.

 

 

Football participation and Parkinson disease among men

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK





About The Study: In this study, 729 participants with a history of playing organized football had higher odds of having a reported parkinsonism or Parkinson disease diagnosis compared with participants in other organized sports. Longer duration of play and higher level of football play were associated with higher odds of a reported diagnosis. 

Authors: Michael L. Alosco, Ph.D., of the Boston University Chobanian & Avedisian School of Medicine in Boston, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.28644)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2023.28644?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081123


Association of caregiver depression risk with patient outcomes in Parkinson disease


JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK





About The Study: Patients with Parkinson disease who had caregivers at higher risk of depression were more likely to have worse quality of life and higher emergency department use than patients who had caregivers not at higher risk of depression. Additional caregiving resources and interventions to reduce caregiver depression symptoms could potentially improve patient outcomes. 

Authors: Nabila Dahodwala, M.D., M.S., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.27485)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2023.27485?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081123

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

 

Five-year trajectories of prescription opioid use

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK




About The Study: The results of this study of 3.4 million adults suggest that most individuals commencing treatment with prescription opioids had relatively low and time-limited exposure to opioids over a 5-year period. The small proportion of individuals with sustained or increasing use was older with more comorbidities and use of psychotropic and other analgesic drugs, likely reflecting a higher prevalence of pain and treatment needs in these individuals. 

Authors: Natasa Gisev, Ph.D., of UNSW Sydney in Sydney, Australia, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.28159)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2023.28159?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081023

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

 

Education program tackles race-based cancer health disparities


Project aims to ‘move the needle’ on Black students’ STEM participation, engagement


Grant and Award Announcement

RICE UNIVERSITY

Carolyn Nichol 

IMAGE: CAROLYN NICHOL IS AN ASSOCIATE RESEARCH PROFESSOR OF CHEMISTRY, DIRECTOR OF THE RICE OFFICE OF STEM ENGAGEMENT AND EDUCATION DIRECTOR FOR THE NSF NANOENABLED WATER TREATMENT (NEWT) ENGINEERING RESEARCH CENTER. view more 

CREDIT: (PHOTO BY JEFF FITLOW/RICE UNIVERSITY)




HOUSTON – (Aug. 10, 2023) Rice University chemist Carolyn Nichol has won a competitive Science Education Partnership Award (SEPA) from the National Institutes of Health to address race-based cancer health disparities by increasing underrepresented minority student populations’ engagement and participation in biosciences education.

The 5-year, $1,038,544 award will support Nichol’s Cancer Health Activism Network for Greater Equity (CHANGE) project in bringing together cutting-edge cancer research with insight on race-based healthcare disparities from the social sciences in a series of transformative high school biology lessons aligned with both state and national standards.

“Our goal is to affect students’ interest in bioscience careers and studies by working with their teachers,” Nichol said. “We're recruiting high school biology teachers to do research in university labs working on projects led by faculty at Rice and at Texas Southern University who are Cancer Prevention and Research Institute of Texas (CPRIT) scholars.

“On the one hand, teachers will learn about the latest innovations in cancer research while, on the other hand, they’ll get to hear from researchers in the social sciences about health disparities affecting Blacks ⎯ it’s a two-pronged approach.”

Nichol hopes that time in the lab will be a “transformative experience for teachers, who will return to classrooms feeling empowered and with a renewed sense of leadership:”

“The research internships could bring a spark to their teaching,” Nichol said. “They'll get hands-on knowledge on topics like CRISPR or epigenetics ⎯ things they may not have learned about when they were in school or that have changed significantly in recent years. They'll also learn about health disparities issues that disproportionately affect minority Black populations, and ways that we can teach science more holistically and more student-driven versus teacher-driven.”

In addition to lab work, the first three years of the program will bring together high school science teachers from Houston-area schools with relatively large Black student populations for a series of workshops where participants will work on developing and refining a portfolio of lessons meant to encourage and motivate students to pursue STEM education and career paths.

“It’s one thing to teach a kid who is already interested in biology and wants to learn about the cell cycle and DNA, for instance, and another thing altogether to try to do that for someone who thinks that’s not for them or that they can’t do that,” Nichol said. “For decades, we've been trying to bring more underrepresented minorities into STEM, but the numbers really haven't changed. Moving that needle has just been really hard.

“This approach of showing kids both the exciting parts of science while letting them know that they have a role to play in changing prevalent race-based disparities in healthcare access could really help break that stalemate.”

During the last two years of the program, participating teachers will attend a 4-day professional development workshop held both in-person and virtually where they will get to share their experience and learn about all the activities and lessons developed.

“One of the reasons it's so powerful to work with teachers is that, according to the Texas Education Agency, each high school teacher works with, on average, 130 students a year,” Nichol said. “So, if there are 187 teachers over the five years of this project, that would impact approximately 25,000 students overall. And, since biology is the only science class that’s required in the state of Texas, we hope to reach kids that might not otherwise self-select to take a science class.”

The program is designed based on a transformational leadership model that cultivates individuals’ strengths and self-worth to drive engagement.

“It’s really about teaching from a positive viewpoint,” Nichol said. “A lot of times when a student walks into a classroom, the teacher looks at their deficits and tries to correct them. Instead, this is an asset-based approach where teachers find positive things to reinforce in the students, build up their self-esteem and help them not feel alienated if they're different or have different skill sets.

“That's what this theory is about: It's this belief that every student has something of value they can bring to the classroom.”

Nichol hopes that a teaching approach based on the transformational leadership theory paired with cutting-edge developments in cancer research and studies on health disparities will engage more students in STEM careers.

“I would like to extend my gratitude to my colleagues in the Rice Office of STEM Engagement for their support,” Nichol said.

Nichol is an associate research professor of chemistry, director of the Rice Office of STEM Engagement and education director for the NSF NanoEnabled Water Treatment (NEWT) Engineering Research Center.

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This release can be found online at news.rice.edu.

Follow Rice News and Media Relations via Twitter @RiceUNews.

Image downloads:

https://news-network.rice.edu/news/files/2023/08/JWF_1888.jpg
CAPTION: Carolyn Nichol is an associate research professor of chemistry, director of the Rice Office of STEM engagement and education director for the NSF NanoEnabled Water Treatment (NEWT) Engineering Research Center. (Photo by Jeff Fitlow/Rice University)

Related stories:

Black girls benefit most when STEM teachers train up:
https://news.rice.edu/news/2023/black-girls-benefit-most-when-stem-teachers-train

Links:

Office of STEM Engagement: https://research.rice.edu/rstem/
Cancer Prevention and Research Institute of Texas: https://www.cprit.state.tx.us/

Located on a 300-acre forested campus in Houston, Rice University is consistently ranked among the nation’s top 20 universities by U.S. News & World Report. Rice has highly respected schools of Architecture, Business, Continuing Studies, Engineering, Humanities, Music, Natural Sciences and Social Sciences and is home to the Baker Institute for Public Policy. With 4,552 undergraduates and 3,998 graduate students, Rice’s undergraduate student-to-faculty ratio is just under 6-to-1. Its residential college system builds close-knit communities and lifelong friendships, just one reason why Rice is ranked No. 1 for lots of race/class interaction and No. 4 for quality of life by the Princeton Review. Rice is also rated as a best value among private universities by Kiplinger’s Personal Finance.

THANK THE CONFEDERATE GOP

More than 2 million additional Americans faced food insufficiency following drawdown of pandemic-related SNAP benefits, Penn Medicine study finds


Food insufficiency can contribute to chronic diseases like high blood pressure, heart disease, and diabetes


Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE




PHILADELPHIA— The recent discontinuation of pandemic-related food assistance benefits, known as the Supplemental Food Assistance Program (SNAP) Emergency Allotments, led to a substantial increase in food insufficiency in the United States, according to a new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania. The primary goal of SNAP, which distributes cash-like benefits to low-income families to buy food, is to combat food insecurity, which affects 10 percent of U.S. households. The findings were published in JAMA Health Forum today.

Comparing trends in food insufficiency in states that ended Emergency Allotments before the federal government ended them altogether in March 2023 with the rest of the U.S., the researchers found that after the temporary increases to households’ SNAP benefits ended, SNAP recipients experienced a 21 percent relative increase in both food insufficiency and food insufficiency among children. These findings imply that more than two million more American households faced food insufficiency when Emergency Allotments ended in all states.

According to the U.S. Department of Agriculture, food insecurity refers to the limited or uncertain availability of nutritionally adequate and safe foods, or the limited or uncertain ability to acquire acceptable foods in socially acceptable ways. Food insufficiency is a more severe condition than food insecurity and measures whether a household generally has enough to eat.

“To our knowledge, this is one of the first studies to evaluate the association between changes in SNAP benefit amounts and food insufficiency,” said Aaron Richterman, MD, MPH, an Instructor of Medicine in the Division of Infectious Diseases at Penn and the study’s lead author. “This study shows the severe consequences of reducing SNAP benefit amounts at a time when inflation was causing rapid rises in food prices, and is especially important because of upcoming federal negotiations surrounding SNAP’s renewal in the Farm Bill at the end of September.”

In addition to influencing chronic diseases like high blood pressure, heart disease, and diabetes, previous research found that mothers with school-aged children who face severe hunger are 56.2 percent more likely to have post-traumatic stress disorder and 53.1 percent more likely to have severe depression. Research has found that diet-related illness increased the risk for severe symptoms and death from COVID-19, with nearly two-thirds of COVID-19 hospitalizations in the U.S. were related to obesity, diabetes, hypertension, and heart failure.

Penn researchers analyzed data from more than 3 million survey respondents in the U.S. to assess the impact of losing the SNAP Emergency Allotment benefits. They focused on what happened in 18 states that discontinued the additional benefits earlier than other states in the U.S. by letting their formal public health emergency declarations expire.

“SNAP’s Emergency Allotments represented the largest-ever increases in benefit amounts for SNAP households,” added co-author Harsha Thirumurthy, PhD, a professor of Health Policy at Penn. “Our findings are particularly concerning given previous research linking food insecurity to numerous poor health outcomes. Reducing SNPA benefit amounts will have far-reaching consequences for public health.”

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.

The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines.

The University of Pennsylvania Health System’s patient care facilities stretch from the Susquehanna River in Pennsylvania to the New Jersey shore. These include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Lancaster General Health, Penn Medicine Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is an $11.1 billion enterprise powered by more than 49,000 talented faculty and staff.

 

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Malaria vaccine candidate appears safe and produces promising immune response in a cohort of Tanzanian infants


Peer-Reviewed Publication

CELL PRESS

Graphical Abstract CREDIT Med Silk et al. 

IMAGE: GRAPHICAL ABSTRACT CREDIT MED SILK ET AL. view more 

CREDIT: MED SILK ET AL.



An experimental malaria vaccine appears safe and promotes an immune response in African infants, one of the groups most vulnerable to severe malaria disease. There is currently only one malaria vaccine, “RTS,S” that is approved by the World Health Organization and offers partial disease protection. However, in the results of the early-stage phase Ib trial conducted in Tanzania and published on August 11th in the journal Med, researchers find that targeting RH5 – a protein that the malaria pathogen Plasmodium falciparum uses to invade red blood cells – can generate a promising immune response that is most pronounced in an infant cohort.

"Anti-sporozoite vaccines such as RTS,S need to be 100% effective in stopping the parasite from invading the liver to prevent disease,” says senior author Angela Minassian, a clinician scientist at the University of Oxford. “Even if just one parasite slips through the net, this will then go on to multiply in the liver, burst out into the bloodstream, and then infect red blood cells where the parasites then grow at an exponential rate. Having a blood-stage vaccine like RH5 on board gives you a second line of defense once the parasite has entered the bloodstream, allowing a second chance to stop malaria before it causes illness.”

  A person is infected with malaria when bitten by an infected mosquito, which releases Plasmodium falciparum into the body. RTS,S and many other vaccine candidates teach the immune system how to target the parasite at this sporozoite stage, before it invades the liver. Once the parasite matures and is released from the liver into the bloodstream, Plasmodium falciparum displays RH5 and infects red blood cells, which causes disease. If an anti-sporozoite and an anti-RH5 vaccine were used in combination in the future, individuals could potentially experience more effective protection against malaria for a longer period of time.

“The data in the phase 1b trial reported here confirm, for the first time, that substantial anti-RH5 immune responses can be achieved safely by vaccination in infants from a malaria-endemic area,” say the authors.

The researchers conducted the vaccine trial in Bagamoyo, Tanzania, where the average malaria prevalence throughout the population is 13%. 63 participants aged 6 months to 35 years were enrolled and randomized to receive either the experimental malaria vaccine, called “ChAd63-MVA RH5,” or a control rabies vaccine. The trial was also double-blinded, meaning that neither the participants nor the vaccine administrators knew who received the malaria vaccine or the control. All participants were given the second dose of vaccine two months later and followed for four months after this.

The primary purpose of this study was to evaluate the safety of this vaccine in a population where malaria is endemic. Participants in both the control and treatment group reported pain at the injection site and a mild fever shortly after vaccination, but overall the vaccine was well tolerated and there were no safety concerns.

A secondary outcome of the study was whether the vaccine would promote an immune response. Researchers found that participants who received the malaria vaccine developed antibodies against RH5 in their blood upon follow-up. In the laboratory, these antibodies were able to inhibit the growth of the malaria parasite at high levels that are associated with disease protection. “These data justify onward progression to phase IIb field efficacy trials to determine whether parasite growth-inhibition levels of this magnitude can ultimately protect against clinical malaria.” say the authors.

The authors note that they observed the strongest immune responses in infants under 11 months, followed by children aged 1-6 years, then adults. “Why the infants and young children vaccinated with ChAd63-MVA RH5 induced such high levels of antibody remains to be fully understood,” say the authors. “Given that both anti-sporozoite and blood-stage malaria vaccine strategies necessitate very high levels of antibody to protect against parasite infection, current efforts remain focused on infants and young children.”

The researchers note that this was a small study that followed participants for only four months after receiving their full vaccine schedule. They recommend that additional phase Ia/Ib trials should be conducted to optimize the recommended age range, boosting schedule, and delivery platform for anti-RH5 vaccines. Currently, a phase 1b trial is planned in the Gambia which will look at the effects of combining an anti-RH5 vaccine with an anti-sporozoite vaccine.

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This work was supported by the Medical Research Council.  Information about conflicts of interest can be found in the text of the paper.

Med, Silk et al. “Superior antibody immunogenicity of a viral-vectored RH5 blood-stage malaria vaccine in Tanzanian infants as compared to adults” https://www.cell.com/med/fulltext/S2666-6340(23)00226-X 

Med (@MedCellPress), Cell Press' flagship medical journal, publishes transformative, evidence-based science across the clinical and translational research continuum—from large-scale clinical trials to translational studies with demonstrable functional impact, offering novel insights in disease understanding. Visit: https://www.cell.com/med. To receive Cell Press media alerts, please contact press@cell.com.