A community health worker intervention reduces hospital readmissions

The benefit was seen among patients discharged to short-term rehabilitation

MASSACHUSETTS GENERAL HOSPITAL

Research News

 

BOSTON - The Community CAre Transitions (C-CAT) clinical trial, which paired community health workers (CHWs) with patients admitted to Massachusetts General Hospital (MGH), has found that fewer intervention group participants were readmitted within 30 days than control group participants. The effect was significant for those discharged to short-term rehabilitation but not for those discharged home. The study has been published in JAMA Network Open.

"These results indicate that CHW interventions may help reduce hospital readmissions and improve preventive care among some clinically complex patients within an accountable care organization," says lead author and C-CAT trial principal investigator Jocelyn Carter, MD, MPH, a physician-scientist in the MGH Division of General Internal Medicine.

Hospital readmissions have been identified as a major contributor to health care costs, accounting for a third of total U.S. health care expenditures. Thirty-day readmissions are common and about 27% of adult 30-day readmissions are estimated to be preventable. Previous studies have identified factors such as medical complexity and social determinants of health as contributing to readmission risk.

While community health workers are one of few interventions demonstrating compelling evidence of improving outcomes in clinically and socially complex populations, most CHW studies have focused on disease-based cohorts. The study of CHW interventions at the time of hospital discharge has been underutilized and prior trial results have been mixed.

In the C-CAT study, CHWs, trained in basic knowledge of clinical conditions, provided health coaching and connected patients to specific low and no-cost resources (e.g., food, transportation, housing-related) contributing to gaps in care. Using the framework of motivational interviewing and psychosocial support, CHWs sought to strengthen patient connections to primary care while addressing unmet needs. To test the effect of CHW care delivery on 30-day readmission in a population insured by a Mass General Brigham accountable care organization, 278 participants were randomized to receive usual care along with the 30-day CHW intervention and 273 participants were randomized to usual care only. Members of the C-CAT study team enrolled patients on six internal medicine units from 2017 to 2019. CHWs met participants in-hospital prior to discharge.

Of the 550 participants analyzed, the mean age was 70.1, 48.4% were women, and 70.5% were Medicare insured. All trial participants had a mean of three hospitalizations in the 12 months prior. Overall, 24.5% of control and 21.7% of intervention participants were discharged to rehabilitation with a mean length of stay of 3.9 days.

Just 12.6% of intervention group participants were readmitted in the 30 days following hospital discharge, as opposed to 24.5% of control participants. However, Carter and her colleagues noted a statistically significant reduction in readmissions among patients discharged to rehabilitation but not in those discharged directly home: Intervention vs. control participants discharged to rehabilitation demonstrated a 32.3% reduction in readmissions (5.0% vs 37.3%) compared to a 5.7% reduction seen in those discharged home (14.7% vs 20.4%) . In addition, fewer intervention than control patients had missed appointments (22.0% vs. 33.7%) and ED visits (11.2% vs. 16.8%).

While the intervention effect was seen in patient discharged to short-stay rehabilitation prior to returning home, the researchers note that prior studies have shown that patients with complex co-morbidities discharged to rehabilitation facilities have markedly elevated rates of readmission, ranging from 28% to 75%. CHWs might have positively influenced these numbers by addressing unmet medical and social issues that occurred during the transition from rehabilitation to home, and improving communication between patients, rehabilitation staff, and the primary care providers after discharge. Carter notes: "Surprisingly, there was a strong and significant reduction in 30-day readmissions for patients discharged to rehabilitation. This is a population with limited demonstrated interventions shown to improve outcomes. Additional research is needed to examine why this effect was seen as well as which patients benefitted most from certain CHW intervention activities."

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Carter is an instructor in Medicine at Harvard Medical School (HMS). Senior author Anne Thorndike, MD, MPH, is an investigator in the Division of General Internal Medicine at MGH and associate professor of Medicine at HMS. Additional co-authors are CHW staff members Susan Hassan, B.A., Anne Walton, RN, AsEd AE-C; Karen Donelan, ScD, EdM, of the MGH Department of Medicine and the Mongan Institute and who is also the Stuart H. Altman Chair at the Heller School at Brandeis University; and Liyang Yu, MS Bioinformatics Specialist at MGH.

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The study was supported by a Partners HealthCare Center for Population Health Delivery System Innovation Implementation Grant and the Healthcare Transformation Lab at MGH.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2020, Mass General was named #6 in the U.S. News & World Report list of "America's Best Hospitals."

New study shows never before seen nutrient exchanges between algae and bacteria

Research co-led by Newcastle University has shed new light on important microscopic scale interactions between algae and bacteria predicated on the mutually beneficial exchange of nutrients.

NEWCASTLE UNIVERSITY

Research News

 

IMAGE: THE FIGURE SHOWS HOW THE AMOUNT OF LABELLED CARBON IN ALGAE AND BACTERIA GROWING TOGETHER CHANGES WITH TIME (LOW IS BLUE AND HIGH IS RED). ON THE RIGHT HAND SIDE,... view more 

CREDIT: THE AUTHORS

Research co-led by Newcastle University has shed new light on important microscopic scale interactions between algae and bacteria predicated on the mutually beneficial exchange of nutrients.

The research was carried out at the University of Cambridge and the Nordsim laboratory at the Swedish Museum of Natural History in Stockholm by Dr Hannah Laeverenz Schlogelhofer, now at the University of Exeter, and a team led by Dr Ottavio Croze, of Newcastle University's School of Mathematics, Statistics and Physics.

They have used an advanced high-spatial resolution isotope mapping technique called 'SIMS' (secondary ion mass spectrometry) to chart for the first time how long it takes for labelled carbon produced by microalgae to be transferred to the bacteria they are growing with.

The study reveals the details of important nutrient exchanges between algae and bacteria. Such exchanges determine the functioning of microbial communities in the environment, relevant to climate change cycles and agricultural productivity. Microbial interactions within microbial communities are important on many levels, ranging from the ecology of aquatic and terrestrial food webs, to wastewater treatment. A key characteristic of the interactions within these communities is the exchange of nutrients between species.

Publishing their findings in the journal PLOS ONE, the research team, involving also scientists from Stockholm University, Sweden, also used a mathematical model to predict how the concentrations of nutrients exchanged between the microbes change with time, including vitamin B12, which occurs in very low concentrations and is not easily trackable.

Many species of algae and bacteria share mutually beneficial resources. In this study, the algae depend on bacteria as a source of vitamin B12, as they can't make it themselves. On the other hand, bacteria rely on carbon produced by algae for their growth. The research combines SIMS and mathematical modelling to show what happens when microbial partners able to exchange nutrients are initially brought together.

Principal investigator of the study, Dr Croze said: "The paper concerns the onset of the mutualistic interaction between microalgae and bacteria, that is microbes that need each other to grow and survive, and the transfer of nutrients between them.

"Our results allow establishing when the microbial partners first form a 'relationship' by growing exclusively on the nutrients they respectively produce. The method we have developed is widely applicable to other microbial systems, and we hope it will contribute to furthering a mechanistic understanding of interactions within microbial communities in the environment and biotechnological applications."

Dr Laeverenz Schlogelhofer added: "It is the interdisciplinary nature of our approach to studying microbial interactions that I think will have broad applications. While the single-cell technique SIMS allowed us to visualise and measure the carbon exchange between algae and bacteria, mathematical modelling provided a link between the experimental observations and our understanding of the underlying nutrient kinetics."

Co-author Dr Rachel Foster, from Stockholm University, said: "I appreciate most that the work takes highly resolved single cell measurements and directly applies them for predicting nutrient acquisitions between cells. Hence we can use calculated rate measurements based on the SIMS measures instead of assuming an activity rate, and this approach should be far-reaching and applicable to many other microbial populations-free and/or symbiotic."

CAPTION

The figure shows a schematic of the processes that we considered in out mathematical model, including the production of dissolved organic carbon (DOC) by the algae and its assimilation by the bacteria, and the production of vitamin B12 by the bacteria an its assimilation by the algae.

CREDIT

The authors

Scientists discover a new feature that distinguishes modern humans from Neanderthals

SKOLKOVO INSTITUTE OF SCIENCE AND TECHNOLOGY (SKOLTECH)

Research News

 

IMAGE: SCIENTISTS DISCOVER A NEW FEATURE THAT DISTINGUISHES MODERN HUMANS FROM NEANDERTHALS view more 

CREDIT: PAVEL ODINEV / SKOLTECH

Skoltech scientists and their colleagues from Germany and the United States have analyzed the metabolomes of humans, chimpanzees, and macaques in muscle, kidney, and three different brain regions. The team discovered that the modern human genome undergoes mutation which makes the adenylosuccinate lyase enzyme less stable, leading to a decrease in purine synthesis. This mutation did not occur in Neanderthals, so the scientists believe that it affected metabolism in brain tissues and thereby strongly contributed to modern humans evolving into a separate species. The research was published in the journal eLife.

The predecessors of modern humans split from their closest evolutionary relatives, Neanderthals and Denisovans, about 600,000 years ago, while the evolutionary divergence between our ancestors and those of modern chimpanzees dates as far back as 65 million years ago. Evolutionary biologists are after the particular genetic features that distinguish modern humans from their ancestors and may give a clue as to why humans are what they are.

Researchers from the Skoltech Center for Neurobiology and Brain Restoration (CNBR) led by Professor Philipp Khaitovich and their colleagues from the Max Planck Institutes in Leipzig, Dresden and Cologne and the University of Denver studied metabolic differences in the brain, kidney and muscle of humans, chimpanzees, and macaques.

The research supervisor was a renowned evolutionary biologist, Professor Svante Pääbo, who earlier on had discovered the Denisovan and led the Neanderthal Genome Project.

The team looked at an interesting human mutation that leads to amino acid substitution in adenylosuccinate lyase, an enzyme involved in the synthesis of purine inside DNA. This substitution reduces the enzyme's activity and stability, which results in a lower concentration of purines in the human brain. The team showed that the new mutation is typical for humans only and does not appear in other primates or Neanderthals. The researchers proved that this mutation is indeed the reason for the metabolic peculiarities in humans by introducing it into the mouse genome. The mice subjected to mutation produced fewer purines, whereas an ancestral gene, when introduced into human cells, led to apparent metabolic changes.

"Although a powerful tool for scientists, the decoded human genome, unfortunately, cannot account for all the phenotypic differences between humans. The study of the metabolic composition of tissues can give clues about why functional changes occur in humans. I am delighted that we have succeeded in predicting the metabolic characteristics of modern humans and validated our hypotheses on mouse and cell models, even though we did not have 'live Neanderthals' to work on," says lead author and Skoltech PhD student Vita Stepanova.

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Forensic archaeologists begin to recover Spanish Civil War missing bodies

CRANFIELD UNIVERSITY

Research News

 

IMAGE: THE MISSING FACES OF THOSE WHOSE BODIES THE TEAM ARE TRYING TO FIND. view more 

CREDIT: GEMA ORTIZ IGLESIAS

Forensic archaeologists and anthropologists from Cranfield University have started to recover the bodies of victims executed by the Franco regime at the end of the Spanish Civil War during an excavation in the Ciudad Real region of Spain.

The team from Cranfield is working with partners from the University Complutense of Madrid (UCM) and social anthropologists from Mapas de Memoria (Maps of Memory) to search for, exhume and identify those executed and buried in the civil cemetery at Almagro between 1939 and 1940.

Several bodies with gunshot wounds to the head, personal effects and parts of clothing have already been recovered and in total the team are searching for 26 people in this excavation which is focused on a separate area of the graveyard that has been closed for decades.

Families of victims have been found in the hope of identifying relatives through DNA analysis and returning the human remains for proper burial.

This exhumation is part of a number of recoveries from the Spanish Civil War which are currently being investigated in Spain. Since 2000, over 7,000 victims have been recovered.

Dr Nicholas Márquez-Grant, Senior Lecturer in Forensic Anthropology at Cranfield Forensic Institute (CFI), who is leading the excavation, said: "This excavation is particularly complex due to the number of victims and subsequent burials in the cemetery during the postwar period. Recovery of the bodies is carried out layer by layer and is only the start of the process to identify and bring dignity to the deceased and help to provide closure and peace to their families."

José Barrios, whose great uncle - also named José Barrios - was executed and buried at the site, said: "When the excavation started I did not feel much but when they found the first body, I saw the skull and the feet of an individual, I thought: we are here now, we are coming to find you."

The excavation period will last until the beginning of June and will be followed by a longer investigation involving anthropological analysis in the laboratory and DNA analysis until the end of 2021 to identify human remains recovered.

The first stage in the overall process was carried out by Maps of Memory to locate the graves through archival research and contact the families of victims through social networks and testimonies from neighbours.

Dr Jorge Moreno, director of Maps of Memory, a project of the National Distance Learning University (UNED), said: "Whilst archaeologists and forensic anthropologists work from the ground down, social anthropologists work from the ground up. Whilst scientists search for human remains, social anthropologists search for families, their histories and stories. Originally we had four families identified for this excavation and in ten days we now have 21 families and 21 stories. We find bodies on the one hand, and stories on the other that later connect."

A total of 11 pits have been identified for the excavation, and several pits have more than one individual in them. Cranfield team members also include graduates and alumni from CFI's Forensic Archaeology and Anthropology MSc.

Once remains are recovered, they are taken to the forensic anthropology laboratory at UCM to identify and determine the circumstances of the death of each of the individuals.

Dr Maria Benito Sanchez, director of the scientific team for the project from the School of Legal Medicine at UCM, said: "As forensic anthropology professionals we have the responsibility of putting our science to the service of the relatives who have been searching for their loved ones for a long time now. Since I started working on mass graves, there have been many rewards which I take with me, and all are for the relatives - they are the engine for this work."

Genetic analysis with samples from family members and bone samples recovered then follows and where checks are positive, family members are identified. Remains will then be passed to the families for burial or returned to the cemetery to be buried again if that isn't possible.

The wider Memory Maps project, which is funded by the Ciudad Real Provincial Council, has located 53 mass graves and named 3,457 people killed in the province of Ciudad Real by the Franco regime over the last ten years. So far the Almagro excavation is the largest mass grave opened in the province, although there are known to be others with hundreds of people buried in them.

CAPTION

Archaelogists and anthropologists from Cranfield University, University Complutense of Madrid (UCM) and Mapas de Memoria (Maps of Memory) in Almagro .

CREDIT

Cranfield Forensic Institute

CAPTION

An aerial view of the dig site in Almagro.

CREDIT

Cranfield Forensic Institute

#

 THIRD WORLD USA

Dual impacts of extreme heat, ozone disproportionately hurt poorer areas

A frequent combination on hot days, high temperatures and ozone disproportionately affect low-income ZIP codes, researchers find

UNIVERSITY OF CALIFORNIA - SAN DIEGO

Research News

 

Scientists at UC San Diego, San Diego State University and colleagues find that extreme heat and elevated ozone levels, often jointly present during California summers, affect certain ZIP codes more than others.

Those areas across the state most adversely affected tend to be poorer areas with greater numbers of unemployed people and more car traffic. The science team based this finding on data about the elevated numbers of people sent to the hospital for pulmonary distress and respiratory infections in lower-income ZIP codes.

The study identified hotspots throughout the Central Valley, areas of San Diego County east of downtown San Diego, and places like San Bernardino, where Los Angeles basin smog is often trapped by surrounding mountain ranges, among others.

Results appear the week of May 24 in the journal Proceedings of the National Academy of Sciences. The Office of Environmental Health Hazard Assessment, a division of the California Environmental Protection Agency, funded the research.

"This information can be used to activate measures to protect populations in areas which we know will be at increased risk of experiencing a health burden from these co-occurring environmental events and maximize public health benefits," said study lead author Lara Schwarz, a graduate student who is in a joint doctoral program at San Diego State and the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego.

In places like California, these public health hazards are expected to appear in unison more frequently as the climate continues to warm and heat waves become more prevalent and long-lasting. The study could enable more targeted public health efforts because of its unprecedented consideration of two common hazards in tandem and its relatively high-resolution breakdown of where they are most likely to cause problems. Previous studies had tended only to evaluate city- or regional-level health trends.

"Understanding the health impacts of compounding environmental events such as extreme heat and various air pollutants like tropospheric ozone becomes a priority in a changing climate," said study co-author Tarik Benmarhnia, a climate change epidemiologist with appointments at UC San Diego's Scripps Institution of Oceanography and Herbert Wertheim School of Public Health and Human Longevity Science. "Such events are more frequent, intense and tend to co-occur, potentially creating synergistic effects on population health impacting the most vulnerable communities."

The work could inform early warning systems and prioritize resources more efficiently than at present, the researchers said.

Ozone, a gas and a variant molecular form of oxygen, is formed in the lower atmosphere by the reaction of various hydrocarbons to sunlight, especially during hot days. Car exhaust produces such hydrocarbons. Ozone can exacerbate asthma and other respiratory conditions among vulnerable people and is more prevalent in urban areas with more traffic.

Extreme heat can similarly affect respiratory health by itself or in combination with high ozone levels.

Schwarz's team notes that vulnerability to the excessive heat/ozone combination seems to be diminished in wealthier ZIP codes and correlated results with factors that include better access to healthcare, lower stress levels, and more exercise.

"When considering the ZIP code level, certain areas observed strong joint-effects," said the study authors. "A lower median income, higher percentage of unemployed residents and exposure to other air pollutants within a ZIP code drove stronger joint-effects; a higher percentage of commuters who walk/bicycle, a marker for neighborhood wealth, showed decreased effects."

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Besides Schwarz and Benmarhnia, authors include Kristen Hansen of the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego, Anna Alari of Sorbonne University in Paris, Sindana Ilango of the University of Washington, Nelson Bernal of the University of Brasilia in Brazil, Rupa Basu of the California Environmental Protection Agency, and Alexander Gershunov of Scripps Institution of Oceanography at UC San Diego.

New insights on animals in the African past

Researchers discover new peptide markers to expand identification of Africana bovid taxa

UNIVERSITY OF TENNESSEE AT KNOXVILLE

Research News

 

IMAGE: ANNEKE JANZEN view more 

CREDIT: UNIVERSITY OF TENNESSEE, KNOXVILLE

In order to understand foodways and subsistence strategies of humans in the past, as well as distributions of ancient animal species, it is critical for archaeologists to accurately identify animal taxa in archaeological sites. Many sites across sub-Saharan Africa have fragmented and poorly preserved animal bones, leaving the majority of specimens unidentifiable. Sub-Saharan Africa is also home to the greatest diversity of bovids on Earth, including African buffalo, wildebeest, eland, and duikers, as well as domestic sheep, goat, and cattle. The sheer number of osteologically similar animals in Africa presents a major challenge for identifying animal bones.

During the past decade, archaeologists have increasingly used a bone collagen peptide fingerprinting technique called Zooarchaeology by Mass Spectrometry (ZooMS) to identify ambiguous or unidentifiable bone fragments. However, the lack of complete reference peptide markers for African animals has hindered its application in Africa. In a new study, "Distinguishing African bovids using Zooarchaeology by Mass Spectrometry (ZooMS): New peptide markers and insights into Iron Age economies in Zambia," published in PLOS ONE, researchers present a complete set of confirmed ZooMS peptide markers for all groups of African bovids, revealing new opportunities for archaeologists to identify these species in archaeological sites.

"Our new reference dataset has the potential to revive research interest in, and add value to, assemblages previously considered too poorly preserved for traditional zooarchaeological analysis," said Anneke Janzen, assistant professor in the Department of Anthropology at the University of Tennessee, Knoxville, and lead author on the study.

Using these new peptide markers, Janzen and her team applied the ZooMS method to extremely fragmented animal bone assemblages from six Iron Age archaeological sites in Zambia and discovered the number of species present is greater than expected.

"With this new data, we discovered that Iron Age populations continued to hunt wild bovids, especially small duikers, in addition to relying on cattle-based pastoralism," Janzen said.

"Our research opens new opportunities for addressing questions of paleoenvironment, subsistence strategies, foodways, the spread of and development of herding economies in the African past," Janzen said.

CAPTION

A yellow backed duiker at the Knoxville Zoo.

CREDIT

University of Tennessee, Knoxville

New fishing tech may pose risks to fisheries, says study co-authored by UMass researcher

Scientists need to work closely with resource management agencies to assess impacts

UNIVERSITY OF MASSACHUSETTS AMHERST

Research News

 

IMAGE: ANDY DANYLCHUK RELEASING HIS CATCH. view more 

CREDIT: ANDREW BURR

AMHERST, Mass. - New developments in recreational fishing technology--from the use of aerial drones and social media scouting reports to advances in hook design--are creating challenges for fisheries management and effective policy making, according to a new study co-authored by University of Massachusetts Amherst researcher Andy Danylchuk.

With the opening of the spring fishing season, millions of recreational fishing aficionados across North America are dusting off their tackleboxes, fitting together their rods, and heading to the bait and tackle shop to purchase the latest in fish-catching gear. But what impact does all that new technology have on the fish themselves?

"There are still so many unknowns," says Andy Danylchuk, professor of fish conservation in the UMass Amherst department of environmental conservation, and co-author of a new paper that investigates the relationship between fishing technology and fish ecosystems. "There's more attention paid to products we use with our pets than to what we use to try to catch fish in our streams, lakes and oceans."

Fishing technology has come a long way since the days of hook and worm. Today one can buy battery-powered, artificial lures that wriggle like minnows and are slathered in fish-attracting scent. Underwater cameras and fish finders help anglers not only seek out their targets but also observe as fish either approach or reject the bait. Aerial drones scan for fish and even deliver lures to them. Social media helps pinpoint, in real time, what fish are biting where. Even the seemingly simple hook has been completely redesigned to better reel in the big one. And it's not as if recreational fishing in streams, lakes, and in the ocean is a niche-activity--it is the second most popular leisure activity in North America, falling just behind gardening.

"From improvements in finding and catching fish, to emulating their natural prey and accessing previously inaccessible waters, to anglers sharing their exploits with others, technology is completely changing all aspects of recreational fishing," says Steven Cooke, professor of fish ecology in Carleton University's department of biology and the study's lead author.

Without knowing what impact all this advanced technology has on the fish and their aquatic ecosystems, it has become difficult for fisheries managers to monitor the health of the fishery, and to ensure that the fishing experience is a positive one. "Recreational anglers have always been a strong voice for conservation," says Danylchuk. "If something changes and they are no longer catching fish, they're one of the first stakeholder groups to raise the alarm about possible environmental harms." It turns out that what's good for the fishing community is also good for the fish: more, and healthier fish means a more enjoyable, successful fishing experience.

What this means for the research and management community is that more attention needs to be paid to the effects of high-tech fishing equipment. "An important message here is that resource management agencies need to share their experiences and that scientists should more intensively study the impact of innovations in recreational fishing," write the study's authors. "If science can't keep up in terms of evaluating the impacts of technological innovation to help inform management and policy," says Danylchuk, "it can be really detrimental to the fish, which may ultimately mean fewer fish, and a worse fishing experience for anglers."

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Contacts: Andy Danylchuk, danylchuk@eco.umass.edu Daegan Miller, drmiller@um

Virus infection cycle revealed in dynamic detail

JOHN INNES CENTRE

Research News

 

IMAGE: VIRUS LIKE PARTICLES ARE MIMICS OF THE NUDAURELIA CAPENSIS OMEGA VIRUS A MODEL USED TO PROVIDE DYNAMIC DETAILS ABOUT THE PROCESS OF VIRAL MATURATION view more 

CREDIT: ROGER CASTELLS-GRAELLS

A critical process in the infection cycle of viruses has been revealed for the first time in dynamic detail using pioneering plant-based technology.

Evidence about the process of virus maturation revealed in the research could help us develop new methods for treating viral infections.

Maturation plays a critical role for all animal and bacterial viruses and is required to produce infectious virions or particles. Though the outlines of the process have been determined for many groups of viruses, detailed mechanistic studies have not been reported.

To provide the first detailed mechanistic study of maturation, Roger Castells-Graells, a rotation Ph.D. student working in Professor. George Lomonossoff's laboratory at the John Innes Centre infiltrated genetic material of the insect virus Nudaurelia capensis omega virus (N?V) into dwarf tobacco plants N.benthamiana.

This transient expression technique uses Virus Like Particles (VLPs) which are mimics of the authentic virus. The capsid or protein coat of the virus is produced by plant cells and the research team then analyses the material purified from infiltrated leaves.

The research demonstrated that maturation of procapsids - immature viral structures - can occur within plant cells to yield fully functional mature capsids. This has not been observed previously in the absence of a natural infection and is a new application for the transient expression system pioneered by Professor Lomonossoff at the John Innes Centre.

Comparative cryo-EM analysis of the structures of the procapsids and mature capsids revealed the large structural rearrangements both inside and between the protein subunits of the capsid that accompany maturation. These shape changes enable the chemical reactions that are necessary for the virus to infect the host.

Professor Lomonossoff, a group leader at the John Innes Centre, said: "Most structural studies of virus particles to date have given a static picture of the particles. By isolating particles from plants that are undergoing the process of maturation, we have managed to obtain a picture of the dynamics of an essential part of a virus infection cycle."

The present study, a collaboration involving scientists at the University of Leeds, in Brazil and the USA, as well as at the John Innes Centre, reveals details of the structures at the beginning and the end of the maturation process. What is now required is an analysis of intermediate steps to get a complete understanding of the dynamics.

This will enable the research team to determine the 3-D structures of intermediates in the maturation process to create a "movie."

"We have shown that maturation occurs over time within plant cells and that means we have discovered a valuable tool for studying virus maturation. We hope it will be of interest to potential collaborators and industry," said Professor Lomonossoff.

Plant-expressed virus-like particles reveal the intricate maturation process of a eukaryotic virus appears in Communications Biology

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Posts to Reddit forum "SuicideWatch"

spike in the early hours of Monday

morning

KING'S COLLEGE LONDON

Research News

 

Posts to Reddit forum "SuicideWatch" spike in the early hours of Monday morning

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London has found that people on a social media suicide support forum are most likely to post to the site during the early hours of Monday morning.

The study, which has been published in BMC Psychiatry, suggests that there is a clear variation in behaviour throughout the week and throughout the day. The researchers hope that this means that targeted support to at risk populations can be made more readily available to those most in need.

The researchers looked at the timings at which users of the Reddit forum "SuicideWatch" posted online. The forum is a moderated online community for individuals who are either at risk of, or know someone who is at risk of suicide.

The data, which was taken between 1st December 2008 and 31st August 2015, amounted to 90,518 posts. Over the course of a given week, posts to the forum were at their highest on Mondays between 02:00 and 05:00 in the morning. Posts trended downwards from Tuesday to Saturday. This was in stark contrast to data taken from the control group "AskReddit", a separate forum on the same site in which users can ask general questions of each other, which saw most content posted in the later hours of the day.

Dr Rina Dutta, the study's Primary Investigator from King's IoPPN said "Monday has often been identified as the day of the week which has the highest risk of someone taking their own life. From the data that we've studied, we can see a clear trend over weekly cycles that closely follows the suicide timing patterns reported in some earlier studies."

The timings of the posts suggest that active users are experiencing disturbances to their sleep, and may represent a potentially modifiable risk factor for suicidal thoughts and behaviours.

Dr Dutta said, "Extensive use of social media has been associated with disturbed sleep, anxiety, depression, and low self-esteem. Reducing the use of social media during the night hours might be an effective means of providing targeted psychological interventions in some individuals."

The researchers believe that using this data can be used to target at risk populations with greater levels of support.

"Given that we have a clear indication as to when at risk people are posting to this forum, it is challenging but certainly not implausible to envisage providing higher levels of moderation on Reddit during times of increased posting about suicidality. If developed in the right way, we might have the capacity to target otherwise unreachable populations to deliver suicide prevention messaging and interventions where and when they are needed most."

Ends

For further information please contact Patrick O'Brien, Senior Media Officer (Patrick.1.obrien@kcl.ac.uk)

About King's College London

King's College London is one of the top 10 UK universities in the world (QS World University Rankings, 2018/19) and among the oldest in England. King's has more than 31,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and some 8,500 staff.

The Institute of Psychiatry, Psychology & Neuroscience (IoPPN) which is the premier centre for mental health and related neurosciences research in Europe. It produces more highly cited outputs (top 1% citations) on mental health than any other centre (SciVal 2019) and on this metric we have risen from 16th (2014) to 4th (2019) in the world for highly cited neuroscience outputs. World-leading research from the IoPPN has made, and continues to make, an impact on how we understand, prevent and treat mental illness and other conditions that affect the brain. https://www.kcl.ac.uk/ioppn @KingsIoPPN

 

Clean water and toilets for healthy shelters

TOHOKU UNIVERSITY

Research News

 

IMAGE: TRAINED MEMBERS OF THE ISHINOMAKI ZONE JOINT RELIEF TEAM CONDUCTED VISUAL ASSESSMENTS OF RESOURCE SUPPLIES AND INFRASTRUCTURE IN EVACUATION SHELTERS. view more 

CREDIT: HELIYON

Regular, standardized assessments of evacuation shelters can help keep people healthy following natural disasters, according to research published by Tohoku University scientists and colleagues in the journal Heliyon. The study found that a clean tap water supply and hygienic toilets were especially important for protecting evacuees from the spread of infectious diseases.

"A clean water supply and maintaining hygiene are important for reducing environmental health risks among victims of natural disasters," says Tadashi Ishii, who specializes in disaster medicine at Tohoku University. "But scientists have not yet established a strong evidence base that describes the relationship between damage in resource supplies and infrastructure on the one hand and disaster victims' health status on the other."

Ishii led the Ishinomaki Zone Joint Relief Team following the Great East Japan Earthquake of March 11, 2011. More than 15,000 people died and 2,500 went missing following the disaster, with some 500,000 evacuated to shelters across Japan. It took nearly a year before all shelters were shut down.

The team conducted regular visits to the shelters in order to assess resource availability, infrastructure, and the health status and needs of people residing in the shelters. Now, Ishii and his research team have analysed these 2011 records to evaluate the impacts of resource supply levels and infrastructure damage on the physical health of evacuees.

Their study included 28 mid- to large-sized shelters regularly assessed in the weeks following the earthquake. The study looked specifically at changes made to resources and infrastructure between days 14 and 25 after the earthquake.

The team found that inadequate clean tap water and toilets were insufficiently improved during the assessment period in about half the shelters. Clinical symptoms of common respiratory and gastrointestinal infections were more prevalent in shelters where these two resources had not improved. Shelters that were able to improve the supply of clean tap water and toilet hygiene witnessed significant reductions in the prevalence of gastrointestinal symptoms among evacuees.

"Our study demonstrated the difficulty of quickly collecting objective assessment data from evacuation shelters during the acute phase of a massive disaster," says Ishii. "It also shows the validity of quick visual assessments of resources by trained staff. Importantly, the study reveals the importance of rapidly restoring clean water supply and toilet hygiene in shelters to reduce environmental health risks among evacuees."

Ishii and his team next plan to develop easy, reliable and quick assessment tools for evaluating resource damage and health status in evacuation shelters. He also stresses the importance of collaborating with local governments to set up effective supply chains that can rapidly deploy clean water and hygienic rescue toilets in the aftermath of natural disasters.

CAPTION

Actual scene of quick visual assessment of the rescue toilet by the relief team member.

CREDIT

Tohoku University