Saturday, August 20, 2022

Robotic kidney cancer surgery shows desirable outcomes in study

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO

Anatomy of the kidneys, liver and heart with the inferior vena cava, and surgical intervention to treat cancer — IMAGE: IN THIS ILLUSTRATION, A MASS (DEPICTED AS JAGGED) IS SHOWN ON A KIDNEY (LEVEL I, AT LEFT). THE TUMOR EXTENDS UP THE INFERIOR VENA CAVA VEIN (BLUE) TO THE LIVER (LEVEL III) AND APPROACHES THE HEART (LEVEL IV). SURGICAL CLAMPS TO CONTROL THE TUMOR ARE SHOWN IN RED AND YELLOW. A ROBOTIC SURGICAL INSTRUMENT IS SHOWN IN BLACK. IMAGE COURTESY DHARAM KAUSHIK, MD/JOURNAL OF UROLOGY. view more
CREDIT: DHARAM KAUSHIK, MD/JOURNAL OF UROLOGY

SAN ANTONIO (Aug. 19, 2022) — Kidney cancer is not always confined to the kidney. In advanced cases, this cancer invades the body’s biggest vein, the inferior vena cava (IVC), which carries blood out of the kidneys back to the heart. Via the IVC, cancer may infiltrate the liver and heart. The Mays Cancer Center at The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the high-volume centers in the U.S. with surgical expertise in treating this serious problem. The Mays Cancer Center is San Antonio’s National Cancer Institute-designated Cancer Center.

In a study featured on the cover of the Journal of Urology (Official Journal of the American Urological Association), researchers from the Mays Cancer Center and Department of Urology at UT Health San Antonio show that robotic IVC thrombectomy (removal of cancer from the inferior vena cava) is not inferior to standard open IVC thrombectomy and is a highly safe and effective alternative approach. The affected kidney is removed along with the tumor during surgery, which is performed at UT Health San Antonio’s clinical partner, University Hospital.

Harshit Garg, MD, urologic oncology fellow in the Department of Urology, is first author of the study, and Dharam Kaushik, MD, urologic oncology fellowship program director, is the senior author. Kaushik is an associate professor and the Stanley and Sandra Rosenberg Endowed Chair in Urologic Research at UT Health San Antonio.

The open surgery requires an incision that begins 2 inches below the ribcage and extends downward on both sides of the ribcage. “It looks like an inverted V,” Kaushik said. Next, organs that surround the IVC, such as the liver, are mobilized, and the IVC is clamped above and below the cancer. In this way, surgeons gain control of the inferior vena cava for cancer resection.

“Open surgery has an excellent success rate, and most cases are performed in this manner,” Kaushik said. “But now, with the robotic approach, we can achieve similar results with smaller incisions. Therefore, we need to study the implications of utilizing this newer approach.”

The study is a systematic review and meta-analysis of data from 28 studies that enrolled 1,375 patients at different medical centers. Of these patients, 439 had robotic IVC thrombectomy and 936 had open surgery. Kaushik and his team collaborated with Memorial Sloan Kettering Cancer Center, New York; Cedars-Sinai Medical Center, Los Angeles; and the University of Washington, Seattle, to perform this study.

“We pulled the data together to make conclusions because, before this, only small studies from single institutions had been conducted to compare the IVC thrombectomy approaches,” Kaushik said.

Findings

The results are encouraging and indicate further study of robotic IVC thrombectomy is warranted. The robotic approach in comparison with open was associated with:

Fewer blood transfusions: 18% of robotic patients required transfusions compared to 64% of open patients.
Fewer complications: 5% of robotic patients experienced complications such as bleeding compared to 36.7% of open thrombectomy patients.

These large, technically challenging surgeries last eight to 10 hours and involve a multidisciplinary team of vascular surgeons, cardiac surgeons, transplant surgeons and urologic oncology surgeons, Kaushik said.

“This study is the largest meta-analysis analyzing the outcomes of robotic versus open IVC thrombectomy,” Kaushik said. “In more than 1,300 patients, we found that overall complications were lower with the robotic approach and the blood transfusion rate was lower with this approach.

“That tells us there is more room for us to grow and refine this robotic procedure and to offer it to patients who are optimal candidates for it,” Kaushik said. “Optimal candidacy for a robotic surgery should be based on a surgeon’s robotic expertise, the extent and burden of the tumor, and the patient’s comorbid conditions. The open surgical approach remains the gold standard for achieving excellent surgical control.”

A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

Harshit Garg, Sarah P. Psutka, Abraham Ari Hakimi, Hyung L. Kim, Ahmed M. Mansour, Deepak Pruthi, Michael A. Liss, Hanzhang Wang, Christine S. Gaspard, Chethan Ramamurthy, Robert S. Svatek, Dharam Kaushik

First published: June 28, 2022, Journal of Urology

https://pubmed.ncbi.nlm.nih.gov/35762219/

The Mays Cancer Center at UT Health San Antonio is one of only four National Cancer Institute-designated Cancer Centers in Texas. The Mays Cancer Center provides leading-edge cancer care, propels innovative cancer research and educates the next generation of leaders to end cancer in South Texas. Visit www.cancer.uthscsa.edu.

Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

JOURNAL

The Journal of Urology

DOI

10.1097/JU.0000000000002829

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

Early blood tests predict death, severe disability for traumatic brain injury

In the study, the method predicted poor outcomes six months after injury with high accuracy

Peer-Reviewed Publication

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

TBI Blood Tests — IMAGE: A GRAPHIC OF TBI WITH BLOOD TEST VIALS. view more
CREDIT: JUSTINE ROSS, MICHIGAN MEDICINE

A study finds that blood tests taken the day of a traumatic brain injury can predict which patients are likely to die or survive with severe disability, allowing clinicians to make decisions earlier on possible treatment of TBI.

Researchers from Michigan Medicine, the University of California San Francisco and the University of Pennsylvania analyzed day-of-injury blood tests of nearly 1,700 patients with TBI. Results published in The Lancet Neurology reveal that higher values of two protein biomarkers, GFAP and UCH-L1, are associated with death and severe injury.

This is the first study to examine the association between biomarker levels of these two proteins and all-cause mortality following TBI, says first author Frederick Korley, M.D., Ph.D., associate professor of emergency medicine at the University of Michigan Medical School.

“Early and accurate prediction of TBI outcomes will help clinicians gauge how severe a brain injury is and inform how best to counsel family members about care for their loved ones with brain injury and what to expect with regards to their recovery,” Korley said. “It will also help researchers more precisely target promising TBI therapeutics to the right TBI patients.”

The U.S. Food and Drug Administration cleared the use of GFAP and UCH-L1 in 2018 to help clinicians decide whether to order CT scans for mild traumatic brain injury.

Researchers measured the proteins using two devices from Abbott Laboratories, the i-STAT Alinity and the ARCHITECT. Results were compared to evaluations made six months after injury using the Glasgow Outcome Scale-Extended, a system that grades the functional status of TBI patients.

Investigators found that compared to those with GFAP values in the bottom 20th percentile, those with GFAP values in the top 20th percentile had a 23 times higher risk of death during the subsequent six months. Similarly, compared to those with UCH-L1 values in the bottom 20th percentile, those with UCH-L1 values in the top 20th percentile had a 63 times higher risk of death during the subsequent 6 months.

“Modern trauma care can result in good outcomes in what we had once believed were non-survivable injuries,” said co-senior author Geoffrey Manley, M.D., Ph.D., professor and vice chair of neurosurgery at UCSF. “These blood tests are both diagnostic and prognostic, as well as easy to administer, safe and inexpensive.”

While the method is promising for determining poor outcomes in moderate and severe TBI, researchers say more must be done to examine its role in mild cases.

“As a next step, the TRACK-TBI team is planning a clinical trial that will examine the efficacy of promising therapeutic agents that may help traumatic brain injury patients recover quickly,” Korley said. “As part of this clinical trial, these biomarkers will be used as an objective method for selecting the right patients to enroll in this trial. We will also use these biomarkers to monitor individual patient response to these promising therapeutics.”

Korley previously consulted for Abbott Laboratories. Korley and Robertson have received research funding from Abbott Laboratories. Manley received research funding from a collaboration between Abbott Laboratories and the U.S. Department of Defense. Diaz-Arrastia consulted for MesoScale Discoveries, BrainBox Solutions, and NovaSignal. All other authors and collaborators declare no competing interests.

Paper cited: “Prognostic value of day-of-injury plasma GFAP and UCH-L1 concentrations for predicting functional recovery after traumatic brain injury in patients from the US TRACK-TBI cohort: an observational cohort study,” The Lancet Neurology DOI: 0.1016/S1474-4422(22)00256-3

JOURNAL

The Lancet Neurology

DOI

10.1016/S1474-4422(22)00256-3

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Prognostic value of day-of-injury plasma GFAP and UCH-L1 concentrations for predicting functional recovery after traumatic brain injury in patients from the US TRACK-TBI cohort: an observational cohort study

ARTICLE PUBLICATION DATE

10-Aug-2022

COI STATEMENT

Certain environment authority decisions are based on trust in citizen data

UNIVERSITY OF GOTHENBURG

19-AUG-2022

County administrative boards and the Swedish Forest Agency use species sightings reported by the public to make various environmental decisions. This is done largely on the basis of trust between a few actors who determine which sightings can be used as a basis for decisions. This is shown by researchers at the University of Gothenburg who have investigated how citizen science is used in Swedish society.

In a new study, Dick Kasperowski and Niclas Hagen, both theorists of science, have looked at how county administrative boards and the Swedish Forest Agency use reports in Artportalen – a web portal for species sightings of Sweden's plants, animals and fungi, to which anyone can report species. More than 90 million sightings are registered, and it is now one of the largest species portals in the world. This form of citizen science creates a very valuable knowledge bank for Swedish nature conservation as regards species distribution. As Artportalen is used by several authorities and courts, it also provides researchers with a unique opportunity to understand how citizen data is used.

The study is based on interviews with officials around Sweden who use citizen’s sightings to make decisions on land and water issues. This may concern logging or exploiting land and water areas for road construction, wind turbines, emissions, industrial installations, or other types of interventions that have consequences for the environment. The researchers have studied how officials relate to these sightings when creating basis for such cases.

‘We saw that it is a small number of people who determine which reported sightings will influence decisions about the environment and the use of land and water, and that need not be a problem in itself, but to put it more bluntly, a sighting is not certain just because it has been reported; it is verified through a series of different arrangements and networks where technologies and people interact, and where trust has to be built,’ says Dick Kasperowski.

There are complex interactions between officials' interpretations of legal texts, the use of computer programmes to map sightings, lists of endangered species, tools to determine the time and place of sightings, and validations by committees within Artportalen. But it may also be that an official personally knows the reporter, or local knowledge of members of an ornithological society that is highly valued by agency staff that is involved.

‘Not infrequently, some submitted data is uncertain, and that's where trust comes in. We also show that trust is not evenly distributed in this system, but more concentrated in certain actors, which is due to interpersonal relationships that have developed over time,’ says Niclas Hagen.

The knowledge base that is to help our leaders make more informed decisions about major societal challenges, climate, and species preservation depends on many people getting involved, as is the case with Artportalen.

‘However, the validity of sightings is assessed by a small number of officials, members of evaluation committees and environmental lawyers. This means that the existing high expectations for citizen science to democratise science, in an almost representative sense, cannot be met. The higher up the decision-making pyramids we go, the fewer the assessors become, and the more resources they have. This is an issue that needs to be studied in more detail,’ says Dick Kasperowski.

International research shows that participants in citizen science are generally better educated, upper middle class, and middle-aged or older. In the case of large long-term species observation projects, they are dominated by individuals who identify as male, with an interest in certain species, particularly birds.
‘We will now move on with studies of how inequalities can manifest in citizen science,’ says Niclas Hagen.

The study also shows that Artportalen is used in environmental activism to pursue certain environmental issues, such as when there are plans for logging on sites deemed to be of high conservation value. This has resulted in cases in land and environmental courts against Swedish authorities for not complying with national or international environmental laws and conventions.

‘How this can change the political processes for difficult environmental issues is far beyond the scope of this article, but is definitely a question for future research,’ says Niclas Hagen.

The study is presented in Social Studies of Science and is titled Making particularity travel: Trust and citizen science data in Swedish environmental governance.

The article can be freely downloaded via this link: https://journals.sagepub.com/doi/pdf/10.1177/03063127221085241

The research on which the study is based has been conducted within the Citizen Science: collecting and using data for societal change project, funded by Formas (Registration no 2017 - 01212).

Contact:

Dick Kasperowski, phone: 0766 181 945, email: dick.kasperowski@gu.se
Niclas Hagen, phone: 031 786 5056, email: niclas.hagen@gu.se

Mosquitoes have a bizarre sense of smell, study finds

The unconventional way mosquitoes process odors could help explain why they are so good at finding humans to bite

Peer-Reviewed Publication

BOSTON UNIVERSITY

If you’ve ever sprayed yourself head to toe in bug repellent, yet still felt like a mosquito magnet, it will come as no shock to you that mosquitoes are very, very good at finding humans to bite. One key factor in this superpower is their keen sense of smell, or olfaction, which relies on the olfactory system.

“Mosquitoes are highly specialized,” says Meg Younger, a Boston University College of Arts & Sciences assistant professor of biology who studies mosquito olfaction. These relentless, buzzing creatures are designed to find us, bite us, use proteins in our blood to reproduce—and repeat. Mosquitoes, as much as they feel like a seasonal nuisance in the Northeast US, are deadly creatures that kill more people than any other animal in the world. Depending where they live, certain types of mosquitoes transmit diseases like malaria, West Nile virus, Zika virus, dengue, eastern equine encephalitis, and others. And warmer, dry, and tropical climates battle mosquitoes all year long.

Younger is working to crack the code on how mosquitoes use their sense of smell to track us in order to better understand how we can repel them more effectively. In a new paper published in Cell, Younger and her colleagues describe the unique and previously unknown way Aedes aegypti mosquitoes process smell at the biological level; their findings are a departure from the central theories that previously guided our understanding of insect olfaction.

Aedes aegypti mosquitoes normally inhabit warm, tropical climates, and have caused minor outbreaks of dengue in southern states like Florida and Texas. But in recent years, they’ve been spotted as far north as Connecticut, raising alarm bells about what to expect as global temperatures continue to warm.

“This is part of why this work is going to get more and more important,” says Younger, who began the study while completing postdoctoral research with Leslie B. Vosshall at The Rockefeller University, a biomedical research-focused institution in New York.

How Smell Works

For humans, scents are registered in the brain by a flow of communication that begins in the nose, which is lined with special cells called olfactory sensory neurons. These neurons—which house sensory receptors, specialized molecules that are stimulated by odor particles—act as detectors of odor and as messengers to the brain.

“The central dogma in olfaction is that sensory neurons, for us in our nose, each express one type of olfactory receptor,” Younger says. This is the underlying organizational principle of olfaction: one receptor to one neuron. For example, the smell of a freshly baked apple pie is actually a chemical code created by different odor molecules. As the distinct smell wafts into our noses, it triggers sensory receptors that match the different odor molecules; corresponding neurons then communicate to a brain region called the olfactory bulb—or the antenna lobe in insects—where it maps the odor code.

According to the study findings, Aedes aegypti mosquitoes’ olfactory system is organized very differently, with multiple sensory receptors housed within one neuron, a process called gene coexpression. This uniquely specialized olfactory system could help explain why mosquitoes are so good at sniffing out humans to bite.

“This is shockingly weird,” says Younger, who initially thought her look into mosquito sensory neurons would prove it to be like every other olfactory system, like in flies and mice. The difference might seem technical, but it suggests that mosquitoes’ sense of smell is highly attuned to humans. “It’s not what we expected,” she says.

Past research has found that even eliminating entire receptors in mosquitoes that are used for decoding carbon dioxide—a major chemical cue that they use to hunt humans—does not interfere with them finding people. Younger’s latest study may indicate one reason why.

In her lab at BU, Younger is raising mosquitoes in incubators and using modern genetic tools to understand olfaction in ways that were not possible a decade ago. For this study, the researchers developed mosquitoes that would light up under the microscope when exposed to certain smells—they expressed fluorescent proteins that glow under the microscope, allowing the researchers to see chemical responses to odorants. They also used CRISPR technology (which stands for clustered regularly interspaced short palindromic repeats and is a genetic tool created to edit DNA in living organisms) to label different groups of sensory neurons, while preserving the function of the cell proteins.

All of the results point to an olfactory system that is unconventional in the way that it coexpresses sensory receptors within individual sensory neurons. This suggests redundancy in the code for human odor—and possibly a stronger sense of smell that draws mosquitoes to humans. The next step is figuring out what role coexpression plays in driving the behaviors of Aedes aegypti mosquitoes.

“A compelling idea is that it’s making them good at finding people,” Younger says. Her long-term goal is to intervene in mosquito biting by generating new, improved repellents, or attractants that are more appealing to mosquitoes than human blood. “As we learn about how odor is encoded in their olfactory system, we can create compounds that are more effective based on their biology,” she says.

Until then, Younger uses bug spray—brands with 15 to 25 percent DEET or picaridin tend to be rated most effective—to protect herself from mosquitoes outdoors. Eventually, with more and more research, she hopes there will be a better option.

JOURNAL

Cell

ARTICLE TITLE

Non-canonical odor coding in the mosquito

Anti-Black racism linked to lower support for some gun rights

Racial resentment leads some to associate gun rights with white people, study finds

Peer-Reviewed Publication

AMERICAN PSYCHOLOGICAL ASSOCIATION

Racially resentful white Americans are less likely to support some gun rights if they believe Black people are exercising those rights more than white people, according to research published by the American Psychological Association.

White Americans who expressed high levels of anti-Black sentiments associated gun rights with white people and gun control with Black people, the study found. Those research participants were quicker to match photos of white people to gun rights phrases (e.g., self-protection, National Rifle Association) and photos of Black people to gun control phrases (e.g., waiting period, weapons ban).

While Republicans were more likely to make racially biased assumptions about gun rights than white Democrats, anti-Black views had a greater impact on the findings than party affiliation, the study found. The research was published online in the Journal of Experimental Psychology: General.

The study examined only racial resentment toward Black people, expressed as the belief that racial inequities are due to Black Americans not working hard enough to succeed and unfairly receiving entitlements to promote racial equity.

Guns are both symbolically and practically tied to power in the U.S., said lead researcher Gerald Higginbotham, PhD, a postdoctoral research associate at the University of Virginia. “Gun rights are just one of the many rights we have in the United States, like voting, that a large number of white Americans have both knowingly and unknowingly racialized as being for white citizens, and especially not for Black citizens,” he said.

As more people take notice that Black Americans are legal gun owners, too, race and racism may play an increasingly explicit role in debates over gun rights and gun control reforms, Higginbotham said.

Since January 2019, 7.5 million people, or almost 3% of the U.S. adult population, bought guns for the first time, according to a recent study. Black people, who accounted for 20% of the first-time purchases, make up about 12% of the U.S. population.

The current research was made up of three online studies with more than 850 white participants, including one nationally representative sample. In two of the three studies, the participants were equally divided into two groups, with one group reading a real Fox News article accurately reporting that Black Americans were obtaining concealed-carry gun permits at a greater rate than white Americans. The second group read an identical article except the races were reversed, with white Americans obtaining permits faster.

Racially resentful participants – as measured by responses to four questions – expressed less support for concealed-carry permits when they perceived Black Americans as obtaining them at a greater rate. However, their support for gun rights unrelated to concealed-carry was not impacted. This provides some evidence that racial bias accounted for the lessened support for concealed-carry permits because it was the specific gun right Black people were described as exercising more than white people.

Higginbotham said the findings mirror the racist motives behind historical efforts to limit gun rights for Black people, dating from before slavery to the Jim Crow era and onward to the Mulford Act, a California law approved in 1967. The National Rifle Association, which today opposes most gun control reforms, supported the Mulford Act’s statewide ban on open carry of loaded firearms. The act was spurred by opposition to Black Panther Party members who carried loaded guns in a protest at the California state capitol, and in their neighborhoods, meant to protect residents from police brutality.

The researchers emphasized that their findings don’t support the use of anti-Black racism as a means of building support for gun control reforms. “An attempt to politically weaponize racist beliefs expressed toward Black lawful gun owners would be shortsighted and could dangerously infringe upon the rights of Black people instead of focusing on saving lives from gun violence,” Higginbotham said.

The research did not examine potential intersections between racism and other gun rights or gun control measures, such as bans on assault weapons and high-capacity magazines.

Article: “When an Irresistible Prejudice Meets Immovable Politics: Black Legal Gun Ownership Undermines Racially Resentful White Americans Gun Rights Advocacy,” Gerald Higginbotham, PhD, University of Virginia, and David Sears, PhD, and Lauren Goldstein, PhD, University of California Los Angeles. Journal of Experimental Psychology: General, published online Aug. 25, 2022.

Contact: Gerald Higginbotham, PhD, may be contacted via public.affairs@apa.org.

JOURNAL

Journal of Experimental Psychology

SUBJECT OF RESEARCH

People

ARTICLE TITLE

When an Irresistible Prejudice Meets Immovable Politics: Black Legal Gun Ownership Undermines Racially Resentful White Americans Gun Rights Advocacy

ARTICLE PUBLICATION DATE

25-Aug-2022

Historical rates of enslavement predict modern rates of American gun ownership

Peer-Reviewed Publication

UNIVERSITY OF WISCONSIN-MADISON

The higher percentage of enslaved people that a U.S. county counted among its residents in 1860, the more guns its residents have in the present, according to a new analysis by researchers exploring why Americans’ feelings about guns differ so much from people around the globe.
More than 45% of the world’s civilian-owned firearms are in the United States, where just 5 percent of the world’s people live. This disparity may have something to do with the way the majority of American gun owners view gun ownership.
“Gun culture is one case where American Exceptionalism really is true,” says Nick Buttrick, a University of Wisconsin–Madison professor of psychology. “We are really radically different even from countries like Canada or Australia, places that have similar cultural roots.”
Pew Research Center surveys show two-thirds of Americans who own guns say it’s a way to keep themselves safe, while in other countries, people are more likely believe the presence of a gun adds risk and danger to their lives, considering, for example, the far higher rates of homicide and suicide in households with guns. Gun culture scholars have also explored the role of race in American gun attitudes for some time, Buttrick says, and the two may be linked.
In a study published recently in the journal PNAS Nexus, Buttrick and co-author Jessica Mazen, a psychology graduate student at the University of Virginia, describe a shift in sentiment away from the predominant, pre-Civil War idea of guns as tools for hunting and sport. In the post-Civil War South, the belief that a gun was necessary to protect family, property and a way of life grew prominent among white southerners. This was driven by a flood of surplus military weapons, the rise of armed, white-supremacist organizations like the Ku Klux Klan, and elite rhetoric that Reconstruction governments would not protect the interests of white southerners from newly freed and politically-empowered Black people.

The researchers compared county-level population data from the 1860 census to gun ownership patterns in the present. Because there is no national record of gun ownership, the study uses a widely accepted proxy — the proportion of suicides in a county that involved a firearm, according to Centers for Disease Control and Prevention mortality records from 1999 to 2016.
“What we see is a strong correlation between the number of slaves in a county in 1860 and the number of guns there now, even after we control for variables like personal politics, crime rates, and education and income,” says Buttrick, who produced the study while working as a postdoctoral researcher at Princeton University, before joining the UW–Madison faculty this year.
This correlation was strong even when the researchers focused only on white gun owners, narrowing their proxy for gun ownership to firearm suicides involving only non-Hispanic white victims.
The study further pinpoints a particularly Southern root for the American belief that guns keep people safe.
“The extent to which people feel unsafe only predicts gun ownership in counties in the South, where the more unsafe people feel, the more likely they are to own a gun,” Buttrick says. “If you look in areas that didn't have any slaves in the 1860s, whether people feel unsafe there today does not predict today’s county-level gun ownership.”

Additionally, areas in the North and West with more guns in the present day are home to people that are more likely to have Facebook friends that live in parts of the South that had higher historical rates of slavery. In these areas, as in the South, feeling unsafe is more likely to predict increased gun ownership. The researchers say this suggests that social transmission of beliefs about guns is at work.
“The question is, how do these ideas about guns get to the rest of the country?” Buttrick says. “As people move, they bring with them the culture that formed them. We can see the remnants of those moves and the lingering connections to family and community in people’s social media connections, and it lines up with the slavery-gun-ownership pattern.”
The results may give researchers a clearer sense of how gun culture has developed and evolved differently across the country – why some parts of the country still retain a hunting culture, while others are dominated by a gun culture based around personal protection.
“It helps to elucidate some things — why is it that race and guns are so tightly tied together? Why is it that guns are so present in the public mind and discussion for white people and not for Black people?” Buttrick says. “And it does help make sense of why protective gun ownership is such a popular idea in the United States, but not elsewhere.”
###
— Chris Barncard, barncard@wisc.edu

JOURNAL

PNAS Nexus

DOI

10.1093/pgac117

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Historical prevalence of slavery predicts contemporary American gun ownership

ARTICLE PUBLICATION DATE

5-Aug-2022

Climate change likely to raise wheat prices in food-insecure regions and exacerbate economic inequality

Peer-Reviewed Publication

CELL PRESS

Wheat harvest season in North China Plain — IMAGE: WHEAT HARVEST SEASON IN NORTH CHINA PLAIN view more
CREDIT: HUIRU PENG

Wheat is a key source of nutrition for people across the globe, providing 20% of calories and protein for 3.4 billion people worldwide. Even if we meet climate mitigation targets and stay under 2°C of warming, climate change is projected to significantly alter the yield and price of wheat in the coming years. Researchers publishing in the journal One Earth on August 19 predict that wheat yield is likely to increase at high latitudes and decrease in low latitudes, meaning that prices for the grain are likely to change unevenly and increase in much of the Global South, enhancing existing inequalities.

“Most studies primarily focus on how modelling climate change impacts on wheat yields,” says lead author Tianyi Zhang, an agro-meteorologist with the Institute of Atmospheric Physics at the Chinese Academy of Science. “This is indeed important, but crop yields do not provide a holistic vision of food security. In the real world, many countries, especially developing countries, heavily rely on agribusiness.”

The team has developed a new climate-wheat-economic ensemble modeling approach. This improved model system allows the researchers to explicitly look at impacts of both climate mean conditions and extreme events on wheat yields, price and global supply-demand chain. “We know from previous research that extreme events do not necessarily respond in the same way as the mean conditions, and because these extreme events are the most impactful on societies, this is an important step forward,” says co-author Karin van der Wiel, a climate scientist in the Royal Netherlands Meteorological Institute.

The model predicts that yield will increase in high latitude regions—countries like the United States, Russia, and much of northern Europe. In countries like Egypt, India, and Venezuela, however, wheat yields are likely to drop—in some areas by more than 15%. “With this change in yields, the traditional trade position of the wheat market could be deepened, and this may cause the wheat-importing regions located in low latitudes, such as Southern Asia and Northern Africa, to see more frequent and steeper wheat price spikes than wheat exporting countries,” says Zhang.

Not only could these changes mean that countries already facing food security issues pay even more for a pivotal food crop, but wheat prices on the global market could become more volatile and exacerbate existing inequalities. “Trade liberalization policy under 2° warming could stabilize or even increase farmers’ income in wheat-exporting countries but would reduce income for farmers in wheat importing countries,” says Zhang. “This may create new economic inequality between farmers in wheat -exporting and -importing countries.”

Zhang and his team hope that their predictions about wheat prices and volatility will prompt global action. “Helping improve the grain food self-supplies in developing countries is crucial for global food security,” says Zhang. “This is worthy of discussion between countries in future international agricultural collaboration policy.”

###

This work was supported by the National Key Research and Development Project of China, JPI-Belmont Forum, and European Union Horizon 2020.

One Earth, Zhang et al. “Increased wheat price spikes and larger economic inequality with 2oC global warming” https://www.cell.com/one-earth/fulltext/S2590-3322(22)00371-2

One Earth (@OneEarth_CP), published by Cell Press, is a monthly journal that features papers from the fields of natural, social, and applied sciences. One Earth is the home for high-quality research that seeks to understand and address today’s environmental Grand Challenges, publishing across the spectrum of environmental change and sustainability science. A sister journal to Cell, Chem, and Joule, One Earth aspires to break down barriers between disciplines and stimulate the cross-pollination of ideas with a platform that unites communities, fosters dialogue, and encourages transformative research. Visit http://www.cell.com/one-earth. To receive Cell Press media alerts, contact press@cell.com.

JOURNAL

One Earth

DOI

10.1016/j.oneear.2022.07.004

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Increased wheat price spikes and larger economic inequality with 2oC global warming

ARTICLE PUBLICATION DATE

19-Aug-2022

Comparing prevalence of HPV infection

JAMA Health Forum

Peer-Reviewed Publication

JAMA NETWORK

About The Study: Researchers compared the prevalence of human papillomavirus (HPV) among women born in the 1980s versus the 1990s and a pre-HPV vaccination period (2005-2006) versus a recent vaccination period (2015-2016).

Authors: Ashish A. Deshmukh, Ph.D., M.P.H., of the University of Texas Health Science Center School of Public Health in Houston, 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/jamahealthforum.2022.2706)

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.

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JOURNAL

JAMA Health Forum

FOR PROFIT HEALTHCARE

Out-of-pocket cost of naloxone may keep may uninsured from using life-saving treatment

Study finds costs rise 500% for uninsured while falling for those with health insurance

Peer-Reviewed Publication

RAND CORPORATION

The cost of buying the opioid antidote naloxone is out of reach for many uninsured Americans, a hurdle that may keep the treatment from saving more people who overdose on opioids, according to a new RAND Corporation study.

While laws making it easier to prescribe and obtain naloxone have increased use of the medication, the out-of-pocket cost of the drug for the uninsured has risen sharply even while falling for many who are insured.

The study found that the average out-of-pocket cost per naloxone prescription among those who have health insurance declined by 26% from 2014 to 2018, while out-of-pocket costs increased by more than 500% for people who are uninsured. Uninsured Americans are a vulnerable population that represent about 20% of adults with an opioid-use disorder and nearly one-third of opioid overdose deaths.

The findings are published in the latest edition of the journal JAMA Health Forum.

“The price of naloxone is almost certainly an impediment to more widespread adoption among the uninsured,” said Evan Peet, the study’s lead author and an economist at RAND, a nonprofit research organization. “Policymakers who want to further expand access to naloxone -- particularly among the uninsured and vulnerable -- need to pay greater attention to the out of-pocket costs.”

Among the strategies adopted by federal and state policymakers to battle the opioid crisis is increasing the distribution of naloxone, which can reverse the effects of an opioid overdose if given to a person promptly.

While many states have adopted laws to make it easier to prescribe and dispense naloxone, less attention has focused on potential financial barriers to naloxone access.

Researchers from RAND and the University of Southern California examined more than 700,000 prescription records from 2010 to 2018 for both generic and name-brand naloxone to examine trends in out-of-pocket costs. The sample included information from more than 70% of the nation’s retail pharmacies.

Prescriptions filled for naloxone increased sharply over the study period. While the sample saw 11,432 naloxone prescriptions filled during 2010, the number grew to 386,249 in 2018.

Despite legal changes that make it easier to buy naloxone and pharmaceutical innovations that have enabled laypersons to administer naloxone, the increase in naloxone prescriptions were not equally distributed. While naloxone distribution rose substantially starting in 2017 among the insured, naloxone access among the uninsured did not experience similar gains.

Researchers say cost is likely one important factor in the lower use among the uninsured. As use of naloxone increased, the out-of-pocket costs fell for most people with health insurance, while it increased for those who are uninsured.

In 2014, the average out-of-pocket cost per naloxone prescription among insured people was $27, while it was $35 for those who were uninsured.

By 2018, the average out-of-pocket cost per prescription for naloxone among the uninsured was $250. The same year, the average out-of-pocket per naloxone prescription for the insured was $18.

“Federal and state policies have regularly targeted legal barriers to accessing naloxone, with less emphasis on financial barriers,” Peet said. “These results provide evidence that while naloxone access has improved, out-of-pocket costs remain a significant impediment, particularly for the uninsured.”

Researchers say that in order to increase the use of naloxone and prevent opioid overdose deaths, policymakers could consider implementing price subsidies for naloxone purchases, regulating co-pays for the insured and issuing coupons targeting the uninsured.

Support for the study was provided by the federal Centers for Disease Control and Prevention and the National Institute on Drug Abuse.

Other authors of the study are David Powell of RAND and Rosalie Liccardo Pacula of the University of Southern California.

RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

JOURNAL

JAMA Health Forum

DOI

10.1001/jamahealthforum.2022.2663

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Trends in Out-of-Pocket Costs for Naloxone by Drug Brand and Payer in the US, 2010-2018

ARTICLE PUBLICATION DATE

19-Aug-2022

Out-of-pocket costs for naloxone

JAMA Health Forum

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this observational study of nearly 720,000 pharmacy claims data, out-of-pocket cost of naloxone had been an increasingly substantial barrier to naloxone access for uninsured patients, potentially limiting use among this population, which constituted approximately 20% of adults with opioid use disorder.

Authors: Evan D. Peet, Ph.D., of the RAND Corporation in Pittsburgh, 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/jamahealthforum.2022.2663)

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JOURNAL

JAMA Health Forum