Thursday, November 03, 2022

Lack of access to healthy food may raise risk of death from heart failure

A new study in the journal Circulation: Heart Failure has found an association between not having healthy food available in communities and increased rates of death from heart failure

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

DALLAS, Oct. 25, 2022 — A study reviewing data from nearly 3,000 counties in the United States has found that living in a community with easy access to grocery stores and affordable, healthy food is associated with lower heart failure death rates, according to new research published today in Circulation: Heart Failure, an American Heart Association journal.

Food insecurity occurs when healthy food is not readily available on a daily basis, due to poverty or socioeconomic challenges, causing people to go hungry or eat food that is of reduced quality, variety or desirability. While previous research has confirmed that food insecurity is associated with adverse cardiovascular outcomes, little research is available about the local food environment and its potential relationship to death from heart failure. A 2019 paper published in the Journal of the American Heart Association found that, on a county level in the U.S., poverty was the strongest socioeconomic factor associated with heart failure and coronary heart disease, and the association was stronger for heart failure than coronary heart disease.

“Heart failure mortality is on the rise in populations that live in socioeconomic deprivation, and, importantly, we believe that nutrition plays a role in heart failure mortality, and food insecurity may be particularly detrimental in this population,” said lead study author Keerthi T. Gondi, M.D., an internal medicine resident at the University of Michigan Health System in Ann Arbor, Michigan. “We know that important relationships exist among food access and food affordability and heart health. This will have to be addressed in order to make changes to the burden of cardiovascular disease in populations that live in socioeconomic deprivation moving forward.”

This study is one of the first analyses to investigate the association between local food environments and heart failure mortality. Heart failure is a chronic, progressive condition in which the heart muscle becomes so weak it no longer pumps blood as it should. According to Gondi, he and his colleagues examined the death rate from heart failure because it is a consistent metric reported across all US counties, providing an ability to comprehensively evaluate heart failure outcomes at the population level. In 2019, heart failure death accounted for nearly more than 86,000 deaths in the U.S., according to the Association’s Heart Disease and Stroke Statistics Update for 2022.

The researchers sought to determine whether food environment by county level was associated with heart failure death rates. They reviewed 2018 data from the National Vital Statistics System – a database of all births and deaths in the U.S. – and examined the potential for associations among the heart failure death rates in each county with the county’s 2018 Food Insecurity Percentage score and Food Environment Index score.

The researchers collected each county’s Food Insecurity Percentage score — the percentage of the population who lack adequate, consistent access to healthy food — and Food Environment Index score — an index ranked from 0 (worst) to 10 (best) based on a composite of metrics including affordability of nutritious food, food insecurity, grocery store proximity, transportation and socioeconomic factors — from the USDA’s Food Environment Atlas and the Robert Woods Johnson Foundation County Health Rankings. The Food Environment Atlas assembles statistics on food environment indicators and provides a spatial overview of a community's ability to access healthy food.

Evaluated together, the Food Insecurity Percentage and Food Environment Index provide a clear picture of a population’s food environment.

Of the 2,956 counties in the study, the analysis found:

  • The average Food Insecurity Percentage was 13% for all counties, and the average Food Environment Index score was 7.8.
  • Counties with a Food Insecurity Percentage above the national median of 13.7% had a higher rate of deaths from heart failure compared to counties with a Food Insecurity Percentage below the median (30.7 deaths versus 26.7 deaths per 100,000 people, respectively).
  • After adjusting for a range of socioeconomic and health factors – including the poverty rate, income inequity, rural vs. urban locations, Type 2 diabetes, obesity and smoking - a 1% decrease in Food Insecurity Percentage by county was associated with a 1.3% lower heart failure death rate. Similarly, a 1-unit increase in the Food Environment Index score by county was associated with a 3.6% decrease in the heart failure death rate.
  • On the county level, decreases in the Food Environment Index and increases in the Food Insecurity Percentage were found to have a stronger association with the death rate from heart failure than with the death rate for other subtypes of cardiovascular disease, as well as with the all-cause death rate.
  • The strongest association between food environment and heart failure death rate was found in counties with the highest income inequity and the highest poverty rate.

“The findings of this study are unfortunate yet not surprising. These results are consistent with prior studies that have demonstrated the association of cardiovascular disease and food insecurity,” said Anne Thorndike, M.D., M.P.H., FAHA, who was not involved in this study, director of the Cardiac Lifestyle Program at Massachusetts General Hospital in Boston, immediate past chair of the Association’s Nutrition Committee and a member of the Association’s Lifestyle Council. “This study provides a robust evaluation of the food environment by U.S. counties and shows that characteristics of the food environment are strongly associated with death from heart failure.”

A limitation of the study is that it only captures data from one year, before the COVID-19 pandemic, therefore, it may have limited generalization at this time. More studies are needed to examine these associations over a longer period of time.

The study also revealed that counties with higher heart failure death rates also had fewer food stores, poorer access to healthy foods for adults older than age 65 and a lower participation rate in SNAP, the Supplemental Nutrition Assistance Program. SNAP is the U.S. government’s program that supplements food budgets to help reduce food insecurity for families and individuals who have an annual income level at or below 130 percent of the federal poverty criteria (for a family of three, those with annual income below $29,940 quality for SNAP).

According to the Association’s Life’s Essential 8, dietary intake, which is affected by food insecurity, is one of the key contributors to cardiovascular disease risk, and the low prevalence of ideal diet drives the overall low prevalence of ideal cardiovascular health in the U.S. Better cardiovascular health helps lower the risk for heart disease, stroke and other major health problems.

“Food insecurity and lack of access to healthy food are key contributors to poor dietary quality and what is referred to as ‘nutrition insecurity,’” Thorndike said. “The American Heart Association and others are now acknowledging that to help Americans achieve ideal cardiovascular health, particularly ideal diet, we need to broaden our efforts to address both the psychological and social determinants of our health behaviors and well-being. These efforts need to include policy, health care, and community interventions that improve access to nutritious food for people at every stage of life.”

Co-authors are John Larson, M.D.; Aaron Sifuentes, M.D.; Neil B. Alexander, M.D., M.S.; Matthew C. Konerman, M.D.; Kali S. Thomas, Ph.D., M.A.; and Scott L. Hummel, M.D. Authors’ disclosures are listed in the manuscript.

The authors reported no funding sources for this study.

Statements and conclusions of studies published in the American Heart Association’s scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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JOURNAL

Circulation Heart Failure

DOI

10.1161/CIRCHEARTFAILURE.122.009651 

ARTICLE TITLE

Health of the Food Environment Is Associated With Heart Failure Mortality in the United States

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Novel insecticides are bad news for bee health and their guts

Peer-Reviewed Publication

MARTIN-LUTHER-UNIVERSITÄT HALLE-WITTENBERG

Honey bees 

IMAGE: BEES ARE OFTEN EXPOSED TO MULTIPLE PESTICIDES IN NATURE. view more 

CREDIT: UNI HALLE / MARKUS SCHOLZ

Insecticides containing flupyradifurone and sulfoxaflor can have devastating effects on honey bee health. The substances damage the insects' intestinal flora, especially when used in conjunction with a common fungicide, making them more susceptible to disease and shortening their life span. This was recently proven in a study conducted at the Martin Luther University Halle-Wittenberg (MLU) and the Helmholtz Centre for Environmental Research (UFZ), as published in Science of the Total Environment. The two insecticides were considered harmless to bees and bumblebees when approved, but their use has since been severely restricted.

For the study, honey bees that were free from environmental influences were first bred in the laboratory. "We wanted to control every aspect of the bees’ lives - from their diet to their exposure to pathogens or pesticides", says Dr Yahya Al Naggar, the biologist who led the project at MLU and who now works at Tanta University in Egypt. In the first few days, all bees were given the same food: sugar syrup. They were then divided into several groups and various pesticides were added to their food. One group was given flupyradifurone, while another was given sulfoxaflor. Both substances are approved insecticides in Germany, but their use is now limited to greenhouses.

As pesticides are often used as a mixture, the scientists also took this into account in their laboratory experiment by enriching the food administered to two other groups not only with the insecticides mentioned, but also with azoxystrobin, which has been used to protect plants from harmful fungi for many decades. The concentration of the substances was well below the legal requirements in each case. "Our approach was based on the realistic concentrations that might be found in pollen and nectar from plants that have been treated with the pesticides", says Al Naggar. A control group continued to receive the normal sugar syrup without additives.

Over a period of ten days, the team observed whether the substances had any effects on the bees and, if so, what. They found that the pesticides are anything but harmless: Around half of all bees whose diet had been supplemented with flupyradifurone died during the study - and even more when combined with azoxystrobin. While sulfoxaflor produced similar effects, more insects survived the diet. 

The scientists also analysed the bees’ intestinal flora, i.e. the bacteria and fungi living in their digestive tract. "The fungicide azoxystrobin led to a significant reduction in naturally occurring fungi. That was to be expected, as fungicides are used to control fungi", says Dr Tesfaye Wubet from the Helmholtz Centre for Environmental Research (UFZ), who is also a member of the German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig. Over the course of the ten-day study, however, the team was able to show that the mixture of fungi and bacteria detected in the insects differed greatly from the control group depending on the substances used. According to the researchers, the bacterium Serratia marcescens was able to spread alarmingly well in the digestive tract of the treated insects. "These bacteria are pathogenic and harmful to bees’ health. They can make it harder for the insects to fight off infection, leading to premature death", explains Al Naggar. 

As the study was conducted in a laboratory in Halle to exclude the number of external influences, it is unclear whether the same results can be found in nature. "The effects of the pesticides could well be even more dramatic - or the bees might be able to fully or at least partially compensate for the negative effects", concludes Wubet. With this in mind, the team calls for the potential effects of new pesticides on beneficial insects to be researched more rigorously before they are approved and for their effects on aspects such as intestinal flora to be included as standard in the risk assessment.

The study was funded by the Alexander von Humboldt Foundation with additional support via the EU-funded project "Poshbee". 

Study: Al Naggar Y., Singavarapu B., Paxton R.J. & Wubet T.. Bees under interactive stressors: the novel insecticides flupyradifurone and sulfoxaflor along with the fungicide azoxystrobin disrupt the gut microbiota of honey bees and increase opportunistic bacterial pathogens. Science of the Total Environment (2022). doi: 10.1016/j.scitotenv.2022.157941

JOURNAL

Science of The Total Environment

DOI

10.1016/j.scitotenv.2022.157941 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Bees under interactive stressors: the novel insecticides flupyradifurone and sulfoxaflor along with the fungicide azoxystrobin disrupt the gut microbiota of honey bees and increase opportunistic bacterial pathogens

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NASA fieldwork studies signs of climate change in Arctic, Boreal regions

Business Announcement

NASA/GODDARD SPACE FLIGHT CENTER

Aerial view of Alaska 

IMAGE: AERIAL VIEW OF ALASKA OUT THE WINDOW OF A NASA GULFSTREAM III PLANE. THE LAND IS MOSTLY LUSH AND GREEN, WITH LAKES DOTTING IT AND RIVERS SNAKING THROUGH THE LANDSCAPE. THE SKY IS BLUE AND HAS PUFFY WHITE CLOUDS. view more 

CREDIT: CREDIT: NASA / SOFIE BATES

From the window of a NASA Gulfstream III research aircraft, Alaska looks like a pristine wilderness untouched by humans. The land is covered in lush, green vegetation and dotted with bright blue lakes. Snow-capped mountains reach toward the sky, and chocolate milk-colored rivers snake across the landscape. The obvious signs of human activity – cities, roads, infrastructure – are hard to spot.

But on closer inspection, some hints of human-induced change appear to the eye. Sunken pockets of land. Abnormally tilted trees. Ponds where there used to be dry ground. Through the eyes of scientists collecting data from the ground and the air, the signal is clear: The Arctic is being affected by climate change more than most places on Earth. Since 2015, scientists participating in NASA’s Arctic Boreal Vulnerability Experiment (ABoVE) have been studying the impacts of climate change on Earth’s far northern regions and how those changes are intertwined.

“ABoVE is a large-scale study of environmental change, not just climate change,” said Peter Griffith, a carbon cycle researcher at NASA’s Goddard Space Flight Center in Greenbelt, Maryland, and one of the leaders of ABoVE. “And we’re doing this as only NASA can: by studying this region from leaf to orbit.”

 

Previous field and airborne campaigns focused on things like changes in plant cover and shifting animal migration patterns. In the summer of 2022, the team investigated permafrost thaw, methane emissions from lakes, and the effects of wildfires in Alaska and northwestern Canada. They did this with instruments observing from research aircraft and with scientists collecting measurements on the ground.

Studying Arctic Changes from Air and Space

One of the key components of ABoVE is the airborne campaign, which uses research aircraft like the NASA Gulfstream III airplane. This year the plane was mounted with the Uninhabited Aerial Vehicle Synthetic Aperture Radar, or UAVSAR, which sends out pulses of radio waves that reflect off of Earth's surface and give scientists an accurate idea of the shape of the land and water surfaces below – even when looking through clouds or thick vegetation.

 

Each year members of the ABoVE team fly over their field sites, as well as wildfire burn scars and other areas of scientific interest, allowing them to compare measurements taken from both the air and ground. They also revisit sites from year to year to see how the landscapes evolve over time.

 

UAVSAR is similar to the main instrument on an upcoming satellite. The NASA-ISRO (NISAR) satellite will be a joint mission between the Indian Space Research Organization and NASA to observe Earth’s land and ice. NISAR is also part of NASA’s upcoming Earth System Observatory.

“ABoVE and UAVSAR give the research community a really good example of what NISAR data will look like and what kind of science they can extract from these datasets,” explained Franz Meyer, a NISAR science team member who also is the chief scientist of the Alaska Satellite Facility in Fairbanks.

  

Matt Macander, with Alaska Biological Research, kneels to point at a baby spruce tree growing amidst small shrubs and fireweed three years after the 2019 Shovel Creek Fire burned near Fairbanks, Alaska.

CREDIT

Credits: NASA / Sofie Bates

NISAR will collect data globally and year-round, allowing research groups like the ABoVE team to study critical processes – the development of methane emission hotspots, how and where permafrost is thawing, long-term consequences of wildfires – even when they can't be there in person.

Thawing Permafrost is Making New Lakes, New Methane Hotspots

 

Permafrost – layers of soil that have stayed frozen for at least two years – underlie much of Alaska and northwestern Canada. In some areas, especially within the Arctic Circle, the landscape is rich with permafrost. In others, this frozen soil is found in patches. Either way, it has mostly stayed frozen for thousands of years.

 

But as our planet warms, permafrost is thawing at an accelerating rate. This is changing the shape and vegetation of landscapes and, in some cases, creating new ponds and lakes that are also hotspots for greenhouse gas emissions.

When the hard, frozen permafrost layer warms, it changes into softer, spongier ground. That mushy ground sinks and can damage roads, houses, and other infrastructure sitting on top of it. In some areas like interior Alaska, the permafrost layer also contains large chunks of ice. As permafrost thaws and this ice melts, the resulting sinkholes can fill with the meltwater and form new ponds and lakes.

 

The warmer temperatures that cause permafrost to thaw also increase the activity of microbes that digest dead plants and other thawed organic matter. This microbial decay releases methane, a potent greenhouse gas that bubbles to the lake surface and enters the atmosphere.

This thawing process is happening all over Alaska and northwestern Canada, which already has millions of lakes and ponds. But most of these lakes are hundreds or thousands of years old, meaning the microbes have run out of organic matter to decompose and the lakes are no longer releasing significant amounts of methane.

 

In 2022, the ABoVE team closely examined Big Trail Lake, just outside of Fairbanks. “Lakes like Big Trail are new, young, and important because they are what’s going to happen in the future as the climate changes and permafrost thaws,” said Katey Walter Anthony, an ecologist at the University of Alaska-Fairbanks working with the ABoVE team.

Arctic and Boreal Fires are Becoming More Extreme

Year-to-year observations from the sky and the ground are especially important for understanding the evolving impacts of wildfires on Arctic and boreal landscape. Fires have long been a natural part of these ecosystems. But as Earth’s climate changes, wildfires in these areas are becoming larger, more frequent, and more severe. This can make it difficult for ecosystems to recover after a fire – changing the plants that grow back and accelerating permafrost thaw.

Fires in Alaska and northwestern Canada can be different from those in the continental United States. Sometimes the ground itself burns, as the soft, peaty layer of soil and organic material above the permafrost layer is flammable. Also, fires in remote areas are usually left to burn themselves out unless they threaten houses or other infrastructure. This gives scientists a “natural experiment” to see how fire runs its course.

 

“These tundra fires are so rare that we don’t always get a great opportunity to study them,” said Liz Hoy, a wildfire researcher at NASA Goddard and one of the lead scientists for ABoVE.

 

For several years, the ABoVE team has flown over recent wildland fires. For instance, the team flew over the site of the 2019 Shovel Creek Fire and the 2021 Yankovich Road Fire before and after they burned. Such repeat flights allow scientists to see the immediate impact of wildfire and how the ecosystems respond. This year the team flew over the site of the Contact Creek Fire, which burned in late May 2022 in a largely treeless tundra near Katmai National Park in Alaska.

The ABoVE team is interested in not only in the local impacts on the ecosystems, but also how the fires may be caused by or contribute to climate change.

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Largest trial to date shows that COMP360 psilocybin reduces depression symptoms

Peer-Reviewed Publication

KING'S COLLEGE LONDON

A multicentre clinical trial led by COMPASS Pathways across 22 international sites including Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and South London and Maudsley NHS Foundation Trust has found that a single 25mg dose of COMP360 psilocybin, alongside psychological support, had a significant impact in reducing symptoms of depression in participants with treatment-resistant depression. 

Approximately 100 million people in the world suffer with treatment-resistant depression, which means they have not responded to at least two antidepressant treatments for their major depressive disorder.

The study, published in the New England Journal of Medicine, investigated the change from baseline in the severity of depression, as assessed using the Montgomery–Åsberg Depression Rating Scale, in participants with treatment-resistant depression over the course of 12 weeks following a single dose of COMP360 psilocybin alongside psychological support.  Researchers found that participants reported a greater reduction in depression scores three weeks after taking a single 25 mg dose of COMP360 psilocybin compared to those who took the lowest 1 mg dose.

Some adverse effects, such as headaches, nausea, dizziness, fatigue, and thoughts around suicide, were reported across all dose groups.

 

This phase 2b clinical trial was conducted at 22 sites in 10 countries across Europe (Czech Republic, Denmark, Germany, Ireland, the Netherlands, Portugal, Spain, and the United Kingdom) and North America (Canada and the United States) between 1 March 2019 and 27 September 2021. 233 participants with treatment-resistant depression were allocated at random to receive a single 25 mg, 10 mg, or 1 mg dose of COMP360 psilocybin, along with psychological support; with those who received the 1 mg dose acting as a control group.  Neither the participants nor the researchers were aware which dose the participant had received.

 

Dr James Rucker, Consultant Psychiatrist & Lead for the Psychoactive Trials Group at IoPPN, at King’s College London and South London and Maudsley NHS Foundation Trust, who took part in the research said:

‘Whilst many patients with mental health problems get better with available treatments, a subgroup of patients do not even though they try many different forms of treatment. This is sometimes called ‘treatment resistance’. This can lead to a variety of other problems that seriously impact on patients and the people around them. Treatment options are often limited, coming with troublesome side effects and/or stigma. Therefore, new paradigms of treatment are needed, and clinical research of new treatments is important. Psilocybin therapy may be a new paradigm of treatment, but this needs to be tested in clinical trials. We are doing this work at the Psychoactive Trials Group, and we deliver new and pioneering treatments in collaboration with our colleagues at the Maudsley Centre for Advanced Treatments.’

‘This study, which is by far the largest clinical trial on the use of psilocybin for treatment-resistant depression to date, demonstrated that a single 25 mg dose of psilocybin improved participants’ symptoms of depression in comparison to a 1 mg dose (control). These findings are a positive step in the right direction. Our task now is to investigate psilocybin for treatment-resistant depression in larger clinical trials with more participants, comparing it both to placebo and to established treatments.’ 

 

‘The publication of our COMP360 psilocybin therapy study in the most prestigious peer-reviewed medical journal in the world is a proud moment for everyone involved,’ said Professor Guy Goodwin, Chief Medical Officer, COMPASS Pathways. ‘We saw positive results in a particularly difficult to treat group of patients, and the highest dose of COMP360 psilocybin had the greatest impact on people’s depression. This suggests that COMP360 psilocybin has a true pharmacological effect, a finding that is critical for it to be recognised as a new treatment option in the future. We look forward to starting our phase 3 programme later this year, moving us closer to providing COMP360 psilocybin with psychological support for patients who desperately need it.’

All participants were assessed on the severity of their depressive symptoms the day before the COMP360 psilocybin was administered, and follow up assessments were conducted on day two, and weeks one, three, six, nine, and 12.

 

Participants were given COMP360 psilocybin in specialised rooms designed to provide a nonclinical and calming atmosphere. The psychedelic effects lasted between 6 to 8 hours, and during this time an experienced therapist was in the room to provide psychological support. All therapists underwent a detailed training programme designed for the trial. After the psychedelic effects were fully dissipated participants were able to return home.

 

Researchers found that participants who received the 25 mg dose of COMP360 psilocybin, with psychological support, experienced a rapid and greater reduction in depression scores than those who received the 1 mg control dose (p<0.001).

 

 

Over the 12-week study period adverse effects, including headache, nausea, dizziness, and fatigue, occurred in 84% of participants in the 25 mg dose group, 75% in the 10 mg dose group, and 72% in the 1 mg dose group.  Suicidal ideation and intentional self-injury were seen in all dose groups, as is common in treatment-resistant depression studies. Most cases occurred more than a week after the COMP360 psilocybin session. There was no mean worsening of suicidal ideation scores on the MADRS scale in any dose group. Suicidal behaviours were reported at least one month after COMP360 administration for three non-responders in the 25mg group.

The trial was designed and funded by COMPASS Pathways. It was conducted in collaboration with the Psychoactive Trials Group at the IoPPN and the South London and Maudsley NHS Foundation Trust.

 

Ends

For further information please contact: Patrick O’Brien, Senior Media Officer, IoPPN King’s College London Tel: +44 7813706151 Em: patrick.1.obrien@kcl.ac.uk

‘Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression’ Goodwin et al is published in New England Journal of Medicine on 2 November 2022 5pm ET/9pm GMT DOI: 10.1056/NEJMoa2206443

Link to publication when embargo lifts http://www.nejm.org/doi/full/10.1056/NEJMoa2206443

 

About King’s College London

King's College London is one of the top 35 universities in the world and one of the top 10 in Europe (QS World University Rankings, 2021/22) and among the oldest in England. King's has more than 33,000 students (including more than 12,800 postgraduates) from over 150 countries worldwide, and 8,500 staff. King's has an outstanding reputation for world-class teaching and cutting-edge research.

 

The Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s is a leading centre for mental health and neuroscience research in Europe. It produces more highly cited outputs (top 1% citations) on psychiatry and mental health than any other centre (SciVal 2021), and on this metric has risen from 16th (2014) to 4th (2021) in the world for highly cited neuroscience outputs. In the 2021 Research Excellence Framework (REF), 90% of research at the IoPPN was deemed ‘world leading’ or ‘internationally excellent’ (3* and 4*). World-leading research from the IoPPN has made, and continues to make, an impact on how we understand, prevent and treat mental illness, neurological conditions, and other conditions that affect the brain. 

 

www.kcl.ac.uk/ioppn | Follow @KingsIoPPN on Twitter, Instagram, Facebook and LinkedIn

 

About COMPASS Pathways         

 

COMPASS Pathways plc (Nasdaq: CMPS) is a mental health care company dedicated to accelerating patient access to evidence-based innovation in mental health. Our focus is on improving the lives of those who are suffering with mental health challenges and who are not helped by current treatments. We are pioneering the development of a new model of psilocybin therapy, in which our proprietary formulation of synthetic psilocybin, COMP360, is administered in conjunction with psychological support. COMP360 has been designated a Breakthrough Therapy by the US Food and Drug Administration (FDA) and has received Innovative Licensing and Access Pathway (ILAP) designation in the UK for treatment-resistant depression (TRD). We have completed a phase 2b clinical trial of psilocybin therapy for TRD, in 22 sites across Europe and North America. This was the largest randomised, controlled, double-blind psilocybin therapy clinical trial ever conducted, and our topline data showed a statistically significant (p<0.001) and clinically relevant improvement in depressive symptom severity after three weeks for patients who received a single high dose of COMP360 psilocybin with psychological support. We are also running phase 2 clinical trials of COMP360 psilocybin therapy for post-traumatic stress disorder (PTSD) and anorexia nervosa. COMPASS is headquartered in London, UK, with offices in New York and San Francisco in the US. Our vision is a world of mental wellbeing. www.compasspathways.com

JOURNAL

New England Journal of Medicine

DOI

10.1056/NEJMoa2206443 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression

ARTICLE PUBLICATION DATE

2-Nov-2022

COI STATEMENT

The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health or Care Research, or the Department of Health and Social Care in the United Kingdom. Supported by COMPASS Pathfinder. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. A data sharing statement provided by the authors is available with the full text of this article at NEJM.org. We thank the participants, without whom this research would not have been possible; the following staff members at COMPASS Pathfinder and Worldwide Clinical Trials for their contributions: Molly Lennard-Jones, Rachel Winzer, Batya Septimus, Merve Atli, Ozlem Redjep, Hannah Tadley, Nisha Thiara, Hollie Simmons, Julia Forte, Niccolo Bassani, and Alexandra Novikova; Edward Schweizer for helping with the first draft of the manuscript; Megan Croal for helping revise subsequent drafts; the staff at all the sites for help with recruitment of participants, including the Champalimaud Foundation (Portugal), Hospital del Mar (Spain), Leiden UMC (the Netherlands), and St. Pancras Clinical Research (United Kingdom); and Bill Richards, Mike Emmanuel, and Mary Johnson for their advice in designing the trial originally.

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Trade agreements can ease the pain of a possible global recession

Study is the first to provide direct evidence assessing the relationships trade agreements have on firm investment decision making

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN DIEGO

Uncertainty is bad for business; however, it can be mitigated by trade agreements which help countries become more resilient to economic shocks, according to a new University of California School of Global Policy and Strategy study.

Published in in Journal of International Economics, the study finds that credible, international trade agreements provided U.S. firms with valuable insurance against the widespread threat of a global trade war during the 2008 financial crisis. The research suggests that trade agreements would have a similar effect when another global recession occurs.

“There is ample evidence that protectionist policies such as trade tariffs are a common response to economic and political shocks, but trade agreements tie the hands of policymakers that would otherwise raise barriers,” said study coauthor, Kyle Handley associate professor of economics at the School of Global Policy and Strategy. “By making policies more permanent, they also increase the value of firms’ investments in new export markets, particularly during economic downturns.”

The study is the first to provide direct evidence on the impact trade agreements have on specific investment decisions.

It shows that U.S. exports contracted by 22% from 2008 and 2009, but exports to markets were not all impacted the same way. Export growth to countries where the U.S. had signed a preferential trade agreement, such as the North American Free Trade Agreement (NAFTA) declined less during the 2008 crisis and recovered more quickly. The shock of 2008 was three times larger for markets without trade agreements.

“As it is looking like we could have another global recession within in the next 12 to 18 months, we hope our research can provide motive for governments to address economic uncertainty with trade agreements that can make trade relationships more resilient to downturns and speed up recoveries,” said Handley.

Trade agreements — to the extent that their policy commitments are upheld — will help U.S. export-dependent industries, such as the automobile industry and capital goods, including aircraft and electronic machinery and equipment such as semiconductors.

The findings are based on an economic model in the study that uses data on firms’ international trade decisions during the 2008 recession and recovery—a period when international trade collapsed and fear of a trade war was initially widespread.

The data also suggests credible trade agreements have a stronger impact on business investment. NAFTA was dissolved during former President Donald Trump’s term in office and it was replaced by the United States-Mexico-Canada Agreement (USMCA); however, it is less credible, according to the authors.

“At the time of the 2008 financial crisis, NAFTA had been in place since 1994,” Handley said. “But in 2018 the Trump Administration threatened to exit the agreement and levied new tariffs on Mexican and Canadian imports. Exiting NAFTA would have raised tariffs on nearly all U.S. imports and exports. While the renegotiated USMCA avoided this outcome, the credibility of U.S. commitments on trade policy in a future crisis may have been damaged.”

Brexit had a similar negative impact on British and European markets.

 “Renegotiation of agreements is not necessarily bad,” Handley added. “But if negotiating international policy under duress or exiting first and hoping to work out the details later becomes more common, the value of these agreements in the next crisis may be greatly diminished.”

Handley and co-authors conclude that the insurance value of trade agreements contributes to their larger effects on trade and should be considered when deciding to enter or exit such agreements.

The paper, “Economic and Policy Uncertainty: Aggregate Export Dynamics and the Value of Agreements” was co-authored by Jeronimo Carballo of the University of Colorado and Nuno Limão of the University of Maryland. The study can be accessed at this link.

JOURNAL

Journal of International Economics

DOI

10.1016/j.jinteco.2022.103661 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Economic and policy uncertainty: Aggregate export dynamics and the value of agreements

ARTICLE PUBLICATION DATE

1-Nov-2022

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Waikīkī Beach studies reveal complex drivers of changing shoreline

Peer-Reviewed Publication

UNIVERSITY OF HAWAII AT MANOA

Aerial image of Royal Hawaiian Beach 

IMAGE: AERIAL IMAGE OF ROYAL HAWAIIAN BEACH. view more 

CREDIT: UH CLIMATE RESILIENCE COLLABORATIVE.

The Royal Hawaiian Beach in Waikīkī is a popular beach at the center of Hawai‘i’s tourism hub, with a valuation of $2.2 billion, according to a 2016 study. Two recently published studies from researchers at the University of Hawai‘i (UH) at Mānoa’s Climate Resilience Collaborative (CRC) provide new understanding of how and why this iconic beach is chronically eroding—enabling coastal managers and policymakers to more effectively manage the coastline.

During a two-year study from 2018 to 2020 that included weekly surveys, a research team led by CRC geospatial analyst Anna Mikkelsen, found that the beach is primarily dominated by longshore transport, meaning that sand is moved from one end of the beach to another. This is contrary to standard beach models that predict cross-shore transport where sand is moved from nearshore to an offshore section of the beach.  

“Another surprising finding was that we did not find any clear seasonal signal,” said Mikkelsen. “Instead of seeing high volumes of sand in summer, and low volumes in winter, we saw consistently increasing beach volume the first 12 months of the study and then erosion of the beach the following 10 months.”

The researchers discovered that the primary environmental drivers controlling the amount of sand present and the width of the beach include wave energy from south swell and trade-wind generated waves, and the water level.

In another study, led by Kristian McDonald, a geospatial analyst with the CRC, the team surveyed the beach weekly between April and November 2018, a time that bracketed the Central Pacific hurricane season and the season of more powerful southerly swell.

“We found a clear relationship between increases in south swell and beach accretion, and, on the flipside, increased trade swell was associated with beach erosion,” said McDonald. “In addition, the hurricane activity of 2018 generally increased the surface area and volume of this beach due to the associated increase in south swell wave energy.”

CAPTION

Aerial image of Royal Hawaiian Beach

CREDIT

UH Climate Resilience Collaborative

Eye in the sky spies changing shoreline

In each study, the researchers employed consumer-grade small uncrewed aerial systems (sUAS), or drones, to conduct weekly surveys of the Royal Hawaiian Beach. Using photogrammetric techniques, they created three-dimensional reconstructions of the beach, allowing them to derive surface area, volume, beach width, and beach slope. The team then compared these metrics with water level, wave conditions, wind, and run-up to figure out what was most important in determining beach behavior, and whether trade-wind generated waves, south swell, Kona storms, high water levels or other conditions, build or erode each section of the beach.

“Among the positive outcomes of this work is that it demonstrates that off-the-shelf consumer-grade drones can capture changing beach conditions at a very high resolution,” said McDonald. “These survey methods are relatively inexpensive and can be employed anywhere—even on remote shorelines—to inform communities and scientists of coastal dynamics and changes.”

“In addition to gaining insight into where and how the Royal Hawaiian Beach gets its sand, these studies help our understanding of how the beach may be impacted by sea level rise and changes in ocean conditions and provide information so that this resource can be effectively managed,” said Mikkelsen.

CAPTION

Survey lines superimposed on an aerial image of Waikiki Beach, Hawai‘i.

CREDIT

McDonald, et al., 2022.

Future steps

The CRC continues coastal monitoring of the beaches on O‘ahu. They are using drone survey techniques to document every beach on Oʻahu which will provide a high resolution baseline of the status of beaches today. Secondly, to get an idea of how the beaches change daily or weekly, and how they have changed historically, they are comparing satellite imagery back to about 1990.

“Together, these two studies will help inform the next generation of our shoreline models and provide insights into short-term, seasonal, and long term changes our shoreline displays,” said Chip Fletcher, CRC director and interim Dean of the UH Mānoa School of Ocean and Earth Science and Technology. “To effectively manage our coastline for ecological, societal and economic sustainability, we need this improved understanding of the behavior of our beaches and nearshore dynamics.”


JOURNAL

Remote Sensing

DOI

10.3390/rs14205108 

METHOD OF RESEARCH

Imaging analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Weekly small uncrewed aerial system surveys, structure from motion, and empirical orthogonal function analyses reveal unique modes of sediment exchange generated by seasonal and episodic phenomena: Waikīkī, Hawaiʻi

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 Evidence found for “substantial” monkeypox transmission before symptoms appear

Transmission detected up to four days before symptoms. Findings may have important implications for infection control globally

Peer-Reviewed Publication

BMJ

A UK study published by The BMJ today found evidence for “substantial” monkeypox transmission before symptoms appear or are detected (known as pre-symptomatic transmission).

Transmission was detected up to a maximum of four days before the onset of symptoms, and the researchers estimate that more than half (53%) of transmission occurred in this pre-symptomatic phase, meaning that many infections cannot be prevented by asking individuals to isolate after they notice their symptoms.

In a linked editorial, researchers say that if these findings are supported by other studies, pre-symptomatic transmission “would have important implications for infection control globally.”

Since the international outbreak of monkeypox in May 2022, more than 70,000 cases have been recorded globally, with just over 3,500 cases in the UK.

Although case numbers are now declining, it’s still important to understand the “transmission dynamics” of the virus - for example, how it spreads from one person to another and how quickly symptoms appear - to help inform policy decisions and future interventions.

While previous research on pox viruses did not rule out transmission prior to symptoms, this work represents the first evidence to support this.

To explore this further, researchers at the UK Health Security Agency set out to analyse the transmission dynamics of the monkeypox outbreak in the UK.

Their findings are based on routine surveillance and contact tracing data for 2,746 individuals who tested positive for monkeypox virus in the UK between 6 May and 1 August 2022. Their average age was 38 years and 95% reported being gay, bisexual, or men who have sex with men.

The two main measures of interest to the researchers were serial interval (time from symptom onset in the primary case patient to symptom onset in the secondary contact) and incubation period (time from exposure to onset of symptoms).

To estimate this, they linked information on exposure and symptom onset dates from these individuals to their contacts through contact tracing case questionnaires, which they then analysed using two statistical models.

The models were adjusted for several biases common to virus outbreaks, such as changes in infection rates over time, that would otherwise affect the results.

The mean incubation period was estimated to be 7.6 days in one model and 7.8 days in the other model, while the estimated mean serial interval was 8 days in one model and 9.5 days in the other. 

For both models, the median serial interval was between 0.3 and 1.7 days shorter than the median incubation period, indicating that considerable transmission is occurring before the appearance or detection of symptoms.

Analysis of individual level patient data, collected from a subset of patients with more detailed information, seemed to confirm this explanation, with 10 out of 13 case-contact patient pairs reporting pre-symptomatic transmission. Four days was the maximum time that transmission was detected before symptoms appeared.

Based on these results, the researchers say an isolation period of 16 to 23 days would be required to detect 95% of people with a potential infection.

These are observational findings, and the researchers point to several limitations, such as relying on contact tracing to identify the correct case-contact pairs and the self-reported data on date of symptom onset. What’s more, the results may not necessarily be directly applicable to other populations with different transmission patterns.

Nevertheless, this was a large study using robust methods and adjusting for key biases that are present in the data, providing greater confidence in the conclusions.

These findings have important implications for isolation and contact tracing policies, say the researchers, adding that backward contact tracing strategies (tracing from whom disease spreads) should account for a pre-symptomatic infectious period when trying to find the contacts of confirmed cases.

In a linked editorial, researchers based in the US, UK and Nigeria argue that pre-exposure vaccination and vaccine equity are urgently needed worldwide.

Vaccination is likely to be more cost effective than managing the consequences of preventable infections, including hospital admissions, loss of income during isolation, and long term complications, they explain.

However, they point out that many of the public health measures that have been critical during monkeypox outbreaks in high income countries remain unavailable in much of Africa.

“As the monkeypox outbreak declines in Europe and North America, we have a responsibility to deploy effective tools for viral control on a global level - not just in wealthy nations,” they write. “These tools include research into understanding transmission dynamics in African settings and the inclusion of endemic countries in vaccine trials.”

 

JOURNAL

The BMJ

DOI

10.1136/bmj-2022-073153 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE PUBLICATION DATE

2-Nov-2022

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