Friday, February 07, 2025

AMERIKA

ALS survival may be cut short by living in disadvantaged communities

Social determinants of health negatively impact many diseases, including neurological conditions

Michigan Medicine - University of Michigan

Living in a disadvantaged community may decrease the length of time a person can survive with amyotrophic lateral sclerosis, or ALS, by over 30%, a Michigan Medicine-led study suggests.

ALS is a progressive, incurable condition that causes muscle wasting and loss of muscle control.

While most people survive with ALS around two to four years, some people can live significantly longer.

In the study of more than 1,000 patients with ALS seen between 2012 and mid-2024, people from the most disadvantaged neighborhoods had up to a 37% shorter survival time compared to those from the most resourced areas.

U-M researchers used the Area Deprivation Index, a tool created at University of Wisconsin, which measures neighborhood disadvantage using factors such as income, education, employment and housing.

The results are published in Neurology, the medical journal of the American Academy of Neurology.

“Our results show a significant link between adverse social determinants of health and shorter survival in patients with ALS,” said senior author Stephen Goutman, M.D., M.S., Harriet Hiller Research Professor, director of the Pranger ALS Clinic and associate director of the ALS Center of Excellence at University of Michigan.

“For years, we have defined the ALS ‘exposome’ as how environmental exposures over a lifetime affect a person’s ALS risk and survival. The lived environment — in other words, the social exposome — is a key contributor to the overall exposome and is important to consider. Moreover, a deeper understanding of how socioeconomic factors contribute to ALS survival is important for making ALS a more livable disease and reducing the impact of health disparities.”

The cost of caring for someone with ALS is tremendous: People with ALS can pay up to $250,000 out-of-pocket each year, according to the ALS Association.

The study design didn’t offer insight into the cause of the survival differences, but researchers note that more resourced patients often can afford additional care to limit burnout for family caregivers.

“A person’s social determinants of health may uniquely impact ALS due to the incredible costs of care, so it is important that we consider social factors and highlight the urgent need for interventions to reduce health disparities in ALS care,” said first author Dae Gyu Jang, Ph.D., postdoctoral fellow in the U-M Health Department of Neurology. 

Similar studies have shown that living in resource-deprived areas is associated with a higher burden of Alzheimer’s Disease and related dementias.

Researchers say living in a disadvantaged community is also linked to measures of inflammation and accelerated biological aging, which may affect the trajectory of ALS.

“This is a critical area that requires further attention to help improve the lives of people with ALS,” Goutman said.

“This work could also highlight necessary changes in the systems of care for persons living with ALS to ease the burden of care.”

Additional authors: Adam Patterson, MADS, Meredith Pedde, Ph.D., and Eva L. Feldman, M.D., Ph.D., all of University of Michigan, W. Ryan Powell, PhD, M.A., and Amy J Kind, M.D., Ph.D., both of University of Wisconsin School of Medicine and Public Health.

Funding/disclosures: This research was supported by the National Institute of Environmental Health Science (K23ES027221, R01ES030049), the National Institute of Neurological Disorders and Stroke (R01NS127188), and the National Institute on Aging (R01AG070883), all of the National Institutes of Health.

This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additionally, this work was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (R01TS000327). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

The Standford Morris ALS research fund also supported this research.

Paper cited: “Impact of the adverse social exposome on survival in individuals with amyotrophic lateral sclerosis,” Neurology. DOI: 10.1212/WNL.0000000000213362

Journal

Neurology

DOI

10.1212/WNL.0000000000213362

Method of Research

Observational study

Subject of Research

People

Article Title

Impact of the Adverse Social Exposome on Survival in Individuals With Amyotrophic Lateral Sclerosis

COI Statement

This research was supported by the National Institute of Environmental Health Science (K23ES027221, R01ES030049), the National Institute of Neurological Disorders and Stroke (R01NS127188), and the National Institute on Aging (R01AG070883), all of the National Institutes of Health. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additionally, this work was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (R01TS000327). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. The Stanford Morris ALS research fund also supported this research.

AMERIKAN RACISM

Cardiovascular health risks continue to grow within Black communities, action needed

CPR training and heart health education remain critical to closing the survival gap and advancing equitable health solutions in Black communities

American Heart Association

DALLAS, Feb. 7, 2025 — The American Heart Association’s 2025 Heart Disease and Stroke Statistical Update reports that while progress has been made in reducing cardiovascular and cerebral health disparities, Black communities in the United States still face disproportionately higher risk of heart disease, stroke and hypertension. These gaps subsequently contribute to equally disproportionate high death rates, underscoring the urgent need for lifesaving intervention. As part of its nationwide Heart Month and Black History Month activations, the American Heart Association -- devoted to changing the future to a world of healthier lives for all -- is highlighting the need to close the survival gap through continued education, advocacy and Hands-Only CPR training. The American Heart Association’s goal: ensuring all people, especially those at greatest risk, have the opportunity to live longer, healthier lives.

Addressing the Disproportionate Burden of Cardiovascular Disease

According to the American Heart Association, cardiovascular disease (CVD) remains the leading cause of death in the U.S. The report notes that Black Americans suffer some of the worst CVD health outcomes, likely due to the increasing prevalence of health risk factors that lead to CVD.

CVD Prevalence: Among people aged 20 and older in the U.S., nearly 60% of Black adults have some type of CVD, including coronary heart disease, heart failure, stroke and hypertension; that’s compared to about 49% of all U.S. adults who have some type of CVD.
Stroke Disparities: Among all adults in the U.S., the prevalence of stroke is highest among Black women (5.4%) and Black men (4.8%), compared to all women at 2.9% and all men at 3.6%.
High Blood Pressure Crisis: Black adults in the U.S have some of the highest prevalence of hypertension in the world, with 58.4% of Black women and 57.5% of Black men having high blood pressure. That compares to 50.4% of all U.S. adult men and 43% of all women.
Heart Failure Burden: Black adults account for over 50% of heart failure hospitalizations among U.S. adults under 50.

“The science is clear—Black communities continue to face disproportionate risks of heart disease, stroke, and other cardiovascular conditions, leading to poorer survival outcomes. But data alone won’t drive change,” said Dr. Keith Churchwell, MD, FACC, FACP, FAHA, chief volunteer scientific and medical officer of the American Heart Association. “Real impact happens when we work directly with communities formulating ideas and creating plans and programs to create solutions that address these disparities. By providing access to Hands-Only CPR training, advocating for equitable healthcare, and fostering heart health education, we are committed to working with the community to change the future of health.”

Act and Become a Lifesaver

This February, the Association is challenging families, schools and community organizations to take part in its Hands-Only CPR training initiative and join Nation of Lifesavers™. With nine out of every ten cardiac arrests that happen outside of a hospital resulting in death, learning CPR can double or triple a person’s chance of survival. Only 46% of people who suffer from cardiac arrest receive CPR from a bystander, while CPR is 41% less likely if the person is Black or Hispanic.

“Learning Hands-Only CPR is a simple, powerful step we can all take to save lives. Black History Month serves as a powerful reminder of the resilience and contributions of Black Americans throughout history, as well as the persistent disparities in health that impact Black and Latino communities today,” said Churchwell. “Through the Nation of Lifesavers movement, we’re not only equipping individuals with critical CPR skills, but we’re also working to close the health equity gap, so every individual has the opportunity for a longer, healthier life.”

The Association’s Commitment to Closing the Health Gap

To combat these disparities, the American Heart Association is leading initiatives to:

Expand CPR Education in Black Communities – Encouraging every household to have at least one person trained in Hands-Only CPR to increase survival rates during cardiac emergencies.
Improve Access to Hypertension Management – Raising awareness about the importance of early detection and treatment of high blood pressure, which is a leading cause of stroke and heart disease.
Increase Stroke Prevention Efforts – Providing resources and education about lifestyle changes, early warning signs, and emergency response to reduce stroke-related disabilities and deaths.
Advocate for Equitable Healthcare Policies – Supporting policies that ensure that Black individuals, as much as everyone else, receive timely, high-quality cardiovascular care, including expanding community-based health screenings.

Expanding Heart Health Awareness

To bridge this gap and improve heart health outcomes, the American Heart Association is collaborating with Black-led organizations, Historically Black Colleges and Universities (HBCUs), and community leaders to create and implement culturally relevant solutions to ensure that heart health education reaches those most affected.

Some examples include:

With a commitment to investing in young entrepreneurs, The Association’s EmPOWERED to Serve Business Accelerator™ is a fully remote training and grant opportunity focused on empowering business owners who are focused on equitable health solutions.

The Heart of Innovation HBCU Challenge is a business accelerator opportunity specifically for HBCU undergraduates, graduates and alumni who are developing entrepreneurial technology intended to address the social drivers of health, improve cardiovascular health and/or promote healthy environments. In collaboration with MATTER Heart Health, a global healthcare startup incubator, the American Association will host the Final Virtual Showcase of the four-week Innovation at Heart HBCU Challenge, on Feb. 24.

Historically Black colleges and universities graduate the largest number of African American scholars in the field of medicine. (More than 70% of African American medical professionals earn degrees from HBCUs.) The American Heart Association designed the HBCU Scholars Program to increase the number of HBCU students who can compete successfully for acceptance and matriculation into graduate programs leading to professional degrees in the biomedical and health sciences.

The American Heart Association’s Health Equity in the Workforce initiative, Well-Being Works Better™, in collaboration with the Deloitte Health Equity Institute and the Society for Human Resource Management ( SHRM) Foundation, is convening employers and industry leaders to build a comprehensive roadmap that creates tools, resources and knowledge products to help improve the health and well-being of our nation's workforce.

The American Heart Association’s Social Impact Funds were established to bring equitable health across the board. The Association’s financing fills a critical resource gap for traditionally overlooked and underfunded organizations, and solutions, both for-profit and nonprofit. Providing solutions to aid everyone in overcoming barriers that prevent high-quality, accessible health care, food security and economic empowerment. Since its launch in 2018 and initial community investments in 2019, the American Heart Association’s Social Impact Funds, including the Bernard J. Tyson Impact Fund, have supported more than 100 local social enterprises across the country. Learn more about the American Heart Association Social Impact Funds here.

Additional Resources:

For more information on Hands-Only CPR training and how to get involved, find a nearby class.
Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association
Difference in Cardiac Arrest vs. Heart Attack
Learn Hands-Only CPR/use an AED (English, Spanish, Mandarin)
AHA health information: Bystander CPR
AHA health information: Bystander CPR Infographic
AHA health information: Hands-Only CPR Resources
Follow AHA/ASA news on X @HeartNews

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About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.   

First in Belgium: Successful bee insemination using frozen semen

Until now, no bee insemination using frozen sperm had been reported in Belgium. This innovative method opens new avenues for biodiversity and agriculture.

University of Liège

Graphical Abstract of the Research Protocol — image:
The semen was collected and then analysed for viability. A portion was inseminated immediately, while the rest was frozen. The viability of the thawed semen was also analysed. The thawed semen was then inseminated. In total, sixteen queens received thawed semen, while thirteen received freshly collected semen as a control group. Three queens from the control group produced female brood, whereas five queens from the thawed semen group produced female offspring.
Graphical abstract created using BioRender. Egyptien, S. (2025) https://BioRender.com/i71j767.
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Credit: University of Liège / Sophie Egyptien

Researchers from the University of Liège, as part of the FreezeBEE project, have achieved a promising breakthrough in bee insemination. For the first time, an attempt using frozen semen without the addition of antibiotics has resulted in the production of female brood, with a viability rate equivalent to traditional methods. This discovery paves the way for new opportunities in bee conservation and agriculture.

The conservation of bees is essential for ensuring crop pollination and maintaining biodiversity. With this in mind, a team of researchers from the University of Liège has developed an innovative protocol for the cryopreservation of drone semen, the male equivalent of bees. Their study presents a simplified, antibiotic-free method, creating new possibilities for apiculture and bee conservation.

"Bees play a crucial role in the ecosystem and agriculture," explains Sophie Egyptien, a doctoral researcher at ULiège and the lead author of the article. "Unfortunately, their populations are declining in many regions of the world. The conservation of their genetic material, such as drone semen, is a key strategy to preserve biodiversity and support breeding programmes." Cryopreservation is a research area with very few scientific teams working on it globally. It not only allows for the preservation of valuable genetic lines but also helps overcome restrictions related to the international transport of live animals.

A simple, antibiotic-free protocol

Since the 1980s, several freezing protocols have been developed, but with varying results. These protocols were often complex, involving multiple steps and the use of antibiotics to limit microbial contamination, and did not always produce reproducible outcomes. The ULiège team tackled this challenge with a more accessible approach: a simple dilution of the semen in a medium containing cryoprotectants. Cryoprotectants are substances used to protect cells, tissues, or organisms from damage caused by freezing and thawing. When an organism or cell is exposed to very low temperatures, ice crystal formation can damage cellular structures and lead to their destruction. Cryoprotectants, such as egg yolk, help mitigate these effects by reducing ice formation and maintaining cell integrity.

"Our method has demonstrated that, despite a 37% loss of sperm viability during freezing, five out of the eight queens inseminated with this frozen semen produced female brood," says Stefan Deleuze, Professor and Researcher at ULiège. "These results are comparable to those obtained with fresh semen in our study, which is very encouraging!"

This advancement offers several opportunities for apiculture. It enables the preservation of valuable genetic lines, allowing beekeepers to freeze the semen of disease-resistant or locally adapted strains. It also helps mitigate health risks by avoiding the transport of live bees, thereby reducing the spread of pathogens. Moreover, it supports breeding programmes by facilitating access to greater genetic diversity, even during reduced breeding periods, thereby strengthening the sustainability of colonies and preserving ecological balance.

A pioneering achievement in Belgium

This study is the first in Belgium to demonstrate that frozen semen can be used to produce female bees. To ensure a thorough analysis of their samples, the team benefited from the access to advanced microscopy facilities, which allowed for precise analysis of sperm quality.

"These results are promising, but we know that improvements are needed. We will now focus on optimising cryoprotectant concentrations and reducing viability losses," explains Stefan Deleuze. "We also need to assess the long-term impact on queen survival and female brood production."

This simple, antibiotic-free protocol marks a significant step towards bee preservation and global food security. With continued efforts, this technology could transform apicultural practices and help protect a vital pollinator within our ecosystem.

Drones marked with colours and workers (unmarked) moving around a frame of broods (open and closed cells).

Credit

ULiège/S.Egyptien

Illustrations (a) and (b) show samples stained with a mix of fluorochromes (Hoechst, SYBR14, and Propidium Iodide). Illustrations (c) and (d) display samples stained with a second fluorochrome mix (Draq5, Calcein Violet, and PI). Both fluorochrome mixes are used to assess sperm viability, a crucial parameter for evaluating semen quality before and after freezing. The results obtained from both analyses were comparable.

(a) A living spermatozoon, where the nucleus is positive for Hoechst (blue), a DNA marker, and SYBR14 (green), also a marker for live cell DNA. (b) A dead spermatozoon, where the nucleus is marked blue by Hoechst and red by Propidium Iodide (PI), which stains the DNA of dead cells (permeable membrane) in orange. (c) The cell indicated by the arrow is dead, as it is also positive for PI. It is marked red by Draq5, another type of DNA marker. The second spermatozoon is alive, its DNA stained red, and its flagellum appears blue due to Calcein Violet staining, indicating cell viability. (d) A moribund spermatozoon with double staining: PI and Calcein Violet.

Credit

University of Liège / Sophie Egyptien