Month: June 2023

Categories : Diet and Nutrition Healthcare Politics and RegulationsTags :

New Billboard Campaign Challenges Politicians and Businesses to Close the Food Gap

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Photo by Gemma on Unsplash

Child hunger and resulting malnutrition is a national emergency so consequential that it should be the number one issue for politicians and businesses ahead of next year’s general elections. Already, one in five South African households don’t have enough food on the table, and times are getting tougher as food prices soar.

This is why public innovator, the DG Murray Trust (DGMT) and Grow Great, a national zero-stunting organisation, have launched a national advocacy campaign, involving over 300 billboards, to demand urgent action to make basic nutritious food more affordable.

The first set of billboards is a picture of a child making his mark at a voting booth with the words ‘I vote for food’. It’s a challenge to every political party to respond to the growing food crisis by ensuring that household food security is a central objective of every election manifesto.

“Our campaign features a series of incisive messages that present child nutrition as a national priority for public health, education and economic growth,” says David Harrison, DGMT’s Chief Executive Officer.

“South Africa has the worst record of household food insecurity compared to middle-income countries of similar per capita GDP. The last national survey, done in 2016, found that 27% of children under the age of five had stunted growth – a proxy for impaired brain development,” Harrison explains.

The relationship between malnutrition and low education outcomes is highlighted in the second set of billboards of a uniformed schoolboy conveying a lesson to a group of adults with the words ‘if I grow well, I learn well’ written on a chalkboard. This message makes the point that without good nutrition our children’s bodies and brains are deprived of the fuel they need to grow and develop.

Stunted children are more likely to drop out of school, struggle to find employment and live in poverty as adults. The consequence is successive generations of children unable to reach their full potential.

The third set of billboards show a girl confidently seated on an office desk overlooking a cityscape with the message ‘good nutrition today is good for business tomorrow’.“

According to the World Bank, high stunting rates are one of the main reasons for South Africa’s dismal economic growth because our country doesn’t have a sufficient human capital pipeline to drive productivity. But if we ensured that all children had enough food, our long-term economic prospects would be radically different,” says Harrison.

These billboards also aim to build public support for a bold new proposal championed by DGMT and Grow Great earlier this year – a proposal that requires food producers, retailers and the government to work together to reduce the cost of 10 nutritious foods by at least 30%.

These items are eggs, dried beans and lentils, tinned fish, fortified maize meal, peanut butter, rice, amasi, soya mince, 4-in-1 soup mix, and powdered full cream milk – many are already staple pantry items in South African households.

What’s in the proposal?

The proposal involves food manufacturers and retailers agreeing to waive the mark-ups of at least one product label of each of the ‘10 best buys’. Government would then show its support by agreeing to provide a rebate to retailers and manufacturers.

A fourth set of billboards acknowledges that times are tough and invites parents and caregivers to contact Grow Great to learn more about the 10 best buys.

“Civil society organisations can do their part by raising awareness about the 10 best buys and sharing the resources and information we’ve made available on our platforms, like our WhatsApp number 060 073 3333,” says Dr Edzani Mphaphuli, Grow Great executive director.

Good nutrition cannot only be the responsibility of the Department of Health, Mphaphuli adds. “Given what we know about the consequence of child malnutrition on households and the economy, we need the whole of society to mobilise to turn things around.”

“We call on the government, food producers, wholesalers and retailers to stand in solidarity with South African families to close the food gap,” she concludes.

Categories : Genetics Immune SystemTags :

Neanderthal Genetic Influences on Human Immune System and Metabolism

On By ModernMedia
Diagram comparing the nose shape of a Neanderthal with that of a modern human by Dr Macarena Fuentes-Guajardo.

Neanderthal genes comprise some 1 to 4% of the genome of present-day humans whose ancestors migrated out of Africa, and new research has shown that their lingering presence shapes the immune systems and metabolism of people of non-African ancestry. Some of these genetics changes are detrimental, but are slowly being replaced by human versions.

A multi-institution research team including Cornell University has developed a new suite of computational genetic tools to address the genetic effects of interbreeding between humans of non-African ancestry and Neanderthals that took place some 50 000 years ago. (The study applies only to descendants of those who migrated from Africa before Neanderthals died out, and in particular, those of European ancestry.)

In a study published in eLife, the researchers reported that some Neanderthal genes are responsible for certain traits in modern humans, including several with a significant influence on the immune system. Overall, however, the study shows that modern human genes are winning out over successive generations.

“Interestingly, we found that several of the identified genes involved in modern human immune, metabolic and developmental systems might have influenced human evolution after the ancestors’ migration out of Africa,” said study co-lead author April (Xinzhu) Wei, an assistant professor of computational biology in the College of Arts and Sciences. “We have made our custom software available for free download and use by anyone interested in further research.”

Using a vast dataset from the UK Biobank consisting of genetic and trait information of nearly 300 000 British people of non-African ancestry, the researchers analysed more than 235 000 genetic variants likely to have originated from Neanderthals. They found that 4303 of those differences in DNA are playing a substantial role in modern humans and influencing 47 distinct genetic traits, such as how fast someone can burn calories or a person’s natural immune resistance to certain diseases.

Unlike previous studies that could not fully exclude genes from modern human variants, the new study leveraged more precise statistical methods to focus on the variants attributable to Neanderthal genes.

While the study used a dataset of almost exclusively white individuals living in the United Kingdom, the new computational methods developed by the team could offer a path forward in gleaning evolutionary insights from other large databases to delve deeper into archaic humans’ genetic influences on modern humans.

“For scientists studying human evolution interested in understanding how interbreeding with archaic humans tens of thousands of years ago still shapes the biology of many present-day humans, this study can fill in some of those blanks,” said senior investigator Sriram Sankararaman, an associate professor at the University of California, Los Angeles. “More broadly, our findings can also provide new insights for evolutionary biologists looking at how the echoes of these types of events may have both beneficial and detrimental consequences.”

Source: Cornell University

Categories : HospitalsTags :

To Improve, Doctors Don’t Mind Comparisons with Peers

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Photo by RDNE Stock project

Showing people how their behaviour compares to their peers is a commonly used method to improve behaviour. But after the burnouts of the pandemic, it wasn’t clear whether this was still a good idea for highly stressed healthcare workers.

Recent research published in JAMA Network Open throws new light onto the relationship between peer comparison and job satisfaction among clinicians, challenging prior findings that such feedback increases job dissatisfaction and burnout.  

Researchers found that behavioural interventions aimed at improving performance can be designed to protect clinician job satisfaction and improve quality of care. To avoid negative impact, the research team discovered it is important for clinicians to have control over the behaviour being evaluated or encouraged, such as ordering tests or whether to prescribe medication.

“Our research demonstrates that peer comparison aimed at improving performance can be designed in a manner that safeguards clinician job satisfaction,” said lead author Dr Jason Doctor at the University of Southern California. “Prior findings to the contrary don’t appear tied to peer comparison, but rather clinicians being measured for things they don’t have full control over.”

The Importance of Methodology in Peer Comparison

Performance feedback using peer comparison is a widely used approach in healthcare to change behaviour. Study authors emphasize the importance of methodology when conducting peer comparison intervention. They note the present study gave clinicians full agency over the outcome, kept performance private, did not restrict the number of top performers, and was successful in improving clinician behaviour without lowering job satisfaction.

Doctor and his team assessed data from their previously published research that assessed the impact of three interventions – Suggested Alternatives, Accountable Justification, and Peer Comparison – to reduce inappropriate antibiotic prescribing. In this study, they focused on on peer comparison, where clinicians received an email informing them of their ranking, from highest to lowest, for inappropriate prescriptions compared to their peers.

The findings contribute to the ongoing dialogue surrounding healthcare quality improvement and clinician well-being.

“By better understanding behavioural interventions and developing more effective strategies, healthcare organisations can foster a sense of ownership and agency, leading to improved job satisfaction and decreased burnout rates,” said Doctor.

Source: University of Southern California

Categories : Antibiotics GeneticsTags :

Scientists Discover New Antibiotic Resistance Genes in Common Bacteria

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Photo by CDC on Unsplash

Genes that make bacteria resistant to antibiotics are much more widespread in our environment than was previously realised. A new study published in Microbiome shows that bacteria in almost all environments carry resistance genes, with a risk of them spreading and aggravating the problem of bacterial infections that are untreatable with antibiotics.

“We have identified new resistance genes in places where they have remained undetected until now. These genes can constitute an overlooked threat to human health,” says Erik Kristiansson, a professor in the Department of Mathematical Sciences.

According to the World Health Organisation (WHO), antibiotic resistance is one of the greatest threats to global health. When bacteria become resistant to antibiotics, it becomes difficult or impossible to treat illnesses such as pneumonia, wound infections, tuberculosis and urinary tract infections. According to the UN Interagency Coordination Group on Antimicrobial Resistance (IACG) 700,000 people die each year from infections caused by antibiotic-resistant bacteria.

Looking for resistance genes in new environments

The genes that make bacteria resistant have long been studied, but the focus has traditionally been on identifying those resistance genes that are already prevalent in pathogenic bacteria. Instead, in the new study from Sweden, researchers have looked at large quantities of DNA sequences from bacteria to analyse new forms of resistance genes in order to understand how common they are. They have traced the genes in thousands of different bacterial samples from different environments, in and on people, in the soil and from sewage treatment plants. The study analysed 630 billion DNA sequences in total.

“The data requires a great deal of processing before information can be obtained. We have used metagenomics, a methodology, that allows vast quantities of data to be analysed,” says Juan Inda Díaz, a doctoral student in the Department of Mathematical Sciences, and the article’s lead author.

The study showed that the new antibiotic resistance genes are present in bacteria in almost all environments. This also includes human microbiomes and, more alarmingly, pathogenic bacteria, which can lead to more infections that are difficult to treat. The researchers found that resistance genes in bacteria that live on and in humans and in the environment were ten times more abundant than those previously known. And of the resistance genes found in bacteria in the human microbiome, 75% were not previously known at all.

The researchers stress the need for more knowledge about the problem of antibiotic resistance.

“Prior to this study, there was no knowledge whatsoever about the incidence of these new resistance genes. Antibiotic resistance is a complex problem, and our study shows that we need to enhance our understanding of the development of resistance in bacteria and of the resistance genes that could constitute a threat in the future,” says Kristiansson.

Preventing bacterial outbreaks in healthcare

The research team is currently working on integrating the new data into the international EMBARK project (Establishing a Monitoring Baseline for Antibiotic Resistance in Key environments). The project is coordinated by Johan Bengtsson-Palme, an assistant professor in the Department of Life Sciences at Chalmers, and aims to take samples from sources such as wastewater, soil and animals to get an idea of the way in which antibiotic resistance is spreading between humans and the environment.

“It is essential for new forms of resistance genes to be taken into account in risk assessments relating to antibiotic resistance. Using the techniques we have developed enables us to monitor these new resistance genes in the environment, in the hope that we can detect them in pathogenic bacteria before they are able to cause outbreaks in a healthcare setting,” says Bengtsson-Palme.

The method used by the researchers is called metagenomics, and is not new, but so far has not been used to analyse new types of antibiotic resistance genes in such large quantities. Metagenomics is a method of studying the metagenome, which is the complete gene set of all different organisms in a given sample or within a given environment. Using the method, it is also possible to study microorganisms that cannot be grown in a lab.

Source: Chalmers Institute of Technology

Categories : Ageing Diet and NutritionTags :

Taurine may Help Extend Healthy Lifespan

On By ModernMedia
Photo by Barbara Olsen on Pexels

A deficiency of the amino acid taurine is a driver of ageing in animals, according to a new study published in Science. The same study also found that taurine supplements can slow down the ageing process in worms, mice, and monkeys and can even extend the healthy lifespans of middle-aged mice by up to 12%.

“For the last 25 years, scientists have been trying to find factors that not only let us live longer, but also increase healthspan, the time we remain healthy in our old age,” says study leader Vijay Yadav, PhD, assistant professor of genetics & development at Columbia University. “This study suggests that taurine could be an elixir of life within us that helps us live longer and healthier lives.”

Anti-ageing molecules within us

Many studies into ageing have found that various molecules carried through the bloodstream are associated with ageing. Less certain is whether these molecules actively direct the ageing process or are just passengers going along for the ride. If a molecule is a driver of ageing, then restoring its youthful levels would delay ageing and increase healthspan, the years we spend in good health.

Taurine first came into Yadav’s view during his previous research into osteoporosis that uncovered taurine’s role in building bone. Around the same time, other researchers were finding that taurine levels correlated with immune function, obesity, and nervous system functions.

“We realised that if taurine is regulating all these processes that decline with age, maybe taurine levels in the bloodstream affect overall health and lifespan,” Yadav says.

Taurine declines with age, supplementation increases lifespan in mice

First, Yadav’s team looked at levels of taurine in the bloodstream of mice, monkeys, and people and found that the taurine abundance decreases substantially with age. In people, taurine levels in 60-year-old individuals were only about one-third of those found in 5-year-olds.

“That’s when we started to ask if taurine deficiency is a driver of the ageing process, and we set up a large experiment with mice,” Yadav says.

The researchers started with close to 250 14-month-old female and male mice (about 45 years old in people terms). Every day, the researcher fed half of them a bolus of taurine or a control solution. At the end of the experiment, Yadav and his team found that taurine increased average lifespan by 12% in female mice and 10% in males. For the mice, that meant three to four extra months, equivalent to about seven or eight human years.

Taurine supplements in middle age improves health in old age

To learn how taurine impacted health, Yadav brought in other ageing researchers who investigated the effect of taurine supplementation on the health and lifespan in several species.

These experts measured various health parameters in mice and found that at age 2 (60 in human years), animals supplemented with taurine for one year were healthier in almost every way than their untreated counterparts.

The researchers found that taurine suppressed age-associated weight gain in female mice (even in “menopausal” mice), increased energy expenditure, increased bone mass, improved muscle endurance and strength, reduced depression-like and anxious behaviours, reduced insulin resistance, and promoted a younger-looking immune system, among other benefits.

“Not only did we find that the animals lived longer, we also found that they’re living healthier lives,” Yadav says.

At a cellular level, taurine improved many functions that usually decline with age: The supplement decreased the number of “zombie cells” (old cells that should die but instead linger and release harmful substances), increased survival after telomerase deficiency, increased the number of stem cells present in some tissues (which can help tissues heal after injury), improved the performance of mitochondria, reduced DNA damage, and improved the cells’ ability to sense nutrients.

Similar health effects of taurine supplements were seen in middle-aged rhesus monkeys, which were given daily taurine supplements for six months. Taurine prevented weight gain, reduced fasting blood glucose and markers of liver damage, increased bone density in the spine and legs, and improved the health of their immune systems.

Randomised clinical trial needed

The researchers do not know yet if taurine supplements will improve health or increase longevity in humans, but two experiments they conducted suggest taurine has potential.

In the first, Yadav and his team looked at the relationship between taurine levels and approximately 50 health parameters in 12 000 European adults aged 60 and over. Overall, people with higher taurine levels were healthier, with fewer cases of type 2 diabetes, lower obesity levels, reduced hypertension, and lower levels of inflammation. “These are associations, which do not establish causation,” Yadav says, “but the results are consistent with the possibility that taurine deficiency contributes to human ageing.”

The second study tested if taurine levels would respond to an intervention known to improve health: exercise. The researchers measured taurine levels before and after a variety of male athletes and sedentary individuals finished a strenuous cycling workout and found a significant increase in taurine among all groups of athletes (sprinters, endurance runners, and natural bodybuilders) and sedentary individuals.

“No matter the individual, all had increased taurine levels after exercise, which suggests that some of the health benefits of exercise may come from an increase in taurine,” Yadav says.

Only a randomized clinical trial in people will determine if taurine truly has health benefits, Yadav adds. Taurine trials are currently underway for obesity, but none are designed to measure a wide range of health parameters.

Other potential anti-ageing drugs – including metformin, rapamycin, and NAD analogues – are being considered for testing in clinical trials.

“I think taurine should also be considered,” Yadav says. “And it has some advantages: Taurine is naturally produced in our bodies, it can be obtained naturally in the diet, it has no known toxic effects (although it’s rarely used in concentrations used ), and it can be boosted by exercise.

“Taurine abundance goes down with age, so restoring taurine to a youthful level in old age may be a promising anti-ageing strategy.”

Source: Columbia University Irving Medical Center

Categories : COVID VaccinesTags :

After COVID, Trust in Vaccines has Plunged in Sub-Saharan Africa

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Photo by Mika Baumeister on Unsplash

In a concerning trend, a study of 17 000 people has revealed that public confidence in vaccines has plunged across sub-Saharan Africa since the COVID pandemic. The study, published in Human Vaccines & Immunotherapeutics, covered eight countries including South Africa – which saw one of the biggest falls in trust.

The findings come as the World Health Organization and UNICEF have reported the largest sustained fall in uptake of routine childhood immunisations in three decades. Six million fewer children in Africa received routine shots for diseases including tetanus, polio, diphtheria and measles over the past two years, and rising outbreaks threaten to reverse decades of progress against preventable diseases. 

Previously, this was attributed to pdisruption of vaccination programs by the pandemic – however these new findings, which followed a study carried out by a team from London School of Hygiene & Tropical Medicine (LSHTM) and the Africa Centres for Disease Control and Prevention, suggest there could be other possible reasons too. 

“Our study paints a worrying picture of declining vaccine confidence trends across many sub-national regions in sub-Saharan Africa, notably in the Democratic Republic of Congo, where confidence losses are particularly large,” states lead author Dr Alex de Figueirido, a Research Fellow at LSHTM. 

The team’s results could be an early warning sign of wider scale loss in vaccine confidence, say the authors. Critically, regional losses in confidence – as seen in this study – could lead to clusters of non-vaccinated people which could have a negative impact on ‘herd immunity’ – the point at which a population is protected from a disease, either by enough people being vaccinated or by people having developed antibodies through having the disease.  

The research involved face-to-face interviews with over 17 000 adults across eight sub-Saharan African countries: the Democratic Republic of Congo (DRC), Ivory Coast, Kenya, Niger, Nigeria, Senegal, South Africa and Uganda. The experts used sampling methods to get an accurate cross section of the population and to gain a picture of vaccine confidence at both national and regional levels. 

Interviewees’ age, sex, religion, employment status and highest education level were recorded to help the researchers to analyse whether social background affected confidence in vaccines. The interviews were carried out in 2020 and again in 2022, after the pandemic. 

Respondents were asked to say how strongly they agreed with statements such as ‘Vaccines are important for all ages’, ‘Vaccines are important for children’ and ‘Vaccines are safe’. They were also asked specifically about COVID vaccines, rating their agreement that COVID vaccines would be important, safe and effective – both before they had been developed (in 2020) and then after they had been developed and rolled out, in 2022. 

Findings showed a fall in people’s view that vaccines are important for children across all eight countries between 2020 and 2022, particularly in DRC (20% decline), followed by Uganda (14%) and Nigeria (10.5%). In Nigeria and DRC, public confidence in vaccine safety and effectiveness also declined, and fewer people agreed that ‘vaccines are important for all ages’ in Ivory Coast, Kenya, Nigeria, South African and Uganda.  

When it came to COVID vaccines, people thought they were less important in 2022 than they had in 2020 in seven out of the eight countries, with the biggest loss of trust in DRC, South Africa and Uganda. People in DRC, Kenya, Niger, Senegal and Nigeria thought that the COVID vaccine was less effective in 2022 than they had expected it to be in 2020. However, trust in the safety of the COVID vaccine stayed consistent over the two years.  

In 2022, the over-60s were more likely than younger adults to agree that vaccines are generally safe, effective and important for children, but no other links were found between vaccine confidence and sex, education, employment status or religious affiliation.  

“Early warning signals of confidence losses – such as those detected in this study – can provide time to respond, in the case of other epidemics, pandemics or other emerging crises,” adds co-author, Professor of Anthropology, Risk and Decision Science Heidi Larson, who is the Founding Director of the Vaccine Confidence Project at LSHTM. 

“Confidence monitoring at sub-national resolutions can also provide clearer signals to the regions and groups facing confidence losses and can better prepare policymakers and stakeholders for potential losses in vaccine uptake.” 

A thorough investigation is now needed to find out whether loss of confidence in COVID vaccines will trigger mistrust of other immunisation programmes, say the study authors.  

“Considering global decreases in routine immunisation rates over the past two years, vaccine confidence losses could prove to be highly disruptive at this time when there are concerted efforts to address losses in routine immunization rates post pandemic. We need to understand the impact of the COVID pandemic on confidence in routine immunisation programmes, not just in Africa, but across the world,” says Dr Defigueirido. 

“Understanding the role of the COVID pandemic and associated policies on wider vaccine confidence can inform post-COVID vaccination strategies and help rebuild immunisation system resilience.”

Source: EurekAlert!

Categories : GeneticsTags :

The Genes that Determine the Thickness of Eyebrows

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Photo by Stormseeker on Unsplash

The first gene mapping study on eyebrow thickness in Europeans discovered three previously unreported genetic loci, as reported in the Journal of Investigative Dermatology. The study conducted by the International Visible Trait Genetics (VisiGen) Consortium demonstrates that eyebrow appearance has partly the same and partly different underlying genes in people from different parts of the world.

The appearance of human eyebrows is not just a matter of grooming but is in the genes. Eyebrow thickness, as any other appearance trait, is highly heritable. Thus far, genetic knowledge on eyebrow thickness has been very limited and solely restricted to non-Europeans. This study is the first genome-wide association study (GWAS) on eyebrow thickness in Europeans. By identifying new genes and rediscovering some of the genes previously identified in non-Europeans, the study expands genetic knowledge on human eyebrow variation, which is of broad interest and has implications for dermatology and other fields.

Previous studies were performed among Latin American and Chinese individuals, establishing four eyebrow thickness -associated genetic loci. Because no European eyebrow thickness GWAS had been reported, researchers did not know whether the genetic eyebrow thickness effects described in non-Europeans persist in Europeans, or whether there are European-specific genetic loci involved in eyebrow thickness, or both.

Lead investigator Prof Dr Manfred Kayser, Department of Genetic Identification, Erasmus MC University Medical Center Rotterdam, and co-chair of the VisiGen Consortium responsible for this study, commented, “Despite the immense efforts in mapping genes underlying human complex traits, we still know much more about the genes that make us sick than about those behind our healthy looks. For the first time, we performed a gene mapping study on eyebrow thickness variation in Europeans. Previous genetic knowledge on eyebrow thickness was limited and solely restricted to non-Europeans. We discovered new genes involved in eyebrow variation in Europeans and rediscovered some of the genes previously identified in non-Europeans.”

The study among 9948 individuals from four groups of European ancestry not only discovered three previously unreported genetic loci associated with eyebrow thickness, but also rediscovered two of the four genetic loci previously found in non-Europeans. Two other genetic loci previously reported in non-Europeans had minimal effects in Europeans, due to very low allele frequencies in Europeans.

Prof Dr Kayser concluded, “Our study significantly improves the genetic knowledge of human eyebrow appearance by increasing the number of known genes from four to seven and delivers new targets for future functional studies. By having demonstrated that eyebrow variation is determined by both shared and distinct genetic factors across continental populations, our findings underline the need for studying populations of different ancestries for unveiling the genetic basis of human traits, including, but not restricted to, physical appearance.”

Source: Elsevier

Categories : Cancer Cardiovascular DiseaseTags :

Some Antihypertensives might Boost the Effectiveness of Cancer Immunotherapy

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Photo by CDC on Unsplash

A study reported in the latest issue of Nature has shown that some molecules previously used to treat hypertension might also help the immune system to better target cancer cells. The researchers believe that these findings could eventually be applied to significantly improve the effectiveness and applicability of cancer immunotherapy.

“Immunotherapy today can effectively fight only 30% to 40% of cancers,” said Benoît Van den Eynde, at the Ludwig Institute for Cancer Research, co-director of the de Duve Institute and professor of Tumour Immunology at the University of Oxford. “Many cancers are resistant, largely because their T lymphocytes are not reactive enough. We discovered that drugs once used to treat hypertension could have a very interesting effect in combating these forms of immunotherapy-resistant cancers.”

T lymphocytes are active components in the immune system, recognising and destroying cells that appear foreign. Cancer cells, however, are not foreign and are therefore often not recognised and attacked by T lymphocytes. But about thirty years ago, Thierry Boon and his colleagues at the former Brussels Branch of the Ludwig Institute for Cancer Research at the de Duve Institute discovered specific markers on the surface of cancer cells – tumour antigens – that can be recognised by T cells that then destroy the cancerous cells.

This work paved the way for cancer immunotherapy, a treatment approach that helps T cells destroy cancerous cells. Thanks to T cells’ specificity and memory of tumour antigens, immunotherapy makes it possible to treat advanced cancers with some success. It is now used worldwide. However, such therapies are not equally effective in all patients or against all types of cancer.

In the current study, a team led by Jingjing Zhu in Van den Eynde’s laboratory shows that anti-hypertensive drug-molecules known as α2-adrenergic receptor (α2AR) agonists also influence the behaviour of macrophages. While doing that job, macrophages also alert T cells of any abnormalities they encounter, presenting suspicious antigens to the cells to trigger a possible immune response.

Zhu, Van den Eynde and colleagues discovered that alongside their known hypotensive and anaesthetic effects, α2AR agonists can also stimulate macrophages in their role as sentinels, making T cells more reactive and more effective at rejecting cancer cells. The effect extended, most notably, to cancer models that are resistant to standard immunotherapy. This suggests the new approach could boost the efficacy of clinical immunotherapy, even for the many types of cancer that are largely unresponsive to such interventions.

These findings also present a rationale for the development of new molecules that might be used in combination with immunotherapy to improve its efficacy.

“One could imagine using existing blood pressure-lowering drugs,” said Van den Eynde. “But that would be quite risky, owing to the undesired effects and the toxicity of these drugs at the necessary doses. Another approach would be to develop new molecules that would act in the same way on macrophages but would not have the unwanted toxic effects. We have already made significant progress in this direction.”

Source: Ludwig Cancer Research

Categories : Antibiotics Healthcare Politics and RegulationsTags :

SA one of Many Countries Failing to Combat Antimicrobial Resistance, International Review Finds

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Methicillin resistant Staphylococcus aureus (MRSA) bacteria, the bane of hospital infection control strategies. Image by CDC on Unsplash.

Governments around the world must do more to tackle the growing threat of antimicrobial-resistant infections, new research suggests – with South Africa falling quite short in the rankings.

The review, published in The Lancet Infectious Diseases, assessed national action plans developed by more than 100 countries to tackle the threat from antimicrobial resistance (AMR). It comprehensively graded international AMR efforts and national action plans and generate comparable quantitative results across countries and regions.

National action plans focus on designing policies to curb AMR and devising tools to implement the policies – but they do not adequately factor in monitoring and evaluation.

The new research, carried out by experts at the universities of Leeds, Edinburgh and Hamburg, is the first large-scale analysis of these plans. They were designed after encouragement from the World Health Organisation, which has declared AMR one of the top 10 public health threats facing humanity.

Lead author Jay Patel, undergraduate dental student in the University of Leeds’ School of Dentistry, said: “Our analysis showed that countries were highly focused on designing AMR policies, and thinking about what tools would be required to implement those, but they generally did not consider how they would monitor and evaluate the impact of those efforts.

“This suggests that the international response may be inadequate to meet the scale and severity of AMR. This is particularly concerning in low and middle-income countries, where action plan activities often lack sustainable funding – relying instead on funds from foreign donors and philanthropies.

“The available evidence also suggests that simply developing a national action plan may not necessarily mean a country is more prepared to respond to the threat of AMR.

“Our study shows that the global response to AMR, and preparedness for the predicted challenges of AMR, require improvement in all locations around the world.”

The research team says governments across the world must strengthen their responses to AMR.

In 2017, the World Health Organization encouraged member states to develop national action plans stipulating how countries would tackle AMR. More than 100 countries have produced action plans, with several being implemented – but there had been no global analysis of the contents of these plans.

The 114 action plans, which were created in 2020-21, were evaluated against 54 elements, such as education, stewardship, and accountability, and each awarded a score out of 100. A mean score out of 100 for each country’s plan was then taken from these results.

The findings

At 43 points for AMR governance, South Africa falls far short of the top score of 85, and rather closer to the lowest score of 29. Reproduced from The Lancet. Figure 2b, Patel et al., 2023. (Open Access)

Norway’s response was the highest scoring with 85, followed by the USA with 84 and the UK with 83. The lowest scoring countries were Ukraine and Sierra Leone with 29 points each, and Barbados and Micronesia with 28 points. With 43 points, South Africa trailed behind Brazil, Namibia, Rwanda and Egypt – and received 0 for research and development as well as the effectiveness of its monitoring and evaluation.

The study found that across all plans, there was a greater focus on policy design and implementation tools, but efforts to monitor and evaluate activities are generally poorly-considered.

Of all areas evaluated, accountability and feedback mechanisms were the joint-lowest scoring, followed by education.

Training and professional education across human health, veterinary, and agricultural sectors were insufficient in many countries, with several lacking a sustainable workforce strategy to deliver antimicrobial stewardship policies.

Countries scored well on participation, demonstrating a shared awareness that AMR can only be successfully addressed through engagement with multiple sectors spanning human, animal and environmental health. Infection prevention and control was frequently recognised as a critical objective.

Source: University of Leeds

Categories : Implants and Prostheses NeurologyTags : 2 Comments

‘Digital Bridging’ Enables Paraplegic Man to Walk Again

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Study participant Gert-Jan Oskam walking with the brain-spine interface. Credit: Swiss Federal Institute of Technology in Lausanne

A 40 year-old man, Gert-Jan Oskam, has regained the ability to walk independently after being paralysed from a spinal cord injury with the use of a new brain-spine interface. The ‘digital bridging’ technology, developed at the Swiss Federal Institute of Technology in Lausanne and described in Nature, consists of implants and a computer to translate brain signals of the intention to move into stimulations that move the legs accordingly..

This BSI system could be calibrated in minutes, and remained stable for one year, including use at home. The BSI enabled the participant to exert natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains.

In addition to the digital bridging, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.

The system consists of a pair cortical of sensors, each an array with 64 electrodes housed in 5cm-diameter titanium discs. These discs are implanted snugly in the skull to pick up brain activity. They transmit the data wirelessly to a personalised headset, which also provides power for the sensors. The headset then sends the data to a portable processing unit (which may be carried in a backpack). Using specialised software, it uses this brain signal data to generates real-time predictions of motor intentions. These decoded intentions are translated into stimulation commands and sent on to another implant, a paddle array of 16 electrodes implanted next to the spinal cord, delivering current to the targeted dorsal root entry zones.

Neurosurgical implantation procedure

Oskam had sustained an incomplete cervical (C5/C6) spinal cord injury during a biking accident 10 years previously. He had already participated in a neurological recovery programme, the STIMO trial, which had used neurostimulation to get him to the stage where he could walk with the aid of a front-wheel walker. The neurorehabilitation from the trial also enabled him to use his hip flexors and lift his legs against gravity, but recovery had plateaued for the three years prior to his participation in the present study.

For the BSI to function, the researchers needed to locate neural features related to the intention to move the legs. To pinpoint the cortical regions associated with the intention to move, they used CT scans and magnetoencephalography. Taking into account anatomical restraints, they then decided on the positions of the implants.

Under general anaesthesia, surgeons performed a bicoronal incision of the scalp to allow two circular-shaped craniotomies over the planned locations of the left and right hemispheres. They then replaced the bone flaps with the two implantable recording devices, before closing the scalp.

The paddle lead had already been emplaced over the dorsal root entry zones of the lumbar spinal cord during the STIMO clinical trial. Its optimal positioning was identified using high-resolution structural imaging of the spine, and its final position was decided during the surgery based on electrophysiological recordings. The implantable pulse generator was inserted subcutaneously in the abdomen. Oskam was able to return home 24 hours after each procedure.