Author Archives: support

A Rutgers Health Study Reveals the Vital Role of Social Networks in Supporting Older Adults Living with HIV

In a study featured in AIDS Care and spearheaded by Kristen Krause, an instructor at the Rutgers School of Public Health, an examination was conducted into the social networks of older individuals grappling with HIV in Newark, N.J. – a locale often sidelined in research focused on this demographic. “This study is instrumental in deciphering the impact of support networks on older adults contending with HIV and how the presence of stigma and fractured relationships can pave the way for adverse health outcomes,” remarked Krause. She highlighted that many studies concentrate on more significant urban hubs like New York, Los Angeles, and San Francisco.

With a staggering 1.2 million individuals living with HIV in the United States, advancements in medical technology have stretched their lifespans, challenging the notion of HIV primarily afflicting young demographics. The Centers for Disease Control and Prevention underscore that half of those living with the virus in the United States are aged 50 or above, underlining the significance of grasping the dynamics of social support for this cohort. Older individuals grappling with HIV often confront stigma tied to both their HIV status and advancing age, which can impinge upon their mental well-being and escalate social seclusion.

Assistance from diverse sources such as community organisations, family, and healthcare providers proves pivotal in mitigating these hurdles, furnishing avenues for connection and encouragement towards self-care. Research indicates that social support not only acts as a buffer against stigma but also diminishes levels of stress, anxiety, and depression among older individuals living with HIV. “Social support stands as a pivotal element in resilience and surmounting formidable obstacles that older adults dealing with HIV may encounter,” affirmed Krause.

“Social support stands as a pivotal element in resilience and surmounting formidable obstacles that older adults dealing with HIV may encounter,” affirmed Krause. “It can manifest in various forms, ranging from friendships and familial bonds to support groups, each serving distinct yet collective roles in ensuring favourable health outcomes in older individuals grappling with HIV.” Researchers enlisted 40 participants aged 51 to 69 through diverse sampling methods within the Newark metropolitan area, encompassing drag shows, pride events, and medical facilities.

From the amassed data, four principal themes surfaced regarding participants’ experiences navigating life with HIV as older individuals: friendships and relationships, support groups, stigma and discrimination, and family, all of which underscored the recurring significance of social support. The study’s findings underscore the imperative for older adults contending with HIV to foster robust support systems, particularly in underexplored regions such as Newark. The absence of such networks correlated with a spectrum of challenges among participants as they age, including heightened substance use, depressive episodes, anxiety, homelessness, and adverse health outcomes.

“It is imperative for researchers and public health practitioners to collaborate in devising programmes that can facilitate consistent and affirming interactions for older adults grappling with HIV,” emphasised Krause. “This will significantly enhance the overall quality of life for many individuals and bolster positive health outcomes.” Looking forward, Krause emphasised the necessity for further research tailored to this demographic, advocating for augmented funding and the formulation of interventions and programmes that nurture social support through dependable and affirmative experiences, given that not all older adults living with HIV have seamless access to such support and resources.

More information: Susannah C. Gervolino et al, The role of social support networks in a sample of older adults living with HIV: the GOLD studies, AIDS Care. DOI: 10.1080/09540121.2024.2312877

Journal information: AIDS Care Provided by Rutgers University

Probiotics in kombucha mimic fasting and decrease fat reserves in worms

In a recent study, it has been discovered that the microbes in kombucha tea induce alterations in fat metabolism within the intestines of a model worm species, mirroring the metabolic effects typically associated with fasting. This research was conducted by Robert Dowen and his colleagues at the University of North Carolina at Chapel Hill, and their findings were published on March 28 in the journal PLOS Genetics.

Kombucha, a sweetened and fermented tea, has gained considerable popularity due to its health benefits. These include reducing blood pressure, preventing cancer, and protecting against metabolic diseases and liver toxins. The supposed benefits are attributed to the probiotic microbes present in the beverage and their metabolic effects. However, the health claims associated with kombucha have yet to be thoroughly investigated in human studies.

Dowen’s research focused on exploring the impact of kombucha tea’s microbes on metabolism. This was achieved by administering these microbes to the model nematode worm, C. elegans. The study revealed that the yeast and bacteria from the kombucha colonize the worm’s intestines, prompting metabolic changes akin to those observed during fasting. Specifically, these microbes influence the expression of genes linked to fat metabolism, increasing proteins that degrade fats and decreasing proteins that synthesize a type of fat molecule known as triglycerides. Consequently, these alterations lead to a reduction in the fat stores within the worms.

The implications of this study are far-reaching, illuminating how the probiotics in kombucha tea can reshape metabolism in a model worm species, potentially offering insights into their effects on human metabolism. While further research is needed to confirm whether humans consuming kombucha can experience similar effects as those observed in the C. elegans model, the results align with the reported health benefits of kombucha in humans. This could potentially pave the way for the integration of kombucha into future complementary healthcare strategies.

The authors of the study were astounded by the significant impact of the kombucha-derived probiotics on the model organism. They remarked, “Animal consuming a diet consisting of the probiotic microbes found in Kombucha Tea displayed reduced fat accumulation, lower triglyceride levels, and smaller lipid droplets – an organelle that stores the cell’s – when compared to other diets.” These unexpected observations suggest that the microbes in kombucha tea can induce a ‘fastin’-like’ state in the host, even when nutrients are plentiful. This underscores the profound influence that dietary components can have on biological processes and underscores the potential therapeutic benefits of carefully selected probiotics in the diet.

More information: Rachel N. DuMez-Kornegay et al, Kombucha Tea-associated microbes remodel host metabolic pathways to suppress lipid accumulation, PLoS Genetics. DOI: 10.1371/journal.pgen.1011003

Journal information: PLoS Genetics Provided by PLOS

Unveiling the Oversight: The Neglect of Cancer Research in Older Adults

A critical evaluation of existing research unveils a significant oversight in addressing the intricate nexus of ageing, health disparities, and cancer outcomes among older adults. This revelation emerges from a recent publication in the esteemed Journal of the American Geriatrics Society, spearheaded by Dr. Nikesha Gilmore, a distinguished member of the Wilmot Cancer Institute at the University of Rochester.

With projections indicating a potential doubling in the population of cancer survivors aged 65 and above over the next two decades, the review underscores the pressing necessity for studies aimed at mitigating biases influencing cancer prognosis in this demographic. The absence of research dedicated to disparities, coupled with the lack of policies and targeted interventions to enhance health equity, perpetuates cancer inequities and renders the healthcare system ill-equipped to cater to the distinctive needs of the burgeoning and increasingly diverse older adult cancer populace, as posited by the research team.

This imperative resonates particularly strongly at Wilmot, where the catchment area spans 27 counties in the Rochester region. Notably, this area exhibits a higher proportion (18%) of individuals aged 65 and older than state and national averages. Moreover, the region grapples with an elevated cancer incidence rate surpassing that of New York state and the nation at large.

Dr. Gilmore, an esteemed Assistant Professor of Surgery at the University of Rochester Medical Center and a pivotal figure within Wilmot’s Cancer Prevention and Control (CPC) research program, assumes lead co-authorship of the paper alongside Dr. Shakira J. Grant MBBS, from the University of North Carolina at Chapel Hill. Their collaboration includes Dr. Supriya Mohile, a renowned mentor and senior co-author of the study, and esteemed National Cancer and Aging Research Group members. Undertaking a scoping review encompassing articles published between 2016 and 2023, the team’s rigorous analysis garnered commendation from Nancy Lundebjerg, CEO of the American Geriatrics Society.

Dr. Gilmore’s commitment to fostering diversity and nurturing the next generation of researchers is palpable within the University of Rochester Medical Center (URMC) community. Notably, she spearheads various initiatives to identify key avenues for future investigation and dismantle barriers for underrepresented undergraduate students keen on pursuing careers in science and medicine. One such initiative is the immersive student enrichment program, EmREACh, which was developed in collaboration with peers at Wilmot and the CPC. EmREACh endeavours to provide mentorship, manuscript writing guidance, and exposure to clinical research and professional development opportunities, thereby nurturing a cadre of diverse, talented individuals poised to drive innovation in cancer research and beyond.

More information: Nikesha Gilmore et al, A scoping review of racial, ethnic, socioeconomic, and geographic disparities in the outcomes of older adults with cancer, Journal of the American Geriatrics Society. DOI: 10.1111/jgs.18881

Journal information: Journal of the American Geriatrics Society Provided by University of Rochester Medical Center

Winding down the window, consuming tea and coffee, increasing the radio volume, and singing while driving could indicate a hazardous snoring condition

A study published in ERJ Open Research suggests that regularly using multiple methods to stay awake while driving might indicate severe sleepiness due to obstructive sleep apnea (OSA).

Individuals with OSA typically experience loud snoring, intermittent breathing during sleep, and frequent awakenings. Although it is estimated that one in five people suffers from OSA, most are unaware of their condition. Untreated, OSA leads to extreme drowsiness, significantly increasing the risk of vehicular accidents.

The research highlights the potential of using certain behaviours, such as opening car windows, consuming caffeinated beverages, or increasing radio volume, as indicators to identify drivers at heightened risk of incidents due to OSA.

This study, led by Dr Akshay Dwarakanath and his team at St James’s University Hospital in Leeds, UK, compared 119 untreated OSA patients with 105 individuals without the disorder. Participants were queried about their general and driving-specific sleepiness, strategies employed to combat drowsiness while driving, and any history of driving incidents.

The research findings are significant, revealing that those with OSA were more likely to adopt multiple alertness strategies while driving compared to their non-OSA counterparts. Notably, nearly a third of the OSA group reported frequently using over three techniques to stay awake, a practice nonexistent among the control group. Furthermore, OSA patients engaging in multiple strategies not only felt generally sleepier but also reported a higher incidence of crashes—22.8% versus 2.4% among those using fewer strategies.

Standard methods among OSA sufferers included adjusting the car environment by opening windows or using caffeinated drinks, as well as behavioural tactics like singing, adjusting seating positions, chewing gum, taking breaks for physical activity, and even stopping to refresh themselves with cold water.

Dr Dwarakanath emphasized the clinical challenge in assessing patients’ fitness to drive, mainly when it affects their employment, especially for professional drivers. Nonetheless, he stressed the responsibility of medical professionals to advise against driving when there is a substantial risk of accidents.

The study underscores the crucial role of healthcare providers in inquiring about these adaptive strategies during clinical assessments. They can serve as indirect indicators of sleepiness and aid in identifying patients who may be more susceptible to driving-related accidents. This approach could empower healthcare providers to better manage the risks associated with untreated OSA in drivers.

More information: Akshay Dwarakanath et al, An exploratory study evaluating the use of coping strategies while driving in obstructive sleep apnoea syndrome patients and controls, ERJ Open Research. DOI: 10.1183/23120541.00638-2023

Journal information: ERJ Open Research Provided by European Respiratory Society

The type of surgery and its associated risk level exert a considerable influence on the occurrence of complications and mortality rates among elderly patients

Frailty stands as a well-established predictor concerning the likelihood of complications and mortality following surgery. Nonetheless, a recent study, as published in the Journal of the American College of Surgeons (JACS), reveals a significant escalation in postoperative complications and death among patients aged over 65 who undergo high-risk emergency surgeries compared to those evaluated solely based on frailty levels.

In the foreseeable future, the elderly demographic in the United States is expected to undergo a doubling, compelling surgeons to confront numerous considerations in decision-making processes, particularly concerning postoperative recuperation. Dr. Raul Coimbra, the study’s co-author and a prominent figure in the surgical field, underscores the deteriorating outcomes observed among elderly patients in emergency settings undergoing significant surgeries, urging for transparent communication with patients and their families regarding the associated risks and potential consequences.

The researchers postulated that, for the elderly cohort, the degree of procedural risk, whether high or low, holds greater significance in determining adverse outcomes when juxtaposed with frailty status alone. Utilising the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), the researchers scrutinised records of elderly patients over 65 who underwent emergency surgeries between 2018 and 2020. This program is a benchmark for nationally evaluating and enhancing surgical care quality across hospitals.

Patients were categorised based on frailty levels — non-frail, frail, and severely frail — and then further grouped according to procedural risk, distinguishing between low-risk and high-risk operations. High-risk procedures included open cholecystectomy, open colectomy, laparoscopic colectomy, small bowel resection, and perforated ulcer repair, while low-risk procedures encompassed appendectomies and cholecystectomies.

The evaluation encompassed five key outcomes: 30-day mortality, 30-day postoperative complications, failure to rescue, hospital readmission, and 30-day reoperation. The aim was to delineate the impact of surgical procedure types on outcomes among elderly patients.

Among the study’s sample of 59,633 elderly patients, 29.3% were classified as non-frail, 66.4% as frail, and 4.3% as severely frail. Within these groups, 25,157 underwent low-risk procedures, whereas 34,476 underwent high-risk procedures. Both frailty and procedural risk correlated with elevated risks of mortality, postoperative complications, failure to rescue, and readmissions. However, when comparing the impact of procedural risk against frailty alone, the former emerged as a more robust predictor of adverse outcomes.

For instance, non-frail patients subjected to high-risk emergency surgeries exhibited a mortality rate of 7.1%, contrasting with a mere 0.2% mortality rate associated with low-risk procedures. Conversely, frail and severely frail patients undergoing high-risk procedures demonstrated mortality rates of 11.5% and 25.8%, respectively, compared to 1.0% and 4.1% following low-risk procedures.

High-risk procedures were associated with a fourfold increase in surgical complications among non-frail patients and similarly among frail and severely frail patients. The disparity between high-risk and low-risk procedures was consistently at least four times greater across all outcome measures compared to frailty status alone, with high-risk procedures magnifying the risk of 30-day mortality by eightfold.

Dr Coimbra underscores the urgent nature of many surgeries among elderly patients, attributing it to the delayed seeking of surgical care and surgeons’ reluctance to address issues electively. Delaying minor surgeries could significantly compromise long-term health and quality of life in elderly patients. Consequently, the study authors advocate for a shift in approach, emphasising the importance of early surgical intervention to mitigate the need for emergency surgeries and their associated risks.

The findings underscore the imperative of timely surgical intervention for elderly patients, aiming to circumvent the heightened risks associated with emergency surgeries. Transparent communication and informed decision-making are pivotal in guiding treatment strategies and managing expectations regarding postoperative outcomes in this vulnerable demographic.

More information: Zakhary, Bishoy et al, Procedure Risk vs Frailty in Outcomes for Elderly Emergency General Surgery Patients: Results of a National Analysis, Journal of the American College of Surgeons. DOI: 10.1097/XCS.0000000000001079

Journal information: Journal of the American College of Surgeons Provided by American College of Surgeons

Intelligent skin bacteria can produce and secrete molecules to combat acne

An international research project, spearheaded by the Translational Synthetic Biology Laboratory within the Department of Medicine and Life Sciences (MELIS) at Pompeu Fabra University, has successfully engineered a strain of Cutibacterium acnes, a common skin bacterium, to produce and secrete a molecule aimed at alleviating acne symptoms. This engineered bacterium has been tested on skin cell lines, and experiments with mice have confirmed its effectiveness. This breakthrough paves the way for synthetic biology to transform non-engineerable bacteria into agents that can manage skin conditions and other diseases through biotherapeutic methods.

The research consortium includes eminent scientists from prestigious institutions such as the Bellvitge Biomedical Research Institute (Idibell), the University of Barcelona, the Protein Technologies Facility of the Centre for Genomic Regulation, Phenocell SAS, Medizinische Hochschule Brandenburg Theodor Fontane, Lund University, and Aarhus University.

Acne is a prevalent skin ailment caused by the clogging or inflammation of pilosebaceous follicles. Manifestations range from whiteheads and blackheads to more severe forms like pustules and nodules, predominantly affecting areas such as the face, forehead, chest, upper back, and shoulders. While acne commonly appears during adolescence, it does not discriminate by age.

For more severe acne cases, traditional treatments have included antibiotics to eradicate bacteria within the follicles or isotretinoin (also known as Accutane), a vitamin A derivative that promotes the death of sebocytes—epithelial cells producing sebum. Nevertheless, these treatments can disrupt the balance of skin microbiota due to their non-selective bacterial eradication or cause severe side effects like photosensitivity and congenital disabilities.

The study, published today in Nature Biotechnology, describes how the researchers modified the genome of Cutibacterium acnes to enable the secretion of the NGAL protein, which mimics the action of isotretinoin. This protein effectively reduces sebum production by promoting the apoptosis of sebocytes.

Nastassia Knödlseder, the study’s lead author and a postdoctoral researcher at the UPF Translational Synthetic Biology Laboratory, commented on the innovation: “We have devised a topical treatment that leverages what nature already provides. By engineering a naturally occurring skin bacterium to produce therapeutic agents, we have opened the door to treating not only acne but potentially other conditions as well.”

Engineering C. acnes, previously deemed intractable for genetic modification, was overcome by improving methods for DNA delivery, enhancing the stability of DNA within the cell, and optimizing gene expression. The research team, led by Marc Güell, employed regulatory strategies to develop a biocontainment approach that eliminates concerns related to mobile genetic elements, plasmids, or antibiotic resistance markers, ensuring the safety of the synthetic bacterium for potential therapeutic applications.

The synthetic C. acnes wereld secreted NGAL in tests, regulating sebum production in cell cultures. Although initially tested in mice, whose skin differs significantly from human skin, the researchers underscore the need for alternative models that more closely resemble human skin, such as 3D skin models, to validate these findings further.

Looking ahead, Güell highlights the broader implications of their work: “Our technology platform is not limited to treating acne. It can potentially be used to engineer any bacterium to treat a wide range of diseases, from skin conditions to immune system disorders, by delivering genetic modifications that enable bacteria to sense and respond to bodily changes.”

The ongoing research under the European ‘SkinDev’ project aims to extend this technology to tackle atopic dermatitis, a chronic inflammatory skin condition prevalent among young children, by engineering C. acnes to address this and potentially other dermatological disorders.

This innovative approach to creating living therapeutics holds promise for transforming the treatment of skin conditions and other diseases, offering a new realm of possibilities in medical science. Given the safe and effective history of non-engineered C. acnes in clinical settings, the researchers remain optimistic about the potential application of these engineered microbes in human patients.

More information: Nastassia Knödlseder et al, Delivery of a sebum modulator by an engineered skin microbe in mice, Nature Biotechnology. DOI: 10.1038/s41587-023-02072-4

Journal information: Nature Biotechnology Provided by Universitat Pompeu Fabra

Medicare is covering message-based e-visits. Are older adults utilising this service?

At the onset of the pandemic, Medicare made a pivotal move, announcing its intention to reimburse healthcare providers for the time spent managing patients’ digital messages. This landmark initiative, which primarily focused on messages involving at least five minutes of medical decision-making, marked a significant shift in healthcare policy. While these asynchronous “e-visits” conducted through secure patient portals may have received less attention compared to video and phone telehealth visits, recent research indicates that they have become a routine aspect of healthcare for some of the 30 million older Americans under traditional Medicare. Approximately 1% of this demographic engaged in patient portal messaging, prompting their healthcare providers to bill Medicare for their time. However, these billed e-visits represented only a minuscule fraction (0.05%) of all visits aimed at evaluating or managing health conditions in this population.

The study, led by researchers from the University of Michigan and published in Health Affairs Scholar, revealed that nearly half of the billed e-visits involved primary care providers, primarily assisting patients with hypertension or diabetes. Following a surge at the pandemic’s onset, the rate of billed e-visits in traditional Medicare stabilised consistently until the end of 2022. Nonetheless, it’s important to note that a considerable volume of patient portal messages circulate daily without generating a bill, such as requests for prescription refills or updates on the patient’s well-being, which were not part of the study due to the unavailability of data without billing information.

The transformation in care delivery, particularly the increasing use of patient portal messaging, has significantly impacted the workflow of primary care clinicians. Dr Terrence Liu, the study’s lead author and a National Clinician Scholar at U-M’s Institute for Healthcare Policy and Innovation, emphasises the need for a deeper understanding of how such care modalities can be optimally utilised by both patients and providers. He highlights the potential implications on clinic operations, provider burnout, and patient outcomes. For instance, while e-visits offer a convenient tool for chronic disease management, they also pose challenges for clinicians, especially those managing large patient panels, as even a few lengthy e-visits can consume significant time not accounted for in their schedules.

To effectively handle the influx of patient portal messages, some clinics have implemented triage systems, assigning dedicated staff members to screen and allocate messages to appropriate responders. This strategic approach helps preserve physician and advanced-practice provider time for addressing inquiries that require their expertise the most. However, variations exist in how different clinics triage portal messages, underscoring the need for standardised protocols to ensure consistency and efficiency across healthcare settings. This discussion on managing patient portal messages presents an intriguing area for further research and development in healthcare delivery.

Despite the potential benefits of e-visits, concerns linger regarding the financial implications for patients. At the same time, Medicare covers e-visits and insurance coverage for such services varies, leading some providers to hesitate to bill portal exchanges to avoid passing costs onto patients. Dr Liu underscores the importance of further research to assess the impact of e-visits on overall healthcare utilisation and explore the content and outcomes of these interactions, particularly regarding chronic disease management. Additionally, it’s crucial to evaluate whether adopting patient portal e-visits exacerbates healthcare disparities, potentially widening the gap among patients with differential access to and proficiency in communication technologies.

More information: Terrence Liu et al, National trends in billing patient portal messages as e-visit services in traditional Medicare, Health Affairs Scholar. DOI: 10.1093/haschl/qxae040

Journal information: Health Affairs Scholar Provided by University of Michigan Health

Research review highlights the gut-skin connection as a key factor in atopic dermatitis

Atopic dermatitis (AD), a chronic inflammatory skin condition, primarily manifests through symptoms such as redness, swelling, and itchy rashes. It predominantly affects individuals genetically predisposed to the condition. The presentation of symptoms is influenced by a complex interplay among the immune system, environmental factors, and gut microbiota, with many aspects of this intricate relationship yet to be fully uncovered. Recent studies have shed light on critical elements contributing to AD severity. For instance, changes in gut microbiota composition have been linked to exacerbated disease symptoms, while environmental triggers like allergens and pollution can aggravate the condition. Genetic predispositions also play a critical role in susceptibility to AD, and emerging treatments such as dietary adjustments and faecal transplantation show promise in managing the disease.

The understanding of these interconnected factors is crucial for advancing our comprehension of AD and serves as a foundation for developing new therapeutic approaches, as discussed in a collaborative review article from the International Journal of Molecular Sciences. This research, conducted by teams from the University of São Paulo (USP) and Federal University de São Paulo (UNIFESP) in Brazil, delves into these dynamics, showcasing the global effort in tackling this complex condition.

Often referred to as atopic eczema, AD impacts approximately 7%-10% of adults and 20%-25% of children, with no clear consensus on its prevalence between genders. The frequency of AD has significantly risen in the 21st century, a trend attributed to various factors, including genetic and autoimmune influences, compromised skin barrier function, viral infections, changes in gut microbiome composition, dietary habits, and lifestyle alterations.

A notable hypothesis posits that the surge in AD cases in developing regions might stem from reduced exposure to beneficial bacteria, potentially affecting immune system maturation. In this critical process, the immune system evolves its response following initial microbial contact.

The review underscores the pivotal role of gut microbiota in recent AD research. According to Sabri Saeed Sanabani, a researcher at the Institute of Tropical Medicine (IMT-USP) and the article’s senior author, the gut microbiome is integral not only for regulating 70% of the immune system but also for maintaining the integrity of the skin barrier and gastrointestinal tract structure. It is crucial in nutrient absorption and energy balance and is directly connected to the skin through the gut axis.

Recent findings suggest that disturbances in gut microbiome composition can lead to AD pathogenesis. Research indicates an increased presence of pathogenic bacteria like Clostridium difficile, Escherichia coli, and Staphylococcus aureus, alongside a reduced abundance of beneficial bacteria such as Bifidobacteria and Bacteroides, which produce short-chain fatty acids (SCFAs). A decrease in SCFA levels is often linked with intestinal inflammation in otherwise healthy individuals.

Genetic research, particularly genome-wide association studies (GWAS), continues to identify genetic variants associated with AD susceptibility and progression. Notably, mutations in the filaggrin gene (FLG), vital for maintaining skin barrier integrity, have been identified as a significant risk factor for AD. However, it remains unclear whether alterations in the gut microbiome are genetically determined.

Although not fully understood, the role of environmental factors in AD is acknowledged in the context of how allergens, irritants, pollution, and microbial exposure can undermine skin barrier function and disrupt gut microbiome balance.

The review discusses promising therapeutic approaches targeting epigenetic changes and modulating gut microbiome diversity through dietary interventions, probiotics, prebiotics, and faecal transplants. These innovative treatments hold the potential to revolutionize the management of atopic dermatitis, offering new hope for patients and healthcare professionals alike.

As with all comprehensive reviews, the primary aim is to analyze existing scientific literature, confirm what is known, and identify gaps that require further investigation, as explained by Sanabani. This ongoing research is pivotal for paving the way towards more effective and targeted treatments for atopic dermatitis.

More information: Rodrigo Pessôa et al, The Interaction between the Host Genome, Epigenome, and the Gut–Skin Axis Microbiome in Atopic Dermatitis, International Journal of Molecular Sciences. DOI: 10.3390/ijms241814322

Journal information: International Journal of Molecular Sciences Provided by Fundação de Amparo à Pesquisa do Estado de São Paulo

A spiral-shaped lens offers clear vision across distances and lighting conditions

Researchers have developed a groundbreaking spiral-shaped lens capable of maintaining sharp focus across different distances and lighting conditions, akin to progressive lenses but without their typical distortions. Dubbed the “spiral diopter,” this innovative lens has the potential to significantly advance various fields, including contact lens technology, intraocular implants for cataracts, and miniaturised imaging systems.

Unlike existing multifocal lenses, the spiral diopter performs exceptionally well under a wide range of lighting conditions and maintains its multifocality regardless of pupil size. This unique characteristic could revolutionise the field of ophthalmology by providing consistently clear vision for individuals, particularly those with age-related farsightedness or needing intraocular implants.

Published in Optica, the journal for high-impact research by Optica Publishing Group, the research team unveils the innovative design of the spiral diopter. Its spiralling features create multiple points of focus, akin to having multiple lenses in one. This design offers wearers the ability to see clearly at various distances, presenting a versatile solution for vision correction across different visual tasks and environments. The novelty of this design is sure to pique the interest of the scientific community.

The inspiration behind the spiral lens design originated from analysing severe corneal deformations in patients, leading to the conceptualisation of a lens with a unique spiral design. This design induces a phenomenon known as an optical vortex, where light spins like water going down a drain, creating multiple clear focus points. Integrating these elements directly into the lens’s surface simplifies the creation of optical vortices, marking a significant advancement in optics.

By combining an intuitively crafted design with advanced fabrication techniques, the researchers have harnessed the potential of the spiral diopter. Validation studies using the lens to image a digital ‘E’ demonstrated satisfactory image quality regardless of aperture size. Volunteers reported noticeable improvements in visual acuity across various distances and lighting conditions. The researchers are now poised to conduct systematic trials to comprehensively establish the lens’s real-world performance and advantages in correcting vision. Moreover, they are exploring the potential application of the concept to prescription eyeglasses, promising clear vision across multiple distances for users. This breakthrough technology enhances depth perception in changing lighting conditions. It holds promise for advancing compact imaging technologies, wearable devices, and remote sensing systems for drones or self-driving cars, contributing to their reliability and efficiency. The potential of the spiral diopter lens is vast, sparking excitement for its future applications.

More information: Laurent Galinier et al, Spiral diopter: freeform lenses with enhanced multifocal behavior, Optica. DOI: 10.1364/OPTICA.507066

Journal information: Optica

New research reveals that ageing adults have withdrawn from civic life since the onset of the pandemic

Several years after the United States started to gradually recover from the enforced COVID-19 lockdowns, new findings from the University of Colorado Boulder indicate that a significant number of older adults continue to spend more time at home and less time engaging socially in public areas compared to their pre-pandemic habits. This research highlights that over half of the older adult population still avoids the social scene, driven by fears of infection and a social atmosphere they find increasingly uncomfortable and hostile.

Jessica Finlay, an assistant professor of geography, shared insights from her recent research through a series of papers. She pointed out that for many, the pandemic still significantly impacts their lives. “The pandemic is not over for a lot of folks,” she remarked, acknowledging that some individuals feel neglected in the current recovery phase.

This study is particularly relevant in the context of what the U.S. Surgeon General has described as an ‘epidemic of loneliness,’ with older adults, especially those who are immunocompromised or have disabilities, being acutely vulnerable. Finlay elaborated on how the pandemic has profoundly transformed ageing Americans’ community dynamics and daily routines, posing long-lasting effects on their physical, mental, social, and cognitive well-being.

As a health geographer and environmental gerontologist, Finlay is particularly interested in how social and physical environments influence health outcomes as people age. Her curiosity about the long-term effects of the pandemic was piqued in March 2020 when restaurants, gyms, grocery stores, and other communal spaces were suddenly closed under shelter-in-place directives. This prompted her to initiate the COVID-19 Coping Study in collaboration with Lindsay Kobayashi, an epidemiologist at the University of Michigan. Their ongoing study began with a baseline survey followed by monthly updates, gathering responses from nearly 7,000 individuals aged 55 and over across the United States.

The research has been particularly attentive to the evolving social landscape, surveying participants at critical moments, including shortly after the murder of George Floyd in May 2020 and following the attack on the U.S. Capitol in January 2021. The findings collectively depict a concerning scenario where a large segment of the older population remains isolated while the rest of society moves forward.

Results from one of the papers published in February in the journal Wellbeing, Space and Society show that 60% of respondents now spend more time at home, 75% dine out less frequently, and over half report decreased attendance at cultural, artistic, and religious gatherings compared to their life before the pandemic. Despite the survey being two years old, more recent data from spring 2023 continues to reflect similar trends, indicating persistent changes in these individuals’ social and entertainment routines.

Another study, “I just can’t go back,” reveals that 80% of participants hesitate to revisit certain public places. The research presents personal accounts, like that of a 72-year-old man who cannot envision returning to a gym, highlighting the deep-seated apprehensions about public gatherings in enclosed spaces.

Respondents who still venture into public places like grocery stores do so with minimal interaction, quickly moving in and out to avoid prolonged contact. This shift in behaviour is a stark departure from the pre-pandemic norms, where casual conversations were commonplace. Many participants expressed concerns about contracting or transmitting the virus to vulnerable family members, and the social stigma associated with mask-wearing and social distancing only reinforces their reluctance to engage publicly.

However, it’s not all grim. Finlay points out some positive shifts, such as a 10% increase in older adults exercising outdoors more frequently and a small subset who have embraced the digital expansion of meetings, concerts, and classes. Yet, she remains concerned about the broader health implications of reduced spontaneous social interactions, often called ‘third places’ in sociological terms. The absence of these interactions, she warns, can heighten the risk of premature death, mental illness, and dementia, comparable to the health risks of smoking 15 cigarettes a day.

Finlay advocates for societal adaptations that could reintegrate older adults into public life, suggesting enhancements like outdoor dining, ventilated cultural spaces, and accommodations for masked or hybrid events. She also calls for a more understanding approach towards those who continue to practice caution in their social interactions, emphasizing that for many, overcoming the pandemic is not merely a matter of choice but a complex challenge shaped by various personal factors. Her work aims to foster a more inclusive environment that acknowledges and addresses these continued disparities in the post-pandemic landscape.

More information: Jessica Finlay et al, Altered place engagement since COVID-19: A multi-method study of community participation and health among older americans, Wellbeing Space and Society. DOI: 10.1016/j.wss.2024.100184

Journal information: Wellbeing Space and Society Provided by University of Colorado Boulder

Researchers demonstrate the impact of insomnia and depression on asthma management

Researchers from National Jewish Health have illuminated the adverse effects of underlying mood and sleep disorders on asthma control. Data unveiled a significant interplay between insomnia, depression, and obstructive sleep apnea in individuals managing asthma. Recently published in the Journal of Asthma, this study sheds crucial light on the intricate relationship between these conditions.

Dr. Michael Wechsler, a pulmonologist, Professor of Medicine, and Director of The Cohen Family Asthma Institute at National Jewish Health, and the paper’s senior author, emphasized the importance of collectively considering asthma control, sleep quality, and mood. He highlighted the strong correlation among these factors, stating that individuals with asthma should undergo regular screening for both sleep quality and co-existing mood disorders.

In their investigation, researchers conducted a retrospective chart review of 659 adult patients participating in a long-term study at National Jewish Health. The evaluation of asthma patients encompassed factors such as concurrent obstructive sleep disorder, mood disorders, frequency of asthma exacerbations, and asthma control test scores (ACT). The findings underscored a notable increase in mood disorders among asthma patients experiencing insomnia compared to those without sleep disturbances.

The association between poor sleep quality and asthma, especially in those with inadequate asthma control, is well-established. Moreover, insomnia frequently overlaps with depression. While previous research has explored the link between sleep issues and asthma management, the interaction between these conditions and mood disorders has not been extensively examined.

Upon scrutinizing the data, researchers observed that individuals with insomnia were more likely to receive concurrent diagnoses of obstructive sleep apnea, depression, or anxiety compared to those without sleep disturbances. Moreover, among patients with insomnia, there was a higher average frequency of asthma exacerbations per year compared to those without insomnia.

Dr. Wechsler underscored the importance of addressing asthma comorbidities, such as sleep and mood disorders, akin to other conditions impacting asthma management, including reflux, sinus disease, and vocal cord dysfunction.

Further research is imperative to elucidate the mechanisms underlying the intricate interactions between asthma, sleep, and depression. Such understanding may pave the way for developing guidelines for screening and managing sleep and mental health disorders in individuals with asthma.

More information: Sarah L. Rhoads et al, The impact of insomnia and depression on asthma control, Journal of Asthma. DOI: 10.1080/02770903.2024.2335367

Journal information: Journal of Asthma Provided by National Jewish Health

Scientists identify skin biomarkers in infants that forecast the early onset of food allergies

Food allergies are prevalent during childhood and pose severe or even life-threatening risks. Researchers at National Jewish Health are actively developing strategies to prevent these allergies and have made significant strides in identifying early indicators of the condition.

A study recently published online in the March 2024 edition of the Journal of Allergy & Clinical Immunology revealed groundbreaking findings from skin tape strips collected from the forearms of two-month-old infants, an age before any observable signs of food allergies. The researchers at National Jewish Health pioneered this non-invasive and gentle skin tape sampling technique specifically for young patients. The process involves applying tape to the skin to collect superficial proteins and lipids, which are then analysed to examine the constituents of the skin. Following the initial testing, the children were closely monitored until age two to determine if any allergies would manifest.

Dr. Evgeny Berdyshev, a distinguished researcher at National Jewish Health and the first author of the study, provided insightful explanations. He stated, “The immune system’s interaction with the skin barrier alters its composition. With our gentle skin tapes, we can detect whether the proteins on the surface are abnormal.” He further noted that the presence of abnormal lipids and proteins is an early indicator of potential future conditions such as atopic dermatitis and food allergies.

Dr. Donald Leung, the head of the Division of Pediatric Allergy & Immunology in the Department of Pediatrics at National Jewish Health and senior author of the study, highlighted the broader aims of the research. “Our goal is to identify individuals at risk of developing food allergies and intervene early by addressing abnormalities in the skin barrier, thus preventing these conditions,” he said.

Dr. Leung, the head of the Division of Pediatric Allergy & Immunology in the Department of Pediatrics at National Jewish Health and senior author of the study, shared insights on the ongoing efforts. He stated, “This study marks just the beginning. We have now identified a biomarker for atopic dermatitis and food allergies, characterised by abnormal lipids, microbes, and proteins. Our current trials involve administering a lipid cream to newborns to see if it can correct these abnormalities by penetrating and enriching the skin with fatty acids.” The researchers are also developing an anti-inflammatory cream based on their findings.

National Jewish Health is recruiting. It is one of four global sites participating in the study known as SEAL—an acronym for ‘Stop Eczema and Allergy.’ The study is looking for expectant mothers and babies aged between 0 and 12 weeks to participate in this pivotal research.

More information: Evgeny Berdyshev et al, Skin biomarkers predict the development of food allergy in early life, Journal of Allergy and Clinical Immunology. DOI: 10.1016/j.jaci.2024.02.014

Journal information: Journal of Allergy and Clinical Immunology Provided by National Jewish Health