App That Listens to Coughing Developed to Tell if People Have COVID-19

If this app works effectively, it will be very important in allowing people to group up more freely again.

As millions of people worldwide battle the symptoms of COVID-19, a group of “silent patients” may not even know they’re sick and spreading the virus. Asymptomatic people, by definition, have no physical symptoms of the illnesses they carry.

Researchers at the Massachusetts Institute of Technology (MIT) however, say they may be showing symptoms after all — in the sound of their cough. Their study has created an artificial intelligence program that can identify if someone has coronavirus by the way their coughing sounds. Researchers programmed their AI model with thousands of different recorded coughs from both healthy and sick volunteers. When they fed in recordings of new patients, the system accurately detected 98.5 percent of coughs coming from people with a confirmed case of COVID-19. AI also successfully picked out 100 percent of asymptomatic cases from volunteers who reported not having any symptoms but tested positive for the virus.

The team is now working on turning their model into a user-friendly app. If approved by the Food and Drug Administration, the app would give people a non-invasive and quick way to screen themselves during the pandemic daily.

“The effective implementation of this group diagnostic tool could diminish the spread of the pandemic if everyone uses it before going to a classroom, a factory, or a restaurant,” says co-author Brian Subirana in a university release.

The MIT team notes researchers have been working on audio-based medical screenings since before the coronavirus emergency began. Their group in particular originally created this AI model to screen for Alzheimer’s disease.

Although the degenerative neurological condition is mostly associated with memory loss, it also affects the muscles and vocal cords. With this knowledge, researchers trained a general machine-learning algorithm called ResNet50 to detect changes in vocal cord strength. Subirana taught the neural network using an audiobook collection with over 1,000 hours of speech files. The AI model could eventually tell the difference between similar worlds like “them” and “the” or “then.”

The system can also read the emotions of the speaker based on the tone of their voice. The team says this is a key in Alzheimer’s detection because patients tend to display more frustration when they try to get words out. The program learned to assess these moods and put them into categories including neutral, calm, happy, and sad.

Finally, the team turned to coughing. Using recordings of patients coughing, the AI model could analyze the lung and respiratory performance of the cougher. An algorithm to detect muscular degradation was also added to help AI distinguish strong coughs from weaker ones.

With all of this data, study authors discovered that the technology could effectively screen for Alzheimer’s based on a patient’s vocal cord strength, sentiment, lung performance, and muscular degradation.

Once the pandemic began, the team at MIT changed gears and started looking at their model to see if it could detect COVID. Researchers say there is growing evidence coronavirus patients also suffer from neurological symptoms and temporary muscular impairment.

“The sounds of talking and coughing are both influenced by the vocal cords and surrounding organs. This means that when you talk, part of your talking is like coughing, and vice versa. It also means that things we easily derive from fluent speech, AI can pick up simply from coughs, including things like the person’s gender, mother tongue, or even emotional state. There’s in fact sentiment embedded in how you cough,” Subirana explains. “So we thought, why don’t we try these Alzheimer’s biomarkers [to see if they’re relevant] for COVID.”

The team created a website to collect audio samples from volunteers, including many with coronavirus. From nearly 200,000 forced-cough audio samples, the group was able to find 2,500 recordings that came from confirmed COVID-19 patients. Many of these patients were also asymptomatic. After adding more random samples to act as a control, the team chose 4,000 coughing samples to train their AI model to screen for the virus.

Along with amazing accuracy in detecting coronavirus patients, researchers say the tests reveal “a striking similarity between Alzheimer’s and COVID discrimination.” They add that the same four biomarkers for detecting Alzheimer’s effectively screen out the virus as well.

“We think this shows that the way you produce sound, changes when you have Covid, even if you’re asymptomatic,” the research scientist in MIT’s Auto-ID Laboratory adds.

Subirana and his team stress that their AI system is not meant to diagnose what illness you may have; whether it be the flu, asthma, or COVID-19. The tool, instead, works by screening out who is healthy from who is asymptomatic but carrying an illness.

The MIT team is now partnering with several hospitals to collect more coughing samples to refine the system’s accuracy. Their hope is to introduce a free pre-screening app to the public which can cut down on clinical testing delays.

“Pandemics could be a thing of the past if pre-screening tools are always on in the background and constantly improved,” the study authors contend.

The study appears in the IEEE Journal of Engineering in Medicine and Biology.

Will Trump Win Again?

American president Donald Trump will not be victorious in the popular vote — that is certain. He will probably lose the popular vote by an even higher margin than what Hillary Clinton beat him with in 2016. That said, the Electoral College is what determines presidential outcomes, and there are factors that may allow Trump to win the Electoral College again.

A poll credited with predicting Trump’s Electoral College win in 2016 — the IBD/TIPP Poll — shows Trump with a 0.7 point lead among Hispanics and a 3 point lead in the Midwest. The Midwest is particularly important to win due to having swing states such as Michigan, Ohio, Wisconsin, and Pennsylvania. Most polls show that Trump has maintained a multiple percentage point lead in the state of Ohio, a state that seems to have largely been neglected by the national media outlets based in coastal areas such as California and New York. (The people working for those coastal media outlets have been increasingly seen as out of touch with the realities of wage stagnation, drug epidemics, and deindustrialization that has taken place place in much of America.) Whoever wins Ohio has won the presidency every year since 1964 — a record of over half a century that makes it stand out even among the other swing states.

Much of my own family supports Trump, something that continues to disturb and disappoint me in 2020. That being said, something people don’t always realize is that much of the population is struggling to an absurd degree in what has long been world history’s wealthiest nation. A CNBC article from before the pandemic found that 78 percent of people were living paycheck to paycheck, a number that can only have grown worse with what is essentially now an economic depression during the pandemic. Many people are therefore too stressed and too busy to consistently study politics effectively, and the American formal education overall does a terrible job at giving people a decent political education. It doesn’t help that there is so much disinformation now that it takes a fair amount of intelligence to see through it, and too many people in America have suffered cognitive problems for reasons such as growing up in extreme poverty, being subjected to abuse generated in their family members by America’s flawed society, and even — as seen in Flint, Michigan — drinking lead in their water supply. The Flynn Effect is a phenomenon recounting how average IQ scores have gone up as factors such as nutrition have improved. It’s been apparent for all of us since our days in school that high general intelligence is somewhat rare, but many people are not as smart as they would otherwise be growing up in healthier environments. Since democracy is about making choices based on information, democracy suffers when the general capacity of the population to make intelligent decisions is reduced. America would look different if the average IQ was 10 points higher than what it is today.

One of the worst things that Trump has said is encouraging his supporters to vote twice — once by mail and once at the polls. This is encouraging his supporters to commit voter fraud, a felony punishable by up to 5 years in prison. With so many people in my family that support Trump, I have spent a considerable amount of time thinking about and reading the more scientific reasoning about why they support him. One of the reasons is that Trump speaks with short sentences that are easier to understand, at what was once evaluated as a speaking level lower than many other politicians. In association with that, Trump is an accomplished con man, seen through the history of his fraudulent for-profit college and his casino bankruptcies, and he is good at making his supporters feel good. He’s an incredibly charismatic politician — the people who deny this are delusional to what his supporters and many others feel. In getting a bit more anecdotal here, even people who know me and don’t particularly like me (i.e., some people in my family) admit that I am perceptive and by nature feel certain things many others don’t. This doesn’t mean I am a sensitive snowflake — I am not and I hate the amount of our discourse taken up by identity politics rather than focus on people’s material interest. In any case, I always seem to feel when someone is charismatic, no matter how vile that person is. Trump is charismatic. The other main reasons are that Trump is an authoritarian, something much of the population identifies with, and — my biggest takeaway from seeing so much of my family support Trump — is that support of Trump is something for people to come together on. American society has become broken, divisive, run-down, and incredibly politically polarized for much of the population, and support of Trump presents an opportunity for what is arguably one of the few ways for Trump supporters to have meaningful positive interactions with each other. Politics is not like talking about the weather or other small talk subjects — it presents a much greater opportunity than those subjects to have more valuable and fulfilling conversations, even if the people discussing the politics are wrong about what issues to support to benefit the majority of the population. The desire to have these fulfilling social conversations, I posit, is an integral part of human social contact, and one that was increasingly fading in the device-driven world before the pandemic and the term social distancing became a widely used term.

In addressing Trump’s perceived strength, the idea that Trump had a significant positive impact on the economy is a joke. The biggest positive factor on the economy in the last decade was probably the appointment of Janet Yellen and her low interest rate policies at the Federal Reserve, and that allowed the unemployment rate to drop low and it therefore also allowed some of the only minor wage growth for low-wage workers in the last 50 years. To his credit, Trump appointed Jerome Powell, who largely continued the policies of Janet Yellen by not raising interest rates and thus allowing the unemployment rate to remain low before the pandemic hit. Trump also refused to go along with the terrible Trans-Pacific Partnership trade agreement, and the tax cuts mainly for the wealthy and corporations that he pressed for did have a slight boost in demand for the economy. If Trump had done well on other major economic things I would give him credit for them, and it’s clear from these points that he did some decent things for the economy while in office. The decent things he did for the economy are heavily outweighed by the flaws of his governing, such as his illogical trade war and his failure on managing the pandemic. The result of his impact on the economy is a net negative effect, one that may prove to be far more net negative later on as the impacts of those policies are felt for years, but many left-wingers don’t admit the very few things he did that were decent. I consider Trump the worst president by far in modern history, but I consider it important to tell the truth about matters such as these and give credit where it’s due. Trump is stunningly ignorant of most important political issues, and he doesn’t talk about it anymore like he did in 2016, but he does seem to understand that trade deficits in America are bad, and that’s part of why in 2016 he won over so many Rust Belt workers who have been screwed by trade policy. The trade deficit increased under Trump however, despite his having the ability to decrease it through policy, and this was before the pandemic. The reason that trade deficits for the U.S. are bad is that it decreases demand in the economy, and we generally have needed more demand to help workers in the last 50 years. On another note, I read an article by a former Republican governor endorsing Joe Biden, and I read it looking for positive things he had to say about Trump. Essentially the most he said that was good about Trump are some regulatory changes. That was all. In conducting surveys of Americans, I would venture a guess that few are fond of the deregulations that allow more coal debris and pollutants to be deposited in streams near residential water supplies and the deregulation that allows imported meat to claim to be made in America. It is rather incredible that so many continue to support Trump despite him not enacting policies that benefit their material interest. The vast majority of the Trump tax cuts go to the richest people in America, not middle-income or low-wage workers. Trump blocked the Post Office from sending out masks to hundreds of millions of Americans because he “didn’t want to create a panic.” There is audio of Trump with Bob Woodward where Trump back in February acknowledges that COVID-19 is far more deadly than the flu, but then he lies to the public in trying to downplay its severity and holds mass gatherings of people close together where many of them don’t wear masks. Trump’s campaign recently had an event in Nebraska where people caught hypothermia and were left out in the cold due to a lack of transportation provided by the campaign. I scanned social media when this happened and I didn’t find any defense of this from the Trump supporters. Trump is a con man that has successfully deceived millions of people, and that includes many things such as his lies about the pandemic, his lies about stopping the wars overseas and his lies about bringing many manufacturing jobs back. If American society was a more rational place, the CNBC program American Greed that focuses on corporate crime would have had an episode on Trump where they focus on his immoral business dealings and damage to much of the population. There’s a long list of how Trump has negatively impacted the public, but I chose to focus more on the economic conditions since that’s more concrete than focus on controversial issues such as abortion and religion.

All of this said, even as a president with an awful track record, Trump may still win the Electoral College. It looks unlikely by polling and the history of presidents losing when they in power during awful economic conditions, but there are variables present in this pandemic election year that normally haven’t been present in past elections. One is that many more Democrats than Republicans will vote by mail, and a considerable percentage of these mail-in ballots won’t be counted. This isn’t a conspiratorial claim — it’s the state of the voter suppression in American politics. In the 2016 election, Greg Palast — author of the book titled “How Trump Won 2020” — found that 141,000 ballots were thrown out after a challenge due to their signatures. He found that there weren’t any voters arrested for forgery because of this. Additionally, Palast said recently that “Once a year, secretaries of state can literally wipe off the voter rolls those voters they think shouldn’t vote. And not surprisingly, these hacks tend to remove people of color where they can, where Republicans control the state. So for example, in Georgia, as you just heard, the Secretary of State [Raffensperger] removed 198,000 voters illegally on false information. Almost all of them [were] black voters, young voters, including Martin Luther King’s 92-year-old cousin.” Palast also said that “In 2016, 5.8 million ballots were cast and never counted. By the way, that’s an official number from the EAC [Election Assistance Commission], from our federal agency; 5.8 million votes cast not counted.” Most disturbingly, Palast mentioned the study finding that “According to MIT [Massachusetts Institute of Technology], 22%, [i.e.,] one in 5 million mail-in ballots, is never counted.”

If 22 percent of mail-in ballots aren’t counted in 2020, that combined with the voter suppression of other people likely to vote for Joe Biden may hand Trump another Electoral College victory. Again, there is a far higher percentage of Republicans going to the polls to vote for Trump than there is Democrats going to the polls to vote for Biden, and this may culminate in not only Trump eventually winning the Electoral College yet again but it may make Trump have an overall lead today on election day before more mail-in ballots are counted. This may then devolve into a scenario where the contested election is taken to the 6-3 conservative majority on the Supreme Court, where the results of the election that are not favorable to Trump may be thrown out.

America will suffer further harm from another four years of Trump. I dislike Biden and consider him to be a politician with a long record of terrible policies, but after years of Trump, it’s apparent that another four years of Trump will continue to have the sort of vast consequences and immense damage seen during the pandemic. In any case, with either person winning the presidency, I would encourage people to try to make the most of what they have even if it’s not that good. A year from now may be an even worse time than today, and now is already bad for so many of us. That’s just the realistic view of things. Exercise and a healthy diet (including plenty of vitamin D to protect against COVID-19 problems) will help us stay strong, and staying strong will remain important when life is tough.

Honey Has Been Shown to Treat Upper Respiratory Infections Better Than Traditional Remedies

Honey is unique in that its a bacteria-killing agent that hasn’t been shown to trigger antibiotic resistance due to how it naturally contains hydrogen peroxide.

A trio of researchers at Oxford University has found that honey is a better treatment for upper respiratory tract infections (URTIs) than traditional remedies. In their paper published in BMJ Evidence-based Medicine, Hibatullah Abuelgasim, Charlotte Albury, and Joseph Lee describe their study of the results of multiple clinical trials that involved testing of treatments for upper respiratory tract infections (URTIs) and what they learned from the data.

Over the past several years, the medical community has grown alarmed as bacteria have developed resistance to antibacterial agents. Some studies have found that over-prescription of such remedies is hastening the pace. Of particular concern are antibacterial prescriptions written for maladies that they are not likely to help, simply due to demands from patients. One such case is often URTIs, the vast majority of which are caused by viruses, not bacteria. Because of such cases, scientists have been looking for other remedies for these infections, and one therapy in particular has begun to stand out: honey.

Anecdotal evidence has suggested that honey can be used to treat colds in general and coughs in particular—people have been using it as a therapy for thousands of years. In this new effort, the researchers looked at the results of multiple clinical trials testing the effectiveness of therapies against URTIs. In all, the team looked at data from 14 clinical trials involving 1,761 patients.

In analyzing the data from all of the trials combined, the researchers found that the trials had included studies of virtually all of the traditional remedies such as over-the-counter cold and sinus medicines as well as antibiotics—and honey. They found that honey proved to be the best therapy among all of those tested. In addition to proving more effective in treating coughing (36 percent better at reducing the amount of coughing and 44 percent better at reducing coughing severity), it also led to a reduction in average duration of infection by two days.

The researchers note that the reason honey works as a treatment for URTIs is because it contains hydrogen peroxide—a known bacteria killer—which also makes it useful as a topical treatment for cuts and scrapes. Honey is also of the right consistency—its thickness works to coat the mouth and throat, soothing irritation.

Hangover Cure Found by Finland Researchers

This seems to be the most legitimate research done on a compound (amino acid L-cysteine) that will remove symptoms of an alcohol-induced hangover. The consumption of alcohol weakens the immune system and therefore might be something people might not want to have during a global pandemic, but if people do choose to consume alcohol, L-cysteine is relatively cheap to buy and (unlike many other remedies) has clinical data to support its efficacy.

Hangover Cure Successfully Tested on Drunk Subjects in Finland

A dose of 1,200 milligrams of amino acid L-cysteine was found to reduce alcohol-related nausea and headache, while a dose of 600 milligrams helped alleviate stress and anxiety, according to a study published in the journal Alcohol and Alcoholism by researchers at the University of Helsinki and the University of Eastern Finland.

The randomized, double-blind study had 19 healthy male volunteers consuming alcohol doses of 1.5 grams per kilogram over three hours in a controlled setting. The subjects were then asked to swallow placebo or L-cysteine tablets containing vitamin supplements.

Researchers say that as well as reducing or even eliminating hangovers entirely, L-cysteine also helps “reduce the need of drinking the next day,” thereby cutting the risk of alcohol addiction.

Binge drinking is common in Finland, with more than half a million Finns considered at risk from excessive drinking.

The researchers received funding from Catapult Cat Oy, which sells the L-cysteine supplements.

The study ran into certain difficulties. Some participants weren’t able to consume all the alcohol required and had to be excluded, some had such high tolerance levels that they experienced no hangover symptoms; and some were sidelined because they insisted on topping up the dose by heading for the bar, researcher Markus Metsala told local media.

Study: Honeybee Venom Contains a Chemical (Melittin) That Kills Breast Cancer Cells

A very real study out of Australia’s Harry Perkins Institute of Medical Research once again confirms that there are ways animal venom is applicable for medicine. This finding about honeybee venom is obviously significant since breast cancer is the most common cancer among women.

A groundbreaking discovery in Australia is giving new meaning to the term natural remedy. Using hundreds of honeybees, a new study reveals the venom in these insects’ stingers quickly kills breast cancer cells.

Dr. Ciara Duffy says honeybee venom destroys multiple types of breast cancer, even the hard to treat triple-negative variety. Her study in the journal npj Precision Oncology finds the venom not only eradicates these cancers, it also breaks up a cancerous cell’s ability to reproduce. It also contains a compound called melittin which researchers say helps this natural remedy stop the disease with remarkable speed.

“The venom was extremely potent,” the researcher from the Harry Perkins Institute of Medical Research says in a media release. “We found that melittin can completely destroy cancer cell membranes within 60 minutes.”

In just 20 minutes, melittin breaks down the chemical messages breast cancer cells transmits to trigger both cell growth and cell division. The compound suppresses the receptors that commonly overexpress themselves in triple-negative breast cancer and HER2-enriched breast cancer.

Venom was also tested against hormone receptor positive breast cancer cells and normal breast cells. With a specifically concentrated dose of the venom, researchers are able to kill 100 percent of cancer cells. At the same time, the study finds bee venom does little harm to normal cells.

“This study demonstrates how melittin interferes with signaling pathways within breast cancer cells to reduce cell replication. It provides another wonderful example of where compounds in nature can be used to treat human diseases,” Professor Peter Klinkenhe from the University of Western Australia says.

Do all bees carry this special venom?

Although there are around 20,000 different species of bees, the study finds not every insect can fight cancer. Dr. Duffy’s tests on 312 honeybees and bumblebees from Perth, Western Australia reveal bumblebee venom does not induce cancer cell death. Honeybees from other regions however, share this special ability to rapidly stop the disease.

“I found that the European honeybee in Australia, Ireland and England produced almost identical effects in breast cancer compared to normal cells,” Duffy reports.

Researchers add Perth bees are some of the healthiest members of their species. While the study dissects live bee stingers to extract melittin, it finds this compound can be successfully reproduced in labs.

“The synthetic product mirrored the majority of the anti-cancer effects of honeybee venom,” the Australian scientist adds.

Adding honeybee venom to chemotherapy treatments

Study authors say melittin can also help current cancer treatments like chemotherapy. The report discovers melittin also forms numerous pores (tiny holes) in the breast cancer cell membrane. Duffy suspects other cancer drugs may be able to use these openings to penetrate the cells and kill the disease.

“We found that melittin can be used with small molecules or chemotherapies, such as docetaxel, to treat highly-aggressive types of breast cancer. The combination of melittin and docetaxel was extremely efficient in reducing tumor growth in mice.”

Using bee venom as a medical remedy has been studied since the 1950’s, but Duffy’s team says it’s only been considered as treatment for cancer during the last two decades. More research needs to be done to find out what kind of a dose human patients will require.

Scientist’s Plasma Shot That Could Prevent COVID-19 Isn’t Being Considered by The Government

That the use of plasma (shown effective in many other cases) isn’t being considered is another inefficiency by the (U.S. at least) governmental response to the coronavirus pandemic.

It might be the next best thing to a coronavirus vaccine.

Scientists have devised a way to use the antibody-rich blood plasma of COVID-19 survivors for an upper-arm injection that they say could inoculate people against the virus for months.

Using technology that’s been proven effective in preventing other diseases such as hepatitis A, the injections would be administered to high-risk healthcare workers, nursing home patients, or even at public drive-through sites — potentially protecting millions of lives, the doctors and other experts say.

The two scientists who spearheaded the proposal — an 83-year-old shingles researcher and his counterpart, an HIV gene therapy expert — have garnered widespread support from leading blood and immunology specialists, including those at the center of the nation’s COVID-19 plasma research.

But the idea exists only on paper. Federal officials have twice rejected requests to discuss the proposal, and pharmaceutical companies — even acknowledging the likely efficacy of the plan — have declined to design or manufacture the shots, according to a Times investigation. The lack of interest in launching development of immunity shots comes amid heightened scrutiny of the federal government’s sluggish pandemic response.

There is little disagreement that the idea holds promise; the dispute is over the timing. Federal health officials and industry groups say the development of plasma-based therapies should focus on treating people who are already sick, not on preventing infections in those who are still healthy.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said an upper-arm injection that would function like a vaccine “is a very attractive concept.”

However, he said, scientists should first demonstrate that the coronavirus antibodies that are currently delivered to patients intravenously in hospital wards across the country actually work. “Once you show the efficacy, then the obvious next step is to convert it into an intramuscular” shot.

But scientists who question the delay argue that the immunity shots are easy to scale up and should enter clinical trials immediately. They say that until there’s a vaccine, the shots offer the only plausible method for preventing potentially millions of infections at a critical moment in the pandemic.

“Beyond being a lost opportunity, this is a real head-scratcher,” said Dr. Michael Joyner, a Mayo Clinic researcher who leads a program sponsored by the Food and Drug Administration to capitalize on coronavirus antibodies from COVID-19 survivors. “It seems obvious.”

The use of so-called convalescent plasma has already become widespread. More than 28,000 patients have already received the IV treatment, and preliminary data suggest that the method is safe. Researchers are also looking at whether the IV drip products would prevent new infections from taking root.

The antibodies in plasma can be concentrated and delivered to patients through a type of drug called immune globulin, or IG, which can be given through either an IV drip or a shot. IG shots have for decades been used to prevent an array of diseases; the IG shot that prevents hepatitis A was first licensed in 1944. They are available to treat patients who have recently been exposed to hepatitis B, tetanus, varicella and rabies.

[…]

The proposal for an injection approach to coronavirus prevention came from an immunization researcher who drew his inspiration from history.

Dr. Michael Oxman knew that, even during the 1918 flu pandemic, the blood of recovered patients appeared to help treat others. Since then, convalescent plasma has been used to fight measles and severe acute respiratory syndrome, or SARS, among other diseases.

Like other doctors, Oxman surmised that, for a limited time, the blood coursing through the veins of coronavirus survivors probably contains immune-rich antibodies that could prevent — or help treat — an infection.

[…]

Throughout May, researchers and doctors at Yale, Harvard, Johns Hopkins, Duke and four University of California schools sent a barrage of letters to dozens of lawmakers. They held virtual meetings with health policy directors on Capitol Hill, but say they have heard no follow-up to date.

Dr. Arturo Casadevall, the chair of the National COVID-19 Convalescent Plasma Project, said he spoke to FDA officials who told him they do not instruct companies on what to produce. Casadevall told The Times that the leaders of the national project were “very supportive of the need to develop” an IG shot rapidly and that he believed it would be “very helpful in stemming the epidemic.”

Joyner, of the Mayo Clinic, said there are probably 10 million to 20 million people in the U.S. carrying coronavirus antibodies — and the number keeps climbing. If just 2% of them were to donate a standard 800 milliliters of plasma on three separate occasions, their plasma alone could generate millions of IG shots for high-risk Americans.

“At a hot-spot meatpacking plant, or at a mobile unit in the parking lot outside a mall — trust me, you can get the plasma,” Joyner said. “This is not a biological problem nor a technology problem. It’s a back-of-the-envelope intelligence problem.”

The antibody injections, for now, do not appear to be a high priority for the government or the industry.

Grifols, on April 28 — the same day that the U.S. topped 1 million confirmed coronavirus cases — made a major product announcement that would “expand its leadership in disease treatment with immunoglobulins.”

The product was a new vial for IG shots — to treat rabies.

How Air Pollution Can Harm Brain Health

It has long been rather stunning to me how careless many people are about air pollution. One of the most important things that people shouldn’t do is drive with their windows down in areas with significant traffic (and thus significant amounts of air pollution from vehicles). The motive for caring is rather simple — air pollution’s negative impact on brain health means possibly reduced performance on a variety of tasks, and that can negatively correlate with achieving life goals, which in turn is detrimental to human happiness and satisfaction.

Long thought to primarily harm the lungs and cardiovascular system, air pollution is now catching the attention of neuroscientists and toxicologists.

The buzz of a leaf blower and its gaseous fumes fill the air outside a lab facility at the University of Washington in Seattle. Inside the building, neurotoxicologist Lucio Costa is investigating how polluted air—such as garden tool exhaust—could be bad for the brain.

Next to the building sits a 5,500-watt diesel generator, enclosed in a metal box. Pipes carry the diesel exhaust—the same stuff emitted by diesel engines in vehicles and heavy equipment—into the facility, across an exposed ceiling and into a room where plastic cages of mice are stacked high against the wall. Tubes filter the diesel exhaust through the cages, Costa explains, in an effort to mimic the contaminated air you might breathe while sitting in traffic or living near a busy road.

After spending most of his career studying mercury, pesticides, and flame retardants, Costa knows well that many toxins in the environment can hurt the brain. But only in the last several years has the possibility of air pollution as a culprit crossed his mind. A growing body of literature on the topic inspired him to begin research in this diesel lab. “For a long time, I thought that air pollution was affecting mostly the lungs and the cardiovascular system and not the brain,” says Costa. “So I stayed away from any issue related to air pollution.”

Now, mounting evidence seems to link a variety of neurological problems to dirty air. Troubling recent findings include hallmarks of Alzheimer’s disease found in the brains of children living in Mexico City (1) and a nearly doubled risk of dementias for older women in highly polluted parts of the United States (2). Costa’s own research has identified autism-like social and behavioral issues in mice exposed to diesel exhaust (3). Today, Costa is among a growing cadre of biologists, toxicologists, and doctors raising the alarm over this pervasive yet overlooked menace to our memory, attention, and behavior.

A Global Threat

Although the coronavirus disease 2019 (COVID-19) pandemic and associated “shelter in place” policies have reduced fossil fuel use to offer a temporary respite from extreme pollution in some places, most countries face an ongoing epidemic of dirty air as a result of growing urban congestion and an uptick in climate-driven wildfires, among other factors. Indoor air pollution further plagues many of the world’s poorest communities. Around 3 billion people cook indoors over open fires or stoves fueled by wood, biomass, kerosene, or coal. In 2018, the World Health Organization (WHO) identified air pollution as the second-largest risk factor for noncommunicable disease worldwide. And the WHO’s stats don’t include the full range of neurological effects now being discovered, notes neurotoxicologist Deborah Cory-Slechta at the University of Rochester in New York.

Globally, more than 90 percent of people breathe air that fails to meet WHO standards. That includes an estimated four in 10 people in the United States, although efforts such as the US Clean Air Act and its amendments of 1990 have helped. Between 2000 and 2016, the average concentration of particulate matter (PM) with a diameter of less than 2.5 micrometers (PM2.5), tiny particles produced by combustion, fell by around 40 percent in the United States. But the country’s overall air quality has worsened since 2016. Partly to blame is a rise in wildfire smoke, which is now responsible for an estimated 40 percent of particulate matter pollution.

Yet cleaner, healthier air remains achievable, notes Dean Schraufnagel, a pulmonologist at the University of Illinois at Chicago. “There are no death certificates that say air pollution exposure,” he says. “But we know that air pollution affects every organ in the body. If we stop the air pollution at its source, we can get strikingly important health benefits.”

Schraufnagel, also the director of the Forum of International Respiratory Societies, points to one easy target: idling diesel-powered school buses. A 2019 study out of Georgia in the United States found that districts that retrofitted school buses to reduce diesel emissions reported significant increases in students’ English test scores as well as smaller improvements in math (4).

The havoc air pollution can wreak on the brain is also a new area of interest for Schraufnagel, whose research and clinical practice has long focused on lung disease. Today, he is working with international organizations to get air pollution on the minds of not just pulmonologists but also neurologists and other medical experts. “This should be a call to action,” adds Schraufnagel.

Air pollution is a cocktail of suspended gases, solids, and liquid particles. While this mix contains numerous hazardous ingredients, such as ozone, sulfur dioxide, and carbon monoxide, the component that appears most concerning for the brain is PM.

The US Environmental Protection Agency (EPA) regulates PM10 and PM2.5, defined as particles less than 10 and 2.5 micrometers in diameter, respectively. PM2.5, also known as fine particulate matter, generally comes from smoke, dust, and vehicle exhaust. Because PM2.5 is so tiny—30 times smaller than the width of the average human hair—it can remain airborne for long periods of time, infiltrate buildings, and penetrate the body. Ultrafine particles, which measure less than 0.1 micrometer across, may be even worse offenders. Yet the miniscule mass of these particles makes them difficult to monitor. They remain unregulated by the EPA.

Fine and ultrafine particulate matter tends to circumvent the mechanisms that the human body has evolved to deflect, detain, and destroy unwelcome visitors. “The health effects of air pollution are all about particle size,” says Cory-Slechta. Studies suggest that these tiny particles can even go up the nose and be carried straight to the brain via the olfactory nerve (5)—hence bypassing the blood–brain barrier. And they don’t travel alone. On their surfaces these particles carry contaminants, from dioxins and other chemical compounds to metals such as iron and lead. “PM is simply acting as a vector,” says Masashi Kitazawa, a molecular neuropathologist at the University of California, Irvine. “It might be a number of chemicals that get into the brain and act in different ways to cause damage.”

Because of their large surface area relative to their volume, the smallest particles are the biggest offenders. Cory-Slechta’s research has largely focused on lead and mercury, neurotoxic metals that are abundant in air pollution. “Ultrafine particles are like little Trojan horses,” she says. “Pretty much every metal known to humans is on these.”

Metal-toting particles that reach the brain can directly damage neurons. Both the particles themselves and their toxic hitchhikers can also cause widespread harm by dysregulating the activation of microglia, the immune cells in the brain. Microglia may mistake the intruders for pathogens, releasing chemicals to try to kill them. Those chemicals can accumulate and trigger inflammation. And chronic inflammation in the brain has been implicated in neurodegeneration (6).

Particles may also afflict the brain via the bloodstream. Research shows that small particles can slip through the plasma membrane of alveoli—the tiny air sacs in the lungs—and get picked up by capillaries. The particles are then distributed around the body in the blood. Although some of these particles may eventually breach the blood–brain barrier, a pollutant need not enter the brain to cause trouble there. The immune system can react to particles in the lung or bloodstream, too, triggering widespread inflammation that affects the brain.

Even an ingested particle could have indirect neurological effects, via the gut. Researchers now recognize strong connections between the gut microbiome and the brain (7), and studies show that delivering fine particles to the gut can cause systemic inflammation (8).

In January 2010, Cory-Slechta received a surprising request from some University of Rochester environmental medicine colleagues. Typically, the group researched the effects of air pollution on the lungs and hearts of adult animals. But they had just exposed a group of newborn mice and asked Cory-Slechta’s team to look at the brains.

At first she didn’t think much of the request. Cory-Slechta was much more concerned about deadly lead exposure in children, her research focus at the time. “I didn’t think of air pollution as a big problem for the brain,” she says. Then she examined the animals’ tissue. “It was eye-opening. I couldn’t find a brain region that didn’t have some kind of inflammation.”

Her team followed up with their own studies. In addition to inflammation, they saw classic behavioral and biochemical features of autism, attention-deficit disorder, and schizophrenia in mice exposed to pollutants during the first days after birth. The mouse brains had noticeably less white matter, particularly in the corpus callosum connecting the right and left cerebral hemispheres. In work published last November, Cory-Slechta’s group further linked short-term exposures to air pollution with impaired learning and memory in aged mice, based on measures of spontaneous movement, navigation of a maze, short-term object recognition, and the ability to discriminate odors (9). The concentrations of particulate matter used, she notes, “easily include sitting in traffic in major cities.”

[…]

Research in Ontario, Canada, found that living farther away from a major road lowered the risk of developing dementia (13). A study of nearly 3,000 Barcelona schoolchildren found that those attending schools with more traffic pollution had slower cognitive development (14). And in the United States, a study found that living in locations where ambient particulate matter exceeded EPA recommendations nearly doubled women’s risk of developing dementia. When those researchers looked specifically at older women with two copies of the APOE4 gene variant, a strong genetic factor for Alzheimer’s disease, the dementia risk associated with living in those locations jumped almost threefold (2).

Does Vitamin D Help Protect People from COVID-19? Some Evidence Suggests Yes

A comprehensive global study published in 2017 on respiratory infections would say yes:

A new global collaborative study has confirmed that vitamin D supplementation can help protect against acute respiratory infections. The study, a participant data meta-analysis of 25 randomized controlled trials including more than 11,000 participants, has been published online in The BMJ.

“Most people understand that vitamin D is critical for bone and muscle health,” said Carlos Camargo of the Department of Emergency Medicine at Massachusetts General Hospital (MGH), the study’s senior author. “Our analysis has also found that it helps the body fight acute respiratory infection, which is responsible for millions of deaths globally each year.”

Additionally, a professor of respiratory infection and immunity at Queen Mary University of London had this to say about vitamin D:

“Vitamin D could almost be thought of as a designer drug for helping the body to handle viral respiratory infections,” he said. “It boosts the ability of cells to kill and resist viruses and simultaneously dampens down harmful inflammation, which is one of the big problems with Covid.”

The pharmaceutical industry obviously can’t make enormous profits from vitamin D, and that’s part of why it hasn’t been explored more as a protective mechanism. With all the benefits of vitamin D and the lack of downsides to it however, it is worth getting enough vitamin D (through sufficient sunlight exposure and a good diet) to protect against respiratory infections such as the flu and COVID-19.

Widely Available Drug Dexamethasone Shown to Cut Deaths by a Third in Severely Ill COVID-19 Patients

The coronavirus pandemic remains severe, but dexamethasone (a steroid) is a cheap and relatively common drug that has apparently been shown in a rigorous trial to significantly reduce mortality rates in the most severely ill COVID-19 patients. This drug is not a cure and it wasn’t shown to help patients with moderate COVID-19 symptoms, but the drug has been shown to save lives, and that’s important since presumably more people will eventually be able to recover instead of dying to the coronavirus.

An inexpensive and commonly used steroid can save the lives of people seriously ill with COVID-19, a randomized, controlled clinical trial in the United Kingdom has found. The drug, called dexamethasone, is the first shown to reduce deaths from the coronavirus that has killed more than 430,000 people globally. In the trial, it cut deaths by about one-third in patients who were on ventilators because of coronavirus infection.

“It’s a startling result,” says Kenneth Baillie, an intensive-care physician at the University of Edinburgh, UK, who serves on the steering committee of the trial, called RECOVERY. “It will clearly have a massive global impact.” The RECOVERY study announced the findings in a press release on 16 June, but its researchers say that they are aiming to publish their results quickly and that they are sharing their findings with regulators in the United Kingdom and internationally.

The RECOVERY trial, launched in March, is one of the world’s biggest randomized, controlled trials for coronavirus treatments; it is testing a range of potential therapies. The study enrolled 2,100 participants who received dexamethasone at a low or moderate dose of six milligrams per day for ten days, and compared how they fared against about 4,300 people who received standard care for coronavirus infection.

The effect of dexamethasone was most striking among critically ill patients on ventilators. Those who were receiving oxygen therapy but were not on ventilators also saw improvement: their risk of dying was reduced by 20%. The steroid had no effect on people with mild cases of COVID-19 — those not receiving oxygen or ventilation.

Shortly after the results were released, the UK government announced that it had immediately authorized use of dexamethasone for patients hospitalized with COVID-19 who required oxygen, including those on ventilators.

Rigorous study

“It is a major breakthrough,” says Peter Horby, an infectious-disease specialist at the University of Oxford, UK, and a chief investigator on the trial. Use of steroids to treat viral respiratory infections such as COVID-19 has been controversial, Horby notes. Data from steroid trials during outbreaks of SARS (severe acute respiratory syndrome) and Middle East respiratory syndrome caused by related coronaviruses were inconclusive, he says. Nevertheless, given dexamethasone’s widespread availability, and some promising results from steroid studies in previous outbreaks, Horby says RECOVERY investigators felt it important to test the treatment in a rigorous clinical trial.

Treatment guidelines from the World Health Organization and many countries have cautioned against treating people with coronavirus with steroids, and some investigators were concerned about anecdotal reports of widespread steroid treatment. The drugs suppress the immune system, which could provide some relief from patients whose lungs are ravaged by an over-active immune response that sometimes manifests in severe cases of COVID-19. But such patients may still need a fully functioning immune system to fend off the virus itself.

The RECOVERY trial suggests that at the doses tested, the benefits of steroid treatment may outweigh the potential harm. The study found no outstanding adverse events from the treatment, investigators said. “This treatment can be given to pretty much anyone,” says Horby.

And the pattern of response — with a greater impact on severe COVID-19 and no effect on mild infections — matches the notion that a hyperactive immune response is more likely to be harmful in long-term, serious infections, says Anthony Fauci, head of the US National Institute of Allergy and Infectious Disease. “When you’re so far advanced that you’re on a ventilator, it’s usually that you have an aberrant or hyperactive inflammatory response that contributes as much to the morbidity and mortality as any direct viral effect.”

“Finding effective treatments like this will transform the impact of the COVID-19 pandemic on lives and economies across the world,” said Nick Cammack, head of the COVID-19 Therapeutics Accelerator at Wellcome, a UK biomedical research charity in London, in a statement. “While this study suggests dexamethasone only benefits severe cases, countless lives will be saved globally.”

Easy to administer

So far, the only drug shown to benefit COVID-19 patients in a large, randomized, controlled clinical trial is the antiviral drug remdesivir. Although remdesivir1 was shown to shorten the amount of time that patients may need to spend in the hospital, it did not have a statistically significant effect on deaths.

Remdesivir is also in short supply. Although the drug’s maker — Gilead Sciences of Foster City, California — has taken steps to ramp up production of remdesivir, it is currently available only to a limited number of hospitals around the world. And remdesivir is complex to administer: it must be given by injection over the course of several days.

Dexamethasone, by contrast, is a medical staple found on pharmaceutical shelves worldwide and is available as a pill — a particular benefit as coronavirus infections continue to rise in countries with limited access to healthcare. “For less than £50, you can treat 8 patients and save one life,” said Martin Landray, an epidemiologist at the University of Oxford, and another chief investigator on the RECOVERY trial.

The findings could also have implications for other severe respiratory illnesses, Baillie adds. For example, steroid treatments for a condition called acute respiratory distress syndrome are also controversial. “This really gives us a very good reason to look closely at that, because the mortality benefit is so extraordinarily large,” Baillie says. “I think this will affect patients well beyond COVID-19.”

Low Vitamin D Levels Associated With Higher Coronavirus Mortality Rates

Patients with severe vitamin D deficiencies have been found in research to experience more coronavirus-related complications. Exposure to 20 or 30 minutes of sunlight a day and a healthy diet are good ways to keep high vitamin D levels.

After studying global data from the novel coronavirus (COVID-19) pandemic, researchers have discovered a strong correlation between severe vitamin D deficiency and mortality rates.

Led by Northwestern University, the research team conducted a statistical analysis of data from hospitals and clinics across China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States.

The researchers noted that patients from countries with high COVID-19 mortality rates, such as Italy, Spain and the UK, had lower levels of vitamin D compared to patients in countries that were not as severely affected.

This does not mean that everyone — especially those without a known deficiency — needs to start hoarding supplements, the researchers caution.

“While I think it is important for people to know that vitamin D deficiency might play a role in mortality, we don’t need to push vitamin D on everybody,” said Northwestern’s Vadim Backman, who led the research. “This needs further study, and I hope our work will stimulate interest in this area. The data also may illuminate the mechanism of mortality, which, if proven, could lead to new therapeutic targets.”

The research is available on medRxiv, a preprint server for health sciences.

Backman is the Walter Dill Scott Professor of Biomedical Engineering at Northwestern’s McCormick School of Engineering. Ali Daneshkhah, a postdoctoral research associate in Backman’s laboratory, is the paper’s first author.

Backman and his team were inspired to examine vitamin D levels after noticing unexplained differences in COVID-19 mortality rates from country to country. Some people hypothesized that differences in healthcare quality, age distributions in population, testing rates or different strains of the coronavirus might be responsible. But Backman remained skeptical.

“None of these factors appears to play a significant role,” Backman said. “The healthcare system in northern Italy is one of the best in the world. Differences in mortality exist even if one looks across the same age group. And, while the restrictions on testing do indeed vary, the disparities in mortality still exist even when we looked at countries or populations for which similar testing rates apply.

“Instead, we saw a significant correlation with vitamin D deficiency,” he said.

By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.

“Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients,” Daneshkhah said. “This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.”

This is exactly where Backman believes vitamin D plays a major role. Not only does vitamin D enhance our innate immune systems, it also prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death, from COVID-19.

“Our analysis shows that it might be as high as cutting the mortality rate in half,” Backman said. “It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected.”

Backman said this correlation might help explain the many mysteries surrounding COVID-19, such as why children are less likely to die. Children do not yet have a fully developed acquired immune system, which is the immune system’s second line of defense and more likely to overreact.

“Children primarily rely on their innate immune system,” Backman said. “This may explain why their mortality rate is lower.”

Backman is careful to note that people should not take excessive doses of vitamin D, which might come with negative side effects. He said the subject needs much more research to know how vitamin D could be used most effectively to protect against COVID-19 complications.

“It is hard to say which dose is most beneficial for COVID-19,” Backman said. “However, it is clear that vitamin D deficiency is harmful, and it can be easily addressed with appropriate supplementation. This might be another key to helping protect vulnerable populations, such as African-American and elderly patients, who have a prevalence of vitamin D deficiency.”

Backman is the director of Northwestern’s Center for Physical Genomics and Engineering and the associate director for Research Technology and Infrastructure at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University.

New Blood Test Offers Detection of 50 Types of Cancer

Another helpful advance in modern medicine.

A new blood test that can detect more than 50 types of cancer has been revealed by researchers in the latest study to offer hope for early detection.

The test is based on DNA that is shed by tumours and found circulating in the blood. More specifically, it focuses on chemical changes to this DNA, known as methylation patterns.

Researchers say the test can not only tell whether someone has cancer, but can also shed light on the type of cancer they have.

Dr Geoffrey Oxnard of Boston’s Dana-Farber Cancer Institute, part of Harvard Medical School, said the test was now being explored in clinical trials. “You need to use a test like this in an independent group at risk of cancer to actually show that you can find the cancers, and figure out what to do about it when you find them,” he said.

Writing in the journal Annals of Oncology, the team reveal how the test was developed using a machine learning algorithm – a type of artificial intelligence. Such systems pick up on patterns within data and as a result learn to classify it.

The team initially fed the system with data on methylation patterns in DNA from within blood samples taken from more than 2,800 patients, before further training it with data from 3,052 participants, 1,531 of whom had cancer and 1,521 of whom did not.

Using this information, the system sorted the samples into groups based on the methylation patterns. The team then taught the system which groups reflected which type of cancer.

“In pregnant women we look in their free-floating DNA for foetal abnormalities,” said Oxnard. “We know this [approach] exists, the question is how do you fine-tune and perfect the art of looking for cancer in this free-floating DNA? And that is what the machine learning did.”

The team then tested the trained system on another set of samples from 1,264 individuals, about half of whom had cancer.

The results reveal that less than 1% of those without cancer were wrongly identified by the system as having the disease. “It is really important you don’t tell non-cancer patients they have cancer,” said Oxnard.

When it came to identifying people with cancers the team found that, across more than 50 different types of cancer, the system correctly detected that the disease was present 44% of the time – although the team stress that figure could differ if the test was used to screen a general population, rather than those known to have cancer.

Detection was better the more advanced the disease was. Overall, cancer was correctly detected in 18% of those with stage I cancer, but in 93% of those with stage IV cancer.

The team say the results are exciting as they offer the possibility of a new way to screen for cancers that are otherwise difficult to detect. For example, the system correctly identified 63% of those with stage I pancreatic cancer, rising to 100% in stage IV.

The team further found that the system could shed light on the type of cancer. For 96% of samples deemed to show cancer, the test was able to offer a prediction for in which the tissue the cancer originated, with 93% of these predictions found to be correct.

Dr David Crosby, head of early detection at Cancer Research UK, said that detecting cancers in their early stages is important as they are less aggressive and more treatable.

Although this test was still at an early stage of development, the initial results were encouraging, he said. “And if the test can be fine-tuned to be more efficient at catching cancers in their earliest stages, it could become a tool for early detection.”

But Crosby added there was work to do. “More research is needed to improve the test’s ability to catch early cancers and we still need to explore how it might work in a real cancer screening scenario,” he said.