Archive for December 2020
Now you see me, now you don’t: Shrinking budgets can affect crucial location research for first responders
By Dorothy Butler, PhD
Firefighters often find themselves in dangerous situations in unknown indoor and outdoor environments. The ability to locate and track them in real-time would significantly aid their missions and safety. In 1999, six career firefighters lost their lives responding to a cold storage and warehouse fire in Worcester, Massachusetts. The firefighters became lost inside the six-floor, maze-like building on a rescue mission and could not find an exit before running out of breathing air. Additionally, it took over six days to recover their bodies because they had no way of locating the firefighters other than digging through the rubble. Better location tracking devices are needed to give insight to those in command and to locate a firefighter needing assistance. Good tracking devices can improve service and help save lives. As part of a federal investigation of the fire in Worcester, improving techniques to better track the movements of firefighters within a structure became one of the priorities for increasing the safety of these first responders, and developing this technology has been given a dedicated portion of the President’s Budget.
There are many different types of tracking devices, but none are fully sufficient to track a firefighter in all situations. Outside, GPS can most easily be used to track firefighters. However, when a firefighter moves inside a building or inside other locations, like metro stations, composed of concrete and steel, GPS technology becomes unreliable. Some solutions for indoor tracking have been developed, such as the Pak-Tracker Firefighter Locator System, which relies on RF signals, and the MSA Connected Firefighter, which combines thermal imaging and firefighter ranging. These rely on triangulation and time-difference-of-arrival techniques, and these technologies can still be unreliable because they are time consuming to use and can be inaccurate. Specifically, they often break down in non-line-of-sight environments where obstructions, such as walls, terrain, foliage, and other obstacles, block or reflect signals to cause confusion when trying to locate a firefighter. These limitations are detrimental to firefighters needing accurate tracking in every scenario.
Developing new tracking systems or improving those already in existence can be expensive and often rely on the emergence of new technology in other fields, and individual firefighter and first responder communities do not have the capacity to do this kind of research on their own. Instead, the Department of Homeland Security (DHS) has taken the initiative to fund the development of more accurate firefigher location systems.
In 2003, DHS created the Science and Technology Directorate (S&T) to address current gaps in various areas considered relevant to DHS. One of the primary focus areas of the S&T is the firefighter community within the DHS’s First Responder Technologies Division. The S&T serves as the primary research, development, testing, and evaluation agency for this community. One promising research project from the S&T is a novel tracking system designated by the name POINTER: Precision Outdoor and Indoor Navigation and Tracking for Emergency Responders. POINTER was developed by the S&T in partnership with the National Aeronautics and Space Administration’s Jet Propulsion Laboratory. POINTER uses magnetoquasistatic fields, which are low-frequency magnetic fields that can transmit signals through common construction materials, instead of the previous electromagnetic fields. The ability for these signals to penetrate through materials gives POINTER a distinct advantage over current location and tracking systems. This technology can be used to locate the exact floor, movement, and orientation of a firefighter, expanding the system’s benefits.
POINTER does have a few limitations. First, one of the main limitations of POINTER is the distance it can track. For the first iteration, POINTER could track firefighters at a distance up to 70 meters. In large buildings or environments, this distance is not enough to be able to send signals from firefighters to the command center. Improving the distance that the POINTER signal can be transmitted will improve the technology. Though the initial version will be designed for use in building with three stories or less, future versions likely be able to be used in tall buildings, underground, and outdoors. A second limitation, largely already overcome, is the size and weight of the system. In 2017, POINTER was the size of a shoe box that weighed about 3 pounds and could be carried like a backpack. Firefighters already carry around 70 pounds of equipment and do not need an additional burden. Ideally, a tracking system would be small enough to fit into a pocket or be attached to another piece of equipment like a radio, helmet, or air tank. The goal for POINTER has been to be able to attach it to a belt buckle. A report in early 2020 described the POINTER receiver worn by a first responder as being the “size and weight of an iPhone 11.” A third limitation is automation, both for the receiver and the transmitter. According to a career firefighter from Loudoun County, Virginia, integrating POINTER into their air pack and syncing the power switch to their breathing air would provide a seamless transition to using this system. The POINTER transmitter remains outside the building and is suggested to elevate from a fire engine once it has arrived on the scene. The transmitter set up and initiation needs to be as seamless as possible and integrated into the programming of the apparatus computers. Firefighters do not have time to set up multiple pieces of equipment when they arrive, and integrating the POINTER transmitter into their computers would eliminate unnecessary steps. Lastly, there should be some portion of the transmitter or another receiver that is mobile and can be used to direct rescue personnel to locate a downed firefighter who needs assistance. Researchers plan to continue to develop POINTER and improve its accuracy and transmission capabilities.
POINTER’s success and future commercialization has been touted as “a great example of leveraging research across government in a way that allows for first responder input to create a product that can be game changing.” It also shows that a dedicated portion of the S&T budget focused on the first responder community is critical for developing new technology to quickly and effectively improve the safety of these crucial individuals. However, the FY 2021 President’s Budget has decreased the S&T budget by nearly $100M from the FY 2020 budget with an estimated decrease of 25% for the First Responder Research and Development organization directly responsible for the research and development to support, equip, and help first responders across the nation. Stable and sufficient funding allow for critical developments like POINTER that can save lives within our first responder communities.
Vaccine hesitancy amidst a global pandemic
By Will Becker, PhD
photo credit: Phil Murphy on flickr
It has almost been a year since the first case of Coronavirus disease 2019 (COVID-19) appeared in Wuhan, China. Ravaging global health, infrastructure and the economy, COVID-19 has since resulted in an estimated 1.5 million deaths, 68.5 million cases, and a monetary a loss of 28 trillion dollars in global output, to date. The Centers for Disease Control (CDC), using an ensemble forecast, estimates a sobering 9,500 to 19,500 deaths and up to 300,000 new cases by the end of December in the U.S. alone. Despite initial hope that we could quell the spread of COVID-19 through preventative measures, cases continue to rise, making it clear to all that a COVID-19 vaccine – along with public acceptance and adoption of such a vaccine – is the first step towards ending the pandemic.
At just 11 months into the pandemic, two vaccines: one from Moderna Therapeutics and a second one from a collaboration between Pfizer and BioNTech show greater than 90 percent efficacy in Phase 2/3 clinical trials, and the Pfizer/BioNTech vaccine has just been issued Emergency Use Authorization (EUA) by the FDA. The speed with which these vaccines were developed, and their apparent efficacy is astonishing and unprecedented. Buffeted by a swarm of cash from private and public groups such as Operation Warp-Speed in the U.S., the European Commission, and the Gates Foundation, the monumental task of vaccine development and testing is reaching its apotheosis, while vaccine distribution is just beginning. Last week, the first non-clinical trial vaccine was delivered to a 90-year-old in the United Kingdom (U.K.), and this week frontline workers in the U.S. are getting their first vaccine doses. While this crucial benchmark in the fight against COVID-19 is an extraordinary scientific achievement, much more work is yet to be done. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease (NIAID) and one of the leading members of the White House Coronavirus Task Force, said we need “at least 80 to 85 percent” of the population vaccinated to reduce infection rates to a level that would allow for a return to normalcy. This of course comes with the reminder that people are still expected to wear masks and social distance during the vaccine distribution — however long that may take. And although concerns remain about the logistics of vaccine distribution and equitable access for poorer countries, the largest hurdle to achieving high vaccination rates might be that some people simply do not want the vaccine.
A recent study examining the global attitude towards accepting a COVID-19 vaccine published in the journal Nature Medicine showed that 71.5% of surveyed responders were accepting of a ‘safe and effective’ vaccine. However, these results were not uniform across countries. Places where acceptance exceeded 80% tended to be Asian nations (such as China, South Korea, Singapore) and the authors posit a strong trust in a central government as an indicator for vaccine acceptance. On the other end of the spectrum are countries with the lowest positive response rates (Russia and Poland, ~55%),while the U.S. and U.K. fall near the global average with 75.4% and 71.4% vaccine acceptance rate, respectively. In the U.S., which has the most COVID-19 cases, and where cases are expected to continue to rise, vaccine acceptance is relatively in line with other high-income countries, but our opinions are ever-changing. Multiple nationwide polls from PBS/NPR/Marist and Gallup found 61% of respondents in the U.S. saying ‘yes’ to a vaccine in mid-August, down to a low of 50% in mid-September, then a rebound to 58% in late October, tracking other nationwide polling. While a clear majority believe a COVID-19 vaccine has many benefits and is worth taking, it is of utmost importance to understand the heterogeneous reasons that one might not want to get a vaccine so those can be addressed.
A study published in the journal Annals of Internal Medicine took an in-depth look at Americans’ attitudes towards the COVID-19 vaccine and found among those who were vaccine hesitant, that is, responding ‘no’ or ‘not sure’ when asked if they intended to be vaccinated, the reasons were typically listed as some form of the following: vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust. These are not uniquely American responses as evidenced by another study that looked at 32,000 adults in the U.K. and found similar reasons amongst those who were vaccine hesitant. Demographically, those who are least likely to accept a COVID-19 vaccine are those who did not get a flu vaccine in recent years, Black Americans, people with lower educational attainment and those who perceive little risk to themselves. This is especially troubling because of the increased COVID-19 risk disparities for racial minorities and the socioeconomically disadvantaged, who have not been able to decrease their mobility compared to other groups and have suffered a disproportionate COVID-19 burden because of it.
People who list vaccine-specific concerns as their top priority typically rank as ‘not sure’ as opposed to ‘no’ about whether or not they will get the vaccine and their main concern is safety and efficacy. Despite extremely promising vaccine efficacy data, an AP-NORC poll conducted after the efficacy results were released in early November suggests only half of the U.S. population plan to get the vaccine. Indeed, for some people, the speed with which the vaccine was developed raises concerns about the validity of the data and reflects their distrust of government and pharmaceutical industries, which is another one of the top reasons people are vaccine hesitant. It is likely that vaccine acceptance will continue to rise now that the FDA has approved one of the vaccines for emergency use. The FDA is still regarded as a trusted institution, and approval of the rigorous clinical trials it conducts may instill confidence in those wary of potential vaccine side-effects. For people who responded ‘no’ to whether they would get a vaccine, many cite antivaccine beliefs and emotions, indicating they “do not like, want, or believe in vaccines,” including some who referenced scientifically inaccurate information, like the association between vaccines and autism and that it is not possible to vaccinate against a virus. Some anti-vaccine activists have already mobilized in opposition to a COVID-19 vaccine. At the heart of both anti-vax and vaccine hesitant sentiments lie a front of misinformation that governing bodies must work to address. Among those beliefs are the aforementioned trust issues in the scientists generating and reporting the data, even though independent clinical-trial review boards monitor the progress of vaccines; or that profiteering will occur, despite assurances in the U.S. that vaccines will be free. Some are concerned the vaccine itself could infect people, something that is scientifically impossible, but believed by 43% of Americans who do not plan to get vaccinated. Targeting this misinformation will be paramount in increasing the rate at which people get vaccinated in our society.
Fortunately, steps are being taken to clarify misapprehensions about the vaccine. The Department of Health and Human Services (HHS) launched an ad campaign featuring the Commissioner of the FDA, the Chief Scientific Officer of Operation Warp-Speed, and Dr. Anthony Fauci to reassure the public about the historic success of vaccines in preventing polio and smallpox and to raise general vaccine awareness. A study found that interventions like these from trusted public health experts are likely to improve vaccine acceptance rates. Other factors that improve vaccine acceptance among the hesitant are their doctor recommending the vaccine and for the vaccine to be free. While these strategies may increase the rate at which those concerned about the safety of the vaccine agree to get the shot, a one-size fits all policy for engendering trust in vaccines will not work. A 2018 study in the journal Vaccine found that a multi-faceted approach cognizant of the different cultural and context-specific concerns of the targeted demographic are more likely to be effective. To that end, Black Americans, who have been hit the hardest by COVID-19, may benefit from different approaches that ease concerns about the vaccine and tackle fear of racial inequality that their White counterparts do not have the burden of. There is also the hurdle of anti-vaccine advocates, whose emotional investment and intense opposition to vaccination will be the hardest to overcome. Because correcting misinformation alone is unlikely to have an effect, more personal messages designed to engage emotions such as compelling stories and experiences about vaccines saving lives may be more profound in reaching these people.
Regardless of demographics about age, gender, race or vaccine beliefs, the world is unified in wanting an end to this pandemic and a return to normal, even if we must adapt to a new normal post-pandemic. A vaccine will not be a magic bullet to change the world back, but it is our best chance at bringing us collectively to a safer place where we can rest a bit easier amongst our loved ones.
Early High School Timing and Sleep Disorder Among Teenagers
By Koyeli Banerjee, PhD
Parents of high school teenagers have always complained about their kids staying up late at night and having a hard time being completely awake the next morning. Furthermore, many high school students find it challenging to focus during morning classess. Children and adolescents with lack of enough sleep show various adverse effects with symptoms of diabetes, obesity, anxiety and attention deficit syndromes, aggression, lack of focus and mental growth, impaired learning, and memory loss. According to the American Academy of Sleep Medicine, children aged 6–12 years should regularly sleep 9–12 hours, and teenagers aged 13–18 years should sleep 8–10 hours.
Teenagers are busy bees with various activities that include long school hours, after school programs, part-time jobs, and typical start bell timings. High school starts typically very early (7:00 – 7:30 am) in most of the United States. Conversely, the adolescent brain is biologically programmed to stay up late at night and wake up late in the morning, which is associated with puberty. The American Academy of Pediatrics acknowledges that inadequate sleep among adolescents is a growing nation-wide public health concern that needs attention. Tantamount research evidence suggest early school start times contribute significantly to the disturbance in the adolescent circadian rhythm, which results in insufficient sleep leading to adverse effects. A study on the impacts of sleep deprivation shows that sleep loss and a prolonged state of wakefulness alter cognitive and emotional behaviors. For a functional cognitive brain, both an awake and sleep states play a significant role, acting in a complementary mechanism. There is a bi-directional relationship between sleep and emotional brain function. Sleep is essential to adequately synchronize and communicate emotions in the brain and behavioral level. On the other hand, sufficient sleep provides a reconditioning of critical emotional reactivity the next day. A good sleep enhances the offline processing and amalgamation of emotional well-being. And this emotional sanity works to precondition the developing adolescent brain. Another finding indicates that sleep loss acts as social resistant behavior, and thus amplifies inter-personal separation, in turn affecting bilateral facets of social interaction.
Adolescents, who are lacking sleep, face several cognitive and emotional challenges. Furthermore, change in school start time can have several effects. During the transition from middle school to high school, insufficient sleep is highly prevalent and worsens among adolescents, largely during early school start times. This change in timing with transition and sleep deprivation correlation calls for an urgent and necessary intervention to adjust the high school start timing. One study shows that delay in the school start (by 45 minutes) reduces tardiness among high schoolers and overall improvement of disciplinary and behavioral issues. Another study involving high school students and their parents was conducted to study the impact of starting school time on adolescent sleep. This study compared the school day and weekend sleep times and standardized the circadian sleep/wake cycle by controlling bright light in the morning. The study revealed that with the current early high school start times, the adolescents are sleep deprived. Moreover, along with augmentation of the lag in the circadian sleep phase, the performance of the students was better later in the day than in the early morning. This sleep deprivation among adolescents should be considered as an epidemic, and long-term strategies should be implemented to meet superior health conditions and accelerated school performance.
A significant number of researches reveals the pros of delayed school start time, which include improved physical and mental health, safety while driving, and academic performance. A very short delay in school start time showed a positive correlation with improvements in sleep duration and a negative correlation with daytime sleepiness, mood swings, and caffeine use. A study conducted in Hong Kong teens showed that only a 15 min delay in school start time improved adolescent sleep with corresponding enhancement in behavioral changes and mental well-being.
Based on the extensive studies which favor delaying school start time for adolescents, the American Academy of Pediatrics strongly recommends school district take measures to optimize sleep quantity among students and urges high school authorities to change the start times to later than 8:30 AM. The main challenges in bringing this policy change into fruition can be overcome by educating parents, school administrators, and teachers, students, transportation staff, businesses that employ students, law enforcement officials about the scientific rationale and the benefits of delayed start time. They should be warned of the negative effects of insufficient sleep among adolescents. The school authority and other stakeholders should be encouraged to critically review and consider the scientific findings and the rationale behind late start timing recommendations. Discussions should be initiated to evaluate the global changes in academic performance, economic trends, traffic patterns and accidents, and teacher and student retention.
Therefore, for the benefit of our youth, science says it is time to let the adolescents sleep in for longer hours on the school day mornings. Overall, these studies have significant indications for changes in the current public policy, and scientific research suggests the health benefits of upgrading the school bell schedules to better align with circadian rhythms and sleep needs of adolescents. School administrators and policymakers and parents should come together and discuss the pros and cons of delayed school start time to promote healthy sleep habits and overall positive performance and sound mental health among school-aged adolescents. Stakeholder education and community engagement is the key to achieve a healthy next generation.
National publishing centres: an alternate model for disseminating scientific research
By Nicholas William Ashton, PhD
Much of the research conducted throughout the world by university and government scientists is publicly funded. For government researchers, this money is made available as a yearly provision, while for scientists at universities, funding is largely sourced from competitively awarded research grants. From a societal perspective, public funding of scientific research can be seen as an investment to improve the health, wellbeing and livelihoods of the general public as well as a way to identify new techniques and technologies of economic importance.
To be beneficial, scientific research needs not only to be conducted but also to be disseminated to a wider audience. Currently, the gold standard for disseminating scientific research is to publish completed studies in scientific journals. These journals facilitate a peer-review process, where the work is evaluated by other researchers in the field to ensure it is scientifically sound. Journal editors invite reviewers and takes their recommendations into account before accepting the paper, rejecting the work outright, or asking for it to be modified prior to a second submission. Publication in a peer-reviewed journal can, therefore, be thought of as both a means to disseminate research findings as well as a certification that the work is of acceptable quality.
Although the above model has become the standard for scientific publishing, the limitations of this system have become increasingly clear. Firstly, despite the predominant funding of academic and government research by the public, accessing this work post-publication requires the prospective reader, or their employer, to have a subscription to the journal or pay an exorbitant one-off fee. These fees limit access for researchers who do not have a subscription to the journal and for the general public who pay for the studies in the first place. Although an increasing number of journals now offer “open-access,” which allows anyone to access the published work, it requires the authors pay a fee (often between $2000 – $5000 USD) that can be dissuasively – or prohibitively – expensive. Open-access publishing has also driven the rise of predatory “pay-to-publish” journals. These journals typically employ an “in-name-only” form of peer-review that essentially guarantees authors, that for a fee, their work will be published regardless of its quality, or lack thereof.
A second major issue with our current scientific publishing model is related to the so-called “reproducibility crisis.” According to a survey published in Nature, 70% of researchers have tried and failed to reproduce another scientist’s experiments. Even more shocking, some reports suggest between 51 and 89% of published studies cannot be reproduced. Although reasons for poor reproducibility are multi-factorial and not solely the fault of scientific journals, it does raise the question of reliability, even if you can access a publication. Many publishers have tried to address this issue by introducing policies aimed to increase transparency in the work they publish. For instance, most journals have data retention and availability policies, which state that primary data must be made available upon request. Other journals take this further by requiring raw data be deposited upon submission, either as supplemental files or via deposition to a public data repository. Another approach taken by many journals is to establish best practice guidelines for the collection and processing of image-based data. As an example, the Journal of Biological Chemistry (JBC) make such statements in their ‘Collecting and Presenting Data’ guidelines as, “papers should describe biological materials with enough information to uniquely identify materials” and “gels and blots [common forms of image-based data] should not be excessively cropped.” While such attempts to address scientific reproducibility and transparency are creditable, these guidelines are not universal requirements amongst science publishers. In addition, even for journals that provide such advice, an inspection of recent issues will demonstrate that these are often little more than optional guidelines not adhered to by all authors or universally enforced at the editorial level.
Another detrimental contributor to scientific irreproducibility is the perceived hierarchy of scientific journals as measured by scientometric indices designed to rank journals by their relative importance. These ranking systems incentivise journals to publish work that the editor feels are most impactful and will most benefit the standing of the journal in the scientific community. A higher standing is beneficial to publishers, for whom this will equate to further subscriptions and/or pay-to-publish fees. Most scientists compete for federal funding, which is awarded largely based on their ability to publish in highly ranked journals, creating heavy pressure for researchers to “spin” their research findings into the most novel and impactful stories. This is problematic when we consider that, in the Nature survey cited above, more than 60% of respondents mentioned “pressure to publish” and “selective publishing” as major contributors to scientific irreproducibility. This is not to say that most authors are actively trying to mislead others. Instead, this is more likely an unintended consequence of publication bias towards positive findings and the key consideration of journals to publish the most exciting story. This culture also leaves little room for researchers to publish studies aimed to reproduce already published work, despite suggestions that publishing such studies would be a leap forward in addressing the reproducibility crisis.
Given the limitations of our current science publishing system illustrated above, I wish to propose an alternate model, which would be for the good of the public, other researchers, and contributing scientists themselves. Rather than publicly funded research being published by privately owned for-profit publishing companies, I propose this work should instead be taken over by national publishing centres. These centres should be funded directly by the federal government, at the level where they can coordinate the peer-review and distribution of research material, in a manner which is freely and immediately accessible. Such a system would thereby ensure open access to publicly funded work, while eliminating the financial barrier for those researchers where an open access fee is an impediment. In addition to a more equitable publishing system, establishing such centres would also be an opportunity to ensure all publicly funded research is reported under the same guidelines in regard to transparency. This model would also contribute to addressing the reproducibility crisis, by removing the pressure for researchers to “spin” their research into a story they feel would most appeal to a journal. National publishing centres could further be an ideal avenue to publish reproduction studies as well as those studies that generate negative data and are not seen by private publishers as profitable articles.
As an Australian living in the United States, my thoughts around this topic have largely centred on how this system could be implemented in these two countries, which have their own publicly funded research councils (e.g. the National Health and Medical Research Council (NHMRC) in Australia and the National Institutes of Health (NIH) in the United States). However, this model could also be employed across countries that share a common funding body, such as the European Research Council (ERC) within the European Union.
While a national publishing scheme may seem like a new idea, similar suggestions have been made as early as the 1940s, where a centralised ‘British Publishing Authority’ was proposed by the Irish scientist J.D. Bernal. However, this proposal was rejected by the scientific community at the time, who were concerned about the potential for censorship of research if distribution were controlled by the state. Censorship remains a real concern and raises an important point about the essential independence of a national publisher from government and partisan politics. In this way, I propose that rather than government agencies, such centers could be more akin to public broadcasters such as the Australian Broadcasting Corporation (ABC), which is assured of editorial independence through an act of parliament.
A likely criticism of this model is the drain on the public purse. While it is outside the scope of this essay to offer a true cost analysis for a national publishing scheme, it is important to note that the general public already pays for science publishing in the form of journal subscriptions and open access fees. This enterprise is indeed highly profitable for scientific publishers, some of whom report profit margins of close to 40%. Rather than increasing, these costs may instead decrease in a nationalised scheme due to the non-profit nature of such a system. Furthermore, a nationalized publishing scheme would save researchers an immense amount of time, which would itself be of economic and scientific value. One reason for this is due to the pressure for scientists to publish their work in journals with the highest impact factor. Because of this, many scientists employ a top-down approach when trying to publish, by first submitting to the highest impact journal of relevance and then working downwards until their paper is accepted elsewhere. This can delay the time to publication by months or years. Such delays adversely affect research productivity, both by taking away from the time researchers could be focused on other tasks, as well as delaying this research from reaching other scientists whose work would benefit from such findings. Removing this onus of playing-the-journal-game would undoubtedly boost productivity and thus be economically beneficial.
As a final thought, while I have criticized the role of private publishing companies and society-based publishers, I want to acknowledge that these entities provide positive value to scientists aside from the distribution of scientific research. For instance, the Nature survey cited above was coordinated and published by the Nature Publishing Group and is a highly valuable contribution to the scientific community. Scientific societies – many of which manage their own journals – also provide numerous benefits to their readers by organizing scientific conferences and professional development opportunities, as well as by engaging in science advocacy. Although I question the appropriateness of these journals to be publishing publicly funded research, the complete loss of these voices from scientific discussion would be to our detriment. How we best support these interests, while aiming for a more open, equitable and transparent publishing system, should be a matter for future debate.
Science Policy Around the Web December 10, 2020
By Jubayer Rahman, PhD
How kids’ immune systems can evade COVID
Although children are generally considered more vulnerable when compared with adults, COVID-19 infections in children seem to be less severe and not as life-threatening compared to infection in older populations. However, recently some COVID-19 related complications have been reported in children under 18 years old, but not enough information is available to explain all viral pathogenesis outcomes in children. In fact, in most cases, children who are exposed to the virus do not display symptoms and few develop symptoms and antibodies against SARS-CoV-2 like those seen in adults against COVID-19.
Studies have reported that children who develop multisystem inflammatory syndrome after COVID-19 infection show variable test positivity (29-50%). Interestingly, children also show lower viral counts when compared with adult patients. This observation suggests that children have better immune responses to COVID-19 than adults. One study also showed that children only develop antibodies against COVID-19 spike protein while adults develop antibodies against both viral spike protein and the nucleocapsid protein. Nucleocapsid protein levels are enhanced when viruses multiply. Antibodies against nucleocapsid proteins are an indication of viral replication in adults. Children’s T cells are relatively naïve, and this may result in a weaker T cells response against this new pathogen.
Children have fewer ACE2 receptors in the nasal area where SARS-CoV-2 typically invades the host cells. Lack of binding receptors and an ability to mount a strong immune response is likely beneficial to the children who are infected with SARS-CoV-2. Innate immune responses are rapid but do not always remain. Cross reactive antibodies from seasonal viral infections in children could also increase protection from SARS-CoV-2 infection. A child’s immune system may be working as a frontline first responder against COVID-19. As more studies are done to understand the difference between adult and child immune responses, it will also give insight into how the vaccines may respond in children.
(Bianca Nogrady, Science)
Science Policy Around the Web December 8, 2020
By Tam Vo, PhD
Image by Elionas2 from Pixabay
Scientists fear no-deal Brexit as deadline looms
As the Brexit deal is getting closer to reality, the outcome for science, particularly researchers, remains ambiguous. The UK left the European Union (EU) earlier this year but still retains the EU trade and travel agreements while waiting for policymakers to finalize the deal. James Wilsdon, a research policy professor at the University of Sheffield, noted that research funding and related matters are somewhat on a back-burner, sitting beside highlights of the agreement.
One of the most critical issues that the UK might face is data privacy. The EU may limit data sharing with the UK if negotiators deem the UK data protection law inadequate. Such limitations can hinder research studies at the COVID-19 Genomics UK Consortium, which works with other governmental and academic institutes to track changes and mutations in SARS-CoV-2 that might affect the virus transmission rate. Data sharing restrictions also present challenges to the UK Medicines and Healthcare products Regulatory Agency (MHRA), a key player in the European Medicine Agency. MHRA might face an increasing workload regarding COVID-19 vaccines and drugs in the coming days. New regulations might also disrupt the flow of the supply chains to the research labs, which might be detrimental to some of the research instruments if there is a supply shortage.
Another issue that UK scientists face is their potential participation in Horizon Europe, an ambitious €100 billion research and innovation program for 2020-2027. One problem the UK might face in the future is an initial cost associated with the program. The EU currently offers the UK €15 million to cover initial costs, plus any extra amount that UK researchers win in grants. Vivianne Stern, director of Universities UK International, told a parliamentary committee that the new price for UK scientists to participate is too high after analyzing the EU’s current offer. Kieron Flanagan, a science policy expert at the University of Manchester, proposed a price cap for non-EU members of Horizon Europe. The EU has not released any official comments on the matter since.
The Brexit deal will also complicate the flow of talent and researchers from the EU to the UK. A current “global talents visa” offered by the UK government can eliminate some bureaucratic and administrative loops for researchers. However, such visa applications for a family of four can cost approximately £15,000, which might discourage researchers from seeking opportunities in the UK.
The current fate of the UK research and innovation is indecisive because the Brexit deal is still being finalized. The UK can join Horizon Europe later down in the line, but the new immigration policy will present challenges for years to come.
(Cathleen O’Grady, Science)
The Story of Deinstitutionalization – Good Intentions, Budget Cuts, and a Modern Mental Health Crisis
By Spencer Andrews, BSc
Recent estimates from the National Institute of Mental Health show that 13.1 million adults in the United States (5.2% of the US population) suffer from some form of serious mental illness. Despite the prevalence of nearly 1 in 20 individuals, the misconceptions surrounding psychiatric illnesses have long driven societal maltreatment of these individuals and resulted in years of disconnected health policies. After decades of reducing the public resources designated to help those with mental illness, we find ourselves left with only about 12 available psychiatric care beds per 100,000 people today – the fewest since before the nation stopped treating mental illness as a crime in the mid 19th century. This may lead you to ask: “How did we end up here?” The answer is lost in a web of well-intentioned policies and insufficient oversight.
According to a report from Doris Fuller and others at the Treatment Advocacy Center (a non-profit mental illness advocacy group), in 1955, there were an estimated 559,000 state and county psychiatric beds. This translates to nearly 340 beds per 100,000 people. While these numbers seem encouraging, the treatment of the patients in these institutions was far from it. Many of these beds were located in large psychiatric hospitals such as the Willowbrook State School in Staten Island, where children with varying levels of mental illnesses or delays were often dropped off by their parents and never picked back up. The patients at this institution suffered from widespread abuse and neglect, including reports of being deliberately exposed to hepatitis. Unfortunately, Willowbrook was only one of many publicly funded institutions to have reportedly mistreated patients with serious mental illness.
As details of the inhumane conditions of these psychiatric hospitals began to spread, well-intentioned policymakers began pushing for a series of policies to reintroduce these individuals back into mainstream society. As explained in the AMA Journal of Ethics, this period of “deinstitutionalization” was driven by three forces: “the belief that mental hospitals were cruel and inhumane, the hope that new antipsychotic medications offered a cure, and the desire to save money.” The first in a series of policies, which started in the 1960s and continued through the 1980s, was the 1963 Community Construction Act. This established community mental health centers in anticipation of patient release from the institutions. Legal cases, such as Lake v Cameron (1966) and O’Conner v Donaldson (1975), helped to define the rights of those with mental illness including their right to less restrictive psychiatric treatment and limits on confinement.
With the introduction of Medicaid in 1965, funding for people with serious mental illness was shifted to a shared responsibility between the federal government and the states. Many of the state psychiatric hospitals closed and patients were transferred to community hospitals and long-term nursing homes which were largely funded by the federal government. However, just as soon as federal funding was allocated to such programs, the stripping of resources began. With the Omnibus Budget Reconciliation Act of 1987, direct funding for the patients in nursing homes – the primary treatment facilities at the time – ended. A patient’s only option became budget-restricted, for-profit private institutions. This left thousands suffering from serious mental illness with very few options, and in many cases, nowhere to turn.
While deinstitutionalization achieved its goal and decreased the state hospital bed population by 96%, the many policy changes throughout the 60s, 70s, and 80s resulted in an unorganized, and underfunded mental health system. As a consequence, according to Dominic Sisti, director of the Scattergood Program for Applied Ethics of Behavioral Health Care at the University of Pennsylvania, many of these individuals now “find themselves homeless or more and more in prison.” She explains, “Much of our mental health care now for individuals with serious mental illness has shifted to correctional facilities.” Sisti goes on to point out that most private mental health facilities still in operation do not accept insurance and can cost upwards of $30,000 a month. Medicaid is the only option for many low-income individuals, but provisions in the laws following deinstitutionalization prevent the federal government from paying for long-term mental healthcare in an inpatient facility.
Today, the state of our mental health system – specifically for individuals with serious mental illness – is particularly limited, creating a grim situation for many. With the reality of a largely privatized and expensive mental health care system, many individuals with mental illness quite literally have nowhere to go. According to the National Alliance to End Homelessness, there are nearly 550,000 homeless persons in the US on a given night. Nearly a quarter of these individuals have serious mental illness. This means that at any given time, there are more individuals with untreated serious mental illness on the streets in the United States than receiving care in hospitals. One report from the New York Times on the homeless population in Berkeley, California found that “on any given night there are 1,000 to 1,200 people sleeping on the streets. Half of them are deinstitutionalized mentally ill people…it’s like a mental ward on the streets.”
During the same years that publicly funded mental health resources were being stripped, bill after bill of sweeping reform on crime and harsher penalties for drug use came into effect. Between 1972 and 2009, there was a 700% growth in the prison population in the United States. As would be expected, individuals with serious mental illness – many unable to hold a job and living in poverty – were hit pretty hard by these crime reforms. A study in 2014 by Torrey et al., found that approximately 20% of jail inmates and 15% of prison inmates have a serious mental illness. They went on to estimate that there are approximately 356,000 total inmates with serious mental illness, which is “10 times more than the approximately 35,000 individuals with serious mental illness remaining in state hospitals.” A Special Report by the Bureau of Justice Statistics broke the issue down even further, showing that nearly 75% of state prisoners who had a mental health problem met criteria for substance dependence or abuse. Additionally, they found that the same prisoners with mental health issues were “twice as likely as those without to have been homeless in the year before their arrest.”
Rather than getting ahead of the problem, much of the spending in the US has turned to largely reactive measures. Many people are not diagnosed with serious mental illness until after they are charged with a major crime. Today, nearly half of the state hospital beds remaining in service are occupied by forensic patients charged with or convicted of crimes. However, the research shows that increasing access and providing psychiatric care to individuals before they are arrested could be a solution. A paper by Dr. Fred Markowitz at Northern Illinois University showed that public psychiatric hospital capacity actually has a significant negative effect on crime and arrest rates.
While a reorganization of our mental health system may not be easy, its widespread impacts on our society – specifically on the state of homelessness and incarceration – are evident. There is much work to be done, but evidence reported by researchers across the fields of neuroscience, psychiatry, and public health has helped to lay out precise, achievable goals for our future. One such achievable goal is to increase access to long-term psychiatric care for individuals suffering from serious mental illness. Modern estimates state that the United States should target to have 40 to 60 beds per 100,000 people in such facilities. Thanks to major strides in ethical guidelines for the care of the individuals with mental illness, these institutions would look quite different from the ones rightfully closed down a generation ago. Instead, modern inpatient facilities could offer individuals the professional help they need to overcome their illness in a productive and healthy manner. While increasing access to psychiatric care will by no means solve all of the nation’s problems, it serves as a simple and achievable step forward to improve our society and the outcome of millions of lives.
Science Policy Around the Web December 3, 2020
By Andrew M. Wright, BSc
E.P.A.’s Final Deregulatory Rush Runs into Open Staff Resistance
The final stage of the Strengthening Transparency in Regulatory Science (STRS) rules, known colloquially as ‘secret science’ rules, is running into a barrier that may cause complications for its enactment in the next federal administration.
These rules, which the US Environmental Protection Agency (EPA) originally proposed in early 2018 under its previous administrator Scott Pruitt, would dismiss or give less weight to studies that do not release their raw data to the public. While the original secret science rules only applied to dose-response toxicity studies, the current version applies to all scientific studies used by the EPA and is retroactive. These expanded rules are seemingly crafted around the ‘Six Cities Study’ from Harvard in 1993 (and a similar study by the American Cancer Society in 1995) that demonstrated a link between air pollution and premature deaths, and that involved confidentiality agreements with the individuals studied. Under this new framework, air pollution regulations that rely on that study, or others like it, could be prevented from being implemented or could be reversed by EPA administrators and US courts.
While there has been enormous public opposition to these rules by the general public, public interest groups, and medical associations, there has more recently emerged internal criticism by the EPA’s science advisory office that is staffed by career scientists. In an official ‘dissenting scientific opinion,’ the director of the science advisory office, Thomas Sinks, stated that existing medical privacy regulation including the Health Insurance Portability and Accountability Act (HIPPA) would cause STRS rules to invalidate relevant scientific studies and ‘compromise the scientific integrity of our scientists, the validity of our rulemaking, and possibly the health of the American People.’ This could allow the next administration to more easily reverse the secret science rules after they are enacted in the upcoming months prior to inauguration.
(Lisa Friedman, New York Times)
Science Policy Around the Web December 1, 2020
By Silvia Preite, PhD
‘The game has changed.’ AI triumphs at solving protein structures
Proteins are essential components of the cells and perform various functions in all living organisms. They are composed of small chemical “building blocks,” the 20 amino acids, combined into linear strings, like pearls on a bead to create more than 20,000 proteins in the human body. Proteins need to fold and acquire a specific three-dimensional (3D) structure to perform their functions properly. Predicting the structure of a protein is of critical importance to dissect its interaction with other proteins and to pharmacology interfere with its function. Currently, NMR spectroscopy, x-ray crystallography, and cryo-electron microscopy can experimentally determine the 3D protein structure, although with low efficiency and in a very time-consuming manner.
The Google artificial intelligence (AI) subsidiary DeepMind revealed a AI-based strategy — AlphaFold — to predict how proteins curl up from a linear amino acid chains into 3D shapes, a biology challenge that has puzzled numerous academic groups for decades. The AlphaFold approach uses deep-learning to map amino-acid sequences to their 3D structures based on information from known proteins sequences. While several other research teams have presented competing methods, none of them have come clear to reaching the threshold necessary to consider the problem ‘solved’ — AlphaFold just did that in the Critical Assessment of protein Structure Prediction Experiment (CASP) competition, an annual benchmark of leading methods in the field.
This development is a game-changer representing the beginning of many scientific and technological advances in the health, pharmaceutical, food, and environmental sectors, until now held back by expensive experimental structure determination.
(Robert F. Service, Science Magazine)
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