Ageing

Last week in Nature there was a summary of articles on ageing. Interestingly, they concerned not just the biology of ageing, but also the social-economic aspects.

It is known that with increased life-span and decreased natality, the burden of an ageing population is increasing – with governments worldwide trying to find ways to ease the pressure. While I believe that a big aspect of taking care of the elderly concerns keeping their independence, which can be promoted by targeted and well-thought Digital Health interventions, one cannot disregard the molecular biology of ageing. In one of the pieces from Nature, inflammation, stress and isolation, as side effects of the COVID-pandemic, are highlighted as mechanisms capable of contributing to accelerated ageing.
You can read it here:

https://www.nature.com/articles/d41586-022-00071-0?utm_source=Nature+Briefing&utm_campaign=8ea8646386-briefing-dy-2022021&utm_medium=email&utm_term=0_c9dfd39373-8ea8646386-42782315

The importance of training the trainers

As a PhD student, one of the running jokes we had in the lab was to call people by their numbers: “Postdoc number 7, have you submitted your paper yet?” is a “(in)famous quote” attributed to me. Myself, I was PhD number 4.

As much as this was supposed to be funny, it really stemmed from the feeling that we were chosen to carry on a project, but anyone else could have been chosen instead. Most importantly it seems that once someone arrived at the lab, no effort was put into understanding how to best work with them, or even exploit ways to best use their capacities.

One reason for this, is of course, lack of time as PIs are supposed to put on so many different hats and perform at so many different levels. As much as can understand it, I still can´t quite accept that at the end of the day, what seems to suffer the most is: the education of PhD students and the quality of the courses lectured at undergrad level.

“Science” speaks about it in this article:
https://www.science.org/content/article/scientists-aren-t-trained-mentor-s-problem?utm_campaign=SciMag&utm_source=Social&utm_medium=LinkedIn

This is not a post about vaccination against Sars-CoV-2

Last year I was asked to make a short summary of the literature regarding the differences in vaccine hesitancy between males and females. I came across the text again and decided to publish it.

In studies where men and women were surveyed regarding their attitude towards being vaccinated themselves (opposing taking the decision as a proxy for children or other people), I found the following trends for (central) European women:

High compliance when the vaccines are part of the established and recommended vaccination plan from the health authorities of their country.

Hesitancy towards vaccines that are in the market for a long-time but are not part of the recommended vaccination plan.

Even higher hesitancy regarding vaccination against pathogens that can be avoided by avoiding “risky” behaviours (e.g., hepatitis A), or for which behaviour changes can significantly decrease the risk of exposure (e.g., influenza). Importantly, this attitude is accompanied by high self-report of adoption of preventive measures (e.g., washing hands and food).

Hesitancy regarding novel vaccines is high, but only when the perceived risk of infection, disease severity or long-term consequences are low (e.g., swine flu). Interestingly, hesitancy is low (matching that of the general population) when the perceived risks of infection, disease severity or long-term consequences are high.

Women are mostly hesitant due to risk of side effects, whereas when men show high hesitancy when they perceive themselves as healthier and more capable of positively enduring the infection.

NOTES: This is a summary of a short list of studies performed in the last 10-15 years (with higher prevalence of papers published between 2015 and 2020), that as much as possible look into sex differences in “self-vaccination”

References

DOI: 10.1093/fampra/cmr064

DOI: 10.1016/j.vaccine.2019.11.068. Epub 2019 Dec 14.

DOI: 10.1080/21645515.2018.1564436. Epub 2019 Feb 20.

DOI: 10.1016/j.vaccine.2019.03.041. Epub 2019 Mar 30.

DOI: 10.1007/s00508-016-1062-1. Epub 2016 Aug 26.

DOI: 10.1038/s41467-020-20226-9.

DOI: 10.1016/j.socscimed.2020.113414

DOIi: 10.3390/ijerph17124565.

DOI: 10.1016/j.jhin.2020.11.020

DOI: 10.1016/j.vaccine.2020.09.041. Epub 2020 Sep 17.

DOI: 10.7417/CT.2019.2174.

DOI: 10.1136/bmjopen-2019-032218.

DOI: 10.1016/j.vaccine.2019.09.085. Epub 2019 Oct 17.

Apps, apps and more apps – digital health made inefficient?

I travel across a country-border for work. Therefore, I must be attentive to the different measures that the governments of country A and country B have in place to mitigate the impacts of COVID-19. Some of the measures implemented by both governments are contact tracing and immunity certificates. Mostly, in a digital form, through deployment of apps.

As I choose to actively use the covid-19 tracking app, and the countries have deployed different products, I need to have two tracking apps. And I have a digital certificate. As you can imagine, different countries have different apps for storing/using the certificate. So, I also need two different apps for this.

Recently, I got an “exposure alert” on app A after being abroad for work. Without having to call anyone, I could have downloaded a “medical leave” to justify my need for quarantining at home. I found this option extremely useful and very well thought.

After this event, I could not stop wondering: how is it possible that I have been using the tracking app from my country of residence (app B) since it first came out in 2020 and never received a “exposure alert”? My best guess is that there are not enough people using this tracking app – as some studies from 2020 were already suggesting. Indeed, the number of downloads of the tracking-app B (as per in-app statistics) accounts for less than 20% of the country’s population.

What could explain that not enough people feel compelled to use the tracking-app? I am pretty sure there are plenty of reasons of a different nature, but let’s focus on the “3 principles of digital health”:

  1. Be useful for the users
  2. Be easy to implement and integrate with existing systems
  3. Positively impact society

While country A has a combined tracking/certificate app (app A). The country B has a distinct app for tracking and for storing the certificate, doubling the implementation efforts by the user. The consequence is that the usage numbers are very different, with the tracking app of the country B being too low to become useful for the users and positively impacting society.

Philip O’Keefe tweeted

On the 26th of December Philip O’Keefe sent out a tweet. This wouldn’t have been any surprising, if not for the fact that Mr O’Keefe suffers from severe paralysis due to ALS (Amyotrophic lateral sclerosis) and did not use any voice-recognition messaging tool.

The tweet read “no need for keystrokes or voices. I created this tweet just by thinking it”

How was Mr O’Keefe able to tweet?

He made used of a new Brain Machine Interface (BMI) produced by Synchron, a company with headquarters in Brooklyn, New York.

What are BMI?

BMI are implantable medical devices that can record and sometimes stimulate brain activity. Hence, they can decode intention and help producing an action, being it movement or speech. This makes them of incredible importance for patients with ALS, Spinal Cord Injury (SCI) or locked in syndrome. The first of its kind was implanted in 2004 in a tetraplegic patient, by Cyberkinetics Inc.

With the advance of technology, these days most BMIs are equipped with multiple (recording/stimulating) channels, use low power, and have compact electronics making them more and more useful in medicine. Moreover, it is possible to use a range of recording options (or electrode types) according to the need of the patient and the invasiveness of the electrode.

Roughly, there are 3 traditional types of electrodes, ordered here by invasiveness: ECog grids, Utah arrays and Michigan arrays.

  1. ECoG grids look like tape that can be stuck to the top of the brain cortex (under the skull) without the need for puncturing the brain. They are widely used in epilepsy research.
  2. Utah arrays look like a hairbrush (infinitesimally smaller, or course) with needles that puncture the brain tissue and can recording/stimulate from neurons at a certain depth (not just from the top of the cortex).
  3. Michigan arrays, which are nail like structures that can record/stimulate from an even higher depth.

What type of electrodes has Mr O’Keefe in his BMI?

None of the above!

Synchron is developing an innovative approach that uses the blood vessels to send a stent-scaffold electrode array to a brain region of interest. The stent-electrode never leaves the blood vessel but is still capable of recording and stimulated to the same extend as if it was directly on the brain.

Is this the future of rehabilitative medicine?

References:
https://doi.org/10.1016/j.copbio.2021.10.001 (including the figure)

https://synchron.com/medicine
On twitter: here