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SNF Brain Insight Lecture on ‘Making the Right Moves in a Pandemic’ – The National Herald

NEW YORK The Stavros Niarchos Foundation (SNF) Brain Insight Lecture series, hosted by Columbia University's Mortimer B. Zuckerman Mind Brain Behavior Institute, continued with Making the Right Moves in a Pandemic on November 10. The virtual event, via Zoom featured the speakers Dara Kass, MD, Associate Professor of Emergency Medicine at the Columbia University Irving Medical Center, and Andrs Bendesky, MD, PhD, Assistant Professor of Ecology, Evolution and Environmental Biology at Columbia University's Zuckerman Institute. The discussion was moderated by Natalie Steinemann, PhD, Columbia's Zuckerman Institute.

Rui Costa, director and chief executive officer of Columbia's Zuckerman Institute and a professor of neuroscience and neurology at Columbia's Vagelos College of Physicians and Surgeons, gave the welcoming remarks to open the virtual event, thanking SNF in particular for its continuing support of this important lecture series.

According to the event's description, the COVID-19 pandemic continues to affect our lives at multiple levels: our health, our daily lives and our communities. Dealing with the pandemic requires us to make effective decisions, communicate rapidly and harness all our resources.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has challenged the world with unprecedented public health and economic crises. We need effective strategies to slow the spread of the virus.

We must be able to rapidly and affordably diagnose the virus because a major reason for the extreme societal and economic disruptions is the lack of appropriate testing technology to easily identify infectious people, especially those who do not have symptoms. We also need effective decision making and communication at both the clinical and community level to mitigate SARS-CoV-2 transmission in schools, at work and in the community at large.

The National Herald

The Stavros Niarchos Foundation Brain Insight Lecture, titled Making the Right Moves in a Pandemic, hosted by Columbia University's Mortimer B. Zuckerman Mind Brain Behavior Institute, featured Dr. Dara Kass and Dr. Andres Bendesky with moderator Natalie Steinemann.

In the virtual SNF Brain Insight Lecture Series event, the discussion featured two experts from Columbia University who are involved in the response to the COVID-19 pandemic in very different ways. Dr. Dara Kass reflected on decision making, both clinical and community, from the perspective of an emergency medicine doctor who, herself, was infected with the virus. She also discussed how to communicate rapidly evolving information in an effective manner. Dr. Andrs Bendesky discussed his lab's work to develop a simple, affordable test that can be performed at home.

The informative presentation was followed by a Q&A session which offered even more insights into the pandemic and the significant advances that have been made so quickly in the study of the SARS-CoV-2 virus. Both speakers were hopeful for the future, and as Dr. Kass noted concerning the response to the pandemic by New York in particular, We had our nationally renowned health centers, clear and consistent messaging from our leadership, and we had a citizenry that felt united around a collective identity, so to me that reaction was very helpful. It made me realize that New Yorkers can do anything and I'd never been more proud to be a New Yorker and I've been one my entire life.

This talk was part of the Stavros Niarchos Foundation Brain Insight Lecture series, offered free to the public to enhance understanding of the biology of the mind and the complexity of human behavior. The lectures are hosted by Columbia's Zuckerman Institute and supported by the Stavros Niarchos Foundation.

The lecture was also streamed live online and is available on YouTube: https://youtu.be/zF_219Mv1_0.

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SNF Brain Insight Lecture on 'Making the Right Moves in a Pandemic' - The National Herald

A Covid-19 surge of depression and anxiety is being treated by robots – CNBC

Hundreds of millions of people around the world were suffering from common mental health issues including anxiety and depression before Covid-19, and the scale of the health-care crisis has escalated as a result of the pandemic. But demand for mental health services is far outstripping the available supply of trained professionals. Machines are rising to the challenge as a first point of contact for struggling individuals, but just how far can the robot brain go in treating the mind of the human individual?

The research is still in the early days, but as artificial intelligence technology including natural language processing experiences a period of rapid advances, experts confront the delicate issue of how to properly use technology for mental health treatment. One factor is becoming undeniable, though: many people prefer to reveal their mental health struggle to a non-human confidante: a robot.

A recent survey from Workplace Intelligence and Oracle found that across more than 12,000 workers around the globe only 18% prefer humans over robots to support their mental health. Sixty-eight percent prefer to talk to a robot over their manager about stress and anxiety at work, and 80% indicated they were open to having a robot as a therapist or counselor.

As mental health issues around the world increase and resources are limited, experts are devising technological approaches to patient treatment, though some experts say an AI-based approach can never offer one critical human skill: empathy.

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"Unbiased information is what people want," said Dan Schawbel, founder and managing partner of Workplace Intelligence.

There are a few primary reasons people are turning to technology for this sensitive conversation: accessibility of getting help 24-7, and getting that help without having to admit to a struggle.

"There really is a stigma behind mental health globally. Talking about stress, or anxiety and depression with managers, employees will hold back. People don't seek help from humans because they don't want to be judged," Schawbel said.

Technology does have the potential to provide mental health support at scale, as well as unbiased information, non-judgmental responses, and a blindness to rank in the workplace context a machine doesn't discern if the employee seeking help is a CEO or lower down the company hierarchy.

"We're not going to have a billion therapists in the world so we need technology," Schawbel said. "But there is no AI replacement for one of the greatest values that therapists provide: human empathy. Robots can't do that yet."

The use of chatbots in mental health is backed, at least in a general sense, by research already decades-old: people were more likely to be honest using telephone voice-response systems than when talking to a live human.

"Chatbot are OK for basic things," said Bruce Rollman, director of the Center for Behavioral Health and Smart Technology at the University of Pittsburgh School of Medicine, who has researched online treatments for mood and anxiety disorders. "But when we start getting into mental health, it's a game of chess and we're not always playing with Deep Blue," he said, referencing the IBM AI that beat world champions.

"I'd be skeptical if was just computer algorithm, but it might be fine before you talk to a therapist, and AI that does a questionnaire," Rollman said.

Employers expect a wave of mental health challenges for the labor force in the prolonged remote work period, and they realize a chatbot might be preferable for reasons that go beyond the basic stigmatization of mental health, but because employees worry about risking promotions or raises, and job safety. Managers are not always adept at providing the right answers, either.

"Humans are not adequately trained on mental health issues. When people tell you they are stressed or depressed, we often give the wrong answers, and technology is a great way to scale some sequence of questions and best practices," said Emily He, senior vice president of the human capital management in Oracle's cloud business group.

Technology can help guide an employee through a mental health journey in a manner similar to it already does for the onboarding process as a new hire. Conversational AIs, or chatbots, can interface on a daily basis and track answers to questions, in some cases monitoring voice tone as well, and identify and predict someone who needs more advanced treatment.

"The end goal is to enable humans to do what they are best at, which is managing relationships, but there are some baseline questions and great ways to leverage technology," He said.

Record levels of venture capital money are flowing into the sector. According to digital healthcare-focused venture fund Rock Health's proprietary database, $9.4 billion was invested in overall digital health this year, and $4 billion of that was in Q3 alone.Investment in U.S.-based, AI-powered digital health start-ups it has tracked since 2011 are above $10 billion, with investment in mental/behavioral health AI reaching over $230 million across close to 20 deals. And the numbers are getting bigger: in 2020, there was $72 million invested across two sizable mental health AI transactions.The sums recently invested into mental health start-ups, including those not focused specifically on AI, are far higher.

"As an investor in a handful of mental and behavioral health start-ups, we know first hand that our portfolio companies have experienced strong and rising demand throughout the pandemic," said Rock Health CEO Bill Evans. "Like never before, automation and thoughtful use of technologies like AI is absolutely critical to delivering a human touch to those of us in greatest need."

"Eighty percent of the U.S. population owns a phone, and phones can tell you if there's been a change in your behavior," Pitt's Rollman said. He added that while it may sound creepy, predictive analytics are the future across many aspects of our lives, from Spotify knowing what music we prefer to listen to, to maybe mental health. The big gap right now in mental health is an AI that can make the right suggestion at the right time, especially if it is a high-risk person, a person with substance abuse or suicidal tendencies.

Woebot offers therapy options for people suffering from anxiety, depression, and mental health issues, in a stigma-free environment. "A robot can see me on my worst day and it's just a robot, it's not judging me," says founder Alison Darcy.

David Paul Morris | Bloomberg | Getty Images

Among the AI pioneers pushing the boundaries of what the technology can do is Alison Darcy, founder and president of Woebot Health, a start-up that has engineered a conversational agent (chatbot) to provide digital mental health counseling. Darcy, a research psychologist and former software engineer, worked earlier in her career with Coursera co-founder Andrew Ng at his Stanford University Health Innovation Lab in Computer Science (Ng is the chairman of Woebot).

Darcy said the technology has come a long way in a short number of years and it can help to push people past the primary reason they don't reach out for help: the stigma and fear of being judged.

"Therapists have to spend so much time building rapport. A robot can see me on my worst day and it's just a robot, it's not judging me. They have no judgment," Darcy said. "It's just software."

Woebot refers to itself as a robot in communication with users, and the company chose to not create a human avatar for the interface, though these design decisions also point to the challenge. "There is no human connection, no deep relationship, and that is the limit of the technology," Darcy said.

The limitations, combined with the recent increased investment, worry some mental health experts.

"There is a gold rush in the space and we believe in it, but also believe in science," said Catherine Serio, a clinical psychologist and associate vice president of digital behavior solutions at the University of Pittsburgh Medical Center. "There is lots of money to be made out there."

The University of Pittsburgh Medical Center recently launched a behavioral health app called RxWell which aims for a middle ground between reliance on technology and the need to offer increased access to individuals enabling them to take the first step in seeking help for depression and anxiety.

Serio, who has treated patients with depression and anxiety for years, acknowledged the issue with stigma and scaling in behavioral health, but believes a hybrid model is the only responsible route. "We believe the AI needs to mature more. A chatbot is basically a series of business rules to respond to people and we have not seen a completely coded response that is going to work for people with depression and anxiety," she said.

Building a relationship, a therapeutic bond, has been cited as the reason digital therapy cannot be effective. But Woebot has shown in a trial of young adults the ability to reduce mental health symptoms and deliver cognitive behavioral therapy. "That is not to say it's replacing therapy. It's really not, but it is allowing for full potency of therapy to be unlocked," Darcy said. "Our data shows it can be a useful first step. It is incredibly easy and destigmatizing."

Woebot can also detect crisis language and in those cases it is programmed to tell the user they require a human therapist. Or in other words, the robot's programming is designed to identify its own limitations. "The robot would rather ask you about your mood than detect it. The best person to tell us how you are doing is you," Darcy said.

She said research shows users are also turning to the robot further along in recovery as follow up care. "We see people talking to robots over a long period, maybe for three months when it is a difficult time, and then checking in again nine months later when in another difficult patch. And that is a longer-term perspective than what we normally think about," the Woebot founder said. "Humans respond well to the needs of a patient in the moment. A chatbot can do it too. It is responsive to where a person is at."

The Covid-19 pandemic has resulted in a boom in technology-based health care, and in psychiatry departments, a rare financial feat: an area of care that usually loses money for health institutions becoming a source of profits, according to Soo Jeong Youn, a research psychologist at Harvard Medical School and the Massachusetts General Hospital. She says technology should be used more to combat stigma in mental health, and to provide greater access to care across more cultures and populations, but she added that the research is still preliminary.

"We're not there yet. We're not close to what we see in Sci-Fi movies and responses catered to each person, but the AI has gotten really good," she said.

For example, if a person says they are feeling anxious, the AI can provide resources tailored to anxiety. "Even just searching on 'I'm anxious. What do I do?' There is something to having more information through an app," she said.

The need for help is great, and getting greater, as more Americans have face issues including job loss and food insecurity. Among the client base that UPMC works with to provide health care, the population saying their mental health was negatively impacted jumped from 32% in March to 58% in August. "That one statistic alone is a massive amount of individuals," said Jim Kinville, senior director of the LifeSolutions group at UPMC.

Can AI and chatbots be helpful? Absolutely and partially.

Bill Duane

former Google wellness and performance guru

Wellness and prevention apps offering access to skills, and cognitive behavioral therapy techniques, to help people manage stress and anxiety are now widespread. Some apps like Talkspace provide a way to connect with a human therapist online, or combine digital tools with live support, like UMPC's RxWell.

"There is lots of unmet need out there and people we call the 'walking wounded' ... functioning OK, but could benefit more from digital tools," Kinville said. "These tech tools can start the process and get people engaged."

The recent VC deals in the space show that the bets on mental health business models using AI are not limited to the creation of compelling chatbots. Ginger raised $50 million August, including funds from major insurer VC arms at Cigna and Kaiser Permanente, for its on-demand behavioral health platform offering access to coaching, video therapyand self-guided activities. In early 2020, Spring Health raised $22 million for what it describes as "precision mental health care" which uses a proprietary machine learning approach to diagnose conditions and identify the best therapy options for individuals.

While core AI technology including natural language processing underlying chatbots has advanced in the past few years, research shows algorithms continue to analyze the same data sets and come to different results, predicting different outcomes.

That makes Harvard's Youn cautious beyond what she is comfortable saying a chatbot can do today: the equivalent of a first session with a therapist, in which the goal is an understanding of what an individual is going through.

"Hopefully with the push of the pandemic we will get there much faster, and there is huge room and space and need for these chat-based apps to deliver help and relieve distress through the power of AI," the Harvard psychologist said.

For some experts working at the intersection of technology and human performance, choosing a side in the battle between human mental-health professionals and machines risks missing how serious the battle has become and the fact that we need to throw all we have at our disposal at it.

The recent increases in serious mental health struggles, especially among younger adults who say they have felt suicidal, speak to the importance and poignancy of improving access to mental health care, especially for people of color and lower incomes.

"The demands on mental health are massively increasing," said Bill Duane, former Google wellness and performance executive who now runs his own consulting firm. "Existential fear, financial insecurity, nebulous boundaries between work and home ... fear of job security causing people to try and push through and work harder, which only works for the short term. I'm heartbroken at everything going on. But I am extraordinarily optimistic about ways AI can be involved."

Woebot is experiencing increased usage during the pandemic, "huge increases," Darcy said, and it has tracked more need for support among younger users, which the recent research shows to be at elevated levels of risk. At the time of its August deal, Ginger noted "skyrocketing demand" for anxiety and depression care among U.S. workers.

More employees are willing to ask for help because there is a greater shared sense of going through a difficult experience as a community, Oracle's He said, and tech-based support for mental health is a logical extension of how people already interact with machines fitness apps support better physical health and have edged into other areas of wellness like sleep patterns.

But UPMC's Serio said that once an initial assessment has been done, there is no AI replacement for the "nuance and cues, and all those things human beings do. ... What people need is empathy. Anyone who says that will be fully automated one day, I don't know what reality they are grounded in."

Duane thinks people should not understate the value of how far the technology already has come not needing to make an appointment or deal with a doctor as a first step, eliminating feelings of shame or discomfort. It is a stigma workaround, a Band-aid on the larger problem of getting more individuals to seek help, but he said it also speaks to the fact that chatbots already are part of the solution.

"To everyone feeling the weight of 2020, it's a reasonable response to what's going on and the massive increase in demand. Access and timeliness are really important when we look at the quantity of people who need mental health care. .... Can AI and chatbots be helpful? Absolutely and partially."

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A Covid-19 surge of depression and anxiety is being treated by robots - CNBC

Utah failed to flatten the curve: these two numbers show why – Deseret News

The novel coronavirus has infected more than 10 million people in the United States nearly the entire population of Sweden.

As of Sunday afternoon, more than 237,000 Americans have died 659 in Utah.

As striking as those numbers are, experts have long worried that a second wave of COVID-19 cases in the fall and winter would be even worse than the first, said Dr. Steven Woolf, a social epidemiologist and director emeritus and senior adviser at the VCU Center on Society and Health at Virginia Commonwealth University.

As states loosened restrictions, the spring surge was never fully controlled and instead of an epidemiological curve we got a staircase. That means the impending second wave is more like a very dangerous third surge, Woolf said. Growing case counts are being fueled by pandemic fatigue, decreasing vigilance and colder weather pushing gatherings indoors.

Utahs figures are especially concerning:

The states current seven-day average for new confirmed cases is 2,290, which in a state of 3.21 million translates to 71 cases per 100,000 per day.

In New York, at the peak of its crisis in April, the Empire State was averaging nearly 10,000 confirmed cases a day. In a state of 19.45 million that translates to 51 cases per 100,000 per day.

In terms of cumulative cases, there are more in New York, said David Dowdy, an associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, but in terms of when we would have said New York was on fire thats where Utah is right now.

As the country marches toward Thanksgiving, per capita cases is just one of two figures that epidemiologists and statisticians say offer a more nuanced and well-rounded view of the pandemic and its impacts. The second is excess deaths, a number that captures just how far-reaching those impacts are.

Most years, there are zero excess deaths in the U.S. deaths above and beyond the number officials were expecting but this year, theres been nearly 300,000 so far, with two-thirds attributed to COVID-19.

This story explores the true human cost of COVID-19 and the forecast for winter. Because if changes arent made, even more people will die.

The spread is happening in our homes and it is killing people and overwhelming our hospitals, Spencer Cox, Utahs governor-elect said Thursday. This is crunch time. ... The next two months are absolutely critical. We are in a dire situation and we cannot emphasize that enough.

Despite pleas from the governor and from Cox since summer that Utahns wear masks and socially distance, not all are willing to wear face coverings (some remain adamantly opposed) and many continue to gather, closely. Case numbers continue to climb.

And its not just in Utah.

The New York Times tracker shows a positive cumulative case rate for North Dakota of 7,127 per 100,000 residents one of the highest rates in the country right now.

Thanks to advances in treating the disease, the number of people dying of COVID-19 isnt increasing at the same speed as the number of cases, said Dowdy, but at some point, the number of cases goes up so dramatically that deaths cant help but follow.

The mostly rural North Dakota is currently at 8 deaths per million the only state besides Montana glowing red on the daily COVID-19 death rate projections from the University of Washingtons Institute for Health Metrics and Evaluation. Utah is at 1 to 1.9 per million.

The fact that the virus has seemingly moved from politically left-leaning blue states to more right-leaning red states, and states like North Dakota and Utah are now topping charts for all the wrong reasons isnt entirely surprising, said Dr. Ali Mokdad, a professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation and chief strategy officer for Population Health at the University of Washington. Rather, it reflects the reality of how diseases spread.

The novel coronavirus first hit large urban hubs with international airports, wreaking havoc in big cities while giving folks in smaller cities a false sense of security (that) this is not us, he said. Hes seen the same thing happen with tobacco and HIV, where big cities were hit first, then rural communities which are still struggling.

By definition of epidemic, its going to hit everybody, Mokdad said. COVID-19 doesnt know age, it doesnt know geography, doesnt know race. (Its a) stubborn virus, opportunistic virus. Make a mistake, let down your guard, this virus is going to get you.

Utah, which staved off a major spike in the spring, is now dealing with the virus running rampant.

Masks are now required in 22 (of 29) counties where transmission levels are high and hospital officials are teetering on the edge of entering crisis levels of care, which means care rationing and even more exhausted providers the very things flattening the curve was supposed to prevent.

But Utahs numbers no longer portent a curve just a line headed north.

In the latest Institute of Health Metrics and Evaluation projection, 2,121 Utahns will die from COVID-19 by Feb. 1, 2021.

In the United States, deaths are projected to total 399,163 by Feb. 1, with nearly 2,250 COVID-19 deaths a day by mid-January three times higher than current daily deaths. (The institute usually issues new projections weekly.)

Those numbers are based on states locking back down when they hit 8 deaths per million people what 90% of states did in the spring when they reached those same levels.

Under that timeline, Utah would be locking down again sometime in December along with Kansas, Oklahoma, Minnesota, Louisiana, Alabama, Pennsylvania, New Jersey, Connecticut and Massachusetts.

If states choose not to, or even loosen restrictions, numbers just climb higher: Utah potentially loses 2,932 people to COVID-19, the nation nearly 513,657.

IHME predictions about hospital beds considered facilities under extreme stress if more than 20% of regular beds or 60% of intensive care units are filled by COVID-19 patients. Utah is projected to hit extreme stress for both bed types by the end of December.

However, the projections also calculated that if 95% of people wear masks the rate seen in Singapore closures could be delayed and nearly 62,000 lives could be saved nationwide by Feb. 1.

The best strategy to delay reimposition of mandates and the associated economic hardship is to expand mask use, the IHME Oct. 22 finding brief explained.

In Utah, masking at 95% would mean a total of 1,381 deaths by Feb. 1 about 740 fewer COVID-19 deaths than the current prediction.

For Mokdad, whos been in public health for more than 30 years, these upward trends are painful and discouraging. He would love to see people wear masks, limit mobility and stay distanced, and have his teams numbers prove to be drastic overestimates.

We hope that people will change their behaviors, he said. I pray that I am wrong, that people will make me wrong.

And its possible.

Projections and models are good at predicting what will happen under certain circumstances, said Fred Brauer, a professor emeritus of the University of Wisconsin and currently an honorary professor of mathematics at the University of British Columbia who studies epidemiological modeling. However, they have a harder time capturing human behavior, which can change rapidly when faced with a serious disease.

Brauer notes that during the 2014 Ebola outbreak in Africa, the models predicted millions of deaths, but by the end of the crisis, the death figure was around 11,300 still tragic, but significantly less than feared.

The best explanation Ive heard so far is people really changed their behavior and avoided the very dangerous funeral practices, said Brauer, even before there was any government move to encourage this behavior.

Peoples behavior changed because they took Ebola seriously, he said, which he hopes will finally happen with COVID-19.

You dont know what influences them, he said, whether its the number of cases, or the number of new cases or the number of deaths, we just dont know.

One new alarming number is 299,028.

Thats the number of people who died in the United States from late January to Oct. 3 above and beyond the number of deaths officials were expecting, according to a recent Centers for Disease Control and Prevention report.

Excess death is calculated by comparing all the deaths during a certain time period against the average number of deaths during that same time period in previous years, considering both population dynamics and seasonal fluctuations. Anything above the expected number for a specific time and place is considered excess.

Last year, like most years, there were zero excess deaths in the U.S., said Dowdy, but this year, theres been nearly 300,000 so far, with two-thirds attributed to COVID-19.

We have had a higher mortality rate on the U.S. level than in any recent year in history, Dowdy said. We know that this is a deadly disease.

Excess deaths is an important metric because it adjust for flaws or gaps in record keeping thats been disrupted by a crisis, said Nancy Krieger, a professor of social epidemiology at the Harvard T.H. Chan School of Public Health.

It also cuts out worries about politicization or manipulation of data.

Perhaps a state isnt testing enough. Not a problem.

Faulty tests? Doesnt matter.

What if a death is labeled a stroke instead of COVID-19 or vice versa? No impact.

None of these record-keeping problems affect the excess death figure, because its a measure of mortality stripped of all other factors. A death is a death.

During most Januarys in the United States, statisticians and epidemiologists project an average of 60,000 weekly deaths both from natural causes like old age, influenza and other health conditions, plus nonnatural causes like car accidents, homicides and even skiing accidents.

They also calculate a worst-case scenario number, shown in the CDC excess death graphs as a red-orange line, meaning the highest number of deaths they would expect in any given week in a year.

The last time U.S. deaths broke through the orange line was late December 2017 likely due to a particularly virulent flu season. But the peak subsided after January 2018 and deaths dropped below the orange line for the next two years.

Then COVID-19 hit.

By March 28, roughly two months after the first U.S. case, the observed number of weekly deaths was already punching through the orange line, peaking on the week ending April 11 at nearly 79,000 deaths 36% higher than even the worst-case scenario of 58,266 deaths.

For more than six months, weekly U.S deaths remained abnormally high.

The week ending October 24, 2020 was the first time since late March that deaths fell below the worst-case scenario level though deaths still remain above average.

From March to Aug. 1, Utah saw 953 excess deaths, with 311 or 33% due to COVID-19, according to Woolfs research recently published in JAMA. His findings echoed the CDCs: U.S. deaths have increased 20% during 2020.

In 13 of the last 17 weeks in Utah, CDC week-by-week death data show the state has surpassed the worst-case-scenario number of deaths ranging from 13% to 26% increases this year over years past.

But if only two-thirds of the U.S.s excess deaths and one-third of Utahs deaths (as of Aug. 1) were caused by COVID-19, what else is causing so many people to die?

Utahs Chief Medical Examiner Erik Christensen is busier now than hes ever been during his 12 years in this position.

Thus far in 2020, hes seen 300 to 400 more non-COVID-19 deaths (not every death is reviewed by his office) than last year. While he doesnt know all the reasons why numbers are so high, he has a few theories.

First, some of the gap deaths may be unclassified COVID-19 deaths.

Doctors are continually learning about COVID-19s effects on the body, leading to more accurate labeling of such deaths now compared to what happened during the first months of the pandemic.

Christensen said hes both diagnosing COVID-19 in previously undiagnosed deaths, (around a quarter of the 300 to 400 deaths) and removing any COVID-19 designation if its unwarranted (around a dozen times).

However, he along with many other public health officials believes the bulk of excess deaths are collateral COVID-19 damage: people dying as a result of disruptions from the pandemic.

Woolf further divides this group into three categories.

The first is people experiencing acute emergencies someone with chest pain whos afraid to call 911 because of COVID-19 and dies of a heart attack. Or the reverse, someone who actually calls 911, but medical personnel are too busy with COVID-19 patients to respond.

The second group is anyone with a chronic disease diabetes, cancer, HIV who, because of the pandemic, cant stay in control of their illness, develops complications and dies.

The third group includes those with behavioral health concerns like depression or substance abuse disorders who, under stressors produced by the pandemic develop fatal complications, said Woolf, noting that the opioid epidemic didnt stop when the virus arrived.

Woolf said their research also found a spike in deaths from Alzheimers and dementia within states hit first by the pandemic. He noted nursing home residents are more likely to be dealing with those two diseases, and many nursing homes have been hit hard by the novel coronavirus.

These deaths may not carry a COVID-19 tag, but they will show up in excess death numbers the collateral damage of a crisis and a view into how this pandemic is shaping peoples risk of dying, said Krieger at Harvard.

Other potential causes for the gap between the number of excess deaths and counted COVID-19 deaths are those who died as a result of domestic violence or homicides results of being locked down with abusers or stuck in volatile situations during pandemic restrictions.

While theres some validity to the concern that our reaction to the virus and our steps to protect public health have these immediate harms, its a mistake to back off on trying to nip this in the bud and control community spread, Woolf said, because in the end, (failure to do so) will even cost even more lives.

Having any mortality data at this point in the pandemic is helpful, considering mortality stats arent normally finalized until up to 18 months after the year in question, said Michael Staley, suicide prevention research coordinator with the Utah Department of Health. (Hes still waiting for official 2019 mortality data.)

Nearly every expert the Deseret News spoke with mentioned how time will prove a great clarifier for death data. Even the CDC notes on their graphics that data in recent weeks are incomplete, and that it can take up to eight weeks for mortality data to be at least 75% complete.

In the meantime, heres a look at what Utah officials know about deaths in the state this year:

There was a 30% decrease in the number of people seeking medical attention for suicide ideation during the first few months of the pandemic, but returned to normal levels around mid-June, said Staley. However, the number of suicide deaths hasnt changed significantly in 2020 compared to 2019 or 2018.

The drug overdose death rate has been going down since its peak in 2015, but did start to increase in April, said Staley. However, drug overdose counts are still within the average range.

In 2020, there have been 29 domestic-violence related deaths. Last year at this time, thered been 32. However, calls to the Utah Domestic Violence LINKLine (1-800-897-LINK) have increased 25% to 50% since March, with an increased need for shelter and longer shelter stays, said Liz Sollis, spokesperson for the Utah Domestic Violence Coalition.

By late October, 233 people had died on Utah roads. Last year at this time, it was 191, and in 2018 at the same time there were 234 traffic deaths, said Jason Mettmann, communications manager for the Utah Highway Safety Office.

Officials will continue to gather and sort death data for months, looking for ways to show the pandemics full impact on the state. Yet, even if the data arent perfectly clear yet, Christensens message is.

Just wear a mask, he said. It doesnt reduce things to zero, but every one we dont have to deal with is somebody thats still going home.

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Utah failed to flatten the curve: these two numbers show why - Deseret News

bioAffinity Technologies to Present at 2020 American Society of Cell Biology Meeting – Business Wire

SAN ANTONIO--(BUSINESS WIRE)--bioAffinity Technologies, a privately held biotech company, today announced that its poster Meso-tetra (4-carboxyphenyl) porphyrin (TCPP) is incorporated into cancer cells by the CD320 receptor and clathrin mediated endocytosis will be presented during the session Cancer Therapy: Defining Therapeutic Targets and New Therapeutics at the American Society of Cell Biologys Cell Bio Virtual 2020 - An Online ASCB|EMBO Meeting Dec. 2-16, 2020.

The poster and an accompanying video presentation by bioAffinity Technologies Vice President of Research David Elzi, PhD, also will be available to conference participants for on-demand viewing from Dec. 2-23. Dr. Elzi will participate and present his research as part of a 45-minute panel discussion during the Cancer Therapy session on Monday, Dec. 14, at 1 p.m. Eastern time.

Porphyrins are known to exhibit high affinity for cancer. The fluorescent porphyrin TCPP is used to mark cancer and cancer-associated cells for detection by flow cytometry in bioAffinity Technologies CyPath Lung test, a non-invasive diagnostic for the early detection of lung cancer. The presence of cells with high TCPP uptake is one of several parameters that distinguish samples from cancer patients from those at high risk who are cancer-free. Dr. Elzi has conducted research into the biological mechanisms of action by which cancer cells preferentially take up TCPP. Research findings have furthered the Companys diagnostic applications and also led to discoveries that are being advanced by bioAffinity Technologies to develop cancer therapies that can selectively kill cancer without harm to healthy cells.

About bioAffinity Technologies, Inc.

bioAffinity Technologies, Inc. (www.bioaffinitytech.com) is a privately held company addressing the significant unmet need for non-invasive, early-stage cancer diagnosis and treatment. The Company develops proprietary in-vitro diagnostic tests and targeted cancer therapeutics using breakthrough technology that preferentially targets cancer cells. Research and optimization of its platform technology are conducted in bioAffinity Technologies laboratories at the University of Texas San Antonio. The Companys platform technology is being developed to diagnose, monitor and treat many cancers.

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bioAffinity Technologies to Present at 2020 American Society of Cell Biology Meeting - Business Wire

Epidermal Growth Factor in the CNS: A Beguiling Journey from Integrated Cell Biology to Multiple Sclerosis. An Extensive Translational Overview -…

This article was originally published here

Cell Mol Neurobiol. 2020 Nov 5. doi: 10.1007/s10571-020-00989-x. Online ahead of print.

ABSTRACT

This article reviews the wealth of papers dealing with the different effects of epidermal growth factor (EGF) on oligodendrocytes, astrocytes, neurons, and neural stem cells (NSCs). EGF induces the in vitro and in vivo proliferation of NSCs, their migration, and their differentiation towards the neuroglial cell line. It interacts with extracellular matrix components. NSCs are distributed in different CNS areas, serve as a reservoir of multipotent cells, and may be increased during CNS demyelinating diseases. EGF has pleiotropic differentiative and proliferative effects on the main CNS cell types, particularly oligodendrocytes and their precursors, and astrocytes. EGF mediates the in vivo myelinotrophic effect of cobalamin on the CNS, and modulates the synthesis and levels of CNS normal prions (PrPCs), both of which are indispensable for myelinogenesis and myelin maintenance. EGF levels are significantly lower in the cerebrospinal fluid and spinal cord of patients with multiple sclerosis (MS), which probably explains remyelination failure, also because of the EGF marginal role in immunology. When repeatedly administered, EGF protects mouse spinal cord from demyelination in various experimental models of autoimmune encephalomyelitis. It would be worth further investigating the role of EGF in the pathogenesis of MS because of its multifarious effects.

PMID:33151415 | DOI:10.1007/s10571-020-00989-x

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Epidermal Growth Factor in the CNS: A Beguiling Journey from Integrated Cell Biology to Multiple Sclerosis. An Extensive Translational Overview -...

Staying in touch! – Science Codex

For our cells to assemble into tissues and whole organs, the extracellular ma-trix (ECM) as well as the integrins are required. The ECM forms a kind of extra-cellular protein meshwork, the integrins are surface proteins, which our cells use to attach to this extracellular support structure. How human cells balance attachment to versus detachment from the ECM is a yet unsolved question. The research team led by Professor Christof Hauck in the Department of Biolo-gy at the University of Konstanz, now identified a key enzyme, PPM1F, which regulates the integrins' detachment from the ECM. The results have been pub-lished in the online edition of the Journal of Cell Biology https://doi.org/10.1083/jcb.202001057.

The ECM mainly consists of a network of protein fibres such as collagen and other filamentous extracellular proteins. In order to adhere to this meshwork, nearly every human cell possesses surface proteins termed integrins. Integrins operate like mo-lecular carabiners that lock the cells to the network of collagen fibres or other ECM proteins and thus provide a strong focal point of attachment for the cell. However, cells in our body do not always stay in place, but sometimes need to migrate over long distances to their final destination - just think of immune cells that have to travel from the lymph node to a skin wound. As a solution, nature provided integrins with special features.

Like a sailor in the ship's rigging

Integrins are peculiar, because they can be repeatedly folded over and extended: When folded over, integrins cannot connect to the ECM, as the carabiner is buried. Upon extension of the integrin, the carabiner is exposed and can lock the cell to the ECM. Interestingly, cells can extend integrins at the front end of the cell, while they fold over their integrins at the rear and detach from the ECM at these positions. Cy-cles of integrin-mediated "gripping and let loose" allow cells to move in the protein meshwork of the extracellular matrix like a sailor climbs in the ship's rigging. Integrins consist of two parts, the - and the -subunit. Both subunits traverse the cell mem-brane, so that a small part of the protein is inside the cell, but the larger portion, the actual carabiner, is outside of the cell. It has been known for some time that the ex-tension of the integrin is initiated by the integrin -subunit: In particular, the protein talin initially binds to the intracellular part of the -subunit and triggers integrin exten-sion and thus the activation of the carabiner.

Without phosphorylation the carabiner hook remains buried

Tanja Grimm and Nina Dierdorf, doctoral researchers at the Konstanz Research School Chemical Biology have discovered that the -subunit is being marked for talin binding by a small chemical modification, a so-called phosphorylation. This phos-phorylation works like a switch: Upon phosphorylation, talin can bind and the integrin is extended. If phosphorylation does not take place or if this position in the integrin is mutated, talin does not associate and the carabiner remains buried. Consequently, the cells lose their grip. Moreover, the doctoral researchers now showed for the first time that a single enzyme is responsible for reversing the phosphorylation of the integrin -subunit: the protein phosphatase PPM1F. This enzyme can remove the phosphorylation and thus trigger the integrins to fold over. The PPM1F-regulated "phosphorylation switch" in the integrin seems to be essential, because in the absence of PPM1F, embryonic development, when different cell types have to arrange themselves into functioning tissues, terminates prematurely. Isolated cells, in which the PPM1F gene is disrupted, show enhanced attachment to the extracellular matrix and can hardly move, as they are unable to release integrin-based matrix contacts.

Does less cell adhesion allow uncontrolled migration?

The researchers now hope that this knowledge can be used in the future to specifi-cally control PPM1F activity and thus the functionality of integrins. In some tumour cells, this phosphatase appears to be particularly abundant, and the resulting reduced adhesion of such tumour cells could be one of the reasons, why they are able to leave the primary tumour and form metastases at distant body sites.

"In the next step, we want to learn how to manipulate the phosphorylation switch and thus the function of integrins," says Tanja Grimm, first author of the study. "We might be able to specifically influence integrin-dependent processes in our body, from im-mune cell movement to tumour metastasis. With these novel findings we might help our cells to firmly stay in touch with their surrounding and prevent them straying away for the worse".

Key facts:

Original publication: Grimm, T.M., Dierdorf, N.I., Betz, K., Paone, C., Hauck, C.R. (2020): PPM1F controls integrin activity via a conserved phospho-switch, Journal of Cell Biology (2020) 219 (12): e202001057; published online on 29 November 2020. doi: https://doi.org/10.1083/jcb.202001057

The team led by Professor Christof Hauck, cell biologist at the Department of Biology, University of Konstanz, discovered new details about the regulation of cell adhesion and cell migration

The phosphatase PPM1F is key for releasing integrin-based contacts between human cells and the extracellular matrix

Research was conducted in the context of the Collaborative Research Centre (SFB 969) "Chemical and Biological Principles of Cellular Proteostasis", which is funded by the German Research Foundation (DFG)

Tanja Grimm and Nina Dierdorf, the lead authors of the study, received schol-arships of the Konstanz Research School Chemical Biology (KoRS-CB).

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Staying in touch! - Science Codex

Eureka Therapeutics Appoints Nobel Laureate Randy Schekman, Ph.D. to its Scientific Advisory Board – BioSpace

Nov. 9, 2020 13:00 UTC

EMERYVILLE, Calif.--(BUSINESS WIRE)-- Eureka Therapeutics, Inc., a clinical stage biotechnology company developing novel T cell therapies to treat solid tumors, announced today that Randy Schekman, Ph.D., has been appointed to its Scientific Advisory Board. Dr. Schekman shared the 2013 Nobel Prize for Physiology or Medicine for his ground-breaking work on cell membrane vesicle trafficking. He is currently a Professor in the Department of Molecular and Cell Biology, University of California, Berkeley, and an Investigator of the Howard Hughes Medical Institute.

Dr. Schekman is a true visionary in the field of medicine, and his scientific research has enabled the production of one third of the worlds supply of insulin and the entire worlds supply of hepatitis B vaccines, said Dr. Cheng Liu, President and CEO of Eureka Therapeutics. I have known Randy for more than 20 years, and his scientific leadership and expertise will be invaluable as we advance our anti-AFP ARTEMIS ET140203 clinical trial in adult patients with hepatocellular carcinoma (HCC), the predominant type of liver cancer.

The approaches Eureka has taken for undruggable diseases using TCR mimic antibodies and its proprietary ARTEMIS T cell platform are entirely novel and quite powerful, said Dr. Schekman. I look forward to working with the Eureka team and its other distinguished SAB members, on advancing its pipeline of therapies to address unmet medical needs in oncology.

In addition to being awarded the Nobel Prize, Dr. Schekman is the recipient of numerous prizes, including the Lewis S. Rosenstiel Award in basic biomedical science, the Gairdner International Award, the Amgen Award of the Protein Society, the Albert Lasker Award in Basic Medical Research, the Louisa Gross Horwitz Prize of Columbia University, the Dickson Prize in Medicine from the University of Pittsburgh, the Massry Prize, the E.B Wilson Award of the American Society of Cell Biology, the Kornberg-Berg lifetime achievement award from Stanford Medical School and the Otto Warburg Prize of the German Society for Biochemistry and Molecular Biology. He is a member of the National Academy of Sciences, the American Academy of Arts and Sciences, the American Philosophical Society, a Foreign Associate of the Accademia Nazionale dei Lincei and a Foreign Associate of the Royal Society of London.

With the appointment of Dr. Schekman, Eurekas Scientific Advisory Board consists of five members, including Dr. Stephan Grupp, Section Chief of the Cellular Therapy and Transplant Section at Childrens Hospital of Philadelphia; Dr. Cameron Turtle, Professor and Anderson Family Endowed Chair for Immunotherapy at Fred Hutchinson Cancer Research Center; Dr. David Scheinberg, Director, Experimental Therapeutics Center at Memorial Sloan Kettering Cancer Center; and Dr. Yuman Fong, Chair and Professor of the Department of Surgery Surgical Oncology at City of Hope.

ABOUT EUREKA THERAPEUTICS, INC.

Eureka Therapeutics, Inc. is a privately held clinical stage biotechnology company focused on developing novel T cell therapies to treat cancers. Its core technology centers around its proprietary ARTEMIS cell receptor platform and E-ALPHA antibody discovery platform for the discovery and development of potentially safer and more effective T cell therapies for the treatment of solid tumors and hematologic malignancies. ET140203, the Companys lead asset, is currently in a Phase I/II US multicenter clinical trial in patients with advanced hepatocellular carcinoma (HCC).

Eureka Therapeutics, Inc. is headquartered in the San Francisco Bay Area. For more information on Eureka, please visit http://www.eurekatherapeutics.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20201109005353/en/

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Eureka Therapeutics Appoints Nobel Laureate Randy Schekman, Ph.D. to its Scientific Advisory Board - BioSpace

The story of mRNA: From a loose idea to a tool that may help curb Covid – STAT

ANDOVER, Mass. The liquid that many hope could help end the Covid-19 pandemic is stored in a nondescript metal tank in a manufacturing complex owned by Pfizer, one of the worlds biggest drug companies. There is nothing remarkable about the container, which could fit in a walk-in closet, except that its contents could end up in the worlds first authorized Covid-19 vaccine.

Pfizer, a 171-year-old Fortune 500 powerhouse, has made a billion-dollar bet on that dream. So has a brash, young rival just 23 miles away in Cambridge, Mass. Moderna, a 10-year-old biotech company with billions in market valuation but no approved products, is racing forward with a vaccine of its own. Its new sprawling drug-making facility nearby is hiring workers at a fast clip in the hopes of making history and a lot of money.

In many ways, the companies and their leaders couldnt be more different. Pfizer, working with a little-known German biotech called BioNTech, has taken pains for much of the year to manage expectations. Moderna has made nearly as much news for its stream of upbeat press releases, executives stock sales, and spectacular rounds of funding as for its science.

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Each is well-aware of the other in the race to be first.

But what the companies share may be bigger than their differences: Both are banking on a genetic technology that has long held huge promise but has so far run into biological roadblocks. It is called synthetic messenger RNA, an ingenious variation on the natural substance that directs protein production in cells throughout the body. Its prospects have swung billions of dollars on the stock market, made and imperiled scientific careers, and fueled hopes that it could be a breakthrough that allows society to return to normalcy after months living in fear.

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Both companies have been frequently name-checked by President Trump. Pfizer reported strong, but preliminary, data on Monday, and Moderna is expected to follow suit soon with a glimpse of its data. Both firms hope these preliminary results will allow an emergency deployment of their vaccines millions of doses likely targeted to frontline medical workers and others most at risk of Covid-19.

There are about a dozen experimental vaccines in late-stage clinical trials globally, but the ones being tested by Pfizer and Moderna are the only two that rely on messenger RNA.

For decades, scientists have dreamed about the seemingly endless possibilities of custom-made messenger RNA, or mRNA.

Researchers understood its role as a recipe book for the bodys trillions of cells, but their efforts to expand the menu have come in fits and starts. The concept: By making precise tweaks to synthetic mRNA and injecting people with it, any cell in the body could be transformed into an on-demand drug factory.

But turning scientific promise into medical reality has been more difficult than many assumed. Although relatively easy and quick to produce compared to traditional vaccine-making, no mRNA vaccine or drug has ever won approval.

Even now, as Moderna and Pfizer test their vaccines on roughly 74,000 volunteers in pivotal vaccine studies, many experts question whether the technology is ready for prime time.

I worry about innovation at the expense of practicality, Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and an authority on vaccines, said recently. The U.S. governments Operation Warp Speed program, which has underwritten the development of Modernas vaccine and pledged to buy Pfizers vaccine if it works, is weighted toward technology platforms that have never made it to licensure before.

Whether mRNA vaccines succeed or not, their path from a gleam in a scientists eye to the brink of government approval has been a tale of personal perseverance, eureka moments in the lab, soaring expectations and an unprecedented flow of cash into the biotech industry.

It is a story that began three decades ago, with a little-known scientist who refused to quit.

Before messenger RNA was a multibillion-dollar idea, it was a scientific backwater. And for the Hungarian-born scientist behind a key mRNA discovery, it was a career dead-end.

Katalin Karik spent the 1990s collecting rejections. Her work, attempting to harness the power of mRNA to fight disease, was too far-fetched for government grants, corporate funding, and even support from her own colleagues.

It all made sense on paper. In the natural world, the body relies on millions of tiny proteins to keep itself alive and healthy, and it uses mRNA to tell cells which proteins to make. If you could design your own mRNA, you could, in theory, hijack that process and create any protein you might desire antibodies to vaccinate against infection, enzymes to reverse a rare disease, or growth agents to mend damaged heart tissue.

In 1990, researchers at the University of Wisconsin managed to make it work in mice. Karik wanted to go further.

The problem, she knew, was that synthetic RNA was notoriously vulnerable to the bodys natural defenses, meaning it would likely be destroyed before reaching its target cells. And, worse, the resulting biological havoc might stir up an immune response that could make the therapy a health risk for some patients.

It was a real obstacle, and still may be, but Karik was convinced it was one she could work around. Few shared her confidence.

Every night I was working: grant, grant, grant, Karik remembered, referring to her efforts to obtain funding. And it came back always no, no, no.

By 1995, after six years on the faculty at the University of Pennsylvania, Karik got demoted. She had been on the path to full professorship, but with no money coming in to support her work on mRNA, her bosses saw no point in pressing on.

She was back to the lower rungs of the scientific academy.

Usually, at that point, people just say goodbye and leave because its so horrible, Karik said.

Theres no opportune time for demotion, but 1995 had already been uncommonly difficult. Karik had recently endured a cancer scare, and her husband was stuck in Hungary sorting out a visa issue. Now the work to which shed devoted countless hours was slipping through her fingers.

I thought of going somewhere else, or doing something else, Karik said. I also thought maybe Im not good enough, not smart enough. I tried to imagine: Everything is here, and I just have to do better experiments.

In time, those better experiments came together. After a decade of trial and error, Karik and her longtime collaborator at Penn Drew Weissman, an immunologist with a medical degree and Ph.D. from Boston University discovered a remedy for mRNAs Achilles heel.

The stumbling block, as Kariks many grant rejections pointed out, was that injecting synthetic mRNA typically led to that vexing immune response; the body sensed a chemical intruder, and went to war. The solution, Karik and Weissman discovered, was the biological equivalent of swapping out a tire.

Every strand of mRNA is made up of four molecular building blocks called nucleosides. But in its altered, synthetic form, one of those building blocks, like a misaligned wheel on a car, was throwing everything off by signaling the immune system. So Karik and Weissman simply subbed it out for a slightly tweaked version, creating a hybrid mRNA that could sneak its way into cells without alerting the bodys defenses.

That was a key discovery, said Norbert Pardi, an assistant professor of medicine at Penn and frequent collaborator. Karik and Weissman figured out that if you incorporate modified nucleosides into mRNA, you can kill two birds with one stone.

That discovery, described in a series of scientific papers starting in 2005, largely flew under the radar at first, said Weissman, but it offered absolution to the mRNA researchers who had kept the faith during the technologys lean years. And it was the starter pistol for the vaccine sprint to come.

And even though the studies by Karik and Weissman went unnoticed by some, they caught the attention of two key scientists one in the United States, another abroad who would later help found Moderna and Pfizers future partner, BioNTech.

Derrick Rossi, a native of Toronto who rooted for the Maple Leafs and sported a soul patch, was a 39-year-old postdoctoral fellow in stem cell biology at Stanford University in 2005 when he read the first paper. Not only did he recognize it as groundbreaking, he now says Karik and Weissman deserve the Nobel Prize in chemistry.

If anyone asks me whom to vote for some day down the line, I would put them front and center, he said. That fundamental discovery is going to go into medicines that help the world.

But Rossi didnt have vaccines on his mind when he set out to build on their findings in 2007 as a new assistant professor at Harvard Medical School running his own lab.

He wondered whether modified messenger RNA might hold the key to obtaining something else researchers desperately wanted: a new source of embryonic stem cells.

In a feat of biological alchemy, embryonic stem cells can turn into any type of cell in the body. That gives them the potential to treat a dizzying array of conditions, from Parkinsons disease to spinal cord injuries.

But using those cells for research had created an ethical firestorm because they are harvested from discarded embryos.

Rossi thought he might be able to sidestep the controversy. He would use modified messenger molecules to reprogram adult cells so that they acted like embryonic stem cells.

He asked a postdoctoral fellow in his lab to explore the idea. In 2009, after more than a year of work, the postdoc waved Rossi over to a microscope. Rossi peered through the lens and saw something extraordinary: a plate full of the very cells he had hoped to create.

Rossi excitedly informed his colleague Timothy Springer, another professor at Harvard Medical School and a biotech entrepreneur. Recognizing the commercial potential, Springer contacted Robert Langer, the prolific inventor and biomedical engineering professor at the Massachusetts Institute of Technology.

On a May afternoon in 2010, Rossi and Springer visited Langer at his laboratory in Cambridge. What happened at the two-hour meeting and in the days that followed has become the stuff of legend and an ego-bruising squabble.

Langer is a towering figure in biotechnology and an expert on drug-delivery technology. At least 400 drug and medical device companies have licensed his patents. His office walls display many of his 250 major awards, including the Charles Stark Draper Prize, considered the equivalent of the Nobel Prize for engineers.

As he listened to Rossi describe his use of modified mRNA, Langer recalled, he realized the young professor had discovered something far bigger than a novel way to create stem cells. Cloaking mRNA so it could slip into cells to produce proteins had a staggering number of applications, Langer thought, and might even save millions of lives.

I think you can do a lot better than that, Langer recalled telling Rossi, referring to stem cells. I think you could make new drugs, new vaccines everything.

Langer could barely contain his excitement when he got home to his wife.

This could be the most successful company in history, he remembered telling her, even though no company existed yet.

Three days later Rossi made another presentation, to the leaders of Flagship Ventures. Founded and run by Noubar Afeyan, a swaggering entrepreneur, the Cambridge venture capital firm has created dozens of biotech startups. Afeyan had the same enthusiastic reaction as Langer, saying in a 2015 article in Nature that Rossis innovation was intriguing instantaneously.

Within several months, Rossi, Langer, Afeyan, and another physician-researcher at Harvard formed the firm Moderna a new word combining modified and RNA.

Springer was the first investor to pledge money, Rossi said. In a 2012 Moderna news release, Afeyan said the firms promise rivals that of the earliest biotechnology companies over 30 years ago adding an entirely new drug category to the pharmaceutical arsenal.

But although Moderna has made each of the founders hundreds of millions of dollars even before the company had produced a single product Rossis account is marked by bitterness. In interviews with the Globe in October, he accused Langer and Afeyan of propagating a condescending myth that he didnt understand his discoverys full potential until they pointed it out to him.

Its total malarkey, said Rossi, who ended his affiliation with Moderna in 2014. Im embarrassed for them. Everybody in the know actually just shakes their heads.

Rossi said that the slide decks he used in his presentation to Flagship noted that his discovery could lead to new medicines. Thats the thing Noubar has used to turn Flagship into a big company, and he says it was totally his idea, Rossi said.

Afeyan, the chair of Moderna, recently credited Rossi with advancing the work of the Penn scientists. But, he said, that only spurred Afeyan and Langer to ask the question, Could you think of a code molecule that helps you make anything you want within the body?

Langer, for his part, told STAT and the Globe that Rossi made an important finding but had focused almost entirely on the stem cell thing.

Despite the squabbling that followed the birth of Moderna, other scientists also saw messenger RNA as potentially revolutionary.

In Mainz, Germany, situated on the left bank of the Rhine, another new company was being formed by a married team of researchers who would also see the vast potential for the technology, though vaccines for infectious diseases werent on top of their list then.

A native of Turkey, Ugur Sahin moved to Germany after his father got a job at a Ford factory in Cologne. His wife, zlem Treci had, as a child, followed her father, a surgeon, on his rounds at a Catholic hospital. She and Sahin are physicians who met in 1990 working at a hospital in Saarland.

The couple have long been interested in immunotherapy, which harnesses the immune system to fight cancer and has become one of the most exciting innovations in medicine in recent decades. In particular, they were tantalized by the possibility of creating personalized vaccines that teach the immune system to eliminate cancer cells.

Both see themselves as scientists first and foremost. But they are also formidable entrepreneurs. After they co-founded another biotech, the couple persuaded twin brothers who had invested in that firm, Thomas and Andreas Strungmann, to spin out a new company that would develop cancer vaccines that relied on mRNA.

That became BioNTech, another blended name, derived from Biopharmaceutical New Technologies. Its U.S. headquarters is in Cambridge. Sahin is the CEO, Treci the chief medical officer.

We are one of the leaders in messenger RNA, but we dont consider ourselves a messenger RNA company, said Sahin, also a professor at the Mainz University Medical Center. We consider ourselves an immunotherapy company.

Like Moderna, BioNTech licensed technology developed by the Pennsylvania scientist whose work was long ignored, Karik, and her collaborator, Weissman. In fact, in 2013, the company hired Karik as senior vice president to help oversee its mRNA work.

But in their early years, the two biotechs operated in very different ways.

In 2011, Moderna hired the CEO who would personify its brash approach to the business of biotech.

Stphane Bancel was a rising star in the life sciences, a chemical engineer with a Harvard MBA who was known as a businessman, not a scientist. At just 34, he became CEO of the French diagnostics firm BioMrieux in 2007 but was wooed away to Moderna four years later by Afeyan.

Moderna made a splash in 2012 with the announcement that it had raised $40 million from venture capitalists despite being years away from testing its science in humans. Four months later, the British pharmaceutical giant AstraZeneca agreed to pay Moderna a staggering $240 million for the rights to dozens of mRNA drugs that did not yet exist.

The biotech had no scientific publications to its name and hadnt shared a shred of data publicly. Yet it somehow convinced investors and multinational drug makers that its scientific findings and expertise were destined to change the world. Under Bancels leadership, Moderna would raise more than $1 billion in investments and partnership funds over the next five years.

Modernas promise and the more than $2 billion it raised before going public in 2018 hinged on creating a fleet of mRNA medicines that could be safely dosed over and over. But behind the scenes the companys scientists were running into a familiar problem. In animal studies, the ideal dose of their leading mRNA therapy was triggering dangerous immune reactions the kind for which Karik had improvised a major workaround under some conditions but a lower dose had proved too weak to show any benefits.

Moderna had to pivot. If repeated doses of mRNA were too toxic to test in human beings, the company would have to rely on something that takes only one or two injections to show an effect. Gradually, biotechs self-proclaimed disruptor became a vaccines company, putting its experimental drugs on the back burner and talking up the potential of a field long considered a loss-leader by the drug industry.

Meanwhile BioNTech has often acted like the anti-Moderna, garnering far less attention.

In part, that was by design, said Sahin. For the first five years, the firm operated in what Sahin called submarine mode, issuing no news releases, and focusing on scientific research, much of it originating in his university lab. Unlike Moderna, the firm has published its research from the start, including about 150 scientific papers in just the past eight years.

In 2013, the firm began disclosing its ambitions to transform the treatment of cancer and soon announced a series of eight partnerships with major drug makers. BioNTech has 13 compounds in clinical trials for a variety of illnesses but, like Moderna, has yet to get a product approved.

When BioNTech went public last October, it raised $150 million, and closed with a market value of $3.4 billion less than half of Modernas when it went public in 2018.

Despite his role as CEO, Sahin has largely maintained the air of an academic. He still uses his university email address and rides a 20-year-old mountain bicycle from his home to the office because he doesnt have a drivers license.

Then, late last year, the world changed.

Shortly before midnight, on Dec. 30, the International Society for Infectious Diseases, a Massachusetts-based nonprofit, posted an alarming report online. A number of people in Wuhan, a city of more than 11 million people in central China, had been diagnosed with unexplained pneumonia.

Chinese researchers soon identified 41 hospitalized patients with the disease. Most had visited the Wuhan South China Seafood Market. Vendors sold live wild animals, from bamboo rats to ostriches, in crowded stalls. That raised concerns that the virus might have leaped from an animal, possibly a bat, to humans.

After isolating the virus from patients, Chinese scientists on Jan. 10 posted online its genetic sequence. Because companies that work with messenger RNA dont need the virus itself to create a vaccine, just a computer that tells scientists what chemicals to put together and in what order, researchers at Moderna, BioNTech, and other companies got to work.

A pandemic loomed. The companies focus on vaccines could not have been more fortuitous.

Moderna and BioNTech each designed a tiny snip of genetic code that could be deployed into cells to stimulate a coronavirus immune response. The two vaccines differ in their chemical structures, how the substances are made, and how they deliver mRNA into cells. Both vaccines require two shots a few weeks apart.

The biotechs were competing against dozens of other groups that employed varying vaccine-making approaches, including the traditional, more time-consuming method of using an inactivated virus to produce an immune response.

Moderna was especially well-positioned for this moment.

Forty-two days after the genetic code was released, Modernas CEO Bancel opened an email on Feb. 24 on his cellphone and smiled, as he recalled to the Globe. Up popped a photograph of a box placed inside a refrigerated truck at the Norwood plant and bound for the National Institute of Allergy and Infectious Diseases in Bethesda, Md. The package held a few hundred vials, each containing the experimental vaccine.

Moderna was the first drug maker to deliver a potential vaccine for clinical trials. Soon, its vaccine became the first to undergo testing on humans, in a small early-stage trial. And on July 28, it became the first to start getting tested in a late-stage trial in a scene that reflected the firms receptiveness to press coverage.

The first volunteer to get a shot in Modernas late-stage trial was a television anchor at the CNN affiliate in Savannah, Ga., a move that raised eyebrows at rival vaccine makers.

Along with those achievements, Moderna has repeatedly stirred controversy.

On May 18, Moderna issued a press release trumpeting positive interim clinical data. The firm said its vaccine had generated neutralizing antibodies in the first eight volunteers in the early-phase study, a tiny sample.

But Moderna didnt provide any backup data, making it hard to assess how encouraging the results were. Nonetheless, Modernas share price rose 20% that day.

Some top Moderna executives also drew criticism for selling shares worth millions, including Bancel and the firms chief medical officer, Tal Zaks.

In addition, some critics have said the government has given Moderna a sweetheart deal by bankrolling the costs for developing the vaccine and pledging to buy at least 100 million doses, all for $2.48 billion.

That works out to roughly $25 a dose, which Moderna acknowledges includes a profit.

In contrast, the government has pledged more than $1 billion to Johnson & Johnson to manufacture and provide at least 100 million doses of its vaccine, which uses different technology than mRNA. But J&J, which collaborated with Beth Israel Deaconess Medical Centers Center for Virology and Vaccine Research and is also in a late-stage trial, has promised not to profit off sales of the vaccine during the pandemic.

Over in Germany, Sahin, the head of BioNTech, said a Lancet article in January about the outbreak in Wuhan, an international hub, galvanized him.

We understood that this would become a pandemic, he said.

The next day, he met with his leadership team.

I told them that we have to deal with a pandemic which is coming to Germany, Sahin recalled.

He also realized he needed a strong partner to manufacture the vaccine and thought of Pfizer. The two companies had worked together before to try to develop mRNA influenza vaccines. In March, he called Pfizers top vaccine expert, Kathrin Jansen.

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The story of mRNA: From a loose idea to a tool that may help curb Covid - STAT

Immune-Onc Therapeutics Announces Orphan Drug Designation of IO-202 (Anti-LILRB4) for Treatment of AML and Poster Presentation at ASH 2020 – BioSpace

Nov. 10, 2020 16:00 UTC

Trials in Progress poster presentation at the American Society of Hematology (ASH) Annual Meeting to detail mechanisms of action, preclinical data and trial design

IO-202, targeting the immune inhibitory receptor LILRB4 (also known as ILT3), is being evaluated in a Phase I trial for acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML)

PALO ALTO, Calif.--(BUSINESS WIRE)-- Immune-Onc Therapeutics, Inc. (Immune-Onc), a clinical-stage cancer immunotherapy company today announced that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation status for its first-in-class antagonist antibody IO-202 for treatment of acute myeloid leukemia (AML). In addition, the company announced acceptance of its Trials in Progress poster presentation for IO-202 at the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition. The meeting is taking place virtually December 5-8, 2020.

Orphan Drug Designation qualifies the sponsor for various development incentives of the Orphan Drug Act, including exemption of FDA application fees and tax credits for qualified clinical testing, to advance the evaluation and development of products that demonstrate promise for the diagnosis and treatment of rare diseases or conditions that affect fewer than 200,000 people in the United States. Orphan Drug Designation can also convey seven years of marketing exclusivity for a drug approved to treat an orphan disease in the United States.

Receiving orphan drug designation for IO-202 in AML is another important milestone for Immune-Onc and underscores the need for effective new treatments for this aggressive and hard-to-treat cancer, said Charlene Liao, Ph.D., chief executive officer of Immune-Onc. We are pleased with the progress we are making in advancing IO-202. As outlined in our ASH poster presentation, IO-202 holds promise for AML patients because it demonstrates novel mechanisms of action in overcoming immune suppression. IO-202 is one of several programs in our pipeline that target the LILRB family of immune inhibitory receptors. We are excited to continue our momentum in evaluating IO-202 and Immune-Onc's preclinical candidates in other cancers, including solid tumors, in the near future.

ASH Trials in Progress Poster

Based on highly selective criteria, Trials in Progress" abstracts are reviewed for the most innovative science. The abstract (#2867), A First-in-Human (FIH) Phase 1 Study of the Anti-LILRB4 Antibody IO-202 in Relapsed/Refractory (R/R) Myelomonocytic and Monocytic Acute Myeloid Leukemia (AML) and R/R Chronic Myelomonocytic Leukemia (CMML), was selected for poster presentation in the 2020 ASH Annual Meeting Program. Lead investigator Courtney D. DiNardo, M.D., MSc, associate professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, will share the poster via a brief PowerPoint presentation with accompanying audio.

The poster (Abstract #2867) will be presented at Session: 616. Acute Myeloid Leukemia: Novel Therapy, excluding Transplantation: Poster III, on Monday, December 7, 2020, 7:00 a.m. - 3:30 p.m. Pacific Time.

In addition to the presentation, the abstract was published online in the November supplemental issue of Blood and in the online meeting program on November 5, 2020.

ABOUT LILRB4 (also known as ILT3)

LILRB4, also known as ILT3, is an immune-modulatory transmembrane protein found on antigen presenting cells (APCs). It inhibits APC activation and induces immune tolerance via T-suppressor cells. It is expressed on certain hematologic cancer cells and immune suppressive myeloid cells in the solid tumor microenvironment. Immune-Onc and The University of Texas published pioneering research in Nature illuminating the role of LILRB4 in immune suppression and tumor infiltration in AML.

ABOUT IO-202

IO-202 is a first-in-class monoclonal antibody that antagonizes LILRB4 with high binding affinity and specificity. It has broad potential in both blood cancers and solid tumors. In hematologic malignancies, preclinical studies showed that IO-202 converts a dont kill me to a kill me signal by activating T cell killing and converts a dont find me to a find me signal by inhibiting infiltration of hematologic cancer cells.

IO-202 is being evaluated in a Phase I trial in two forms of blood cancer, AML and CMML. The U.S. Food and Drug Administration granted IO-202 Orphan Drug Designation status for treatment of AML in October 2020.

In solid tumors, IO-202 has potential to be combined with anti-PD-(L)1, other immunotherapies, and/or immunogenic chemotherapy. The company plans to evaluate IO-202 in solid tumors and in other forms of blood cancer in the near future.

ABOUT AML and CMML

AML, the most common acute leukemia (blood and bone marrow cancer) in adults, is characterized by the proliferation of abnormal myeloblasts (a type of white blood cell) in the bone marrow. Nearly 20,000 new cases are expected in the U.S. in 2020. Despite advances in treatment, less than 30 percent of acute myeloid leukemia patients are alive five years after initial diagnosis.

CMML is a cancer that starts in blood-forming cells in the bone marrow and invades the blood. The condition is rare, with about 1,100 cases in the U.S. each year.

ABOUT IMMUNE-ONC THERAPEUTICS

Immune-Onc Therapeutics, Inc. (Immune-Onc) is a clinical-stage cancer immunotherapy company dedicated to the discovery and development of novel myeloid checkpoint inhibitors for cancer patients. Headquartered in Palo Alto, California, Immune-Onc has assembled a diverse team with deep expertise in drug development and proven track records of success at leading biotechnology companies.

The company aims to translate unique scientific insights in myeloid cell biology and immune inhibitory receptors to discover and develop first-in-class biotherapeutics that disarm immune suppression in the tumor microenvironment. Immune-Onc has a promising pipeline with a current focus on targeting the Leukocyte Immunoglobulin-Like Receptor subfamily B (LILRB) of myeloid checkpoints. The company has strategic research collaborations with The University of Texas, Albert Einstein College of Medicine, and Memorial Sloan Kettering Cancer Center, and has invested in proprietary models, assays and tools to interrogate the biology and translate this cutting-edge research into the development of novel therapies.

In addition to IO-202, Immune-Oncs pipeline includes IO-108, an antibody targeting LILRB2 (also known as ILT4) in the IND-enabling stage of development. Additional preclinical candidates focused on myeloid checkpoints include an anti-LAIR1 antibody and multiple undisclosed programs for solid tumors and hematologic malignancies. For more information, please visit http://www.immune-onc.com and follow us on Twitter and LinkedIn.

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Immune-Onc Therapeutics Announces Orphan Drug Designation of IO-202 (Anti-LILRB4) for Treatment of AML and Poster Presentation at ASH 2020 - BioSpace

ERC Synergy project explores causes of drug tolerance in intractable fungal infections – News-Medical.net

Reviewed by Emily Henderson, B.Sc.Nov 10 2020

Over the next six years, research groups at Charit - Universittsmedizin Berlin and Tel Aviv University will study how invasive fungal pathogens are able to evade treatments and develop tolerance to antifungal drugs. In addition to generating fundamental knowledge of fungal pathogens, this large project aims to provide new insights into fungal cell metabolism. This joint endeavor is supported by a European Research Council ERC Synergy Grant worth approximately 9.7 million.

While fungal infections are extremely common, they are not usually life-threatening. Invasive fungal infections, however, are an exception, as they can lead to sepsis, a severe condition caused by an extreme systemic response to uncontrolled infection. Fungal infections of this kind can have a mortality of up to 50 percent, are often difficult to treat, and are responsible for at least 1.6 million deaths per year.

While bacterial infections can be treated with a range of antimicrobial drugs, only three classes of drugs (azoles, echinocandins and polyenes) have been shown to be effective against invasive fungal infections. Reasons for the paucity of effective drugs include the fact that fungal and human (and other mammalian) cells are very similar, which leaves very few pathogen-specific drug targets to choose from.

In addition to the dearth of antifungals, the situation is further exacerbated by the declining efficacy of these drugs. For instance, the drug of choice in the treatment of invasive candidiasis, fluconazole, is ineffective in approximately half of all invasive infections caused by Candida albicans, the most common human pathogen (better known as the organism responsible for thrush). Treatment failures such as these are, in part, explained by pathogen tolerance, a phenomenon which allows fungal cells to continue growing in the presence of an antifungal drug.

Under the leadership of Prof. Dr. Markus Ralser (Director of Charit's Institute of Biochemistry and Group Leader of the 'Biochemistry and Metabolic Systems Biology' research group) and Prof. Dr. Judith Berman (head of the Judith Berman Lab at Shmunis School of Biomedical and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University) a leading expert in fungal pathogens, the research teams are hoping to identify the precise mechanisms responsible for these treatment failures. One of their key hypotheses is that the explanation may be found in metabolic processes.

Our previous observations revealed that different types of cells work together. This collaboration involves the exchange of metabolites such as nutrients and results in the cells jointly developing tolerance. This metabolic collaboration makes cells heterogeneous. We have evidence that this metabolic heterogeneity may be a key factor in drug tolerance. Furthermore, inhibitors of metabolic pathways appear to influence the stress survival mechanisms in some of these cells."

Prof. Dr. Markus Ralser, Director of Charit's Institute of Biochemistry and Group Leader of the 'Biochemistry and Metabolic Systems Biology' research group

Both the Berlin and Tel Aviv research teams will now study the underlying biological mechanisms in great detail. "The situation regarding invasive fungal pathogens is fundamentally different from that involving antibiotic-resistant bacteria," explains Prof. Berman. She adds: "In problematic bacterial infections, pathogens often acquire mutations which render them resistant to antibiotics. In fungal pathogens, however, resistance is far less common and spreads less rapidly. Rather, what we find is that fungal cells become heterogeneous and adapt to their immediate environment. A proportion of cells continue to grow slowly, even in the presence of an antifungal drug. An examination of these growing cells shows that the growth exhibited by both drug-tolerant and non-tolerant cells is similar to that of the original strains. Cellular tolerance is therefore a phenotypic trait; it is not caused by mutations akin to those seen in bacterial resistance."

Their highly interactive work program will see Prof. Berman and Prof. Ralser work together to test thousands of fungal strains, establishing their drug tolerance levels and comparing their metabolic characteristics. To do so, they will work with clinicians and biologists from across Europe, Canada and the United States. Their common aim is to identify the molecular pathways which explain drug tolerance in fungal pathogens. The researchers also hope to develop new concepts and drugs which will be effective in preventing fungal pathogens from developing increased tolerance to antifungal drugs. The researchers are hopeful that their work will contribute to the development of new antifungal agents and new combination antifungal therapies which will be effective against life-threatening invasive fungal infections.

Prof. Markus Ralser studied genetics and molecular biology at the University of Salzburg and completed a PhD in neurodegenerative disorders at the Max Planck Institute (MPI) for Molecular Genetics in Berlin. Following his training in mass spectrometry at VU Amsterdam (Netherlands), he set up a Junior Research Group at the MPI for Molecular Genetics in Berlin, which he eventually moved to the University of Cambridge (United Kingdom) in 2011. He has been a Group Leader at the Francis Crick Institute in London since 2013. Markus Ralser became Einstein Professor of Biochemistry in 2018 and is one of the two Directors of Charit's Department of Biochemistry. His work focuses on central carbon metabolism (including the evolutionary origins of central carbon metabolism), amino acid metabolism, the metabolic responses to oxidative stress, and the use of self-establishing communities to study the exchange of metabolites in yeast. Prof. Ralser's numerous awards include the EMBO Gold Medal, the BioMed Central Research Award, the Starling Medal and the Colworth Medal.

Prof. Judith Berman completed her PhD at the Faculty of Biology, Weizmann Institute of Science (Israel). After starting her lab as Associate Professor at the University of Minnesota, her steep career path quickly led to her becoming a Distinguished McKnight University Professor at the Department of Genetics & Cellular Biology. In 2012, she became a Full Professor at the Department of Molecular Cell Biology, Tel Aviv University (Israel). Prof. Berman is a world-leading expert in fungal pathogen tolerance and holds numerous awards and honors. She is a researcher at the Shmunis School of Biomedical and Cancer Research at Tel Aviv University, and in addition to being a Member of the EMBO and the Genetics Society of America, she is also a Fellow of the American Academy for the Advancement of Science and a Fellow of the American Academy of Microbiology (ASM).

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ERC Synergy project explores causes of drug tolerance in intractable fungal infections - News-Medical.net