Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology – DocWire News

This article was originally published here

Res Sq. 2020 Aug 17:rs.3.rs-56281. doi: 10.21203/rs.3.rs-56281/v1. Preprint.

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS) but it is unknown whether prone positioning improves outcomes in mechanically ventilated patients with moderate to severe ARDS due to COVID-19.

METHODS: A cohort study at a New York City hospital at the peak of the early pandemic in the United States, under crisis conditions. The aim was to determine the benefit of prone positioning in mechanically ventilated patients with ARDS due to COVID-19. The primary outcome was in-hospital death. Secondary outcomes included changes in physiologic parameters. Fine-Gray competing risks models with stabilized inverse probability treatment weighting (sIPTW) were used to determine the effect of prone positioning on outcomes. In addition, linear mixed effects models (LMM) were used to assess changes in physiology with prone positioning.

RESULTS: Out of 335 participants who were intubated and mechanically ventilated, 62 underwent prone positioning, 199 met prone positioning criteria and served as controls and 74 were excluded. The intervention and control groups were similar at baseline. In multivariate-adjusted competing risks models with sIPTW, prone positioning was significantly associated with reduced mortality (SHR 0.61, 95% CI 0.46-0.80, P < 0.005). Using LMM to evaluate the impact of positioning maneuvers on physiological parameters, the oxygenation-saturation index was significantly improved during days 1-3 ( P < 0.01) whereas oxygenation-saturation index (OSI), oxygenation-index (OI) and arterial oxygen partial pressure to fractional inspired oxygen (P a O 2 :FiO 2 ) were significantly improved during days 4-7 ( P < 0.05 for all).

CONCLUSIONS: Prone positioning in patients with moderate to severe ARDS due to COVID-19 is associated with reduced mortality and improved physiologic parameters. One in-hospital death could be averted for every eight patients treated. Replicating results and scaling the intervention are important, but prone positioning may represented an additional therapeutic option in patients with ARDS due to COVID-19.

PMID:32839769 | PMC:PMC7444300 | DOI:10.21203/rs.3.rs-56281/v1

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Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology - DocWire News

Kiwi hoopster who failed Year 10 maths now new department head at uni in Australia – Stuff.co.nz

Cavan Flynn

I would be willing to concede I had some behavioural issues, I was a bit of a ratbag in those days, said Dr Vernon Coffey.

Education didnt come easily to Vernon Coffey.

Growing up in Feilding, he struggled through high school, more interested in shooting hoops on the basketball court than hitting the books.

I was a terrible student at high school, I struggled big time, I dont even have Year 10 maths.

I just scraped through my other Year 10 subjects. Year 11 was more of a disaster, I pretty much failed everything, but I went back to repeat it because of my love of basketball. I never finished that year either, once the basketball season was over, I lost interest.

My family would try and tell you I had learning difficulties or ADHD before it was really a thing, maybe I did, maybe I didnt, I dont know. I would be willing to concede I had some behavioural issues, I was a bit of a ratbag in those days.

After dropping out of school he drifted, directionless and low on self-confidence; a fringe role with the Manawatu Jets NBL basketball team the only bright spot in an uncertain future.

It took him six years to secure his first job, feeding paper into a recycling machine which turned it into insulation for housing and then drove the truck that collected the paper and cardboard.

Falling back on his passion, he enrolled in a one-year Certificate in Exercise Physiology at the then-Manawatu Polytechnic, in the hope of being able to work at a gym.

In his first exam, he scored 100 per cent the only person in his class to do so.

To say I was scared would be an understatement. I really applied myself, gave it as much effort as I possibly could do . . . and just trying to be a big sponge and taking in everything I could.

Cavan Flynn

Dr Vernon Coffey took six years to secure his first job, feeding paper into a recycling machine which turned it into insulation for housing

It proved to be the first tentative step in a transformative education journey that has seen Dr Coffey recently appointed as the new Head of Sport and Exercise Science at Bond University in Australia.

At the end of that year, he took up a diploma option, before moving to the Waikato Institute of Technology in Hamilton, where he completed his Bachelors Degree in Sport and Exercise Science, with Honours, under the supervision of current All Blacks strength and conditioning coach Nic Gill.

Another move, this time to Australia, led to Dr Coffey earning his PhD in Exercise Physiology at RMIT University in Melbourne, before taking up a dual role as Senior Lecturer/Researcher at QUT and eventually coming to Bond University on the Gold Coast as an Associate Professor at the end of 2014.

As an educator and researcher, hes a firm believer in not asking anyone to do anything he wouldnt do himself. As such, hes had 27 muscle biopsies over the course of his academic career so far.

When we look for research volunteers, when were talking to our students you have to live it, you have to experience these things if you really want to understand.

Cavan Flynn

Dr Vernon Coffey is the new Head of Sport and Exercise Science at Bond University in Australia.

Dr Coffeys life is now very different, but he hasnt entirely left his past behind hes still a huge basketball fan, and the walls of his new office play host to a collection of sports team caps and a banner from the San Antonio Spurs NBA team.

Another thing hes retained from his past is an understanding of the difference education and people can make in someones life.

Ive had a lot of people influence me, particularly when I was a student but being an educator and a teacher the value is in the people, whether its the educator or the student, it goes both ways.

Its something I try to continue to this day and in this position as head of program thatll be my message every year to incoming students, the power of knowledge but the value in people.

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Kiwi hoopster who failed Year 10 maths now new department head at uni in Australia - Stuff.co.nz

India-China standoff: Special clothing, diet for the Indian Army troops this winter along LAC – The Financial Express

Indian Army gets ready for a long winter deployment along the 826-km Line of Actual Control in Ladakh and has plans of sending in additional troops. The Indian Army is already in the process of procuring gloves, sleeping bags, special world class boots as well as layered jackets which would help the troops to deal with the extreme cold. Besides the need additional habitat for more troops being deployed, winter clothing, rations, there is going to be a huge need for fuel and equipment to last through the deadly winters. According to experts while there is expected to be additional expenses involved, maintaining a supply chain too will be a challenge.

Though there are heated facilities with bunker beds for around 10,000 troops who are already there, with additional troops the Army is also working on special diet plan and special arctic tents as the temperatures in the night are expected to touch almost -30 C in winters. The soldiers will be given multiple pair of clothing including shoes which often get wet due to snow.

New sleeping habitat like arctic tents and special high-nutrient diet are to be provided for almost 30,000 troops who have been in the region since May with heavy equipment to respond to any action by the Chinese side.

During the winters patrolling has always been curtailed, however, this time with the tensions mounting between India and China, and the heavy presence of the Peoples Liberation Army (PLA) across the LAC, India is not ready to take any chances.

Special Diet

The troops have to be fed special diet as they will be staying in low oxygen areas where there are no trees in Eastern Ladakh. The Defence Institute of Physiology and Allied Sciences study has done a calorie intake study and concluded that the requirement could be anything between 4,270 and 4,550 calories per day per person. So the ration going for them would include energy bars, chocolates, more fruits and vegetables.

Expert View

An army marches on its stomach; this idiom has been attributed to Frederick the Great (1712) and Napolean Bonaparte (1760-1821). It is an English version of the French phrase cest la soupe qui fait la soldat or its the soup that makes the soldier.

Sharing his view with Financial Express Online, Lt Col Manoj K Channan (Retd), says, The current standoff along the LAC is a nightmare for the Operations and Logistics staff, as modern armys require much more than a piece of bread and soup. The super high altitude and desert terrain, sparse vegetation entails that all items need to be transported both by road and air. While the winter stocking must have been carried out, the lines of communication for logistics need to be kept open irrespective of the weather.

This is a daunting task for the Border Roads Organisation (BRO) as in addition to carrying out the construction of new roads it now has to ensure that the passes are kept open despite the heavy snowfall and minus thirty degree temperatures. While the man is being looked after the machine equipment management will be tested to its extremes as the extreme cold weather conditions have its impact on perishable parts. Make shift shelters need to be created with heating and protection from the moisture.

There is a need to ensure that the troops deployed are sent on rotational rest and recuperation so that mental fatigue of deployment in a cold frigid region does not affect the moral of the troops.

I am sure that the Military Leadership is well seized of the challenges that are being faced and have pragmatic solutions with years of experience, having done such deployments in areas akin to the present deployment, Lt Col Manoj K Channan concludes.

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India-China standoff: Special clothing, diet for the Indian Army troops this winter along LAC - The Financial Express

UNSW researchers find new insights on whale migration – News Of The Area

NSW Science researcher Dr Catharina Vendl with the telescopic pole she used to collect whale snot in Hervey Bay. CREDIT: UNSW Sydney

EAST Australian humpback whales complete, on average, an 8000-kilometre round trip between Antarctica and Queensland from May to November each year, fasting for most of their journey.

Lead author and researcher, Dr Catharina Vendl, was part of a team of UNSW researchers who studied the changes to these whales airway bacteria, which showed the physiological challenges they experience during migration, and indicated a possible compromised state of health.

Our findings are the first to provide good evidence of a connection between the whales airway bacterial communities, their physiology and immune function something that has been established in humans, said Dr Vendl.

In general, we assume that this shift in microbiota is a naturally occurring phenomenon caused by the whales annual migration.

Studies have shown that whales accumulate large volumes of environmental pollutants in their stored fat layers/blubber.

When they live off their blubber during migration these pollutants are released into the body and can have a negative effect on the immune system of the whales, she said.

In addition to reducing marine pollution, Dr Vendl said that its important to minimise potentially stressful impact on the whales, which includes following the legal guidelines for boats to keep a safe distance from the whales.

The whales do recover when they return to their feeding grounds in Antarctica, she said.

However, the increase in marine pollutants and other anthropogenic stressors are a more recent phenomenon adding to the whales compromised immune system.

Humpback whales do not only play an essential role in their marine ecosystem but also represent an important economic resource, because whale watching is a booming industry in many Australian cities and around the world.

By Ashley CHRYSLER

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UNSW researchers find new insights on whale migration - News Of The Area

The open and shut case of a much-loved Kyoto bookstore : The Asahi Shimbun – Asahi Shimbun

KYOTO--A much-beloved bookstore here that recently closed after 70 years in business is still springing surprises on passers-by.

Sangatsu Shobo in the city'sNakagyo Ward now bears a meticulous spray painting on the shutter based on a photo of the store front as it was, giving the impression it is still open. The image appeared on Aug. 24.

The store posted a sign after it closedon June 11 that said, Closed seven days a week, closed all year round.

It opened in 1950, and its unique selection of books in the humanities and social sciences attracted intellectuals such as the acclaimed critic Takaaki Yoshimoto and the waka poet Yuko Kawano.

While books are no longer sold at the store, the owner plans to continue selling inventory over the internet for the remainder of the year.

Soon after in-store sales ended, Tatsuo Shishido, 71, the third-generation owner felt that leaving the shutter closed did not help the ambience of the neighborhood. That was when he was contacted by Shinichi Fukuoka, 60, a biology professor at Tokyos Aoyama Gakuin University.

Having graduated from Kyoto University, Fukuoka was a huge fan of Sangatsu Shobo and he proposed the idea of a painting over the shutter. Shishido loved the idea and the pair agreed to split the expense.

A photo of the bookstore when it was in business proper was enlarged. But the clarity was no good, so it was decided to paint a copy.

The photo showed a reflection of a bicycle on the storefront window, so a real bicycle was placed at the same spot to recreate the photo.

I hope people will be fooled into thinking that a store they thought had closed was still actually open, Shishido said. Some people may say I am not going away gracefully by doing this.

Fukuoka found books at Sangatsu Shobo that would go on to influence his career as a researcher. One such book was Chance and Necessity written by the French biochemist Jacques Monod, who shared the Nobel Prize in Physiology or Medicine in 1965.

Fukuoka described Sangatsu Shobo as the ideal bookstore found in the community that clearly reflected the taste and intellectual background of the owner.

I felt the bookstore was saying If you consider yourself an intellectual you have to read this, Fukuoka said. I wanted it to remain in the memory of many people, but above all, I wanted people to enjoy the surprise.

At around noon on Aug. 25, Yoshihiko Wakuda, 48, a company employee who had come all the way from Kobe admitted to being surprised.

I used to come here often in the past because it was such a good bookstore, Wakuda said. I came today to find out what it looked like now. For a moment, I thought it was still open.

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The open and shut case of a much-loved Kyoto bookstore : The Asahi Shimbun - Asahi Shimbun

Why Do Some People Weather Coronavirus Infection Unscathed? – Medscape

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

One of the reasons Covid-19 has spread so swiftly around the globe is that for the first days after infection, people feel healthy. Instead of staying home in bed, they may be out and about, unknowingly passing the virus along. But in addition to these pre-symptomatic patients, the relentless silent spread of this pandemic is also facilitated by a more mysterious group of people: the so-called asymptomatics.

According to various estimates, between 20 and 45 percent of the people who get Covid-19 and possibly more, according to a recent study from the Centers for Disease Control and Prevention sail through a coronavirus infection without realizing they ever had it. No fever or chills. No loss of smell or taste. No breathing difficulties. They don't feel a thing.

Asymptomatic cases are not unique to Covid-19. They occur with the regular flu, and probably also featured in the 1918 pandemic, according to epidemiologist Neil Ferguson of Imperial College London. But scientists aren't sure why certain people weather Covid-19 unscathed. "That is a tremendous mystery at this point," says Donald Thea, an infectious disease expert at Boston University's School of Public Health.

The prevailing theory is that their immune systems fight off the virus so efficiently that they never get sick. But some scientists are confident that the immune system's aggressive response, the churning out of antibodies and other molecules to eliminate an infection, is only part of the story.

These experts are learning that the human body may not always wage an all-out war on viruses and other pathogens. It may also be capable of accommodating an infection, sometimes so seamlessly that no symptoms emerge. This phenomenon, known as disease tolerance, is well-known in plants but has only been documented in animals within the last 15 years.

Disease tolerance is the ability of an individual, due to a genetic predisposition or some aspect of behavior or lifestyle, to thrive despite being infected with an amount of pathogen that sickens others. Tolerance takes different forms, depending on the infection. For example, when infected with cholera, which causes watery diarrhea that can quickly kill through dehydration, the body might mobilize mechanisms that maintain fluid and electrolyte balance. During other infections, the body might tweak metabolism or activate gut microbes whatever internal adjustment is needed to prevent or repair tissue damage or to make a germ less vicious.

Researchers who study these processes rely on invasive experiments that cannot be done in people. Nevertheless, they view asymptomatic infections as evidence that disease tolerance occurs in humans. At least 90 percent of those infected with the tuberculosis bacterium don't get sick. The same is true for many of the 1.5 billion of people globally who live with parasitic worms called helminths in their intestines. "Despite the fact that these worms are very large organisms and they basically migrate through your tissues and cause damage, many people are asymptomatic. They don't even know they're infected," says Irah King, a professor of immunology at McGill University. "And so then the question becomes, what does the body do to tolerate these types of invasive infections?"

While scientists have observed the physiological processes that minimize tissue damage during infections in animals for decades, it's only more recently that they've begun to think about them in terms of disease tolerance. For example, King and colleagues have identified specific immune cells in mice that increase the resilience of blood vessels during a helminth infection, leading to less intestinal bleeding, even when the same number of worms are present.

"This has been demonstrated in plants, bacteria, other mammalian species," King says.

"Why would we think that humans would not have developed these types of mechanisms to promote and maintain our health in the face of infection?" he adds.

In a recent Frontiers in Immunologyeditorial, King and his McGill colleague Maziar Divangahi describe their long-term hopes for the field: A deeper understanding of disease tolerance, they write, could lead to "a new golden age of infectious disease research and discovery."

Scientists have traditionally viewed germs as the enemy, an approach that has generated invaluable antibiotics and vaccines. But more recently, researchers have come to understand that the human body is colonized by trillions of microbes that are essential to optimal health, and that the relationship between humans and germs is more nuanced.

Meddlesome viruses and bacteria have been around since life began, so it makes sense that animals evolved ways to manage as well as fight them. Attacking a pathogen can be effective, but it can also backfire. For one thing, infectious agents find ways to evade the immune system. Moreover, the immune response itself, if unchecked, can turn lethal, applying its destructive force to the body's own organs.

"With things like Covid, I think it's going to be very parallel to TB, where you have this Goldilocks situation," says Andrew Olive, an immunologist at Michigan State University, "where you need that perfect amount of inflammation to control the virus and not damage the lungs."

Some of the key disease tolerance mechanisms scientists have identified aim to keep inflammation within that narrow window. For example, immune cells called alveolar macrophages in the lung suppress inflammation once the threat posed by the pathogen diminishes.

A deeper understanding of disease tolerance could lead to "a new golden age of infectious disease research and discovery," write King and Divangahi.

Much is still unknown about why there is such a wide range of responses to Covid-19, from asymptomatic to mildly sick to out of commission for weeks at home to full-on organ failure. "It's very, very early days here," says Andrew Read, an infectious disease expert at Pennsylvania State University who helped identify disease tolerance in animals. Read believes disease tolerance may at least partially explain why some infected people have mild symptoms or none at all. This may be because they're better at scavenging toxic byproducts, he says, "or replenishing their lung tissues at faster rates, those sorts of things."

The mainstream scientific view of asymptomatics is that their immune systems are especially well-tuned. This could explain why children and young adults make up the majority of people without symptoms because the immune system naturally deteriorates with age. It's also possible that the immune systems of asymptomatics have been primed by a previous infection with a milder coronavirus, like those that cause the common cold.

Asymptomatic cases don't get much attention from medical researchers, in part because these people don't go to the doctor and thus are tough to track down. But Janelle Ayres, a physiologist and infectious disease expert at the Salk Institute For Biological Studies who has been a leader in disease tolerance research, studies precisely the mice that don't get sick.

The staple of this research is something called the "lethal dose 50" test, which consists of giving a group of mice enough pathogen to kill half. By comparing the mice that live with those that die, she pinpoints the specific aspects of their physiology that enable them to survive the infection. She has performed this experiment scores of times using a variety of pathogens. The goal is to figure out how to activate health-sustaining responses in all animals.

A hallmark of these experiments and something that surprised her at first is that the half that survive the lethal dose are perky. They are completely unruffled by the same quantity of pathogen that kills their counterparts. "I thought going into this that all would get sick, that half would live and half would die, but that isn't what I found," Ayres says. "I found that half got sick and died, and the other half never got sick and lived."

Ayres sees something similar happening in the Covid-19 pandemic. Like her mice, asymptomatics seem to have similar amounts of the virus in their bodies as the people who fall ill, yet for some reason they stay healthy. Studies show that their lungs often display damage on CT scans, yet they are not struggling for breath (though it remains to be seen whether they will fully escape long-term impacts). Moreover, a small recent study suggests that asymptomatics mount a weaker immune response than the people who get sick suggesting that mechanisms are at work that have nothing to do with fighting infection.

"Why, if they have these abnormalities, are they healthy?" asks Ayres. "Potentially because they have disease tolerance mechanisms engaged. These are the people we need to study."

The goal of disease tolerance research is to decipher the mechanisms that keep infected people healthy and turn them into therapies that benefit everyone. "You want to have a drought-tolerant plant, for obvious reasons, so why wouldn't we want to have a virus-tolerant person?" Read asks.

A 2018 experiment in Ayres' lab offered proof of concept for that goal. The team gave a diarrhea-causing infection to mice in a lethal dose 50 trial, then compared tissue from the mice that died with those that survived, looking for differences. They discovered that the asymptomatic mice had utilized their iron stores to route extra glucose to the hungry bacteria, and that the pacified germs no longer posed a threat. The team subsequently turned this observation into a treatment. In further experiments, they administered iron supplements to the mice and all the animals survived, even when the pathogen dose was upped a thousandfold.

When the pandemic hit, Ayres was already studying mice with pneumonia and the signature malady of Covid-19, acute respiratory distress syndrome, which can be triggered by various infections. Her lab has identified markers that may inform candidate pathways to target for treatment. The next step is to compare people who progressed to severe stages of Covid-19 with asymptomatics to see whether markers emerge that resemble the ones she's found in mice.

"Why, if they have these abnormalities, are they healthy?" asks Ayres. "Potentially because they have disease tolerance mechanisms engaged. These are the people we need to study."

If a medicine is developed, it would work differently from anything that's currently on the market because it would be lung-specific, not disease-specific, and would ease respiratory distress regardless of which pathogen is responsible.

But intriguing as this prospect is, most experts caution that disease tolerance is a new field and tangible benefits are likely many years off. The work involves measuring not only symptoms but the levels of a pathogen in the body, which means killing an animal and searching all of its tissues. "You can't really do controlled biological experiments in humans," Olive says.

In addition, there are countless disease tolerance pathways. "Every time we figure one out, we find we have 10 more things we don't understand," King says. Things will differ with each disease, he adds, "so that becomes a bit overwhelming."

Nevertheless, a growing number of experts agree that disease tolerance research could have profound implications for treating infectious disease in the future. Microbiology and infectious disease research has "all been focused on the pathogen as an invader that has to be eliminated some way," says virologist Jeremy Luban of the University of Massachusetts Medical School. And as Ayres makes clear, he says, "what we really should be thinking about is how do we keep the person from getting sick."

Emily Laber-Warren directs the health and science reporting program at the Craig Newmark Graduate School of Journalism at CUNY.

Original post:
Why Do Some People Weather Coronavirus Infection Unscathed? - Medscape

Achieving the College Dream – lareviewofbooks

AUGUST 25, 2020

I TEACH HISTORY at Western Washington University, the kind of school that most four-year college students attend. I have many first-generation students. They are tenacious. But they struggle. They often keep their hardships to themselves, but a recent student admitted to sleeping in his van. Another, who came regularly to my office with her arms piled high with books, has run out of money to pay for food.

These students are not exceptions. The United Statess colleges have created a vast sorting machine. Children of wealthier, better-educated parents get accepted disproportionately to the nations most prestigious institutions, while first-generation students, many nonwhite, attend community colleges or regional four-years until a financial or personal crisis leads them to drop out. They are burdened with debt but get no degree.

This is unconscionable. And that is why Wont Lose This Dream: How an Upstart Urban University Rewrote the Rules of a Broken System is worth reading. Journalist Andrew Gumbel offers a fast-paced narrative celebrating Atlantas Georgia State University (GSU), a school with more Pell grant recipients than the Ivy League, for closing the gap in graduation rates between first-generation and other students. In 2003, GSU graduated a third of its students, but by 2018 that number doubled, even as GSU increased dramatically the number of low-income students admitted. GSU, Gumbel writes, erased all achievement gaps, without lowering its standards or misinterpreting or falsifying the results.

The moral significance of this fact cannot be underestimated. Wont Lose This Dream charts the reforms implemented by GSU president Mark Becker, with the encouragement and support of vice president for student success Timothy Renick, and Allison Calhoun-Brown in the student advising office. It is a top-down inside story of a school that refused to allow some of Americas most hardworking and deserving students to fail. Gumbel calls this the student success revolution.

I.

Despite the authors claims of a revolution, this book actually demonstrates how small changes yield large results. At a time when some reformers dream of disruptive innovation in higher education, Gumbel shows that what is really needed is an emphasis on understanding students. Administrators and professors often assume that first-generation students drop out because they cannot meet academic standards.

This book proves otherwise. At GSU, academic ability is almost never the factor causing a lower-income student to drop out. Poring through student data, GSU leaders discovered that many students about to graduate dropped out with good GPAs. They just ran out of money. They were one crisis away from losing it. The most important lesson to be taken from this book, therefore, is that when students are offered the financial and advising support that they need during a crisis, they will continue their studies. They have proven they can get by on little, but because of their precarity, one push the wrong direction upends years of work. Most students cash needs were small, usually under $1,500. Under Renicks guidance, GSU reached out to these students before they left. Instead of filling out complicated forms, the school would zero out the students accounts, pure and simple.

Their next decision was to reach students in good academic standing but unable to pay tuition, identify their issues, and provide financial support right there and then what came to be called Panther Retention Grants, after GSUs mascot. These small grants vastly improved graduation rates and cost the school almost nothing since, when students remain enrolled, they also continue to receive their grants and scholarships and to pay tuition and fees.

GSUs leaders then turned to students who struggled academically. They realized that the challenge facing these students wasnt lack of potential but difficulty adapting to college. Instead of offering remedial courses for no credit, GSU invited students with lower GPAs and SATs to start in summer to engage in college-level work and take advantage of the quieter time on campus to bond with each other and get a head start on their peers. They received guidance on how the university works, something more privileged students know or can intuit. They received academic support. They were prepped for success; almost 90 percent of the first summer cohort remained enrolled sophomore year and graduated at a higher rate than the university average.

The secret to these changes was that GSU leadership assumed that students were capable of making it. In turn, students knew that the institution believed in them. What we were giving them, Renick said, was the mindset that they can do college work. And it paid off for students and GSU. Speaking of the summer program, Renick stated, The more we retained, the more revenue we were generating.

These important changes combined with smaller ones such as a chatbot to interact with students via text, or a bio-bus to provide students shots when they couldnt locate their immunization records offered students what Gumbel calls a net. But it was more than that. It was a platform. GSU refused to believe that students dropped out because they werent good enough and the data was on their side. They left because they were poor, because they didnt understand how college worked, and because it was too hard to get the help that they needed when they needed it.

But when students academic, financial, and personal needs are taken care of efficiently and openly, first-generation students, like other students, can focus on learning. And they will flourish.

II.

College is about more than degrees. It is about education. Like their more privileged peers, first-generation students often arrive seeking a degree. Unlike Ivy League students, they are not imagining their degree as the ticket to a Wall Street job or federal clerkship. They simply want financial security for themselves and, often, their families.

In my experience at Western, if many students come seeking a degree, many also learn to value their education. I cannot name the number of first-generation students I have known who did not believe that they had minds worth taking seriously until a professor in one of their classes did so. When students are respected, they realize that one does not need to be at Harvard to think profoundly about the world. Indeed, Id wager, one of the joys of teaching at a school like mine is that, unlike elite students, when my students light up, they are free to pursue ideas precisely because they are not worried about every grade.

My experience as a professor shaped how I read this book. Gumbels book inspired me to ask more of myself and of colleges. It also frustrated me because of the authors dismissal of professorial work and the deeper purposes of scholarly life to which my colleagues and I are devoted.

Wont Lose This Dream is an authorized account [] initiated by Becker and Renick. Perhaps thats why the heroes are administrators and staff while almost all the villains are skeptical professors. There is no sense that professors care about anything other than themselves. Gumbel offers little awareness of the hours most professors devote to students. There is little about the commitments that animate our work. Many professors could have gone to Wall Street or worked for McKinsey. We didnt. We chose scholarship because we believe that what we teach and write about matters. And it does.

Gumbels failure to recognize the purposes of academic life weakens the book. Too often, it leads him to misrepresent issues. For example, the author dismisses shared governance as a way for professors to protect their interests. He offers nothing about its history nor why, in its absence, academic freedom is threatened by the centralization of power. In 1940s Georgia, for example, Governor Eugene Talmadge pressured universities to dismiss professors he thought insufficiently anticommunist or who favored racial integration. As Henry Reichman, author of The Future of Academic Freedom, reminds us, academic freedom is essential to fulfilling the mission of colleges and universities. Without it, colleges and universities will not be able to explore new ideas, advance science and the professions, and promote the arts and humanities to the benefit of all.

These issues never arise for Gumbel because, I think, he sees the primary purpose of college as getting out of college. He is less concerned with how colleges are organized, nor even what students learn. Thus, he writes dismissively of the tendency to load the first-year curriculum with courses that had little or no application to any other field of study, burdening students with unusable credits. Unusable in what sense? These are general courses. They offer a broad foundation prior to specialization. They might be the most important courses on campus. After all, they are the only ones all students must take, whether they major in chemistry or marketing. Instead of wasteful, why are they not fundamental?

Gumbel considers them wasteful because he shares with administrators the premise that students need to get into majors as fast as possible. Choosing a major may encourage retention, but there are reasons to resist asking students to choose a path too early. To Gumbel, students who dont know their major when they arrive are doing something wrong. I would argue that they are doing something right. College is for exploration. As a department chair, I know that every major I sign up secures more resources for my department. Nonetheless, when a first-year student comes to my office to declare their major, I ask them to come back in a year. I worry that if I sign them up too soon, theyll treat their other courses as irrelevant since, after all, they are unusable in their major. But that would be a mistake.

III.

The most important chapter in this book, the one on which the plot pivots, is called Moneyball. Like the managers of the Oakland As, the subject of the book Moneyball, GSU administrators and their advising staff decided to track students progress by computer and lay out a map of which courses they should take in what order to graduate on time. The first step was to get the data. The next step was to use it to guide students with predictive analytics.

There are two advantages to GSUs approach. First, the data can be used to generate flags that allow advisors to reach out to students when they stumble but before they fail. Second, data can be used to improve instruction. For example, if a certain course is consistently correlated with future student success, how can professors ensure more students master the material?

But the danger is that the data can be used in ways that threaten the above two goals. For example, in GSUs nursing program, data showed that first-year chemistry was correlated with success in the program, whereas first-year physiology was not. Why ask students to take it? Renick urged professors to remove the requirement. Perhaps that was the right decision. On the other hand, perhaps there are good reasons for wanting students to study physiology. We dont know because Gumbel doesnt think to ask.

And by refusing to consider this question, we see where the Moneyball approach to curricula becomes less appealing. The Moneyball approach is about winning, but not how the game is played or, for that matter, the development and well-being of the players. With the single metric of improving graduation rates, GSU did not use student data to support students and professors, but to predict what students should or shouldnt do.

Instead of directing students to professors who might help them, staff advisors sat down with students, shared the data, and let them know their odds. No doubt, were not all destined to become engineers or literary critics. The reality principle has a function. But the Moneyball approach treats all course credits and all classes as fungible. But credits, like money, mediate between unlike things.

This book therefore must be read alongside Jerry Mullers The Tyranny of Metrics. Whereas Gumbel presumes that anyone who questions data-based decision-making is self-serving and unscientific, Muller reminds us that metric fixation is itself an ideology that leads to unintended negative consequences, not just because all important things cannot be counted, but because most organizations have multiple purposes, and that which is measured and rewarded tends to become the focus of attention, at the expense of other essential goals. Far from being unscientific, scholars have found that [t]rying to force people to conform their work to preestablished numerical goals tends to stifle innovation and creativity and encourages the valuation of short-term goals over long-term purposes.

We know that the U.S. News & World Report rankings skewed universities priorities. One does not need a vivid imagination to assume the same incentive structures could be at work here. Maybe pre-nursing students need introductory physiology and maybe they do not. But if efforts to maximize degrees is not balanced by other values, students might be pressured to choose some majors over others, while faculty will be pressured to alter curricula to raise metrics in ways that will threaten educational quality.

One particular concern is that if data are used to guide first-generation students away from challenging majors, it could increase degree attainment through greater internal stratification. This would exacerbate preexisting inequalities. To Gumbel, my worry is unfounded because at GSU, the number of African American men obtaining science degrees shot up 60 percent in two years. If that holds over time across the arts and sciences, this would be welcome news.

IV.

This books primary villain is a GSU business professor and longtime dean who considered the business school the most prestigious in the university and wanted to keep it that way by maintaining high admission standards and weeding out weaker students. This attitude reflects the worst of contemporary academic culture. That same attitude was present among Beckers predecessors, who sought to improve GSU by recruiting students with higher SAT scores and bringing in research dollars to raise their U.S. News standings. Such attitudes are barriers to the student success revolution, Gumbel rightly argues.

What Gumbel fails to see is that the old guard was making the same mistake as the new guard. Both are driven by a singular focus on a small number of outcomes SAT scores and rankings in one case, degree production in the other. Both ignore the ways in which the metrics they favor can pervert the culture, values, and academic quality of their institutions.

We need a third way. What gets lost in this book is that college is not a place for degrees, but for education. It is a place for contemplation. Colleges should consider intellectual inquiry their highest ideal. Colleges may prepare leaders, but they should not be committed to flawed visions of meritocracy. What matters are not rankings and credentials but teaching, learning, and research. Most professors are devoted to students, but professors are human beings and we, too (I include myself), can get caught up with external measures of success status, prestige, money that threaten our core values. Colleges need a reformation, but one true to the academys purposes. If we believe that everyone who is capable of learning deserves a great education, we together must foster a culture of student success that pervades the entire institution.

I am grateful that GSU took seriously their students potential and challenged economic and racial inequality. GSU has proven that students struggle for reasons having little to do with academic ability or intellectual potential. That fact alone is enough to demand better of our institutions.

Ultimately the product of college education is not degrees but people. I recall the wisdom of a first-generation student in my seminar on contemporary American thought. He worked evenings at a local grocery store, a good union job. His co-workers teased him for wasting time studying history. But he told me that history gave him perspective on a complicated world and inspired him to want to keep learning. My student received a degree, but he valued his education more. Wont Lose This Dream recounts how one institution confronted roadblocks students face. The next step is to ensure we do so in ways that encourage students to receive the kind of education that they deserve.

Johann N. Neem is author of Whats the Point of College? Seeking Purpose in an Age of Reform and Democracys Schools: The Rise of Public Education in America. He teaches history at Western Washington University.

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Genetic Study Reveals Theres More to Melons Than Meets the Eye – Technology Networks

On the surface, the humble melon may just look like a tasty treat to most. But researchers from Japan have found that this fruit has hidden depths: retrotransposons (sometimes called "jumping sequences") may change how genes are expressed.

In a study published recently inCommunications Biology, researchers from the University of Tsukuba and the National Agriculture and Food Research Organization (NARO) have revealed that retrotransposons had a role in altering gene expression when melon genomes were diversifying, and may affect gene expression that induces fruit ripening.

Melons comprise one of the most economically important fruit crops globally. A special feature of melons is the coexistence of two fruit types: climacteric (which produce ethylene and exhibit a burst in cellular respiration as ripening begins), and non-climacteric. Ethylene is a plant hormone important to the regulation of climacteric fruit-ripening traits such as shelf life, which is of major economic importance.

"Because Harukei-3 melons produce ethylene during ripening, we wanted to look at ethylene-related gene expression in this type of melon," says lead author of the study Professor Hiroshi Ezura. "Harukei-3 produces an especially sweet fruit if grown in the right seasons. Because of its taste and attractive appearance, Harukei-3 has been used for a long time in Japan as a standard type for breeding high-grade muskmelon."

To examine ethylene-related gene expression, the researchers assembled the whole genome sequence of Harukei-3 by using third-generation nanopore sequencing paired with optical mapping and next-generation sequencing.

"We compared the genome of Harukei-3 with other melon genomes. Interestingly, we found that there are genome-wide presence/absence polymorphisms of retrotransposon-related sequences between melon accessions, and 160 (39%) were transcriptionally induced in post-harvest ripening fruit samples. They were also co-expressed with neighboring genes," explains Dr. Ryoichi Yano, senior author. "We also found that some retrotransposon-related sequences were transcribed when the plants were subjected to heat stress."

Retrotransposons are transposons (also referred to as "jumping sequences" because they can change their positions within a genome) with sequences similar to those of retroviruses.

"Our findings suggest that retrotransposons contributed to changes in gene expression patterns when melon genomes were diversifying. Retrotransposons may also affect gene expression that brings on fruit ripening," says Professor Ezura.

The Harukei-3 genome assembly, together with other data generated in this study, is available in the Melonet-DB database. Combined with future updates, this database will contribute to the functional genomic study of melons, especially reverse genetics using genome editing.

Reference: Yano et al. (2020).Comparative genomics of muskmelon reveals a potential role for retrotransposons in the modification of gene expression. Communications Biology.DOI: https://doi.org/10.1038/s42003-020-01172-0.

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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BCW, Lab of Misfits Are Using Neuroscience To Understand Consumer Behavior – PRovoke Media

NEW YORK BCW has partnered with consultancy Lab of Misfits on a new offering that uses neuroscience to understand what really makes people tick, in a bid to provide brands with better insights.

We want to understand the greatest depths of the way people think, feel and behave, BCW chief innovation officer Chad Latz said to PRovoke. Our goal here is to really understand whats driving people's motivations at the most fundamental level and use that information to drive greater connections between brands and audiences."

BCW NeuroLab Powered by Lab of Misfits, which focuses on studying perceptions, gleans that information through experiments that test and assess how participants brains react to stimuli such as language, ideas, images, emotions and events. Tech companies, for instance, could study what consumers frustration with technology looks like neurologically and adjust their positioning accordingly, Latz said.

BCW NeuroLab offers clients four services: using neuroscience to define brand purpose, marketplace strategy and positioning; creating experiments to better understand the perceptions and needs of stakeholders; studying the obstacles and opportunities associated with organizational change to drive better engagement and transformation; and applying principles of perception to create more effective marketing and communications experiences.

Experiments run the gamut from testing the brain activity of thousands of online participants to individual immersive experiences. Although a multitude of marketers leverage behavioral science in creating strategy, the NeuroLab goes further by focusing on the scientific drivers of consumer behaviors versus simply evaluating them, Latz said.

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Transfusions to possibly help the brain from stroke damage, recent WVU neuroscience research suggests – WBOY.com

MORGANTOWN, W.Va. A recent study conducted by neuroscientists from West Virginia University shows a potential step towards improving stroke therapy.

The study, which is believed to be the first, shows that blood substitution therapy rescues the brains of mice from ischemic damage. The idea is to eventually be able to use blood transfusions in humans who suffer from a stroke.

According to neuroscientists, most strokes (ischemic) occur when the blood supply to the brain is interrupted, usually by a blockage of the arteries leading to the brain. There is no known single medication for stroke, however, the only FDA-approved treatment for ischemic strokes is tPA, or tissue plasminogen activator, which dissolves the clot and improves blood flow.

Xuefang Sophie Ren, research assistant professor in the Department of Neuroscience and director of the WVU Experimental Stroke Core led the team in this study.

What we were able to demonstrate is that if you remove part of the blood from a subject undergoing stroke, and replace that blood from a subject thats never had a stroke, the outcomes of that stroke are profoundly improved, said Ren.

While tPA typically has to be administered within three hours of the stroke, Rens research indicates that blood transfusions can take place beyond that limited window. With a blood transfusion, it can take up to seven hours and still have a positive impact.

According to release, the study showed that replacing 20 percent of the blood in a mouse was enough to show a profound reduction in damage to the brain. The average adult holds around one-and-a-half gallons of blood in the body.

The idea is to change the immune response that happens after stroke, said James Simpkins, co-author of the study and director of the Center for Basic & Translational Stroke Research.

Simpkins is also a professor of the Department of Neuroscience. Heng Hu, postdoctoral fellow and Experimental Stroke Core surgeon, also helped co-author the study.

Following a stroke, the makeup of a patients blood changes, causing disruptions in the brain and how the body responds, explained by researchers. A type of white blood cell that helps lead the immune systems response, known as Neutrophils, play a role in increasing the levels of an enzyme called MMP-9, which can lead to blood-brain barrier leakage and degeneration in brain tissue.

The study concluded that blood replacement therapy removes inflammatory cells and decreases neutrophils and MMP-9 levels following a stroke.

The immune system doesnt recognize much of whats happening when theres a stroke. So the neutrophils go to the brain and try to clean up the damage that happens. But theres too much in the brain and those same neutrophils release MMP-9, which then exacerbates the damage.

What we learn is that stroke is simply not a cerebral vascular event. Its a whole-body event. Both the brain and the body get signals that somethings going on in the brain and as the immune system responds to try to help, it actually worsens the outcome. Therefore, by removing the blood and replacing it with the blood of those that have not experienced stroke, we get good outcomes.

Ren said that now, blood replacement therapy is a proven strategy that targets the pathological systemic responses to stroke, and could reduce the mortality of stroke patients.

In an ideal circumstance, a person having a stroke would show up to Ruby (Memorial) or any hospital. Theyd go through the proper protocol. We would remove their stroke blood and magically restore it with the right kind of blood that would tamp down this immune response theyre experiencing. If it works out, thats good for all of us, said Simpkins.

According to the Centers for Disease Control and Prevention, more than 795,000 Americans experience a stroke each year and 140,000 die from it.

Blood indeed saves our brains and lives from stroke damage, Ren said.

Full research article published on Nature Communications.

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Transfusions to possibly help the brain from stroke damage, recent WVU neuroscience research suggests - WBOY.com