Medically Speaking Team

A smell from human skin attracts mosquitos that spread Zika, dengue, and yellow disease. The particular composition of the fragrance remained unknown up to this moment.

According to UC Riverside study, the fragrance that encourages a mosquito to locate and settle on its victim is formed by a combination of carbon dioxide and the chemicals 2-ketoglutaric and lactic acids. This chemical combination also encourages probing, or piercing mouthpieces to check for blood. This chemical combination appears to attract female Aedes aegypti mosquitos, which carry the Zika, chikungunya, dengue, and yellow fever viruses. Although this mosquito was found in Africa, it has subsequently migrated to many tropical and subtropical nations, including the United States.

In the journal Scientific Reports, the team’s new research finding and how it was made are described in detail. “Although others have discovered substances that attract mosquitoes, many of them don’t have a noticeable, immediate impact. This one does, according to entomologist Ring Carde of UCR.

Mosquitoes employ a number of indicators, such as carbon dioxide, sight, temperature, and humidity, to find their prey. Recent studies by Carde, however, indicate that skin scents are much more crucial for identifying a bite location.

We showed that mosquitoes land on visually unclear targets that are infused with these two scents, and these targets are not connected to heat or wetness, according to Carde. Skin odour is now the main determining factor.

Given the importance of smell in mosquitoes’ ability to successfully feed on humans, Carde set out to identify the precise compounds that give humans’ fragrance such power to the insects. Lactic acid, a component of the equation, was recognised as one of the chemical components of the odour cocktail as early as 1968.

Since then, numerous studies have found that human-produced compounds, such as ammonia and carbon dioxide, also draw these insects. Carde, who has spent 26 years studying mosquitoes, concluded that these additional compounds were not potent attractants.

Carde stated, “I had a sneaking suspicion there was some unexplored aspect to the chemistry of smells tempting the yellow fever mosquito. I sought to identify the precise combination.

The 2-ketoglutaric acid could not have been identified using the methods that chemists generally employ, according to Carde. Gas chromatography would not have detected this acid, which separates substances based on their polarity and molecular weight.

Because of the intricacy of the human odour profile and the minute levels of these compounds present in sweat, said scientist Jan Bello, previously of UCR and currently with insect pest control business Provivi, “I suspect that these molecules may not have been detected earlier.”

Carde turned to Bello, who was drawing substances from the sweat on his own foot to use as a mosquito attractant. He put glass beads in his socks and wore them for four hours while walking about to gather odours.

Bello remarked that wearing the beads was similar to “squeezing stress balls full of sand, but with your feet.” They would eventually become unpleasant after doing that for a while because they would get trapped in between your toes, which is the most aggravating aspect.

The expense was worthwhile despite the hassle. Bello purified compounds from the perspiration left on the sock beads and tracked how the chemicals affected the behaviour of mosquitoes. The combo that was the most active was thus revealed.

Future research is intended to ascertain whether the same substance works against other mosquito species and why different people are prone to be bitten differently. Some are more alluring to these mosquitoes than others, but no one has yet determined why, according to Carde.

Even while their discovery may not give information for the development of new repellents, the study team is confident that it may be used to attract, catch, and perhaps kill disease-carrying mosquitos.

Finally, we’re relieved that we identified these substances since we weren’t always sure we would. Thoughts don’t always come true, but we had a feeling they did, Carde added.

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India reported 5,747 fresh Covid-19 infections in the last 24 hours, the Union Ministry of Health and Family Welfare informed on Saturday.

India’s active caseload currently stands at 46,848 which accounts for 0.11 per cent of the total infections. According to the Health Ministry, the country has seen 5,618 recoveries from the infection in the last 24 hours which has taken the total recoveries to 4,39,53,374. The total recovery rate is currently 98.71 per cent.

The daily positivity rate stood at 1.69 per cent while the weekly positivity rate is at 1.74 per cent.

So far, India has conducted a total of 89.12 crore Covid tests, of which 3,40,211 were conducted in the last 24 hours alone.
The Union Government is committed to accelerating the pace and expanding the scope of COVID-19 vaccination throughout the country.

Covid vaccination

The nationwide COVID-19 vaccination began on 16th January 2021. The new phase of universalisation of COVID-19 vaccination commenced on 21st June 2021.

Meanwhile, as part of the nationwide vaccination drive, the Government of India has been supporting the States and UTs by providing them with COVID Vaccines free of cost. In the new phase of the universalisation of the COVID-19 vaccination drive, the Union Government will procure and supply (free of cost) 75 per cent of the vaccines being produced by the vaccine manufacturers in the country to States and UTs.

Under the Nationwide Vaccination Drive, out of the total of 216.17 crore Vaccine doses for Covid-19 infection (94.62 cr Second Dose and 19.14 cr Precaution Dose) have been administered so far, 23,92,530 doses have been jabbed in the last 24 hours.

According to the ministry, more than 216.41 crores (2,16,41,70,550) vaccine doses have been provided to States/UTs so far through the government of India (free of cost channel) and through direct state procurement category and more than 3.94 Crore (3,94,02,820) balance and unutilized COVID Vaccine doses are still available with the States/UTs to be administered.

Also Read: Researchers find exercise might be a developing treatment for movement disorders

A study of students undertaken by researchers at the University of Rochester Medical Center found that the majority of children with asthma also had allergic rhinitis, popularly known as hay fever. The symptoms of hay fever include a runny nose, sneezing, congestion, and sinus pressure, and it can worsen asthma.

Jessica Stern, M.D., an assistant professor in the department of Pediatrics and the division of Pediatric Allergy and Immunology, led the study, which showed that children who had both asthma and hay fever had lower asthma outcomes. The study’s findings were reported in the Journal of Asthma.

This study examined data from three NIH-funded studies including 1,029 Rochester schoolchildren with asthma (directed by Jill Halterman, M.D., professor in the department of Pediatrics). The studies’ major purpose was to see if giving children preventative asthma drugs at school improved their asthma symptoms. While the majority of children in these studies had better asthma symptoms after receiving their drugs, a subset of children did not. This encouraged the researchers to investigate additional health issues that may have prevented the youngsters from receiving a complete therapeutic response.

“Through our study, we found that many of the children who did not report improved symptoms had allergic rhinitis in addition to asthma, and these children had more asthma symptoms, used their rescue medication more, and missed more school days compared to those without allergic rhinitis,” said Stern.

This study examined data from three NIH-funded studies including 1,029 Rochester schoolchildren with asthma (directed by Jill Halterman, M.D., professor in the department of Pediatrics). The studies’ major purpose was to see if giving children preventative asthma drugs at school improved their asthma symptoms. While the majority of children in these studies had better asthma symptoms after receiving their drugs, a subset of children did not. This encouraged the researchers to investigate additional health issues that may have prevented the youngsters from receiving a complete therapeutic response.

Importantly, less than half of the children with hay fever were receiving proper treatment for their symptoms, including nasal sprays and recommended anti-histamines; nor had they been seen by asthma or allergy specialists.

“This is critical because it highlights gaps in care and needed treatments, which may contribute to the disparities in asthma outcomes that we see in children who primarily identify as Black or Latino, or are from low resourced communities,” said Stern. “These findings also encourage a focus on contributing environmental factors and the social determinants of health for these children. The burden of allergic disease is often under-recognized and undertreated in historically marginalized populations, and we have an opportunity and obligation to address this to improve outcomes.”

Dr. Stern will be continuing this work to understand the multiple influences in a child’s life that impact their asthma. She has grant funding from the Robert A. Winn Diversity in Clinical Trials Career Development Award, NHLBI, and the URMC Quality Institute.

“We are working to create a comprehensive, multi-disciplinary approach to overcome structural obstacles to equitable care for children with asthma. This will involve collaboration with caregivers and patients to plan systems of care that work for them. We understand that families are the experts, and we have to listen to what they think,” said Stern.

Also Read: Balanced meal timing may enhance brain health: Study

In mice affected by SCA6, the McGill team, led by biology professor Alanna Watt, found that exercise restored the health of cells in the cerebellum, the part of the brain implicated in SCA6 and other ataxias.

Spinal cerebellar ataxia 6 (SCA6) is a genetic neurological disorder that causes problems with motor coordination. Medical experts have given little attention to SCA6 since it affects just around one in 100,000 persons. There is presently no known cure and just a few treatment options.

The findings of the study “Activation of TrkB – Akt signaling rescues deficits in a mouse model of SCA6” by Anna Cook et al. was published in Science Advances. Now, a team of McGill University researchers specializing in SCA6 and other forms of ataxia, have published findings that not only offer hope for SCA6 sufferers but may also open the way to developing treatments for other movement disorders.

Exercise in a pill

In mice affected by SCA6, the McGill team, led by biology professor Alanna Watt, found that exercise restored the health of cells in the cerebellum, the part of the brain implicated in SCA6 and other ataxias. The reason for the improvement, the researchers found, was that exercise increased levels of brain-derived neurotrophic factor (BDNF), a naturally occurring substance in the brain which supports the growth and development of nerve cells. Importantly for patients with a movement disorder, for whom exercise may not always be feasible, the team demonstrated that a drug that mimicked the action of BDNF could work just as well as exercise, if not better.

Early intervention crucial

The researchers also discovered that BDNF levels in SCA6 mice declined well before movement difficulties began to appear. The drug, they found, worked to arrest the decline only if it was given before the onset of outwardly visible symptoms.

“That’s not something we really knew about SCA6,” said lead author Anna Cook, a Ph.D. candidate in Professor Watt’s lab. “If there are these early changes in the brain that people don’t even know about, it tends to advocate for more genetic screening and early intervention for these rare diseases.”

Also Read: Repeated infections associated with increased risk of some neurodegenerative diseases: Study

Dementia affects over 55 million individuals globally, and its incidence has gradually increasing. The population is predicted to quadruple by 2050, with the greatest growth occurring in low- and middle-income nations. Dementia not only diminishes people’s quality of life, but it also imposes huge financial costs on families and society meal.

Epidemiological studies have found a link between the time distribution of energy intake throughout the day (TPEI) and the risk of developing chronic illnesses including diabetes and hypertension. However, research on the link between TPEI and cognitive performance in the general population is limited. Previous research in animal models has demonstrated that disrupting meal time might change clock rhythms in the hippocampus, impacting cognitive performance.

A short-term intervention study of 96 young people found that splitting similar amounts of food over four meals between 9 a.m. and 3 p.m. improved cognitive performance more than eating twice between 9 a.m. and 3 p.m. However, long-term research on TPEIs and cognitive performance is insufficient.

Recently, Drs Changzheng Yuan and Dongmei Yu at Zhejiang University published a paper in Life Metabolism entitled “Temporal patterns of energy intake and cognitive function and its decline: a community-based cohort study in China” Based on the China Nutrition Health Survey (CHNS) public database, a total of 3,342 participants were included in this study, who were middle-aged and older adults (mean age 62 years) from nine provinces in China with a baseline age >= 55 years.

The researchers used: 1) A data-driven k-means algorithm to identify six patterns of TPEIs, including “evenly-distributed” pattern, “breakfast-dominant” pattern, “lunch-dominant” pattern, “dinner-dominant” pattern, “snack-rich” pattern, and “breakfast-skipping” pattern; 2) Cognitive function was assessed using the modified Telephone Interview for Cognitive Status (TICS-m), comprising immediate and delayed word recalls (20 points), backward counting (2 points), and serial-7 subtraction test (5 points).

The total global cognitive score ranged from 0 to 27, with a higher score representing a better cognitive function; 3) The correlation of TPEIs to cognitive function over 10 years was assessed using linear mixed models (LMMs), which were adjusted for age, gender, residence, total energy, physical activity, smoking status, alcohol consumption, household income, education level, and body mass index (BMI).

The result showed that, compared with those with an “evenly-distributed” pattern, the long-term cognitive function scores were significantly lower in those who had unbalanced TPEIs, especially those with a “breakfast-skipping” pattern. Thus, maintaining balanced TPEIs has potentially positive effects on cognitive health, whereas skipping breakfast may significantly increase the risk of cognitive decline in middle-aged and older adults. In conclusion, this study highlights the importance of optimal TPEIs in cognitive function.

Also Read: Repeated infections associated with increased risk of some neurodegenerative diseases: Study

According to a new study, infections treated with specialty hospital care in early and mid-life are related with an elevated risk of Alzheimer’s (AD) and Parkinson’s diseases (PD), but not amyotrophic lateral sclerosis (ALS).

Animal studies have shown that infection has a role in the development of various neurodegenerative disorders, but human data is lacking.

In the new study, researchers used data on people diagnosed with AD, PD or ALS from 1970-2016 in Sweden and five matched controls per case, all identified from the Swedish National Patient Register. The analysis included 291,941 AD cases, 103,919 PD cases and 10,161 ALS cases. A hospital-treated infection 5 or more years before diagnosis was associated with a 16% higher risk of AD (95%CI: 1.15-1.18, P < 0.001) and a 4% higher risk of PD (95%CI: 1.02-1.06, P < 0.001), with similar risks seen for bacterial, viral and other infections and for different sites of infection.

The highest risk of disease was seen in people with multiple hospital-treated infections before the age of 40, with more than double the risk of AD (OR=2.62, 95%CI: 2.52-2.72, P < 0.001) and more than 40% increase in the risk of PD (OR=1.41, 95%CI: 1.29-1.53, 3 44 P < 0.001). No association was observed for ALS, regardless of age at diagnosis.

“These findings suggest that infectious events may be a trigger or amplifier of a pre-existing disease process, leading to clinical onset of neurodegenerative disease at a relatively early age,” the authors say, while also pointing out that “due to the observational nature of the study, these results do not formally prove a causal link.”

Sun adds, “Hospital-treated infections, especially in early- and mid-life, were associated with an increased risk of Alzheimer’s disease (AD) and Parkinson’s disease (PD), primarily among AD and PD cases diagnosed before 60 years.”

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A new research headed by Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, and outside colleagues builds on previously published work by integrating more races and ethnicities.

The researchers discovered that particular plasma metabolites—substances produced by the body when it digests food—were linked to global cognitive function scores across a wide range of races and ethnicities. Their findings were published in Alzheimer’s & Dementia: The Alzheimer’s Association Journal.

“Our study has huge strengths in expanding the sample size and in adding demographics compared to what previous research has done,” said Tamar Sofer, Ph.D., and director of the Biostatistics Core Program in Sleep Medicine Epidemiology and a member of the Division of Sleep and Circadian Disorders at the Brigham.

Tamar added, “It also illustrates that studies that begin by focusing on minorities can give rise to insights that may be beneficial to other populations. We hope our findings will help people in making specific nutritional choices and in improving their cognitive health.”

Researchers may now find biomarkers linked to health changes and illnesses using techniques such as metabolomic profiling, which can assess hundreds of compounds in blood samples. An first investigation in Boston of elderly persons of Puerto Rican heritage discovered a variety of metabolites linked to evaluated cognitive abilities.

Researchers may now find biomarkers linked to health changes and illnesses using techniques such as metabolomic profiling, which can assess hundreds of compounds in blood samples. An first investigation in Boston of elderly persons of Puerto Rican heritage discovered a variety of metabolites linked to evaluated cognitive abilities.

Building off that work, Brigham researchers tested metabolite-cognitive function associations in 2,222 U.S. Hispanic/Latinx adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), and in 1,365 Europeans and 478 African Americans from the Atherosclerosis Risk In Communities (ARIC) Study. They then applied Mendelian Randomization (MR) analyses to determine causal associations between the metabolites and cognitive function, as well as between a Mediterranean diet and cognitive function.

The team discovered that six metabolites were consistently associated with a lower global cognitive function across all of the studies. Four of them were sugars or derivatives of sugars. Another metabolite, beta-cryptoxanthin, was associated with a higher global cognitive function in the HCHS/SOL and is also strongly correlated with fruit consumption.

“It is possible that these metabolites are biomarkers of a more direct relationship between diet and cognitive function,” said lead author Einat Granot-Hershkovitz, Ph.D., who worked on this study as a postdoctoral fellow in Sofer’s lab at Brigham.

Diet itself can be an important source of many metabolites, including some with positive or negative associations with cognitive function. In this study, the Mediterranean diet score was associated with higher levels of beta-cryptoxanthin, which was positively associated with cognitive function. The Mediterranean diet was also negatively associated with the levels of other metabolites, which were associated with lower cognitive function. Previous research has also shown that adherence to the Mediterranean diet is associated with cognitive benefits.

While the study did have limitations like its cross-sectional, observational design which limited conclusions about the potential influence of modifying metabolite levels on cognitive function (causal inference), the researchers attempted to use MR analyses to account for unmeasured confounding and establish some level of causal inference. Their results showed weak causal effects between specific metabolites and global cognitive function.

The researchers recommend that future studies assess metabolite associations with cognitive function and work to evaluate whether observed associations indeed indicate that changes in diet – manifesting in changing metabolite levels – can improve cognitive health.

“While the causal effect seen in our study may be weak, repeated research has shown that the Mediterranean diet is associated with better health outcomes, including cognitive health,” said Sofer. “Our study further supports the importance of a healthy diet towards safeguarding cognitive function, consistent across races and ethnicities.”

Also Read: Regular vitamins may boost memory in older persons: Study

In recent years, managing one’s mental health has become a bigger priority, with a greater emphasis on self-care. More than 300 million individuals worldwide suffer from depression each year. Recognizing this, there is a lot of interest in leveraging popular wearable electronics to measure markers like activity level, sleep, and heart rate to monitor a person’s mental health.

A team of researchers from Washington University in St. Louis and the University of Illinois Chicago utilised data from wearable devices to predict the effects of depression therapy on people who participated in a randomised clinical trial.

Instead of constructing a distinct model for each group, they created a unique machine learning model that examines data from two sets of patients: those who were randomly selected to get therapy and those who did not. This unified multitask model is a step toward personalised medicine, in which clinicians develop a treatment plan tailored to each patient’s requirements and forecast outcomes based on data from that individual. The study’s findings were published in the ACM Proceedings on Interactive, Model, Wearable, and Ubiquitous Technologies, and they will be presented at the UbiComp 2022 conference in September.

Chenyang Lu, the Fullgraf Professor at the McKelvey School of Engineering, led a team including Ruixuan Dai, who worked in Lu’s lab as a doctoral student and is now a software engineer at Google; Thomas Kannampallil, associate professor of anesthesiology and associate chief research information officer at the School of Medicine and associate professor of computer science and engineering at McKelvey Engineering; and Jun Ma, MD, PhD, professor of medicine at the University of Illinois Chicago (UIC); and colleagues to develop the model using data from a randomized clinical trial conducted by UIC with about 100 adults with depression and obesity.

“Integrated behavioral therapy can be expensive and time consuming,” Lu said. “If we can make personalized predictions for individuals on whether it is likely a patient would be responsive to a particular treatment, then patients may continue with treatment only if the model predicts their conditions are likely to improve with treatment but less likely without treatment. Such personalized predictions of treatment response will facilitate more targeted and cost-effective therapy.”

In the trial, patients were given Fitbit wristbands and psychological testing. About two-thirds of the patients received behavioral therapy, and the remaining patients did not. Patients in both groups were statistically similar at baseline, which gave the researchers a level playing field from which to discern whether treatment would lead to improved outcomes based on individual data.

Clinical trials of behavioral therapies often involved relatively small cohorts due to the cost and duration of such interventions. The small number of patients created a challenge for a machine learning model, which typically performs better with more data. However, by combining the data of the two groups, the model could learn from a larger dataset, which captured the differences in those who had undergone treatment and those who had not. They found that their multitask model predicted depression outcomes better than a model looking at each of the groups separately.

“We pioneered a multitask framework, which combines the intervention group and the control group in a randomized control trial to jointly train a unified model to predict the personalized outcomes of an individual with and without treatment,” said Dai, who earned a doctorate in computer science in 2022. “The model integrated the clinical characteristics and wearable data in a multilayer architecture. This approach avoids splitting the study cohorts into smaller groups for machine learning models and enables a dynamical knowledge transfer between the groups to optimize prediction performance for both with and without intervention.”

“The implications of this data-driven approach extend beyond randomized clinical trials to implementation in clinical care delivery, where the ability to make personalized prediction of patient outcomes depending on the treatment received, and to do so early and along the treatment course, could meaningfully inform shared-decision making by the patient and the treating physician in order to tailor the treatment plan for that patient,” Ma said.

The machine learning technique offers a potential tool for developing tailored prediction models using data from randomised controlled trials. The team intends to use the machine learning method in a new randomised controlled trial of telehealth behavioural therapies utilising Fitbit wristbands and weight scales among patients enrolled in a weight reduction intervention research in the future.

According to a Thursday update from the Union Health Ministry, India’s daily Covid tally has risen to 6,422 new infections in the previous 24 hours.

Earlier on Wednesday, the country saw a rise in infections with 5,108 Covid cases after it reported 4,369 Covid-19 cases on Tuesday.

According to new research comparing the time it takes to meet blood glucose objectives, tirzepatide accomplishes blood sugar management and weight reduction goals faster than existing diabetic medicines.

The latest analyses of the SURPASS-2 and SURPASS-3 trials, being presented at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept), found that adults treated with various doses of injectable tirzepatide (5, 10, and 15 mg) reached blood glucose targets about four weeks sooner than those taking injectable semaglutide (1 mg), and between four and 12 weeks sooner than those taking once-daily insulin (degludec; iDeg), along with diet and exercise and oral glucose-lowering medications. “Tirzepatide is unique because it mimics two natural insulin-releasing and appetite-suppressing hormones in one injection”, says lead author Dr Adie Viljoen, a Consultant Metabolic Physician and Chemical Pathologist from the East and North Hertfordshire NHS Trust, UK.

He added, “The speed we are seeing in glucose-lowering and weight loss is beyond anything else we have available right now and it may put adults with type 2 diabetes in a better position for preventing long-term complications. But it is important to remember that these medications should be used in addition to diet and exercise.”

T2D is a chronic and progressive condition in which the body does not make or use insulin normally, leading to high levels of glucose in the blood. More than 30 million Americans have T2D, but despite the availability of many medications to treat diabetes, only around half of US adults with T2D achieve target haemoglobin A1c (HbA1c; a measure of blood sugar control) of less than 7 per cent. Higher HbA1c levels are associated with complications like heart disease, stroke, kidney disease (nephropathy), eye disease (retinopathy) and nerve disease (neuropathy).

Tirzepatide is a single molecule that belongs to a new class of diabetes drugs that mimics two hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), involved in blood sugar control and appetite suppression. It was approved for the treatment of T2D by the US Food and Drug Administration in May 2022.

The SURPASS-2 and SURPASS-3 trials compared different doses of tirzepatide (5, 10, and 15 mg) with a once-weekly injectable semaglutide 1 mg (which is a single hormone, GLP-1 mimic agent) as an add-on therapy to metformin, or long-acting insulin (iDeg), as an add-on therapy to metformin with or without a sodium-glucose cotransporter-2 inhibitor, respectively.

On average, participants treated with all doses of tirzepatide lowered their HbA1c more than those treated with semaglutide and iDeg, and a greater proportion achieved an HbA1c of less than 7 per cent (&lt;53 mmol/mol), less than or equal to 6.5 per cent (<=48 mmol/mol), and less than 5.7 per cent (&lt;39 mmol/mol) at 40-weeks (SURPASS-2) and 52-weeks (SURPASS-3), respectively.
In this latest analysis comparing the time to reach HbA1c targets from the start of the study, researchers found that participants taking tirzepatide reached HbA1c targets of less than 7 per cent and 6.5 per cent or less considerably faster than both semaglutide and iDeg (see table in notes to editors).

The average (median) time to achieve a HbA1c level of less than 7 per cent was around 8 weeks for all tirzepatide doses compared to 12 weeks for both semaglutide and iDeg; and to reach 6.5 per cent or less was 12 weeks versus about 16 weeks and 24 weeks, respectively.

Further analyses of SURPASS-2, found that participants treated with tirzepatide also reached weight-loss goals significantly faster than semaglutide. The average time to reach 5 per cent or more weight loss was around 12 weeks on the two higher doses of tirzepatide (10 and 15 mg) compared to 24 weeks for semaglutide.

“Even a modest weight loss of 5 per cent of initial body weight is associated with clinically significant improvements in weight-related health issues for many individuals”, says Viljoen. “For people with type 2 diabetes to be able to achieve these improvements in health in around half the time is pretty incredible.”

Mild to moderate gastrointestinal side effects such as nausea, vomiting, and diarrhoea were reported most often during the dosage escalation phase and reduced with time in tirzepatide individuals.