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Morning Rounds Shraddha Chakradhar

Good morning! Elizabeth Cooney sitting in today for Shraddha.

Did the U.S. miss its chance to block Covid-19?

New research undermines the prevailing theory that the Covid-19 outbreak in Washington state — the country’s first — was triggered by the very first confirmed case of the infection in the U.S. The study, posted to a preprint site so not yet peer-reviewed or published in a scientific journal, also raises the disturbing possibility that because the outbreak started in mid-February, there was more time to stop it, STAT's Helen Branswell reports.

In other Covid-19 coverage:

  • Researchers are tapping electronic health records in the Covid-19 response. For the data wranglers, that's a daunting and time-consuming task, STAT’s Rebecca Robbins tells us. 
  • As data starts to trickle out from Covid-19 vaccine trials, how are researchers conducting this research? Watch our short explainer from STAT’s Alex Hogan.
  • Trained to practice evidence-based medicine, family physician Alison Block uses that as her guide when asked, “What would you do, doc?” With Covid-19, she now finds herself turning to the decidedly unscientific guidelines provided by her head, her heart, and her gut. “There’s no playbook. We’re in a data-free zone,” she writes in a new STAT First Opinion.

Lab Chat: 3D-mapping the ‘little brain of the (rat) heart’

A map of the rat heart’s intrinsic cardiac nervous system. (Achanta, Gorky, Leung, Moss, Robbins/iScience)

Even cardiologists might not know about the intracardiac nervous system. This “little brain of the heart” works with the brain to keep neuronal communication flowing smoothly, sometimes protecting cardiac muscle after a heart attack. Raj Vadigepalli of Thomas Jefferson University told me more about his team’s research, in rats, just published in iScience.

What’s different about your 3D map of the rat heart?
The key is it's a spatially tracked, single-neuron molecular map. Suddenly, it's almost as if you discovered a new world and it's a bunch of new islands.

Why does that matter?
There's a spatial gradient. On one island, the forest is a bit more tilted this way and the beaches more that way, and the mountains all this way. So there are molecular gradients. And in response to physiological perturbations like hypertension, those gradients can shift. It's almost as if you have analog knobs to tune them. If you know the system behaves that way, you think differently when you want to intervene.

STAT Plus subscribers can read our full conversation here.

Inside STAT: A mother and son confront cancer in the age of Covid-19

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Amy Sapien with her son Landen inside their home in Tamp, Fla. (EVE EDELHEIT FOR STAT)

Amy Sapien and her 7-year-old son, Landen, are both facing cancer. They are united by something else: Both are going through the most frightening and painful moments of their lives without the family warmth and support that was standard practice at the nation’s medical centers — until Covid-19. The pandemic’s broad impact on cancer care in the U.S. is well-known: non-essential surgeries, biopsies, and scans delayed, and clinical trials disrupted. But it’s in stories like the Sapien family’s that one sees the depth of the harm it’s causing. “In the exact moment where we could have reached out for everything our support system could offer,” Amy says, “we were forced to retract completely into ourselves.” STAT contributor Gabrielle Glaser tells their story here.

Bullying before suicide is more common among LGBTQ young people

The toll of bullying on young people in their teens or younger can be lethal. For LGBTQ adolescents who died by suicide, it was worse. Researchers who combed through 15 years of national death records discovered that the odds of being bullied were nearly five times higher for LGBTQ young people who took their own lives than for others who didn’t identify as LGBTQ. And it was even more so for 10- to 13-year-olds. Two-thirds of suicides in LGBTQ children aged 10 to 13 followed bullying, compared to about 1 in 7 non-LGBTQ children. “Bullying can be a deadly antecedent to suicide, especially among LGBTQ youth,” the authors conclude, noting that because LGBTQ information isn’t always reported, their statistics probably underestimated the problem.

Do workplace wellness programs work? Depends on what you believe

Businesses value wellness programs so highly that 84% of large U.S. companies providing health benefits include them, typically offering classes on physical activity, nutrition, and stress management, as well as financial incentives. A new study split nearly 5,000 participants at a large university into two groups — one to get the benefit and the other to be a control group — to compare health beliefs (guesses on their BMI, blood pressure, cholesterol, or glucose numbers), medical diagnoses, and health care costs. After two years the researchers came up empty on differences in health outcomes and costs, but they found two differences in the wellness group: They believed their health was better, even though their numbers stayed the same. One thing did improve: More said they had a primary care physician than at the study’s start.

Getting ready for the ‘killer experiment’ once labs reopen

Looking for a silver lining to the Covid-19 pandemic? On the latest episode of the podcast “This Week in Pediatric Oncology,” two researchers said they found one. Carol Thiele, deputy chief of the National Cancer Institute’s Pediatric Oncology Branch, is working at home and busier than ever. “There’s so much genomic data out there that I do think there's so much a translational scientist can still be doing even though they’re not in lab shaking tubes.” Pamela Kearns, director of Cancer Research UK’s Clinical Trials Unit, concedes some projects were casualties of shuttered labs. But when scientists return to their labs and face tighter timelines, they’ll be more focused, ready to do “the killer experiments rather than just churning through the work.

If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

What to read around the web today

  • Census Bureau reports spike in signs of anxiety and depression since coronavirus. Axios
  • The largest lockdown in the world is ending. India is bracing for what comes next. Washington Post
  • Trump tries to convince voters he’s lowered drug prices, based only on a modest tweak to Medicare. STAT
  • They evoke Darth Vader, but these masks may save your doctor's life. New York Times
  • Experts push for a ‘seal of approval’ to improve the quality of medicines. STAT Plus 

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, May 27, 2020

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