Medical Bulletin 27/ November/ 2024
Here are the top medical news for the day:
Significant Drop in Online Healthcare Reviews After Covid: Study Finds
After the COVID-19 pandemic struck, online reviews of health care facilities dropped signficiantly, and they have not yet fully recovered, according to a new analysis led by researchers at the Perelman School of Medicine at the University of Pennsylvania. More than half of reviews on the online platform, Yelp, now are negative, flipping the pre-COVID picture. The findings are published today in JAMA Network Open.
By analyzing all reviews of health care facilities in the United States on the online platform Yelp dated from 2014 through 2023, Researchers saw that the percentage of positive—four- and five-star—reviews dropped from 54.3% before March 2020 (marked as the beginning of the COVID pandemic in the United States) to 47.9% after.
In fact, from the latter half of 2021 on, the researchers found that positive reviews were never more than 50%. In analyzing the reviews, the researchers used a language processing technique to tease out the most common topics from the reviews, organized them into themes, and measured how they changed over time.
The themes that saw the greatest change in mentions between the pre- and post-COVID periods were “insurance and billing issues” and “customer service and staff behavior.” One theme mentioned less in negative reviews after the arrival of COVID—and a renewed, supercharged focus on hygiene: Facility cleanliness.
While positive reviews of health care facilities on Yelp, as a whole, declined over time, health care facilities in rural areas already had lower ratings at the start of the time period examined, and the differences became more significant after COVID struck. Post-COVID, rural facilities were 23% less likely to have positive reviews, compared to health facilities in urban areas, which were 7% less likely to have positive reviews.
Reference: Sehgal NKR, Agarwal AK, Southwick L, et al. Disparities by Race and Urbanicity in Online Health Care Facility Reviews. JAMA Netw Open. 2024;7(11):e2446890. doi:10.1001/jamanetworkopen.2024.46890
Women Who Suffer Severe Complications During First Pregnancy May Have Fewer Children
Women who suffer severe complications during their first pregnancy or delivery are less inclined to have more babies, a study published in JAMA by researchers at Karolinska Institutet reports.
In this new population-based study, the researchers have studied the association between severe maternal morbidity in first-time mothers and the likelihood of their having a second baby. The study comprised over a million women in Sweden who had their first baby between 1999 and 2021.
“We found that the likelihood of having more children was much lower in women who had experienced severe complications during their first pregnancy, delivery or postnatal period,” says the study’s last author Neda Razaz, associate professor at the same department. “Such events can often have a physical and mental impact on women for a long time to come.”
All in all, 3.5% of the first-time mothers in the study suffered serious complications and were 12% less likely to have a second baby. Most impacted were women who had experienced cardiac complications, a ruptured uterus or severe mental health problems, who were 50% less likely to have another birth than women who had not experienced such complications.
Women who needed respiratory care or who suffered a cerebrovascular accident like stroke or intracranial haemorrhage were 40% less likely to have a second baby. Acute kidney failure, severe preeclampsia and blood clotting were also associated with a lower probability of a second pregnancy. The researchers also compared the women with any sisters they had to control for familial factors.
Reference: “Association of Severe Maternal Morbidity With Subsequent Birth”, Eleni Tsamantioti, Anna Sandström, Charlotte Lindblad Wollmann, Jonathan M Snowden, Neda Razaz, JAMA, online 25 November 2024, doi: 10.1001/jama.2024.20957.
A Protein Based Gel Can Be Used for Higher Performance, More Sustainable Skincare Products
NYU Tandon School of Engineering researchers have created a novel protein-based gel as a potential ingredient in sustainable and high-performance personal skincare products (PSCPs). This protein-based material, named Q5, could transform the rheological -- or flow-related -- properties of personal skincare products, making them more stable under the slightly acidic conditions of human skin. This innovation could also streamline the creation of more eco-friendly skincare products, offering increased efficacy and durability while addressing market demands for ethically sourced ingredients.
In a new study published in ACS Applied Polymer Materials from the lab of Professor of Chemical and Biomolecular Engineering Jin Kim Montclare, researchers have created a novel protein-based gel as a potential ingredient in sustainable and high-performance personal skincare products.
Current formulations often rely on ingredients such as polysaccharides or synthetic polymers to achieve the desired texture, stability, and compatibility with skin's natural pH, which is mildly acidic. However, these traditional rheological modifiers have raised environmental concerns regarding sourcing and sustainability.
To take on this challenge, Montclare and her colleagues fabricated a self-assembling coiled-coil protein they call Q5. In the study, Q5 demonstrated impressive pH stability. The protein's unique structure enables it to form strong gels that do not degrade easily under acidic conditions, enhancing the longevity and performance of skincare products. This resilience marks a significant improvement over earlier protein-based gels, which typically disassemble in lower pH environments.
Notably, the research suggests that Q5 could be produced sustainably via bacterial or yeast fermentation, circumventing the ethical and ecological issues associated with animal-derived proteins or synthetic polymers. The protein's natural ability to attract and retain moisture -- also enables it to bind various molecules, adding versatility as a moisturizer or binding agent in skincare products.
Reference: https://engineering.nyu.edu/news/self-assembling-proteins-can-be-used-higher-performance-more-sustainable-skincare-products
Study Unveils new way to unlock blood-brain barrier
Researchers at the Icahn School of Medicine at Mount Sinai have developed an innovative approach—demonstrated in mouse models and isolated human brain tissue—to safely and effectively deliver therapeutics into the brain, providing new possibilities for treating a wide range of neurological and psychiatric diseases.
Published in the online issue of Nature Biotechnology, the study introduces a blood-brain barrier-crossing conjugate (BCC) system, designed to overcome the protective barrier that typically blocks large biomolecules from reaching the central nervous system (CNS).
The blood-brain barrier-crossing conjugate (BCC) system, designed to overcome the protective barrier that typically blocks large biomolecules platform takes advantage of a specialized biological process called γ-secretase-mediated transcytosis to deliver large therapeutic molecules, like oligonucleotides and proteins, directly into the brain through a simple intravenous injection.
The study showed that when the researchers injected a compound called BCC10 linked to specialized genetic tools known as antisense oligonucleotides into mice, it successfully reduced the activity of harmful genes in the brain. In a transgenic mouse model of ALS, the treatment significantly lowered levels of the disease-causing gene called Sod1 and its associated protein.
BCC10 proved to be highly effective at delivering these genetic tools to the brain, improving their ability to silence harmful genes in different models and even in samples of excised human brain tissue studied in the laboratory. Importantly, the treatment was well tolerated in mice, causing little or no damage to major organs at the tested doses, say the investigators.
Reference: Wang, C., Wang, S., Xue, Y. et al. Intravenous administration of blood–brain barrier-crossing conjugates facilitate biomacromolecule transport into central nervous system. Nat Biotechnol (2024). https://doi.org/10.1038/s41587-024-02487-7
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