A rat-human mindmeld

When neuroscience drugs fail in human trials, there’s an easy fall guy — fall animal — researchers can turn to. Despite decades of efforts, our mouse and rat models of neurological conditions, be it schizophrenia or Alzheimer’s, remain poor simulacrums of the real thing. This rodent-hominin disparity impacts not only drug research but also our basic understanding of how the human brain learns and develops.

In a scientific first, though, Stanford researchers were able to grow human brain-lets — clusters of neurons around the size of a lentil — implant them in baby rats, and then watch them influence the rats’ behavior. “This paper really pushes the envelope,” one neuroscientist tells STAT’s Megan Molteni. “The field is desperate for more experimental models…it really expands our toolkit for asking more nuanced questions.”

Finally, an answer on Paxlovid rebound?

Six months after reports of Paxlovid rebound first emerged, it seems, we’re finally getting a systematic trial to figure out how to deal with it.

Pfizer last week quietly registered a clinical trial that aims to enroll 411 rebounding patients and randomize them to receive either placebo or another five-day course of Paxlovid. Investigators will assess whether the repeat dose can clear patients of virus or alleviate symptoms more quickly than simply waiting.

It’s a welcome study for clinicians after Pfizer and regulators gave diametrically opposed guidance earlier in the year on whether rebound patients should receive more treatment. But it still won’t answer many key questions, said Tufts professor of medicine Shira Doron, including: Is rebound a Paxlovid phenomenon or one common to many Covid infections? Are rebounding patients infectious? Should a 10-day course be given from the start?

For that, other studies will be needed and some may be afoot. A Pfizer spokesperson said the company is considering whether to test at longer initial course.

FDA authorizes Omicron boosters for kids 5 and up

When the first Omicron-specific boosters were authorized earlier this year, they were only available for adults and kids over 12. But on Tuesday, the FDA OK'd the updated shots for kids as young as 5, STAT's Drew Joseph reports.

Although that will certainly be welcome news for some parents, especially those who have kids with conditions that put them at heightened risk, it's unclear how many people will take advantage of the shots. Although the data on the importance of boosters is increasingly clear, few adults have taken advantage of the updated shots, and a stubbornly low percentage of kids have received even their primary series.

Closer look: AlphaFold's Actual Impact

Courtesy DeepMind

Two years ago, Google debuted AlphaFold, software that could accurately predict the structure of most proteins, and drug discovery was changed forever. Or was it?

In a must-read work of scientific discernment, STAT’s Brittany Trang examines the extraordinary hype around a technology that has already swept labs around the world but whose actual impact on human health remains nebulous and distant. The tool’s importance is undeniable. It’s a democratizing force, as one researcher notes: You can do biology from your phone. And nearly every approved medicine binds to a protein. AlphaFold will help companies better visualize the ones they want to inhibit, activate or modulate. But that visualization is just the first and cheapest step in the Schoolhouse Rock-esque journey from idea to marketed pill.

And AlphaFold isn’t even perfect at that. Proteins in the body are shapeshifting molecular machines, but AlphaFold only captures a snapshot. “They’re a structural biologist’s version of a picture of a toddler who is sitting down and looking at the camera,” Trang writes. “In real life, that toddler is in constant motion, playing or crying or covered in spaghetti.”

A small group of researchers, though, aren’t trying to visualize proteins. They think they can use AlphaFold to design protein. These so-called de novo protein therapeutics could be tested more quickly and at “greater scale and variety,” one drug developer said, although the Schoolhouse Rock journey remains.

Who gets to see the surgeon?

The surgical consult: A staple of medical shows and actual medicine, essential for assuring patients learn the full array of options available to them.

But not everyone admitted to a hospital actually receives one, and a new study suggests that the difference may be one factor driving racial disparities in health care.

In a new study for JAMA Surgery, researchers looked at medical records from nearly 1.7 million Medicare patients admitted to emergency rooms for conditions that could be treated with emergency general surgery. They found that, even after controlling for a long list of demographic and medical factors, Black patients were between 8% and 14% less likely to receive a surgical consult.

“The involvement of a surgical specialist in decision making for patients with emergency general surgery conditions is critical, as surgeons are trained in both operative and nonoperative management,” the authors wrote. “Our study highlights the need for equitable access to surgical care for all racial groups to ensure expert management for surgical conditions.”

East African Ebola outbreak death toll reaches 39

Officials from nine countries in East Africa met in Kampala on Wednesday to coordinate responses to the Ebola outbreak in Uganda. The outbreak, which was first detected on Sept. 20, has grown to 74 confirmed and probable cases; 39 people have died. To date, all cases have been detected within Uganda’s borders, but neighboring countries are on high alert because of the substantial cross border movement of people in the region.

Mike Ryan, the director of the World Health Organization’s Health Emergencies Program, attended the Kampala meeting after touring the areas west of the capital where the virus is spreading. “The main components of the response are coming together,” Ryan said at a WHO press briefing Wednesday. “But there are still gaps.” Chief among the problems he identified is a low level of “alerts” from communities — indications that someone is exhibiting symptoms consistent with the disease. As is often the way in outbreaks, communities can be reluctant to admit to harboring Ebola cases.