Breaking News

A twist in the retraction saga, potential 'brain fog' predictors, & how Medicare's payment decisions influence physician specialties

September 1, 2023
Reporter, Morning Rounds Writer
Good morning. It's time to say farewell to summer but then welcome fall (almost) on Tuesday, after we observe our Labor Day break.

in the lab 

Departing Stanford president retracts two prominent papers, but there's a twist

Mattarella in San Francisco

The retractions were expected, but the objection was not. Following a wide-ranging investigation that discovered manipulated data and other problems in scientific papers co-authored by Stanford's Marc Tessier-Lavigne, the neuroscientist retracted two 2001 Science studies yesterday. The move, made on the day his resignation as university president took effect, was anticipated. But in a surprising development, former postdoctoral researcher Elke Stein, the lead author on both studies, disagrees with the retractions. 

As the first author, Stein would typically have performed the bulk of the experiments for those papers. Tessier-Lavigne is the last author listed, indicating that he supervised the work. Stein did not respond to multiple requests for comment from STAT. The news adds yet another twist to a case that has resurfaced longstanding questions about the conduct of elite science and how much responsibility research advisers should bear for the work they supervise. STAT's Jonathan Wosen has more.


long Covid

Two blood-clot proteins tied to long Covid brain fog

A clue to one of the most troubling features of long Covid — brain fog — may lie in blood samples drawn during acute infection that show a high concentration of two blood-clotting proteins, new research in Nature Medicine tells us. Blood clots have been implicated in acute Covid infections from the pandemic's earliest days, but signaling troubling symptoms six to 12 months later is new. 

Researchers from Oxford examined blood samples from more than 1,800 unvaccinated patients who required hospital admission — a group representing only some who suffer from long Covid. They found two proteins, fibrinogen and D-dimer, were higher in people who later had brain fog, making fibrinogen a potential predictor of cognitive struggles and D-dimer of fatigue and shortness of breath as well. These findings mostly matched a separate study of the health records of 17,911 patients in the U.S., the authors said, while urging more research to develop prognoses and care for long Covid.


mental Health

One psilocybin dose had lasting effect on depression, study says

Just one dose of psilocybin helped reduce symptoms of major depression up to six weeks later, a mid-stage randomized clinical trial published in JAMA concludes. The study moves beyond previous research that looked at more immediate effects from the psychedelic compounds produced by certain mushrooms. Authors of the study, sponsored by Usona Institute, a nonprofit focused on psilocybin in mental health care, declined to be interviewed but Greg Fonzo of the University of Texas at Austin's Dell Medical School praised the study for "adding to the evidence base suggesting potential efficacy of psilocybin for depression."

In the study, 104 people were given either psilocybin or niacin, a placebo whose side effect of flushing was intended to make it harder to guess which was the drug. The psilocybin group reported more improvement on depression scores eight days and six weeks after their dose than the placebo group. STAT's Annalisa Merelli has more.



Closer Look

How Medicare reimbursement policies might shape doctors' specialty choices

Money may influence how doctors choose a particular specialty, a recent paper suggests, reflecting how the health care system values procedures over prevention. The U.S. will see a shortfall of 52,000 family doctors next year, sending more patients to emergency or specialty care. A working paper from the Becker Friedman Institute for Economics says the average physician salary is $405,000 a year, but primary care physicians make about half that while the top 1% hits $1.3 million. And top medical students gravitate toward higher earning potential. 

The source of this compensation differential is Medicare, the authors contend, and its higher reimbursement rates (mirrored by private insurers) for procedures. "I can think about a patient's very complex medical issues for half an hour, and that can get paid less than a procedure that might take 10 minutes," said Heather Paladine of the New York State Academy of Family Physicians. STAT's Annalisa Merelli has more


Aging

100 older adults died from falls every day in 2021

Of all the ailments of aging, falls may not seem dramatic, but they're actually the leading cause of injury and death in people over 65. A new CDC report determined that on average, 100 older adults died every day from falls in 2021. Over the previous 20 years, age-adjusted death rates have increased each year. There were some differences: 

  • Non-fatal falls were higher among women than among men, but fall-related death rates were higher among men than among women.
  • In 2020, 19.9% of older adults in Illinois said they fell in the previous year, but 38.0% said the same in Alaska.
  • In 2021, the unintentional fall-related death rate among older adults ranged from 30.7 per 100,000 people in Alabama to 176.5 in Wisconsin.  

"Falls are not an inevitable part of aging," the researchers write. "Older adult falls can be prevented by addressing modifiable risk factors through effective preventive strategies."


cancer

A new approach to spotting cancer in a blood test taps DNA's cousin

Biotech companies are racing to develop liquid biopsies, tests that detect signs of cancer from a person's blood. Most of these firms take the same tack, studying free-floating bits of DNA released by tumors and searching for telltale mutations and chemical modifications that give away a cancer's existence and its location. But a new study published in Nature Biomedical Engineering shows that researchers can do the same with RNA, DNA's older and often-overlooked cousin, STAT's Jonathan Wosen tells us.

Even though just 1% to 2% of DNA codes for proteins, 75% of it is transcribed into RNA. Researchers found that broadly studying RNA in a person's blood helped them detect cancers of the liver, colon, and stomach, among others. Daniel Kim, the study's senior author, told STAT that RNA may be easier to detect from early-stage tumors than DNA, in part because it is released while cells are still alive and sent out in small, blubbery spheres that protect the molecules.


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What we're reading

  • McConnell releases letter declaring him 'medically clear' to work after episode, New York Times
  • Omicron was the deadliest pandemic wave for cancer patients, Axios

  • Sly CAR-T strategy evades 'fratricide' problem to aim at all blood cancers, STAT
  •  Some U.S. airports strive to make flying more inclusive for those with dementia, Associated Press

  • Drug firms test medicines to halt Alzheimer's before symptoms appear, Boston Globe

Thanks for reading! Til Tuesday,


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