A study published in Proceedings of the National Academy of Sciences details a novel path in the inflammatory mechanism associated with the bone damage caused by rheumatoid arthritis, reports News-Medical . The process involves the release by T-lymphocytes of extracellular vesicles packed with genetic material (microRNAs), which penetrate cells in bone tissue, boosting the formation of osteoclasts that break down bone matrix in joints. Earlier research illustrated that cigarette smoke worsens the inflammatory process in arthritis by triggering the aryl hydrocarbon receptor (AhR) on Th17 cells. The latest research indicated that the microRNA miR-132 in Th17 cells was more expressed due to AhR activation. "When we treated T-cells with antagonists of the microRNAs, they continued to differentiate normally into Th17 cells, releasing the cytokines characteristic of the inflammatory process in rheumatoid arthritis," said Paula Donate at the University of São Paulo's Center for Research on Inflammatory Diseases. When the researchers isolated extracellular vesicles emitted by Th17 and studied them in vitro, they found that the large amounts of miR-132 bundled in extracellular vesicles acted as inflammatory mediators, causing differentiation of osteoclasts by inhibiting the enzyme cyclooxygenase 2. "In the case of Th17 cells, the vesicles released in joints can transport microRNAs to bone tissue, augmenting the quantity of osteoclasts and bone erosion," Donate said. "In sum, this is a previously unknown mechanism that we succeeded in elucidating and that, in the future, could be a basis for novel therapies for joint injury."

The Minneapolis Star Tribune reports that the state of Minnesota is nearing its goal of vaccinating 80 percent of its senior population against COVID-19, having provided at least first doses as of this past weekend to 1.3 million, including 670,379 people 65 and older. Seniors were prioritized for vaccination, having suffered 89 percent of Minnesota's 6,777 deaths from the virus. The Minnesota Department of Health also disclosed 1,400 more infections, bringing the known case count to 504,273. State Infectious Disease Director Kris Ehresmann last week said more-infectious variants of the virus have been associated with clusters of cases in the southwest metropolitan, Mankato, and the East Range in northern Minnesota. Continued vaccination could decelerate the variants' spread and the development of new mutations, but health officials urged continued mask-wearing and social distancing to reduce chances for transmission. Minnesota has now reached 2,143,348 total doses administered.

Makers of COVID-19 vaccines are accelerating production and stepping up mass vaccination campaigns in the United States, reports the Wall Street Journal . Pfizer, BioNTech, and Moderna have boosted output by gaining experience, scaling up production lines, and generating raw materials by themselves. They also are partnering with other companies to raise production even further. Moreover, the U.S. government has helped vaccine manufacturers access supplies under the Defense Production Act. This month the Biden administration evoked the act to provide $105 million in funding to help Merck make doses of Johnson & Johnson's vaccine and speed up materials used in its manufacture. Evercore ISI analysts project that monthly output for the three authorized vaccines in the U.S. should reach 132 million doses for March, nearly triple the 48 million last month. They also estimate that the higher output should be sufficient to fully inoculate 76 million Americans in March, another 75 million in April, and 89 million more in May.

The Snohomish Health District (SHD) in Snohomish County, Wash., last week reported no COVID outbreaks in assisted living or supportive living communities in the county for the first time in more than a year, according to KING 5 News . The district credits the decline to infection control and prevention measures, as well as sacrifices made by residents, personnel, and their families — in addition to vaccinations. There are active outbreaks at a skilled nursing community and an adult family community, with both outbreaks expected to clear up by the end of March as long as no more cases are reported. "This is a remarkable recovery from late December when we had over 100 cases being reported weekly from long-term care communities and all 17 skilled nursing communities in the county with ongoing outbreaks," said SHD Health Officer Chris Spitters. The week before, Washington Gov. Jay Inslee said families can once again visit loved ones at nursing and long-term care communities, with indoor visitation permitted for fully-vaccinated visitors or residents.

A new study published in the Journal of Alzheimer's Disease estimated that half the people living with Alzheimer's may have mild rather than moderate or severe cases of the disorder, reports the U.S. National Institute on Aging . The researchers considered data from the Framingham Heart Study, analyzing medical information for more than 17,000 people through information compiled from 2004 to 2009. They determined that more than 1,000 people were diagnosed with Alzheimer's disease or mild cognitive impairment (MCI). Among those with Alzheimer's, 50.4 percent had mild disease, 30.3 percent had moderate disease, and 19.3 percent had severe disease. Among subjects with either Alzheimer's or MCI, 29.5 percent exhibited MCI that did not worsen over time and 19.6 percent had MCI that progressed to dementia.

Becker's Hospital Review reports that UnitedHealthcare has launched a new virtual care option for individuals needing hearing assessments or hearing aids. The Right2You option can be accessed by those enrolled in eligible Medicare Advantage plans and UnitedHealthcare employer-sponsored plans. Members can use the virtual offering by first taking an online hearing test. If potential hearing loss is detected, they can receive the results of a hearing test from an in-person appointment with a UnitedHealthcare audiologist to develop custom-programmed hearing aids shipped directly to wherever the enrollee lives. UnitedHealthcare also is offering enrollees remote customization for hearing aids through smartphone or a tablet paired with the device.

FOX 17 West Michigan reports that the state of Michigan is easing safety rules for allowing visitors to nursing and assisted living communities. Certain precautions, like mask-wearing, are still in effect, but families appreciate the eased regulations. One such community is St. Ann's home in Grand Rapids. Prior to the relaxation, visitors were often separated from loved ones by plexiglass and forced to interact from six feet away. Families and visitors to St. Ann's are required to sign up online for open slots, but Karen Lynema, whose mother is a resident, says there are only four slots a day. Although COVID tests are not required to visit St. Ann's, the state is strongly urging people to consider taking them. Staff administer temperature checks, and if any resident tests positive, they cannot have visitors for two weeks.

A Danish study published in The Lancet found that people infected during the first COVID-19 outbreak were unlikely to be reinfected during the second, but the odds of reinfection were higher for people older than 65, reports ABC News . The investigators learned that out of nearly 17,000 people who were infected during the first wave of the pandemic, only 72 were reinfected during the second wave. Natural infection offers about 80 percent immunity against a second infection, but only an estimated 47 percent for adults over 65. Older adults may have weaker protection because their immune system response is not as strong when infected naturally. The University of Copenhagen's Steen Ethelberg said this finding "reinforces the notion that everybody should get the vaccine," as well as "suggests you should be a bit careful if you had the disease, especially if you are a senior citizen." Vanderbilt University Medical Center Professor William Schaffner agreed. "It's absolutely imperative that people age 65 and older get vaccinated, even if they have had previous COVID infection," he advised.

OnShift on Friday announced the results of recent surveys it conducted to capture the intent of senior care employees related to the COVID-19 vaccine, reports Globe Newswire . The results shows a seismic shift in employee acceptance from the initial poll in December 2020 to this month's findings, with a 94 percent increase in willingness to take the vaccine and a 41 percent decrease in plans to decline. Also according to the research, 62 percent of respondents expressed their willingness to take the vaccine in the March 2021 survey versus 32 percent in December 2020. Argentum President and CEO James Balda comments, "We are extremely pleased to see this substantial increase in intent by senior living employees to get the COVID-19 vaccine. It's been such a challenging year for them, and their dedication to caring for and protecting those they serve continues to shine through. We applaud them for their ongoing commitment."

The Fort Worth Business Press reports that the James L. West Center for Dementia Care in Fort Worth, Texas, has deployed a robot sanitizer that applies ultraviolet (UV) light to disinfect residents' rooms. The robot and its UV equipment, including shoe sanitizing stations, are sourced from Homelike Solutions and Direct Supply. Following 10 days of installation and training, the robot and its UV accessories were put into action on March 11. The high-intensity UV ray technology was acquired via funding provided by the City of Fort Worth through the federal CARES Grant Program. "COVID has had a significant impact on the long-term care sector and James L. West Center is moving boldly into the future — a future that includes COVID now and more viruses in the future," declared West Center CEO Cheryl Harding. "This technology complements our existing environmental services platform with a goal to create germ-free environments for today's residents and our team, as well as for future West Center stakeholders."