Culture

The higher prevalence of suicide among Indigenous peoples in Canada has been extensively documented, but little research has focused on factors associated with recovery among those who have had suicidal thoughts. A new nationally representative Canadian study from the University of Toronto and Algoma University found that three-quarters of formerly suicidal Indigenous adults who are living off-reserve had been free from suicidal thoughts in the past year.

"It was encouraging to discover so many formerly suicidal Aboriginal peoples were no longer seriously considering suicide, but with one-quarter of respondents still having these thoughts, there remains a dire need for improvements. Individuals who spoke an Indigenous language were less likely to have been suicidal in the past year. Knowing one's ancestral language provides valuable understandings of Aboriginal beliefs, values and traditions, and these factors may improve self-esteem and a positive identity, thereby promoting overall wellbeing and recovery," reported co-author Rose Cameron who is an Anishinaabekwe elder and a tenured professor at the University of Algoma in Sault Ste. Marie, Canada.

"Social support played a key role in remission; Individuals with at least one person to turn to for support in times of need were much more likely to be free of suicidal thoughts for the past year than those who were socially isolated (77% vs. 61%)," reported co-author Alexandra Sellors, a recent MSW graduate of the Factor-Inwentash Faculty of Social Work (FIFSW) at the University of Toronto. "Social connections can promote a sense of meaning and value in life. Clearly, we need targeted efforts to decrease social isolation and loneliness."

"We were dismayed to learn that one-quarter of formerly suicidal Indigenous adults reported that they had been hungry at some point in the last year but could not afford to purchase food. It isn't surprising that those who were so destitute were twice as likely to still be suicidal compared to those who had money for food," reported lead author Esme Fuller-Thomson, professor at the University of Toronto's FIFSW and director of the Institute for Life Course & Aging. "As a nation, we have an urgent responsibility to eradicate this devastating impoverishment."

"Our study found that those with at least a high school degree were more likely to be in recovery compared to their counterparts who had not completed high school. Education opens doors to better careers, higher income, better access to mental-health care and more opportunities in life. Currently, many isolated reserves do not have local high schools, which forces children as young as 14 to leave their family, home and community and move to larger towns and cities in order to study. These inequities need to be addressed if we hope to improve the high school graduation rate of Indigenous youth in Canada," suggested co-author Senyo Agbeyaka, an MSW graduate of the University of Toronto.

"Our findings indicated that each decade of age was associated with 17% higher odds of recovery from suicidal ideation. Indigenous elders often play a pivotal and revered role in Aboriginal communities and this respect may act to buffer against depression and suicidal ideation," reported co-author Philip Baiden, a graduate of the FIFSW who is now an assistant professor at the University of Texas at Arlington.

"In sum, there are multiple factors that are associated with recovery from suicidal thoughts among Aboriginal people, in particular, being older, food secure, female, having at least a high school diploma and speaking an Aboriginal language. While it is encouraging that recovery rates are high, there are many policy changes that could hasten better outcomes for Aboriginal peoples who are vulnerable," concluded Cameron.

In every modern microcircuit hidden inside a laptop or smartphone, you can see transistors - small semiconductor devices that control the flow of electric current, i.e. the flow of electrons. If we replace electrons with photons (elementary particles of light), then scientists will have the prospect of creating new computing systems that can process massive information flows at a speed close to the speed of light. At present, it is photons that are considered the best for transmitting information in quantum computers. These are still hypothetical computers that live according to the laws of the quantum world and are able to solve some problems more efficiently than the most powerful supercomputers.

Although there are no fundamental limits for creating quantum computers, scientists still have not chosen what material platform will be the most convenient and effective for implementing the idea of a quantum computer. Superconducting circuits, cold atoms, ions, defects in diamond and other systems now compete for being one chosen for the future quantum computer. It has become possible to put forward the semiconductor platform and two-dimensional crystals, specifically, thanks to scientists from: the University of Würzburg (Germany); the University of Southampton (United Kingdom); the University of Grenoble Alpes (France); the University of Arizona (USA); the Westlake university (China), the Ioffe Physical Technical Institute of the Russian Academy of Sciences; and St Petersburg University.

The physicists studied the propagation of light in a two-dimensional crystal layer of molybdenum diselenide (MoSe2) which is only one atom thick - this is the thinnest semiconductor crystal in the world. The researchers found that the polarisation of light propagating in a superfine crystalline layer depends on the direction of light propagation. This phenomenon is due to the effects of spin-orbit interaction in the crystal. Interestingly, as the scientists noted, the graph that shows the spatial distribution of the polarisation of light turned out to be rather unusual - it resembles a multi-coloured marine rapana.

Ultrafine molybdenum diselenide crystals for experiments were synthesised in the laboratory of Professor Sven Höfling at the University of Würzburg. It is one of the best crystal growth laboratories in Europe. Measurements were carried out both in Würzburg and in St Petersburg under the supervision of Alexey Kavokin, professor at St Petersburg University. An important role in the development of the theoretical base was made by Mikhail Glazov. He is a corresponding member of the Russian Academy of Sciences, an employee of the Spin Optics Laboratory at St Petersburg University, and a leading research associate at the Ioffe Physical Technical Institute.

'I foresee that in the near future, two-dimensional monoatomic crystals will be used to transfer information in quantum devices,' said Professor Alexey Kavokin, head of the Spin Optics Laboratory at St Petersburg University. 'What classic computers and supercomputers take a very long time to do, a quantum computing device will do very quickly. Therein lies the great danger of quantum technologies - comparable to the danger of an atomic bomb. With their help it will be possible, for example, to hack banking protection systems very quickly. That is why today intensive work is under way, including the creation of means of protecting quantum devices: quantum cryptography. And our work contributes to semiconductor quantum technologies.'

Additionally, as the scientist noted, the research was a major step forward in the study of light-induced (i.e. appearing in the presence of light) superconductivity. It is the phenomenon when the materials that allow electric current to pass through have zero resistance. At present, this state cannot be achieved at temperatures above minus 70 C. However, if the proper material is found, this discovery will make it possible to transfer electricity to any point on Earth without any loss, and to create a new generation of electric motors. It should be recalled that in March 2018, the research team of Alexey Kavokin predicted that structures containing superconducting metals, such as aluminium, can help solve the problem. Nowadays, scientists at St Petersburg University are looking for a way to obtain experimental evidence of their theory.

Researchers from University of Texas A&M and University of Texas at Austin published a new paper in the Journal of Marketing that examines how incumbent domestic companies can use marketing tools to counter the threat of foreign entrants after the domestic market is liberalized.

The study, forthcoming in the September issue of the Journal of Marketing and titled "Effects of Liberalization on Incumbent Companies' Marketing Mix Responses and Performance: Evidence from a Quasi-Experiment," is authored by Nandini Ramani and Raji Srinivasan.

In recent years, several governments have liberalized by opening their domestic markets to foreign investment in the hope of increasing economic growth. Foreign companies often bring superior technologies, products, and management practices to these markets. Countries that liberalize in a quest for economic growth can, however, create negative consequences for incumbent domestic companies who have become accustomed to operating in protected markets and may not have the resources to match their incoming foreign rivals.

Managers of incumbent companies are, naturally, concerned about the effects of liberalization on their companies' performance. For example, in response to the potential liberalization of the Indian retail sector, Kishore Biyani, chief executive of the largest incumbent retailer in India, stated in opposition to the reform, "The retail sector...should not be given away to the foreign players while it is too young to compete on a level-playing field." Similarly, founders of incumbent Indian technology startups, who have been fiercely battling U.S. entrants such as Amazon and Uber, argue that foreign competitors destroy domestic industry and have asked the Indian government to introduce protectionist measures.

Given that liberalization may be inevitable, how can managers protect themselves against its negative consequences? In a new study in the Journal of Marketing, two researchers examined whether incumbent companies can change their marketing mix responses to liberalization in order to improve their performance. They consider several aspects of incumbent companies that may influence marketing responses and performance, including knowledge of domestic institutions and market forces and prior exposure to foreign markets and companies.

To estimate the effects of liberalization on incumbent companies' marketing mix responses and performance, the researchers took advantage of a quasi-experiment conducted by the Indian government in 1991 in which some industries were liberalized, while others were not. The findings suggest that incumbent companies with greater knowledge of domestic institutions and market forces should intensify their distribution in response to liberalization. "Incumbent companies' knowledge of domestic distribution networks and trade partners is a strong advantage, which they can exploit by intensifying their distribution to achieve superior performance following liberalization," says Ramani. For incumbent companies that have prior exposure to foreign markets and performance, the findings suggest that they can improve their performance by increasing their promotions, such as consumer rebates and discounts.

For policymakers who may be tempted to raise barriers to protect domestic companies from foreign competitors, our study identifies incumbent companies' marketing mix responses as a mechanism to prevent being crowded out following liberalization. Srinivasan explains that, "Policymakers need not accede to the demands of incumbent business leaders to heighten protectionist barriers, but can find ways to facilitate incumbent companies' learning from foreign entrants such as through fostering alliances and trade associations, creating a win-win situation for domestic firms and policymakers."

Before life began on Earth, the environment likely contained a massive number of chemicals that reacted with each other more or less randomly, and it is unclear how things as complex as cells could have emerged from such chemical chaos. Now, a team led by Tony Z. Jia of the Earth-Life Science Institute (ELSI) at the Tokyo Institute of Technology and Kuhan Chandru of the National University of Malaysia, has shown that simple α-hydroxy acids, like glycolic and lactic acid (which is used in common store-bought facial peels), spontaneously polymerize and self-assemble into polyester microdroplets when dried at moderate temperatures followed by rehydration, as might have happened along primitive beaches and river banks or in drying puddles. These form a new type of cell-like compartment which can trap and concentrate biomolecules like nucleic acids and proteins. These droplets, unlike most modern cells, are able to easily merge and reform and thus could have hosted versatile early genetic and metabolic systems potentially critical for the origins of life.

Scientists from around the world are actively working to understand how life began. All modern Earth life, from bacteria to humans, is made up of cells. Cells are comprised of lipids, proteins, and nucleic acids, with the lipid forming the cell membrane, an enclosure that keeps the other components together and interfaces with the environment, exchanging food and waste. How molecular assemblages as complex as cells originally formed remains a mystery.

Most origins of life research focuses on how the molecules and structures present in contemporary life were produced by the environment, and then assembled into structures that led to the first cells. However, there were likely many other types of molecules that formed alongside biomolecules on early Earth, and it is possible that life started using very simple chemistry unrelated to modern biomolecules then evolved through increasingly complex stages to give rise to the structures found in modern cells.

Previous work conducted at ELSI showed that moderate temperature drying of the simple organic compounds known as alpha-hydroxyacids, which are found in meteorites and many simulations of prebiological chemistry, spontaneously polymerizes them into mixtures of long polyesters. Building on this work, Jia and colleagues took the next step and examined these reactions under the microscope, and found that these mixed polyester systems form a gel phase and spontaneously self-assemble when rewetted to form simple cell-like structures.

The most challenging aspect of this work was devising new methods to characterize the droplets' properties and functions, as no one had analyzed such systems before. Jia noted that the team was fortunate to have such a diversity of multidisciplinary expertise including chemists, biochemists, materials scientists, and geologists. After determining their composition and showing their propensity to self-assemble, the next question was whether these cell-like structures might be able to do something chemically useful. Modern cell membranes perform many crucial functions that help maintain the cell; for example, retaining macromolecules and metabolites in one place, as well as providing a constant internal environment, which can be very different from the one outside the cell. They first measured how stable these structures were and found they could persist for very long periods depending on the environmental conditions, but could also be made to merge and coalesce.

They then tested the ability of these structures to sequester molecules from the environment and found they accumulated large dye molecules to a remarkable degree. They then showed that these droplets could also host RNA and protein molecules and still permit them to be functionally catalytic. Further, the team showed that the droplets could assist in the formation of a lipid layer on their surface, suggesting they could have helped scaffold protocell formation.

Jia and colleagues are not certain these structures are the direct ancestors of cells, but they think it is possible such droplets could have enabled the assembly of protocells on Earth. The new compartmentalization system they have found is extremely simple, they note, and could form easily in primitive environments throughout the Universe. Says Jia, "This allows us to imagine non-biological systems on early Earth that could have still had a hand in the origins of life on Earth. This suggests there may be many other non-biological systems that should be targets of future investigations of this type." He thinks the development of these or similar model systems could allow better study of the evolution of diverse chemical systems representative of the complex chemistries likely to be found on primitive planetary bodies.

"The early Earth was certainly a messy place chemically," Jia explains, "and often most origins of life studies focus on modern biomolecules under relatively "clean" conditions. Perhaps it is important to take these "messy" mixtures and see if there are interesting functions or structures that can arise from them spontaneously." The authors now think that by systematically increasing the chemical complexity of such systems, they will be able to observe how they evolve over time and possibly discover divergent and emergent properties.

"We have this new experimental system we can now play with, so we can start to study phenomena like evolution and evolvability of these droplets. The possible combinations of structures or functions these droplets might have are almost endless. If the physical rules that govern the formation of droplets are fairly universal in nature, then we hope to study similar systems to discover whether they also can form microdroplets with novel properties," adds Jia.

Finally, while the team is presently focused on understanding the origins of life they note this basic research could have applications in other areas, for example, drug delivery and personalized medicine. "This is just a wonderful example of the unexpected ways projects can develop when a team of diverse scientists from around the world come together to try and understand new and interesting phenomena," said team member Jim Cleaves, also of ELSI.

BINGHAMTON, N.Y. -- Facebook can help first-semester college students maintain relationships with high school friends and assist them in creating new friendships, according to new research from Binghamton University, State University of New York. When it comes to making new friends, those with higher confidence in their social skills have less to gain from relying on Facebook, while people with lower confidence in their social skills have more to gain from a reliance on the social media platform.

"Transitioning from high school to college can be stressful for many students. To help them adjust to life in college, it is critical for them to maintain connections with pre-college friends and to form new relationships," said Surinder Kahai, associate professor of management information systems at Binghamton University's School of Management.

For the study, Kahai and fellow researcher, SUNY College at Old Westbury's Yu Lei, focused on first-semester college students by surveying undergraduate college students, mostly sophomores, about their experiences with different channels used to maintain and grow relationships.

Accounting for Facebook's effect on relationships versus the impact of more traditional media (face-to-face interaction, phone calls, etc.), researchers also incorporated how each student's social self-efficacy (confidence in their social skills) affected the use of both Facebook and traditional media to build and maintain relationships.

"You've known your high school friends for a long time. You're not shy in front of them and you can act naturally," said Kahai. "But when it comes to making new friends in college, your ability to be social and open yourself up to new people will matter. If you have low self-efficacy, you may need to rely more on social media to make up for less face-to-face interaction."

In terms of how "best" to use Facebook to maintain and build new relationships, some of the findings include:

Facebook can compensate for the lower use of traditional media to maintain relationships with close friends from high school.

Facebook works best when supplementing traditional media when it comes to making new college friends.

Students with high self-efficacy have more to gain from prioritizing traditional media over Facebook when making new college friends.

Students with low self-efficacy have more to gain from prioritizing Facebook use over traditional media when making new college friends.

Kahai said the findings are relevant to university officials and counselors helping new students adjust to college life.

"New college students often stress about trying to maintain their high school friendships while struggling to develop new ones. These findings can help counselors advise students on how to balance the use of social media and traditional media to enhance their new and older friendships," said Kahai.

Kahai believes that any long-distance relationship can be maintained with the right use of media, which served as some of his motivation to conduct this study.

"If there is an intent to continue the relationship, you can make it happen. Whether you use phone calls, snail mail or Facebook, if you want to maintain a relationship, you can," he said.

And with the growing presence of social media in the lives of college students, Kahai recommends to stop focusing on the "is social media good or bad?" debate.

"It's here, it's not going away. It's a part of society now," said Kahai. "The results of our study suggest that instead of asking whether or not Facebook builds relationships and social capital, we should be focusing on finding the conditions in which it does."

AUGUSTA, Ga. (July 23, 2019) - When someone is depressed and having suicidal thoughts or their depression treatment just isn't working, their caregivers might want to check to see if they have obstructive sleep apnea, investigators say.

That's true even when these individuals don't seem to fit the usual profile of obstructive sleep apnea, which includes males who are overweight, snore and complain of daytime sleepiness, says Dr. W. Vaughn McCall, chair of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University.

"No one is talking about evaluating for obstructive sleep apnea as a potential cause of treatment-resistant depression, which occurs in about 50 percent of patients with major depressive disorder," says McCall, corresponding author of the study in The Journal of Psychiatric Research. Now he hopes they will.

The investigators found clinically relevant disease in 14 percent of 125 adult patients with major depressive disorder, insomnia and suicidal thoughts, even though the sleep-wrecking apnea was an exclusion criterion for the original study.

While more work remains, McCall reasons that the new evidence already suggests that testing for obstructive sleep apnea should be part of the guidelines for managing treatment resistant depression.

"We were completely caught by surprise that people did not fit the picture of what obstructive sleep apnea is supposed to look like," says McCall.

While it's known that people with obstructive sleep apnea have higher rates of depression than other populations, little is known about rates of obstructive sleep apnea in patients with major depressive disorder, so investigators decided to look in a population of patients they already were studying.

The primary intent of the original study was looking at whether treating patients' insomnia in addition to their depression reduced suicidal thoughts. Patients considered at risk for obstructive sleep apnea were excluded since sleeping pills tend to relax muscle and already-too relaxed throat muscles is a primary problem in obstructive sleep apnea. Also excluded were individuals with restless leg syndrome, which is common with sleep apnea even in patients on therapy, and those with morbid obesity, considered a major risk for obstructive sleep apnea.

But when the 125 people enrolled were actually tested with a sleep study at home or in a sleep center, investigators still found disease in 17.

The investigators note that neither the degree of daytime sleepiness nor insomnia accurately predicted the severity of obstructive sleep apnea they identified in these patients and that six of the 17 individuals diagnosed were female, not obese and reporting insomnia rather than classic daytime sleepiness.

Treatment of obstructive sleep apnea may improve symptoms of depression, and comprehensive screening for the sleep problem should be included for treatment resistant depression, write the team of investigators that also includes researchers from the University of California, Irvine; the University of Wisconsin in Madison; Wake Forest School of Medicine in Winston-Salem, North Carolina; and the University of California, San Francisco

It's acknowledged that undetected medical or psychiatric conditions can be a cause of treatment-resistant depression, but obstructive sleep apnea is not on the relatively long list that includes endocrine disorders, like hypothyroidism, as well as problems like coronary artery disease and cancer.

In the quest to find a reason for a lack of response, patients may get an MRI scan, carotid artery studies even a spinal tap.

"I am thinking before we do a spinal tap for treatment-resistant depression, we might need to do a sleep test first," says McCall. He notes that even other depression treatment options, like transcranial magnetic stimulation, which uses rapid magnetic pulses to change brain activity, while noninvasive are still far more costly than a sleep study.

"We know that patients with sleep apnea talk about depression symptoms," McCall says. "We know that if you have obstructive sleep apnea, you are not going to respond well to an antidepressant. We know that if you have sleep apnea and get CPAP, it gets better and now we know that there are hidden cases of sleep apnea in people who are depressed and suicidal."

Forty-four percent of the 125 patients in this study had treatment-resistant depression and four of the 17 diagnosed with obstructive sleep apnea had severe problems. Most with obstructive sleep apnea were in the upper end of the age range of 18 to 65 -- sleep apnea and other sleep problems tend to increase with age -- and were similar in other respects like sex and weight.

Ten years ago in a study of 73 outpatients with depression and insomnia but considered at low risk for sleep apnea, McCall identified 8.2 percent actually had moderate sleep apnea. A subsequent larger study by another group found 14 percent of 703 adults with depression also had obstructive sleep apnea, and others have reported similar findings. This appears to be the first study in which suicidality also was a factor.

Important remaining questions include whether when suicide is also a factor, does treating sleep apnea also reduce suicidal thoughts, says McCall, an expert in the trifecta of depression, insomnia and suicide.

McCall and others have shown that if you don't sleep you get depressed and depression is a major risk for suicide. In fact, McCall reported several years back that when people lose hope of ever getting another good night's sleep, they are at high risk for suicide.

Sleep apnea tends to produce excessive daytime sleepiness but this study was recruiting for patients with insomnia, and most with insomnia don't have sleep apnea, rather issues like anxiety, stress and depression and other emotional and psychological factors are more likely interfering with their sleep. Rather than complain of daytime sleepiness, females are more likely to say they are unable to fall asleep and stay asleep at night and are more likely to be depressed, McCall says.

Treatment-resistant depression also can result as a side effect of other medications, including commonly prescribed drugs like beta blockers and corticosteroids for problems like lupus and rheumatoid arthritis.

"The fact is depression treatment often does not work very well," says McCall. In fact, evidence has shown that patients who do not respond to one antidepressant are actually progressively less likely to respond to subsequent drugs that are tried. "It's the law of diminishing returns," McCall says.

DALLAS, July 23, 2019 - Patients appear to be at higher risk of heart problems or stroke when prescriptions for the newest cholesterol-lowering drugs are rejected by insurance companies or unfilled by patients, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

The drugs, PCSK9 inhibitors (PCSK9i), can substantially lower levels of low-density lipoprotein (LDL, the "bad" cholesterol) in the blood. But they are also more expensive than other prescription treatments - costing about $14,000 a year at the time this study was conducted in 2015 - 2017. Last fall, the American Heart Association encouraged drug companies to lower prices to improve patient access.

The study reviewed the medical records and pharmacy claims of about 139,000 high risk adults over a 29-month period after the drugs were first made available in 2015. On average patients' outcomes were tracked for 11.5 months from the prescription date.

Researchers found:

Insurers rejected about two-thirds of prescriptions for those at highest risk.

Patients were 16% more likely to have a cardiovascular event (such as heart attacks, unstable angina, angioplasty, coronary bypass surgery, cardiac arrest, and heart disease or stroke attributed to clogged arteries) if their prescription was rejected than if it was covered and filled for almost a year of treatment.

Patients were 21% more likely to have a cardiovascular event if they had a prescription approved but did not fill it.

"Our study shows that when high-risk groups of individuals with familial hypercholesterolemia or already established atherosclerotic disease are rejected for prescribed PCSK9i therapies it can have consequences," said lead author Kelly D. Myers, B.S., chief technology officer for The FH Foundation, a leading research and advocacy non-profit organization focused on reducing heart disease by driving scientific understanding and evidence-based care of familial hypercholesterolemia (FH).

"We have both treatment guidelines and available medications to help reduce cholesterol and associated cardiovascular events in the most vulnerable high-risk patients, and yet barriers in the healthcare system - such as higher treatment costs, tight restrictions on approvals, Medicare rules against co-payment assistance, and lack of coverage - are delaying treatment."

PCSK9i drugs are typically given as injections once or twice a month, often with other cholesterol-lowering drugs including statins. The newer medication is approved to treat two groups of high-risk patients: those with an inherited condition defined by a defect in how the body processes LDL called familial hypercholesterolemia (FH) and those with arterial plaque buildup who have high LDL despite other treatments.

Donald Lloyd-Jones, M.D., a member of the writing committee for the American Heart Association's 2018 cholesterol guidelines, noted this study reviewed data from 2015-2017, prior to several positive steps that have been taken to make this medication more relevant, available and affordable for the people who can best benefit from it.

"Following a thorough review of the science, the American Heart Association guidelines now support the use of PCSK9 inhibitors for certain populations - after use of statins and ezetimibe - and we encourage clinicians and payors to take this into consideration in determining prescription approvals," said Lloyd-Jones, chair of the Department of Preventive Medicine at Northwestern University. "Additionally, the Association has taken bold action in working directly with pharmaceutical companies to address the considerable costs that can hinder access to life-saving medications. So, we hope to see this trend turning and for future data to show that people have access to the medications they need and are using them to their greatest benefit."

Among other findings in the study:

Prescriptions written for women were more likely to be rejected than those for men.

Rejections were more common among both blacks and Hispanics than whites.

15% of prescriptions were abandoned by patients, a rate that researchers suspect was driven by high co-payments. The average copayment for abandoned prescriptions was $233.30 - more than $100 higher than for prescriptions that were covered.

About two-thirds of abandoned prescriptions were among Medicare patients.

The authors noted that the use of a large data set and length of time studied are key strengths of the research. But the data did not capture why claims were rejected, individuals' LDL levels, drug samples patients were given, patient deaths, and missed diagnoses of cardiovascular disease. They also noted potential biases of the study team - employees and advisers for the FH Foundation - adding that their research questions were rooted in patients' health concerns and experiences with prescription claim denials.

BOSTON - An analysis of three previous studies of children and young adults with attention-deficit hyperactivity disorder (ADHD) quantifies for the first time the extent to which stimulant treatment reduces the development of mood disorders, school problems, conduct disorders, substance use disorders and other problems. The study led by Massachusetts General Hospital investigators is being published online in the Journal of Adolescent Health.

"Our study documents that early treatment with stimulant medication has very strong protective effects against the development of serious, ADHD-associated functional complications like mood and anxiety disorders, conduct and oppositional defiant disorder, addictions, driving impairments and academic failure," says Joseph Biederman, MD, chief of the Pediatric Psychopharmacology and Adult ADHD Program at MGH and MassGeneral Hospital for Children. "In quantifying the improvement seen with stimulant treatment, it measures its potency in mitigating specific functional outcomes."

Previous studies of stimulant treatment for ADHD have had limitations, such as only investigating outcomes in boys or not calculating the magnitude of the protective effects of treatment. The current study determined the number needed to treat (NNT) statistic, often used to show the effectiveness of an intervention. As the title indicates, NNT reflects the number of individuals receiving a medication or other treatment needed to prevent a specific unwanted outcome - the lower the NNT, the more effective the treatment.

The investigators analyzed data from three separate studies they had previously published to calculate the NNT needed to prevent specific outcomes. Two of these were long-term, prospective studies of children with and without ADHD - one of boys, one of girls - some of those diagnosed with ADHD were treated with stimulants, some were not. The third study was a randomized, double blind study of young adults with ADHD that compared their performance on a driving simulation upon entering the study with their performance after six weeks of treatment with either a stimulant medication or a placebo. Participants in the long-term studies averaged age 11 upon study entry and 20 at follow-up, and the current investigation focused only on those with ADHD. Participants in the driving study were ages 18 to 26.

The NNTs for the outcomes of interest were found to be quite low:

three participants with ADHD needed to be treated to prevent one from repeating a grade or developing conduct disorder, anxiety disorders or oppositional-defiant disorder.

four participants with ADHD needed to be treated to prevent one from developing major depression or experiencing an accident during the driving simulation.

five participants with ADHD needed to be treated to prevent one from developing bipolar disorder, six to prevent one from smoking cigarettes, and ten to prevent one from developing a substance use disorder.

Adjustments for the sex of participants and several other factors did not change the impact of treatment on those outcomes, except that the protection against substance use disorders was stronger in younger participants.

"Now we have the evidence allowing us to say that stimulant treatment of ADHD prevents the development of several very serious functional outcomes," says Biederman, a professor of Psychiatry at Harvard Medical School. "However, the impact on other serious outcomes - such as post-traumatic stress disorder, traumatic brain injury, suicide risk and employment success - still needs to be investigated." (is your team planning any such studies?)

Knowing which direction to go in order to reach a food location or home is important for many animal species, including humans. For human foragers who travel long distances every day hunting and gathering, orientation skills are essential. Haneul Jang and her colleagues from the Max Planck Institute for Evolutionary Anthropology set out to study how the Mbendjele BaYaka people in Republic of Congo orient themselves in the dense rainforest. To this aim, the researchers conducted more than 600 pointing tests with 54 Mbendjele BaYaka men, women and children aged between 6 and 76 years, in which the participants were asked to point an out-of-sight target in more than 60 different rainforest locations (including the camp).

Jang and her colleagues found that the Mbendjele BaYaka are highly accurate at pointing to distant and out-of-sight target locations. The researchers found pointing accuracy was equally good in men and women. "Gender equality in the Mbendjele BaYaka population may result in Mbendjele women's long-distance foraging for fishing and hunting as do men. This might allow women and men to develop similar orientation abilities. Our results are consistent with previous studies that found no sex differences in orientation abilities in hunter-gatherer societies where both sexes actively travel away from home. Studies from various cultures suggest that sex differences in orientation abilities may indeed result from sex-specific mobility, and our results add to this growing body of evidence", says Jang, lead author of the study.

"In contrast to men and women in our society, where women may still be more likely to work at home or closer to home compared to men, we observed that Mbendjele men and women travel equally far from home, and it is therefore perhaps not surprising that they score equally well in orientation tasks. The results of our study confirm how important experience is for our cognitive development", says Karline Janmaat, main supervisor of the study.

Interestingly, Jang and her colleagues found that at around age six, Mbendjele BaYaka children already performed as accurately as adults in the pointing tests when the tests were conducted close to the camp. Moreover, the researchers found that when the sun was visible in the sky, children's pointing accuracy increased substantially, especially in more distant and less familiar areas. Adults, on the other hand, performed accurately throughout their range also on cloudy days. "Unlike the adults, who have a very good sense of direction in distant areas even if they cannot see the sun's position, the children make large pointing errors in less familiar areas when they cannot see the sun. However, if they can see the sun, children's performances improve considerably", says Jang. "The Mbendjele BaYaka people live in flat lowland rainforests where orienting oneself is challenging due to heavy vegetation and the absence of distant landmarks like mountain peaks. People who live in such an environment may need to start learning how to use the position of the sun to ascertain a direction from a very early age."

According to the authors, this study provides the first behavioural evidence for sun compass use in humans. "We know that bees can use the sun to navigate, but surprisingly there has been no scientific evidence yet that humans may have this skill, too, and that children may develop this skill by age six", says Janmaat. "Our study shows that there is still so much to discover and with a high level of urgency. All forests inhabited by human rainforest foragers in Congo have been sold to foreign companies, causing these people to lose not only their foraging grounds, but their intriguing navigation skills as well."

Previous studies showed that chimpanzees have excellent long-term memory abilities. However, little is known so far about their working memory abilities. To shed light on these abilities researchers presented chimpanzees with a task, in which they could search for food in a number of small, opaque boxes. The chimpanzees first watched how pieces of food were hidden in these boxes. Then the apes could start to search for the food items by pointing at these boxes one by one. If a chosen box contained food, the chimpanzees received this food reward. After each choice, the boxes were covered for 15 seconds.

To retrieve all of the food items chimpanzees needed to keep in mind, which boxes they had already searched for food. The researchers increased the difficulty of the task depending on the ability of each chimpanzee by increasing the number of boxes and by shuffling the boxes between each search. The study revealed key similarities between chimpanzee and human working memory: the best-performing chimpanzees remembered at least four items, one young chimpanzee more than seven items. They used both the appearance of the boxes as well as their position to remember their previous choices.

Humans typically perform worse in working memory tests if they need to do something in parallel. Likewise, if the chimpanzees had to perform a second, similar task in parallel, their performance declined. Differences in working memory ability between chimpanzees were stable over months. The most obvious difference between chimpanzees and humans was not the working memory capacity but the search strategies that humans typically employ to facilitate this task: chimpanzees did not come up with the idea to search the boxes in line from one side to the other.

This study demonstrates that chimpanzees, like humans, possess working memory abilities that allow them to keep track of a series of previous events or actions. Contrary to previous claims, chimpanzees' working memory capacity does not appear to be fundamentally different from the human capacity. "Our findings suggest that chimpanzees perform similar to seven-year-old children in an intuitive working memory task that does not rely on extensive training", says Christoph Voelter from the Max Planck Institute for Evolutionary Anthropology and the University of Veterinary Medicine Vienna.

EAST LANSING, Mich -- Scientists think that green algae are plants water-living ancestors, but we are not sure how the transition to land plants happened.

New research from Michigan State University, and published in the journal eLife, presents evidence that algae could have piggybacked on fungi to leave the water and to colonize the land, over 500 million years ago.

"Fungi are found all over the planet. They create symbiotic relationships with most land plants. That is one reason we think they were essential for evolution of life on land. But until now, we have not seen evidence of fungi internalizing living algae," said Zhi-Yan Du, study co-author and member of the labs of Christoph Benning, and Gregory Bonito.

Researchers selected a strain of soil fungus and marine alga from old lineages, respectively Mortierella elongata and Nannochloropsis oceanica.

When grown together, both organisms form a strong relationship.

"Microscopy images show the algal cells aggregating around and attaching to fungal cells," Du said. "The algal wall is slightly broken down, and its fibrous extensions appear to grab the surface of the fungus."

Surprisingly, when they are grown together for a long time - around a month - some algal cells enter the fungal cells. Both organisms remain active and healthy in this relationship.

This is the first time scientists have seen fungi internalize a eukaryotic, photosynthetic organism. They call it a photosynthetic mycelium.

"This is a win-win situation. Both organisms get additional benefits from being together," Du said. "They exchange nutrients, with a likely net flow of carbon from alga to fungus, and a net flow of nitrogen in the other direction. Interestingly, the fungus needs physical contact with living algal cells to get nutrients. Algal cells don't need physical contact or living fungus to benefit from the interaction. Fungal cells, dead or alive, release nutrients in their surroundings."

"Even better, when nutrients are scarce, algal and fungal cells grown together fend off starvation by feeding each other. They do better than when they are grown separately," explained Du.

Perhaps this increased hardiness explains how algae survived the trek onto land.

"In nature, similar symbiotic events might be going on, more than we realize," Du said. "We now have a system to study how a photosynthetic organism can live inside a non-photosynthetic one and how this symbiosis evolves and functions."

Both organisms are biotech related strains because they produce high amounts of oil. Du is testing them as a platform to produce high-value compounds, such as biofuels or Omega 3 fatty acids.

"Because the two organisms are more resilient together, they might better survive the stresses of bioproduction," Du said. "We could also lower the cost of harvesting algae, which is a large reason biofuel costs are still prohibitive."

Researchers at Tel Aviv University, led by Prof. Carmit Levy and Dr. Tamar Golan of the Department of Human Genetics and Biochemistry at TAU's Sackler School of Medicine, have discovered that fat cells are involved in the transformation that melanoma cells undergo from cancer cells of limited growth in the epidermis to lethal metastatic cells attacking patients' vital organs.

"We have answered a major question that has preoccupied scientists for years," explains Prof. Levy. "What makes melanoma change form, turning aggressive and violent? Locked in the skin's outer layer, the epidermis, melanoma is very treatable; it is still Stage 1, it has not penetrated the dermis to spread through blood vessels to other parts of the body and it can simply be removed without further damage.

"Melanoma turns fatal when it 'wakes up,' sending cancer cells to the dermis layer of skin, below the epidermis, and metastasizing in vital organs. Blocking the transformation of melanoma is one of the primary targets of cancer research today, and we now know fat cells are involved in this change."

The research was conducted in collaboration with several senior pathologists: Dr. Hanan Vaknin of Wolfson Medical Center, and Dr. Dov Hershkowitz and Dr. Valentina Zemer of Tel Aviv Medical Center.

The study was on published July 23 in Science Signaling and is featured on the journal's cover.

In the study, the researchers examined dozens of biopsy samples taken from melanoma patients at Wolfson Medical Center and Tel Aviv Medical Center, and observed a suspicious phenomenon: fat cells near the tumor sites.

"We asked ourselves what fat cells were doing there and began to investigate," adds Prof. Levy. "We placed the fat cells on a petri dish near melanoma cells and followed the interactions between them."

The researchers observed fat cells transferring proteins called cytokines, which affect gene expression, to the melanoma cells.

"Our experiments have shown that the main effect of cytokines is to reduce the expression of a gene called miRNA211, which inhibits the expression of a melanoma receptor of TGF beta, a protein that is always present in the skin," says Prof. Levy. "The tumor absorbs a high concentration of TGF beta, which stimulates melanoma cells and renders them aggressive."

Critically, the researchers have also found a way to block this transformation.

"It is important to note that we found the process reversible in the laboratory: When we removed the fat cells from the melanoma, the cancer cells calmed down and stopped migrating," adds Prof. Levy.

A trial of mouse models of melanoma yielded similar results: When miRNA211 was repressed, metastases were found in other organs, while re-expressing the gene blocked metastases formation.

In the search for a potential drug based on the new discovery, the researchers experimented with therapies that are known to inhibit cytokines and TGF beta, but which have never before been used to treat melanoma.

"We are talking about substances that are currently being studied as possible treatments for pancreatic cancer, and are also in clinical trials for prostate, breast, ovarian and bladder cancers," Dr. Golan said. "We saw that they restrained the metastatic process, and that the melanoma returned to its relatively 'calm' and dormant state."

"Our findings can serve as a basis for the development of new drugs to halt the spread of melanoma -- therapies that already exist, but were never used for this purpose," concludes Prof. Levy. "In the future, we are seeking to collaborate with drug companies to enhance the development of the metastatic melanoma prevention approach."

In an open-label study of women in southern and eastern Africa, a vaginal ring that is inserted once a month and slowly releases an antiviral drug was estimated to reduce the risk of HIV by 39%, according to statistical modeling. In addition, the study found that participants appeared to use the ring more in the open-label study than in a previous clinical trial. These and other results of the HIV Open Label Extension (HOPE) study were presented today at the 10th IAS Conference on HIV Science (IAS 2019) in Mexico City.

In 2017 alone, nearly 870,000 women and girls acquired HIV, according to UNAIDS. Currently available forms of HIV prevention for women are limited, and many women are unable to negotiate condom use with male sexual partners. The vaginal ring tested in the HOPE study, which continuously releases the anti-HIV drug dapivirine, was designed to be a discreet, long-acting HIV prevention option for women. The wearer replaces the product herself once every four weeks. The dapivirine vaginal ring is currently under regulatory review with the European Medicines Agency.

"Women need choices of HIV prevention tools that fit their needs and that they can initiate," said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health and the primary funder of the HOPE study. "With the invaluable contributions of thousands of study participants, the HOPE study has estimated the effectiveness of the dapivirine ring and examined its appeal to users. Additional efforts to develop HIV prevention options continue in the hope that one day, women will have a range of HIV prevention products from which to make an informed choice."

The Phase 3b HOPE study was a follow-on to the NIH-funded ASPIRE clinical trial. ASPIRE and a sister trial called The Ring Study demonstrated in 2016 that the dapivirine ring reduced the risk of HIV infection by roughly 30% in women ages 18 to 45 years and was well-tolerated. The goals of the HOPE study were to gather additional data on the safety of the dapivirine ring and new data on whether and how women used it knowing that the earlier trials had shown it was modestly effective.

The HOPE study began in 2016 and enrolled 1,456 former ASPIRE study participants at 14 sites in Malawi, South Africa, Uganda and Zimbabwe. The women were sexually active, HIV-negative and aged 20 to 49 years.

While the ASPIRE study participants did not know until the end of the trial whether they had received the dapivirine ring or a placebo ring, all women who enrolled in the HOPE study were offered the dapivirine ring. During their first three months in the HOPE study, participants attended monthly study visits where they could receive one new ring. Thereafter, they attended quarterly visits where they could receive three new rings, a schedule that more closely resembled how the ring might be distributed in a real-world setting.

Women could remain in the study regardless of whether they chose to accept the ring. Some 92% of participants accepted the ring at enrollment, and 90% accepted it at their first study visit. The proportion of participants who accepted the ring declined at each subsequent visit, falling to 79% at the 9-month study visit.

Although it was not possible to precisely quantify how much of the time participants wore the dapivirine ring in either the HOPE study or the ASPIRE trial, adherence appeared to be higher in HOPE than in ASPIRE. Adherence was assessed by measuring how much dapivirine was left in returned rings, since the dapivirine level declines when the ring is worn. The amount of dapivirine left in 90% of the rings returned by HOPE study participants indicated that those rings had been used for at least some of the prior month. In contrast, the amount of dapivirine left in 77% of the rings returned by ASPIRE study participants indicated that those rings had been used for at least some of the prior month. The ring is designed to be worn continuously throughout the month to provide effective protection.

The HOPE study participants became infected with HIV at a rate of 2.7% over the year of follow-up. Because the study lacked a concurrent control group receiving a placebo ring, investigators used a mathematical approach based on the ASPIRE placebo group to estimate what the HIV incidence in HOPE would have been had the women lacked access to the dapivirine ring. In this modeling exercise, the average HIV incidence was 4.4% over the year of follow-up. Based on these incidence rates, investigators estimate that the ring reduced the risk of acquiring HIV by 39% in the HOPE study. The study was not designed to determine the effectiveness of the ring.

Comparing the HOPE study population to the ASPIRE placebo group has important limitations. These include the fact that all participants in the HOPE study had previously completed the ASPIRE trial without acquiring HIV. This suggests that an aspect of their behavior other than use of the dapivirine ring, or characteristics of their sexual networks, may have contributed to protection from the virus.

Also known as MTN-025, the HOPE study was implemented by the NIH-funded Microbicide Trials Network (MTN). The Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, both part of NIH, co-fund the MTN with NIAID.

The HOPE study was sponsored by the nonprofit International Partnership for Microbicides (IPM), which developed the dapivirine ring and provided it for the study. IPM conducted its own open-label study of the dapivirine ring called DREAM, which reported final results on June 13 at the South African AIDS Conference in Durban.

The HOPE study was led by Jared Baeten, M.D., Ph.D., a professor of global health, medicine and epidemiology at the University of Washington in Seattle; Thesla Palanee-Phillips, Ph.D., M.Sc., director of network trials and research center programs at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa; and Nyaradzo M. Mgodi, M.B.Ch.B., M.Med., a clinical pathologist and clinical research site leader at the University of Zimbabwe College of Health Sciences Clinical Trials Research Program in Harare.

"Women urgently need more options for HIV prevention that fit into their lives," said Dr. Baeten. "The results reported today show that some women may desire to use the monthly dapivirine vaginal ring, if available, to help protect themselves from HIV."

Pre-exposure prophylaxis, or PrEP, provides high levels of protection from HIV in women and men. PrEP involves taking daily oral tablets of the medication Truvada, which reduces the risk of HIV by more than 95 percent in people at high risk when taken as prescribed. However, taking a daily pill can present challenges for some populations.

In addition to the vaginal ring, NIH is investigating several other long-acting forms of HIV prevention that may prove to be safe and effective options for both women and men.

Among the confounding challenges of diagnosing and treating Alzheimer's disease (AD) is the fact that patients with asymptomatic and symptomatic versions of the degenerative condition may share similar neuropathological burdens but experience significantly different rates of cognitive decline.

In a new study, published July 23, 2019 in Cell Reports, a team led by researchers at University of California San Diego School of Medicine used the transcriptome -- the sum of all messenger RNA (mRNA) molecules expressed from genes -- to compare 414 study participants with clinically diagnosed and neuropathologically confirmed AD with an age-matched, non-demented control group from a community-based neuropathological study.

Their findings suggest that integrating protein interactions with gene perturbations can generate a comprehensive framework for characterizing alterations in the molecular network related to AD.

While familial AD has a strong genetic factor, the causes of sporadic AD (the most common form) are multiple and not completely known. Primary risk factors include age, gender and family history, but also include a variety of biological, psychological and social factors.

Much research has focused upon two key elements of AD pathology -- the accumulation of amyloid protein plaques and abnormal neurofibrillary tau protein tangles in the brain, which are thought to cause dysfunction and death of neurons. But scientists increasingly recognize the relevance and importance of other factors, such as inflammation, blood circulation problems and brain atrophy -- all of which "correlate with clinical symptoms of cognitive decline and have led to changes in diagnostic criteria during the last decade," wrote the authors.

The new study combined analyses of gene perturbations and protein interactions, said senior author Robert Rissman, PhD, professor of neurosciences at UC San Diego School of Medicine, director of the Biomarker Core for the Alzheimer's Disease Cooperative Study (ADCS) and director of the Neuropathology/Brain Bank and Biomarker Cores for the UC San Diego Shiley-Marcos Alzheimer's Disease Research Center, which ultimately identified functionally distinct composite clusters of genes revealing extensive changes in expression levels in AD. These clusters broadly corresponded to synaptic transmission, metabolism, cell cycle, cell survival and immune response -- all critical aspects involved in AD pathology.

"One of the big problems in AD research is identifying patients at risk at the right time," said Rissman. "Understanding the gene networks that may change in specific patient groups can help streamline clinical trials recruitment efforts and reduce costs and time to enroll trials. With the field shifting more and more toward pre-symptomatic disease, we need to expand our understanding of the molecular mechanisms that underlie the entire disease spectrum."

From searching for extraterrestrial life to tracking rainfall, non-experts are increasingly helping to gather information to answer scientific questions.
One of the most established hands-on, outdoor citizen science projects is the University of Washington-based Coastal Observation and Seabird Survey Team, COASST, which trains beachgoers along the West Coast, from California to Alaska, to monitor their local beach for dead birds.

With about 4,500 participants in its 21-year history and roughly 800 active participants today, COASST's long-term success is now the subject of scientific study in its own right. What makes people join citizen science projects, and what motivates people to stick with them over years?

A UW-led paper published in the July issue of Ecology and Society explores the interests and identities of participants who join and remain active in citizen science. Results could help other science projects aiming to harness the power of large teams.

Previous research led by the UW has shown that people who join online-based citizen science projects generally try it just once, and fewer than 1 in 10 remain active past one year. The rates for hands-on, in-person efforts are much higher: COASST, for example, has 54% of participants still active one year after joining.

But what separates those who stay from those who go? Years of responses to surveys from the COASST team's recruitment and engagement efforts provide a unique window on citizen science.

"I came to the UW to analyze a gold mine of social science datasets accumulated by COASST," said social scientist and lead author Yurong He, a postdoctoral researcher in the UW School of Aquatic and Fishery Sciences. "Over a four year period, hundreds of participants responded to survey questions about why they were joining - or continuing - with the program. This represents an unparalleled opportunity."

She analyzed answers to two freeform questions posed to project participants: "Why did you join COASST?" and "Why do you continue to be involved in COASST?" Some 310 new participants chose to answer the questions during their initial training. Another 623 seasoned participants, who had been involved for more than one year, completed a mail-in survey.

"People's memory can be a bit tricky," He said. "You may think that two or five years ago you had a particular motivation, but is that really so? With this study we can definitively answer the motivation question at two different times: at the moment of joining the program, just after they finish being trained, and once they have spent at least a year on the beach collecting monthly data."

The analysis shows that new participants wanted to be outdoors on the beach, learning about birds. Many listed their scientific degrees, previous occupations and birding expertise. But responses from longer-term contributors displayed a slightly different pattern: Although birds and beach remained dominant interests, seasoned volunteers were more likely to mention interests such as the desire to monitor and observe their beach, help in making scientific discoveries, and the importance of project data and results for environmental conservation. Moreover, their "science identity" became focused on their data-collection team and the project collective, rather than on their personal traits.

One important finding, He said, was the value of place. Volunteers often mentioned the importance of continuing to visit their beach even if they hadn't found any birds washed ashore after several months.

"We thought they would talk a lot about birds, and they did, but they actually talked more about the coastal environment, the beach and the ocean," He said. "Place was either equally important or even more important to them than birds."

Another surprising finding is the degree to which participants consider citizen science to be a social activity. Of the five tasks volunteers listed as most important in defining their work for COASST, two - "communicating project results" and "recruiting others to participate" - were social. The other three tasks were "collect data," "make measurements" and "enter data."

"Activities that help connect family members and friends, and provide opportunities to meet new people who share similar interests, can also be scientific in nature," He said. "COASST fulfills both science and social interests for coastal residents."

The study's conclusions based on the surveys included some take-home messages for organizers of hands-on citizen science efforts:

Long-term participants tend to be motivated by a project's mission and goals, and successful programs communicate scientific findings back to participants so that they can see their individual contribution as part of the big picture of project results.

Experienced participants focus on where they conduct their project activities, indicating that sense of place is important to volunteers.

Both new and long-term participants focused on their social interactions as a central part of project activities, suggesting that successful hands-on, citizen science combines high-quality scientific activity with building and maintaining social relationships.