Culture

The 2017 wildfire season was the most extensive and expensive in U.S. history. Fires scorched 10 million acres in the western U.S. and federal fire-suppression expenditure surpassed a record $2.9 billion. There's no end to the record breaking in sight: climate change will continue to produce longer, drier fire seasons with substantial burning that will consume residential developments. In a paper released last week, researchers have found that society is doing little to adapt in the aftermath.

"Often, after a fire, a community rebuilds, allows everything to grow back and continues to function the same way," said Brian Buma, PhD, assistant professor in the department of integrative biology at University of Colorado Denver. "But humans have changed the playing field with climate change. Many times, something burns and the vegetation that comes back is coming back differently - or not at all - in the new climate. We can no longer force the systems to stay the same and we have to adapt with them. It may not be what we're used to, but it may be the new reality."

Buma, along with several biologists and sociologists across the U.S., laid out an appeal for the paradigm shift in a paper for the journal Nature Sustainability. It is an appeal not just to think about fire, but to fundamentally rethink our relationships with fire - one that, in the future, has to have fire as an integral component of the landscape (including around our houses, parks, and cities).

Promoting the right kind of resilience

Without adapting to the changing environment, Buma says our current pattern continues to put people at risk by replicating community vulnerabilities. The researchers found the key was promoting the right kind of resilience. In cases where emerging fire behavior is more or less consistent with historical patterns, supporting basic resilience (or recovery to the same state) is probably fine where natural patterns of recovery are likely sufficient and human exposure fairly low. In cases where fire behavior is somewhat new (like more frequent fires with similar intensity), adaptive planning - like reducing the flammability of houses - could reduce the potential for a future disaster.

But Buma and his associates found many cases where fire behaviors resulting from climate change are simply too novel, too intense - the ecosystem and human system simply can't adapt or recover. In that case, transformation as a path to resilience requires fundamentally altering our relationship to the changing dynamic role of fire. Instead of bouncing back, communities should think of it as "bouncing forward."

After a series of catastrophic wildfires in Santa Barbara, the city of Montecito began a community partnership to acknowledge and tackle the issue of their susceptibility to wildfires. The city educated their community, removed vegetation, thinned trees, traded out flammable chaparral shrubs for grass, improved fire response through better infrastructure planning, and required defensible spaces and retrofitting around area homes. Their efforts paid off. When 2007's Thomas Fire hit the city, only seven houses burned, rather than the 400 to 500 homes it was projected to lose.

Altering the social-ecological systems

Convincing people that we need to change is hard, says Buma, especially in a society where the pride of rebuilding is ingrained.

"We tend to force resilience on a system that can no longer be resilient," said Buma. "There are people who continually rebuild in flood-prone areas like the Mississippi Valley. In Colorado, we're developing neighborhoods in the fire-prone foothills of the Rocky Mountains without defensible spaces around the houses or mitigation plans in place. As a society, maybe we should fundamentally rethink how our neighborhoods interact with the inevitable future fire."

The paper outlines the ways in which we can adapt for the future. Decades of fire research has shown that communities need to reduce the woody fuel they've built up, schedule controlled burns and allow some fires under moderate weather conditions. Communities also need to come together to further educate and mitigate other sources of fuel, even though it means intentionally altering social-ecological systems.

"It's a societal shift to get people to get behind the idea of prescribed burns around their property and the smoke that comes with it," said Buma. "But the idea is not a new one. Indigenous populations in the southwest used to set controlled fires regularly and many communities do it. Fire is here and we have to work with it."

"Even as ecologists, we have to abandon this idea of this pristine environment," said Buma. "It's okay to say that this is a managed environment and it will be different from the natural world. We began altering it when we prevented fires. We continue to alter it by warming the climate."

The loss of forest cover in the Amazon has a significant impact on the local climate in Brazil, according to a new study.

The UN Environment Programme has said warned that the Amazon wildfires threaten "...this precious natural resource..." and that the forest helps mitigate the effects of climate change.

Insight into the effects of deforestation in the Amazon - and the way it can intensify climate change, particularly at a local level - has been published open access in the journal Frontiers.

Using satellite data, Jess Baker and Professor Dominick Spracklen from the University of Leeds, evaluated the climatic consequences of deforestation in the Amazon between 2001 and 2013.

They found that deforestation causes the local climate to warm - and that warming intensified as the severity of deforestation increased.

Intact forests in the region, with less than 5% canopy loss, had the most climate stability over the ten years, showing only small increases in temperature.

Areas that had tree cover reduced to below 70% warmed 0.44°C more than neighbouring intact forests during the study period.

The differences between intact and disturbed forests were most pronounced during the driest part of the year, when temperature increases of up to 1.5°C were observed in areas affected by severe deforestation. This increase is additional to global temperature rises driven by climate change.

Study co-author Jess Baker from the School of Earth and Environment at Leeds said: "The Amazon wildfires have reminded us all of the important role that forests play in our global systems. But it cannot be overlooked that intact Amazon forests are also crucially important for Brazil's own local climate.

"A healthy intact Amazon forest helps regulate the local climate and can even act as a buffer to the warming effects of climate change, compared with disturbed forests."

Study co-author Dominick Spracklen, Professor of Biopshere-Atmosphere Interactions at Leeds said: "Deforestation decreases the amount of water emitted to the atmosphere from the forest through a process called evapotranspiration.

"Evapotranspiration can be thought of as the forest 'sweating'; when the moisture emitted by the forests evaporates it cools the local climate. Deforestation reduces evapotranspiration, taking away this cooling function and causing local temperatures to rise.

"As temperatures rise this increases drought stress and makes forests more susceptible to burning."

Researchers from Stellenbosch University, South Africa found that tortoises, one of the main herbivores of the daisies, were unable to distinguish the lower petal surfaces against a green leaf background. Tortoises prefer to eat protein-rich flowers over leaves, but when confronted with closed flowers, they showed no preference between them.

When the researchers modelled the colours of the lower petal surfaces in the vision of other herbivores, they also found these colours to be indistinguishable from leaves.

In contrast, species of daisy that do not close at night produced the same colouration on their lower petals as the upper petals exposed to pollinators.

Plants face an evolutionary conflict between having flowers that attract pollinators while avoiding herbivores. Often plants defend themselves chemically, but this can have adverse effects on pollination.

"When plants defend their flowers chemically, the pollination interactions can be negatively influenced. Our study shows a novel way in which flowers can avoid herbivores, without compromising pollination interactions." Says Dr. Jurene Kemp, lead author of the study.

"These flowers can potentially circumvent the conflict of attracting both pollinators and herbivores by producing attractive colours on the surfaces that are exposed to pollinators (when flowers are open) and cryptic colours that are exposed when herbivores are active (when flowers are closed)."

In Namaqualand, South Africa, where the research took place, daises bloom annually in a spring flowering. This makes preserving flowers, responsible for reproduction, particularly important.

The researchers examined the colouration of 77 Asteraceae species, modelling how they appear in the visual systems of chameleons, horses and goats as proxies for tortoises and larger herbivores in the area, like springbok. They then tested the preferences of real tortoises with both open and closed flowers against leaf backgrounds.

Not all Asteraceae species that close their flowers had cryptically coloured lower petal surfaces, but in the experiments, the tortoises did not readily eat these flowers. Dr. Kemp said, "One interesting question would be to test whether non-cryptic flowers have chemical defences, and whether these chemical defences are absent in the cryptic flowers."

On further research Dr. Kemp said "Unfortunately, we could only do this using one plant family in one botanical region, it would be great to see if other plant species also use colour to avoid herbivores."

The researchers would also have liked to use larger herbivores such as springboks in their behavioural experiments, but Dr. Kemp adds that "this was practically not possible."

Longer NFL careers and certain playing positions appear to each spell greater long-term risk for serious cognitive problems such as confusion, memory deficits, depression and anxiety in former football players, according to a new report published Aug. 30 in The American Journal of Sports Medicine.

The study is believed to be the first to explore the interplay between career length, position and cognitive and mental health outcomes among professional football players.

The analysis--based on a survey of nearly 3,500 former NFL players--was conducted by investigators at the Harvard T.H. Chan School of Public Health and Harvard Medical School as part of the ongoing Football Players Health Study at Harvard University.

The study results show that players who experienced concussions had elevated risk for serious cognitive problems, depression and anxiety, which persisted over time, as long as 20 years following injury. The investigators caution that their analysis relied on players' memories of experiencing concussion rather than on diagnosis at the time of injury. And the findings do not mean that everyone with concussion will necessarily experience cognitive or mental health problems, they add. Contrary to previous reports, the new research did not find a link between starting football at a young age and cognitive problems in adulthood.

On one level, the researchers say, many of their findings make intuitive sense and confirm what some might have already suspected: The longer players remain in the game, the more likely they are to suffer a head injury, which increases the risk for neurocognitive problems. It also affirms that certain positions are more prone to concussions and, therefore, players in them face greater risk for experiencing the downstream of effects of head injury.

Nonetheless, the researchers said, the analysis is the first to document and quantify the risk that stems from lengthier careers and certain high-impact positions.

Specifically, the analysis showed that players who reported the most concussion symptoms had 22-fold risk of reporting serious long-term cognitive problems and six times the risk of having symptoms of depression and anxiety, compared with those who reported the fewest symptoms.

"Our findings confirm what some have suspected--a consistently and persistently elevated risk for men who play longer and who play in certain positions," said study lead investigator Andrea Roberts, a research scientist at the Harvard T.H. Chan School of Public Health. "Our results underscore the importance of preventing concussions, vigilant monitoring of those who suffer them and finding new ways to mitigate the damage from head injury."

For the study, former players, average age 53, were asked about the number of seasons played in the NFL, their positions and any history of blows to the head or neck followed by symptoms of concussion such as dizziness, confusion, vision problems, loss of consciousness, nausea, headaches and seizures, among other symptoms. Based on the number and severity of symptoms, players were given a concussion score.

Overall, one in eight players (12 percent) reported signs of serious cognitive problems. By comparison, about 2 percent of people in the general population in the United States report such problems. Age made no difference in the interplay between concussion and cognitive problems, the study showed. Those under age 52 reported serious cognitive problems at a similar rate as the rest (13 percent), a finding that suggests neurocognitive decline was likely not a function of mere aging. Alarmingly, that risk remained magnified even in those 45 and younger. Indeed, 30 percent of players 45 and younger who had the most concussions reported serious cognitive problems.

To gauge whether the number of seasons played and position type were linked to depression, anxiety and cognitive problems, the researchers used standard questionnaires commonly used to screen for the presence of such disorders. The researchers compared the proportion of players with serious cognitive problems among individuals with various career lengths--one season, two to four seasons, five to six seasons, seven to nine seasons and 10 seasons or more. Overall, those with the longest careers--10 seasons or more--were twice as likely to report severe cognitive problems compared with players who'd played a single season--12.6 percent in the 10-plus season group reported signs of severe cognitive problems, compared with 5.8 percent in the single-season category. The risk crept up proportionally with the number of seasons played, growing progressively higher as the number of years increased. Every five seasons of play carried a nearly 20 percent increase in risk for serious cognitive problems.

Which position one played also mattered. To evaluate the risk-position link, the researchers divided players into three groups based on the average concussion symptoms per year that players reported in each position. Kickers, punters and quarterbacks had the fewest symptoms per year, followed by wide receivers, defensive backs, linemen and tight ends. The groups with the highest number of symptoms included running backs, linebackers and special teams.

Those in the group with the most concussion symptoms had twice the risk for serious cognitive problems--15 percent of those in this group had cognitive difficulties--compared with those reporting the fewest concussion symptoms (6 percent). Those with the most concussions also had a nearly 50 percent greater risk for depression and anxiety, compared with those playing in the group with the fewest concussion symptoms. One in four in the first group had symptoms indicative of depression, compared with 15 percent of players reporting problems in the latter one, while 27 percent had signs of anxiety, compared with 16 percent in the group with the fewest concussions. Those who played in the mid-range group had a 75 percent higher risk of cognitive problems and a 40 percent elevation in risk for depression and anxiety, compared with players in the group with the fewest symptoms.

Nearly one in four players reported symptoms of anxiety (26 percent) and depression (24 percent), and nearly one in five (18 percent) reported symptoms of both conditions. Career length influenced risk for depression, with every five seasons boosting the risk by 9 percent. The number of seasons, however, was not linked to greater anxiety risk.

The age at which an individual started playing organized football did not affect risk. Indeed, outcomes were similar between those who began playing the game before age 12 and those who began later. The findings, however, pertain solely to former NFL players and not necessarily to the general population, the researchers caution. The question of when a child should start playing organized football remains very much open, and should be made by each individual family, the researchers said.

"The overarching goal of the Football Players Health Study is to unravel risk factors and disease mechanisms and to inform interventions that preserve and optimize player health and wellness," said study senior author Marc Weisskopf, the Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology at the Harvard T.H. Chan School of Public Health. "These latest findings confirm much of what we know but they add much needed granularity and specificity to risk magnitude by career length and position."

"Clearly, not everyone who sustains a concussion is destined for cognitive trouble, but the results of the research highlight just how critical it is to continue to find ways to prevent head injuries from occurring in the first place because of the many downstream and long-lasting effects on physical, cognitive and mental health," said Ross Zafonte, the Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation and head of the Department of Physical Medicine and Rehabilitation at Harvard Medical School. Zafonte is also principal investigator of the Football Players Health Study.

Humans had caused significant landcover change on Earth up to 4000 years earlier than previously thought, University of Queensland researchers have found.

The School of Social Sciences' Dr Andrea Kay said some scientists defined the Anthropocene as starting in the 20th century, but the new research showed human-induced landcover change was globally extensive by 2000BC.

The Anthropocene - the current geological age - is viewed as the period in which human activity has been the dominant influence on Earth's climate and the environment.

"The activities of farmers, pastoralists and hunter-gatherers had significantly changed the planet four milennia ago,'' Dr Kay said.

The ArchaeoGLOBE project used an online survey to gather land-use estimates over the past 10,000 years from archaeologists with regional expertise.

"The modern rate and scale of anthropogenic global change is far greater than those of the deep past, but the long-term cumulative changes that early food producers wrought on Earth are greater than many people realise," Dr Kay said.

"Even small-scale, shifting agriculture can cause significant change when considered at large scales and over long time-periods."

Fellow researcher Dr Nicole Boivin said the innovative crowdsourcing-from-experts approach to pooling archaeological data had provided the project with a unique perspective.

"Archaeologists possess critical datasets for assessing long-term human impacts to the natural world, but these remain largely untapped in terms of global-scale assessments," Dr Boivin said.

Another researcher on the team, Dr Alison Crowther, said the study could help plan for future climate scenarios.

"This research and the collaborative approach we used means we can better understand early land use as a driver of long-term global environmental changes across the Earth's system," Dr Crowther said.

Many anesthesiologists forbid patients from chewing gum in the immediate hours before surgery for fear that it would increase the risk that the patient's stomach contents might end up dumped (aspirated) into the patient's lungs, with potentially deadly consequences (aspiration pneumonitis). However, current data now suggest that the preoperative use of chewing gum does not adversely affect gastric emptying and that the postoperative use of chewing gum may actually aid recovery in some forms of major surgery. The Open Anesthesia Journal is pleased to announce the publication of a clinical review on this important topic. Entitled "Chewing Gum Use in the Perioperative Period " and authored by Dr. D. John Doyle from the Department of General Anesthesiology at Cleveland Clinic Abu Dhabi, this open-access peer-reviewed article will be valuable for hospitals and clinics interested in updating their perioperative policies.

A unique Victorian databank that profiles children with hearing loss will help researchers globally understand why some children adapt and thrive, while others struggle.

The Victorian Childhood Hearing Impairment Longitudinal Databank, which has collected information for eight years, is featured in the latest International Journal of Epidemiology.

Its data shows that language development and speech in hearing-impaired children lags behind other children, despite advancements in earlier detection and intervention in the past decade.

The paper's* lead author, Murdoch Children's Research Institute's (MCRI) Dr Valerie Sung, says researchers world-wide can use the databank to answer questions around childhood hearing loss.

"This register can help us understand why some children with a hearing loss do so well, while others experience greater difficulties," she says.

"Universal newborn hearing screening is detecting hearing loss earlier than ever before, usually within a few weeks of birth.

"Children with hearing loss have very early access to hearing aids, early intervention services and for some, cochlear implantation. It was expected that hearing-impaired children would quickly come to enjoy the same language and educational outcomes as their hearing peers.

"However, early clinical diagnosis and intervention does not guarantee equality in health outcomes, with language and related outcomes of children with hearing loss remaining on average well below population means and the children's true cognitive potential.

"Demonstrating the reasons for this inequality has been hampered until now by the lack of population based prospective research."

The Victorian Childhood Hearing Impairment Longitudinal Databank (VicCHILD) is a population-based longitudinal databank open to every child with permanent hearing loss in Victoria.

VicCHILD started in 2012 and stems from 25 years of work by The Royal Children's Hospital and MCRI. At the end 2018, 807 children were enrolled and provided baseline data. By 2020 more than 1000 children will be taking part, making it the largest hearing databank in the world.

VicCHILD collects data at enrolment, two years of age, school entry and late primary /early high school. It involves parent questionnaires, child assessments and taking saliva samples.

Dr Sung, who is also a honorary fellow at the University of Melbourne, says about 600 Australian infants each year are diagnosed with congenital hearing loss within weeks of birth.

"As these children grow, they can face challenges in things that come naturally to others like language and learning. This can impact their quality of life," she says.

"Hearing loss incurs significant burden and medical costs and impacts adversely on educational attainment and employment opportunities.

"This important bank of information could improve interventions and ultimately the lives of children with hearing loss and their families. It will also act as a platform for research trials to understand the effectiveness of different interventions."

Our teeth take thousands of bites per day, and understanding exactly what holds them in place and how is key to helping people live with their own teeth for longer.

Now new research published in the Journal of Dental Research has shed light on the science behind the formation of the periodontal ligament, which helps keep the tooth stable in the jawbone. This improved understanding will also help scientists work towards regenerating the tissues that support teeth.

The study, led by the Universities of Plymouth and Geneva, shows how a *signalling pathway called Notch, which is known to be activated in stem cells and cancer, is important for periodontal ligament development.

*A signalling pathway describes how a group of molecules in a cell work together to control one or more cell functions, such as cell division or cell death. After the first molecule in a pathway receives a signal, it activates another molecule. This process is repeated until the last molecule is activated and the cell function is carried out.

Abnormal activation or inhibition of certain signalling pathways can lead to cancer and other conditions, including problems with tissue regeneration.

A key finding in the new study, which was conducted in rodent teeth, is that Lamin A, a cell nuclear protein, is a direct target of Notch pathway.

Lamin A is best known for its mutated form progerin, which causes fatal 'early ageing' disease, Progeria syndrome - but by uncovering its involvement in periodontal ligament formation, scientists have better insight into how molecules function during tissue regeneration, and how the process could be affected during disease.

Corresponding author Dr Bing Hu, Associate Professor of Oral and Dental Health Research in Peninsula Dental School at the University of Plymouth, said: "The periodontal ligament starts to properly hold the tooth in the jawbone when a tooth breaks out and becomes functional.

"Understanding the mechanisms of how periodontal ligaments develop and the molecules that assist the tissue becoming mature is really important for our understanding of tissue regeneration and repair.

"The next steps are for us to see if and how the molecules we have identified in this study can be translated into a human-only model and, in turn, how they are affected in both healthy and diseased conditions."

Dr Hu is also part of the University's Institute of Translational and Stratified Medicine (ITSMed).

This research is a part of the MD-PhD thesis of Dr Balázs Dénes of the University of Geneva, entitled Post-emergent tooth eruption: eruption rate, periodontal ligament maturation and cell signalling, directed by Professor Stavros Kiliaridis.

Dr Dénes said: "We believe that our findings are an important stepping stone to better dental treatments in situations involving the periodontal ligament, such as gum disease (periodontitis), tooth restoration by dental implants or orthodontic tooth movement."

Researchers from Sweden, Germany, Brazil and the USA have developed a financial mechanism to support the protection of the world's natural heritage. In a recent study, they developed three different design options for an intergovernmental biodiversity financing mechanism. Asking what would happen if money was given to countries for providing protected areas, they simulated where the money would flow, what type of incentives this would create - and how these incentives would align with international conservation goals.

After long negotiations, the international community has agreed to safeguard the global ecosystems and improve on the status of biodiversity. The global conservation goals for 2020, called the Aichi targets, are an ambitious hallmark. Yet, effective implementation is largely lacking. Biodiversity is still dwindling at rates only comparable to the last planetary mass extinction. Additional effort is required to reach the Aichi targets and even more so to halt biodiversity loss.

"Human well-being depends on ecological life support. Yet, we are constantly losing biodiversity and therefore the resilience of ecosystems. At the international level, there are political goals, but the implementation of conservation policies is a national task. There is no global financial mechanism that can help nations to reach their biodiversity targets", says lead author Nils Droste from Lund University, Sweden.

Brazil has successfully implemented Ecological Fiscal Transfer systems that compensate municipalities for hosting protected areas at a local level since the early 1990's. According to previous findings, such mechanisms help to create additional protected areas. The international research team has therefore set out to scale this idea up to the global level where not municipalities but nations are in charge of designating protected areas. They developed and compared three different design options:

An ecocentric model: where only protected area extent per country counts - the bigger the protected area, the better;

A socio-ecological model: where protected areas and Human Development Index count, adding development justice to the previous model;

An anthropocentric model: where population density is also considered, as people benefit locally from protected areas.

The socio-ecological design was the one that proved to be the most efficient. The model provided the highest marginal incentives - that is, the most additional money for protecting an additional percent of a country's area - for countries that are the farthest from reaching the global conservation goals. The result surprised the researchers.

"While we developed the socio-ecological design with a fairness element in mind, believing that developing countries might be more easily convinced by a design that benefits them, we were surprised how well this particular design aligns with the global policy goals", says Nils Droste.

"It would most strongly incentivize additional conservation action where the global community is lacking it the most", he adds.

As the study was aimed at providing options, not prescriptions for policy makers, the study did not detail who should be paying or how large the fund should exactly be. Rather, it provides a yet unexplored option to develop a financial mechanism for biodiversity conservation akin to what the Green Climate Fund is for climate change.

"We know that we need to change land use in order to preserve biodiversity. Protecting land from degradation and providing healthy ecosystems, clean air or clean rivers is a function of the state. Giving a financial reward to governments for such public ecosystem services will ease the provision of corresponding conservation efforts and will help to put this on the agenda", concludes Nils Droste.

The momentum behind a move to plant-based and vegan diets for the good of the planet is commendable, but risks worsening an already low intake of an essential nutrient involved in brain health, warns a nutritionist in the online journal BMJ Nutrition, Prevention & Health.

To make matters worse, the UK government has failed to recommend or monitor dietary levels of this nutrient--choline--found predominantly in animal foods, says Dr Emma Derbyshire, of Nutritional Insight, a consultancy specialising in nutrition and biomedical science.

Choline is an essential dietary nutrient, but the amount produced by the liver is not enough to meet the requirements of the human body.

Choline is critical to brain health, particularly during fetal development. It also influences liver function, with shortfalls linked to irregularities in blood fat metabolism as well as excess free radical cellular damage, writes Dr Derbyshire.

The primary sources of dietary choline are found in beef, eggs, dairy products, fish, and chicken, with much lower levels found in nuts, beans, and cruciferous vegetables, such as broccoli.

In 1998, recognising the importance of choline, the US Institute of Medicine recommended minimum daily intakes. These range from 425 mg/day for women to 550 mg/day for men, and 450 mg/day and 550 mg/day for pregnant and breastfeeding women, respectively, because of the critical role the nutrient has in fetal development.

In 2016, the European Food Safety Authority published similar daily requirements. Yet national dietary surveys in North America, Australia, and Europe show that habitual choline intake, on average, falls short of these recommendations.

"This is....concerning given that current trends appear to be towards meat reduction and plant-based diets," says Dr Derbyshire.

She commends the first report (EAT-Lancet) to compile a healthy food plan based on promoting environmental sustainability, but suggests that the restricted intakes of whole milk, eggs and animal protein it recommends could affect choline intake.

And she is at a loss to understand why choline does not feature in UK dietary guidance or national population monitoring data.

"Given the important physiological roles of choline and authorisation of certain health claims, it is questionable why choline has been overlooked for so long in the UK," she writes. "Choline is presently excluded from UK food composition databases, major dietary surveys, and dietary guidelines," she adds.

It may be time for the UK government's independent Scientific Advisory Committee on Nutrition to reverse this, she suggests, particularly given the mounting evidence on the importance of choline to human health and growing concerns about the sustainability of the planet's food production.

"More needs to be done to educate healthcare professionals and consumers about the importance of a choline-rich diet, and how to achieve this," she writes.

"If choline is not obtained in the levels needed from dietary sources per se then supplementation strategies will be required, especially in relation to key stages of the life cycle, such as pregnancy, when choline intakes are critical to infant development," she concludes.

Exercise immediately prior to and during pregnancy restores key tissues in the body, making them better able to manage blood sugar levels and lowering the risk of long term health problems, suggests new research carried out in mice.

Researchers at the University of Cambridge, who led the study published today in the journal Physiological Reports, say the findings reinforce the importance of an active lifestyle when planning pregnancy.

In the UK, more than a half of all women of reproductive age and almost a third of pregnant women are overweight or obese. This is particularly concerning, as being overweight or obese during pregnancy increases the risk of complications in the mother, such as gestational diabetes, and predisposes both her and her infant to develop metabolic diseases such as type 2 diabetes in the years after pregnancy.

Exercise is known to improve how the body manages blood sugar levels and thereby reduce the risk of type-2 diabetes and metabolic syndrome in non-pregnant women. It also has positive effects prior to and during pregnancy, with beneficial outcomes for both mother and her child, preventing excessive gestational weight gain and the development of gestational diabetes, and the need for insulin use in women who have already developed gestational diabetes. However, little is known about the changes that exercise causes to the tissues of obese pregnant mother.

To answer this questions, researchers at the University of Cambridge fed mice a sugary, high fat diet such that they become obese and then the obese mice were exercised. The mice exercised on a treadmill for 20 minutes a day for at least a week before their pregnancy and then for 12.5 minutes a day until day 17 of the pregnancy (pregnancy lasts for around 20 days in mice).

Mice are a useful model for studying human disease as their biology and physiology have a number of important characteristics in common with those of humans, including showing metabolic changes with obesity/obesity-causing diets and in the female body during pregnancy.

The researchers found that the beneficial effects on metabolic health in obese mothers related to changes in how molecules and cells communicate in maternal tissues during pregnancy.

"A moderate level of exercise immediately before and then during pregnancy leads to important changes in different tissues of the obese mother, effectively making the tissues more like those seen in non-obese mothers," says Dr Amanda Sferruzzi-Perri, a Royal Society Dorothy Hodgkin Research Fellow from the Centre for Trophoblast Research in the Department of Physiology, Development and Neuroscience at the University of Cambridge, who co-led the study.

"We believe these changes may explain how exercise improves the metabolism of the obese mother during pregnancy and, in turn, may prevent her babies from developing early signs of type 2 diabetes after birth."

The key organs of the mother that were affected by exercise were:

white adipose tissue - the fatty tissue that stores lipids and can be found in different parts around the body, including beneath the skin and around internal organs;

skeletal muscle - muscle tissue that uses glucose and fats for contraction and movement;

the liver - the organ that stores, as well as syntheses lipids and glucose.

Exercise affected key signalling pathways - the ways that molecules and cells within tissue communicate - involved in responding to insulin (the hormone that stimulates glucose uptake by white adipose tissue and skeletal muscle), in storage and breakdown of lipids (fats found in the blood and tissue) and in growth and the synthesis of proteins.

White adipose tissue showed the greatest number of changes in response to exercise in the obese pregnant mouse, being restored to a state similar to that seen in the tissue of non-obese mothers. This suggests that insulin resistance of the mother's white adipose tissue may be the cause of poor glucose-insulin handling in obese pregnancies. The findings are different to that seen in non-pregnant animals, whereby exercise typically affects insulin signalling in the skeletal muscle.

In addition, the team's previous work showed that exercise improves sensitivity to insulin and glucose handling throughout the whole body in the obese mother. It also prevents the development of insulin resistance in the offspring of obese mothers after birth. Low insulin sensitivity/insulin resistance requires larger amounts of insulin to control blood glucose levels.

"Our findings reinforce the importance of having an active lifestyle and eating a healthy balanced diet when planning pregnancy and throughout for both the mother and her developing child," says co-lead Professor Susan Ozanne from the Wellcome Trust-Medical Research Council Institute of Metabolic Science at the University of Cambridge.

"This is can be important in helping to reduce the risk of adverse health problems in the mother and of later health problems for her child."

Tiny changes in the microscopic structure of the human brain may affect how patients respond to an emerging therapy for neurological problems.

The technique, called non-invasive electrical brain stimulation, involves applying an electrical current to the surface of a patient's head to stimulate brain cells, altering the patient's brain activity. It is being trialled for a range of neurological problems including recovery from stroke, traumatic brain injury, dementia, and depression, but research to date has found the effects to be inconsistent

Now, a team led by researchers at Imperial College London has shed more light on why these inconsistencies occur and may provide physical evidence for why some patients respond better than others - because of the fine structure of their brain tissue. The new research suggests it may be possible to target the therapy to those patients most likely to benefit.

They found that differences in the makeup of the brain's white matter - the tissue deep in the brain and rich in the branching 'tails' of nerve cells - were key. The research revealed that those who had more connectivity in the regions being stimulated were more likely to respond better to the treatment.

According to the team, the findings, published in the journal Brain, could help to personalise the non-invasive electrical brain stimulation, targeting the treatment to patients who are most likely to gain clinical benefits.

Dr Lucia Li, a clinical lecturer in neurology in the Department of Brain Sciences at Imperial College London, and lead author of the study, said: "With all the current buzz around brain stimulation for altering brain activity, it's important to understand who will benefit most from this technique in the clinic.

"Problems with white matter structure are a feature of a range of different neurological conditions. Our study is a step towards more personalised use of brain stimulation, which will improve the outcomes using this technique, as well as reduce the number of people treated un-necessarily."

In the study, researchers looked at 24 healthy patients and 35 patients recovering from a moderate or severe traumatic brain injury (TBI). Participants performed a task inside an MRI scanner (see 'The Stop Signal Task' in notes to editors) while receiving small amounts of electrical current through electrodes on the surface of the scalp or a placebo. They were unable to tell whether they were receiving brain stimulation or not.

They found that healthy participants who received brain stimulation performed better in the task than when they didn't receive the treatment. For patient with TBI, task performance in response to stimulation varied widely.

However, when they analysed MRI scans, they found that those participants with highly-connected white matter in the brain region being stimulated responded best to the treatment, and those who had damaged or less-connected regions of white matter showed less improvement.

They also found that brain stimulation could partially reverse some of the abnormalities in brain activity caused by TBI.

The team cautions that while more work is needed to confirm the findings, it could mean brain stimulation might prove a useful treatment approach for other neurological conditions with abnormal brain activity as a feature, such as dementia.

"We found that people with stronger white matter connections in their brain had better improvement with stimulation," Dr Li explained. "This might be an important reason why previous studies have found that some people benefit from stimulation, whilst others don't and means we can start using brain stimulation in a more personalised way."

According to the researchers, the study is limited in that in that they only investigated one type of cognitive behaviour and would need to be replicated in other types of behaviour to show if the findings apply more generally. In addition, they only stimulated one region of the brain, so they don't know whether the effects are specific to this region, or whether other regions can be stimulated.

Dr Li explains the team will now focus on larger studies with more participants to investigate what other factors influence someone's response to brain stimulation. They will also apply the technique to other conditions with abnormalities in brain activity to see if they can alter activity and improve brain function.

Since chikungunya virus emerged in the Americas in 2013, it has infected millions of people, causing fever, headache, rash, and muscle and joint pain. For some people, painful, debilitating arthritis lasts long after the other symptoms have resolved. Researchers have suspected that the virus or its genetic material - in this case, RNA - persist in the body undetected, but they have been unable to find its hiding places.

Now, researchers at Washington University School of Medicine in St. Louis have figured out a way to detect cells infected with chikungunya virus that survive the infection. They genetically modified the virus such that it activated a fluorescent tag within cells during infection. Months after the initial infection, the researchers could detect glowing red cells still harboring viral RNA.

The study, in mice, opens up new ways to understand the cause of - and find therapies for - chronic viral arthritis.

The findings are published Aug. 29 in PLOS Pathogens.

Senior author Deborah Lenschow, MD, PhD, an associate professor of medicine and of pathology and immunology, and co-first author and graduate student Marissa Locke answered questions about the research, which was conducted in collaboration with co-first author Alissa Young, PhD, co-author Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine, and others.

How common is chronic arthritis caused by chikungunya infection?

Lenschow: Between 30% and 60% of people infected with chikungunya virus go on to develop chronic arthritis that can last up to three or four years after infection. Researchers had found viral RNA in joint fluid from people with chronic arthritis, but they didn't know whether the virus had gone dormant or whether it was still multiplying and infecting new cells at an undetectably low level.

Locke: Nobody had located the cells that harbored the viral RNA. This matters because if we can't find the infected cells, we can't study them.

Where did you find the virus, and what does that tell you about the cause of chronic arthritis?

Locke: We found the virus in muscle cells and in connective tissue cells in the skin and muscle. These cells likely had become infected within the first week of the virus invading the body, yet managed to survive. They were still there in the muscles and joints up to 114 days after infection, and they still had viral RNA inside them.

Lenschow: One hypothesis would be that the viral RNA that's persisting in the cells is triggering chronic inflammation, and that is what contributes to the symptoms of arthritis. For reasons that we don't understand, inflammation fails to get rid of the viral RNA, or at least not quickly.

What impact will the development of this new tagging technique have on people suffering from chronic viral arthritis?

Lenschow: We're a long way from having a treatment to offer people. But the first step to developing a therapy is understanding the cause of the symptoms, and this technique helps us accomplish that. If we understand the cause, that could hopefully lead us to identify therapeutic interventions to help alleviate some of the chronic symptoms.

Locke: We can use this approach to find out what's driving the chronic inflammation and how to resolve it. We can study which proteins or other components of the immune response worsen or alleviate the inflammation, and what happens to the infected cells when we turn those components up or down.

A significant proportion of eScooter injuries in the US seem to be occurring while 'drivers' are under the influence of drugs and/or alcohol and almost never wearing a helmet, suggests a study of admissions to three US major trauma centres, published online in Trauma Surgery & Acute Care Open.

Most of those injured are men aged 20 to 40, the findings indicate.

Motorised stand up or kick scooters date back to 1915. But electronic or eScooters have only recently gained mass appeal and come into widespread use since 2017.

Promoted as a cheap, eco friendly means of transport, eScooters combine the size of a child's push scooter with the speed and power of an electronic bicycle.

Although partially or completely banned in some US cities, they are nevertheless widely available to rent all over the US, and in many other regions of the world, including Europe.

They are currently banned from use on public roads in the UK, but the Department of Transport is currently reviewing the law.*

Given their soaring popularity in the US, the researchers wanted to look at the patterns of injury associated with their use, and other potentially influential factors, such as the wearing of helmets and drug and alcohol use.

They drew on the numbers of patients admitted to three Level 1 (major) trauma centres between September 2017 and October 2018.

During this period, 103 people were admitted with eScooter injuries, with monthly admissions rising sharply from August 2018 onwards, to reach 43 by October 2018 alone.

The average age of the injured was 37, with more than six out of 10 (62%) in the 20 to 40 age bracket.Two thirds of the patients were men.

More than four out of 10 (42%) were moderately to severely injured, as measured by the Median Injury Severity Score. One person was critically injured.

The bulk of the injuries (42%) involved fractures to the leg bones (tibia and fibula); the bony protrusions at the ankle (malleoli); the collar bone (clavicle); shoulder blades (scapula); and the forearm bone (ulna). Half the patients (53%) with these injuries required surgery.

Facial fractures were the next most common type of injury: 27 (26%) patients had these, most of which were mild, but required surgery in six (22%) cases.

Nearly one in five (18%) patients had a bleed on the brain, although none required surgery, and a further 17 people were concussed.

Five other serious injuries included haemothorax (blood in the space between the lungs and the chest wall); tears in the spleen; kidney injury; and neck injury (cervical spine).

In all, one in three people required surgery. And while most (86%) were discharged home, six patients required long term nursing care/rehabilitation, and two needed care at home.

Information on helmet use was missing for five patients, but of the remainder, virtually none was wearing one at the time of the incident (98%).

Drug and alcohol use was common. Most patients (79%) were tested for alcohol, and around half (48%) were well above the legal limit. Sixty per cent were also screened for drugs, and half (52%) tested positive.

The most common substances found were tetrahydrocannabinol (THC), one of the active ingredients in cannabis (32%), followed by methamphetamine and amphetamines (18%).

The researchers suggest that eScooters may be particularly attractive to risk takers. "Studies in China have found that eScooter riders are also more likely to exhibit risky driving such as riding in traffic lanes and driving against traffic compared with bicycle and electronic bicycle riders.

"Our current study also supports this hypothesis, consisting primarily of men aged 20 to 40 years with a high rate of alcohol use, drug use, and lack of helmet use," they write.

This is an observational study, and as such, can't establish cause. The total number of patients was small and the researchers weren't able to glean information on the frequency, locations, or patterns of eScooter use.

What's more, the research focused on patients admitted to major trauma centres, and there may be a large number of people who sustain more minor injuries after riding an eScooter.

But they conclude: "As the popularity of alternate modes of transportation continues to rise, eScooter related injuries are likely to increase as well."

A mutation that causes a type of muscular dystrophy that affects the limbs protects against HIV-1 infection, according to a study published August 29 in the open-access journal PLOS Pathogens by Sara Rodríguez-Mora, Mayte Coiras and José Alcamí of the Instituto de Salud Carlos III in Madrid, Spain, and colleagues. As the authors noted, this is the second reported genetic defect known to induce strong resistance against HIV-1 infection in humans.

The Transportin 3 gene (TNPO3) encodes a protein, TNP03, that has been described as a key factor in HIV-1 infection. In 2001, researchers discovered a relationship between a genetic defect in TNPO3 and limb girdle muscular dystrophy 1F (LGMD1F) -- a rare muscle disease that causes weakness in the limbs and pelvis. In LGMD1F patients, TNPO3 generates a mutated protein called TNPO3_mut.

In the new study, Rodríguez-Mora Coiras and Alcamí analyzed the effect of TNPO3_mut on HIV-1 infection using blood cells from patients with LGMD1F. The results show that cells from patients with this mutation in TNPO3 are resistant to HIV-1 infection. According to the authors, cells from LGMD1F patients can be used to understand the mechanisms of action of TNPO3 in HIV infection and to design new therapeutic strategies for the treatment of both diseases.