Culture

DALLAS, Aug. 12, 2020 — Patients with peripheral artery disease (PAD) and depressive symptoms experience worse recovery especially women, compared to counterparts without depressive symptoms, one year after receiving specialty care for PAD,  according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

PAD is a narrowing of the peripheral arteries serving the legs, stomach, arms and head, and most commonly affects arteries in the legs. PAD is associated with a high risk of death and illness from cardiovascular diseases and is a significant global health problem that may cause excruciating pain while walking and may impact mobility, functioning, health status and quality of life.  

“This is the first study to document how depressive symptoms may complicate PAD recovery even among patients receiving specialty care,” said senior study author Kim G. Smolderen, Ph.D., FAHA, a clinical health psychologist and co-director of the Vascular Medicine Outcomes Research Program in the internal medicine department at Yale New Haven Hospital, Yale University School of Medicine in New Haven, Connecticut. 

For one year, researchers followed 1,243 patients treated at vascular specialty clinics in the U.S., the Netherlands and Australia who were being treated for new or recurrent symptoms of PAD. Patients included in the study (average age 67, 38% women) were enrolled from the Patient-centered Outcomes Related to Treatment Practices in Peripheral Artery Disease Investigating Trajectories (PORTRAIT) Registry. The international registry addresses gaps in knowledge about the quality of care and health outcomes of patients with PAD, especially as seen from the patients’ perspectives.

Researchers assessed depressive symptoms at the beginning of the study using the standard 8-item Patient Health Questionnaire (PHQ-8). Patients rated statements about how often they:

have “little interest or pleasure in doing things;”
feel “down, depressed or hopeless;”
have “trouble sleeping;”
feel ”tired/no energy,”
have “poor appetite or overeat;”
feel “bad about yourself;” or
believe they are “moving or speaking so slowly that other people notice/or the opposite, being so fidgety or restless that they have to move around a lot more than usual.“

Disease-specific and general health status were measured at the beginning of the study and at three, six and 12 months later with standardized patient interviews.

The researchers then reconstructed the one-year health status trajectory by whether or not patients reported depressive symptoms when they were diagnosed with PAD.  The analysis found:

Men and women with depressive symptoms had worse health status at each time point, compared to patients who did not report such symptoms.
More women than men, had depressive symptoms, 21.1% vs. 12.9%, respectively.
One in five women with a new diagnosis or worsening symptoms of PAD may have clinically relevant depressive symptoms one year after diagnosis, approximately two times higher than men.  The women experienced worse health status outcomes that are partially explained by depressive symptoms.

“A major goal of PAD treatment is improving patients’ health status and quality of life,” said study first author Qurat-Ul-Ain Jelani, M.D., an interventional cardiologist in training at Yale University School of Medicine. “Not recognizing or treating depressive symptoms may stand in the way of realizing optimal recovery.   

“As more value-based care options are designed for patients with PAD, integrating mental health screening and treatment pathways into chronic disease management may increase the opportunity for patients to receive more holistic care, thus improving outcomes. A multidisciplinary approach that includes mental health supports for patients with PAD would be beneficial.”

Because the study was focused on patients treated at vascular specialty clinics, the findings may not be representative of the general PAD population who may not have access to specialty care. Researchers also acknowledged that the emphasis on depressive symptoms excludes many mental health concerns, such as anxiety or stress, and also excludes unmeasured clinical factors that could contribute to depressive symptoms.

“PAD is more than treating the legs and the corresponding pain,” Smolderen said. “We need awareness for the patient as a whole in order to provide patient-centric care.”

New research suggests Black women with natural hairstyles, such as curly afros, braids or twists, are often perceived as less professional than Black women with straightened hair, particularly in industries where norms dictate a more conservative appearance.

The findings, published in the journal Social Psychological and Personality Science, offer empirical evidence that societal bias against natural Black hairstyles infiltrates the workplace and perpetuates race discrimination, said Ashleigh Shelby Rosette, a management professor and a senior associate dean who conducted the research at Duke University's Fuqua School of Business.

The impact of a woman's hairstyle may seem minute, Rosette said, "but for Black women, it's a serious consideration and may contribute to the lack of representation for Blacks in some organizational settings. In the aftermath of the George Floyd murder and the corresponding protests, many organizations have rightly focused on tactics to help eradicate racism at systemic and structural levels. But our individually held biases often precede the type of racist practices that become embedded and normalized within organizations."

To detect bias against Black women with natural hair, the researchers recruited participants of different races and asked them to assume the role of recruiters screening job candidates.

Participants were given profiles of Black and white female job candidates and asked to rate them on professionalism, competence and other factors. Black women with natural hairstyles received lower scores on professionalism and competence and were not recommended as frequently for interviews compared with three other types of candidates: Black women with straightened hair and white women with curly or straight hair, the researchers found.

"In many Western societies, whites have historically been the dominant social group and, as a result, the standard for professional appearance is often based on the physical appearance of whites. For women's hair, that benchmark is having straightened hair," said Rosette, who collaborated with Christy Zhou Koval, a Fuqua alumna and assistant professor at Michigan State University.

Some straightening processes can cost hundreds to thousands of dollars and can cause hair breakage, scalp disease and other health complications, Rosette noted.

"When a Black woman chooses to straighten her hair, it should be a personal preference, not a burden to conform to a set of criteria for which there could be adverse consequences," she said.

In one experiment, two groups of participants evaluated the exact same job candidate, who was a Black woman. One group saw a photo of the candidate with natural hair while the other group saw her with straight hair. The group who saw a candidate with straight hair rated her as more professional -- defined as more polished, refined and respectable -- and they more strongly recommended her for an interview.

The fictional job candidates with natural hair were subject to discrimination when they were being evaluated for jobs in consulting, an industry with conservative dress norms.

However, when participants considered profiles of women who wanted to work at an ad agency, the candidate's hair texture didn't affect perceptions of professionalism or whether they were recommended for interviews. This may be because advertising is viewed as a more creative industry than consulting with less rigid dress norms, the authors posited.

"Some organizations strip away biographical information such as a person's name and other clues about gender or race from application materials. This procedure is known as blinding and has been shown to reduce similar types of bias as what we found in our research," she said. "But there fundamentally has to be a level of awareness that the natural hair bias exists. If you don't know that it exists, you can't know its influence on your decision-making processes."

It was only three years ago that the U.S. Army eased restrictions on natural hairstyles for Black soldiers, Rosette noted. In recent months, several cities and states have passed laws prohibiting discrimination against natural hairstyles for Black people at work and public school. Federal legislators have drafted similar bills to ban hair-based race discrimination under U.S. law.

"Although there have been some policy changes protecting Black people from discrimination based on their natural hair, these changes are fairly recent and not as widely implemented as they should be," Rosette said. "This work illustrates that racial discrimination based on hair can occur, and we hope it can inform new policies and practices for firms to ensure they're considering candidates equally, and furthermore, aren't missing out on top talent."

Sleep paralysis - a condition thought to explain a number of mysterious experiences including alleged cases of alien abduction and demonic night-time visits - could be treated using a technique of meditation-relaxation, suggests a pilot study published today.

Sleep paralysis is a state involving paralysis of the skeletal muscles that occurs at the onset of sleep or just before waking. While temporarily immobilised, the individual is acutely aware of their surroundings. People who experience the phenomenon often report being terrorised by dangerous bedroom intruders, often reaching for supernatural explanations such as ghosts, demons and even alien abduction. Unsurprisingly, it can be a terrifying experience.

As many as one in five people experiences sleep paralysis, which may be triggered by sleep deprivation, and is more frequent in psychiatric conditions like post-traumatic stress disorder. It is also common in narcolepsy, a sleep disorder involving excessive daytime sleepiness and sudden loss of muscle control.

Despite the condition being known about for some time, to date there are no empirically-based treatments or published clinical trials for the condition.

Today, in the journal Frontiers in Neurology, a team of researchers report a pilot study of meditation-relaxation therapy involving 10 patients with narcolepsy, all of whom experience sleep paralysis.

The therapy was originally developed by Dr Baland Jalal from the Department of Psychiatry, University of Cambridge. The current study was led by Dr Jalal and conducted in collaboration with Dr Giuseppe Plazzi's group at the Department of Biomedical and Neuromotor Sciences, University of Bologna/IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy.

The therapy teaches patients to follow four steps during an episode:

1. Reappraisal of the meaning of the attack - reminding themselves that the experience is common, benign, and temporary, and that the hallucinations are a typical by-product of dreaming

2. Psychological and emotional distancing - reminding themselves that there is no reason to be afraid or worried and that fear and worry will only make the episode worse

3. Inward focused-attention meditation - focusing their attention inward on an emotionally-involving, positive object (such as a memory of a loved one or event, a hymn/prayer, God)

4. Muscle relaxation - relaxing their muscles, avoiding controlling their breathing and under no circumstances attempting to move

Participants were instructed to keep a daily journal for four weeks to assess sleep paralysis occurrence, duration and emotions. Overall, among the 10 patients, two-thirds of cases (66%) reported hallucinations, often upon awakening from sleep (51%), and less frequently upon falling asleep (14%) as rated during the first four weeks.

After the four weeks, six participants completed mood/anxiety questionnaires and were taught the therapy techniques and instructed to rehearse these during ordinary wakefulness, twice a week for 15 min. The treatment lasted eight weeks.

In the first four weeks of the study, participants in the meditation-relaxation group experienced sleep paralysis on average 14 times over 11 days. The reported disturbance caused by their sleep paralysis hallucinations was 7.3 (rated on a ten-point scale with higher scores indicating greater severity).

In the final month of the therapy, the number of days with sleep paralysis fell to 5.5 (down 50%) and the total number of episodes fell to 6.5 (down 54%). There was also a notable tendency towards reductions in the disturbance caused by hallucinations with ratings dropping from 7.3 to 4.8.

A control group of four participants followed the same procedure, except participants engaged in deep breathing instead of the therapy - taking slow deep breaths, while repeatedly counting from one to ten.

In the control group, the number of days with sleep paralysis (4.3 per month at the start) was unchanged, as well as their total number of episodes (4.5 per month initially). The disturbance caused by hallucinations was likewise unchanged (rated 4 during the first four weeks).

"Although our study only involved a small number of patients, we can be cautiously optimistic of its success," said Dr Jalal. "Meditation-relaxation therapy led to a dramatic fall in the number of times patients experienced sleep paralysis, and when they did, they tended to find the notoriously terrorising hallucinations less disturbing. Experiencing less of something as disturbing as sleep paralysis is a step in the right direction."

If the researchers are able to replicate their findings in a larger number of people - including those from the general population, not affected by narcolepsy - then this could offer a relatively simple treatment that could be delivered online or via a smartphone to help patients cope with the condition.

"I know first-hand how terrifying sleep paralysis can be, having experienced it many times myself," said Dr Jalal. "But for some people, the fear that it can instil in them can be extremely unpleasant, and going to bed, which should be a relaxing experience, can become fraught with terror. This is what motivated me to devise this intervention."

Researchers from University of New South Wales, University of Southern California, and Imperial College London published a new paper in the Journal of Marketing that analyzes how varying levels of hope and anxiety about outcomes from new products affect consequential adoption intentions and actual product adoption.

The study, forthcoming in the Journal of Marketing, is titled "Strong Anxiety Boosts New Product Adoption When Hope Is Also Strong" and is authored by Yu-Ting Lin, Deborah J. MacInnis, and Andreas B. Eisingerich.

New products offer consumers the opportunity to create positive outcomes that are congruent with the goals they hope to achieve. However, because they are new and untried, new products might also create anxiety about outcomes that are incongruent with consumers' goals. The research team demonstrates that strong anxiety about outcomes from a new product actually enhances (vs. weakens) consequential adoption intentions toward and actual adoption of that new product when hope is also strong. Lin explains that "We show that this effect occurs because strong hope and strong anxiety motivate individuals to engage in action planning--that is, to contemplate actions that support the occurrence of hoped-for outcomes and actions that avoid the occurrence of anxiety-arousing ones." Action planning boosts new product adoption by enhancing consumers' perceived control over outcomes from new product adoption. These findings aid marketers in understanding how emotions like hope and anxiety can affect new product adoption. They also aid policymakers by suggesting that disclaimers that make consumers anxious about potentially negative outcomes from new product purchase or usage could encourage thoughtful processing in the form of action planning when hope is also strong.

Specifically, if market research reveals that consumers already have strong anxiety about outcomes from new product adoption, marketing communications should emphasize the product's relevance to the goals that consumers hope for, as opposed to downplaying consumers' anxiety about potential adverse outcomes. Conversely, if market research reveals that consumers have strong hope for the product but low anxiety, the results suggest that marketers might benefit by providing warning labels, disclaimers, and disclosures. Beyond encouraging new product adoption, such communications could also enhance product satisfaction. MacInnis adds, "In other words, to the extent that consumers consider goal-incongruent outcomes and plan for how they can be avoided, they may ultimately be more satisfied with the product than would consumers who never considered potential anxiety-evoking outcomes or engaged in action planning."

Relatedly, and from a public policy perspective, the findings suggest that disclosures or labels that evoke strong anxiety about goal-incongruent outcomes from new product use might encourage more thoughtful decision making when hope is also strong. Whereas marketers may be loath to use such disclaimers, this research suggests that when a new product evokes strong levels of hope, anxiety-inducing disclosures might not harm, and could potentially help, new product adoption.

The Korea Institute of Science and Technology (KIST) announced that a research team led, by Dr. Hyungmin Kim at the Center for Bionics, Biomedical Research Institute of the KIST, found a strong correlation between a ultrasonic stroke rehabilitation method for treating damaged brain and a change in delta waves, which is a type of brain waves.

A stroke is the result of a cerebrovascular hemorrhage/infarction and is a disease with a high mortality rate. Even when a stroke does not lead to death, it results in the blockage of the affected person's blood supply and damage to the nerve cells, causing the impairment of physical movement. Many researches are underway on post-stroke rehabilitation methods that can be used to repair damaged brain.

Dr. Hyungmin Kim of the KIST recently published a study on hemiparalysis treatment for motor function recovery, a treatment in which the deep cerebellum is stimulated using low-intensity focused ultrasound stimulation (Neurorehabil Neural Repair. 2018 Sep;32(9):777-787). This treatment method, which can be used to treat stroke patients with various brain lesions, has received much attention as it does not require surgical procedures and can be used to selectively stimulate deeper parts of the brain areas.

To apply this method for various stroke treatments, a 'stimulation guide' is required. This can be used to assess the patient's prognosis after brain stimulation and to optimize the intensity and frequency of the stimulation for maximizing motor function recovery.

In order to develop such a guide, the KIST research team observed changes in the brain waves of the nerve cells of stroke lesions during treatment. In particular, the research team observed and analyzed changes in delta waves (1-4 Hz), which abnormally increase in brain lesions, in both the normal cerebral hemisphere and the cerebral hemisphere affected by the legion.

The KIST research conducted the ultrasound stimulation treatment on the deep cerebellum of mice for three days. On the first day, the motor functions of the mice improved almost three-fold, and on the fourth day, the mice were able to retain their improved motor functions. During the experiment, changes in the delta waves were observed, which increased up to three times, confirming that interhemispheric balance was retained and held steady at a normal level in the ultrasound stimulation group.

The study found that ultrasound stimulation can suppress delta waves and induce a change in damaged brain, signifying the improvement of motor functions. If a patient-specific ultrasound stimulation method can be developed by monitoring brain waves, this type of treatment can be translated from animal experimentation to actual patient treatment.

"Given that ultrasound brain stimulation progresses at a rapid pace and given that it is being studied in relation to various brain diseases, it will likely be used as an effective stroke treatment in the near future," said Dr. Hyungmin Kim of the KIST. "In order to develop an ultrasound stimulation treatment, it is essential to verify the safety of such treatment based on the careful observation and long-term tracking of various stimulation conditions."

CORVALLIS, Ore. - A compound given as a dietary supplement to overweight but otherwise healthy people in a clinical trial caused many of the patients to slim down, research by Oregon State University and Oregon Health & Science University showed.

The research, published in the Journal of Nutrition, analyzed the effects of 24 weeks of daily, 600-milligram doses of lipoic acid supplements on 31 people, with a similarly sized control group receiving a placebo.

"The data clearly showed a loss in body weight and body fat in people taking lipoic acid supplements," said Balz Frei, director emeritus of OSU's Linus Pauling Institute and one of the scientists on the study. "Particularly in women and in the heaviest participants."

Produced by both plants and animals, lipoic acid sets up shop in cells' mitochondria, where it's normally attached to proteins involved in energy and amino acid metabolism. A specialized, medium-chain fatty acid, it's unique in having two sulfur atoms at one end of the chain, allowing for the transfer of electrons from other sources.

The body generally produces enough lipoic acid to supply the enzymes whose proper function requires it. When taken as a dietary supplement, lipoic acid displays additional properties that might be unrelated to the function in the mitochondria. They include the stimulation of glucose metabolism, antioxidant defenses and anti-inflammatory responses - making it a possible complementary treatment for people with diabetes, heart disease and age-related cognitive decline.

"Scientists have been researching the potential health benefits of lipoic acid supplements for decades, including how it might enhance healthy aging and mitigate cardiovascular disease," said Alexander Michels, another Linus Pauling Institute scientist involved with the study. "In both rodent models and small-scale human clinical trials, researchers at the LPI have demonstrated the beneficial effects of lipoic acid on oxidative stress, lipid metabolism and circadian rhythm."

The OSU/OHSU project addressed two issues commonly ignored by previous human trials, said Tory Hagen, a professor of biochemistry and biophysics in the OSU College of Science and the study's corresponding author.

"Many existing clinical studies using lipoic acid have focused on volunteers with pre-existing conditions like diabetes, making it difficult to determine if lipoic acid supplements simply act as a disease treatment or have other beneficial health effects," said Hagen, principal investigator and Helen P. Rumbel Professor for Healthy Aging Research at the institute. "Another issue is the formulation of the supplement. Many previous studies have used the S form of lipoic acid, which is a product of industrial synthesis and not found in nature. We only used the R form of lipoic acid - the form found in the body naturally."

Contrary to what was expected by the researchers, decreased levels of triglycerides - a type of fat, or lipid, found in the blood - were not seen in all the participants taking lipoic acid.

"The effect of lipoic acid supplements on blood lipids was limited," said Gerd Bobe, another LPI scientist who collaborated on the study. "But people who lost weight on lipoic acid also reduced their blood triglyceride levels - that effect was clear."

Other effects of the lipoic acid supplements were measurable as well.

"By the end of the study, some markers of inflammation declined," Hagen said. "The findings also suggest that lipoic acid supplementation provides a mild reduction in oxidative stress. It is not a perfect panacea, but our results show that lipoic acid supplements can be beneficial."

Identifying which patients will benefit the most from lipoic acid supplementation, and how much they need, is important for both clinical and economic reasons, he added.

"Lipoic acid supplements are often quite expensive," he said. "So understanding how we can maximize benefits with smaller amounts of the supplement is something we are interested in pursuing."

Companies across the world are competing fiercely to provide high-resolution displays to electronic devices such as TVs and smartphones. In particular, the virtual reality, a keyword of the 4th industrial revolution, requires a much higher resolution to improve the picture quality. A Korean research team developed a technology to produce a 'nano display' with a phenomenal resolution based on the 3D printing technique and posted the result of the study on a SCI journal, garnering much global attention.

A team led by Dr. Jaeyeon Pyo and Dr. Seung Kwon Seol at Nano Hybrid Technology Research Center of Korea Electrotechnology Research Institute (KERI), a government-funded research institute under National Research Council of Science & Technology (NST) of the Ministry of Science and ICT (MSIT), developed a 'nanophotonic 3D printing technology' allowing the production of super-high-resolution display devices with high-density integration of nanoscale pixels based on the 3D layout for the first time in the world.

The nanophotonic 3D printing technology of KERI enables the production of three-dimensional (3D) pixels with nanoscale dimensions based on the 3D printing of quantum dots. When stimulated by light or electricity, quantum dots emit light in multiple colors. Thanks to the color purity and high stability, they are widely used as light emitting materials for displays in many electronic devices such as TV, smartphones, tablets.

To manufacture displays applying quantum dots, pixels are produced by coating them lightly in film. Here, a high resolution display device means that it contains many pixels on the screen. As more pixels are densely integrated, users can enjoy a more precise and delicate image or picture.

Companies are making an effort to decrease the pixel size to increase their numbers for an enhanced resolution. However, they faced with a problem of limited intensity of light as the pixel size was reduced. As TVs, smartphones, and other electronic devices largely boost super high resolution displays, securing a higher definition with a smaller pixel size has become the key to lead the highly competitive market.

The KERI research team commenced the R&D project based on the idea that the production of pixels with a 3D structure, instead of using a thin film, would help them secure the intensity of light required for a high resolution. The research team successfully demonstrated the production of pixels with a lateral dimension of 620nm and 10,000nm in height with its own 3D printing technology. Instead of using a 2D patterning, the team applied the 3D structure to overcome the light intensity problem. The 3D layout enabled a 2-fold increase in brightness with full colors (red, green, blue) compared to conventional thin film based structure.

With regard to pixels per inch (PPI), an indicator used to measure the pixel density (resolution), the KERI technology demonstrates the three primary colors in 5,600PPI, overwhelmingly exceeding that of 8K QLED TV (100PPI), laptop (200PPI), and smartphone (800PPI), while surpassing the limit of commercial technology (1,000PPI) by 5 times or more. Such an outstanding pixel density allows the technology to be applied extensively to future innovative displays adopting VR and AR, beam projector, etc., requiring a super-high-resolution. In addition, the 3D printing technology can be applied to ultra-high density data storage medium anti-forgery technology using super-high-resolution encryption pattern in 3D structure camera sensor bio technology etc.

One of the biggest benefits of 'nanophotonic 3D printing technology' of KERI is that 3D printing of quantum dots onto Polyimide (PI) or Polyethylene terephthalate (PET), materials used to produce flexible substrates, is available. Hence, it can be applied to wearable or rollable devices as well.

Dr. Jaeyeon Pyo said, "It is not easy to find cases of using 3D printing techniques to the display industry across the world. We took a different approach from previous 3D printing research, which was mostly relying on foreign tools and equipment. It can be considered as a complete technology independence to develop an 'integrated solution' from 3D printing materials to original technology and equipment."

In recognition of the outstanding outcome of the KERI research, the result was published in ACS Nano (American Chemical Society), the world's most prestigious academic journal in material science (7.31/ First author: Jongcheon Bae in master's course, Corresponding author: Dr. Jaeyeon Pyo, Project leader: Dr. Seung Kwon Seol). With regard to the impact factor used as a proxy for the relative importance of a journal within its field, it recorded 14.588 and belonged to the top 1.625% among all SCI academic journals.

Research by INRS (Institut National de la Recherche Scientifique) Professor Salim Timo Islam and his PhD student Fares Saïdi has recently revealed that multicellular physiology in the social bacterium Myxococcus xanthus--a bacterium that can actively reorganize its community according to the environment in which it is found--is modulated by the secretion of two natural sugar polymers in separate zones of a swarm. Results from their research, done in collaboration with an international team, have been published in the journal PLOS Biology.

Professor Salim Timo Islam has been carrying out research in bacterial physiology for four years, focusing on the interactions of bacterial cells with each other, as well as with underlying surfaces. Along with his PhD student Fares Saïdi, they are investigating the origins of multicellularity. More precisely, their work revolves around the factors that allow cells to multiply, specialize, communicate, interact, and move. These behaviours are all associated with multicellularity as they promote the expansion of a community of cells and the formation of complex structures.

Their research has characterized two compounds contributing to multicellularity and the distinct areas of production, for each, within a community. Exopolysaccharide (EPS) is produced more by cells at the periphery of the swarm. Production of the second sugar polymer, a novel biosurfactant (BPS), is enriched toward the centre of the swarm. "Since the factors contributing to the development of bacterial communities remain poorly understood, it is very exciting to have identified another," mentions Professor Islam, a specialist in microbial biochemistry and co-first author of the study along with his PhD student Fares Saïdi.

A Model Bacterium

Multicellularity is typically associated with organisms such as fungi, plants, and animals. As part of this study, the researchers studied the basis for this evolutionary transition on a smaller scale: the bacterium Myxococcus xanthus. This organism has the distinction of being able to reorganize the structure of its population, allowing it to react to different environmental signals and even eat other bacteria.

In response to a hostile environment, such as in instances of nutrient deficiency, this bacterium directs its homogenous population to specialize into three subtypes of cells. These communities thus form 3-dimensional structures, visible to the naked eye. It is thanks to this multicellular lifestyle that they ensure the survival of their community.

Breast screening women aged 40-49 reduces breast cancer mortality, with minimal increased overdiagnosis, according to a study led by Queen Mary University of London that looked at data from 160,000 women.

The UK, along with many other countries, has a breast cancer screening programme offering mammography to women aged 50-70 years every 3 years. However, uncertainty currently exists over whether to start screening at a younger age, including whether it might lead to overdiagnosis of breast cancer.

Between 1990 and 1997, the UK Breast Screening Age Trial randomised more than 160,000 UK women aged 39-41 to receive either annual mammography, or the usual NHS breast screening which commences at age 50. The primary outcome was mortality from breast cancers diagnosed prior to first NHS breast screen.

In a new analysis, published in The Lancet Oncology which presents the 23-year follow-up results of the trial, it was found that screening women aged 40-49 led to a substantial and significant 25 per cent reduction in breast cancer mortality in the first ten years. The total years of life saved from breast cancer in the intervention group was estimated as 620, corresponding to 11.5 years saved per 1,000 women invited to earlier screening.

The results also suggest at worst modest overdiagnosis in this age group, and that any overdiagnosed cancers would otherwise be diagnosed at NHS screening from 50 years of age. Therefore, screening in the age group of 40-49 years does not appear to add to overdiagnosed cases from screening at age 50 years and older.

Lead researcher Professor Stephen Duffy from Queen Mary University of London said: "This is a very long term follow-up of a study which confirms that screening in women under 50 can save lives. The benefit is seen mostly in the first ten years, but the reduction in mortality persists in the long term at about one life saved per thousand women screened.

"We now screen more thoroughly and with better equipment than in the 1990's when most of the screening in this trial took place, so the benefits may be greater than we've seen in this study."

The researchers say that more research is needed to clarify whether progress in early detection technology and treatment of breast cancer might modify the screening-related reduction in mortality in the 40-49 age group. They also did not consider the cost-effectiveness of lowering the screening age.

Children made up a very small proportion--just 1%--of all confirmed COVID-19 cases in England during the first wave of the coronavirus pandemic, despite the large numbers of them tested, reveals a study based on national monitoring data, and published in the Archives of Disease in Childhood.

The findings confirm that, unlike adults, children aren't an important source of COVID-19 infection, say the researchers.

Children account for only a small proportion of confirmed cases of COVID-19. But it's not clear if this is due to low levels of testing or higher than expected death rates.

To compare disease trends in adults and children during the first wave of the coronavirus pandemic in England between January and May 2020, the researchers reviewed COVID-19 test result data for this period.

The data included NHS and Public Health England (PHE) test results plus those carried out by family doctors at 300 general practices contributing to the Royal College of General Practitioners monitoring system for flu-like illness.

Between 16 January and 3 May, a total of 540,305 people, including 35,200 children under the age of 16, were tested for SARS-CoV-2, the virus that causes COVID-19 infection.

Around one in four (24%) of all those tested (129,704 out of 540,305) had the virus. Children accounted for 1408 of those 129,704 positive results, equal to 1% of the total and 4% of the 35,200 tests carried out on them. This compares with around 19%-35% of adults.

The first confirmed cases of the infection in children were reported on 29 February and these continued to increase before peaking on 11 April, echoing the trends seen in adults.

On average, children were nearly 6 years old when they tested positive for the virus, and just over half (53%; 742) the cases were among boys. The highest number of tests and positive results were among infants, particularly those under 3 months, and among 1 year olds.

In general practice, SARS-CoV-2 positivity was low even in children with acute respiratory infections, the data show.

In all, 2,961 people with respiratory illnesses were tested for SARS-CoV-2 and only 10 children (2.8%) were positive, compared to 9% of 15-44 year olds; 18.5% of 45-64 year olds; 20.5% of 65-79 year olds; and 45.5% of those aged 80 and above.

The total number of deaths among children between January and May in England wasn't higher than expected compared to the same time period in the previous four years. This contrasts sharply with the estimated 56,456 excess deaths occurring among adults in England between March and May.

In all, 8 of the 1,408 children who tested positive for SARS-CoV-2 died, but only four died of COVID-19; they were aged between 10 and 15, and three had several co-existing conditions. The others died of other causes, with SARS-CoV-2 confirmed as an incidental or contributory factor.

The case fatality rate for children with COVID-19 in England was estimated to be less than 1 in 200 (0.5%).

The figures are in line with those reported for children in other countries, say the researchers, who write: "The experience in England adds to the growing body of evidence on the limited role of children in the COVID-19 pandemic, with just over 1% of confirmed cases occurring in children.

"With nearly half a million SARS-CoV-2 tests performed during the first 4 months of 2020, the positivity rate among 35, 200 children tested was only 4.0% compared with 19.1%-34.9% in adults and older adults."

In additional comments not found in the text of the paper, lead author Dr Shamez Ladhani says: "It is still not clear why young children have such a low risk of infection compared to older children or adults. One theory is that, compared to adults, children have fewer ACE2 receptors which the virus can bind to in cells that line the respiratory tract.

"The way the immune system reacts to the virus is also likely to be different in children compared to adults."

He adds: "Whilst these numbers are reassuring for children, they include a long period of complete lock down where children were less likely to have been exposed to the virus."

And he cautions: "We need to remain vigilant as the lock down eases and children have increased contact with other children and adults in the coming weeks. In particular, we need more information about asymptomatic infections and silent transmission."

The gender of the human remains found inside a cremation pyre pit in Beisamoun, Israel remains unknown. What is known is that the individual was a young adult injured by a flint projectile several months prior to their death in spring some 9,000 years ago. Preserved due to it being buried, the pit represents the oldest proof of direct (1) cremation in the Middle-East. An international team lead by CNRS archaeo-anthropologist Fanny Bocquentin (2) with aid from PhD candidate Marie Anton and several experts in animal, plant, and mineral remains, discovered and studied the bones found inside the pyre. An analysis of the clay used to coat the inside of the pit showed the 355 bone fragments, some of which were burnt, were exposed to temperatures reaching 700°C. The position of the bones and the preserved joints seem to indicate the body was placed seated onto the pyre and was not moved during or after cremation. Whether used as fuel, as ornamentation, or as a scent, siliceous traces indicated the presence of flowering plants, which made it possible to identify the season the person died. In addition to the exceptional pyre pit, the cremated remains of five other adults were discovered at the site. They dated back to the same period as burials whose traces were discovered among the ruins of abandoned dwellings. The use of cremation indicates an evolution of the relationship to death in the region. The veneration of ancestors and lengthy funerary practices seem to have given way to shorter rituals. This could be evidence of a transition phase because, some two to three centuries later, the dead were no longer buried inside or near villages and their traces are much more difficult to find.

The study is based on joint archaeological digs completed between 2007-2016 by the CNRS, the French Ministry for Europe and Foreign Affairs and the Israel Antiquities Authority.

One of the hallmarks of severe COVID-19 is shortness of breath and significantly reduced levels of oxygen in the blood, called hypoxemia. Upon hospitalization, these patients are administered oxygen in an attempt to bring their levels back up to normal. However, a new study hints that this universal therapy may have unintended consequences via an unexpected source--the microbiome.

"It had been assumed that the lungs were relatively clean and free of bacteria," says Shanna Ashley, Ph.D., a former Post-Doctorate Fellow with the Division of Pulmonary and Critical Care Medicine at U-M Medical School. "We now know that the balance of bacteria inside the lungs matters much like it does in the gut." Ashley worked with a team led by Robert Dickson, M.D., Assistant Professor of Pulmonary & Critical Care Medicine and Microbiology and Immunology, whose lab has spent years exploring the role of the lung microbiome in health and disease. Their work has found that oxygen disrupts this balance, contributing to lung injury.

Scientists have long known that oxygen can damage the lungs. "Oxygen is actually a potent lung toxin," says Dickson. "If I put healthy mice in 100% oxygen, they will die in five days, and they'll have the same kind of severe lung injury that patients with COVID-19 or other lung damage have."

Patients in intensive care are often treated with high concentrations of oxygen for long periods of time. Their team began to explore how therapeutic oxygen was affecting the lung microbiome. They looked at critically ill patients who were on a ventilator for more than 24 hours and studied bacteria detected in specimens from their lungs. They found marked differences in the bacteria species present in samples from patients depending on whether they received low, intermediate, or high concentrations of oxygen. Specifically, patients who received high oxygen concentrations were much more likely to grow Staphylococcus aureus, bacteria that are very oxygen-tolerant and a common cause of lung infections in the ICU.

"Different types of bacteria vary quite a bit from each other in how well they can handle oxygen," Dickson says, "So we wondered if the oxygen we give our patients might be influencing the bacterial communities in their respiratory tract."

To better understand the relationship between oxygen and lung bacteria, the team designed a series of experiments in mice. They first exposed healthy mice to high concentrations of oxygen to determine the effects of oxygen on the lung bacteria of healthy mice.

"When we gave high concentrations of oxygen to healthy mice, their lung communities changed quickly, and just like we predicted," said Ashley. "The oxygen-intolerant bacteria went down, and the oxygen-tolerant bacteria went up." After three days of oxygen therapy, oxygen-tolerant Staphylococcus was by far the most commonly detected bacteria in mouse lungs.

The team next designed experiments to answer a key "chicken or the egg" question: do these altered bacterial communities contribute to lung injury? Or are bacterial communities altered because the lung is injured? They first addressed this by comparing the relative timing of changes in lung bacteria as compared to the onset of lung injury.

Using mice, they were able to demonstrate that while the lung microbiome was changed by high oxygen concentrations after only a day, lung injury wasn't detectable until after 3 days, proving that damage to the lung followed the disruption of the microbiome, and not the other way around. Furthermore, they showed that natural variation in lung bacteria was strongly correlated with variation in the severity of inflammation in oxygen-exposed mice.

To further strengthen the causal link, they turned to germ-free mice, which completely lack a microbiome. "We wanted to see whether there was a selective advantage or disadvantage to having bacteria-free lungs when exposed to therapeutic oxygen," says Ashley. When comparing two groups of genetically identical mice--one with bacteria and one without--the mice without bacteria were protected from oxygen-induced lung injury.

"That was an extraordinary finding for us," said Dickson. "Compared to conventional mice, these germ-free mice have the same genetics and receive the same oxygen dosing, but their lungs are protected from injury. Nothing in our current understanding of oxygen-induced lung injury can explain that finding."

"It really makes the case that the microbiome is somehow playing a role in lung injury," said Ashley.

Targeting the microbiome

Critically ill patients receiving oxygen are typically administered antibiotics as well. The team wondered: Could antibiotics alter the severity of oxygen-induced lung injury in mice? "The short answer is yes, we can affect the severity, but it wasn't in the direction we predicted," says Dickson. Vancomycin, an antibiotic that targets gram-positive bacteria like Staphylococcus, had no effect on lung injury, while ceftriaxone, a gram-negative antibiotic, made things worse.

"The microbiome is not all good and not all bad," comments Dickson. "That's why it's important for us to figure out the mechanisms here. We're currently using very non-specific interventions, when what we need is targeted manipulation of the microbiome."

Ashley agrees. "We need to think about using the microbiome as a therapeutic target to prevent doing further damage to patients' lungs while they are on a ventilator or receiving oxygen."

Dickson cautions against changing clinical practice prematurely based on these findings. "The question of how much oxygen to give critically ill patients is a complex one, and a topic of intense study," says Dickson. "Our findings are exciting, but I still look to randomized controlled trials to inform my decisions about how to dose oxygen in sick patients."

James Kiley, director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, agrees. "This study provides important insights into the contributions of the microbiome toward inflammation and damage in lungs exposed to varying levels of oxygen, and supports the continued importance of understanding how the microbiome and related factors impact lung disease and clinical outcomes."

NEW YORK, NY (Aug. 12) -- Columbia researchers have uncovered an array of new genes that cause stillbirth, significantly increasing the understanding of the condition's genetic foundations. The findings suggest that genetic analysis could be used to counsel parents who have previously experienced stillbirth and to unlock new human biology.

Using both standard and advanced analysis techniques, the team led by David Goldstein, PhD, and Ronald Wapner, MD, of Columbia University Vagelos College of Physicians and Surgeons (VP&S) identified the likely genetic cause of stillbirth in about one of every 10 cases studied.

"This study shows that careful genetic analyses can often identify the precise genetic causes of stillbirth and demonstrates the importance of diagnostic sequencing in all cases of unexplained stillbirth," says Goldstein, director of the Institute for Genomic Medicine at Columbia University Irving Medical Center. "Of equal importance, the work highlights how little we currently understand about the biology of stillbirth and the role that genomic analysis can play in helping us understand it."

The study was published online today in the New England Journal of Medicine by the Columbia team. Kate Stanley, MS, a research associate in the Goldstein lab, and Jessica Giordano, MS, a research genetic counselor in the reproductive genetics division of the Department of Obstetrics & Gynecology at VP&S, were co-first authors of the study.

Presumed Genetic Underpinning, but Few Studies

Stillbirth (the in utero death of a fetus after 20 weeks' gestation) occurs in approximately one in 100 pregnancies and is about 10 times more common than sudden infant death syndrome.

But in the majority of cases, the cause of stillbirth is unknown. Some have been linked to maternal medical conditions such as infection and preeclampsia; 10% to 20% are attributed to large and easily detectable chromosomal abnormalities. Only a few genes have been implicated.

"Unlike postnatal childhood conditions that are presumed to be strongly genetic, stillbirth had yet to be systematically analyzed with modern genome sequencing approaches," says Goldstein.

"All too often, we have no explanation to give parents who experience a stillbirth," says Wapner, professor of obstetrics & gynecology. "Not only are they devastated, they're often left to wonder if it's something they did wrong or if it might happen again."

Genomic Sequencing Plus New Bioinformatic Analyses Find Hidden Genetic Causes

Genomic sequencing has been particularly useful in diagnosing otherwise unexplained childhood disorders and fetal structural defects, and the Columbia team used it for the first time to search for genetic variants that cause stillbirth.

The researchers sequenced all protein-encoding genes--where most known disease-causing genetic variants occur--from 246 stillborn fetuses and deployed new statistical analyses to identify the genetic mutations that caused the death of the fetus.

The combination of traditional sequencing and new analytical techniques revealed small changes in 13 genes that caused fetal death; six of the genes had not been previously linked to stillbirth.

"Although these are small changes in only a single site in the genome, they are, in effect, genomic sledgehammers that either dramatically change or knock out essential genes and appear responsible on their own for fetal demise," Goldstein says.

The small genetic changes explained 8.5% of the stillbirths in the study. When combined with a previous analysis of larger genomic alterations in this group, the researchers determined that 18% of the stillbirths had a known genetic cause.

The analysis also showed a critical difference compared with the study of postnatal genetic conditions.

"Interestingly, some of the changes we found in genes known to cause postnatal diseases and conditions appeared to have more profound effects than the mutations linked to postnatal disease," Goldstein adds.

Clinical Implications

Currently, the analyses required to find causal genetic causes of a stillbirth can be conducted in only a few academic medical centers.

But eventually the findings from this study--and future studies--will help physicians counsel parents and guide clinical care.

"To a woman who's just had a stillbirth, specific knowledge about the cause is critical," Wapner says. "They often blame themselves and some decide not to have any more children."

If the stillbirth can be attributed to a genetic mutation that has only occurred in the fetus, not in the parents, the same problem is unlikely to occur in future pregnancies.

"That knowledge would change the way we would provide care," Wapner says, "and facilitate closure and bereavement for families."

Unlocking New Human Biology

Most genetic diagnostic studies focus on genes already known to cause disease. Because stillbirth has been understudied, however, the team wanted to test whether genetic changes in genes not currently linked to disease contribute to stillbirth.

For this assessment, the researchers used a bioinformatic tool pioneered by the Goldstein lab that focuses on genes that are under the strongest natural selection in the human population--known as "intolerant" genes. The lab team showed that at least 5% of stillbirths are likely explained by mutations in intolerant genes that are not currently linked to any known human disease.

"These novel disease genes appear to be critical for early human development, and the only way to discover them is through the analysis of fetuses that do not develop," Goldstein says.

"We're opening up new frontiers in biology and the more we understand about basic human development, the more we can potentially intervene."

ADELPHI, Md. -- In the future, a Soldier and a game controller may be all that's needed to teach robots how to outdrive humans.

At the U.S. Army Combat Capabilities Development Command's Army Research Laboratory and the University of Texas at Austin, researchers designed an algorithm that allows an autonomous ground vehicle to improve its existing navigation systems by watching a human drive. The team tested its approach--called adaptive planner parameter learning from demonstration, or APPLD--on one of the Army's experimental autonomous ground vehicles.

"Using approaches like APPLD, current Soldiers in existing training facilities will be able to contribute to improvements in autonomous systems simply by operating their vehicles as normal," said Army researcher Dr. Garrett Warnell. "Techniques like these will be an important contribution to the Army's plans to design and field next-generation combat vehicles that are equipped to navigate autonomously in off-road deployment environments."

The researchers fused machine learning from demonstration algorithms and more classical autonomous navigation systems. Rather than replacing a classical system altogether, APPLD learns how to tune the existing system to behave more like the human demonstration. This paradigm allows for the deployed system to retain all the benefits of classical navigation systems--such as optimality, explainability and safety--while also allowing the system to be flexible and adaptable to new environments, Warnell said.

"A single demonstration of human driving, provided using an everyday Xbox wireless controller, allowed APPLD to learn how to tune the vehicle's existing autonomous navigation system differently depending on the particular local environment," Warnell said. "For example, when in a tight corridor, the human driver slowed down and drove carefully. After observing this behavior, the autonomous system learned to also reduce its maximum speed and increase its computation budget in similar environments. This ultimately allowed the vehicle to successfully navigate autonomously in other tight corridors where it had previously failed."

This research is part of the Army's Open Campus initiative, through which Army scientists in Texas collaborate with academic partners at UT Austin.

"APPLD is yet another example of a growing stream of research results that has been facilitated by the unique collaboration arrangement between UT Austin and the Army Research Lab," said Dr. Peter Stone, professor and chair of the Robotics Consortium at UT Austin. "By having Dr. Warnell embedded at UT Austin full-time, we are able to quickly identify and tackle research problems that are both cutting-edge scientific advances and also immediately relevant to the Army."

The team's experiments showed that, after training, the APPLD system was able to navigate the test environments more quickly and with fewer failures than with the classical system. Additionally, the trained APPLD system often navigated the environment faster than the human who trained it. The peer-reviewed journal, IEEE Robotics and Automation Letters, published the team's work: APPLD: Adaptive Planner Parameter Learning From Demonstration .

"From a machine learning perspective, APPLD contrasts with so called end-to-end learning systems that attempt to learn the entire navigation system from scratch," Stone said. "These approaches tend to require a lot of data and may lead to behaviors that are neither safe nor robust. APPLD leverages the parts of the control system that have been carefully engineered, while focusing its machine learning effort on the parameter tuning process, which is often done based on a single person's intuition."

APPLD represents a new paradigm in which people without expert-level knowledge in robotics can help train and improve autonomous vehicle navigation in a variety of environments. Rather than small teams of engineers trying to manually tune navigation systems in a small number of test environments, a virtually unlimited number of users would be able to provide the system the data it needs to tune itself to an unlimited number of environments.

"Current autonomous navigation systems typically must be re-tuned by hand for each new deployment environment," said Army researcher Dr. Jonathan Fink. "This process is extremely difficult--it must be done by someone with extensive training in robotics, and it requires a lot of trial and error until the right systems settings can be found. In contrast, APPLD tunes the system automatically by watching a human drive the system--something that anyone can do if they have experience with a video game controller. During deployment, APPLD also allows the system to re-tune itself in real-time as the environment changes."

The Army's focus on modernizing the Next Generation Combat Vehicle includes designing both optionally manned fighting vehicles and robotic combat vehicles that can navigate autonomously in off-road deployment environments. While Soldiers can navigate these environments driving current combat vehicles, the environments remain too challenging for state-of-the-art autonomous navigation systems. APPLD and similar approaches provide a new potential way for the Army to improve existing autonomous navigation capabilities.

"In addition to the immediate relevance to the Army, APPLD also creates the opportunity to bridge the gap between traditional engineering approaches and emerging machine learning techniques, to create robust, adaptive, and versatile mobile robots in the real-world," said Dr. Xuesu Xiao, a postdoctoral researcher at UT Austin and lead author of the paper.

To continue this research, the team will test the APPLD system in a variety of outdoor environments, employ Soldier drivers, and experiment with a wider variety of existing autonomous navigation approaches. Additionally, the researchers will investigate whether including additional sensor information such as camera images can lead to learning more complex behaviors such as tuning the navigation system to operate under varying conditions, such as on different terrain or with other objects present.

Entirely novel materials and known materials alike can be produced by means of self-organization in chemical systems. Applications range from sensors and batteries to fuel cells, among other technological possibilities. Achieving a deeper understanding and control of the processes involved is the goal of the Campinas Electrochemistry Group (CampEG), affiliated with the University of Campinas’s Institute of Chemistry (IQ-UNICAMP) in the state of São Paulo, Brazil, and led by Raphael Nagao.

Some results of the research were published in a recent article in The Journal of Physical Chemistry (JPC). A review of the group’s work as a whole is featured on the cover of ChemElectroChem.

FAPESP supports the group via several grants, especially a Young Investigator Grant to Nagao for the project “Design and control of self-organized electrochemical patterns”.

“In a reactor with electrodes, the electrochemical process in itself creates self-organizing nanometric or micrometric metal structures. The material grows because of oscillations in the electric potential,” Nagao told Agência FAPESP. “Energy conversion is one possible application of the resulting product – for example, as a catalyst of carbon dioxide (CO2) conversion into ethylene (C2H4), which is a more significant molecule in terms of its potential applications.”

A copper solution was used in the experiment reported in the JPC article. “The electrochemical process produced a deposition on the electrode, detected by means of the variation in potential,” Nagao said. “Using two organic ligands to prevent precipitation of the copper, we were able to control two parameters: the electric oscillation amplitude, which can be correlated with the chemical composition of the resulting material, and the oscillation period, which correlates with the thickness of the layer. Advance knowledge of the structure of the ligands therefore enables growth of the deposit to be controlled.”

Nagao added that the group now wants to achieve a detailed understanding of how these processes work from a basic science standpoint. Potential technological applications will be the next step. “Self-organization in chemical systems can be used as a sophisticated molecular construction mechanism. Exploration of catalytic advantages in terms of the selectivity and efficiency of these materials holds considerable promise going forward,” he said.