Culture

Modernizing health records by making them electronic has gained momentum as technology evolves and policies push health care toward digital solutions. But the same trend has not been evident for physicians who remain in private practice, new research finds.

The research led by Jordan Everson, PhD, assistant professor in the Department of Health Policy at Vanderbilt University Medical Center (VUMC), finds striking differences in use of electronic health records (EHRs) among more than 291,000 physicians included in the study.

Forty-nine percent of physicians who had remained independent since 2011 and were surveyed in the study attested to Meaningful Use of EHRs, such as electronic prescribing of medications and online patient portals -- at least once. In contrast, 70% of doctors in both group practices and working for hospitals during the study's timeline attested to meaningful use.

Meaningful Use of EHRs was first defined in 2009 by the America Reinvestment & Recovery Act, and financial incentives were offered to physicians and health systems that serve Medicare and Medicaid patients. The program was voluntary, and after 2015 the Centers for Medicare and Medicaid Services (CMS) began reducing payments to providers if there was no expansion in adoption of EHR Meaningful Use practices.

Everson said this can be interpreted in several ways. One is independent doctors have more authority over the technology they use and could simply choose not to continue in the program as opposed to doctors in integrated systems where management could require participation.

"Another way to interpret this is that the cost-benefit equation was worse for independent physicians," Everson said. "In other words, the financial incentives in later years were not enough to overcome the cost of keeping up with Meaningful Use in addition to the time burden of using EHRs. Financial costs are likely particularly high for independent physicians who can't spread the cost across a large organization."

About half of independent physicians who participated in the EHR incentive program in the first years -- 2011 through 2013 -- left the program by 2015. In the same time frame, less than 20% of physicians who worked for hospitals left the program.

The study highlights other possible factors in this trend, such as an aging independent physician population that is retiring in greater numbers.

And while doctors have been moving into larger, integrated health practices for decades as the U.S. health system has grown more complex, that option might not be available for physicians that haven't kept up with new technologies. The study showed that independent physicians who participated in Meaningful Use on their own were more likely to later join integrated systems than physicians who did not participate.

"That may mean that physicians who are not technologically savvy do not have the option to join a bigger system to get help with new technologies," Everson said.

Everson's research, conducted with Melinda Buntin, PhD, Mike Curb Chair of Health Policy at Vanderbilt, and Michael Richards, MD, PhD, an associate professor at Baylor, is the most recent in a number of studies that have illustrated challenges faced by independent practices in adopting new and costly technology, or what many clinicians describe as physician burnout with electronic records.

Oakland, Calif. July 19, 2019 -- The number of women using cannabis in the year before they get pregnant and early in their pregnancies is increasing, and their frequency of use is also rising, according to new data from Kaiser Permanente.

The research, published July 19, 2019, in JAMA Network Open, examined self-reported cannabis use among 276,991 pregnant women (representing 367,403 pregnancies) in Northern California over 9 years and found that cannabis use has increased over time.

From 2009 to 2017, the adjusted prevalence of self-reported cannabis use in the year before pregnancy increased from 6.8% to 12.5%, and the adjusted prevalence of self-reported cannabis use during pregnancy increased from 1.9% to 3.4% (rates were adjusted for demographics). Annual rates of change in self-reported daily, weekly, and monthly-or-less cannabis use increased significantly, though daily use increased most rapidly.

Among women who self-reported cannabis use during the year before pregnancy, the proportion who were daily users increased from 17% to 25%, and weekly users increased from 20% to 22%, while monthly-or-less users decreased from 63% to 53% during the study period. Similarly, among women who self-reported cannabis use during pregnancy, the proportion who were daily users increased from 15% to 21%, and weekly users from 25% to 27%, while monthly users decreased from 60% to 52%.

"These findings should alert women's health clinicians to be aware of potential increases in daily and weekly cannabis use among their patients," said lead author Kelly Young-Wolff, PhD, MPH, a research scientist with the Kaiser Permanente Division of Research. "The actual numbers are likely higher, as women may be unwilling to disclose their substance use to a medical professional."

In addition, the prevalence of daily and weekly cannabis use may have risen even further in the past year and a half following legalization of cannabis for recreational use in California in 2018, Young-Wolff said.

The data come from women's initial prenatal visits at Kaiser Permanente in Northern California, which usually take place at around 8 weeks gestation, and do not reflect continued use throughout pregnancy. Investigators were unable to differentiate whether self-reported cannabis use during pregnancy occurred before or after women were aware that they were pregnant.

While the current findings are based on women's self-reporting, the results are supported by the Kaiser Permanente research team's December 2017 JAMA Research Letter showing an increase in prenatal cannabis use via urine toxicology testing. In this newer study, the authors focus on trends in frequency of use in the year before and during pregnancy.

Some women may use cannabis during pregnancy to manage morning sickness, the authors noted. The authors' previous work published in JAMA Internal Medicine in 2018 found women with severe nausea and vomiting in pregnancy were nearly 4 times more likely to use cannabis during the first trimester of pregnancy.

Women may get the impression from cannabis product marketing and online media that cannabis use is safe during pregnancy, said Young-Wolff. However, there is substantial evidence that exposure to cannabis in pregnancy is associated with having a low-birthweight baby, and the American College of Obstetricians and Gynecologists recommends women who are pregnant or contemplating pregnancy discontinue cannabis use because of concerns about impaired neurodevelopment and exposure to the adverse effects of smoking.

"There is still much that is unknown on the topic, including what type of cannabis products pregnant women are using and whether the health consequences differ based on mode of cannabis administration and frequency of prenatal cannabis use," Young-Wolff noted.

More research is needed to offer women better, specific advice, said study senior author Nancy Goler, MD, an obstetrician/gynecologist and associate executive director of The Permanente Medical Group.

"There is an urgent need to better understand the effects of prenatal cannabis exposure as cannabis becomes legalized in more states and more widely accepted and used," Dr. Goler said. "Until such time as we fully understand the specific health risks cannabis poses for pregnant women and their fetuses, we are recommending stopping all cannabis use prior to conceiving and certainly once a woman knows she is pregnant."

The study was supported by a grant from the National Institute on Drug Abuse.

Young-Wolff and Kaiser Permanente Division of Research colleague Lindsay Avalos, PhD, MPH, have received a new 5-year grant from NIDA to support further research on maternal cannabis use during pregnancy. They plan to study whether prenatal cannabis use is associated with increased risk of adverse maternal, fetal, and neonatal outcomes using data from urine toxicology testing, self-reported frequency of prenatal cannabis use, and mode of cannabis administration. They will also test whether legalization of cannabis for recreational use in 2018 and local regulatory practices (such as retailer bans) are associated with variation in prenatal cannabis use.

A survey of 93 people with 3q29 deletion syndrome reveals a distinct pattern of social disability and anxiety, even without a diagnosis of autism spectrum disorder.

The results were published online in Molecular Autism on July 16.

Geneticists at Emory University School of Medicine teamed up with clinicians at Children's Healthcare of Atlanta's Marcus Autism Center to evaluate the largest cohort of people with 3q29 deletion ever assembled. Because 3q29 deletion syndrome is relatively rare (1/30,000 people), most physicians who have seen a case have only seen one. Study participants were recruited through a registry website, and they or their parents completed questionnaires about social, communication and behavioral issues. The average age was 10, but adults up to age 41 were included.

In 3q29 deletion syndrome, a stretch of DNA containing several genes is missing from one of a child's chromosomes. 3q29 deletion -- usually spontaneous, not inherited -- is one of the strongest genetic risk factors for schizophrenia, increasing the risk at least 20 fold. It also increases the likelihood of autism spectrum disorder at a similar level, the survey indicates: 24 fold for males and more than 40 fold for females.

Most people with 3q29 deletion did not have autism spectrum disorder (ASD) diagnoses (29 percent did), but overall they did have higher scores for social disability and anxiety. While not all participants were the same, their average profile was distinct from the general picture of autism spectrum disorder, in that people with 3q29 deletion tended to have high scores for restricted interests and repetitive behaviors, but only mild impairment in social motivation.

"The kids are motivated to have peer relationships, and desperately want them, yet aside from social motivation, they often lack other skills with which to form those relationships," says senior author Jennifer Mulle, PhD, assistant professor of human genetics at Emory University School of Medicine.

"One of our recommendations is that all individuals with 3q29 deletion should receive a thorough ASD evaluation as standard of care, so that they can have access to social services and therapeutic programs." Mulle says. "Because their intellectual disability is generally mild, cognitive behavioral therapy to teach social skills may be an effective intervention."

Another distinctive aspect of 3q29 deletion syndrome is its relatively greater effects on ASD risk in females compared with males. In the general ASD population, males outnumber females 4 to 1; this ratio is reduced to 2 to 1 for ASD diagnoses in the 3q29 group.

The first author of the paper is Genetics and Molecular Biology graduate student Rebecca Pollak. She worked with associate scientist Melissa Murphy, PhD at Emory and Celine Saulnier, PhD and Cheryl Klaiman, PhD at Marcus Autism Center. Emory geneticists Michael Epstein, PhD and Michael Zwick, PhD also contributed to the paper.

Mulle sees investigating 3q29 deletion syndrome - and other genetic variations connected with schizophrenia and autism -- as a way of unraveling the biological complexity of both conditions.

The Emory team is beginning to investigate individual genes found within the 3q29 deletion, aiming to understand molecular mechanisms. Working with cell biology chair Gary Bassell, scientists plan to create a human neuronal model of 3q29 deletion, using induced pluripotent stem cell lines. They are also investigating the patterns of gene activity in blood samples from 3q29 donors.

In April, Mulle and her colleagues from the Department of Human Genetics, including Tamara Caspary, PhD, David Weinshenker, PhD and Steve Warren, PhD published a mouse model of 3q29 deletion in Molecular Psychiatry. The mice display social and cognitive impairments that correspond to some symptoms of related neuropsychiatric disorders.

EVANSTON, Ill. -- Either to check the time or waste time, people often look at their smartphones after waking in the middle of the night.

While this acute burst of light does make it more difficult to fall back to sleep, a new Northwestern University study reports that it won't interfere with the body's overall circadian rhythms.

For the first time, researchers directly tested how short pulses of light are processed by the brain to affect sleep. They discovered that separate areas of the brain are responsible for short pulses versus long-term exposure to light. This finding challenges the widely accepted, long-held belief that all light information is relayed through the brain's suprachiasmatic nucleus (SCN), which synchronizes the body's sleep/wake cycles.

"Prior to the widespread use of electricity, our exposure to light and darkness occurred in a very predictable pattern," said Northwestern's Tiffany Schmidt, who led the study. "But light has become very cheap. We all have smartphones, and their screens are very bright. We're all getting exposed to light at the wrong times of day. It's becoming more important to understand how these different types of light information are relayed to the brain."

The paper will publish July 23 in the journal eLife. Schmidt is an assistant professor of neurobiology in Northwestern's Weinberg College of Arts and Sciences. The study was carried out in collaboration with the laboratories of Fred Turek, the Charles and Emma Morrison Professor of Neurobiology in Weinberg, and Samer Hattar, section leader at the National Institute of Mental Health.

After light enters the eye, specialized neurons called intrinsically photosensitive retinal ganglion cells (ipRGCs) carry the light information to the brain. Before Northwestern's study, researchers widely believed that all light information went through the SCN, a densely packed area in the hypothalamus known as the body's "circadian pacemaker."

"Light information comes into the SCN, and that's what synchronizes all of the body's clocks to the light/dark cycle," Schmidt said. "This one master pacemaker makes sure everything is in sync."

To conduct the study, Schmidt and her team used a genetically modified mouse model that only had ipRGCs projecting to the SCN -- but no other brain regions. Because mice are nocturnal, they fall asleep when exposed to light. The mice in the experiment, however, stayed awake when exposed to short pulses of light at night. The mice's body temperature, which also correlates to sleep, also did not respond to the short-term light.

The mice maintained a normal sleep/wake cycle and normal rhythms in their body temperature, suggesting that their overall circadian rhythms remained intact. This helps explain why one night of restless sleep and smartphone gazing might make a person feel tired the following day but does not have a long-term effect on the body.

"If these two effects -- acute and long-term light exposure -- were driven through the same pathway, then every minor light exposure would run the risk of completely shifting our body's circadian rhythms," Schmidt said.

Now that researchers know that the light-response system follows multiple pathways, Schmidt said more work is needed to map these pathways. For one, it is still unknown what area of the brain is responsible for processing acute light.

After more is known, then researchers might understand how to optimize light exposure to increase alertness in those who need it, such as nurses, shift workers and emergency personnel, while mitigating the harmful effects of a wholesale shift in circadian rhythms.

"Light at the wrong time of day is now recognized as a carcinogen," Schmidt said. "We want people to feel alert while they are exposed to light without getting the health risks that are associated with shifted circadian rhythms, such as diabetes, depression and even cancer."

Developed eco-friendly, low-cost, and high-efficiency wastewater processing catalyst made from agricultural byproduct, and High efficiency and removal rate achieved through application of ultrasound stimulation, leading to high expectation for the development of an environmental hormone removal system

The research team of Dr. Jae-woo Choi and Dr. Kyung-won Jung of the Korea Institute of Science and Technology's (KIST, president: Byung-gwon Lee) Water Cycle Research Center announced that it has developed a wastewater treatment process that uses a common agricultural byproduct to effectively remove pollutants and environmental hormones, which are known to be endocrine disruptors.

The sewage and wastewater that are inevitably produced at any industrial worksite often contain large quantities of pollutants and environmental hormones (endocrine disruptors). Because environmental hormones do not break down easily, they can have a significant negative effect on not only the environment but also the human body. To prevent this, a means of removing environmental hormones is required.

The performance of the catalyst that is currently being used to process sewage and wastewater drops significantly with time. Because high efficiency is difficult to achieve given the conditions, the biggest disadvantage of the existing process is the high cost involved. Furthermore, the research done thus far has mostly focused on the development of single-substance catalysts and the enhancement of their performance. Little research has been done on the development of eco-friendly nanocomposite catalysts that are capable of removing environmental hormones from sewage and wastewater.

The KIST research team, led by Dr. Jae-woo Choi and Dr. Kyung-won Jung, utilized biochar,** which is eco-friendly and made from agricultural byproducts, to develop a wastewater treatment process that effectively removes pollutants and environmental hormones. The team used rice hulls, which are discarded during rice harvesting, to create a biochar that is both eco-friendly and economical. The surface of the biochar was coated with nano-sized manganese dioxide to create a nanocomposite. The high efficiency and low cost of the biochar-nanocomposite catalyst is based on the combination of the advantages of the biochar and manganese dioxide.

**Biochar: a term that collectively refers to substances that can be created through the thermal decomposition of diverse types of biomass or wood under oxygen-limited conditions

The KIST team used the hydrothermal method, which is a type of mineral synthesis that uses high heat and pressure, when synthesizing the nanocomposite in order to create a catalyst that is highly active, easily replicable, and stable. It was confirmed that giving the catalyst a three-dimensional stratified structure resulted in the high effectiveness of the advanced oxidation process (AOP), due to the large surface area created.

When used under the same conditions in which the existing catalyst can remove only 80 percent of Bisphenol A (BPA), an environmental hormone, the catalyst developed by the KIST team removed over 95 percent in less than one hour. In particular, when combined with ultrasound (20kHz), it was confirmed that all traces of BPA were completely removed in less than 20 minutes. Even after many repeated tests, the BPA removal rate remained consistently at around 93 percent.

Dr. Kyung-won Jung of KIST's Water Cycle Research Center said, "The catalyst developed through this study makes use of a common agricultural byproduct. Therefore, we expect that additional research on alternative substances will lead to the development of catalysts derived from various types of organic waste biomass." Dr. Jae-woo Choi, also of KIST's Water Cycle Research Center, said, "We have high hopes that future studies aimed at achieving process optimization and increasing removal rates will allow for the development an environmental hormone removal system that is both eco-friendly and low-cost."

Many human cultures associate the colour red with sexuality and fertility. Among nonhuman primates too, red skin coloration is thought to contribute to sexual attractiveness. Indeed, in certain species, females are drawn more to the most colourful males. Yet the link between female coloration and attractiveness has been the subject of less investigation. So researchers from the CNRS (1), Kyoto University, and New York University looked at Japanese macaques to address this question. During their reproductive season, from November to February, both male and female macaques present redder faces and hindquarters. The scientists demonstrated that, contrary to what had been assumed for several years, such colour variations among female macaques do not precisely indicate the time of ovulation. On the other hand, dominant female macaques, who usually have greater reproductive success, have darker hindquarters. To reach these conclusions, the research team studied 12 female macaques at the Kyoto University Primate Research Institute over a three-month period. Using photographs taken every two days, the scientists developed a model of macaque visual perception to determine which colour variations these primates were able to detect. Their findings have been published in Behavioral Ecology and Sociobiology.

Sustainable land management key to reducing Amazon wildfires, study shows

The unrelenting deforestation of the Amazon region could lead to a dramatic increase to the risk of destructive wildfire outbreaks, research has shown.

The new study suggests that unrestrained deforestation, converting rainforest to agricultural land, could expand the areas at risk of wildfires by more than 70 per cent by the end of the century.

In response, the international team of researchers, including Dr Luiz Aragão from the University of Exeter, suggest that concerted efforts to improve sustainable land management in the area could provide the best method of defence over the coming decades.

The study is published in the prestigious journal Global Change Biology.

The research team, led by the National Institute of Space Research (INPE) and the Centre for Disaster Research and Monitoring (CEMADEN) in Brazil and also including Stockholm University, used sophisticated modelling techniques to conduct the study.

It showed that policies such as the construction and paving of new highways, increased deforestation and reducing the effectiveness of protected areas could dramatically increase the risk of wildfires.

Crucially, when coupled with the IPCC´s CMIP5 pessimistic climate change scenario, which projects increased greenhouse gas (GHG) emissions throughout the 21st century, the area with high probability of wildfires could increase by up to 110%.

Dr Aragão, who is also head of INPE's Remote Sensing Division, said: "The study identifies a very serious problem and we have to use this result for the benefit of Brazil's sustainable development

"For the first time, we have been able to demonstrate that although the climate is changing, with the possibility of negative consequences for the Amazon, the biggest villain on the burning issue is the poorly planned use of land in this region.

"The bottom line is that unlike the climate, land use issues can be addressed through control measures that can be implemented quickly, solving a significant fraction of the problem."

According to the DETER/INPE deforestation alerts, between July 2018-2019, 5,364 km2 of forests - an area the size of the island of Trinidad - were cleared, and another 4,405 km2 were affected forest fires.

Dr Marisa Fonseca, a postdoctoral researcher at INPE and lead author of the study said: "This means that if we continue removing forest cover in Amazonia, we will be potentializing wildfire degradation of the remaining forests, with consequences for the stability of carbon stocks and environmental services."

Conservation units and indigenous lands may not be safe. The results from the model indicate that more than 1 million km2 within indigenous lands or protected areas would be subject to an increased likelihood of occurrence of wildfires, threatening both ecosystems and human populations in these areas.

The adoption of measures aimed at reducing deforestation and GHG emissions, however, can significantly reduce the probability of wildfires, even with the intensification of droughts in the Amazon by the end of the century.

The study, Effects of climate and land-use change scenarios on fire probability during the 21st century in the Brazilian Amazon, can be accessed here.

A research team led by Leonor Saúde, Principal Investigator at Instituto de Medicina Molecular (iMM; Lisbon, Portugal), in partnership with the company Technophage, SA, has designed a simple and efficient platform that uses zebrafish to discover and identify new drugs to treat spinal cord lesions. This study, published this week in open access in Scientific Reports, is the proof-of-concept for the use of this zebrafish platform that, combined with drug repurposing, has the potential to accelerate the translation period from the discovery to the clinics.

Spinal cord injuries can have devastating consequences because of their importance for day-to-day activities such as walking, but also because of the failure to regenerate, leading to permanent disabilities. These lesions are a complex clinical condition for which the current treatment options have limited success in neurological and functional recovery. "For a significant functional recovery, it is likely that different therapies for multiple targets will be needed, due to the complex nature of the spinal cord lesions" starts explaining Leonor Saúde, "with this work we have shown that, using zebrafish, we can accelerate the discovery of new therapeutic targets for spinal cord lesions".

"Here, we have designed a simple and efficient platform that allows testing a large number of molecules and selecting them based on their ability to accelerate the regeneration of the spinal cord in zebrafish. Our platform consists of a model of spinal cord transection in zebrafish larvae where we test different therapeutic protocols and evaluate its efficacy through larvae locomotor function over time", explains Diana Chapela, a PhD student and first author of this paper. The researchers validated this platform by testing molecules that entered clinical trials for spinal cord injury, namely Riluzole, Minocycline and D-Cycloserine. The results obtained showed that these drugs can also accelerate the regeneration of the spinal cord in the zebrafish.

"We then tested on our zebrafish platform more than 100 molecules already approved by the Food & Drug Administration (FDA) for other conditions and identified a molecule with motor recovery properties in zebrafish larvae, the Tranexamic Acid", says Leonor Saúde. Next, the efficacy of this drug was tested in a spinal cord injury model in rodents. "Our results show that this molecule, which is an antifibrinolytic agent, has the ability to improve motor function in mammals with spinal cord injury" adds the researcher.

These promising results show the high potential of this platform, which " combined with drug repurposing, has the potential to boost the rapid translation of new therapeutics for the spinal cord lesions in humans," says Leonor Saúde.

The results of a recent Nordic collaboration study showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures.

Proximal humerus fractures are more common in older persons than in younger adults. This fracture usually occurs as a result of falling, usually at home, directly on to the shoulder. In the proximal humerus, the bone is more fragile than lower in the forearm. The healing potential in the proximal humerus is, however, better than lower in the forearm.

In the study, published in Plos Medicine journal, only fractures with a significant displacement between bone fragments were included. Traditionally, humerus fractures have been operatively treated using a metal plate and screws. In the non-operative treatment group, patients used a collar and cuff sling for three weeks and underwent instructed physiotherapy.

The trial included 88 patients who were followed for two years, and was conducted as a multinational, multicenter study in six trauma centers.

The findings of the study are novel and challenge current treatment protocols. "Moreover the result had a positive impact on both the lives of the patients as well as on the economic cost of treatment," says Aare Märtson, Professor in Orthopedics at the University of Tartu Institute of Clinical Medicine.

Abandoning those procedures that offer no benefit to the patient could result in savings of up to one million euros per year. Furthermore, patient recovery will be as successful as previously but without the surgery-related pain and complications.

The leading center was Tampere University Hospital, Finland. Other centers included Jyväskylä Central Hospital, Finland, Karolinska Hospital, Stockholm and Uppsala University Hospital from Sweden, Viborg Hospital from Denmark, and Tartu University Hospital from Estonia.

Next object for the NITEP study group is to assess whether older adults would benefit from surgery after distal radius fracture.

Many nocturnal animals including insects use a species-specific smell, that is sex a pheromone, to locate and attract potential mates. For example, female American cockroaches emit sex pheromones called "periplanones" with unique chemical structures. Males that detect them with their antennae orientate towards the pheromone source, preform courtship rituals, and mate.

The Turkestan cockroach, Blatta lateralis, also known as red cockroach, has now growing attention as a world-wide invasive pest, especially in the southern United States. Its origin is temperate to subtropical zones of the Middle East. "The Turkestan cockroach is popular as live food among reptile breeders and can be easily purchased online. So, this would be the first species that expands its habitat via the internet," says Hiroshi Nishino of Hokkaido University.

Recent molecular genetic studies have shown that the Turkestan cockroach is phylogenetically close to the American cockroach in the genus Periplaneta, despite their morphological and habitational differences.

This study, led by Hiroshi Nishino and published in Neuroscience Letters, found that the Turkestan cockroach uses periplanones or similar substances as sex pheromones. The experiments showed a male Turkestan cockroach has an extremely large glomerulus that specifically processes sex pheromones in a part of the brain called the antennal lobe. The glomerulus was three times bigger than that of American cockroaches, suggesting it has more sensory cells for processing sex pheromones. Accordingly, the output neuron from the large glomerulus was extremely sensitive to periplanones. As little as 0.1 femtograms of pheromone contained in a filter paper was sufficient to excite the output neuron when the paper contacted a very small region (approx. 1mm) of the antenna. This sensitivity to periplanone was more than 100 times higher compared to that of the American cockroach.

Researchers also found that a male Turkestan cockroach was attracted to periplanone, but, unlike American cockroaches, the pheromone alone did not trigger courtship rituals. Courtship rituals started only after coming in contact with a female of the same species. This implies that a low volatile substance on the female's body plays an important role in preventing the species from mating with other species.

"Turkestan cockroaches adapt to inground containers where odor molecules diffuse very slowly and this could be why they have evolved an enlarged glomerulus to detect tiny packets of pheromones," says Hiroshi Nishino. He added, "We need exercise caution when handling Turkestan cockroaches because they are a member of the genus Periplaneta, in which most have become household pests worldwide.

Just as lions are apex predators on land, lionfish in Florida are an underwater force to be reckoned with. The biggest threat they pose, however, is not their venomous spines. It is the alarming speed and ferocity with which they invade new waters, eating prey that have not evolved to recognize them as a predator, stealing food from important commercial fish like snapper and grouper, and spawning baby lionfish at incredible rates.

In the 1980s, lionfish (native to the South Pacific and Indian Ocean) were introduced to Floridian waters, possibly by humans who bought them as exotic pets and later released them to the ocean. Over the next decades they spread rapidly, and today they have thoroughly invaded their preferred warm waters in the Atlantic, Gulf of Mexico, and Caribbean, damaging the native coral reef systems and food webs.

"The destructive nature of the lionfish invasion is partly to blame on their reproductive success," says Montana Airey, a masters student at Columbia University who studies lionfish. "They can produce thousands of eggs every week, which after hatching can spread widely on ocean currents. Also, since they are invaders, their prey don't recognize them as dangers, so they can eat without much effort." 

As adults, lionfish tend to be slow-moving and stay local, not straying far from their settled reef home. The invasiveness of lionfish is therefore thought to happen when they are small, larval fish being carried to new places by currents. However, researchers have little information about how grown lionfish might invade or move to new waters because tracking small marine organisms poses difficulties.

One way to investigate their movements, though, is to study their ear-bones.

Lionfish ear-bones, or otoliths, grow over time in the way tree-rings do. "Since otoliths have growth rings related to their age," Airey explains, "we can look at different parts of the otolith to understand the fish's life at different points in time. The otolith core is the fish's juvenile growth and the outer rim is the most recent growth."

Airey studies otoliths of lionfish captured at various depths and habitat types (such as coral reefs or sandy bottoms) along the Gulf Coast of Florida and the Florida Keys. She looks at carbon and oxygen atoms in the otolith layers, specifically analyzing the makeup of stable isotopes - a version of an atom, in this case an oxygen or carbon atom, which has equal numbers of protons and neutrons in its nucleus and is therefore balanced and non-radioactive. The chemical traits of stable isotopes make them extremely useful in environmental studies investigating detailed records of past water conditions.

The makeup of stable isotopes in each otolith layer is dependent on water temperature and the type of algae or plants present throughout the fish's life. Because water temperature and type of algae changes with water depth, Airey can determine where a lionfish has lived, and she creates a profile of movement between a lionfish's larval settlement location and its home when caught.

Airey hopes these data will reveal how often lionfish move away from certain water depths, what proportion stay local (also called "site-specific"), and what habitat type they tend to migrate towards. In preliminary results she will present at the August meeting of the Ecological Society of America, she found something unexpected.

"Lionfish have been shown to be very site-specific," she says. "But I observed many individuals with compositions in their otoliths that suggest they moved some distance at least once throughout their life."

If adult lionfish are more mobile than previously thought, the strategies for management of this invasive species could become even more complex. Understanding their choice of habitat once they grow up can help managers to more effectively focus their removal and conservation efforts.

Airey's research is the first to use this stable isotope analysis to explore settlement and migratory behavior of lionfish in their invaded waters. "Lionfish weren't commonly studied in their native habitat before the invasion began," she adds. "I feel that stable isotopes are a strong tool to be used in studies, like my own. They allow us to 'see' general patterns underwater that we would have a hard time actually seeing otherwise." 

ITHACA, N.Y. - Having healthy gut flora - the trillions of bacteria housed in our intestines - could lower the risk of infection following knee and hip replacement surgeries, while an unhealthy intestinal flora may increase the risk of infection.

Over 1 million Americans opt for a knee or hip replacement each year. Infection of an artificial hip or knee is a rare, but debilitating complication. A study by researchers at Cornell's College of Engineering and the Hospital for Special Surgery (HSS) published July 8 in the journal Clinical Orthopaedics and Related Research shows gut microbiome health influences the risk of infection. The study of mice is a first step toward understanding the implications for humans.

"This research is in early stages, but if it pans out in humans, it's possible we could change or fix the patient's gut microbiome before they go in for hip or knee replacement and that could further reduce the risk of infection," said Christopher Hernandez, associate professor in the Sibley School of Mechanical and Aerospace Engineering and the Meinig School of Biomedical Engineering, and the paper's first author.

To prevent infection, surgeons take multiple precautions during surgery. As a result, infections following joint replacement surgeries are rare, affecting only 1% of patients who have procedures. However, infections are the No. 1 reason for replacing an artificial knee and the No. 3 cause for replacing an artificial hip.

In the study, the researchers used mice fitted with tiny artificial knees developed by co-authors Dr. Alberto Carli and Dr. Mathias Bostrom, both surgeon scientists at HSS in New York who are also faculty at Weill Cornell Medicine. The Cornell-HSS Program in Biomechanics has linked researchers at HSS with those at Cornell's College of Engineering for over 40 years, resulting in multiple advancements in joint replacement technology.

The mouse knee replacement was originally developed to improve implant design and to study how bone grows into these implants. Carli then advanced the model to study infections.

In normal mice, immune system markers in the bloodstream rise during an infection, as the body responds. But in the study, these markers did not rise in mice with unhealthy microbiomes that also developed infections. The results suggest that mice with unhealthy microbiomes may have compromised immune systems.

In the future, the researchers will investigate whether patients could be prepped ahead of surgery with emerging microbiome-based therapies or a readily available one, such as a regimen of probiotics.

We've all heard the saying that individuals learn at their own pace. Researchers at Carnegie Mellon University have developed an automated, robotic training device that allows mice to learn at their leisure. The technology stands to further neuroscience research by allowing researchers to train animals under more natural conditions and identify mechanisms of circuit rewiring that occur during learning.

A research team led by Carnegie Mellon neuroscientist Alison Barth has used the automated technology to identify new, previously unidentified pathways activated when the brain rewires its circuits in response to experience. Their findings are published in the July 17 issue of Neuron.

Barth's lab focuses on understanding the process by which cortical circuits receive sensory information and adapt to it in order to learn. Understanding the algorithm that underlies the changes in the brain's learning circuitry will have important implications for creating engineered systems that use deep learning and artificial intelligence.

"Neural circuits in the cerebral cortex have had 3.5 billion years to evolve to become perfectly adapted to learning things," said Barth, a professor of biological sciences and member of the Carnegie Mellon Neuroscience Institute. "There is valuable information about what happens in the brain that can be used to inform computations that need to change based on experience."

To better study how the brain changes during sensory learning, the researchers constructed an army of automated robotic devices, in an effort that was spearheaded by Sarah Bernhard, an undergraduate student in Carnegie Mellon's Department of Biological Sciences. These devices allowed mice to voluntarily approach a water port in their home cage where they would receive a gentle puff of air to their whiskers followed by a drop of water. If they approached the port and didn't feel a puff of air, they wouldn't get a drop of water. Eventually, they learned that a puff of air meant water and they would start to drink when they felt it.

"It was almost like we gave the mice homework. Some took 50 tries to learn, others took 400. Some learned early in the evening, others learned late at night. But they all learned and learned quickly," said Barth. "One thing that is critical to learning is that you have to be ready to learn. This device let mice learn when they wanted and at their own pace."

They found that when they used the device, the mice learned quickly and independently, with no intervention from the researchers. As a result, they could capture a larger data set that more accurately reflects the individual diversity in learning.

In the Neuron study, Barth and colleagues used the robotic device to determine what sensory learning pathways were conserved across the population, regardless of how long learning took. They found some surprising results.

The pathways that changed the most in response to the sensory stimulus, indicating learning, were not the ones they expected. It was commonly thought that in sensory learning information came from the skin, traveling rapidly to the neocortex through the thalamus. However, the research team found that this pathway remained relatively unchanged during sensory learning. Instead, they were surprised to find that the cortical synapses, responding to a high-order and more integrative part of the thalamus, were much more plastic.

"Our results suggest that the brain maintains the pathway that represents the fast sensory input, things that you want to know for certain in any given situation. The pathway that is responsible for processing more context-rich information is the one that is flexible," Barth said. "The brain keeps the original file but edits a copy of it."

The results provide insight into the algorithm that the neocortex uses to rewire itself during learning. Barth plans to use this training paradigm to understand how and when different types of tasks and rewards can change the brain.

Restricted oxygen during early life development might result in lasting heart damage for many creatures, but not for alligators. Low oxygen doesn't hurt their hearts; it makes them stronger.

Now, University of Guelph researchers are beginning to understand why, pinpointing how alligator hearts benefit from tough early conditions in the egg, in a new study published in Scientific Reports.

It's foundational research that has significant potential to benefit humans.

Alligators, like many lizards and turtles, begin life as eggs buried in deep nests, with the ones buried deepest receiving the least amount of oxygen.

"Low oxygen at this early stage of life affects normal growth and developmental processes, especially in the heart. In placental mammals, like us, these changes are negative and last into adulthood. But in alligators we're seeing something different: the ones with the least oxygen in the nest might actually thrive," said Sarah Alderman, an adjunct professor in U of G's Department of Integrative Biology who led the study.

The alligators that develop under low oxygen conditions - or hypoxia - emerge from the nest with hearts that are bigger and stronger than their siblings that had access to more air as embryos. Their hearts also perform better during exertion, which might help them hold their breath longer or endure through a chase.

What Alderman and her collaborators wanted to understand was which changes occur that create these stronger, more efficient hearts. So they set out to identify what protein differences mark the hypoxic gator heart.

A team from the Rockefeller Wildlife Refuge in Louisiana retrieved alligator eggs from the refuge's wetlands and sent them to colleagues at the University of North Texas. There, some of the eggs were kept in incubators with hypoxia while the rest were raised in incubators with normal levels of oxygen.

The U of G team received samples of the alligator hearts and, with funding from the Natural Sciences and Engineering Research Council of Canada (NSERC), analyzed the proteins inside these hearts using a method known as "shotgun proteomics."

They found signs that the low oxygen in the egg induced a shift in the abundance of certain key molecules the heart uses for making heart proteins, for integrating these proteins into their cells, and for quickly removing and recycling any damaged proteins.

"Essentially, these alligators ramped up the machinery they needed for these processes," Alderman said.

Most of the changes they found in the embryo hearts were still evident two years later in the hearts of juvenile alligators also raised in hypoxia.

As well, Alderman found the hypoxic hearts had more proteins involved in the breakdown of lipids, or fats, needed for energy.

"Hearts are most efficient when they burn fats for energy," Alderman said, noting that athletes' hearts are especially good at this. "But in humans, when the heart progresses into heart failure, it switches to burning sugars."

The fact that alligator hearts from the embryos raised in hypoxia develop an increased ability to use lipids for energy into later life might be key as to why hypoxia is not detrimental to them as similar condition would have been to a developing human heart.

While the Texas team was able to study the alligators only until they were two years old - "After that, it becomes a little dangerous to keep alligators in a lab," Alderman noted - all signs point to these changes in protein expression in the heart being permanent.

Prof. Todd Gillis, a professor in the Department of Integrative Biology, says this research shows how important environmental conditions during embryonic development are to the subsequent health of the adult.

"Clearly, stressors that occur at this early stage have long-term consequences because, as we see here, it changes the biology of the animal," he said.

Gillis, who is a founding member of U of G's Centre for Cardiovascular Investigations, says the next step is to identify what triggers these important changes in protein expression. If that can be identified, it opens a way of applying the findings to humans with weakened hearts, Gillis said.

"If you could find a way to turn on these pathways and then maintain that, that could be a way of improving cardiac function and keeping the heart healthy."

This research team recently received funding from the National Science Foundation in the U.S. to continue this work. Alderman looks forward to the next phase of research, noting that alligators are fascinating to study.

"Alligators have walked this planet far longer than humans have, and they haven't changed much in that time - so whatever their hearts are doing, they are doing really well."

Women's perceived competence has increased relative to men's,
consistent with their growing participation in the labor force and
education

The perception of women as more compassionate and
affectionate has strengthened over time

Researchers: Women's perceived advantage in competence and
communion should favor women's employment

Less positive -- women perceived as less ambitious and decisive,
a disadvantage in relation to leadership

EVANSTON, Ill. --- Good news for women -- they are no longer regarded as less competent than men on average, according to a nationally representative study of gender stereotypes in the United States. Less positive, however, is that women's gains in perceived competence have not propelled them to the top of hierarchies.

A new Northwestern University analysis investigated how gender stereotypes in the U.S. have evolved over seven decades (1946-2018), a span of time that brought considerable change in gender relations due in large part to women's increased participation in the labor force and education. Women now earn more bachelor's, master's and doctoral degrees than men, unlike decades ago.

The study, published in the journal American Psychologist, analyzed 16 nationally representative opinion polls conducted in the United States with more than 30,000 adult respondents. These polls asked respondents to compare women's and men's competence (e.g., intelligent, organized, creative), communion (e.g., affectionate, compassionate, emotional), and agency (e.g., ambitious, aggressive, decisive).

Most adults now report that women and men are equal in general competence. But among those who see a difference, most see women as more competent than men.

For instance, in the most recent poll, conducted in April 2018, most respondents (86%) said that men and women are equally intelligent. However, 9% said that women are more intelligent, compared to a smaller percentage (5%) who said that men are more intelligent.

Alice Eagly, lead author of the study and professor of psychology in the Weinberg College of Arts and Sciences at Northwestern, also said that the study's findings about communion and agency are surprising.

"The perceptions of women as communal and men as agentic have not eroded since the 1940s, contrary to conventional wisdom about convergence in gender roles," Eagly said. "Rather, communal stereotypes have changed but increasingly towards portraying women as more compassionate, affectionate and sensitive than men. Men are still viewed as more ambitious, aggressive and decisive than women, and that agency stereotype has not substantially changed since the 1940s."

The researchers note that different groups of respondents -- men, women, racial subgroups -- generally agree about these stereotypes. For instance, respondents in recent U.S. samples ascribed competence more often to women than men, regardless of the respondent's sex, race, ethnicity, college education, marital status, employment status or birth cohort.

Interpretation of these findings, said Eagly, also a faculty fellow with Northwestern's Institute for Policy Research, is that women's increasing labor force participation and education likely underlie the increase in their perceived competence, but that occupational segregation underlies the other findings.

"Specifically, women are concentrated in occupations that reward social skills or offer contribution to society," she said. "People observe the social roles of women and men and infer the traits that make up gender stereotypes. In general, stereotypes reflect the social position of groups in society and, therefore, change only when this social position shifts. That's why gender stereotypes have changed."

"The current stereotypes should favor women's employment, because competence is, of course, a job requirement for virtually all positions," Eagly said. "Also, jobs increasingly reward social skills, making women's greater communion an additional advantage."

But the findings are not all positive for women, she adds. "Most leadership roles require more agency than communion and the lesser ambition, aggressiveness and decisiveness ascribed to women than men are a disadvantage in relation to leadership."

The researchers' findings about change over time are novel, Eagly said.

"There are many studies on gender stereotypes, but no others have investigated change in these stereotypes over many decades using representative samples."

"Gender Stereotypes Have Changed: A Cross-Temporal Meta-Analysis of U.S. Public Opinion Polls From 1946 to 2018" will publish July 18 in the journal American Psychologist. In addition to Eagly, co-authors include Christa Nater, University of Bern; David I. Miller, American Institutes for Research; and Michéle Kaufmann and Sabine Sczesny, University of Bern.