Culture

A first-of-its-kind survey of American neurologists reveals that more than half carry the mistaken belief that a patient's sexual orientation and gender identity have no bearing on treatment of neurologic illness.

That belief can have damaging repercussions for patients seeking care, according to a study published today in the journal Neurology.

"Many neurologists are not aware that gender-affirming care can directly impact neurologic health," said Holly Hinson, M.D., M.C.R., an associate professor of neurology in the OHSU School of Medicine.

Hinson, who is leading the American Academy of Neurology initiatives to improve medical care for LGBTQI patients, co-authored the research paper that accompanied the survey results. The survey was distributed to a random, representative sample of 1,000 U.S.-based members of the AAN, resulting in a total of 135 responses.

Sexual and gender minority, or SGM, individuals have been shown to have persistent disparities in health care, researchers write, including twice the mortality rate compared to heterosexuals.

"SGM status can have a direct bearing on diagnosis and treatment, even within a non-primary care specialty like neurology," the authors wrote. "Unfortunately, many medical professionals receive little to no training in SGM health, which could lead to substandard care due to lack of knowledge."

About 36% of survey respondents agreed that they would tailor their neurologic care based on a patient's sexual orientation or gender identity. More than half the respondents were interested in receiving further training in culturally appropriate care.

A lack of awareness can be problematic for neurologic patients in a variety of ways, with the study citing several examples:

Antiretroviral medications such as preexposure prophylaxis (PrEP), increasingly prescribed to gay men, can be associated with neuropathy.

Poor understanding of SGM identity can lead to discrimination within long-term care facilities during neurorehabilitation.

Gender-affirming hormones can interact with other important medications, for example, anti-epileptic therapy used to seizures.

Notably, it is the first survey of any physician group to ask the sexual and gender identity of the physicians themselves: about 88% identified as heterosexual or straight. Some of the providers who identify as sexual or gender minorities reported their own fear of discrimination in the workplace.

"Providers themselves are not immune to stigma and burnout," Hinson said.

Some dinoflagellate plankton species are bioluminescent, with a remarkable ability to produce light to make themselves and the water they swim in glow. Now, researchers reporting in Current Biology on June 17 have found that for one dinoflagellate species (Lingulodinium polyedra), this bioluminescence is also a defense mechanism that helps them ward off the copepod grazers that would like to eat them.

"That bioluminescence, in addition to being a beautiful light phenomenon in the sea, is a defensive mechanism that some species of plankton use to ward off their enemies," said Andrew Prevett of the University of Gothenburg, Sweden. "The bioluminescent cells sense very low concentrations of their grazers and turn up the light when needed, which is rather impressive for a unicellular organism. This in turn helps to better protect them from their grazers, letting them survive longer to reproduce and therefore compete better within the plankton."

Through a combination of high-speed and low-light sensitive videos, the researchers, including Prevett, Erik Selander, and their collaborators at the Technical University of Denmark, revealed that the bioluminescent cells flash upon contact with the copepod grazer. The copepod reacts by rapidly rejecting the flashing cell, seemingly unharmed.

They note that observational data from the west coast of Sweden support their study's prediction that the presence of copepod grazers would have a positive effect on the abundance of bioluminescent L. polyedra. The single-celled, bioluminescent dinoflagellates are usually poor competitors, because they grow at about a third of the rate of other plankton. But copepods reject them in favor of grazing on more poorly defended but otherwise faster-growing plankton species.

The researchers had expected increased bioluminescence to result in reduced grazing by copepods. But they were surprised by just how great the reduction was.

"Earlier studies had shown that dinoflagellates with naturally brighter bioluminescence than L. polyedra were grazed less but still required cell concentrations to be relatively high before all grazing on the bioluminescent cells ceased," Prevett said. "L. polyedra abundance in our study is low by comparison, and we were surprised at how effective the bioluminescence defence became despite this."

It's still not clear exactly how the glow protects L. polyedra, however.

"There are three popular theories as to how bioluminescence protects dinoflagellates," Prevett said. "The first is that it acts as aposematic colouration, a warning to potential grazers that the cell is toxic or harmful to the grazer in some way. The second is that the flash of bioluminescence behaves like a flash-bang and startles the copepod, provoking a copepod escape response or disorienting it long enough for the dinoflagellate to escape. The third theory suggests that the flash acts as a form of burglar alarm, attracting the attention of a larger visual predator, like a fish, which could track and consume the copepod. There is evidence to support each of these theories and bioluminescence protection could be combinations of some or all of the above."

No matter how it works, it appears their ability to ward off predators with bioluminescence serves as a key mechanism behind the success of an otherwise poor competitor such as L. polyedra, the researchers say.

They say that they plan to pursue more studies in the system exploring the ways that the "fear" of being eaten drives the structure of ecosystems. They plan to study compounds produced by copepods as general alarm signals and their influence on complex plankton assemblages.

"These indirect effects of consumers are understudied in unicellular dominated food webs such as marine plankton," Prevett said. "This paper and other similar results suggest that indirect predator effects are strong drivers in the microscopic food web of the oceans too."

An international research team has investigated the transport mechanism of a bacterial membrane protein using an artificially produced antibody fragment. The transport proteins, called ABC exporters, are present, for instance, in the cell membranes of bacteria and in large quantities in cancer cells and are responsible for transporting small molecules out of the cells. Some transporters can pump antibiotics or chemotherapy agents out of the cells, thus rendering therapies ineffective. In the current study, researchers worked with isolated ABC exporters and showed how substrate transport is related to the energy drive of the protein and how both can be modified by an antibody fragment or by mutations. The results were published in the journal Nature Communications on 21st May 2019.

For the study, Professor Enrica Bordignon and Professor Lars Schäfer from Ruhr-Universität Bochum, both members of the Cluster of Excellence Resolv, cooperated with Professor Markus Seeger from the University of Zurich and Professor Mikko Karttunen from the University of Western Ontario.

Multi-stage transport process

ABC exporters consume energy when transporting molecules out of the cells. They obtain this from the splitting of the energy storage molecule ATP on the inside of the membrane. Broadly speaking, the ABC exporter is comprised of three areas: the energy-providing motor inside the cell, a connector that extends through the cell membrane, and a gate on the outside of the membrane.

For the transport process, the ABC exporter opens inside the cell, takes in a molecule from the cytoplasm, and transports it to the other side of the membrane. There, the outer gate opens and the molecule is excreted - but only if the protein motor splits ATP inside. Only once the outer gate is closed again can the next transport process begin.

Motor switched off

The researchers developed an artificial antibody fragment, also known as a sybody, that docked at the isolated ABC exporter in the test tube. Using X-ray crystallography and electron spin resonance, the team showed that the sybody binds to the open outer gate. As a result of this, the gate was no longer able to close and thus no new transport process could be initiated. Consequently, the motor inside remained switched off; no more ATP was split.

The group confirmed the results in further experiments without the sybody. In these, they specifically replaced certain amino acids of the protein using genetic mutation; this also blocked the closing mechanism of the outer gate and ATP splitting.

"Our analyses have shown that the mechanism to open and close the outer gate is structurally related to the splitting of the energy supplier ATP on the inside," describes Enrica Bordignon. "Our results are fundamental research," says the head of the Bocum-based EPR Spectroscopy Research Group. "We hope to use this information to open up new approaches to combat drug resistance."

Cardiogenic shock is a possible complication of serious heart attack involving an associated mortality rate of approximately 50% of all cases

The combination of this new tool with existing methods renders precise and patient-specific decision-making possible

The research is being led by Dr. Antoni Bayés at Germans Trias and the Proteomics Unit of the CRG and UPF, under Dr. Eduard Sabidó

A joint research effort by the Hospital and the Instituto de Investigación Germans Trias i Pujol (IGTP) is characterising and studying a new cohort of cardiogenic shock patients to predict the risk of having this heart attack-derived complication which, while infrequent, sometimes presents a fatal outcome. It is the first molecular study for risk prediction described for this disease and is based on a proteomic meta-analysis that has made it possible to discover biomarkers and validate their use in decision-making. The new method, combined with existing techniques, will help to implement more precise treatments. Moreover, the know-how has been patented and work is under way to transfer it to the immunological techniques widely used in clinical diagnosis, such as ELISA.

The objective of the study was to obtain a reliable method to predict which post-heart attack cardiogenic shock patients have a greater risk of not surviving. Cardiogenic shock is a possible complication of severe infarction in which the heart is suddenly unable to maintain the required blood flow. It does not occur in all heart attack cases, although it is fatal if it goes undetected and is not treated promptly. In this case, the discovery of four proteins that can be used as biomarkers is a new tool which, in conjunction with existing ones, makes it possible to pre-empt this complication more precisely.

The group led by Dr. Antoni Bayés-Genís at the Hospital e Instituto de Investigación Germans Trias i Pujol (CIBER Cardiovascular investigators) and Dr. Eduard Sabidó of the Proteomics Unit (a node of the ICTS OmicsTech and a member of the ProteoRed-ISCIII network) of the Centre for Genomic Regulation (CRG) and the Pompeu Fabra University (UPF), has identified 4 proteins (from more than 2600 analysed) that identify patients with cardiogenic shock and a poor vital prognosis. The work has been published in the European Heart Journal, the leading publication in the cardiovascular field.

"The article demonstrates the complex work of sample collection we conducted for the Barcelona Discovery cohort, following strict and standard criteria that enabled us to use them to perform an in vitro trial in liquid biopsies to prevent death in patients with cardiogenic shock", Dr. Bayés explains. "This type of complication, if detected in time, can be treated specifically in order to restore blood flow. The know-how provided by this new tool will help us to decide the best treatment option on a by-case basis", he continues.

The title of the trial is CS4P, and it is comprised of these 4 proteins, which were discovered with the help of mass spectrometry. "We used a combination of liquid chromatography and mass spectrometry to quantify the proteins present in the cohort samples. It is the first risk-prediction molecular study described for this disease, and the trial has been transferred to ELISA and validated in a European reference cohort", Sabidó adds.

For the first time ever, an integrated quantitative approach combined with proteomics has been used to discover biomarkers and to be validated as a risk assessment tool in patients with this condition, and in which the level of the four proteins involved was compared to two current evaluation methods. "We have discovered that the new method complements existing ones, making them much more reliable," Bayés concludes.

The proteomics aspect of the work also furnished valuable information about the mechanisms that trigger cardiogenic shock, as well as the failure of other organs in critical patients. In other words, they could be valid biomarkers for other types of failure. There are a great many possibilities for extending the use of protein biomarkers in serious patients by means of similar techniques.

One of the next steps will be to fine-tune the ELISA assays for clinical use. A patent application has also been submitted for the use of the CS4P cardiovascular shock risk stratification model for the IGTP, the CRG and the UPF.

BINGHAMTON, N.Y. - Nurse practitioners are more likely to conduct HIV screenings if they feel that their colleagues support routine screenings, according to new research from Binghamton University, State University of New York. This comes in advance of National HIV Testing Day, taking place June 27.

Despite 40 years of efforts to end the throes of the HIV crisis and now the epidemic, the infection continues to affect gay, bisexual, and other men who have sex with men of all races and ethnicities; Black and Latino men and women; people who inject drugs; youth ages 25 - 34; and people in the Southern U.S. disproportionately.

"Research data suggests that the social norm expectation in practice settings where many nurse practitioners work do not support routine HIV screening," said Jodi Sutherland, clinical assistant professor at Binghamton University's Decker School of Nursing. "This is a disappointing finding given that patients often trust and look to providers to make clinical decisions and judgments that best support their health according to recommendations and practice guidelines."

Sutherland, along with the Decker School's Gale A. Spencer, asked 141 nurse practitioners about their attitudinal, social normative and perceived behavioral control beliefs toward HIV screening and their HIV screening behaviors. The researchers found that the strongest predictor of nurse practitioner HIV screening behavior was social normative expectations, followed by their attitudinal beliefs toward routine HIV screening. The findings revealed that the belief that "my office staff supports routine HIV screening with my patients" predicted HIV screening, whereas the belief that "consent from a parent/guardian should be obtained before screening for HIV in a person younger than 18 years" predicted less HIV screening.

"Nurses provide the essential link between the people of the community and the complex healthcare system," said Sutherland. "Nurse practitioners have an important role to increase HIV screening rates and could help put an end to HIV. This would require the support of the office staff even when HIV testing requires additional time."

Sutherland said that health care organizations and leaders of organizations need to advocate translation of HIV screening recommendations into practice to meet the needs of the individuals, families and communities served. She also stressed a need for research efforts and practice recommendations to address screening in a person younger than 18 years. Recommendations that address procedures for health care providers to perform HIV screening for this age group are also needed.

Schizophrenia causes hallucinations and memory or cognition problems inter alia. This psychiatric illness affects 0.5% of the general population, and it may be related to genetic abnormalities of chromosome 22, known as 22q11 deletion syndrome. However, not everyone who has the syndrome necessarily develops psychotic symptoms. So, what triggers the illness? Researchers at the University of Geneva (UNIGE), Switzerland, have provided an initial answer after observing and analysing several years of patients with deletion syndrome. The scientists found that the size of the hippocampus, the area of the brain responsible for memory and emotions, was smaller than normal but followed the same developmental curve as in healthy subjects. Yet, when the first psychotic symptoms appear - generally in adolescence - the hippocampus atrophies dramatically. The results, which you can read all about in the journal Molecular Psychiatry, open up new avenues for understanding the causes of schizophrenia.

22q11 deletion syndrome is a neurogenetic disorder that targets chromosome 22. Thirty percent of people affected by the syndrome end up developing psychotic symptoms specific to schizophrenia, such as auditory hallucinations, memory problems, disorders affecting their perception of reality, and difficulties in social interactions characterised by strong paranoia. "It's now known that schizophrenia is linked to the hippocampus, a complex area of the brain that carries out a vast amount of processes simultaneously linked to memory, imagination and the emotions," explains Stephan Eliez, professor in the Department of Psychiatry in UNIGE's Faculty of Medicine. Recent studies have shown that also people suffering from deletion syndrome have a smaller than average hippocampus. "That's why we studied the development of this structure in detail," continues the UNIGE researcher, "so we could understand why some people affected by deletion syndrome eventually develop psychotic symptoms, while others don't."

18-year study investigating the development of the hippocampus

The Geneva team has been following 275 patients aged 6 to 35 years for 18 years: a control groups of 135 individuals - i.e. individuals without genetic problems - and 140 people with deletion syndrome, including 53 with moderate to severe psychotic symptoms. "They underwent an MRI every three years so that we could observe their brain development," says Valentina Mancini, a researcher in UNIGE's Department of Psychiatry. "This has helped us create a statistical model that measures and compares the development of the hippocampus in both groups of patients." It was discovered that the hippocampus of the group affected by deletion syndrome, although smaller from the beginning, followed a growth curve identical to that of the control group. "This meant that we could hypothesise that the smaller size of the hippocampus originates in utero during its development in the womb." The UNIGE scientists also observed the subfields of the hippocampus in detail, discovering that one of them - called CA3 - was not affected by the decrease in size. "This subfield plays a crucial role in the work of memorisation and seems stronger than the other sub-parts," adds professor Eliez.

Adolescence: the period that counts the most

The researchers then compared the developmental curves of the hippocampus in people with deletion syndrome but no psychotic symptoms with those who developed psychotic symptoms. "There's no doubt about our results: around the age of 17 or 18, people with schizophrenic symptoms experience a drastic atrophy in the size of their hippocampus, and especially in the CA3 area, despite CA3 had initially managed to develop normally, unlike the other subfields," says Mancini. But why?

The researchers don't have yet a precise answer that could explain the drastic drop in the development of this vital brain structure. But their hypotheses are geared towards environmental factors, such as stress or neuronal inflammation. "The hippocampus of individuals with deletion syndrome is smaller; this means it has to compensate for its size through hyperactivity. In the event of a huge stress factor, especially during the critical period of adolescence, this hyperactivity might lead to a significant rise in glutamate that 'poisons' the hippocampus and causes its atrophy," explains Mancini. The psychotic symptoms may result from this hyper-compensation, which ends up destroying the hippocampus.

Act before the critical period

The study suggests the following hypothesis: the small size of the hippocampus in patients with 22q11 deletion syndrome is defined in the mother's womb, probably due to poor vascularisation. However, a "second hit" later in development might determine the further hippocampal atrophy and the emergence of psychotic symptoms. As the critical period for schizophrenia is adolescence, the Genevan team is now working on the possibility of preventing the atrophy of the hippocampus in order to preserve its functions.

Human exposure to unnecessary and potentially harmful chemicals could be greatly reduced if manufacturers add chemicals only when they are truly essential in terms of health, safety and functioning of society. That's the conclusion of a study published today in Environmental Science: Processes & Impacts, a peer-reviewed journal published by the Royal Society of Chemistry.

In this study, researchers propose a framework based on the concept of "essential use" to determine whether a chemical is really needed in a particular application. They demonstrate the concept on a class of synthetic chemicals known as PFAS (per- and polyfluoroalkyl substances).

PFAS are used in many consumer goods because of their unique properties such as water and stain repellency. However, a growing number of scientists and health professionals express concern about these chemicals since they persist for a very long time, seep into our water and soil, and may adversely impact people's health and wildlife. Human health problems linked to certain PFAS exposure include kidney and testicular cancer, liver malfunction, hypothyroidism, high cholesterol, ulcerative colitis, lower birth weight and size, obesity, and decreased immune response to vaccines.

The study classifies many uses of PFAS as "non-essential". For example, the study points out that it may be nice to have water-repelling surfer shorts, but in this instance water repellency is not essential. Other products analyzed with the Essential Use Framework include personal care products and cosmetics, durable water repellency and stain resistance in textiles, food contact materials, medical devices, pharmaceuticals, laboratory supplies and ski waxes. Some uses may be regarded as essential in terms of health and safety, e.g., fire-fighting foams, but functional alternatives have been developed that can be substituted instead.

"Our hope is the approach can inform and encourage manufacturers, retailers and end users to consider phasing out and substituting uses of PFASs." said Ian Cousins of Stockholm University, lead author of the study and a world-leading researcher specializing in understanding the sources and exposure pathways of highly fluorinated chemicals. "A starting point would be the phase-out of the multiple non-essential uses of PFASs, which are driven primarily by market opportunity."

The article notes that some retailers and manufacturers are already taking voluntary measures to phase out the use of PFAS in their products. It suggests that the Essential Use Framework can be applied to other chemicals of concern.

It's a feat three decades in the making: Harvard University chemists have achieved what a new paper calls a "landmark in drug discovery" with the total synthesis of halichondrin. Known to be a potent anti-cancer agent in mouse studies, and found naturally in sea sponges -- though only ever in minuscule quantities -- the halichondrin class of molecule is so fiendishly complex that it had never been synthesized on a meaningful scale in the lab.

Researchers led by Yoshito Kishi, Morris Loeb Professor of Chemistry, Emeritus, in Harvard's Department of Chemistry and Chemical Biology, have now synthesized sufficient quantities of E7130, a drug candidate from the halichondrin class, to enable for the first time rigorous studies of its biological activity, pharmacological properties, and efficacy, all conducted in collaboration with researchers at Japanese pharmaceutical company Eisai.

The molecule has undergone unusually rapid development and is already being tested in a Phase I clinical trial in Japan, under a license from Harvard's Office of Technology Development (OTD) to Eisai. The company hopes to begin a second clinical trial in the United States in due course.

The Kishi Lab's results, driven to completion through an intense, three-year research collaboration with Eisai, are published today in Scientific Reports, an open-access Nature journal. The paper reports the total synthesis of the highly potent halichondrin molecule E7130 -- 11.5 grams of it, with 99.81% purity -- and characterizes its mode of action. In preclinical studies, the research team has identified it not only as a microtubule dynamics inhibitor, as was previously recognized, but also as a novel agent to target the tumor microenvironment.

"We spent decades on basic research and made very dramatic progress," says Kishi, whose laboratory has, since 1978, received significant and sustaining support from the National Cancer Institute (NCI) of the National Institutes of Health to study the synthesis of natural products.

The structure of the complete E7130 molecule derived by total synthesis is particularly challenging to replicate because it has 31 chiral centers, asymmetrical points that must each be correctly oriented. In other words, there are roughly 4 billion ways to get it wrong.

When the natural product was first identified 33 years ago by Japanese researchers, it sparked immediate interest. "At that time, they realized the halichondrins looked exceedingly potent," recalls Takashi Owa, PhD, Chief Medicine Creation Officer and Chief Discovery Officer for Eisai's oncology business group, and a coauthor of the paper. Over time, NCI investigators testing tiny amounts of it recognized that it was affecting the formation of microtubules, which are essential to cell division. "Due to the very unique structure of the natural product, many people were interested in the mode of action, and the investigators wanted to do a clinical study," Owa explains, "but a lack of drug supply prevented them from doing it. So 30 years have passed, very unfortunately, but Prof. Kishi is a pioneer in this field."

Over the years, the Kishi Lab advanced methods of convergent synthesis, which enables complex molecules to be assembled from subunits, rather than constructed linearly. Another innovation, now known as the Nozaki-Hiyama-Kishi reaction, protected the highly reactive functional groups while they were being assembled. And in 1992, Kishi and colleagues achieved the first total synthesis of a halichondrin molecule (halichondrin B). The process required a sequence of more than 100 chemical reactions and produced less than a 1% overall yield. It was a major achievement, however, and a simplified version of that molecule, eribulin, became a drug to treat metastatic breast cancer and liposarcoma, now marketed by Eisai. Since then, Kishi's lab has been engaged in basic research on organic synthesis, including discovery and development of new reactions usable at a late stage of synthesis.

"In 1992, it was unthinkable to synthesize a gram-quantity of a halichondrin," Kishi says, "but three years ago we proposed it to Eisai. Organic synthesis has advanced to that level, even with molecular complexity that was untouchable several years ago. We are very delighted to see our basic chemistry discoveries have now made it possible to synthesize this compound at large scale."

"It's a really unprecedented achievement of total synthesis, a special one," says Owa. "No one has been able to produce halichondrins on a 10-gram scale -- one milligram, that's it. They have completed a remarkable total synthesis, enabling us to initiate a clinical trial of E7130."

The team's Scientific Reports paper describes the results of studies conducted in vitro and in vivo, in animal models, that shed light on the molecule's complex mode of action. The team showed that E7130 can increase intratumoral CD31-positive endothelial cells and reduce alpha-SMA-positive cancer-associated fibroblasts, components of the tumor microenvironment that may be involved in the transformation to malignancy.

"Prof. Kishi's expertise provided us with such an exciting and unique opportunity to test the molecule in our systems," says Owa. "I have never experienced this kind of very efficient and rapid, successful collaboration. Just a three-year collaboration took this from the discovery stage to the clinical development of such a complex molecule, having a very unique mechanism and mode of action. To me this is a kind of track record in drug development."

"The collaboration between scientists at Eisai and Harvard is an example of academia and industry working together successfully to accelerate the development of a new class of therapeutics that may address important unmet medical needs," says Vivian Berlin, Managing Director of Strategic Partnerships in Harvard OTD. "The collaborative spirit and transparency of the relationship contributed enormously to the success of the project."

"Without OTD," Owa adds, "this collaboration could never have happened. Harvard OTD has been a core for bridging industry and Harvard researchers, and facilitating discussions about how to build a win-win relationship."

LEXINGTON, Ky. (June 17, 2019) - Discipline and how it is administered in schools across the U.S. continues to be a hotly debated topic. Now a University of Kentucky doctoral graduate's expansive research on the subject has been published in the Journal of School Psychology and is gaining widespread attention from teachers, administrators, and researchers.

Albert Ksinan, who earned his Ph.D. from the Department of Family Sciences in the UK College of Agriculture, Food and Environment last year, is principal investigator on the study and completed the most comprehensive analysis of the topic to date while still at UK. Currently a postdoctoral fellow in the Department of Psychology at Virginia Commonwealth University (VCU) in Richmond, Ksinan is lead author on the paper, "National Ethnic and Racial Disparities in Disciplinary Practices: A Contextual Analysis in American Secondary Schools." Co-authors are Alexander T. Vazsonyi, John I. & Patricia J. Buster Endowed Professor of Family Sciences (UK); Gabriela Ksinan Jiskrova, also a UK Ph.D. graduate in Family Sciences and now a postdoctoral fellow at VCU's School of Social Work; and James L. Peugh, associate professor of Pediatrics, University of Cincinnati.

The project analyzed how ethnicity and race are associated with school exclusionary discipline practices, which refer to students being removed from school as a form of punishment. Previous studies have found ethnic and racial disparities in the rates of school discipline actions, where ethnic and racial minority students (particularly African American youth) were found to be overrepresented among students that are disciplined.

"Exclusionary discipline can be particularly harmful during adolescence, because in many cases, it leaves adolescents without any real possibility to finish high school," said Ksinan. "Given that adolescence is the developmental period associated with the highest rate of delinquent behaviors, it is can be argued that school expulsion during this 'window of vulnerability' leads to an increased risk of engaging in substance abuse and violent crime, and an associated increased likelihood of contact with the juvenile justice system."

The data for the project included the universe of all U.S. public middle and high schools collected in 2013-14 by the U.S. Department of Education's Civil Rights Data Collection (CRDC). It is the most comprehensive study thus far to provide estimates of ethnic/racial discrepancies in who gets disciplined for 7 ethnic/racial groups (African American, Asian, Native American, Hawaiian, Hispanic, Two or more races, or White), with a dataset including almost 16,000 middle schools and more than 18,000 high schools, representing more than 22 million adolescents. Furthermore, the study assessed whether certain school characteristics (school size, percentage of students receiving free or reduced lunch, ethnic/racial diversity of the student body, whether the school is urban/suburban/rural, the U.S. region in which the school is located) affect the rates of exclusionary discipline practices as well as the ethnic/racial discrepancy.

"The results showed robust evidence of persistent discrepancies in disciplinary practices across ethnic/racial groups, with African American students and students indicating two or more races found to be at increased risk for being suspended/expelled compared to White students in both middle and high schools," said Ksinan. "Further, the risk for African American students and students indicating two or more races were higher in schools with higher poverty rates and a greater ethnic/racial diversity of the student population. Schools with students characterized by higher poverty and ones smaller in size reported higher rates of school discipline actions."

There was a result which surprised the researchers, according to Ksinan.

"Schools in the Midwest had significantly higher rates for most disciplinary measures as compared to Southern schools," he said.

With a focus on ethnic/racial discrepancies, the study provides evidence of systematic differences in how school disciplinary actions are applied, with African American youth and students indicating two or more races at increased risk for being disciplined; in turn, this can lead to a variety of problematic consequences. Thus, this research is instrumental in providing renewed impetus to the broader discussion on disciplinary actions and practices in America's middle and high schools.

New Rochelle, NY, June 14, 2019-The loss of complete segments of the esophagus often results from treatments for esophageal cancer or congenital abnormalities, and current methods to re-establish continuity are inadequate. Now, working with a rat model, researchers have developed a promising reconstruction method based on the use of 3D-printed esophageal grafts. Their work is published in Tissue Engineering, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Click here to read the article for free through July 14, 2019.

Eun-Jae Chung, MD, PhD, Seoul National University Hospital, Korea, Jung-Woog Shin, PhD, Inje University, Korea, and colleagues present their research in an article titled "Tissue-Engineered Esophagus via Bioreactor Cultivation for Circumferential Esophageal Reconstruction". The authors created a two-layered tubular scaffold with an electrospun nanofiber inner layer and 3D-printed strands in the outer layer. After seeding human mesenchymal stem cells on the inner layer, constructs were cultured in a bioreactor, and a new surgical technique was used for implantation, including the placement of a thyroid gland flap over the scaffold. Efficacy was compared with omentum-cultured scaffolding technology, and successful implantation and esophageal reconstruction were achieved based on several metrics.

"Dr. Chung and colleagues from Korea present an exciting approach for esophageal repair using a combined 3D printing and bioreactor cultivation strategy," says Tissue Engineering Co-Editor-in-Chief John P. Fisher, PhD, Fischell Family Distinguished Professor & Department Chair, and Director of the NIH Center for Engineering Complex Tissues at the University of Maryland. "Critically, their work shows integration of the engineered esophageal tissue with host tissue, indicating a clinically viable strategy for circumferential esophageal reconstruction."

EVANSTON, Ill. --- A new meta-analysis on hiring discrimination by Northwestern University sociologist Lincoln Quillian and his colleagues finds evidence of pervasive hiring discrimination against all nonwhite groups in all nine countries they examined. Yet some countries discriminate more than others -- and certain laws and institutional practices might explain why. The study published in Sociological Science today (June 17).

The researchers examined more than 200,000 job applications in nine different countries: Belgium, Canada, France, Germany, Great Britain, Netherlands, Norway, Sweden and the United States.

Quillian and his colleagues measured the level of discrimination by calculating the percentage of interview callbacks a white native person received compared to a person who is not white. France and Sweden had the highest levels of hiring discrimination, while the U.S., the Netherlands and Germany had relatively lower levels.

"Clearly, there is a lot of discrimination against nonwhites in hiring in Western countries with a variety of negative effects," said Quillian, professor of sociology in the Weinberg College of Arts and Sciences and a faculty fellow with the Institute for Policy Research at Northwestern.

In France and Sweden, minority applicants would need to send out 70 to 94 percent more resumes than white applicants to receive the same number of responses as white applicants. In Germany and the U.S., minority applicants would need to send out 25 to 40 percent more.

The levels of discriminations were fairly similar among other nonwhite groups, including those applicants with backgrounds from Africa, the Middle East and Asia. The researchers also found low levels of discrimination against white immigrants, who are only "mildly disadvantaged" when compared to white natives of a country.

Certain laws and institutional practices explain why the U.S. had lower levels of discrimination than most of the other eight countries. More discussions about race and ethnicity take place in U.S. workplaces than in European ones, Quillian said.

"No other countries require monitoring of the racial and ethnic makeup of ranks of employees as is required for large employers in the U.S.," Quillian said. "For instance, large employers in the U.S. are required to report race and ethnicity of employees at different ranks to the Equal Employment Opportunity Commission."

Nevertheless, Quillian found in a previous study he conducted no change in rates of discrimination against African-Americans in field experiments of hiring from 1990 to 2015 in the U.S.

In Germany, the country with the lowest level of racial discrimination in hiring among the nine studied, job applicants submit several documents in their applications, including high school grades and apprenticeship reports.

"We suspect that this is why we find low discrimination in Germany -- that having a lot of information at first application reduces the tendency to view minority applicants as less good or unqualified," Quillian said.

But in some countries with higher levels of hiring discrimination, like France, employers are forbidden from asking about an applicant's race.

"The French do not measure race or ethnicity in any official -- or most unofficial capacities, which makes knowledge of racial and ethnic inequality in France very limited and makes it difficult to monitor hiring or promotion for discrimination," Quillian said.

The more information employers have about applicants, Quillian offers, the less room employers have to project their own views and stereotypes onto minority applicants.

New Rochelle, NY, June 17, 2019--A new study has shown that patients are significantly more likely to correctly identify male physicians and female nurses, demonstrating continuing gender bias in the health care environment. These lingering perceptions may slowly be changing, though, as younger patients were more likely to correctly identify female physicians and male nurses, according to the study published in Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. Click here to read the full-text article on the Journal of Women's Health website through July 17, 2019.

"The Relationship between Physician/Nurse Gender and Patients' Correct Identification of Health Care Professional Roles in the Emergency Department" was coauthored by Laurie Boge, Carlos Dos Santos, and David Farcy, Mount Sinai Medical Center (New York, NY), Lisa Moreno-Walton, Louisiana State University Health Sciences Center (New Orleans), and Luigi Cubeddu, Nova Southeastern University (Davie, FL). The researchers explored gender awareness of healthcare providers in the emergency department and suggest that better recognition of physicians, whether male or female, could improve work satisfaction by female physicians, patient satisfaction, and patient adherence to medical treatments.

Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health, states: "Although Boge and colleagues have shown the persistence of gender bias by patients toward healthcare professionals, it is encouraging that there is a trend toward less gender bias among younger generations, even if the change is occurring slowly."

A homeless prevention interest free loan scheme in Lewisham, which has helped over 300 families escape eviction and saved the council over £1 million, could be replicated across the UK a new study suggests.

In 2018, a study by Shelter recorded 320,000 people as homeless in Britain making it a major issue in current society.

However, a new study published in the journal Public Money & Management has shown how a grant providing 0% interest loans to families, at high risk of eviction who would otherwise be unable to access finance or credit, could play an important role in preventing further additions to the homeless crisis in the UK.

The study details how in 2010 Lewisham Council partnered with Lewisham Plus Credit Union - a community-based credit union catering for people living or working in Lewisham and Bromley - to introduce the £85,000 grant scheme in a bid to help these vulnerable people.

The study - funded by The British Academy - found that to-date the scheme has not only saved over 300 families from eviction, but also saved the authority £1million in costs it would have had to pay in its previous provisions to help these people - including providing temporary accommodation.

"Many of the most vulnerable residents are unable to secure loans from high street banks - who typically only lend to financially-secure, low-risk consumers. This means that tenants struggling to pay rent are often forced to turn to commercial payday lenders, who exploit the financially excluded by offering short-term loans at extremely high interest rates," says Bill Lee, a professor at Sheffield University Management School, who lead the study.

According to Professor Lee one of the biggest benefits of the scheme and using credit unions is that it helps tackle financial and social exclusion. Financial exclusion is when people are denied access to essential financial services that most of us take for granted, such as a bank account or credit card. Social exclusion on the other hand means suffering deprivation by not having access to a range of provisions - such as a job, money, housing, education, health services - that most other people enjoy.

"While the scheme protected the recipients from homelessness by helping them to address their short-term financial problems, it also opened up loans and savings facilities to them, helping them to save, and establish a credit record," says Professor Lee.

The findings suggest that credit unions could play an important role in preventing further additions to the homeless crisis in the UK, while saving local authorities money in the process.

"Schemes like this could be rolled out across the country as many credit unions have high levels of skills in helping vulnerable people manage their very limited finances," says Professor Lee. "However, such schemes need to be underwritten by local authorities or central government, so that credit unions do not carry the burden of loss if people on low incomes are not able to repay the loans."

According to Shelter's latest findings, Lewisham is already in 12th in the UK for the amount of homeless people with one in 49 either in temporary accommodation or sleeping rough.

"The London borough of Lewisham is in the top 20% most deprived local authorities in England, with one in four people earning less than the Living Wage," says Professor Lee.

This is a figure which would have likely been far higher, had it not been for this novel system, which has also benefitted housing associations and landlords financially - through receiving rent that would otherwise not have been paid and saving on re-letting expenses, possible repair costs and a void period in rental income before their property could be re-let.

Professor Lee believes such a scheme could be beneficial if rolled out by other credit unions further afield.

"The homeless prevention loans suggest a way forward for other local authorities to work with social housing providers. Social housing providers in Britain are expected to use business management techniques to sustain their own financial position and do not appear to be in a position to establish independent means to enhance the financial security of their tenants.

"Given that there is less legislative pressure on banks to provide basic banking facilities in Britain than is the case in other developed countries the findings reported here indicate that credit unions are best placed to administer such loans."

High levels of iron in the liver are linked to a number of serious health conditions including cancer, diabetes, high blood pressure and cardiovascular as well as liver disease. But measuring liver iron is difficult and until recently could only be done through an invasive biopsy.

Now researchers from University of Exeter, UK, together with colleagues from the University of Westminster,London, UK, Lund University, Sweden and Perspectum Diagnostics, Owford, UK, have shown that genes regulating iron metabolism in the body are responsible for excess liver iron. These genes are the driving cause of high levels of iron in the liver in populations of European, especially Celtic, ancestry, and suggest that this is most likely a systemic and not organ-related problem. This finding can point the way to simple strategies for reducing the excess. The research is presented at the annual conference of the European Society of Human Genetics today (Monday).

Dr Hanieh Yaghootkar and colleagues carried out genome-wide association studies on liver iron content, measured via magnetic resonance imaging (MRI), in 8200 volunteers who had provided biological samples to the UK Biobank. Genome-wide association studies work by scanning markers across the complete sets of DNA of large numbers of people in order to find genetic variants associated with a particular condition.

They found three independent genetic variants associated with higher liver iron and involved in the production of hepcidin, a protein that regulates the entry of iron into the blood. The results were validated in 1500 individuals whose data had been collected in the pan-European Diabetes Research on Patient Stratification (DIRECT) Consortium. «This is the first time such a study has been carried out in an unselected, large population,» says Dr Yaghootkar.

The investigators used a genetic approach to explore the causal link between higher waist-to-hip ratio and elevated liver iron content. This provided genetic evidence that higher central (abdominal) obesity was associated with increased liver iron levels. « There are animal studies that indicate that fat cells trigger macrophages, a type of white blood cell, to cause inflammation, and that this in turn leads to defective iron handling in the liver. We need to research this association further, but it is a plausible explanation of the phenomenon, » says Dr Yaghootkar.

The fact that the mechanisms causing elevated liver iron were generalised and not organ-specific means that high iron levels probably occur in other organs too, including the brain. The researchers found an association between excess iron and many other disorders, including neuropsychiatric conditions. Because the clinical manifestations of elevated iron levels are so diverse, a multi-specialty approach will be needed to assess and evaluate new therapies, including treating patients with hepcidin to reduce iron accumulation.

MRI is continuing for 100,000 individuals in the Biobank study. « This will allow us to find many more genetic factors associated with this trait. We are also interested in performing such studies in other ethnicities, since our current results are only valid for people of European ancestry, » Dr Yaghootar will conclude.

Chair of the ESHG conference, Professor Joris Veltman, Director of the Institute of Genetic Medicine at Newcastle University, Newcastle upon Tyne, UK, said: "Iron overload is bad for the body and needs to be tightly regulated. The genetic study presented at the ESHG today reveals a key role for genes regulating iron metabolism, and also revealed a link between certain types of obesity and iron overload."

John Stommel of the Agricultural Research Service of the US Department of Agriculture (USDA-ARS) has investigated the desirability for, and practicality of, producing snack peppers, both sweet and hot, with low seed count.

His findings are in the article, "Reduced Seed Count Improves Versatility and Propagation of Small-fruited Peppers (Capsicum annuum L.) for Specialty Markets," published in HortScience.

Small/miniature sweet and hot peppers, such as snack peppers, are a rapidly growing class of specialty peppers. As with grapes and watermelons and certain other fruits, low seed count is an important attribute for consumer acceptance of small-fruited specialty peppers. But, this attribute is understandably counterproductive in terms of maintaining a strong continuous yield.

Environmental stress conditions, including high or low temperature, humidity, high or low light intensity, heavy rain or drought, and even strong wind, negatively affect the quality of fruit and growth. These conditions can also induce fruit to be seedless or with significantly reduced seed.

This is known as parthenocarpy, the development of a fruit without prior fertilization. In parthenocarpy, the ovary is stimulated even without pollination and thus fruit development begins without fertilization. Some of this occurs naturally, as with bananas, pineapples, and persimmons, to name but a few. Other examples are a result of thoughtful intervention.

Induction of parthenocarpy is a common agricultural practice for some horticultural crops. Selective breeding for parthenocarpy has demonstrated the utility of seedlessness for improved yield and quality in selected environments.

Small sweet peppers are popular among consumers because of their versatility, snackability, vibrant colors, and nutrition attributes. Mature peppers comprise the majority of the snack pepper market segment due to enhanced sweetness and the aroma of ripe fruit.

Although characteristically pungent, no-heat habanero cultivars within the snack market class provide unique fruity and floral attributes of the habanero without fruit pungency.

Seasonal field production is supplemented by year-round greenhouse production. Although field production of traditional pepper commodities is in decline in parts of the country, other segments, including snack peppers, are expanding greenhouse acreage for high-value pepper production.

A relatively small number of commercial snack pepper cultivars have been developed, many of which lack uniformity and quality attributes such as low seed count, which enhances culinary convenience for product end users.

True breeding pepper lines selected for reduced fruit seed count exhibited significantly reduced seed count relative to breeding lines with seed set typical for pepper.