Culture

DALLAS - Jan. 29, 2020 - In a new report published today in Circulation, experts outline national and global goals to help people live healthier for longer. While heart disease and stroke-related deaths continue to decline, the rate at which they're declining has slowed and obesity rates are on the rise.

"We believe every person should enjoy health and well-being no matter their age, gender, race, or even the zip code in which they live. And we know disparities exist even to that level -- from one block of a city to another," says John Warner, M.D., Executive Vice President for Health System Affairs at UT Southwestern Medical Center and senior author on the report. The American Heart Association 2030 Impact Goals aim to help all people live healthier for more years of their life:

Across the U.S.: Together, we will equitably increase healthy life expectancy from 66 to 68 years by 2030.

Around the world: Together with global and local collaborators, we will equitably increase worldwide healthy life expectancy from 64 to at least 67 years by 2030.

According to the report, the trend toward cardiovascular health around the U.S. has been generally positive, with adults getting more active and people eating healthier, smoking less, and better controlling their cholesterol. However, some areas continue to worsen: Nearly 40 percent of adults and 18.5 percent of youth in the U.S. are now obese; only 26 percent of U.S. youth meet the national recommendations of an hour a day of moderate to vigorous activity; and between 1990 and 2017 diabetes prevalence in the U.S. increased 129.7 percent for men and 120.9 percent for women.

"To improve individual health, we must make the environments where we live, work, learn, and play equitably supportive of healthy behaviors. We also need to help people better understand the impact their communities have in driving choices for health and well-being," Warner says.

2019-nCoV likely emerged very recently and was detected relatively rapidly.

The virus may use the same molecular 'doorway' as severe acute respiratory syndrome (SARS) to enter human cells.

A new genetic analysis of 10 genome sequences of novel coronavirus (2019-nCoV) from nine patients in Wuhan finds that the virus is most closely related to two bat-derived SARS-like coronaviruses, according to a study published in The Lancet.

The authors say that although their analysis suggests that bats might be the original host of the virus, an animal sold at the Huanan seafood market in Wuhan might represent an intermediate host that enables the emergence of the virus in humans. For this reason, the future evolution, adaptation and spread of this virus requires urgent investigation.

In the study, the authors report the epidemiological data of nine patients who were diagnosed with viral pneumonia of unidentified cause. Cell and secretion samples were taken from the patients' lungs to harvest samples of the 2019-nCoV virus, which were analysed to determine the origin of the virus and how it enters human cells.

Eight of the patients had visited the Huanan seafood market. One patient had never visited the market, but had stayed in a hotel near the market before the onset of their illness.

The authors found 2019-nCoV in all 10 genetic samples taken from the patients - including eight complete genomes, and two partial genomes. The genetic sequences of the samples were nearly identical (shared more than 99.98% of the same genetic sequence) - which indicates a very recent emergence of the virus into humans.

"It is striking that the sequences of 2019-nCoV described here from different patients were almost identical. This finding suggests that 2019-nCoV originated from one source within a very short period and was detected relatively rapidly. However, as the virus transmits to more individuals, constant surveillance of mutations arising is needed," says one of lead authors Professor Weifeng Shi, Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, China. [1]

Comparing the 2019-nCoV genetic sequence with a library of viruses, the authors found that the most closely related viruses were two SARS-like coronaviruses of bat origin - bat-SL-CoVZC45 and bat-SL-CoVZXC21 - which shared 88% of the genetic sequence. 2019-nCoV was more genetically distant to the human SARS virus (which shared about 79% of the genetic sequence) and the Middle East respiratory syndrome (MERS) virus (which shared about 50% of the genetic sequence).

Studying the spike protein of the virus (how it binds then enters human cells), the authors found that 2019-nCoV and human SARS virus have similar structures, despite some small differences. As a result, the authors suggest that 2019-nCoV might use the same molecular doorway to enter the cells as SARS (a receptor called ACE2), but note that this will require confirmation.

Based on their data, the authors say that it seems likely that the 2019-nCoV causing the Wuhan outbreak might also be initially hosted by bats and transmitted to humans via a currently unknown wild animal sold at the Huanan seafood market.

They say that it is more likely that bat coronaviruses are mutating, than 2019-nCoV - meaning that 2019-nCoV is unlikely to have emerged due to a chance mutation. However, more information is needed, and if a more closely related animal virus is identified, this suggestion could be wrong.

"These data are consistent with a bat reservoir for coronaviruses in general and 2019-nCoV in particular. However, despite the importance of bats, it seems likely that another animal host is acting as an intermediate host between bats and humans," says Professor Guizhen Wu, Chinese Center for Disease Control and Prevention.

Explaining this she notes: "First, the outbreak was first reported in late December, 2019, when most bat species in Wuhan are hibernating. Second, no bats were sold or found at the Huanan seafood market, whereas many non-aquatic animals (including mammals) were. Third, the similarities in the genetic sequences between 2019-nCoV and its close relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21 were less than 90%, meaningthese two bat-derived coronaviruses are not direct ancestors of 2019-nCoV. Fourth, in both SARS and MERS, bats acted as the natural reservoir, with another animal acting as an intermediate host, and with humans as terminal hosts.This again highlights the hidden virus reservoir in wild animals and their potential to spill over into human populations." [1]

Highly active adults engage in a greater variety of physical activities than do less active adults, finds a new study led by researchers at NYU Rory Meyers College of Nursing.

The study, published in the journal Translational Behavioral Medicine, also revealed that walking is the most common type of exercise, followed by cycling and dancing.

Physical activity is a cornerstone of a healthy lifestyle and has been shown to reduce the risk of many illnesses, including cardiovascular disease, diabetes, certain cancers, and depression. National guidelines recommend that adults get 150 minutes of moderate-intensity exercise, 75 minutes of vigorous exercise, or a combination of the two each week. However, more than half of U.S. adults do not meet these recommendations.

Physical activity guidelines do not account for the type or variety of activities--for instance, whether someone meets the recommendation by jogging for half an hour five days a week, taking two vigorous boot camp classes, or doing a combination of walking, swimming, and cycling.

"Developing a better understanding of patterns of physical activity, and the individual factors related to these patterns, could inform targeted interventions to increase physical activity," said Susan Malone, PhD, RN, an assistant professor at NYU Rory Meyers College of Nursing and the study's lead author.

Malone and her colleagues analyzed patterns of physical activity across multiple dimensions (frequency, duration, and type of exercise) among a national sample of 9,816 U.S. adults using the CDC's National Health and Nutrition Examination Survey (2003-2006). They also examined demographic and health characteristics and how these factors were linked to different patterns of physical activity.

Notably, the researchers found that highly active adults participate in a greater number of activities, with active adults engaging in at least two different activity types in the last month and the most active participating in five.

"Since a greater variety of activities was associated with meeting exercise guidelines, mixing up your workouts to vary the type of exercise could be beneficial," said Malone.

Walking is the most common type of physical activity, with more than 30 percent of all adults walking an average of four times a week for roughly 40 minutes at a time. After walking, cycling and dancing are the most popular activities.

Among adults who exercise, the researchers identified five "clusters" of physical activity patterns: low frequency, short duration (13 percent of exercising adults); low frequency, long duration (7 percent); daily frequency, short duration (55 percent); daily frequency, long duration (7 percent); and high frequency, average duration (18 percent).

High-activity clusters (daily frequency, long duration and high frequency, average duration) had a greater proportion of younger, white, non-smoking men with at least a high school education. In contrast, active women were more likely to engage in short but frequent bouts of activity.

"There are several scheduling and social barriers that could explain why this pattern of shorter, frequent activity may be more attainable for women as compared to men. For instance, research shows that women have less leisure time, reporting an average of 13.2 hours of household labor per week compared to 6.6 hours for men," said Malone.

Finally, the researchers found that 44 percent of adults report no physical activity; adults with chronic conditions and poor health behaviors like smoking are more likely to fall into this group that does not exercise. Nonetheless, a small percentage of adults with chronic conditions do exercise regularly, suggesting that they can incorporate physical activity into their lifestyles.

"When encouraging their patients to exercise, clinicians should not just ask about frequency, but also what types of physical activities their patients do. They may even suggest engaging in a variety of activities," said Malone. "The ultimate goal is to develop targeted interventions to help people stick to their exercise plans and lower their disease risk."

Members of disadvantaged social groups who engage in contact with members of privileged groups are less likely to support social change toward equality, a multinational study by social psychologists at the University of Zurich shows. To reduce this effect, it is important to actively address and acknowledge inequalities in intergroup contacts.

Are members of advantaged groups, such as white Americans who interact with those of disadvantaged groups such as black compatriots, more likely to support their rights and concerns? And what happens to the commitment among the disadvantaged group members? For more than 50 years, social researchers, and policy-makers have believed that having members of different groups interact with each other can be an effective tool for reducing prejudice and building mutual trust. However, new research findings suggest that positive contact between groups might mask existing group disparities and, therefore, perpetuate rather than challenge structural inequalities.

Survey responses from 13,000 individuals across 69 countries

Tabea Hässler and Johannes Ullrich from the Department of Psychology of the University of Zurich have carried out a statistical investigation into whether and how contact between groups might help to promote support for social change, in pursuit of greater social equality. Working together with a multinational team of 43 researchers, they gathered survey responses from almost 13,000 individuals across 69 countries. The survey respondents included people from advantaged social groups (ethnic or religious majorities and heterosexual people) and members of minority groups, who are socially disadvantaged as a result of their ethnic or religious background, sexual orientation or gender identity.

Different effects on support for social change

The research findings suggest that when members of historically advantaged groups interact with disadvantaged groups, they are more likely to support social change toward equality. For example, heterosexual individuals who experience positive contact with homosexual, bisexual or transgender individuals at work or in their private lives are more likely to take part in demonstrations, sign petitions, discuss inequalities or vote in favor of nondiscrimination rules.

But for members of historically disadvantaged groups, the research team observed the reverse trend: If they had friends or acquaintances in the privileged group, they were generally less likely to support social change to promote equality. "In other words, if an immigrant has frequent positive interactions with people from the host society, then this person might be less aware of the obstacles that immigrants still face," explains first author Tabea Hässler. "They are also less committed to eliminating these inequalities."

Both groups willing to work in solidarity

However, the researchers also point out an important exception. Among members of both advantaged and disadvantaged groups, contact between groups predicted a greater willingness to work in solidarity to achieve greater social equality - for example, to attend a demonstration together. "This willingness to work together in solidarity unites people from all groups and may offer a new route to reach social cohesion and social change," concludes Johannes Ullrich, professor at UZH. In addition, the researchers suggest that advantaged group members who engage in contact should openly acknowledge structural inequalities and express support for efforts by disadvantaged group members to reduce these inequalities. The researchers believe that this could possibly prevent intergroup contact from leading to reduced engagement of disadvantaged group members. "After all, social harmony should not come at the expense of social justice," says Ullrich.

A Dartmouth-led study finds that two common economic interventions in Afghanistan designed to improve economic livelihoods and win the "hearts of minds" of civilians was ineffective in reducing support for the Taliban in the long run.

When civilians support the insurgency, they are more apt to provide assistance to combatants, such as by providing food or tips on the government's whereabouts, or even by joining the insurgent effort. The study is the first to examine how cash transfers and vocational training administered by a humanitarian organization affect combatant support in an active conflict zone. The findings are published in the February 2020 issue of American Political Science Review.

Working with Mercy Corps, the Dartmouth-led research team assessed how vulnerable youth's political attitudes towards the Afghan government and Taliban was affected by two economic interventions: job training and cash. The program, Introducing New Vocational Education and Skills Training (INVEST), was designed to help lift at-risk youth (age 20+) in Kandahar, Afghanistan, out of poverty and minimize the likelihood that they would join the insurgency.

Approximately 2,600 Afghan men and women (average age of 20), took part in the study. Nearly 80 percent had shared Pashtun ethnicity with the Taliban, and just over half of them had experienced forced displacement in the past by either the NATO-led International Security Assistance Force or Taliban.

Participants were randomly assigned to one of four economic interventions, where they received either job training, cash, job training and cash, or no aid at all. The job training was comprised of either three or six months of coursework at one of the local vocational training centers in Kandahar, as well as other skills building. As for the cash, a one-time, unconditional cash transfer of US $75 was wired to a recipient's cell phone. The amount was a significant cash shock, as it was comparable to nearly four months of an average salary. The recipients were informed that the cash came from a "foreign donor" and not from Mercy Corps. By attributing the funds to a foreign source, this could indirectly help build credibility for the current government by signaling to civilians that the government's effectiveness was responsible for attracting foreign funds.

Two weeks and eight months after they had completed the training and/or received the cash, participants were surveyed through in-person interviews on their attitudes towards the Afghan government and Taliban, and violence.

The results of the study were striking. Despite the vocational training, the program had only a modest effect in helping recipients improve their economic livelihoods. There was a 5 percent increase in both the likelihood of recipients earning cash and owning land. Employment outcomes were nominal; participants reported working just one day more per month than before they had completed the training. The intervention also did not appear to have an effect on pro-government sentiment. If anything, the intervention just raised people's expectations. With very few jobs available, supporting the Taliban became an appealing option, where they could stand to earn US $15 a day and receive other perks.

As for the cash infusion, two weeks after receiving the cash transfer, there was increased support for the Afghan government among recipients. Nine months later, however, this trend was reversed. Recipients reported anger towards the government and increased support for the Taliban. Participants had spent most, if not all of the cash on consummables and once that money was gone, their lives really had not improved.

In contrast, there was modest progress among participants who had received both the cash and the vocational training. Support for the Afghan government increased. Yet, if they received the cash or job training separately, the intervention had the adverse effect of increasing support for the Taliban rather than steering participants away from it.

"Throughout the world, the humanitarian industry is spending a tremendous amount of money in conflict areas providing job training and infusing cash; yet, there is little evidence that these aid programs work," explained Jason Lyall, the inaugural James Wright Chair in transnational studies, director of the Political Violence FieldLab and an associate professor of government at Dartmouth, who led the research project, and has conducted fieldwork in Afghanistan.

"In conflict zones, non-governmental organizations often aim to offer vocational training as a way to help civilians break into the market; yet, this approach may be flawed by creating false hope in areas that may have a struggling economy and a limited number of jobs," he added. "Cash transfers are the number one instrument used in the field for dealing with refugees, especially in conflict settings, as this type of intervention is inexpensive and has little overhead. Our research in Kandahar, Afghanistan, demonstrates how a one-time cash infusion in a war zone ultimately increased combatant support, and that from a moral point of view, is problematic," explained Lyall.

With the study's findings, the researchers hope that the humanitarian community will strive to be more rigorous in their methods before implementing aid projects in conflict zones, so as to minimize the potential for a backlash effect.

Discrimination may cause black and Hispanic patients to wait longer for a scheduled primary care appointment, according to a new Tulane University study published in JAMA Network Open.

The research could shine more light on why people who belong to racial and ethnic minority groups experience worse health outcomes than white people in the United States.

"Timeliness of care is really important," said lead author Janna Wisniewski, assistant professor of health policy and management at Tulane University School of Public Health and Tropical Medicine. "Delay in seeing a provider means that the patient spends more time experiencing the illness or injury. They may be anxious or in pain for longer. They may struggle for longer to go to work or take care of their family. Delay also gives the condition more time to worsen, which means that if a health system gives more timely care to one group over another, the health system itself may be contributing to health disparities."

The research team recruited seven female callers who self-identified as non-Hispanic black, non-Hispanic white or Hispanic. Each invented a pseudonym that they felt signaled their gender, racial and ethnic identities and that they felt comfortable using on the calls. The women called more than 800 primary care offices in Texas. Each time, the caller introduced herself by her pseudonym and asked to be scheduled for the next available appointment as a new patient. Callers did not proactively offer any additional information but did answer any questions the scheduler asked using a standardized script.

The study found black and Hispanic callers were more likely to be offered an appointment, but they were asked more frequently about their insurance status. Researchers found black callers were 44% more likely than white callers to be asked about their insurance status during the call. Hispanic callers were 25% more likely than white callers to be asked if they had insurance. The study also found patients belonging to racial/ethnic minority groups received appointments further in the future than white callers.

"Schedulers may have believed that race and ethnicity were associated with insurance status, and those who asked about insurance appeared to be inquiring in response to race and ethnicity signals," Wisniewski said. "Asking about insurance may imply scheduling staff's concern about the caller's ability to pay."

Wisniewski said offices could reduce barriers to care with bias training and other mechanisms, such as automated scheduling systems. She hopes knowing the information will begin a conversation about overcoming bias in healthcare settings.

“This is not something that’s routinely checked in hospitals and clinics, whether they’re inadvertently discriminating based on race or ethnicity,” Wisniewski said. “Starting to even look at that and bring attention to it might be a good first step.”

BALTIMORE, MD., Jan 29 - Over the past year, at least seven children have died from diseases including influenza while being detained by the U.S. Department of Homeland Security's Customs and Border Protection (CBP) agency. Infectious disease experts at the University of Maryland School of Medicine (UMSOM) called for protections like influenza vaccinations to prevent serious outbreaks.

"Detention centers have become tinderboxes for infectious-disease outbreaks," warned Mark Travassos, MD, Assistant Professor of Pediatrics at UMSOM and a pediatric infectious disease specialist in the UMSOM Center for Vaccine Development and Global Health (CVD). In a commentary published in the New England Journal of Medicine, Dr. Travassos and UMSOM Pediatrics-Internal Medicine Resident Carlo Foppiano Palacios, MD, said that it is not a surprise that thousands of detained migrants and asylum seekers have been quarantined because of influenza, mumps and chickenpox outbreaks.

"Children and adults are being held in crowded conditions without adequate sanitation or medical care," they wrote, adding that the physical and emotional stress and trauma that migrants and asylum seekers experience can also weaken their immune systems, thereby increasing their risk of systemic infection.

The rise of outbreaks and deaths in these detention centers point to the urgent need for mandatory influenza immunization for migrant children and an opt-out vaccine policy for adults in CBP detention centers, Dr. Travassos and Dr. Foppiano Palacios warned.

"The logistics of vaccine administration are relatively straightforward. Influenza vaccine is simple to administer and carries a low risk of adverse effects. In the event that a detainee has previously been immunized, there is no drawback to receiving multiple vaccinations," they said.

They also reccommended that employees at these detention centers be held to similar vaccination standards as health care workers at U.S. hospitals during influenza season, citing the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices' recommendation that all people who work in health care facilities receive annual influenza vaccines. "Mandatory immunization of these workers is critical to limiting the spread of diseases such as influenza," they asserted.

Infectious disease specialists at the CVD highlight the importance of the seasonal influenza vaccine. "We know that influenza spreads easily, particularly among children and in crowded conditions, and we know that vaccines are an important tool to prevent outbreaks," said Kathleen Neuzil, MD, MPH, the Myron M. Levine Professor in Vaccinology, Professor of Medicine and Pediatrics and Director of the CVD.

For more than four decades, experts in the CVD have been developing and testing vaccines to protect against infectious diseases like seasonal influenza, as well as emerging strains of this virus. Physician-scientists are also researching ways to develop a longer-lasting seasonal influenza vaccine.

"Our infectious disease research at the University of Maryland School of Medicine has served as a critical tool in protecting even the most vulnerable populations, the elderly and those with weakened immune systems, from complex and emerging diseases. Vaccines are an important tool in preventing serious illnesses such as influenza, measles, mumps and chickenpox," said UMSOM Dean E. Albert Reece, MD, PhD, MBA, who is also Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor, University of Maryland School of Medicine

Freshly burned longleaf pine forests have more than double the total number of bees and bee species than similar forests that have not burned in over 50 years, according to new research from North Carolina State University.

For many forests, fire is as essential as rainfall. But while several studies have outlined the benefits of human-controlled prescribed burns on forest ecosystems, little was understood about how prescribed burns, or fires in general, may impact pollinators.

"There is global concern about the decline of insects in general, and pollinators in particular, so it's really important for land managers to understand how prescribed fire affects insect communities," says Elsa Youngsteadt, co-author of a paper on the work and an assistant professor in NC State's Department of Applied Ecology.

"Given the importance of fire in maintaining longleaf pine ecosystems overall, you would expect it to be good for the region's native bees. But it's also easy to imagine small bees and their nests, especially nests in twigs and stems, just getting incinerated. We weren't sure where we would find the most robust pollinator community."

NC State researchers worked with the Walthour-Moss Foundation's longleaf pine savannah reserve, which was established to protect this endangered pine. The reserve regularly burns 90% of its plots in 3-year cycles, while the remaining 10% of plots have not been burned for at least 50 years. This provided an ideal opportunity to compare bee abundance and diversity between unmanaged and managed ecosystems.

"The southeastern U.S. has some of the highest lightning strike rates in the world, which used to contribute to low-intensity fires passing through the longleaf pine savannas every 2 or 3 years," Youngsteadt says. "But agriculture, development, and logging fragmented this landscape and blocked the movement of fire."

For this study, researchers placed bee "traps" at 16 sites: four that had been burned the year of sampling, four that had been burned one year before sampling, four that had been burned two years before sampling, and four unburned control sites.

The researchers found that burned sites supported 2.3 times more total pollinators than plots that had not burned in 50 years. Burned sites also had 2.1 times as many different bee species as unburned sites. Within those burned areas, bee abundance and diversity tended to be greatest at sites that were most recently burned, and this abundance and diversity decreased with time since the last fire.

But why?

Fires maintain openings in the forest canopy, reduce ground cover and release nutrients into soils at the same time, creating the perfect environment for large blooms, increasing the flower resources pollinators rely on. The study also found that the low-intensity prescribed burns did not reduce the amount of nesting material for above-ground nesting pollinators, and the abundance of above-ground nesting pollinators was not impacted by the fires. Meanwhile, below-ground nesting species appeared to benefit from the increased access to bare soil.

"It's great news that prescribed fire, as currently used in longleaf pine savannas, is helping to support the pollinator community," Youngsteadt says. "But there's still a lot to learn. For example, the fires in this study were set in the winter, but many land managers use summer burns. Knowing the effects of fire in different seasons will be an important next step, as will knowing the optimal area of land to burn at any one time."

Some golf carts and lawnmowers already use airless tires and at least one major tire company produces a non-pneumatic automotive tire, but we still have long way to go before they are on every vehicle that comes off the assembly line. Finding a design that balances puncture-free strength with the elasticity needed for a comfortable, shock-free ride like conventional pneumatic tires is the key.

To address some of the issues, University of Illinois researchers focused on one component of the tire--the shear layer, which is just beneath the tread.

"The shear layer is where you get the most bang for your buck from a design perspective. It's where you have the most freedom to explore new and unique design configurations," said Kai James, assistant professor in the Department of Aerospace Engineering at U of I.

James along with U of I graduate student Yeshern Maharaj used design optimization, a computer algorithm, to come up with a variety of structural patterns for the shear layer of a non-pneumatic tire.

They had a computer simulation that modeled the elastic response on the shear layer. The simulation calculates the material's ability to stretch and twist.

"We were looking for a high level of shear--that is, how much strain the material can take under pressure--but we want stiffness in the axial direction," James said.

These physical pressures are not like aging or weathering on the tire, but about internal pressure and stresses--essentially, how much pressure the material exerts on itself.

"Beyond a certain level of stress, the material is going to fail," James said. "So we incorporate stress constraints, ensuring that whatever the design happens to be, the stress doesn't exceed the limit of the design material.

"There are also buckling constraints. If you have a narrow, slender member, say a strut within the element, that's undergoing compression that could be subject to buckling. We have ways to mathematically predict what force level is going to induce buckling in the structure and modify it accordingly. Depending on how you weight each of the design requirements--buckling, stress, stiffness, shear, and every combination of those--will result in a different design."

The goal is a tire design that can withstand pressure but is also elastic to provide a ride that doesn't feel like you're driving on tires made of steel.

James explained how, as the computer simulation works to find the optimum pattern, it eliminates structural patterns that are not optimal. It begins with a computer-simulated block of the bulk material that the tire will be made from. Because a solid block doesn't have much elasticity, the material is virtually cut away, leaving spaces for flexibility.

"If you carve holes in the material until it is something like a checkerboard pattern, with half of the material, you'd also have half of the original stiffness," he said. "Now, if you do a much more complicated pattern, you can actually tailor the stiffness."

Obviously, on a continuum from a block of material to a thin, lacelike pattern, the number of potential designs is infinite, but it's not realistic to test every design. And, it's important to note that the algorithm doesn't end by spitting out a single, optimal design.

"Search algorithms have clever ways to strategically search the design space so that ultimately you end up having to test as few different designs as possible," James said. "Then, as you test the designs, gradually, each new design is an improvement on the previous one and eventually, a design that is near optimal."

James said computer modeling of a structure like this one, or any physical system has levels of complexity encoded into the model--a higher accuracy model with higher fidelity is more costly.

"From a computational standpoint, we're generally talking about the time it takes to run the analysis on high-powered computers," James said.

Future analysis will require an industry or research collaborator.

Many people turn to artificial or so-called natural sweeteners to cut calories and lose weight. A new study led by Dr. Raylene Reimer, PhD, published in the high-impact journal Gut discovered that the consumption of low-calorie sweeteners while pregnant increased body fat in their offspring and disrupted their gut microbiota - the trillions of bacteria and other microorganisms that inhabit the intestinal tract and affect our health and risk of numerous diseases.

The findings are significant as they impact the critical early years of life, particularly during pregnancy and breast feeding.

"Low-calorie sweeteners are considered safe to consume during pregnancy and lactation, however evidence is emerging from human studies to suggest they may increase body weight and other cardiovascular risk factors," says Reimer, a University of Calgary professor in the Faculty of Kinesiology, and Department of Biochemistry & Molecular Biology at the Cumming School of Medicine , and member of the Alberta Children's Research Institute.

"Even stevia, which is hailed as a natural alternative to aspartame and other low calorie artificial sweeteners, showed a similar impact on increasing offspring obesity risk in early life."

Aspartame, an artificial sweetener, and stevia, a natural low-calorie sweetener extracted from a plant native to South America, are 200-400 times sweeter than sugar. Stevia, gaining popularity, was historically used in Paraguay and Brazil to treat diabetes and is an emerging ingredient in many natural products and protein drinks.

Demand for sweeteners for weight loss

In response to higher obesity rates, the use of low-calorie sweeteners has risen, particularly in women and children. Daily consumption is associated with large babies and early menstruation in young females under 10 years - a known risk factor for chronic diseases. Additionally, the presence of some but not all of these sweeteners has been detected in breastmilk presenting a potential mode of transmission, according to the study.

"Understanding the impact of dietary ingredients on maternal metabolism and gut microbiota may help to define the optimal maternal diet, one which promotes a healthier future for both mother and child," says Reimer.

Altering the gut microbiota of babies

Our understanding of how sweeteners affect weight gain is not complete but there is reason to believe that alterations in the gut microbiota may play a key role. In this animal study, a fecal transplant was used to show the direct influence of altered gut microbiota on causing the increased obesity risk. Transplanting fecal matter from the offspring of mothers that consumed the low-calorie sweeteners into sterile, germ free mice caused the mice to gain more weight and have worse blood glucose control. Even though the offspring had never consumed the sweeteners themselves, the changes to mom's microbiota and metabolism was sufficient to change the microbiota in their offspring and trigger obesity.

"A healthy pregnancy, including good nutrition, is important for a healthy baby," says Reimer. "Our research will continue to examine what makes an optimal diet and more importantly seek to find ways to correct disruptions to gut microbiota should they occur."

Antibiotic-resistant bacteria are prevalent in people, wildlife and the water in northeastern Tanzania, but it's not antibiotic use alone driving resistance. Instead, researchers at Washington State University found transmission of bacteria in the environment is the most important factor.

These conclusions come from a four-year study led by researchers from WSU's Paul G. Allen School for Global Animal Health. The results of the study were just published in Nature Communications.

"We were surprised to find these microbes everywhere," said Douglas Call, a Regents professor and associate director for research at the Allen School, "but it appears that within impoverished communities, there are many opportunities for bacteria to spread between animals and people via contact with waste or through consumption of contaminated food and water."

The study, funded by the National Science Foundation, began in March 2012 and involved visiting 425 households from 13 villages throughout northeastern Tanzania.

At each household, data was collected about people's daily activities, after which researchers collected fecal samples from people, domestic livestock, chickens, dogs, and when present, wildlife. Water was also sampled.

The methods used by the team were unique from most studies, allowing collection and testing of more than 61,000 bacterial isolates. Depending on the community sampled, over 65% of bacteria from people were resistant to at least one of the nine antibiotics tested.

The prevalence of antibiotic-resistant bacteria was highest for people, but it was also high for other domestic animals even when those animals were never exposed to antibiotics.

For example, in some communities up to 50% of bacteria from dogs were antibiotic-resistant.

"In these communities, no one is treating their dog with antibiotics, and yet they have a high prevalence of resistance," Call said. "It's not an antibiotic use problem; they are coming into contact with antibiotic-resistant bacteria in the environment."

Antibiotic-resistant bacteria were also prevalent in wildlife.

More than 50 percent of wildlife feces contained ampicillin-resistant bacteria, which was higher than the average across people, chickens, livestock, and dogs. The prevalence of resistance to the remaining eight antibiotics was highly correlated with results from domestic samples.

"We've got almost as much resistance on the wildlife side as the domestic side," Call said. "This is one factor that shows how bacterial transmission plays such an important role in this system."

Antibiotic-resistant bacteria were also prevalent in water sources.

The World Health Organization recognizes antibiotic resistance as a threat to global health and estimates 10 million deaths worldwide by 2050 if no effective interventions are made.

While antibiotic-resistant bacteria are prevalent throughout the study area, these findings are the first step to address potential health risks.

"Hygiene and sanitation have to figure more prominently in efforts to combat antibiotic resistance," said Mark Caudell, a first-author of this work. Caudell, is a former WSU researcher and now the regional social science coordinator for antimicrobial-resistance at the Food and Agriculture Organization of the United Nations.

"Until hygiene and infrastructure improves, and transmission begins to decline, antibiotic stewardship alone is unlikely to have much impact," he said.

Some forms of domestic violence double victims' risk of depression and anxiety disorders later in life, according to University of Queensland research.

The UQ School of Public Health study found many victims of intimate partner violence at 21 showed signs of mental illness at the age of 30, with women more likely to develop depression and men varying anxiety disorders.

Intimate partner violence classifies physical abuse as pushing, shoving and smacking.

UQ researcher Emeritus Professor Jake Najman said the team also found equal levels of abuse by men and women.

"The number of men and women who experience intimate partner violence is very similar, leading us to believe couples are more likely to abuse each other," Professor Najman said.

"People generally don't end up in the hospital or a shelter, but there is a serious mental burden from this type of abuse."

The research showed defacto couples and those from lower socio-economic backgrounds were more likely to be involved in these types of abusive relationships.

Emotional abuse involves comments that make the person feel worthless.

Then there is harassment - a constant and distressing nagging that may have long-term consequences for those on the receiving end.

"It also raises the question, to what extent is this type of violent behaviour not just a characteristic of the relationship the couple has with each other, but with other people around them and possibly their children," Professor Najman said.

"There is a range of treatment and counselling programs available for couples and families to try and improve the way they relate to one another."

Singapore, January 2020 -- Early mammalian development is a highly complex process involving elaborate and highly coordinated biological processes. One such process is zygotic genome activation (ZGA) which occurs following the union of the sperm and egg, marking the beginning of life. The resultant early embryos, termed 'zygotes' are capable of generating the entire organism, a property known as totipotency.

Totipotent cells sit atop the developmental hierarchy and have the greatest potency of all cell types, giving it limitless therapeutic potential. Surpassing pluripotent embryonic stem cells, which are only able to differentiate into all cell types within the embryo, the totipotent zygote loses its totipotency as in matures into pluripotency.

Scientists at the National University of Singapore's Yong Loo Lin School of Medicine have now found a way to manipulate pluripotent cells into acquiring the totipotent capacity previously thought to exist only in the zygote. This not only provides key insights into how totipotency is formed and the earliest events in mammalian development, but opens new doors for potential cell therapies that were previously unexplored.

The study identified a totipotency-inducing factor - Negative Elongation Factor A (NELFA), which is capable of driving pluripotent embryonic stem cells into totipotency in a petri dish. NELFA achieves this feat by causing specific changes in the gene regulatory and metabolic networks of the cell. Specifically, NELFA has the ability to reactivate certain genes that are only active in the zygote but otherwise silent in embryonic stem cells. NELFA is also able to alter the energy using pathways in the pluripotent stem cells. All these changes will result in pluripotent stem cells reverting into a totipotent-like state.

Discovering this method of inducing totipotency in cells outside of the embryo also provides a means to engineer cells with maximum cell plasticity for therapeutic purposes. This increases the potential applications of regenerative medicine, especially in cell replacement therapies.

According to Assistant Professor Tee Wee Wei, the lead investigator in this study, the eventual goal of this research is to translate the findings into the development of rapid and efficient cellular reprogramming strategies for clinical application, such as in the treatment of debilitating diseases and developmental disorders.

The overuse of antibiotics poses an increasing threat to children who develop -- or already have -- drug-resistant infections that are difficult or impossible to treat, and can cause extended hospitalization, disability and even death.

At any given time, about 1 in 3 patients in U.S. children's hospitals receive one or more antibiotics. However, for one-quarter of those children, the antibiotic treatments are unnecessary or otherwise "suboptimal," according to research led by Washington University School of Medicine in St. Louis.

The research -- involving nearly 12,000 children at 32 U.S. children's hospitals -- is published online in Clinical Infectious Diseases, a journal of the Infectious Diseases Society of America.

The study also found that nearly half of this inappropriate use of antibiotics would have gone undetected by current antibiotic stewardship programs designed to prevent antibiotic resistance. Such programs involve the routine review of certain patient prescriptions to determine if the correct dose, drug and duration were used. Problems can be flagged and addressed through such reviews.

"Antibiotic resistance is a growing danger to everyone; however, there is limited data on children," said Jason Newland, MD, a Washington University professor of pediatrics in the Division of Pediatric Infectious Diseases and director of the Antimicrobial Stewardship Program at St. Louis Children's Hospital, where he treats patients.

"Data on adults have suggested that 30% to 50% of antibiotics used in hospitalized adults is inappropriate," Newland said. "Our goal was to understand if antibiotics used to treat hospitalized children were suboptimal, meaning doctors shouldn't have prescribed any antibiotics; they could have used a more effective antibiotic; or they could have prescribed a different dose or for a shorter duration. Health-care workers must be vigilant since the inappropriate use of antibiotics is fueling dangerous drug resistance in children."

The multicenter study involved examining the medical records of 11,784 children from birth to age 17 who had been prescribed, in 32 U.S. children's hospitals, one or more antibiotics to treat or prevent infections. The researchers evaluated data collected on six separate days from July 2016 through December 2017.

Researchers found 2,946 (25%) of the patients received at least one antibiotic deemed suboptimal.

Altogether, health-care providers prescribed antibiotics 17,110 times. Of those, 3,593 were considered suboptimal. The most common cases of inappropriate antibiotic use included:

27% due to "bug-drug mismatch," meaning the wrong antibiotic was given for a particular infection.

17% due to prolonged antibiotic use after surgery to prevent surgical-site infections.

11% due to use of antibiotics when they were unnecessary.

11% due to use of broad-spectrum antibiotics, when a drug that targets a specific type of bacteria could have been used.

The study also found that almost half of the suboptimal prescriptions identified in the study would not have been routinely reviewed by the physicians and pharmacists involved in hospital antimicrobial stewardship programs, which only scrutinized the use of specific drugs.

"Arguably, this is one of the most important findings because it helps us to identify blind spots in antimicrobial stewardship programs," Newland said. "Antibiotics currently not targeted for review still have a significant need for oversight. The obvious solution is to expand routine reviews to include all antibiotics. Unfortunately, this is resource-intensive and may not be feasible at some hospitals."

However, the study also pinpointed medical conditions that would benefit from increased scrutiny. For example, the most common medical condition for antibiotic prescriptions was bacterial lower respiratory tract infection, or pneumonia. It also accounted for the greatest percentage of suboptimal prescriptions -- 18%.

A number of suboptimal prescriptions stemmed from antibiotics used to prevent surgical-site infections, mainly because the drug was prescribed for longer than necessary. "Notably, recently revised guidelines from the Centers for Disease Control and Prevention recommend that some surgeries limit antibiotics to a single preoperative dose," Newland said. "This means that an even greater proportion of the cases in our study now would be considered suboptimal."

The study involved researchers from seven other institutions: University of Michigan in Ann Arbor; Children's Mercy Hospital in Kansas City, Mo.; Novant Health Eastover Pediatrics in Charlotte, N.C.; University of Pennsylvania in Philadelphia; Children's Hospital of Philadelphia; University of Utah in Salt Lake City; and the University of Washington in Seattle. Participating hospitals were recruited by the Sharing Antimicrobial Reports for Pediatric Stewardship Collaborative, which Newland co-founded and currently leads.

"Our study also highlights the need for antimicrobial stewardship programs to expand current practices and efforts," Newland said. "Such evolution is imperative to ensure optimal antibiotic use for all hospitalized children."

Solitary female bees inspect other nests for signs of danger before making decisions on where to build their own, a new London-based study suggests.

The study, led by researchers at Queen Mary University of London, found the clever bees looked for signs of parasite infection in other species' nests and used this information to select a safe place to bring up their own brood.

The research team set up artificial nests in parks and grasslands across South East England and London from 2016-2018 to study the behaviours of different species of solitary cavity-nesting mason bees.

The scientists also tested the ability for these species to notice other cues of parasite infection in the surrounding environment.

They showed that solitary bees were surprisingly intelligent in their observations and were able to remember geometric symbols found next to parasitised nests, and avoid nests near these symbols in future breeding periods.

Dr Olli Loukola, lead author and postdoctoral fellow at Queen Mary University of London and the University of Oulu, said: "It's amazing that solitary bees are able to use such a complex strategy in their nest-site decisions. It really requires a sophisticated cognitive flexibility and it is fascinating to uncover how much genius is found in these small-brained solitary bees.

"Despite being solitary, these bees live in communities and can learn from each other. As environmental factors such as nesting suitability, predation and parasitism change both spatially and over time, it makes sense for bees to glean information from their neighbours, even if they aren't the same species."

Most research to-date has focused on social species, which live in communities led by a queen with several dozen to several thousand workers. However, most wild species are in fact solitary and individuals build their own nest rather than living in a hive as part of a larger community.

Whilst these bees live independently, they often exist in in groups with multiple different species residing in close proximity to each other.

Dr Lars Chittka, Professor of Sensory and Behavioural Ecology at Queen Mary University of London, said: "There are around 20,000 solitary bee species in total and about 150 live right here in London. In these species, female individuals, 'single mothers' build their own nests. The male bees never do any work.

"Our research suggests that despite the fact that these females largely work alone, they're able to use cues in their environment and activities of other animals in their surroundings, to successfully protect their broods."

With reported declines in bee numbers over the last few years, studies that improve our understanding of their behaviour and the environmental pressures they face are important for future conservation efforts to save these pollinators.