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A Tyrannosaurus rex could bite hard enough to shatter the bones of its prey. But how it accomplished this feat without breaking its own skull bones has baffled paleontologists. That's why scientists at the University of Missouri are arguing that the T. rex's skull was stiff much like the skulls of hyenas and crocodiles, and not flexible like snakes and birds as paleontologists previously thought.

"The T. rex had a skull that's 6 feet long, 5 feet wide and 4 feet high, and bites with the force of about 6 tons," said Kaleb Sellers, a graduate student in the MU School of Medicine. "Previous researchers looked at this from a bone-only perspective without taking into account all of the connections -- ligaments and cartilage -- that really mediate the interactions between the bones."

Using a combination of imaging, anatomy and engineering analysis, the team observed how the roof of the mouth of the T. rex reacted to the stresses and strains from chewing by applying models of how two present day relatives of T. rex -- a gecko and a parrot -- chew to how the T. rex skull worked.

"Dinosaurs are like modern-day birds, crocodiles and lizards in that they inherited particular joints in their skulls from fish -- ball and socket joints, much like people's hip joints -- that seem to lend themselves, but not always, to movement like in snakes," said Casey Holliday, an associate professor of anatomy in the MU School of Medicine. "When you put a lot of force on things, there's a tradeoff between movement and stability. Birds and lizards have more movement but less stability. When we applied their individual movements to the T. rex skull, we saw it did not like being wiggled in ways that the lizard and bird skulls do, which suggests more stiffness."

In addition to helping paleontologists with a detailed study of the anatomy of fossilized animals, researchers believe their findings can help advance human and animal medicine by providing better models of how joints and ligaments interact.

"In humans, this can also be applied to how people's jaws work, such as studying how the jaw joint is loaded by stresses and strains during chewing," said Ian Cost, the lead researcher on the study. Cost is an assistant professor at Albright College and a former doctoral student in the MU School of Medicine. "In animals, understanding how those movements occur and joints are loaded will, for instance, help veterinarians better understand how to treat exotic animals such as parrots, which suffer from arthritis in their faces."

Intestinal epithelial cells (IECs) are exposed to diverse types of environmental stresses such as bacteria and toxins, but the mechanisms by which epithelial cells sense stress are not well understood. New research by the universities of Bristol, Heidelberg and the German Cancer Research Center (DKFZ) have found that Nox-ROS-ASK1-MKK3-p38 signaling in IECs integrates various stresses to facilitate intestinal regeneration.

The research, published in Nature Communications today [Wednesday 25 September], used the adult fly intestine, which is remarkably like a human intestine, to understand how IECs sense stress or damage, defend themselves and promote epithelial regeneration.

Stress sensing pathways are activated upon a variety of stresses in fly IECs, but how these pathways are activated and how they promote IEC resilience and intestinal regeneration are not known.

The researchers found that NADPH Oxidase (Nox) in IECs produce reactive oxygen species (ROS) upon stress, but it wasn't fully understood how ROS promote intestinal regeneration. The paper has shown that it is partly effected by Ask1-MKK3-p38 signaling in IECs, stimulating their production of intestinal stem cell (ISC) mitogens and ISC-mediated regeneration. p38 was previously found to facilitate mammalian intestinal regeneration when damaged, but how it senses damage was not understood.

The researchers are still unclear how stress is sensed by intestinal epithelial cells but believe it is possible that Nox senses stress. The study also found damage activates stress sensing pathways in fly IECs but how these pathways effect IEC resilience and intestinal repair is not fully clear.

Dr Parthive Patel, Elizabeth Blackwell Institute (EBI) Early Career Fellow in the School of Cellular and Molecular Medicine at the University of Bristol, said: "Our work has potential applications for regenerative medicine. Reactive oxygen species play an important role in tissue regeneration and even in neuronal axon regeneration."

"It is also relevant for diseases that develop from the loss of epithelial integrity such as inflammatory bowel diseases, which increases risk for colorectal cancer. Understanding how tissues sense stress and promote their resilience and repair will provide novel therapeutic strategies."

A new therapeutic being tested by University of Alberta researchers is showing early promise as a more effective treatment that could help nearly half of patients with Duchenne muscular dystrophy (DMD).

The treatment--a cocktail of DNA-like molecules--results in dramatic regrowth of a protein called dystrophin, which acts as a support beam to keep muscles strong. The protein is virtually absent in those with DMD.

"In muscle, if there is no dystrophin there is no support of muscle membrane, and the muscle cells will become easily damaged or destroyed," said Toshifumi Yokota, a professor of medical genetics at the U of A. "Our DNA-like molecules restore the production of dystrophin so it can support the muscle cell membrane.

"Theoretically, this treatment could treat as many as 47 per cent of patients with Duchenne muscular dystrophy."

The condition is a genetic disorder characterized by progressive muscle degeneration and weakness. The incurable condition causes difficulty in walking and breathing as the muscles and heart are gradually damaged. Many will die from the condition in their 20s or 30s.

In a study published in Molecular Therapy, Yokota and his team describe using a mix of DNA-like molecules--called antisense oligonucleotides--to act like a stitch that could repair a specific gene mutation in patients with DMD. The molecules were tested in both human muscle cells of patients with DMD and in mice containing the human DMD gene.

The U.S. Food and Drug Administration approved the first drug of this class of "DNA stitch," called eteplirsen, in 2016. However, the drug is only applicable to about 13 per cent of DMD patients.

Yokota's team designed the cocktail of molecules to theoretically expand the applicability of the therapy to just under half of all DMD patients. The experimental treatment may also significantly improve the symptoms experienced by patients.

"Our treatment produces a shorter dystrophin protein than the drug being used now. This shorter protein is associated with extremely mild symptoms in some of the muscular dystrophy patients. Some have almost no symptoms at all," explained Yokota.

The researchers are now working to reduce the number of DNA-like molecules in the cocktail to reduce both cost and regulatory hurdles moving forward. They hope to progress the work to a clinical trial in the future.

INFORMS journal Information Systems Research New Study Key Takeaways:

New research analyzes video game player engagement and the response to different motivations to increase game play.

The method researchers tested increases game play by 4-8% and translates into better performance for gaming companies.

The biggest driver of video game growth is online game modes.

CATONSVILLE, MD, September 25, 2019 - In the video game industry, the ability for gaming companies to track and respond to gamers' post-purchase play opens up new opportunities to enhance gamer engagement and retention and increase video game revenue.

New research in the INFORMS journal Information Systems Research looks at gamer behavior and how to match their engagement level with different games to ensure they play more often and for longer periods of time.

The study, "'Level Up': Leveraging Skill and Engagement to Maximize Player Game-Play in Online Video Games," conducted by Yan Huang of Carnegie Mellon University, and Stefanus Jasin and Puneet Manchanda, both of the University of Michigan, works to better match players with games to achieve these goals.

For games with in-game purchase features, the more rounds a player plays, the more the player is likely to spend on in-game purchases, leading to better revenue generation; for games with in-game display ads, the more rounds a player plays the more ads the player sees, which leads to higher click through numbers and higher revenue. For games without either, revenue is boosted because engaged players are likely to upgrade to the premium or next version of the game.

The researchers looked at data from 1,309 gamers' playing history over 29 months from a major international video gaming company.

"We find that high, medium, and low engagement state gamers respond differently and have different motivators such as feelings of achievement or the need for a challenge," said Huang, a professor in the Tepper School of Business at Carnegie Mellon University.

"Using our model, we learn the gamers' current engagement state on the fly and exploit that to match the gamer to a round to maximize gameplay. By doing this we see an increase in game play between 4 and 8%," said Jasin, a professor in the Ross School of Business at the University of Michigan.

What the researchers have found is that by considering player engagement state and their state-dependent motivation, it not only increases use, but also leads to increased revenue for gaming companies.

Challenges in the game positively impact gamers with low or medium engagement levels, but negatively affects players with high engagement. Players' curiosity decreases over time, and therefore, tends to move toward the low engagement state. This happens faster for less engaged players.

"Our findings suggest varying game difficulty based on players' engagement level. For multiplayer video games match players to game rounds with stronger or weaker players; single player games can track players' game play activity to infer players' engagement state and adjust the level of difficulty," said Manchanda, a professor in the Ross School of Business at the University of Michigan. "We also suggest introducing surprises, such as new maps or game modes, to offset the decrease in player curiosity as players become familiar with the game."

EAST LANSING, Mich. - Michigan State University scientists have invented a new way to monitor chemotherapy concentrations, which is more effective in keeping patients' treatments within the crucial therapeutic window.

With new advances in medicine happening daily, there's still plenty of guesswork when it comes to administering chemotherapy to cancer patients. Too high a dose can result in killing healthy tissue and cells, triggering more side effects or even death; too low a dose may stun, rather than kill, cancer cells, allowing them to come back, in many cases, much stronger and deadlier.

Bryan Smith, associate professor of biomedical engineering, created a process based around magnetic particle imaging (MPI) that employs superparamagnetic nanoparticles as the contrast agent and the sole signal source to monitor drug release in the body - at the site of the tumor.

"It's noninvasive and could give doctors an immediate quantitative visualization of how the drug is being distributed anywhere in the body," Smith said. "With MPI, doctors in the future could see how much drug is going directly to the tumor and then adjust amounts given on the fly; conversely, if toxicity is a concern, it can provide a view of the liver, spleen or kidneys as well to minimize side effects. That way, they could precisely ensure each patient remains within the therapeutic window."

Smith's team, which included scientists from Stanford University, used mice models to pair its superparamagnetic nanoparticle system with Doxorubicin, a commonly used chemotherapy drug. The results, published in the current issue of the journal Nano Letters, show that the nanocomposite combination serves as a drug delivery system as well as an MPI tracer.

MPI is a new imaging technology that is faster than traditional magnetic resonance imaging (MRI) and has near-infinite contrast. When combined with the nanocomposite, it can illuminate drug delivery rates within tumors hidden deep within the body.

As the nanocomposite degrades, it begins to release Doxorubicin in the tumor. Simultaneously, the iron oxide nanocluster begins to disassemble, which triggers the MPI signal changes. It will allow doctors to see more precisely how much medicine is reaching the tumor at any depth, Smith said.

"We showed that the MPI signal changes are linearly correlated with the release of Doxorubicin with near 100-percent accuracy," he said. "This key concept enabled our MPI innovation to monitor drug release. Our translational strategy of using a biocompatible polymer-coated iron oxide nanocomposite will be promising in future clinical use."

Smith has filed a provisional patent for his innovative process. In addition, the individual components of the nanocomposite Smith's team created have already earned FDA approval for use in human medicine. This should help speed FDA approval for the new monitoring method.

As the process moves toward clinical trials, which could potentially begin within seven years, Smith's team will begin testing multicolor MPI to further enhance the process's quantitative capabilities, as well as drugs other than Doxorubicin, he said.

This new visualization of a black hole illustrates how its gravity distorts our view, warping its surroundings as if seen in a carnival mirror. The visualization simulates the appearance of a black hole where infalling matter has collected into a thin, hot structure called an accretion disk. The black hole's extreme gravity skews light emitted by different regions of the disk, producing the misshapen appearance.

Bright knots constantly form and dissipate in the disk as magnetic fields wind and twist through the churning gas. Nearest the black hole, the gas orbits at close to the speed of light, while the outer portions spin a bit more slowly. This difference stretches and shears the bright knots, producing light and dark lanes in the disk.

Viewed from the side, the disk looks brighter on the left than it does on the right. Glowing gas on the left side of the disk moves toward us so fast that the effects of Einstein's relativity give it a boost in brightness; the opposite happens on the right side, where gas moving away us becomes slightly dimmer. This asymmetry disappears when we see the disk exactly face on because, from that perspective, none of the material is moving along our line of sight.

Closest to the black hole, the gravitational light-bending becomes so excessive that we can see the underside of the disk as a bright ring of light seemingly outlining the black hole. This so-called "photon ring" is composed of multiple rings, which grow progressively fainter and thinner, from light that has circled the black hole two, three, or even more times before escaping to reach our eyes. Because the black hole modeled in this visualization is spherical, the photon ring looks nearly circular and identical from any viewing angle. Inside the photon ring is the black hole's shadow, an area roughly twice the size of the event horizon -- its point of no return.

"Simulations and movies like these really help us visualize what Einstein meant when he said that gravity warps the fabric of space and time," explains Jeremy Schnittman, who generated these gorgeous images using custom software at NASA's Goddard Space Flight Center in Greenbelt, Maryland. "Until very recently, these visualizations were limited to our imagination and computer programs. I never thought that it would be possible to see a real black hole." Yet on April 10, the Event Horizon Telescope team released the first-ever image of a black hole's shadow using radio observations of the heart of the galaxy M87.

COLLEGE STATION, September 25, 2019 — Humans have never before lived with the high carbon-dioxide atmospheric conditions that have become the norm on Earth in the last 60 years, according to a new research study.

Titled "Low CO2 levels of the entire Pleistocene Epoch” and published in Nature Communications today, the study shows that for the entire 2.5 million years of the Pleistocene era, carbon dioxide concentrations averaged 230 parts per million.

Today’s levels are more than 410 parts per million. In 1965, Earth’s carbon dioxide atmospheric concentrations exceeded 320 parts per million, a high-point never reached in the past 2.5 million years, this study shows.

“According to this research, from the first Homo erectus, which is currently dated to 2.1–1.8 million years ago, until 1965, we have lived in a low-carbon-dioxide environment — concentrations were less than 320 parts per million,” said Dr. Yige Zhang, a co-author of the research study and an assistant professor in the Department of Oceanography, in the College of Geosciences, at Texas A&M University.

“So, this current high-carbon-dioxide environment is not only an experiment for the climate and the environment — it’s also an experiment for us, for ourselves,” he said.

Carbon dioxide is a greenhouse gas that contributes to the warming of Earth’s atmosphere and is considered a driver of global climate change, Zhang explained.

“It’s important to study atmospheric CO2 (carbon dioxide) concentrations in the geological past, because we know that there are already climate consequences and are going to be more climate consequences, and one way to learn about those consequences is to look into Earth’s history,” he said. “Then we can see what kind of CO2 levels did we have, what did the climate look like, and what was the relationship between them.”

Mr. Jiawei Da, Dr. Xianqiang Meng, and Dr. Junfeng Ji, all of Nanjing University in China; and Dr. Gen Li, of the California Institute of Technology, co-authored the research.

Ancient Soil Reveals Millions Of Years Of Data

The scientists analyzed soil carbonates from the Loess Plateau in central China, to quantify ancient atmospheric carbon dioxide levels, as far back as 2.5 million years ago. Climate scientists often use ice cores as the ‘gold standard’ in physical climate records, Zhang said, but ice cores only cover the past 800,000 years.

Analyzing pedogenic carbonates found in the ancient soil, or paleosols, from the Loess Plateau, the scientists reconstructed the Earth’s carbon dioxide levels

“The Loess Plateau is an incredible place to look at Eolian, or wind, accumulation of dust and soil,” Zhang said. “The earliest identified dust on that plateau is from 22 million years ago. So, it has extremely long records. The layers of loess and paleosol there contain soil carbonates that record atmospheric carbon dioxide, if we have very careful eyes to look at them.”

“Specifically, carbonates formed during soil formation generally reach carbon isotopic equilibrium with ambient soil CO2, which is a mixture of atmospheric CO2 and CO2 produced by soil respiration. Through the application of a two-component mixing model, we can reconstruct paleo-CO2 levels using carbonates in fossil soils,” said Nanjing University’s Jiawei Da.

Reconstructing A Carbon Dioxide History, For Clues About Our Future

Using those materials and the techniques, the researchers constructed a carbon dioxide history of the Pleistocene.

“Our reconstructions show that for the entire Pleistocene period, carbon dioxide averaged around 230 parts per million, which is the same as the last 800,000 years’ values,” Zhang said.

“Our paleosol-based CO2 estimates are in line with snapshots of early-Pleistocene CO2 retrieved from Antarctic old, blue ice, suggesting that the Earth system has been operating under low CO2 levels throughout the Pleistocene,” said Dr. Junfeng Ji of Nanjing University.

“We evolved in a low-carbon-dioxide environment,” Zhang said, and how humans will evolve and be affected by today’s carbon-dioxide levels is yet to be seen.

Editor's Note: This release has been updated since it was originally published by request of the submitting institution. The
number, 250, has been updated to 230 parts per million.

Washington, DC - September 25, 2019 - Investigators have now shown that only half of patients presenting with sinus, throat, or ear infections at different treatment centers received the recommended first-line antibiotics, well below the industry standard of 80 percent. The research is published this week in Antimicrobial Agents and Chemotherapy, a journal of the American Society for Microbiology.

At traditional medical offices only 50 percent of patients with sinus, throat, or ear infections received first-line treatment. In contrast, retail clinics--walk-in clinics at retail stores, supermarkets and pharmacies--provided first-line treatment to 70 percent of these patients, with emergency departments following at 57 percent, and urgent care centers bringing up the rear, at 49 percent. The goal for first line treatments is 80 percent, because roughly 10 percent of patients report allergies to first-line treatment, and others have failed it, said principal investigator Katherine E. Fleming-Dutra, MD, Deputy Director, Office of Antibiotic Stewardship, Division of Healthcare Quality, Promotion, Centers for Disease Control and Prevention

"The high percentage receiving first-line treatment at retail clinics is due to the focus on antibiotic stewardship reported by large retail clinic chains," said Dr. Fleming-Dutra. These chains often use treatment protocols, get audited, and receive feedback on how well they are adhering to the protocol.

"We don't have any data on how widespread or not protocols and audit-and-feedback are in urgent cares, EDs, or medical offices. What we know is that implementing treatment protocols and conducting audit-and-feedback on how well providers are adhering to those protocols are effective antibiotic stewardship interventions," said Dr. Fleming-Dutra.

Evaluating treatment by diagnosis, just 46.5 percent of pharyngitis patients received first-line antibiotics, across all settings and all ages. Among sinusitis patients, 45.6 percent received first-line treatment. More than one quarter of sinusitis patients (27.5%) received macrolide antibiotics, despite counter-recommendations from both the American Academy of Pediatrics and the Infectious Disease Society of America, due to high levels of macrolide resistance in Streptococcus pneumoniae.

The counter-recommendations apply even if the patient is allergic to the first-line treatment, amoxicillin or amoxicillin-clavulanic acid. For those patients, the Infectious Diseases Society of America (IDSA) recommends doxycycline or a respiratory fluoroquinolone.

In the case of acute otitis media (ear infection), across all settings, a high 70 percent of patients received first-line treatment. This was a special case, however, because the researchers evaluated antibiotic selection only in children, as acute otitis media is common among them but rare in adults, said Dr. Fleming-Dutra.

Antibiotic selection is superior in children as compared to adults, across all four settings, with 62 percent of children receiving first-line treatment, versus just 41 percent of adults, according to the report.

Several factors probably account for superior prescribing among children, said Dr. Fleming-Dutra. First, since the mid-1990s, numerous public health efforts, from the Centers for Disease Control and Prevention, as well as from the American Academy of Pediatrics and the Pediatric Infectious Diseases Society, have worked to improve antibiotics prescribing among children.

In addition to boosting first-line treatment among children, where appropriate, there has been a reduction in antibiotic use among children. "We think that the efforts on the part of all of these organizations created a culture of using antibiotics more appropriately in the care of children," said Dr. Fleming-Dutra.

HOUSTON -- Pegilodecakin, a first-in-class drug currently in clinical trials, has shown positive safety results and may offer a potential new treatment avenue for patients with non-small cell lung cancer (NSCLC) and kidney cancer. The study, led by The University of Texas MD Anderson Cancer Center, demonstrated that the drug, in combination with two leading anti-PD-1 monoclonal antibodies, pembrolizumab and nivolumab, achieved measurable responses for these patients.

Findings from a multi-center Phase Ib study was published in the Sept. 25 online issue of The Lancet Oncology.

"Pegilodecakin with anti-PD-1 monoclonal antibodies had a manageable toxicity profile and promising anti-tumor activity," said Aung Naing, M.D., associate professor of Investigational Cancer Therapeutics. "Our study showed this combination demonstrated favorable response in NSCLC and kidney cancer patients who previously had been treated when compared to those treated with anti-PD-1 monoclonal antibodies alone."

The study was designed to assess the safety, tolerability and maximal tolerated dose of pegilodecakin in combination with pembrolizumab or nivolumab, while also investigating biomarkers to identify patients likely to respond to treatment.

The study, which took place from February 2015 to September 2017, followed 111 kidney cancer, NSCLC and melanoma patients with advanced malignant solid tumors. The most common side effects were anemia, fatigue, low blood platelet counts and high triglycerides.

Objective responses were seen in 43% of NSCLC patients, 40% of kidney cancer patients and 10% of melanoma patients. Patients received pegilodecakin with pembrolizumab or nivolumab until disease progression, toxicity necessitating treatment discontinuation, patient withdrawal of consent or study end. Patients continued to receive combination therapy or pegilodecakin alone after disease progression if the investigator determined that the patient would continue to benefit.

Pegilodecakin is comprised of recombinant interleukin-10 (IL-10) which is linked to a molecule called polyethylene glycol (PEG). IL-10 is a protein that regulates activity of various immune cells, and high concentrations of IL-10 activate an immune response against cancer cells. The attachment of PEG to IL-10 increases its size, which prevents or delays its breakdown to prolong the time it circulates in the body.

The drug works by stimulating the survival, proliferation and "killing" potential of CD8+ T cells, known for their ability to recognize and destroy cancer cells. Increasing the amount of CD8+ T cells within the tumor is thought to improve prognosis and survival of the patient. The immune stimulatory effect of pegilodecakin complements the action of anti-PD-1 monoclonal antibodies that blocks the immune suppressive effect on T cells.

"The activity of pegilodecakin in combination with anti-PD-1 monoclonal antibodies introduces a new class of drugs to the treatment of advanced solid tumors," said Naing. "Future randomized trials hopefully will determine the tolerability and clinical benefits of pegilodecakin as a single agent and in combinations in a range of cancers."

Palliative Connect, a trigger system developed at Penn Medicine and powered by predictive analytics, was found to be effective at increasing palliative care consultations for seriously ill patients, according to a new study from researchers in the Perelman School of Medicine at the University of Pennsylvania. After the system was implemented, palliative care consultation increased by 74 percent. The study was published this month in the Journal of General Internal Medicine.

"There's widespread recognition of the need to improve the quality of palliative care for seriously ill patients, and palliative care consultation has been associated with improved outcomes for these patients," said the study's lead author, Katherine Courtright, MD, an assistant professor of Pulmonary, Allergy and Critical Care, and Hospice and Palliative Medicine.

According to the Center to Advance Palliative Care, palliative care is specialized medical care focused on providing relief from the symptoms and stress of a serious illness to improve the quality of life for patients and families. Palliative care is appropriate for patients of any age and during any stage of illness, which distinguishes it from hospice care, which takes place near the end of life.

Palliative Connect draws on clinical data from the electronic health record and uses machine learning to develop a score based on 30 different factors of a person's likely prognosis over six months--the timeframe doctors are asked to use when making a decision on whether palliative care consultation would be beneficial.

The study team, which was also led by study senior author Nina O'Connor, MD, the chief of Palliative Care at Penn Medicine, evaluated Palliative Connect over an eight-week period between December 2017 and February 2018. In that span, 134 patients who'd been admitted to a Philadelphia hospital were compared to a similar population of 138 patients selected from a time before Palliative Connect was applied.

In the group of patients from when Palliative Connect was applied, consultations increased significantly, climbing from 22 to 85. Additionally, patients were seen by palliative care earlier in their hospital stay - an average of a day and a half sooner.

However, primary team physicians were able to decline triggered consultations, and the researchers found that about 43 percent did so. The authors note that there were several reasons provided by the primary teams for declining a triggered consult. These included the primary team feeling that they are already meeting the patient's needs, or that the patient doesn't have any palliative care needs at the time. These explanations, Courtright said, highlight the fact that prognosis isn't a perfect measure of palliative care needs for every patient -- it's just one aspect of serious illness.

The study also showed that none of the patients or their caregivers declined a triggered consultation after it was accepted by the primary team physician.

"This approach helps us get a foot in the door and really explain what palliative care is to patients and their families," Courtright explained. "Sometimes, there is this sense from primary teams that patients or families are hesitant or don't want to talk about palliative care, but, when a palliative care clinician walks into the room and explains what they do, often people really are glad to see us there."

The researchers believe this the first time a scalable, data-driven prediction system of this kind has been tested in a real clinical setting for palliative care. There have been other palliative care triggers used, but few that have been developed from empirical evidence, and even fewer that have been rigorously tested.

Moving forward, the researchers plan to continue fine-tuning the Palliative Connect prediction model. Additionally, another study is underway to gauge the perspective of physicians, patients, and palliative care clinicians on consult triggers to better inform future use of such interventions.

"Our goal is for every seriously ill patient to have a conversation with their clinician about their priorities and wishes, and to document those priorities in the medical record," O'Connor said. "We think that triggers are allowing us to do that, so we'll continue to evaluate and refine in order to help more patients."

Are gun owners more or less afraid than people who do not own guns? A new study from researchers at Florida State University and the University of Arizona hopes to add some empirical data to the conversation after finding that gun owners tend to report less fear than non-gun owners.

The study, led by sociology doctoral student Benjamin Dowd-Arrow, used the Chapman University Survey of American Fears to examine both the types and the amount of fear that gun owners had in comparison to non-gun owners.

"There's a lot of popular rhetoric in the media and among politicians as to why people own guns," Dowd-Arrow said. "The biggest claim is that they're cowards. So, we wanted to see if owning guns was truly a symptom of fear."

Dowd-Arrow and his team examined fear pertaining to specific phobias and victimization. The results, published in SSM - Population Health, showed that the popular rhetoric surrounding gun ownership was not true.

The researchers first examined gun ownership as a result of fears. For the most part, the study showed that fears were unrelated to the probability of owning a gun.

There were some exceptions. Adults who reported a fear of animals and adults who reported a fear of being mugged were less likely to own a gun. Adults who reported a fear of being victimized by a random/mass shooting were more likely to own a gun.

The researchers then examined the fears of people who owned guns. They found that people who own guns tend to report fewer phobias and victimization fears than people who do not own guns. This general pattern was observed across multiple types of fear, including fear of animals, heights and being mugged.

"There's little evidence to suggest that gun ownership is an effect of fear," Dowd-Arrow said. "However, gun ownership may be associated with less fear because firearms help their owners to feel safe, secure and protected in a world they perceive to be uncertain and potentially dangerous."

Dowd-Arrow said the team's research offers potential policy implications for the gun debate and gun-safety legislation moving forward.

"By eliminating stereotypes and false information around gun ownership, we can possibly create better or more useful policy," Dowd-Arrow said.

Researchers stressed that even though gun owners were found to be less afraid, they are not endorsing gun ownership as safe.

"Research has already indicated that owning a firearm is linked to increased odds of suicide, accidental injury and death and violence against women," Dowd-Arrow said. "More research is needed to really understand how fear is linked to these health outcomes."

Researchers suggested future studies could examine the fear factor in carrying a concealed weapon versus keeping a gun stowed in a car or house. Additional topics to investigate include regional differences in gun ownership and the effects of gun ownership on mental health and sleep disturbance.

"Firearm culture in America is a fascinating topic that is grossly understudied," Dowd-Arrow said. "More research can help us understand what motivates gun ownership. If it isn't fear, then what is it? Or is it a specific fear, such as being a victim in a random shooting?"

WASHINGTON, D.C., September 25, 2019--Substantial school spending cuts triggered by the Great Recession were associated with sizable losses in academic achievement for students living in counties most affected by the economic downturn, according to a new study published today in AERA Open, a peer-reviewed journal of the American Educational Research Association.

The estimated declines in student math and English language arts achievement in school districts with the most severe school spending cuts represent a loss of approximately 25 percent of the expected annual gains in achievement for students in grades 3 through 8, compared to their peers in the districts least affected by the Great Recession.

According to the study, conducted by scholars Kenneth Shores of Pennsylvania State University and Matthew Philip Steinberg of George Mason University, the steepest declines in expected math and English language arts achievement gains were in school districts serving the poorest students--districts where an average of 72 percent of students received free or reduced-price lunch--and in school districts serving the most African American students--39 percent African American, on average.

As a result, the authors note, the Great Recession was associated not only with declines in average academic achievement among counties most adversely affected by the Great Recession but also with increases in achievement gaps between poor and wealthy school districts and between school districts with many and few African American students.

"Our results reinforce what other recent studies have demonstrated: that there is a link between educational spending and student achievement," said Shores, an assistant professor of human development and family studies at Pennsylvania State University. "What is different about this study is that we show that divestments in educational spending matter nearly as much for student achievement as do investments."

For their study, the authors used a dataset consisting of test scores for 2,548 counties across the continental United States for the 2008-09 through 2014-15 school years, combining student achievement information from the Stanford Education Data Archive, demographic information from the U.S. Department of Education, and county-level economic data from multiple sources. The study sample includes test scores for 86 percent of the population of U.S. students who are annually tested in grades 3 through 8.

Although the authors found that the recession resulted in a decline in per pupil revenues of nearly $900 on average for the entire U.S., the consequences for school spending varied substantially among counties. Comparing counties with employment losses in the top and bottom quartiles, school spending declined at a faster rate in the hardest hit areas--by about $600 more per pupil per year--for the first two years of the recession (2007-08 to 2009-10).

In contrast, in the five years leading up to the start of the Great Recession in December 2007--that is, 2002-03 through 2007-08--changes in school spending differed little across the counties that were most and least affected by the downturn. After the recession hit, school spending continued to decline until the 2012-13 school year, but after the first two years, it declined at similar rates across the two groups of districts.

The resulting achievement gap between students in counties most and least affected by the recession persisted for more than three years following the 2009-10 school year.

"Our findings suggest that the first two years of differential declines in school spending were enough to put those hardest hit students at an academic disadvantage, even after spending levels began to increase," Shores said.

"The Great Recession's effects varied significantly among U.S. counties; yet the federal response, in the form of the American Recovery and Reinvestment Act of 2009, neglected this variation," said Steinberg, an associate professor of education policy at George Mason University. "Our findings suggest that greater fiscal support should be targeted to schools that not only serve the most vulnerable student populations but that also are located in communities that are the most vulnerable to the adverse consequences of an economic recession."

The study also found that achievement decreased more for older students than for younger students, a finding that surprised the authors. Prior evidence had found that divestments in resources for younger children tended to be more consequential than equivalent divestments for older children.

"While our data do not speak to this, one potential explanation is that teacher layoffs were concentrated in older grades," Steinberg said. "If true, parents with older children would rightfully be concerned that schools' responses to spending cuts were affecting those students disproportionately. Improving the understanding of how districts redistribute resources differently across schools and grades during periods of districtwide spending declines in the wake of recessionary events is an important line of future research."

In a first-of-its-kind study, Children's Hospital Los Angeles researchers piece together a road map of typical brain development in children during a critical window of maturation. The study shows how a "wave of brain maturation" directly underlies important social and behavioral changes children develop during the transition from childhood to adolescence.

As children mature, many aspects of their lives shift in preparation for adulthood. Academic and social environments intensify during this time, requiring increasing mastery of thoughts, emotions, and behavioral control. Very little is known about what is going on neurologically during this important transition. A group of researchers at CHLA examined anatomical and behavioral changes during the finite window of neurological development in a group of 9-12 year old children. A more detailed understanding of typical brain development could give scientists and clinicians a better framework to help care for children who may be developing atypically or facing developmental challenges.

"We know that children are growing substantially in their ability to self-regulate during this time," says Mary Baron Nelson, PhD, RN, the first author on this publication. "Among many other changes, their attention spans are expanding and they are learning social norms such as gauging appropriate responses or behaviors." Because these are cognitive processes, the research group hypothesized that measurable changes could be occurring in brain structure and function. This is precisely what they found.

The team of scientists, led by Bradley Peterson, MD, of the Institute for the Developing Mind at CHLA, examined anatomical, chemical, and neuropsychological measures to determine what changes could be occurring in a group of 234 healthy children, aged 9-12 years. "We used brain imaging, measured multiple chemicals and metabolites, and took cognitive and neuropsychological scores," says Dr. Baron Nelson.

Using imaging and measuring brain metabolites, the group observed what Dr. Baron Nelson refers to as a "wave of maturation" sweeping through the brain. White matter tracts - the pathways in the brain that transmit information - showed increasing maturation with age from the back to the front of the brain. This is expected, as the frontal lobes are not fully formed until an individual is in his or her late twenties. The frontal lobes mediate executive function - major planning of complex decisions and actions. But perhaps less expected is that so many of these changes begin to occur so early on. The findings in the study show that this maturation is largely beginning during years 9-12. This brain maturity correlates with a critical and formative period of time: children are undergoing rapid, neurological maturity at the same time that they are facing difficult social and academic decisions.

As a child grows, he or she becomes more able to control impulses and process complex concepts. In support of this observation the group discovered increasing scores on tasks that measured these skills. But how were these children able to have more impulse control and make more complex decisions? The group analyzed the data and were able to determine that anatomical and metabolic changes occurring during this window of development are responsible for this increase in abilities.

"We've learned that this is not a wait-and-see period of time," says Dr. Baron Nelson. "Dynamic changes are happening here and this gives us a real opportunity for intervention. We can help shape these kids as they grow."

CLEVELAND, Ohio (September 24, 2019)--Thanks to increased media attention, sexual assaults occurring in the military are finally getting the attention they deserve. However, most reports involve reproductive-aged women Veterans from recent service eras. A new study confirms the problem has a long history with assaults linked to numerous mental and physical problems. Study results will be presented during The North American Menopause Society (NAMS) Annual Meeting in Chicago, September 25 to 28, 2019.

Only recently has the problem of military sexual trauma (MST), defined as sexual assault and/or sexual harassment during military service, made its way out of the closet and into the headlines. The Veterans Health Administration (VA) instituted mandatory universal annual MST screening in 2003; an estimated one in four women Veterans report MST when screened by healthcare providers.

Not surprisingly, MST is associated with an increased risk for multiple physical and mental health concerns. However, research and clinical attention in this area has largely focused on younger women Veterans who served more recently. Little was known, until now, about MST among postmenopausal women Veterans.

In this new study, researchers examined the prevalence of MST and its physical and mental health-related comorbidities. In the sampling of postmenopausal women, 13% had a positive MST screen which was strongly associated with such mental health diagnoses as posttraumatic stress disorder, depression, and suicidal ideation. MST was also associated with multiple aging-related medical conditions, including insomnia, sleep apnea, and chronic pain.

"Although prior trauma is not often considered in the clinical care in this population, both VA and community providers caring for older women Veterans should recognize the prevalence and importance of MST when assessing patients' health concerns," says Dr. Carolyn Gibson, lead author of the study from the San Francisco VA Health Care System.

"These findings call attention to the need for additional research in this understudied population and underscore the importance of trauma screening regardless of a woman's age," says Dr. Stephanie Faubion, NAMS medical director.

CINCINNATI -- Three new studies by scientists at Cincinnati Children's Hospital Medical Center, in collaboration with researchers at the University of Cincinnati, highlight the relationship between air pollution and mental health in children.

A study to be published Sept. 25 in Environmental Health Perspectives found that short-term exposure to ambient air pollution was associated with exacerbations of psychiatric disorders in children one to two days later, as marked by increased utilization of the Cincinnati Children's emergency department for psychiatric issues. The study also found that children living in disadvantaged neighborhoods may be more susceptible to the effects of air pollution compared to other children, especially for disorders related to anxiety and suicidality.

The lead authors of this study are Cole Brokamp, PhD, and Patrick Ryan, PhD. They are researchers in the division of Biostatistics and Epidemiology at Cincinnati Children's. The article will be available at 9 am Sept. 25 at https://ehp.niehs.nih.gov/ehp4815.

"This study is the first to show an association between daily outdoor air pollution levels and increased symptoms of psychiatric disorders, like anxiety and suicidality, in children," says Dr. Brokamp. "More research is needed to confirm these findings, but it could lead to new prevention strategies for children experiencing symptoms related to a psychiatric disorder. The fact that children living in high poverty neighborhoods experienced greater health effects of air pollution could mean that pollutant and neighborhood stressors can have synergistic effects on psychiatric symptom severity and frequency."

Two other Cincinnati Children's studies were recently published that also link air pollution to children's mental health:

A study published in Environmental Research found an association between recent high traffic related air pollution (TRAP) exposure and higher generalized anxiety. The study is believed to be the first to use neuroimaging to link TRAP exposure, metabolic disturbances in the brain, and generalized anxiety symptoms among otherwise healthy children. The study found higher myoinositol concentrations in the brain - a marker of the brain's neuroinflammatory response to TRAP.

The lead authors of this study are Kelly Brunst, PhD, a researcher in the department of Environmental Health at the University of Cincinnati, and Kim Cecil, PhD, a researcher at Cincinnati Children's.

A study published in Environmental Research found that exposure to TRAP during early life and across childhood was significantly associated with self-reported depression and anxiety symptoms in 12 year olds. Similar findings have been reported in adults, but research showing clear connections between TRAP exposure and mental health in children has been limited.

The lead authors of the study are Kimberly Yolton, PhD, director of research in the division of General and Community Pediatrics at Cincinnati Children's, and Dr. Ryan.

"Collectively, these studies contribute to the growing body of evidence that exposure to air pollution during early life and childhood may contribute to depression, anxiety, and other mental health problems in adolescence," says Dr. Ryan. "More research is needed to replicate these findings and uncover underlying mechanisms for these associations."