Culture

BALTIMORE - Pediatricians and nurse practitioners report using several strategies to improve human papillomavirus (HPV) vaccination, yet also perceive barriers, according to a national American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) network study. Findings from the study will be presented during the Pediatric Academic Societies (PAS) 2019 Meeting, taking place on April 24 - May 1 in Baltimore.

A safe and effective vaccine that prevents HPV-attributable cancers has been available since 2006. Despite demonstrated safety and effectiveness, coverage rates for the HPV vaccine remain suboptimal, and considerably lower than coverage for other adolescent vaccinations.

The study examined barriers to HPV vaccination and strategies used to improve HPV vaccination rates in a sample of pediatricians and nurse practitioners from 19 states who participate in the AAP's primary care practice-based research network. As part of the NIH-funded STOP HPV trial, the lead respondent from 47 practices recruited from the PROS research network completed an online, confidential survey in 2018. The survey measured office characteristics, standard office procedures for and communication about HPV vaccination, and use of evidence-based strategies such as performance feedback, prompts, reminder-recall, and standing orders. Proportions and medians were calculated for categorical and continuous variables, respectively.

All respondents reported more than one barrier to HPV vaccination. The most commonly reported major barrier was parent refusal or delay (over 80%). Respondents reported approximately 30% (range 5%-75%) of parents of their 11 to 12-yr-old patients due for an HPV vaccine refused and 15% (range 5%-60%) hesitated without refusing. Other major barriers reported by respondents included the time required to discuss HPV vaccination with families (17% of practitioners), low proportion of adolescents coming in for well visits (13%), lack of training in providing a strong recommendation (11%), respondents sense that others may view that HPV vaccination can wait (9%), and challenges associated with administering HPV vaccine at acute or chronic care visits (7%).

The most commonly reported strategy to improve HPV vaccination rates was use of prompts when HPV vaccination is needed (89%). Respondents also reported that their practices commonly use tools to improve communication about HPV vaccination with parents and adolescents (87%) and receive performance feedback about HPV vaccination rates (83%). Only 17% of respondents cited that their practice uses reminder-recall messages specific to the HPV vaccine.

The study concluded that respondent-perceived barriers to HPV vaccination remain. Practices are already using a wide variety of strategies to improve delivery of this vaccine, yet room for improvement remains. Alexander Fiks, MD, FAAP, MSCE, the senior author on the abstract, primary care pediatrician at Children's Hospital of Philadelphia, PROS Director and associate director of the Center for Pediatric Clinical Effectiveness and researcher at PolicyLab, added: "The ongoing STOP HPV trial will test the effectiveness of distinct strategies, alone or in combination, to overcome barriers to vaccination and, if effective, may ultimately minimize the burden of HPV-related disease."

Margaret Wright, PhD, one of the authors of the study, will present findings from "Pediatric Practitioners Report Using Strategies to Improve HPV Vaccination, yet Barriers Persist: Results from the National AAP Pediatric Research in Office Settings (PROS) Network" on Monday, April 29 at 10:30 a.m. EDT. Reporters interested in an interview with Dr. Fiks should contact PAS2019@piercom.com.

The PAS 2019 Meeting brings together thousands of pediatricians and other health care providers to improve the health and well-being of children worldwide. For more information about the PAS 2019 Meeting, please visit http://www.pas-meeting.org.

LA JOLLA, CA--A family of cancer suppressive proteins, known as TET proteins, help regulate gene activity via their influence on chromosomal architecture. However, until now it wasn't entirely clear how genes were activated by TET proteins to make sure that cells perform their normal functions efficiently.

The team of La Jolla Institute for Immunology investigator Anjana Rao, Ph.D, addresses that question in the April 26, 2019, issue of the journal Science Immunology. They report that genetic deletion, or mutation, of TET2 and TET3 in mouse B cells damps down the generation of functional IgG antibodies, decreasing the effectiveness of immune responses.

Moreover, they identify a B cell gene that becomes aberrantly silenced in the absence of TET2 and TET3, highlighting how critical "epigenetic" control of gene expression is for healthy immune cell function and hinting at why TET loss promotes oncogenesis.

DNA can be loosely or tightly coiled--tight coiling silences genes buried within chromosomal twists, while gene expression proceeds as coils unwind and DNA becomes more accessible. This process is influenced by TET proteins, which modify the chemical structure of DNA by altering a methyl group attached to C, one of the four DNA bases A, C, T and G. This so-called "epigenetic regulation" by altering DNA accessibility or structure is a major strategy that cells use to switch genes on and off.

"Previously people knew that TET proteins were involved in suppressing cancer," says study-co-author Chan-Wang Jerry Lio, Ph.D., one of the study's two co-first authors. "But it was difficult to tease out what the normal function of TET genes was because mice developed cancer so rapidly when we deleted them."

The new study circumvents this issue by using an alternate "conditional knock-out" strategy in which experimenters deleted TET2 and TET3 in mature B cells at a time point of their choice in experimental mice. Five days later, they removed the mouse's B cells and performed a battery of molecular tests to compare their activity with B cells derived from normal mice in which TET2 and TET3 remained intact.

A critical difference was that when stimulated by an experimental pathogen, mutant B cells that lacked TET2 and TET3 produced an overabundance of a class of antibody called IgM, whereas normal control B cells churned out more effective antibodies classified as IgG or "gamma globulin".

"Antibodies come in different 'flavors'", explains Vipul Shukla, Ph.D., the study's other co-first author. "The standard flavor (IgM) does a poor job of activating other immune cells. So once a normal B cell encounters a pathogen, it tries to convert IgM antibodies to a more beneficial flavor to mount an effective immune response."

That "beneficial" flavor, known to immunologists as IgG, constitutes ~75% of all antibodies found in normal human serum and is what you received if you ever got an immunity-boosting gamma globulin shot.

Healthy B cells have no problem converting IgM to IgG using an innate gene editing trick called "class switching", in which protein tools snip out IgM-specific regions in a DNA strand and then paste in analogous IgG DNA sequences. That maneuver creates recombined genes that express IgG antibodies, which unlike IgM, are capable of neutralizing pathogens, helping other cells recognize invaders (including cancer cells), and maintaining an organism's well-being.

And that is where TET comes in. Rao's group found that mutant B cells lacking TET2 and TET3 flip this switch only poorly and instead remain stuck making IgM antibodies because they lack the requisite DNA splicing tool. Specifically, mutant cells lacking TET2 and TET3 do not make enough of a protein called AID, which actually executes the IgM-to-IgG splicing trick, simply because TET2 and TET3 were not available to demethylate and hence enhance expression of the AID gene. In mutant cells lacking TET2 and TET3, the AID gene likely remains methylated, inaccessible and silent, allowing IgM antibodies to predominate.

An inability to perform class switching has clinical consequences: patients who inherit mutations in the AID gene (which in humans is called AICDA) suffer an immune deficiency called hyper IgM syndrome, in which their B cells can't make the normal conversion of IgM to IgG antibodies. Those individuals are more vulnerable to severe infection and to malignancy.

TET genes have not yet been implicated in hyper IgM syndrome. But the revelation that the AID gene is a TET target makes unquestionable immunological sense to Lio in this context. "TET2 is the most frequently mutated gene in blood cancers including diffuse large B cell lymphomas, which suggests that it restrains cancer progression in normal B cells" he says. "More importantly, the full activity of TET proteins requires vitamin C. Our study may explain how a healthy diet may enhance our immune response."

Shukla concurs. "TET proteins are often inhibited in cancers, including cancers derived from B cells addressed here," he says. "An important rationale for this paper was to identify the normal function of TET proteins so that we better understand why cancers develop when TET genes are restrained."

COLUMBUS, Ohio - If you believe that great scientists are most creative when they're young, you are missing part of the story.

A new study of winners of the Nobel Prize in economics finds that there are two different life cycles of creativity, one that hits some people early in their career and another that more often strikes later in life.

In this study, the early peak was found for laureates in their mid-20s and the later peak for those in their mid-50s.

The research supports previous work by the authors that found similar patterns in the arts and other sciences.

"We believe what we found in this study isn't limited to economics, but could apply to creativity more generally," said Bruce Weinberg, lead author of the study and professor of economics at The Ohio State University.

"Many people believe that creativity is exclusively associated with youth, but it really depends on what kind of creativity you're talking about."

Weinberg did the study with David Galenson, professor of economics at the University of Chicago. Their study appears in a special issue of the journal De Economist.

In the study, the Nobel Prize winners who did their most groundbreaking work early in their career tended to be "conceptual" innovators.

These type of innovators "think outside the box," challenging conventional wisdom and tend to come up with new ideas suddenly. Conceptual innovators tend to peak early in their careers, before they become immersed in the already accepted theories of the field, Weinberg said.

But there is another kind of creativity, he said, which is found among "experimental" innovators. These innovators accumulate knowledge through their careers and find groundbreaking ways to analyze, interpret and synthesize that information into new ways of understanding.

The long periods of trial and error required for important experimental innovations make them tend to occur late in a Nobel laureate's career.

"Whether you hit your creative peak early or late in your career depends on whether you have a conceptual or experimental approach," Weinberg said.

The researchers took a novel, empirical approach to the study, which involved 31 laureates. They arranged the laureates on a list from the most experimental to most conceptual.

This ranking was based on specific, objective characteristics of the laureates' single most important work that are indicative of a conceptual or experimental approach.

For example, conceptual economists tend to use assumptions, proofs and equations and have a mathematical appendix or introduction to their papers.

Experimental economists rely on direct inference from facts, so their papers tended to have more references to specific items, such as places, time periods and industries or commodities.

After classifying the laureates, the researchers determined the age at which each laureate made his most important contribution to economics and could be considered at his creative peak.

They did this through a convention of how academics rate the value and influence of a research paper. A paper is more influential in the field when other scientists mention - or cite - the paper in their own work. So the more citations a paper accumulates, the more influential it is.

Weinberg and Galenson used two different methods to calculate at which age the laureates were cited most often and thus were at the height of their creativity.

The two methods found that conceptual laureates peaked at about either 29 or 25 years of age. Experimental laureates peaked when they were roughly twice as old - at about 57 in one method or the mid-50s in the other.

Most other research in this area has studied differences in peak ages of creativity between disciplines, such as physics versus medical sciences. These studies generally find small variations across disciplines, with creativity peaking in the mid-30s to early 40s in most scientific fields.

"These studies attribute differences in creative peaks to the nature of the scientific fields themselves, not to the scientists doing the work," Weinberg said.

"Our research suggests than when you're most creative is less a product of the scientific field that you're in and is more about how you approach the work you do."

Researchers have sought to identify the factors that promote or contribute to criminal persistence--that is, the likelihood that offenders will continue to offend. A new longitudinal study looked at the impact on criminal persistence of head injuries, which have been linked to increased levels of offending, among adolescents and early adults. It found that changes in individuals with head injuries were associated with increases in self-reported offending, and with violent offending in particular.

The study, by a researcher at the University of Nebraska at Omaha, appears in Justice Quarterly, a publication of the Academy of Criminal Justice Sciences.

"These results provide preliminary evidence that acquired neuropsychological deficits, and head injuries more directly, result in prolonged periods of criminal persistence," suggests Joseph A. Schwartz, professor of criminology and criminal justice at the University of Nebraska at Omaha, who authored the study.

The study drew on data from the Pathways to Desistance study of 1,336 previously adjudicated youth who were 14 to 19 years at the start and came from Philadelphia and Phoenix. The youth, who were mostly male and from a range of races and ethnicities, were interviewed over seven years about criminal behavior and contact with the criminal justice system. Nearly a fifth sustained one or more head injuries during the study and almost a third had sustained a head injury prior to the first interview.

In his work, Schwartz explored the effect of changes in individuals with head injuries on longitudinal trajectories of arrest and monthly reports of overall, violent, and nonviolent offending. He also considered factors such as impulse control, intelligence, pre-existing dysfunction of the prefrontal cortex, family support, and socioeconomic status.

Schwartz found that head injury is five to eight times more common among individuals involved with the criminal-justice system than in the general population. He also found that youth engaged in higher levels of overall and violent offending following a head injury. While Schwartz notes that it is not possible to describe the association between head injury and violent offending as causal, he points to strong evidence of significant changes in trends in offending following a head injury.

A less consistent pattern was seen in the association between head injury and nonviolent offending, indicating that head injury may affect specific forms of criminal persistence differentially. Youth who had a head injury were more likely to be arrested (or commit more nonviolent offenses) than those who didn't have such an injury, but the likelihood of arrest for those individuals who sustained an injury did not increase following an injury.

Schwartz notes that his results should be interpreted with caution because he was unable to examine directly the deficits underlying the association between head injury and criminal persistence, and because the measure of head injury was self-reported and did not address the severity of the injuries.

"The impact of head injury on offending behavior is likely the result of neuropsychological deficits that compromise normative brain development," suggests Schwartz. "We need more research into this critical issue, which would help us understand what sorts of treatment and intervention would work with people affected by head injuries and could contribute to reductions in overall crime."

Asthma, a common respiratory disease that causes wheezing, coughing and shortness of breath, is the most prevalent chronic respiratory disease worldwide. A new study, published April 30, 2019 in Lancet Respiratory Medicine, is the first large investigation to examine the differences in genetic risk factors for childhood-onset and adult-onset asthma.

This genome-wide association study (GWAS) found that childhood-onset asthma was associated with nearly three times as many genes as adult-onset asthma. Genes associated with adult onset asthma were a subset of those associated with childhood-onset asthma, nearly all with smaller effects on adult-onset asthma than on childhood-onset asthma.

The researchers also found that these childhood-onset genes were highly expressed in epithelial cells (skin). Both childhood-onset and adult-onset asthma genes were highly expressed in blood (immune) cells.

"This was the largest asthma-related GWAS yet attempted," said study co-author Carole Ober, PhD, professor and chair of the Department of Human Genetics at the University of Chicago, and her collaborator Hae Kyung Im, PhD, assistant professor in the Department of Medicine. "We found that the genes involved in adult-onset asthma are largely a subset of genes associated with childhood asthma. At later ages, however, the same genes tend to have smaller effects."

The authors concluded that different mechanisms cause the inception of asthma with onset in childhood compared to asthma with onset in adulthood. While both share an immunologic component, the origins of asthma in childhood involves defects in epithelial cell integrity similar to the defects that underlie other common childhood diseases, such as eczema and food allergies.

The researchers defined childhood-onset asthma as younger than 12 years of age. They defined adult-onset cases as those who developed the disease between the ages of 26 and 65.

The study used data from the UK Biobank, a large long-term study based in the United Kingdom that concentrates on the contributions of genetic predisposition and environmental exposure to the development of disease.

The researchers focused on data from 37,846 British individuals who reported an asthma diagnosis, including 9,433 adults who developed asthma as children, 21,564 adults with adult-onset asthma, and an additional 6,849 young adults who developed asthma between the ages from 12 to 25. They also developed a control group of 318,237 people 38 years old or older who did not have asthma.

The GWAS of childhood and adult asthma revealed 61 independent asthma-related genes. Fifty-six of the 61 were significant in childhood-onset asthma and 19 were significant in adult-onset disease. Twenty-eight of those loci had not been previously catalogued; 17 were significant for childhood onset only but only one was significant only for adult-onset asthma.

The authors add that both the "childhood-specific and shared loci were associated with development of asthma at younger ages and those alleles all had larger effects in childhood-onset compared to adult-onset asthma."

Researchers from Queen Mary University of London studied the effectiveness of one of the largest ever national quality improvement programmes in the National Health Service (NHS) and found no improvement in patient survival.

The overall risk of death after inpatient surgery within the NHS is one in 65. However, one in ten patients undergoing emergency bowel surgery die within 30 days.

The Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) trial, which was funded by the National Institute for Health Research (NIHR) and published in The Lancet, tested the effectiveness of a national quality improvement programme in 93 NHS hospitals.

The trial involved patients aged 40 years or older, undergoing emergency major bowel surgery. Data were analysed for 15,856 patients to test whether hospital staff could improve survival by making major improvements to the quality of patient care. There were 37 quality improvements which included more involvement of senior doctors (consultants) in decision making, better assessment of patient risk before and after surgery, consultant presence during surgery and critical admission after surgery.

The researchers found that such extensive changes were too difficult to implement in a short period of time. The 90-day mortality rate was 16 per cent in both the usual care group and Quality Improvement groups, meaning the team found no survival benefit from the programme.

Senior author, Rupert Pearse, Professor and Consultant in Intensive Care Medicine at Queen Mary University of London said: "The main message from this trial is that improving the quality of complex patient care pathways is much harder than we expected. Healthcare leaders, such as senior doctors and nurses, need more dedicated time and resources to improve patient care."

Some health care professionals have argued that quality improvement programmes are ineffective. Despite this, health-care policy is promoting their widespread use to drive large-scale change. The findings of the EPOCH trial suggest this approach will not work unless hospital leaders have the resources to make changes that last.

Before the EPOCH trial, most experts believed that poor awareness of the number of deaths after emergency abdominal surgery was the main reason for poor patient care.

Professor Pearse said: "We now understand the problem better. Clinicians were too busy delivering patient care and had no spare time to improve it. Quality improvement programmes are not a quick or easy solution to improving NHS patient care. We are now taking a much more realistic approach to this work."

The findings suggest future quality improvement programmes should implement fewer changes over a longer time period, and ensure doctors and nurses leading these changes have enough time in their working day to make improvements in patient care.

Professor Pearse added: "This trial tells us why our quality improvement didn't work and what we need to do differently."

This learning has already been shared with teams from the ongoing National Emergency Laparotomy Audit (NELA, http://www.nela.org.uk) and the Emergency Laparotomy Collaborative (ELC) project running across England's Academic Health Science Networks (AHSNs) and in Wales, between now and 2020.

Abundant and healthy wildlife populations are a cultural and ecological treasure in the United States. Over time, however, the decisions about how agencies manage wildlife have become highly contested: How should managers handle human-wildlife conflict, endangered species restoration and predator control?

A new 50-state study on America's Wildlife Values -- the largest and first of its kind -- led by researchers at Colorado State University and The Ohio State University describes individuals' values toward wildlife across states.

Researchers found large declines over time in several states for the group of people defined as traditionalists, or those who believe animals should be used for purposes that benefit humans, like hunting and medical research.

Mutualists, on the other hand, believe that animals deserve the same rights as humans. They view animals as companions and part of their social networks, and project human traits onto animals.

"What's surprising is that the decline in traditionalists in some states is happening at a really rapid pace," said Michael Manfredo, one of the study's lead investigators and head of the Department of Human Dimensions of Natural Resources at CSU.

Researchers also surveyed fish and wildlife agency leaders and staff from 30 states for this project. While diversity continues to grow across the United States, the wildlife profession is dominated by white males: 91 percent of agency respondents identified as white and 72 percent identified as male.

Implications for wildlife managers

The study's findings have implications for wildlife managers who want to engage more diverse state residents in conservation and management efforts. Results from the research show that 50 percent of Hispanic residents and 43 percent of Asians identified as mutualists, compared to 32 percent of Whites, and both groups have half as many traditionalists.

Hispanics and Asians are far less likely than Whites to have ever hunted or fished, according to study data.

The U.S. Census Bureau projects that by 2045, current minority populations will outnumber white, non-Hispanic populations.

As minority populations continue to grow, wildlife agencies will need to engage with them and work together on fish and wildlife management.

Ed Carter, president of the Association of Fish and Wildlife Agencies and executive director of the Tennessee Wildlife Resources Agency, said the study's findings will help state agencies as they interact with traditional partners as well as the rapidly-changing demographics across a wide range of interests and organizations.

"State fish and wildlife agencies have conserved, restored, and sustainably managed many species of fish, wildlife and habitats for hunting and fishing for well over 100 years," he said.

While often associated with species pursued by anglers and hunters, the restoration success stories for imperiled species among wildlife agencies are wide-ranging, Carter noted.

"There is no single pathway to create broader relevancy for state fish and wildlife agencies. This study will help agencies identify and challenge internal assumptions about who 'the public' is and what 'the public' wants or believes."

Fewer people believe animals exist for humans' benefit

Findings from this project build on three sources of data: 2004 data on public values from the 19-state Wildlife Values in the West study, 2018 data on public values from a random sample of nearly 45,000 people in 50 states, and 2018 data on fish and wildlife agency culture from 30 states.

From 2004 to 2018, researchers found that, overall, Western states had a 5.7 percent decrease in traditionalists and a 4.7 percent increase in mutualists. But results varied considerably by state: California had a decline in traditionalists from 28 to 18 percent, while North Dakota stayed constant over the same timeframe.

Across the U.S., traditionalists make up 28 percent of the population, and mutualists make up 35 percent of the population. (Learn more about the four wildlife value orientation types: https://sites.warnercnr.colostate.edu/wildlifevalues/home-page/what-are-value-orientations/)

The 2018 survey on public values included questions on high-profile predator conflict issues, Including lethal removal of coyotes, bears and wolves in different scenarios.

On the question of whether coyotes who kill pets should be lethally removed, nearly 60 percent of residents in North and South Dakota, Wyoming, Mississippi and Alabama agreed, while only about 30 percent of residents in California, Arizona, Nevada, Massachusetts, Rhode Island and Connecticut thought the animal should be killed.

Modernization is driving changes in values

The research team said that the decline in the traditionalist group is occurring due to modernization, which is linked to people obtaining higher levels of income, moving to more urban areas, and achieving higher levels of education.

"As income, education and urbanization increase, we see people adopting a more modernized lifestyle, resulting in less direct experience with wildlife," explained Tara Teel, one of the lead investigators and a professor at CSU.

"People aren't as likely to interact with wildlife in their day-to-day lives," she added. "Instead, they learn about these animals in indirect ways, by seeing them on television or social media, where animals may be depicted as more human-like. This helps shape a new way of thinking about wildlife and wildlife-related issues""

Manfredo said that these values are established at a very young age and are slow to change, which makes these findings so interesting. For so much of human history, values provided stability across generations. But the remarkable changes of the past century have produced a rapid cultural shift.

Intergenerational value change is also accompanied by changes in immigration rates across states. "That's likely what's happening in some of the states that are showing change at a very high rate," Manfredo said.

The research team found that when a traditionalist orientation is more common among people in a state, there is greater support for private property rights over protecting endangered fish and wildlife and prioritizing economic growth over environmental protection.

Traditionalist-heavy states also have greater proportions of hunters and anglers. The opposite is true for states with high numbers of mutualists.

"Our work suggests that the value shift is due to changing societal conditions," said Alia Dietsch, one of the study's co-investigators and an assistant professor at The Ohio State University. "To help wildlife conservation and management efforts remain relevant, it will be important to continue to monitor these changes into the future."

The study, based on interviews with 20 military veterans on a US college campus found that civilians' trivial concerns, inappropriate clothing, lack of respect for lecturers and willingness to criticise the President of the United States clashed with the conservative values instilled in ex service personnel. These cultural differences led to veterans arguing with other students, and becoming increasingly isolated and ostracized from their peers.

"Veterans are one and a half times more likely to commit suicide than civilians, and they're also at a greater risk of depression, suicide, and substance abuse," says William T. Howe Jr, the author of the study from the University of Oklahoma.

"The situation is so bad that veteran suicide has been classified as an epidemic, and a national call has gone out to researchers to try to address this issue."

As part of the effort, Howe interviewed 20 ex service personnel who attend the University of Oklahoma. His study, published in the Journal of Intercultural Communication Research found that despite veterans being the same age as other college students, military service had instilled them with vastly different cultural values, which meant they experienced 'cultural shock' when going from a military environment to a college campus. Interestingly this was true for both combat and non-combat veterans, suggesting that it is not combat that is making it difficult for veterans to return to civilian life, but military training and an adoption of military culture.

"Veterans have been through tougher times, even in basic training alone, than many people may realise, therefore to them complaining about writing a paper is silly when they compare it to their past experiences of facing death," says Howe.

As well as being unable to relate to civilians feeling stress over 'trivial' matters like exams, ex military personnel were often upset by the way their classmates dressed, and their perceived lack of respect towards authority figures.

"In the military good hygiene, grooming, and making sure your clothes are clean and professional are of vital importance, so to a veteran, students coming to class not groomed properly, or in clothes that they perceive as being too casual conflicts with their military values," says Howe.

"In addition, while lecturers at university often encourage open discussion, this is distinctly different from what veterans experienced in the military, where communication is top-down and upward dissent is discouraged. Veterans often got angry when other students talked during lectures."

Finally, while most students enjoyed talking about politics, veterans were very uncomfortable and unwilling to do this.
"The United States Military has very conservative and strict rules that individuals must abide by. For example they are not allowed to criticise the President - doing so could result in forfeiture of pay, dishonorable discharge, and even imprisonment" says Howe.

The culture clash was often exacerbated by differences in the style of language used by veterans and civilians. For example veterans often used military jargon and acronyms when interacting with civilians, and would grow frustrated when other students couldn't understand them. Veterans also felt that the profanities and dark humor they used was often misinterpreted by civilians and seen as crude and vulgar when, for the veterans, this was a normal way of speaking.

"Another issue was the directness of communication by veterans," says Howe. "In the army it is seen as natural to say "do this" and expect others to do it. However this sort of speech usually resulted in the veterans being disliked by others and ostracized from the group."

The study showed that veterans responded to this culture clash in three separate ways: by trying to see things from the perspective of the other students, by verbally lashing out and confronting the person, and finally by remaining silent.

By far the most commonly used strategy was silence: 100% of veterans interviewed said that they often kept quiet or refused to speak their mind in class. The reasons for this varied from not wanting to talk about politics to being afraid of getting in trouble for saying something others would perceive as inappropriate. However eventually some veterans erupted and had verbal conflicts with others.

"Many veterans entered a 'spiral of silence', and in doing so continued to feel more and more isolated," says Howe. "Any prolonged silence about a troubling issue is not good for an individual, and the worry is that this extreme isolation could lead to a feeling that life is not worth living and a decision to permanently silence themselves with suicide."

According to Howe the findings show that more needs to be done to help veterans and civilians understand one another, and to reintegrate veterans into society.

"The military takes 8-12 weeks to strip military members of their civilian culture and replace it with a military culture. To not spend the same time and effort to reverse the process at the end of a servicemember's time in uniform is irresponsible", says Howe.

For the first time, physicists at the University of Basel have succeeded in measuring the magnetic properties of atomically thin van der Waals materials on the nanoscale. They used diamond quantum sensors to determine the strength of the magnetization of individual atomic layers of the material chromium triiodide. In addition, they found a long-sought explanation for the unusual magnetic properties of the material. The journal Science has published the findings.

The use of atomically thin, two-dimensional van der Waals materials promises innovations in numerous fields in science and technology. Scientists around the world are constantly exploring new ways to stack different single atomic layers and thus engineer new materials with unique, emerging properties.

These super-thin composite materials are held together by van der Waals forces and often behave differently to bulk crystals of the same material. Atomically thin van der Waals materials include insulators, semiconductors, superconductors and a few materials with magnetic properties. Their use in spintronics or ultra-compact magnetic memory media is highly promising.

The first quantitative measurement of magnetization

Until now, it has not been possible to determine the strength, alignment and structure of these magnets quantitatively nor on the nanoscale. The team headed by Georg-H.-Endress Professor Patrick Maletinsky from the Department of Physics and the Swiss Nanoscience Institute at the University of Basel have demonstrated that the use of diamond tips decorated with single electron spins in an atomic force microscope is ideally suited to these types of studies.

"Our method, which uses the individual spins in diamond color centers as sensors, opens up a whole new field. The magnetic properties of two-dimensional materials can now be studied on the nanoscale and even in a quantitative manner. Our innovative quantum sensors are perfectly suited to this complex task," says Maletinsky.

The number of layers is critical

Using this technology which was originally developed in Basel and which is based on a single electron spin, the scientists collaborated with researchers from the University of Geneva to determine the magnetic properties of single atomic layers of chromium triiodide (CrI3). The researchers were thus able to find the answer to a key scientific question about the magnetism of this material.

As a three-dimensional, bulk crystal, chromium triiodide is fully magnetically ordered. In the case of few atomic layers, however, only stacks with an odd number of atomic layers show a non-zero magnetization. Stacks with an even number of layers exhibit an antiferromagnetic behavior; i.e. they are not magnetized. The cause of this "even/odd-effect" and the discrepancy to bulk material was previously unknown.

Strain as the cause

Maletinsky's team was able to demonstrate that this phenomenon is due to the specific atomic arrangement of the layers. During sample preparation, the individual chromium triiodide layers slightly move against one another. The resulting strain in the lattice means the spins of successive layers are unable to align in the same direction; instead, the spin direction alternates in the layers. With an even number of layers, the magnetization of the layers cancel out; with an odd number, the strength of the measured magnetization corresponds to that of a single layer.

However, when the strain in the stack is released - for example, by puncturing the sample - the spins of all layers can align in the same direction, as is also observed in bulk crystals. The magnetic strength of the entire stack is then consistent with the sum of the individual layers.

The work conducted by the Basel scientists thereby not only answers a key question about two-dimensional van der Waals magnets, it also opens interesting perspectives on how their innovative quantum sensors can be used in the future to study two-dimensional magnets in order to contribute to the development of novel electronic components.

CHAMPAIGN, Ill. -- By injecting cells that support blood vessel growth into muscles depleted by inactivity, researchers say they are able to help restore muscle mass lost as a result of immobility.

The research, conducted in adult mice, involved injections of cells called pericytes (PERRY-sites), which are known to promote blood vessel growth and dilation in tissues throughout the body. The injections occurred at the end of a two-week period during which the mice were prevented from contracting the muscles in one of their hind legs.

"Just as the mice were becoming mobile again, we transplanted the pericytes and we found that there was full recovery of both muscle mass and the vasculature, too," said University of Illinois kinesiology and community health professor Marni Boppart, who led the research. The mice that received the injections had significantly better improvement than those that regained mobility without the injections. Boppart is a researcher in the Beckman Institute for Advanced Science and Technology at Illinois.

The team also observed that muscle immobility itself led to a significant decline in the abundance of pericytes in the affected muscle tissues.

"This has never been documented before," Boppart said.

Video available

The research is part of a long-term effort to understand the factors that contribute to the loss of muscle mass - in particular as a result of immobility.

"We know that if you are under a condition of disuse - for example, as a result of long-term bed rest, or the immobilization of a body part in a cast - you lose muscle mass," Boppart said. "And even when you come out of that state of immobility and you start moving your muscles again, there's this really long, slow process of recovery."

Older adults might never fully rebuild the lost muscle mass after a period of immobility, she said.

"They can't recover, they become disabled, and there's this downward spiral," Boppart said. "They may become institutionalized and experience early mortality."

Researchers have long searched for clinical interventions that can help restore lost muscle mass and impaired function as a result of inactivity, Boppart said.

"To my knowledge, no one has demonstrated that anything has been effective in improving the recovery process," she said. "We're excited by the new findings because we hope to one day use these cells or biomaterials derived from these cells to help restore lost muscle mass," particularly in elderly or disabled adults who are most likely to see a decline in their overall health as a result of the decline in muscle viability.

The team reports the new findings in The FASEB Journal.

Fossil fuels are the backbone of the global petrochemicals industry, which provides the world's growing population with fuels, plastics, clothing, fertilizers and more. A new research paper, published today in Science, charts a course for how an alternative technology -- renewable electrosynthesis -- could usher in a more sustainable chemical industry, and ultimately enable us to leave much more oil and gas in the ground.

Phil De Luna is the paper's lead author. His research at University of Toronto Engineering involved designing and testing catalysts for electrosynthesis, and last November he was named to the Forbes 30 under 30 list of innovators in the category of Energy. He and his supervisor Professor Ted Sargent collaborated on the paper with an international team of researchers from Stanford University and TOTAL American Services, Inc.

U of T Engineering News sat down with De Luna to learn more about how renewable electrosynthesis could take the "petro" out of petrochemicals.

Can you describe the challenge you're trying to solve?

Our society is addicted to fossil fuels -- they're in everything from the plastics in your phone to the synthetic fibres in your clothes. A growing world population and rising standards of living are driving demand higher every year.

Changing the system requires a massive global transformation. In some areas, we have alternatives -- for example, electric vehicles can replace internal combustion engines. Renewable electrosynthesis could do something similar for the petrochemical industry.

What is renewable electrosynthesis?

Think about what the petrochemical industry does: it takes heavy, long-chain carbon molecules and uses high heat and pressure to break them down into basic chemical building blocks. Then, those building blocks get reassembled into plastics, fertilizers, fibres, etc.

Imagine that instead of using fossil fuels, you could use CO2 from the air. And instead of doing the reactions at high temperatures and pressures, you could make the chemical building blocks at room temperature using innovative catalysts and electricity from renewable sources, such as solar or hydro power. That's renewable electrosynthesis.

Once we do that initial transformation, the chemical building blocks fit into our existing infrastructure, so there is no change in the quality of the products. If you do it right, the overall process is carbon neutral or even carbon negative if powered completely by renewable energy

Plants also take CO2 from the air and make it into materials such as wood, paper and cotton. What is the advantage of electrosynthesis?

The advantages are speed and throughput. Plants are great at turning CO2 into materials, but they also use their energy for things like metabolism and reproduction, so they aren't very efficient. It can take 10 to 15 years to grow a tonne of useable wood. Electrosynthesis would be like putting the CO2 capture and conversion power of 50,000 trees into a box the size of a refrigerator.

Why don't we do this today?

It comes down to cost; you need to prove that the cost to make a chemical building block via electrosynthesis is on par with the cost of producing it the conventional way.

Right now there are some limited applications. For example, most of the hydrogen used to upgrade heavy oil comes from natural gas, but about 4% is now produced by electrolysis, that is, using electricity to split water into hydrogen and oxygen. In the future, we could do something similar for carbon-based building blocks.

What did your analysis find?

We determined that there are two main factors: the first is the cost of electricity itself, and the second is the electrical-to-chemical conversion efficiency.

In order to be competitive with conventional methods, electricity needs to cost less than four cents per kilowatt-hour, and the electrical-to-chemical conversion efficiency needs to be 60% or greater.

How close are we?

There are some places in the world where renewable energy from solar can cost as little as two or three cents per kilowatt-hour. Even in a place like Quebec, which has abundant hydro power, there are times of the year where electricity is sold at negative prices, because there is no way to store it. So, from an economic potential perspective, I think we're getting close in a number of important jurisdictions.

Designing catalysts that can raise the electrical-to-chemical conversion efficiency is harder, and it's what I spent my thesis doing. For ethylene, the best I've seen is about 35% efficiency, but for some other building blocks, such as carbon monoxide, we're approaching 50%.

Of course, all this has been done in labs -- it's a lot harder to scale that up to a plant that can make kilotonnes per day. But I think there are some applications out there that show promise.

Can you give an example of what renewable electrosynthesis would look like?

Let's take ethylene, which is by volume the world's most-produced petrochemical. You could in theory make ethylene using CO2 from the air -- or from an exhaust pipe -- using renewable electricity and the right catalyst. You could sell the ethylene to a plastic manufacturer, who would make it into plastic bags or lawn chairs or whatever.

At the end of its life, you could incinerate this plastic -- or any other carbon-intensive form of waste -- capture the CO2, and start the process all over again. In other words, you've closed the carbon loop and eliminated the need for fossil fuels.

What do you think the focus of future research should be?

I've actually just taken a position as the Program Director of the Clean Energy Materials Challenge Program at the National Research Council of Canada. I am building a $21M collaborative research program, so this is something I think about a lot!

We're currently targeting parts of the existing petrochemical supply chain that could easily be converted to electrosynthesis. There the example I mentioned above, which is the production of hydrogen for oil and gas upgrading using electrolysis.

Another good building block to target would be carbon monoxide, which today is primarily produced from burning coal. We know how to make it via electrosynthesis, so if we could get the efficiency up, that would be a drop-in solution.

How does renewable electrosynthesis fit into the large landscape of strategies to reduce emissions and combat climate change?

I've always said that there's no silver bullet -- instead I think what we need what I call a "silver buckshot" approach. We need recycled building materials, we need more efficient LEDs for lighting, we need better solar cells and better batteries.

But even if emissions from the electricity grid and the transportation network dropped to zero tomorrow, it wouldn't do anything to help the petrochemical industry that supplies so many of the products we use every day. If we can start by electrifying portions of the supply chain, that's the first step to building an alternative system.

A University of Arizona-led research team has shown that evolution is driven by species interaction within a community.

All living things exist within communities, where they depend on resources or services provided by other species. As community members change, so do the products the species depend on and share. The late George Gaylord Simpson, who was a professor of geosciences at the UA and one of the most influential evolutionary thinkers of the last century, proposed that these fluctuating dependencies should determine the speed of evolution.

The theory has been notoriously difficult to test because species interactions are both ubiquitous and ephemeral, said UA ecology and evolutionary biology professor Alexander Badyaev. But he and his team think they've found a way by examining evolution of biochemical pathways that produce color diversity in birds.

Badyaev and his co-authors showed that the way biochemical processes are structured in birds holds the key to understanding how species gain and lose their reliance on others in their communities. Consequently, this dictates how quickly species can diversify and evolve.

The new study, which was published in Nature Communications earlier this month, both confirms this prediction and reveals the mechanisms that show how it works.

Badyaev studied the evolution of the pathways by which birds convert dietary carotenoids into molecules necessary for everything from vision to the immune system to feather pigmentation.

The team, which included undergraduate and graduate students, and a postdoctoral fellow in Badyaev's lab, built and tested the structure of thousands of carotenoid biochemical pathways in nearly 300 bird species. Then, they explored how the pathways had changed over the last 50 million of years.

"The importance of carotenoids for multiple functions contrasts with birds' inability to create carotenoids themselves," Badyaev said. "So a species deriving its dietary carotenoids from a single food source is hostage to the source's disappearance."

The solution resides in the structure of the biochemical pathways, where the same molecules might be interchangeably produced by different dietary carotenoids. Not only does this enable species to reliably receive their essential carotenoids despite environmental fluctuations, it also allows birds to explore additional biochemical pathways. Badyaev calls this "internalizing control."

"Think about hanging by a rope off a cliff. With one rope, if it disappears, you die. If you have two and one fails, you get to live. But having a third safety rope allows enough stability that you can make something out of the first two - like a ladder - and thus take control of your trajectory while the stability lasts," Badyaev said.

His team found that when species temporarily internalize control over their carotenoid production by capitalizing on multiple sources of carotenoids, they evolve at exceptionally high rates and produce some of the most extravagantly colored birds in the world.

"But the moment you do this, you become susceptible to new external controls, and then the cycle repeats itself," he said. "This is because both gains and losses of external controls occur with equal frequency."

This research builds on both Darwin's theory of evolution by natural selection and Simpson's idea that an organism's evolution is dependent on others in their community.

"It shows how adaptation and evolutionary change are linked mechanistically," Badyaev said. "It shows why gaining and losing internal control is a key feature of evolution."

Leuven, Belgium - Societies and schools are facing new, culturally diverse populations and how they respond to these changes can have lasting impacts for everyone involved. Examining middle school diversity policies, a team of researchers from the University of Leuven, Belgium and the Queen's University Belfast, UK, found that in schools with multicultural-based policies, ethnic minority students achieved just as well and felt that they belonged just as much as their majority peers. They also found that in schools that ignore or reject diversity, ethnic minority students had worse grades and felt that they belonged less in the school than their majority peers.

"Approaches that ignore diversity, with rhetoric like 'I don't see color', or those that reject diversity, such as banning headscarves, may intend to minimize discrimination, but in reality these approaches can be harmful for marginalized groups," says Dr. Laura Celeste a social and cultural psychology researcher and lead author of the study.

The research appears in the journal Personality and Social Psychology Bulletin, a publication of the Society for Personality and Social Psychology.

Much of the prior work on assimilation, diversity, and immigration, comes from a North American perspective, according to Celeste and colleagues. They wanted to understand the European experience, which has its own cultural identities, histories, and experiences.

The psychologists assessed policies at over 60 Belgian middle schools, as well as a total of 1,747 minority and 1,384 majority students' school belonging and achievement (self-reported grades) 1 year later.

They found in their initial assessments that minority students reported significantly less belonging (M = 3.52) and lower grades (M = 59.28) than majority peers (M = 3.70 and M = 63.14), respectively. In schools with "multiculturalism" polices, minority students reported higher class grades by the end of the year and those with "colorblindness" polices actually saw grades go down among minority students.

Celeste and colleagues note that other research tracking middle through high school students shows that those who feel less belonging in school are "at risk of disengagement, underachievement, and early school leaving, with lasting consequences for their future life chances in our post-industrial economies."

"These results are also in line with previous research that shows, for instance, how workplace diversity policies can affect relational and performance-related outcomes in organizations," says Celeste.

Popular electronic cigarette (e-cigarette) products sold in the U.S. were contaminated with bacterial and fungal toxins, according to new research from Harvard T.H. Chan School of Public Health.

The study, which examined 75 popular e-cigarette products--cartridges (single use) and e-liquids (refillable material)--found that 27% contained traces of endotoxin, a microbial agent found on Gram-negative bacteria, and that 81% contained traces of glucan, which is found in the cell walls of most fungi. Exposure to these microbial toxins has been associated with myriad health problems in humans, including asthma, reduced lung function, and inflammation.

"Airborne Gram-negative bacterial endotoxin and fungal-derived glucans have been shown to cause acute and chronic respiratory effects in occupational and environmental settings," said David Christiani, Elkan Blout Professor of Environmental Genetics and senior author of the study. "Finding these toxins in e-cigarette products adds to the growing concerns about the potential for adverse respiratory effects in users."

The study will be published online in Environmental Health Perspectives on April 24, 2019.

The use of e-cigarettes has been steadily climbing in recent years, especially among high school and middle school students. It's estimated that more than three million high school students used e-cigarettes in 2018, up from 220,000 in 2011. Previous research from Harvard Chan School has shown that chemicals linked with severe respiratory disease are found in common e-cigarette flavors. Moreover, research by investigators conducted over many decades has shown chronic lung impairment in populations exposed to airborne biological contaminants. Yet, according to the authors, no research exists on the potential contamination of e-cigarettes with microbes or microbial toxins.

For this study, the researchers selected 37 e-cigarette cartridges, sometimes referred to as "cigalikes," and 38 e-liquid products, which can be used to refill certain cartridges, from the 10 top-selling U.S. brands. The products were classified into four different flavor categories: tobacco, menthol, fruit, and other. All of the products were then screened for the presence of endotoxin and glucan.

The findings showed that 17 of 75 products (23%) contained detectable concentrations of endotoxin and that 61 of 75 products (81%) contained detectable concentrations of glucan. Further analysis showed that cartridge samples had 3.2 times higher concentrations of glucan than the e-liquid samples. Glucan concentrations were also significantly higher in tobacco- and menthol-flavored products than in fruit-flavored products. The study also found that endotoxin concentrations were higher in fruit-flavored products, indicating that raw materials used in the production of flavors might be a source of microbial contamination.

The researchers noted that the contamination of the products could have occurred at any point during the production of the ingredients or of the finished e-cigarette product. They hypothesized that cotton wicks used in e-cigarette cartridges may be one potential source of contamination, as both endotoxin and glucan are known contaminants of cotton fibers.

"In addition to inhaling harmful chemicals, e-cig users could also be exposed to biological contaminants like endotoxin and glucan," said Mi-Sun Lee, research fellow and lead author of the paper. "These new findings should be considered when developing regulatory policies for e-cigarettes."

Joseph Allen, assistant professor of exposure assessment science, was also a co-author.

The precious chemistry of a plant used for 2000 years in traditional Chinese medicine has been unlocked in a project that raises the prospect of rapid access to a wide array of therapeutic drugs.

Carried out by CEPAMS - a partnership between the Chinese Academy of Sciences and the John Innes Centre - the project has successfully delivered a high-quality reference genome of the mint-family member Scutellaria baicalensis Georgi.

The plant, commonly known as Chinese Skullcap, is well-known in Traditional Chinese Medicine (TCM) and is cultivated worldwide for its therapeutic properties.

Preparations of its dried roots, 'Huang Qin', show pharmacological activities conferred by novel compounds called flavonoids, including antibacterial, antiviral, antioxidant, anti-cancer, liver-protective and neuroprotective properties.

Despite the commercial interest and increasing demand for Scutellaria, improvements through breeding have been limited by a lack of genome information.

The team took DNA from a single plant at the Shanghai Chenshan Botanical Garden and used a combination of sequencing strategies to assemble 93% of the genome organised into 9 subsets of information or "pseudo chromosomes."

The development means that researchers are now able to identify the genes that produce a wealth of valuable compounds, and then turn them into drug candidates using metabolic engineering techniques in the lab.

The sequencing project outlined in the journal Molecular Plant, also provides a reference gateway for genetic exploration of other valuable members of the Lamiaceae or mint family.

"When I started getting the analysis back on the genome sequence it was like a revelation: it showed at a fundamental level how the pathway to valuable compounds evolved." says Professor Cathie Martin of the John Innes Centre and one of the authors of the study.

"The sequence is so good that it can improve the understanding of all the other genome sequences in the mint family. This is a large family of plants that is hugely important in Traditional Chinese Medicine and flavourings."

This study highlights the current revival in TCM following the award of the Nobel Prize for Physiology and Medicine in 2015 to Professor You-you Tu for her discovery of artemisinin as a broad spectrum anti-malarial from Artemesia annua (wormwood).

Since then, pharmacology has started examining the healing properties of preparations from plants listed in the traditional texts, such as Shennong Bencaojing (The Divine Farmer's Materia Medica) written between 200 and 250 AD. Such preparations have recently been reported as effective against a variety of complaints including as complementary cancer treatments.

Work on the reference genome and sequences from members of the same family has already started to deliver valuable information that could be applied to development of a wider range of remedies.

"This particular plant makes the bioactive compounds in the root, which means you have to wait three years for the plant to get big enough and of course in taking the root you destroy the plant," said Professor Martin.

"We've screened some members of the same family that make similar compounds in the leaves which means you could get more sustainable therapeutics taken in a different way," she added.