Culture

A comprehensive analysis of sewage collected in 74 cities in 60 countries has yielded the first, comparable global data, which show the levels and types of antimicrobial resistant bacteria that are present in mainly healthy people in these countries. The National Food Institute, Technical University of Denmark, headed the study, which was conducted by an international team of researchers.

In a metagenomics study, the researchers have mapped out all the DNA material in the sewage samples and found that according to antimicrobial resistance the world's countries fall within two groups. North America, Western Europe, Australia and New Zealand generally have the lowest levels of antimicrobial resistance, while Asia, Africa and South America have the highest levels.

Brazil, India and Vietnam have the greatest diversity in resistance genes, while Australia and New Zealand have the lowest.

Sanitation and health closely linked to antimicrobial resistance

According to the researchers, the use of antimicrobials only explains a minor part of the occurrence of antimicrobial resistance in the various countries. Therefore, the researchers have searched for other factors that could be either drivers for or indicators of the occurrence of resistant bacteria. In this work, they have used several comprehensive data sets from the World Bank, which e.g. have measured the countries' health status and stage of development.

The researchers' work shows that most of the variables, which are associated with the occurrence of antimicrobial resistance in a country, are related to the sanitary conditions in the country and the population's general state of health.

"In the fight against antimicrobial resistance, our findings suggest that it would be a very effective strategy if concerted efforts were made to improve sanitary conditions in countries with high levels of antimicrobial resistance," Professor Frank Aarestrup from the National Food Institute and head of the study says.

Using the same data from the World Bank, the researchers have also predicted the levels of antimicrobial resistance in 259 countries/territories and they have drawn up a world map of resistance in healthy populations. According to their estimates, the Netherlands, New Zealand and Sweden have the lowest levels of resistance, whereas Tanzania, Vietnam and Nigeria have the highest levels. According to the estimates, Denmark has the sixth lowest level of antimicrobial resistance.

Reusable data

Contrary to data from traditional methods of analysis, raw data from metagenomics studies can be reused to examine other problems. The researchers from the sewage project are e.g. using data from the study to analyze the occurrence of other disease-causing microorganisms in the sewage.

As more resistance genes emerge in the future, researchers will also be able to reanalyse publicly available raw data from metagenomics studies to quickly uncover how these genes have emerged and spread.

A step closer to a global surveillance system

The researchers will use the experience gained from the project to fulfill their overall ambition of developing a worldwide surveillance system that can continuously monitor the occurrence and spread of disease-causing microorganisms and antimicrobial resistance.

"Analysing sewage can quickly and relatively cheaply show exactly which bacteria abound in an area--and collecting and analysing sewage doesn't require ethical approval, as the material cannot be traced back to individuals. Both parameters help to make a surveillance system via sewage a viable option--also in developing countries," Professor Frank Aarestrup explains.

The researchers' ambition is to develop a system, which makes it possible to exchange and interpret information in real time. As such, it would be possible to use the global surveillance data e.g. to manage diseases that threaten to spread beyond a country's borders and develop into pandemics, such as Ebola, measles, polio or cholera.

WASHINGTON--The Endocrine Society is commemorating International Women's day with its March 2019 Women in Endocrinology Collection, a special online thematic issue of peer-reviewed journal articles.

Women now make up nearly one-half of United States medical school graduates, up from just 7 percent 50 years ago. However, medicine remains a male-dominated field and there are less female practicing physicians. Female researchers also remain a minority, and on average publish fewer papers than their male counterparts, which can hinder their future career prospects.

"I am very happy and honoured to be a part of those representing women in endocrinology and grateful that my research was selected to be featured alongside such inspiring and talented women," said Su Young Han, Ph.D., research fellow of the University of Otago in Dunedin, New Zealand. "I feel grateful to have this opportunity to share my science, and this collection provides visibility that I would have never had before."

Nominations had to be published in an Endocrine Society journal within the past two years and include a woman first or senior author to be eligible. The research community nominated papers from female academics at all stages of their career--current or retired, early-career or established, well-known or up-and-coming academics from the United States or international research community.

"It is important to celebrate and support women in science, including endocrinology, as they may serve as role models to inspire girls to pursue a career in science" said one member of the selection panel, Jenny Visser, Ph.D., associate professor, Erasmus MC, Rotterdam, Netherlands. "I am honored to have been a part of this effort to help more female researchers advance in their careers."

Selection for this special issue was determined by a panel of research scientists, clinicians, editors, Endocrine Society committee members, and Women in Endocrinology organization officers.

"Women contribute substantially to advancing science and knowledge in general, and endocrinology in particular. The Endocrine Society is about stewardship, inclusiveness, diversity and gender equality. The Women in Endocrinology Collection is yet another wonderful initiative reflecting our Society's ethos," said another member of the selection panel, Ghada El-Hajj Fuleihan, M.D., M.P.H., professor of medicine of the American University of Beirut in Beirut, Lebanon. "It was a privilege and a most rewarding experience to partake in the review and selection of the top 12 papers, penned by some of the most seasoned women scientists and rising stars in our field, from across the world."

The Society will promote the collection over social media and on the Endocrine News Podcast.

Endocrine Society thematic issues are free to access and reach a global audience of influential researchers to substantially increase the visibility of endocrine researchers and their work.

Scientists from I.M. Sechenov First Moscow State Medical University together with their Russian colleagues studied reaction of wheat plants to damage caused by pathogenic fungi. They examined activation of enzymes involved in cell death induced in response to infection. The research results and enzyme classification were published in the International Journal of Molecular Sciences.

Plant resistance to harmful microorganisms (pathogens) is largely determined by a set of enzymes encoded in DNA, which are involved in death of infected cells and prevent infection spreading. Such enzymes that provide protein breakdown are called proteases.

Despite the importance of wheat in agriculture and science, including biotechnology, reaction of these plants to pathogens is described only in general (for example, in these two papers), without focusing on specific proteins. The complexity of study refers to the fact that wheat, like most other plants, is polyploid. It means that each cell has several sets of chromosomes. In the case of wheat, it is attributed to the fact that Tríticum aestívum (wheat species used in agriculture) were cultivated by crossbreeding of Triticum Urartu, Aegilops tauschii and related species. As a result, wheat genome is complex and contains 107 thousand genes that is almost five times more than a human genome.

Wheat is exposed to various pathogens (bacteria, viruses, fungi), nematodes (roundworms) and insects. Some of them parasitize on living plant cells, slowing their growth (biotrophic pathogens), others feed on cell content that leads to its death (necrotrophic pathogens).

The scientists used two pathogens: biotrophic pathogen (Puccinia recondita), that causes wheat leaf rust, and necrotrophic pathogen (Stagonospora nodorum) that damages leaves, heads and grains. The biologists studied 'Khakasskaya' and 'Daria' wheat cultivars to find out the impact of fungi infectionon plants. They used specific method that combines liquid chromatography and mass spectroscopy. Liquid chromatography is a technique used to identify mixture of substances passing in a liquid flow through a tube filled with sorbent. Due to the fact that substances are absorbed in varying degrees, the mixture is divided into components. Mass spectroscopy is a technique that ionizes neutral atoms and molecules into charged ions based on their mass-to-charge ratio. It makes possible to accurately determine even complex organic compounds.

In total, the scientists discovered 1,544 enzymes that belong to five catalytic types of proteases: serine, cysteine, aspartic, threonine and metalloproteases. They determined that protease proportion common in different plant cultivars is lower than expected (about 60% vs. 79.3%). However, the differences (about 40%) are divided almost equally between several types of proteases, indicating that these enzymes are likely to substitute each other.

The study of proteases helped to predict specific sites in their structures. The process of hydrolysis in such regions may be activated in the course of proteolytic cascades. This chain reaction allows an organism to activate many enzymes quickly that help it to fight infection.

"We have discovered above all that activation of proteases found in infected plants does not involve enzymes with caspase-like or metacaspase-like activities. Although earlier it was assumed that such proteases initiate proteolytic cascade activation, that leads to cell death of the plant organism. We concluded that some other unique proteases might be involved in wheat early response to infection with both biotrophic and necrotrophic pathogens. Surely, this result should be confirmed experimentally using alternative methods," told Prof. Andrey Zamyatnin, Director of the Institute of Molecular Medicine (Sechenov University), co-author of the article.

The detailed study of enzymes allowed to clarify their classification. The scientists have described homologs (the most similar proteins) for enzymes of several groups, and clarified position of these enzymes in a phylogenetic tree (it shows evolutionary distances between proteins). For example, scientists have determined that aspartate proteases that belong to different types differ to such an extent that they may not be related, but have acquired similar functions independently.

The study also helped to clarify ideas about specific mechanisms for triggering cell death in plants. It is known that one of the main apoptosis regulators in animals are caspases - proteolytic enzymes that initiate destruction of the cells into separate elements. Some animal caspases introduce cleavages in others, and thereby send a signal that it is time to start cell death.

"The discovery of programmed cell death commonly called apoptosis (in Greek 'falling off') was not only awarded by the Nobel prize, but also determined the scientific agenda of a significant number of research teams for many decades to come. At the turn of the century, it became clear that, despite the phenomenon of programmed cell death, plants do not have caspases. However, it was discovered that plants have other enzymes with caspase-like activities. Most likely, they just like in animals execute cell death processes in plant cells. However, our study has showed that among plant cell death activators in wheat there are enzymes that do not have caspase-like activities. It confirms once more the existence of different mechanisms of programmed cell death across eukaryotic organisms", concluded Prof. Zamyatnin.

Researchers at Vanderbilt University Medical Center and colleagues have identified a gene that increases the risk for a severe and potentially life-threatening reaction to the commonly prescribed antibiotic vancomycin.

Routine testing for this gene could improve patient safety and reduce unnecessary avoidance of other antibiotics, they reported in the Journal of Allergy and Clinical Immunology.

"We think this test will be important in the clinical care of patients starting vancomycin and will prevent mortality and short- and long-term complications," said the paper's senior author, Elizabeth Phillips, MD, an internationally known expert on severe adverse drug reactions.

"This observation also represents significant progress as we zero in on the mechanisms of these life-threatening immune-mediated drug reactions," she said.

Vancomycin is commonly given in the hospital or as home intravenous therapy for several weeks in combination with other powerful antibiotics to treat serious and potentially life-threatening bacterial infections.

Within two to eight weeks of initiating antibiotic therapy, however, some patients develop a severe reaction known as DRESS -- Drug Rash with Eosinophilia and Systemic Symptoms -- characterized by fever, widespread skin rash and internal organ damage caused by an aberrant T-cell mediated immune response to the drug.

When DRESS develops, all treatment is stopped. The mortality rate that results, often from a combination of organ damage, the need for strong immunosuppressants such as steroids and compromised treatment options for the underlying infection, approaches 10 percent.

While the true incidence of DRESS is not known, every year in the United States "hundreds of thousands of patients are at risk," said Phillips, the John A. Oates Professor of Clinical Research and professor of Medicine, Pharmacology and Pathology, Microbiology and Immunology at VUMC and Vanderbilt University School of Medicine.

For several years, vancomycin has been known to be a common antibiotic trigger for DRESS, however the genetic risk factors predisposing specific patients were not known.

This new finding shows that vancomycin-associated DRESS occurs in patients who carry specific variations in human leukocyte antigen (HLA) genes. HLA genes encode proteins that present foreign peptides (antigens) to T cells (a kind of white blood cell) to stimulate an immune response.

To better understand the HLA-DRESS connection, the researchers searched VUMC's biobank, BioVU, which contains nearly 250,000 unique, research-ready DNA samples linked to de-identified patient records.

Through a detailed search mechanism and review of the records they were able to identify that patients in the databank who developed DRESS while taking vancomycin had an over-representation of the genetic variant HLA-A*32:01.

The researchers confirmed their findings in a prospective cohort of patients from VUMC and Australia who had been diagnosed with DRESS.

Since many patients who develop DRESS are often exposed to multiple antibiotics and other drugs simultaneously, the researchers used a specific diagnostic test developed in their laboratories called gamma-interferon ELISpot, which exposed patients' white blood cells to vancomycin and other concurrently administered antibiotics.

This test enabled them to determine which drug was most likely causing DRESS.

Combining the BioVU and prospective data, the research-ers found that 86 percent of patients who developed probable vancomycin-associated DRESS carried HLA-A*32:01, compared to none of the matched control patients who received vancomycin for several weeks and did not develop a reaction to it.

By conducting a survival analysis of the BioVU patients with HLA-A*32:01 versus controls who did not carry the risk allele, the researchers determined that approximately 20 percent of patients who started vancomycin and who carried the HLA variant developed DRESS within four weeks.

In conjunction with this work, the group has developed a simple and inexpensive diagnostic test for HLA-A*32:01 that can be set up in routine diagnostic laboratories.

Music has the ability to captivate us; when listeners engage with music, they follow its sounds closely, connecting to what they hear in an affective and invested way. But what is it about music that keeps the audience engaged? A study by researchers from The City College of New York and the University of Arkansas charts new ground in understanding the neural responses to music.

Despite the importance, it has been difficult to study engagement with music given the limits of self-report. This led Jens Madsen and Lucas Parra, from CCNY's Grove School of Engineering, to measure the synchronization of brainwaves in an audience. When a listener is engaged with music, their neural responses are in sync with that of other listeners, thus inter-subject correlation of brainwaves is a measure of engagement.

According to their findings, published in the latest issue of "Scientific Reports," a listener's engagement decreases with repetition of music, but only for familiar music pieces. However, unfamiliar musical styles can sustain an audience's interest, in particular for individuals with some musical training.

"Across repeated exposures to instrumental music, inter-subject correlation decreased for music written in a familiar style," Parra and his collaborators write in "Scientific Reports."

In addition, participants with formal musical training showed more inter-subject correlation, and sustained it across exposures to music in an unfamiliar style. This distinguishes music from other domains, where interest drops with repetition.

"What is so cool about this, is that by measuring people's brainwaves we can study how people feel about music and what makes it so special." says Madsen.

CHAMPAIGN, Ill. -- Food waste can be problematic at all-you-can-eat buffet-style restaurants or university dining halls for obvious reasons: With little incentive to pile less food on their plate, diners tend to overindulge.

One way to curb such behavior is a food waste-reduction campaign, which serves as a low-cost solution for promoting the virtues of moderation at the buffet line. But according to new research co-written by a University of Illinois expert who studies consumer food choice and behavior, food waste-reduction campaigns in such settings, however well-intentioned, may have limited efficacy.

Research from Brenna Ellison, a professor of agricultural and consumer economics at Illinois, indicates that the impact of a food waste-education campaign produced a modest, though not statistically significant, reduction in the average waste per diner in an all-you-can-eat dining setting.

"Food waste can be difficult to combat in all-you-care-to-eat settings like buffets and dining halls," she said. "Education campaigns can be a low-cost way to make consumers aware of food waste, but they may have smaller impacts on waste behavior. For greater waste reduction, education campaigns may need to be combined with environmental changes such as removing the flat-fee pricing structure or pre-portioning food items."

Ellison and her co-authors sought to determine the efficacy of introducing a food waste-reduction campaign in a university dining hall setting, as food waste is especially prevalent in university dining facilities, which serve younger consumers who tend to be more wasteful than the average adult.

"In general, the food service industry generates an inordinate amount of food waste, and in all-you-care-to-eat dining settings on a college campus, the problem is exacerbated," Ellison said.

The research took place at two dining facilities on the U. of I.'s Urbana campus during the fall 2016 semester. Consumer plate waste was collected, sorted and weighed at the two dining halls - a treatment site and a comparison site - to assess the impact of an education campaign on the quantity and type of food waste.

"This study is unique in that diners were not tracked," Ellison said. "In other words, they didn't know that their waste was being monitored when they made their food choices, which means we were more likely to observe diners' natural eating behaviors."

The education campaign consisted of a series of pole-wrap posters placed in the student seating area of the treatment site that contextualized the problem of food waste in the U.S.; signage displayed at dining hall entry points and at multiple stations throughout the serving area that tracked student plate waste at lunch; and napkin inserts displayed throughout the student seating area.

The food waste-education campaign had little impact on behavior. Before the campaign, the average student wasted 88 grams of food in the treatment dining facility - the equivalent of about one chicken breast per student meal. After the campaign, the average student decreased their food waste by a modest 3.45 grams, or a 3.9 percent reduction in total food waste.

Although the finding is statistically insignificant, for a dining facility that serves 10,000 students, the aggregate reduction in waste during lunch each week (Monday-Friday) would be 76 pounds of food - an amount that may be far from negligible for a food service operator, Ellison said.

"This study also sorted plate waste so we could determine which meal components - like protein or fruits and vegetables - were wasted in greater volumes," she said. "This is important to food service operators who may be looking to estimate the financial impact of food waste, as foods like meat proteins are likely more expensive than grains and pastas."

Although behavior was relatively unaffected by the education campaign, the researchers observed improvements in some student beliefs related to food waste in the dining halls.

"The campaign resulted in an increased recognition that the dining halls were invested in reducing food waste, and in an increased awareness that individual actions could make an impact on the food waste problem," Ellison said. "The latter could be a signal that students are moving from a state of pre-contemplation, where there is little recognition that a behavior such as food waste is problematic, to a state of contemplation, in which the problem is acknowledged and behavioral change is considered."

While consumer education has been identified as a potentially useful tool in fighting food waste, the results suggest that passive education alone is unlikely to be an effective intervention strategy for reducing plate waste, particularly in an all-you-can-eat dining environment.

"Given the setting of the current study, this finding may not generalize to all consumer education efforts, but it contributes to the broader discussion of how information impacts behavior, which may be an important first step to achieving lasting behavioral change," Ellison said.

MADISON, Wis. -- Blue-blooded and armored with 10 spindly legs, horseshoe crabs have perhaps always seemed a bit out of place.

First thought to be closely related to crabs, lobsters and other crustaceans, in 1881 evolutionary biologist E. Ray Lankester placed them solidly in a group more similar to spiders and scorpions. Horseshoe crabs have since been thought to be ancestors of the arachnids, but molecular sequence data have always been sparse enough to cast doubt.

University of Wisconsin-Madison evolutionary biologists Jesús Ballesteros and Prashant Sharma hope, then, that their recent study published in the journal Systematic Biology helps firmly plant ancient horseshoe crabs within the arachnid family tree.

By analyzing troves of genetic data and considering a vast number of possible ways to examine it, the scientists now have a high degree of confidence that horseshoe crabs do indeed belong within the arachnids.

"By showing that horseshoe crabs are part of the arachnid radiation, instead of a lineage closely related to but independent of arachnids, all previous hypotheses on the evolution of arachnids need to be revised," says Ballesteros, a postdoctoral researcher in Sharma's lab. "It's a major shift in our understanding of arthropod evolution."

Arthropods are often considered the most successful animals on the planet since they occupy land, water and sky and include more than a million species. This grouping includes insects, crustaceans and arachnids.

Horseshoe crabs have been challenging to classify within the arthropods because analysis of the animals' genome has repeatedly shown them to be related to arachnids like spiders, scorpions, mites, ticks and lesser-known creatures such as vinegaroons. Yet, "scientists assumed it was an error, that there was a problem with the data," says Ballesteros.

Moreover, horseshoe crabs possess a mix of physical characteristics observed among a variety of arthropods. They are hard-shelled like crabs but are the only marine animals known to breathe with book gills, which resemble the book lungs spiders and scorpions use to survive on land.

Only four species of horseshoe crabs are alive today, but the group first appeared in the fossil record about 450 million years ago, together with mysterious, extinct lineages like sea scorpions. These living fossils have survived major mass extinction events and today their blood is used by the biomedical industry to test for bacterial contamination.

Age is just one of the problems inherent in tracing their evolution, say Ballesteros and Sharma, since searching back through time to find a common ancestor is not easy to accomplish. And evidence from the fossil record and genetics indicates evolution happened quickly among these groups of animals, convoluting their relationships to one another.

"One of the most challenging aspects of building the tree of life is differentiating old radiations, these ancient bursts of speciation," says Sharma, a professor of integrative biology. "It is difficult to resolve without large amounts of genetic data."

Even then, genetic comparisons become tricky when looking at the histories of genes that can either unite or separate species. Some genetic changes can be misleading, suggesting relationships where none exist or dismissing connections that do. This is owed to phenomena such as incomplete lineage sorting or lateral gene transfer, by which assortments of genes aren't cleanly made across the evolution of species.

Ballesteros tested the complicated relationships between the trickiest genes by comparing the complete genomes of three out of the four living horseshoe crab species against the genome sequences of 50 other arthropod species, including water fleas, centipedes and harvestmen.

Using a complex set of matrices, taking care not to introduce biases in his analysis, he painstakingly teased the data apart. Still, no matter which way Ballesteros conducted his analysis, he found horseshoe crabs nested within the arachnid family tree.

He says his approach serves as a cautionary tale to other evolutionary biologists who may be inclined to cherry-pick the data that seem most reliable, or to toss out data that don't seem to fit. Researchers could, for example, "force" their data to place horseshoe crabs among crustaceans, says Sharma, but it wouldn't be accurate. The research team tried this and found hundreds of genes supporting incorrect trees.

Ballesteros encourages others to subject their evolutionary data to this kind of rigorous methodology, because "evolution is complicated."

Why horseshoe crabs are water dwellers while other arachnids colonized land remains an open question. These animals belong to a group called Chelicerata, which also includes sea spiders. Sea spiders are marine arthropods like horseshoe crabs, but they are not arachnids.

"What the study concludes is that the conquest of the land by arachnids is more complex than a single tradition event," says Ballesteros.

It's possible the common ancestor of arachnids evolved in water and only groups like spiders and scorpions made it to land. Or, a common ancestor may have evolved on land and then horseshoe crabs recolonized the sea.

"The big question we are after is the history of terrestrialization," says Sharma.

For Ballesteros, who is now studying the evolution of blindness in spiders living deep within caves in Israel, his motivations get to the heart of human nature itself.

"I get to look with childish curiosity and ask: 'How did all this diversity come to be?'" he says. "It's incredible what exists, and I never thought I would have the privilege to be able to do this."

DALLAS, March 8, 2019 -- Smoking tobacco in waterpipes, more commonly known as hookahs, results in inhaling toxic chemicals, often at levels exceeding cigarette smoke, that may harm the heart and blood vessels, according to a new scientific statement published in the American Heart Association's journal Circulation.

Waterpipes go by many names - hookah, narghile, argileh, shisha and goza - and usually consist of a head or bowl that holds tobacco, a body, water base and hose that ends with a mouthpiece. Burning charcoal is placed on top of the tobacco-filled bowl. Hookah tobacco is usually a combination of dried fruit, flavored tobacco and substances to keep the tobacco moist.

During a hookah smoking session that typically last for 30 or more minutes, users inhale many liters of smoke filled with large quantities of particulate matter at higher concentrations than cigarettes.

Although direct comparisons between hookahs and cigarettes have some limitations, a single session of hookah use typically results in greater exposure to carbon monoxide than a single cigarette. Even short-term exposure to carbon monoxide in hookahs is toxic and can interfere with exercise capacity, according to the statement authors.

In addition to carbon monoxide, hookah smoke contains other potentially harmful chemicals that can affect the cardiovascular system, including nicotine, air pollutants, particulate matter, volatile organic chemicals, polycyclic aromatic hydrocarbons, acrolein, lead, cadmium and arsenic. Most of these toxins are higher in hookah than cigarette smoke.

"Hookah smoke contains harmful substances and the American Heart Association strongly recommends avoiding the use of tobacco in any form," said Aruni Bhatnagar, Ph.D., chair of the writing group for the statement and professor of medicine and director of the University of Louisville Diabetes and Obesity Center in Kentucky.

There is growing evidence that hookah tobacco smoking acutely impacts heart rate and blood pressure. Chronic use is associated with increased coronary artery disease risk.

"Many young people mistakenly believe that smoking tobacco from a hookah is less harmful than cigarette smoking because the tobacco if filtered through water, but there is no scientific evidence that supports that claim. However, there is evidence to suggest that hookah smoking is addictive and can lead to the use of other tobacco products such as cigarettes," said Bhatnagar.

The spread of hookah smoking, especially among young people, is promoted by several factors, including sweetened and flavored hookah tobacco, social media that promotes this method of tobacco use and misperceptions regarding its addictive potential and adverse health effects.

Unlike cigarette tobacco, hookah tobacco, often colorfully packaged, can be sold in candy and fruit flavors, which appeal to younger audiences. The flavors and sweeteners added to the tobacco mask the harshness of smoke, making it easier to start and continue smoking hookahs.

In addition, because many people smoke hookah in lounges and cafes it is perceived to be a social activity and less habit-forming. More importantly, most of the tobacco marketed to hookah users does not carry a health warning, leading to the misperception that it is not harmful.

In the United States, recent surveys have estimated hookah usage that range from 4. 8 percent among high school students to 13.6 percent of young adults (18-24 years old). People 18-24 years of age also accounted for 55 percent of hookah smokers nationwide. In addition, those who use a hookah are more likely to start smoking cigarettes than those who have never smoked a hookah.

Globally, hookah usage is spreading among younger people. Data from a survey of seven Middle Eastern countries showed that the rates of hookah smoking ranged from 9 percent to 15 percent, which was higher than rates of cigarette smoking in some countries. A study in the United Kingdom found that hookah use was more than twice as common as cigarette smoking.

Currently, there is a persistent misperception among hookah users that this method of tobacco use is harmless. In contrast, many youths are more aware of the risks associated with cigarette smoking and avoid that method of tobacco use because of those risks. Research is needed to effectively communicate the negative health impact of hookah smoking.

Health care professionals are encouraged to ask about hookah use and provide counseling and support to help patients quit.

COLUMBUS, Ohio - New research shows just how powerful the United States' and other countries' influence can be on persuading other nations to ratify international treaties.

The first-of-its-kind study shows the influence of countries in treaty ratification can extend beyond their close allies and could even help persuade rivals to join agreements.

"The simple act of a single country ratifying a treaty can have dramatic ramifications for what other countries do in ways that haven't always been apparent," said Skyler Cranmer, co-author of the study and the Carter Phillips and Sue Henry associate professor of political science at The Ohio State University.

In an article published today (March 7, 2019) in PLOS ONE, the researchers debuted a model that could predict how other countries would react when an individual country ratified one of 198 international environmental agreements between 1972 and 2000.

For example, the study found that the United States' signing of the United Nations Framework Convention on Climate Change (UNFCCC) in 1992 may have influenced Russia to ratify the treaty. Without action by the U.S., Russia would have had only a 40 percent probability of signing the treaty, according to the model.

"Superpowers can influence each other even if they're rivals and their interests aren't always aligned," Cranmer said.

Russia wasn't the only unexpected country that signed the UNFCCC as a result of American ratification. U.S. support of the UNFCCC also influenced Nigeria, Thailand and Uruguay to sign, all of which have lacked significant, direct relationships with the United States.

Cranmer worked to develop the model with colleagues Benjamin Campbell, a Ph.D. candidate in political science at Ohio State; Frank Marrs, a Ph.D. candidate in statistics, and Bailey Fosdick, an assistant professor of statistics, both at Colorado State University; and Tobias Böhmelt, a professor of government at the University of Essex.

The model that the researchers developed allowed them to analyze the complex interactions between countries and treaties, relationships between the countries themselves, and other factors in ways that have never been done, Cranmer said.

"We didn't have a good way of measuring country-to-country influence before, but now we do," Cranmer said.

Most other research that has examined why countries did or did not ratify a particular treaty examined attributes of the country, such as its type of government and level of economic development.

"But this is missing the whole dynamic of international leadership. You're not seeing how states influence each other," he said.

This study found that countries can be both positive and negative influencers on how other nations respond to international agreements. An example of negative influence is one country's ratification of a treaty making it less likely that another will do the same.

One reason may be that some countries are looking for a "free ride," Cranmer said. Countries get a free ride when they don't ratify a treaty, but still benefit from its environmental protections when nearby countries ratify.

The study showed that countries are less likely to ratify treaties when countries within their continent have ratified it. Countries near others that ratify may benefit the most from a free ride.

Still, one country acting as a negative influence on another country's ratification was relatively uncommon.

Positive influence - when ratifying a treaty makes another country more likely to join - was much more common.

"To us, this demonstrates that, on average, international institutions, such as the United Nations, have worked in facilitating global environmental protection. This isn't something that we would always expect given the criticism of these institutions and global governance efforts," Cranmer said.

Cranmer said it was significant that the United States' ratification of the UNFCCC had a positive influence on distant countries like Nigeria and Thailand also acceding.

"These indirect effects are something we have not been able to document before in international politics," he said.

The effects go beyond even the single treaty itself. The study found that the United States' ratification of UNFCCC not only influenced other countries' probability of ratifying that treaty - it also influenced Mexico and Russia's probability of joining a different treaty: the United Nations Convention to Combat Desertification.

"The actions of the United States have indirect influence on a lot of other countries that we could not quantify before," Cranmer said.

The new model developed by the researchers is a powerful tool to study international relations in a variety of ways.

"Environmental treaties are not the only application. We now are using the same tool to examine how countries influence each other on human rights treaties," he said.

It's widely accepted within agriculture that maintaining genetic diversity is important. In areas where crop plants are more diverse, pathogens might kill some plants but are less likely to wipe out an entire crop.

Few studies, however, have focused on such highly specialized pathogens in natural plant communities. In diverse plant communities, pathogens are thought to maintain diversity by killing common species, making room for rare ones. But what happens to diversity if, like in agriculture, pathogens harm some plants within a species, but not all?

A Yale-led research team has found that tree seedlings grew less effectively in soil located below their mother tree than in soil found under a different individual of the same species. After ruling out other potential drivers, they concluded that the differences in growth were most likely due to microbial pathogens that specialize at the genotype level. Theoretical models revealed that such highly specialized pathogens could help maintain diversity in tree communities and promote increased seed dispersal over evolutionary timescales.

"We often think of pathogens as pests," said Jenalle Eck, a postdoctoral researcher at the University of Zurich and a former visiting doctoral student at the Yale School of Forestry & Environmental Studies (F&ES), "but we're finding that they play a key role in a highly diverse ecosystem."

The study was published in the Proceedings of the National Academy of Sciences. The senior author of the paper was Liza Comita, an assistant professor of tropical forest ecology at F&ES.

For the study, Eck conducted a shadehouse experiment, potting more than 200 seedlings of the tropical tree Virola surinamensis grown from seeds collected in a diverse tropical forest in Panama. The soil for the pots was sourced from either the seedlings' maternal tree or other trees of the same species.

The researchers showed that the difference in performance between seedlings growing in "maternal" soil and "non-maternal" soil was not the result of variations in soil nutrients or beneficial symbiotic relationships with fungi, thanks to lab work conducted at Yale by Camille Delavaux '16 M.E.Sc., currently a doctoral student at the University of Kansas.

Using computer simulation models designed by Simon Stump, a postdoctoral associate at F&ES, the team then found that these pathogens can promote species coexistence and can lead to increased seed dispersal, which creates landscapes that allow pathogens to more effectively promote diversity.

"These results suggest that highly specialized pathogens are potentially an important, but largely overlooked driver of plant population and community dynamics," said Comita. "Our findings underscore the importance of conserving both species and genetic diversity in tropical forests."

During his first week in office, President Donald J. Trump issued an executive order known as the Expanded Global Gag Rule that cuts funding to foreign aid organizations that provide or refer women to abortions. A new journal article by researchers in the Global Health Justice and Governance program (GHJG) at the Columbia University Mailman School of Public Health argues that the policy is having a chilling effect, dampening debate, advocacy, and collaboration around abortion and other sexual and reproductive rights. A similar policy known as the Domestic Gag Rule is expected to go into effect by the end of April.

The article, which appears online in the Journal of International Affairs, a Columbia SIPA publication, reports that organizations receiving U.S. global health assistance have pulled out of reproductive health and rights meetings and coalitions.

"Organizations that comply with the rule often over-interpret its restrictions, whether because they lack information about what speech is allowed, they receive misinformation from U.S. government employees about what is allowed, or they fear a major donor," says first author Marta Schaaf, DrPH, director of programming and operations for GHJG. "As a result, organizations that comply with the rule often decline to participate in meetings where abortion or even contraception is discussed. In this way, the Global Gag Rule not only curtails free speech, but it limits the ability of organizations to deliver quality healthcare."

Similar chilling effects were documented when the Global Gag Rule was implemented under previous Republican administrations, but Schaaf and her co-authors argue that the newly expanded policy could be much worse. Whereas previous versions of the Global Gag rule applied to family planning assistance, the new rule applies to all global health assistance, affecting approximately $9 billion in funding, up from $600 million during the George W. Bush Administration. The U.S. is the world's largest global health donor; no other government can make up for the policy's restrictions. Moreover, the Expanded Global Gag Rule comes at a time when civil society organizations and activists in many countries are increasingly under attack.

According to an estimate by CIVICUS, a global civil society alliance, civil society is under attack in 111 of 196 countries worldwide, limiting people's freedom of assembly, freedom of association, and freedom of expression. As one example, in 2018 the government of Tanzania banned advertisements regarding family planning and criminalized the public dissemination of any statistical information contradicting official government figures, making the collection of public health or health service provision data by civil society or the media nearly impossible.

"We're seeing a crackdown on free speech and organizing around the world, particularly on individuals and groups defending women's human rights. The Expanded Global Gag Rule is feeding that trend," says Terry McGovern, JD, director of GHJG, chair of the Columbia Mailman Department of Population and Family Health, and co-author of the journal article.

FOLLOW THE MONEY

Since the launch of GHJG last fall, members of the program have worked to document the far-reaching harms of the Global Gag Rule. Schaaf and her GHJG colleague Emily Maistrellis co-authored a draft policy statement of the American Public Health Association that argues that the rule is harmful to health and in violation of human rights; the statement is currently open for comment by APHA members. A forthcoming journal article by the researchers will report initial findings from a collaborative investigation with the Center for Health and Gender Equity, Washington D.C., funded by the William and Flora Hewlett Foundation and the David and Lucile Packard Foundation. The ongoing research with researchers and NGOs in Kenya, Madagascar, and Nepal is examining the ways that the federal policy is harmful to health--even beyond the domain of sexual and reproductive health.

As one example, a Washington Post article highlighted the story of the nonprofit WaterAid, which works to improve access to clean drinking water, decided not to comply with the Global Gag Rule, as the nonprofit refers women who had been sexually assaulted while collecting water to comprehensive reproductive health services, many of which provide abortion services. As a result, WaterAid ended some projects and has stopped applying for USAID funding, and has significantly decreased the scope and reach of their work in several countries, including in Madagascar.

"The U.S. flow of funding touches so many actors and issues. To understand the impact of the Global Gag Rule, we followed the flows of money, and we followed the flows of people in the health system," Schaaf explains. "People don't realize the real social costs of the Gag Rule because they think all it does is prohibit U.S. funds from supporting abortion. They don't realize it affects all these other things--the integration of health services, referrals within the health system, health services beyond sexual and reproductive health, and free speech. It also undermines sovereignty in these countries. Nepal has liberalized their abortion law. It's not our business to intervene in that."

The GHJG team also has its eye on the domestic front. In late February, the Trump Administration announced that the Domestic Gag Rule will proceed within 60 days, a move that is already facing multiple legal challenges. Last summer, 24 faculty and staff in the Department of Population and Family Health submitted a public comment related to the new rule. Much like the Global Gag Rule, the Domestic Gag Rule aims to prohibit providers from performing, promoting, referring for, or supporting abortion as a method of family planning. The comment stated that the proposed rule "imposes serious risks to the health and well-being of millions of women and girls," particularly poor women of color. College-age women who often rely on programs like Planned Parenthood would also be disproportionally affected. Among the policy's anticipated consequences are an increase in unplanned pregnancies and abortions.

"Globally and domestically, these policies impose the political agenda of a minority of Americans on our health and human rights," says McGovern. "This is nothing short of an attack on women, and we are ready to fight back."

PROVIDENCE, R.I. [Brown University] -- Brown University researchers have developed a new antibacterial coating for intravascular catheters that could one day help to prevent catheter-related bloodstream infections, the most common type of hospital-acquired infection.

"These kinds of infections are a major burden for hospitals, health care providers and most of all for patients," said Anita Shukla, an assistant professor of engineering at Brown and corresponding author of a new paper describing the work. "We wanted to develop a coating that could both kill planktonic [free-floating] bacteria and prevent colonization of bacteria on surfaces. The initial data that we gathered for this paper shows that we have something really promising."

In the paper, the researchers show that a polyurethane coating that can be readily applied to various medically relevant surfaces and gradually releases a drug called auranofin can kill methicillin-resistant Staphylococcus aureus (MRSA) bacteria for nearly a month in lab tests. The tests also showed that the coating could prevent the formation of MRSA biofilms, which, once established, are especially resilient to antimicrobial treatment.

The research, which is published in Frontiers in Cellular and Infection Microbiology, is a collaboration between Shukla's lab in Brown's School of Engineering and the labs of Eleftherios Mylonakis and Beth Fuchs in the Division of Infectious Diseases in Brown's Warren Alpert Medical School.

"It's a perfect collaboration between medicine and engineering," Shukla said of the partnership. "They [Mylonakis and Fuchs] come to us with the types of problems that they commonly see in the clinic. As an engineering lab focused on developing new biomaterials for drug delivery, we can then work on engineering solutions to the problems they bring us."

The problem in this case is a prominent one. More than 150 million intravascular catheters are implanted each year in the United States alone, and infections stemming from implants develop in 250,000 patients a year. Those infections are fatal in up to 25 percent of cases, and even when successfully treated can add up to millions of dollars in extended hospital stays.

Previous approaches to the problem have met with limited success, the researchers say. Other antibacterial coatings tend to lose their effectiveness after two weeks at most, often because they release their drug payload too quickly. Other coatings also tend to use traditional antibiotics, raising concerns about antibiotic resistance over long term use.

For their new coating, Shukla and colleagues utilized auranofin. This drug was originally developed and approved by the U.S. Food and Drug Administration to treat arthritis, but studies by Mylonakis, Fuchs and others have shown that the drug is also highly effective in killing MRSA and other dangerous microbes. In addition, it works in ways that make it hard for bacteria to evolve a natural resistance. Auranofin had never previously been incorporated into a coating technology.

To make the coating, the researchers dissolved polyurethane and concentrations of auranofin in a solution, which was then deposited onto a catheter. The solvent is then evaporated away, leaving a stretchable yet durable polymer coating. Mechanical testing showed that the coating can stretch up to 500 percent without breaking.

To test the coating's effectiveness, the researchers placed coated catheters in MRSA both in solution and on agar plates where MRSA bacteria thrive. The experiments showed that the coatings were able to inhibit MRSA growth for up to 26 days, depending on the initial concentration of auranofin used in the coating. The researchers also used bioluminescence imaging to look for signs of biofilm formation. Those experiments showed that the coatings prevent any trace of biofilm. For comparison, the researchers also tested a catheter loaded with a more traditional antibiotic, highly effective against free-floating MRSA, which proved unable to prevent biofilm formation.

"The antibiofilm finding is very critical," Shukla said. "Biofilms have really effective ways of evading antibiotics, which makes them thousands of times more difficult to treat in terms of the concentration of drug needed compared to planktonic bacteria. The fact that these coatings are able to prevent biofilms from forming in the first place is really important."

Preliminary tests for toxicity in the lab showed that the coatings had no adverse effects on human blood or liver cells, but more testing is required before the coating is ready to be used on patients, Shukla says. The fact that both of the coating's components have been approved by the FDA for other uses should speed the approval process for in vivo testing.

"We're hopeful that the initial results we show here will soon translate to the clinic," Shukla said.

Too much time in front of the bedroom TV deprives the child of more enriching developmental activities and may explain, in part, less optimal body mass, poor eating habits and socio-emotional difficulties as a teenager, says the study, published Dec. 26 in Pediatric Research.

"The early years are a critical period in a child's development," said study author Linda Pagani, a professor at UdeM's School of Psycho-Education, who will be discussing her study today at the International Convention of Psychological Science, in Paris.

"Intuitively, parents know that how their children spend their leisure time will impact their well-being over the long term," said Pagani. "And with TV being their most common pastime, it's clear that the many hours they spend in front of the screen is having an effect on their growth and development, especially if the TV is in a private place like the bedroom."

With their attention diverted, children risk not having enough physical and social interactions to promote proper physical and socio-emotional development, Pagani said. "To test that hypothesis, we longitudinally followed a birth cohort to examine whether there was a link between having a bedroom TV at age 4, during the neurodevelopmentally critical preschool period, and later physical, mental, and social problems in early adolescence. Our goal was to eliminate any pre-existing conditions the children or families had that could bias our results."

Pagani and her team analyzed Canadian birth cohort data of 1,859 Quebec children born between the spring of 1997 and the spring of 1998, part of the Quebec Longitudinal Study of Child Development coordinated by the Institut de la statistique du Québec.

Spending too much time watching TV in their room can harm preschoolers' development, an Université de Montréal study finds.

To assess their health at age 13, independent examiners measured the childrens' body mass index; adolescents also reported their intake of unhealthy foods. To measure psychological problems, teachers rated how much emotional stress the children faced; the teens also completed a short version of the Children's Depression Inventory. For social problems, teachers reported on how the kids got along with their peers and whether they were bullied. All these measures are good predictors of later physical and mental health in adulthood.

Significantly higher body mass index

The study's results were clear: having a TV in the bedroom at age 4 made it more likely the child would later have a significantly higher body mass index, more unhealthy eating habits, lower levels of sociability, and higher levels of emotional distress, depressive symptoms, victimization and physical aggression, regardless of individual and family factors that would have predisposed them to such problems.

"The location of the TV seems to matter," Pagani said. "Having private access to screen time in the bedroom during the preschool years does not bode well for long-term health. The children in our study were born at a time when television was the only screen in the bedroom. Today, given the portability of digital devices and the constant switching from one device to another, the guidelines of the American Academy of Pediatrics clearly have reason to encourage screen-free zones and screen-free locations at home, especially given the implications for the growth and development of children. Our research supports a strong stance for parental guidelines on the availability and accessibility of TVs and other devices."

Scientists are urging for improved regulation on pesticides after finding that they affect genes in bumblebees, according to research led by Queen Mary University of London in collaboration with Imperial College London.

For the first time, researchers applied a biomedically inspired approach to examine changes in the 12,000 genes that make up bumblebee workers and queens after pesticide exposure.

The study, published in Molecular Ecology, shows that genes which may be involved in a broad range of biological processes are affected.

They also found that queens and workers respond differently to pesticide exposure and that one pesticide they tested had much stronger effects than the other did.

Other recent studies, including previous work by the authors, have revealed that exposure even to low doses of these neurotoxic pesticides is detrimental to colony function and survival as it impairs bee behaviours including the ability to obtain pollen and nectar from flowers and the ability to locate their nests.

This new approach provides high-resolution information about what is happening at a molecular level inside the bodies of the bumblebees.

Some of these changes in gene activity may represent the mechanisms that link intoxification to impaired behaviour.

Lead author of the study Dr Yannick Wurm, from Queen Mary University of London, said: "Governments had approved what they thought were 'safe' levels but pesticides intoxicate many pollinators, reducing their dexterity and cognition and ultimately survival. This is a major risk because pollinators are declining worldwide yet are essential for maintaining the stability of the ecosystem and for pollinating crops.

"While newer pesticide evaluation aims to consider the impact on behaviour, our work demonstrates a highly sensitive approach that can dramatically improve how we evaluate the effects of pesticides."

The researchers exposed colonies of bumblebees to either clothianidin or imidacloprid at field-realistic concentrations while controlling for factors including colony social environment and worker age.

They found clothianidin had much stronger effects than imidacloprid - both of which are in the category of 'neonicotinoid' pesticides and both of which are still used worldwide although they were banned in 2018 for outdoor use by the European Union.

For worker bumblebees, the activity levels of 55 genes were changed by exposure to clothianidin with 31 genes showing higher activity levels while the rest showed lower activity levels after exposure.

This could indicate that their bodies are reorienting resources to try to detoxify, which the researchers suspect is what some of the genes are doing. For other genes, the changes could represent the intermediate effects of intoxification that lead to affected behaviour.

The trend differed in queen bumblebees as 17 genes had changed activity levels, with 16 of the 17 having higher activity levels after exposure to the clothianidin pesticide.

Dr Joe Colgan, first author of the study and also from Queen Mary University of London, said: "This shows that worker and queen bumblebees are differently wired and that the pesticides do not affect them in the same way. As workers and queens perform different but complementary activities essential for colony function, improving our understanding of how both types of colony member are affected by pesticides is vital for assessing the risks these chemicals pose."

The researchers believe that the approach they have demonstrated must now be applied more broadly. This will provide detailed information on how pesticides differ in the effects they have on beneficial species, and why species may differ in their susceptibility.

Dr Colgan said: "We examined the effects of two pesticides on one species of bumblebee. But hundreds of pesticides are authorised, and their effects are likely to substantially differ across the 200,000 pollinating insect species which also include other bees, wasps, flies, moths, and butterflies."

Dr Wurm added: "Our work demonstrates that the type of high-resolution molecular approach that has changed the way human diseases are researched and diagnosed, can also be applied to beneficial pollinators. This approach provides an unprecedented view of how bees are being affected by pesticides and works at large scale. It can fundamentally improve how we evaluate the toxicity of chemicals we put into nature."

States with more permissive gun laws and greater gun ownership have higher rates of mass shootings, and a growing divide is emerging between states with restrictive versus permissive gun laws. According to a new study, researchers at Columbia Mailman School of Public Health found that in most years permissive states had higher mass shooting rates compared to restrictive states. The results showed that a 10 unit increase in state permissiveness was associated with a significant 11 percent higher mass shooting rate; a 10 percent higher state firearm ownership rate was associated with a 35 percent higher rate of mass shootings. The findings appear online in the British Medical Journal.

"Our analyses reveal that U.S. gun laws have become more permissive in past decades, and the divide between permissive states and those with more stringent laws seems to be on the uptick in concert with the growing tragedy of mass shootings in the U.S.," said senior author Charles Branas, PhD, Chair and Gelman Professor in the Department of Epidemiology at Columbia's Mailman School of Public Health. Lead author Paul Reeping, also in the Department of Epidemiology, extended this saying that, "Gun laws, or lack thereof, have real potential to influence mass shootings. Our study brings out a key disparity and sets the stage for better data collection on mass shootings and figuring out which specific gun laws could be most impactful in reducing mass shootings."

Mass shootings were defined as events in which four or more individuals were killed by a firearm using data from the FBI's Uniform Crime Reporting System (UCR). To date there has been little research conducted to understand factors at the state level that may influence mass shootings, and nationwide data collection on mass shootings has been limited.

The researchers used the 1998-2015 editions of "Traveler's Guide to the Firearms Laws of the Fifty States" to obtain an annual restrictiveness-permissiveness scale of U.S. state gun laws, which gives a rating between 0 (completely restrictive) and 100 (completely permissive) for the firearm laws of all 50 states, and is designed to support gun owners in complying with the changing laws when traveling outside their own state. The report considers many factors in developing the score, including for example: carry and permit requirements, semiautomatic guns and high capacity magazines, vehicle gun possession, carrying guns where alcohol is served, and out-of-state permit recognition, among others.

According to the findings, there was an overall shift toward permissiveness in gun ownership between 1998 and 2014. Massachusetts was found to have the most restrictive gun laws and Vermont the most permissive over the study period. In particular, a growing divergence was noted in 2010, with decreasing mass shooting rates among restrictive states and increasing rates among states with more relaxed gun laws. On average, more permissive states and states with higher rates of gun ownership appeared to have more mass shootings. Gun ownership was estimated using a common state-level measure, the percent of suicides committed with a firearm.

Researchers further separated annual mass shooting rates into events that likely took place in the home (domestic) and those that occurred outside of the home (nondomestic) for each state, although these two types of mass shootings appeared to be similarly affected by gun laws and gun ownership. Domestic mass shootings included instances where a perpetrator committed the act against family members; nondomestic mass shootings covered all other types of relationships including non-family members, acquaintances, employers, friends, and neighbors. From 1998 to 2014, there were 344 mass shooting incidents, of which 76.5 percent were classified as nondomestic events while the remaining 23.5 percent were identified as domestic.

"We need better nationwide data collection on mass shootings - for instance, the lack of data from Florida highlights this, and may make the differences we found appear even less stark than they really are. More studies that test the impact of specific state gun laws are warranted given our findings, the general increase in state gun law permissiveness, and the pressing need to stem the continued and increasing tragedy of mass shootings in the U.S.," said Reeping.