Culture

More than 87% of golden snub-nosed monkey infants evaluated in a five-year field study were nursed by females other than their mothers - a phenomenon called allomaternal nursing. This is the first evidence of allomaternal nursing in an Old World nonhuman primate, the study's authors say. It occurred predominantly among relatives and was usually reciprocal; around 90% of mothers nursed another female's baby if that female had previously nursed their own. The behavior - costly for non-mothers - likely arose in tolerant kin-based support networks where shared care helped the animals navigate harsh, unpredictable environments, the authors say. The findings may help understand the role of allomaternal nursing behavior in human evolution. Allomaternal nursing has been seen in a variety of mammals, from rodents to humans. The behavior is believed to enhance infant survival and reduce postnatal reproductive costs incurred by the infant's mother. These costs are particularly high for monkeys such as the golden snub-nosed monkey that live in high-elevation temperate forests with extremely cold, five-month-long winters, and strong seasonal changes in food availability. Allomaternal nursing, however, has never before been observed in Old World monkeys. In this study, the authors observed groups of golden snub-nosed monkeys in the Shennongjia National Nature Reserve located in central China. Over the course of five birth seasons, the authors discovered that 40 out of 46 infants (87%) suckled from one or more females that were not their mothers, with 22 out of 46 (48%) suckling from at least two additional females. Allomaternal nursing was seen predominantly during the first three months of an infant's life. Four of the six infants, who did not receive nursing from another female died during winter, whereas only six of the 40 infants who were allonursed died. Relatedness - usually either the grandmother or aunt of the infant - and reciprocity played important roles in allomaternal nursing, the authors say. Around 90% of mothers (25 of 28) reciprocated nursing during the current or following year if that female had nursed their own infant.

Researchers have discovered that food allergies are associated with distinct abnormalities in seemingly-healthy skin in pediatric patients with atopic dermatitis (AD), a common skin disorder. The surprising findings represent one of the most comprehensive skin-related assessments of AD patients to date, and hint that treatments for AD and food allergy should focus on improving the function of the skin barrier. Atopic dermatitis is an inflammatory skin disorder that affects nearly 20% of children worldwide, and one-third of AD patients also have food and respiratory allergies. Scientists have sought to better understand the relationship between AD and food allergy, but progress has been limited because skin sampling methods such as biopsies are overly invasive. Here, Donald Leung and colleagues used a noninvasive sampling approach named skin tape stripping to study the skin of 21 patients with AD and food allergy (FA+), 19 patients with AD and no food allergy (FA-) and 22 healthy controls. Their analysis revealed that nonlesional skin from the AD FA+ patients had unique properties not seen in the AD FA- patients. Specifically, the AD FA+ skin samples showed decreased amounts of a skin-associated protein named filaggrin, elevated type 2 immune responses (a form of immune activity mediated by T helper cells) and increased expression of the skin-associated protein keratin - abnormalities that correlated with structural changes in skin barrier architecture. Nonlesional AD-FA+ skin also harbored a higher amount of the bacterial species Staphylococcus aureus compared to AD FA- patients and controls. Future studies should further examine the complex relationships between S. aureus overgrowth, reduced filaggrin and food allergy sensitization in patients, the authors say.

The connection between bird diet and skull shape is surprisingly weak for most species according to a new study led by UCL and the Natural History Museum, rewriting our understanding of how ecosystems influence evolution.

Charles Darwin's 19th century observations of finches on the Galápagos Islands concluded that bird speciation was primarily influenced by ecosystem; the way a bird forages and eats forms its skull shape and drives evolutionary change.

However, a new study by UCL and NHM researchers testing a wider range of species than ever before has found that on a global scale, shared ancestry and behaviour are more important factors than diet.

The study, published in Royal Society journal Proceedings B, tested the skull shape of 352 bird species, representing 159 out of the 195 existing families, making it the largest study of its kind.

"If we apply Darwin's conclusion for different kinds of birds who primarily eat fish, pelicans and penguins should have exactly the same head and beak shape, as they both use their beaks to eat fish. However, pelicans have a long beak and large throat pouch, while penguins' beaks are comparatively small," explained Dr Ryan Felice (UCL Biosciences), one of the authors of the study.

"Although they eat the same thing, pelicans and penguins acquire their prey in different ways, demonstrating the important role behaviour plays in cranial evolution."

Penguins' mouths have a series of spines pointing down their throats, so that food stays in there when caught. Pelicans ingeniously catch fish in their pouch and then tip it back to drain out the water and swallow the fish immediately.

"It is evolutionary history, rather than diet, that has most significantly influenced cranial shape. If you are descended from a duck-like ancestor, you will probably have a duck bill, no matter what diet you have. However, shared diet establishes the parameters of skull evolution, determining the range of potential shapes which can evolve," added Dr Felice.

The researchers also discovered that birds who eat grains - such as finches and quail - and those who survive on the nectar of flowers - like hummingbirds - exhibit the highest rate of cranial evolution. By contrast, terrestrial carnivores - hawks, falcons, owls and other birds who hunt and eat using their talons - exhibit a very slow rate of cranial change.

"This is where natural selection comes into play," said Professor Anjali Goswami, a Research Leader at the Natural History Museum and a co-author on the study.

"Birds that eat nectar or seeds are going to experience lots of competition for resources and must evolve in order to survive."

"Our study focused on the skull, but we hypothesise that other parts of the body could be shaped by diet and ecology, such as wings, talons, and stomachs, as these are the parts of their bodies which are crucial for catching and digesting prey."

The study used state-of-the-art equipment to build high resolution 3D digital models of the bird skulls. This allowed researchers to plot many more points on the skull than previously possible, allowing them to make robust and accurate measurements.

"Our next step is to expand this analysis to other groups of animals, like mammals, reptiles, and dinosaurs," said Dr. Felice. "Our goal is to understand all of the different factors that have shaped skull evolution through time."

Dr Felice's partners on the paper were Dr Joseph Tobias (Imperial College London), Dr Alex Pigot (UCL Biosciences) and Professor Anjali Goswami (UCL Biosciences & Natural History Museum).

Cervical cancer could potentially be eliminated as a major public health problem in 149 out of 181 countries by 2100.

In high-income countries including the USA, Finland, the UK, and Canada, cervical cancer is predicted to be eliminated as a public health problem within 25-40 years.

If high coverage HPV vaccination and cervical screening cannot be achieved globally, over 44 million women could be diagnosed with cervical cancer in next 50 years--two thirds of these cases, and an estimated 15 million deaths, would occur in countries with low and medium levels of development.

Cervical cancer could be eliminated as a public health problem in most countries by the end of the century by rapid expansion of existing interventions, according to a modelling study published in The Lancet Oncology journal.

The estimates, which are the first of their kind at a global-scale, indicate that combining high uptake of the human papillomavirus (HPV) vaccine and high HPV-based cervical screening rates in all countries from 2020 onwards could prevent up to 13.4 million cases of cervical cancer within 50 years (by 2069) [1], and the average rate of annual cases across all countries could fall to less than 4 cases per 100,000 women by the end of the century--which is a potential threshold for considering cervical cancer to be eliminated as a major public health problem.

Under a more gradual scale-up scenario [2], cervical cancer elimination is expected in countries with very high and high levels of development by the end of the century, but average rates would remain above the threshold in countries with medium (4.4 cases per 100,000) and low (14 per 100,000) levels of development.

Without expanding current prevention programmes, however, the study predicts that 44.4 million cervical cancer cases would be diagnosed over the next 50 years--rising from 600,000 in 2020 to 1.3 million in 2069 due to population growth and ageing.

In May, 2018, the Director General of WHO called for coordinated action globally to eliminate this highly preventable cancer. The findings from this study have helped inform initial discussions of elimination targets as part of the development of the WHO strategy, and future modelling studies will support the development of the final goals and targets for cervical cancer elimination.

WHO has called for urgent action to scale up implementation of proven measures towards achieving the elimination of cervical cancer as a global public health problem (including vaccination against HPV, screening and treatment of pre-cancer, early detection and prompt treatment of early invasive cancers and palliative care). A draft global strategy to accelerate cervical cancer elimination, with goals and targets for the period 2020-2030, will be considered at the World Health Assembly in 2020.

"Despite the enormity of the problem, our findings suggest that global elimination is within reach with tools that are already available, provided that both high coverage of HPV vaccination and cervical screening can be achieved", says Professor Karen Canfell from the Cancer Council New South Wales, Sydney, Australia who led the study. [3]

"More than two thirds of cases prevented would be in countries with low and medium levels of human development like India, Nigeria, and Malawi, where there has so far been limited access to HPV vaccination or cervical screening. The WHO call-to-action provides an enormous opportunity to increase the level of investment in proven cervical cancer interventions in the world's poorest countries. Failure to adopt these interventions will lead to millions of avoidable premature deaths." [3]

Cervical cancer is the fourth most common cancer in women, with an estimated 570,000 new cases diagnosed worldwide in 2018, of which around 85% occur in less developed regions. HPV, a group of more than 150 viruses, is responsible for the majority of cervical cancers. Proven methods are available to screen for and treat cervical pre-cancers, and broad-spectrum HPV vaccines can potentially prevent up to 84-90% of cervical cancers.

Nevertheless, large disparities exist in cervical screening and HPV vaccination coverage between countries. In low- and middle-income countries (LMICs), overall screening rates in 2008 were as low as 19%, compared to 63% in high-income regions; whilst by 2014 less than 3% of females aged 10-20 years in LMICs received the full course of HPV vaccination in 2014, compared to over a third in high-income countries.

The authors analysed high-quality registry data from the International Agency for Research on Cancer to predict future trends in cervical cancer if further action is not taken. They then used a dynamic model to calculate the impact of scaling up HPV vaccination and cervical screening on the cervical cancer burden globally, and in 181 countries of all levels of development, between 2020 and the end of the century.

The modelling focused on the deployment of vaccination and screening in low- and medium- income countries rather than detailed modelling of all the more recent improvements in countries with high levels of development, which may have underestimated timing to elimination in individual countries with high levels of development.

The researchers also predicted the earliest date when rates of cervical cancer might fall enough to achieve elimination (considering a possible elimination threshold of less than 4 cases per 100,000 individuals). The average worldwide age-standardised rate of cervical cancer in 2012 was 12 per 100,000.

Results showed that rapid vaccination scale-up to 80-100% coverage globally by 2020 using a broad-spectrum HPV vaccine could prevent 6.7-7.7 million cases--but more than half of these would be averted after 2060.

If, in addition, cervical screening were scaled-up to high coverage by 2020 (with all women offered screening twice in their lifetime and 70% coverage globally), this could prevent an additional 5.7-5.8 million cases of cervical cancer in the next 50 years, and substantially speed up elimination.

Such efforts could result in cervical cancer being eliminated as a public health problem, with average rates across countries falling to less than 4 cases per 100,000 by 2055-59 in countries with very high levels of development (including the USA, Finland, the UK and Canada); 2065-69 for countries with high levels of development (including Mexico, Brazil, and China); 2070-79 for countries with medium levels of development (including India, Vietnam, and the Philippines); and 2090-2100 onwards for countries with low levels of development (such as Ethiopia, Haiti, and Papua New Guinea) [4].

However, rates of less than 4 cases per 100,000 would not be achieved by the end of the century in all individual countries in Africa (eg, Kenya, Tanzania, and Uganda) even if high coverage vaccination and twice lifetime cervical screening could be achieved by 2020.

The authors note several limitations, including that their predictions are constrained by a lack of high-quality cancer incidence data over time, particularly in developing countries. They also note that the model assumed lifetime duration of vaccine protection and did not fully account for geographical differences in sexual behaviour, which might affect the accuracy of the estimates. They also assumed in their rapid scale-up scenarios that very high global vaccination coverage rates (of 80% or higher) would be achievable worldwide--but successfully providing two doses of the HPV vaccine with appropriate spacing is likely to be challenging, particularly in less developed regions. Finally, the rapid scale-up scenario examined in the study did not account for cultural, logistical, and financial barriers to scaling up screening in low-resource settings.

As many as half of all patients who undergo cardiac surgery may experience delirium, a form of acute confusion that can result in disorientation, impaired memory, delusions, and abrupt changes in mood and behavior, including aggression.

In a new study published in the Journal of the American Medical Association, physician-researchers at Beth Israel Deaconess Medical Center found that intravenous acetaminophen significantly reduced the incidence of postoperative delirium following coronary artery bypass procedures in patients over 60. The findings of this single-center trial may represent the first steps toward a therapeutic intervention for the prevention of postoperative delirium, a common and devastating complication in the often highly vulnerable older adults who undergo cardiac surgery.

"Currently, IV acetaminophen administration is considered an expensive intervention, and there is significant variation in pain management following cardiac surgery," said corresponding author Balachundhar Subramainam, MD, PhD, Director of the Center for Anesthesia Research Excellence in the Department of Anesthesia, Critical Care and Pain Medicine at BIDMC. "If our findings are replicated in a larger, multicenter study, postoperative intravenous administration of acetaminophen could become a standard of care in all cardiac surgical patients and could be incorporated in cardiac surgery recovery protocols."

Subramaniam and colleagues enrolled 120 patients 60 years or older who underwent coronary bypass graft surgery with or without valve repair at Beth Israel Deaconess Medical Center in Boston between September 2015 and April 2018. To evaluate the effect of IV acetaminophen on postoperative delirium, the researchers randomly assigned patients into one of four groups receiving different combinations of sedation and pain medication after surgery: 29 participants received the sedative dexmedetomidine with IV acetaminophen, while 30 participants were given dexmedetomidine and placebo. Thirty-one patients were given the sedative propofol in combination with acetaminophen, and 30 received propofol with placebo.

Patients treated with acetaminophen demonstrated a significant reduction in in-hospital delirium. Only 10 percent of the group given acetaminophen experienced signs of delirium, compared to 28 percent of those given placebo. Moreover, those given acetaminophen also were more likely to have shorter stays in the intensive care unit, less breakthrough pain. Those patients who did experience delirium had shorter bouts of the acute confusion.

In addition to decreasing the incidence of delirium, adding acetaminophen to postoperative care also reduced the need for opioid painkillers in these patients, Subramaniam added.

"Postoperative pain is known to increase the risk for postoperative delirium, as is the use of opioids to manage postoperative pain," he said. "We found that the use of IV acetaminophen provided effective pain control, and we observed a noticeable sparing of opioids in the postoperative period with decreased duration of delirium and intensive care unit length of stay."

Is evolution predictable? What are the mechanisms that allow different fish to respond to the same environmental challenge in slightly different ways? When the same jaw bones and muscles change to produce the same feeding behaviour, are the morphologies of these fish that evolved independently from one another modified in an identical way? What is the genetic basis for this kind of convergence? These are some of the questions that Dr C. Darrin Hulsey and Professor Axel Meyer from the Department of Biology at the University of Konstanz and their international colleagues from the University of California in Los Angeles (USA), Tel Aviv University and the Inter-University Institute for Marine Sciences in Eilat (Israel) are trying to answer.

Their paper "Pleiotropic jaw morphology links the evolution of mechanical modularity and functional feeding convergence in Lake Malawi cichlids" is due for publication in the Proceedings of the Royal Society B on 20 February 2019.

Lake Malawi cichlids are extremely diverse both in how they feed and what they feed on. As Darrin Hulsey, lead author on the study, explains: "One thing about that diversity is that these groups have evolved to eat the same things repeatedly". While the Maylandia species and their close relatives have evolved to eat algae off of rocks, another major group commonly feeds on plankton, other fish or snails. However, one lineage in this second group, Protomelas taniolatus, has also evolved to graze algae. These two lineages have therefore independently evolved to exploit the abundant algal resources in Lake Malawi rapidly relative to most evolutionary timescales, i.e. in less time than the two million years this African lake has existed. This instance of repeated evolution holds particular potential for the study of evolution: "The fact that there are so many species that exhibit so many forms and the fact that this ecological specialization has evolved again and again allows us to ask questions about evolution in a more statistically rigorous way", says Hulsey.

To learn more about the evolution of these converging feeding habits, the researchers studied the anterior jaws of the cichlids, which are characterised by a complex mechanism often found in human-engineered objects such as umbrellas or the pistons of steam engines. This mechanical system is known as a "four-bar linkage" and allows the fish to protrude their jaws to bite off algae. Jaws and teeth are particularly interesting to evolutionary biologists because they have a clear connection to ecology, whereas other changes in the phenotype of an organism - such as chang-ing colours - are much less easy to interpret.

Building evolutionary trees that use large parts of the fish genome, the researchers found out that the bones that make up cichlid jaws can achieve this feeding specialization in multiple ways, a phenomenon that is known as many-to-one-mapping. "Ecologically, both groups of fish are doing the same things. The way that they push their jaws out seem to be very similar. The underlying mechanical aspects of how the bones work are similar. But there are very different morphologies of the bones that underlie these feeding abilities". The fact that two cichlid species have converged on similar jaw protrusion abilities as well as four-bar linkage mechanics, but have evolved these similarities via non-convergent four-bar morphologies suggests that very different morphologies might often translate into overlooked similarities in ecology. Phenotypic complexity could thus fundamentally influence both how organisms diversify and how we understand this diversity.

This line of research also has wider implications. As Hulsey points out, Lake Malawi is the most species-rich lake in the world. But due to hybridization, species are collapsing. One of his goals is to understand how the collapse of species generates diversity in the long term. Another is to study convergence as a way of predicting evolution. "If we can understand on the genetic level how differences as well as complex convergence come about, we may be able to better predict if and when these things will happen".

Specialized lung cells appear in the developing fetus much earlier than scientists previously thought. A new animal study reports how cells that become alveoli, the tiny compartments in which gas exchange occurs in the lung, begin their specialized roles very early in prenatal life. The researchers say that investigating the fetal signaling pathways active in this biological event may offer future opportunities to treat lung damage caused by prematurity and other lung injuries.

A research team from Children's Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania focused on the basic function of respiration--the exchange of oxygen and carbon dioxide within key cells, called alveolar type 1 and type 2 cells.

The same research team previously identified a new cell lineage in the lungs of mice and humans, which they called alveolar epithelial progenitor cells. The new research, published this week in PNAS, used single-cell RNA sequencing analysis, protein expression studies and a new lineage-tracing tool to reveal details of early lung formation in a fetal mouse model.

"This cell specification begins remarkably early in lung development, and it progressively seeds the premature lung alveolus throughout the fetus's gestation," said first author David B. Frank, MD, PhD, a pediatric cardiologist at CHOP and a member of the Penn Center for Pulmonary Biology and the Penn Cardiovascular Institute.

Frank was a co-leader of this study, in collaboration with Edward E. Morrisey, PhD, director of the Penn Center for Pulmonary Biology, and Rajan Jain, MD, an assistant professor of Cardiovascular Medicine at Penn.

The investigators are interested in deciphering the basics of how cells form their identity - essentially, why a cell becomes a lung cell as opposed to a heart cell. In particular, understanding how the lung forms is critical because many babies born prematurely have poorly formed organs. "What we found is that lung cells take on their intended fate much earlier than expected, which is a critical step toward being able to develop new therapeutics," said Jain.

Alveolar cells share similar characteristics in both mice and humans: similar underlying genes, proteins and signaling systems, so the biological mechanisms found in the current study are considered relevant to how these cells function in humans, although follow-up research needs to further study those mechanisms.

The current study found that the specification of alveolar cells begins simultaneously with early lung formation, as cells in the developing embryo begin to move apart and branch out into specialized structures such as airways and alveoli. Many lung cells commit themselves to "cell fates," their specialized roles, during branching morphogenesis, which occurs before the formation of the sac-shaped structure that becomes the lung alveolus.

"The early presence of these specialized alveolar cells may account for the fact that a minority of extremely premature human babies survive even with underdeveloped lungs," said Frank. He added that because many other organ systems in addition to the pulmonary system remain underdeveloped in extremely premature infants, morbidity and mortality remain high in such cases.

The research team plans to further explore how their findings could eventually contribute to future treatments. Better understanding of lung development could lead to potential tools in regenerative medicine, perhaps by manipulating key signaling pathways or novel progenitor cell targets to grow new lung tissue after injury from prematurity or from acquired lung disease.

A new map of newborn babies' brains offers details of structure that will provide a new reference for researchers studying both typical brain development and neurological disorders. Using noninvasive, 20-minute magnetic resonance imaging (MRI) scans, researchers have revealed some of the complex and precisely organized brain architecture that emerges as the brain reshapes itself during the third trimester of pregnancy.

"We used cutting-edge methods to see microstructure throughout the brain during a critical period of maturation," said Hao Huang, PhD, a researcher in the Department of Radiology at Children's Hospital of Philadelphia (CHOP). "In addition to characterizing typical brain development, these measurements offer the potential to detect biomarkers of autism spectrum disorder at an age that could allow early diagnosis and possibly early intervention."

The study, published this week in PNAS, analyzed 76 preterm and term newborns--47 males and 29 females--ranging in age from 31 to 42 postmenstrual weeks. Using advanced diffusion MRIs to measure patterns of water diffusion, the research team produced two measurements. One, called fractional anisotropy, measured microstructural organization; the other, a more complex model metric called mean kurtosis (MK), measured microstructural complexity. Huang's team is one of the earliest to use MK to measure microstructure in the brain's cerebral cortex.

In contrast to previous studies of cerebral cortex microstructure, based on tissue samples after death that offered limited, localized data, the diffusion MRI data spanned the entire cortex. Furthermore, said Huang, studying a number of newborns at different gestational ages provided information about brain development over a key time span.

Applied to a simple pool of water, diffusion MRI detects the random motion of water molecules, but water diffusion in the brain cerebral cortex is altered by the presence of neurons, dendrites and other structures that disrupt randomness and provide clues to anatomical structure.

The third trimester of pregnancy is a dynamic period in brain development. The cortex prunes itself, typically ridding itself of excess neurons and synapses. However, if this process does not occur efficiently, excess interconnections may remain--a situation that is characteristic of autism spectrum disorders (ASDs). By detecting those atypical interconnections, Huang's research could offer an imaging biomarker of ASD in newborns.

Huang added that the brain circuit architectures are only inferred by the imaging measurements, and that further research must occur to investigate whether this approach can reliably predict ASD risk. His group is planning a follow-up study to see if findings in newborns predict whether a child will have ASD symptoms at age two. The study team is also planning to compile a 4-D atlas of the infant brain, portraying three spatial dimensions plus changes over time. Their ultimate goal is to produce a Brain Chart--a baseline standard providing typical measurements of brain development, comparable to the pediatrician's growth chart that incorporates standard measures of child height and weight.

DURHAM, N.C. -- Israel's targeting of agricultural, water and energy infrastructures in the West Bank and Gaza Strip has had dire impacts on human welfare and livelihoods in both locations, a new report by researchers at Duke University and the University of New Hampshire shows.

The report is based on an original database that identifies 982 incidents between 2006 and 2017 in which Israeli forces, agencies or settlers damaged, destroyed, disabled or restricted access to sites and structures that provided food, clean water and other essential services to Palestinians.

"For so long, the international community has largely focused on the direct targeting of civilians in war and has overlooked the way in which governments target infrastructure during war and occupations that can persist for decades," said Erika Weinthal, Lee Hill Snowdon Professor of Environmental Policy at Duke's Nicholas School of the Environment.

Their data on Gaza and the West Bank comes from a larger database they have compiled that documents incidents of infrastructure targeting across the Middle East and North Africa.

"What is happening in Gaza and the West Bank is not an isolated problem," Weinthal added. "Our database shows this type of violence is occurring increasingly in conflict zones throughout the region."

Weinthal and Sowers published their analysis Feb. 11 in the journal International Affairs.

"Our research, which synthesizes findings from hundreds of government documents, UN reports, prior studies and other verifiable sources, shows that when you target objects like cisterns, sewer lines, fishing boats and olive trees, you are also indirectly targeting the humans who depend on them. This has profound long-term implications, not only for Palestinians in the West Bank and Gaza but for peace and security across the region," Weinthal said.

In Gaza, for instance, repeated attacks on water and sewage infrastructure have damaged 60 percent of the area's treatment plants, 27 percent of its pumping stations and more than 20 miles of water or wastewater lines, according to a 2014 analysis by the UN Human Rights Council. By 2014, only 10.5 percent of Gaza's population had access to safe drinking water through the public system, down from 98.3 percent in 2000.

"The cycle of destruction, rebuilding and destruction again has resulted in significant degradation of Gaza's civilian infrastructure and economy," said Jeannie Sowers, associate professor of political science at UNH's College of Liberal Arts. "Combined with border blockades and increased delays or denials for construction permits, it's become difficult to secure international aid and investments or import the materials needed to rebuild."

The systemic use of legal restrictions, permit denials and other indirect forms of oppression is an example of "slow violence," Sowers explained, referring to a term Princeton University scholar Rob Nixon coined in 2011 to describe environmental damage that unfolds gradually and largely out of sight of the public.

"Slow violence has been especially widely used in the West Bank," Sowers said. "It includes a range of practices, from the theft of electrical generators to the denial of construction permits to build water systems for Palestinian villages, as well as refusals to connect them to existing systems. Collectively, such actions have contributed to the fragmentation of the Palestinian population into a series of isolated, donor-dependent enclaves."

Of the 685 West Bank incidents that Weinthal and Sowers document in their report's database, roughly 75 percent targeted agricultural sites and structures. The majority of these incidents were carried out by Jewish settlers and involved the destruction of olive and fruit trees.

To conduct their analysis, they scoured 12 years of records compiled by UN agencies, public utilities and human rights groups; reviewed hundreds of news reports and government documents; and conducted 28 interviews with government officials in Israel and representatives of nongovernmental organizations and aid programs active in the region.

PHILADELPHIA - Patients taking diuretics are often at risk for low potassium levels, which can put patients at an increased risk of death from cardiac arrhythmias or other causes. But researchers from the Perelman School of Medicine at the University of Pennsylvania found that taking prescription potassium supplements can reduce these patients' risk by nearly 10 percent as daily outdoor temperatures increase--a time when patients may be at highest risk due to loss of potassium while sweating. These findings are detailed in a study published today in BMJ Open.

The drug furosemide, a diuretic known commonly as Lasix, is prescribed to patients with heart failure, high blood pressure, and/or kidney and liver disease, to decrease fluid retention and combat swelling in the arms, legs, and/or abdomen. The drug, like many other diuretics, causes patients to urinate more than normal, leading to lower levels of potassium in the body. These lower levels can be more dangerous when outdoor temperatures are high, as patients often lose additional potassium through sweating.

"We already know that hot outdoor temperatures are associated with increased risk of heat stroke, dehydration, heart disease, respiratory diseases, and higher risk of death overall, but people who take furosemide and have insufficient intake of potassium are at increased risk," said senior author Sean Hennessy, PharmD, PhD, a professor of Epidemiology and Systems Pharmacology and Translational Therapeutics. "As outside temperatures increase, the apparent survival benefit of potassium also increases."

The study looked at 1999-2010 data from United States Medicaid patients in California, Florida, New York, Ohio, and Pennsylvania - about 40 percent of total U.S. Medicaid enrollees - making up approximately 20 percent of the total U.S. population. Data was included from those who took furosemide, 40 mg/day or higher and had not been prescribed any furosemide nor diagnosed of hypokalemia - insufficient potassium in the blood-- in the previous 365 days.

Among the 337,885 people who took 40 mg/day or more of furosemide, 32 percent of them also took potassium when starting the diuretic. The team linked these data to zip code-level daily temperature data from the National Oceanic and Atmospheric Administration, and compared two groups--one group included patients who took prescription potassium to prevent hypokalemia when beginning furosemide, and the other included patients who did not take prescription potassium when taking furosemide. The team found that across all temperatures, the potassium-taking group experienced a 9.3 percent lower risk of death than the group who did not take potassium. This survival benefit was also higher when daily maximum temperatures were higher.

"These findings suggest that potassium intake may be important for patients taking furosemide, especially on hot days," said lead author Young Hee Nam, PhD, a post-doctoral researcher in Biostatistics, Epidemiology and Informatics. "It is also important to understand that our findings do not imply that more potassium is better, and do not imply that prescription potassium may be beneficial for all patients. Further studies are needed to find out the generalizability of our findings to other patient populations. The best way to reduce harmful effects of high temperatures on mortality might be to avoid exposure to high temperatures if possible."

The latest work follows a 2014 paper in PLOS ONE from the authors which showed that for the many people taking furosemide, mortality rates decline if they also take potassium.

The authors emphasized the need for future research into temperature and potassium interaction among different socioeconomic groups, as well as work that considers time spent outside and whether individuals living in warmer regions are better at tolerating increasing temperatures than those who live in cooler climates.

ANN ARBOR, Mich. -- With medical marijuana now legal in about two-thirds of U.S. states, there's growing concern about how dispensaries may impact surrounding neighborhoods and communities.

And parents in a new national poll overwhelmingly agree on one place dispensaries should not be allowed: anywhere near children.

Seven in 10 parents think they should have a say in whether dispensaries are located near their child's school or daycare and most say they should be banned within a certain distance of those facilities, according to the C.S. Mott Children's Hospital National Poll on Children's Health at the University of Michigan.

Highest on the list of concerns was the risk impaired drivers may pose to children - with nearly half of parents saying this was a significant worry. A recent study found that more than half of people taking cannabis for chronic pain report driving while high.

"Medical marijuana has become legal in the majority of states but there is wide variation in state and local policies that regulate the location and operation of dispensaries," says poll co-director Sarah Clark, M.P.H.

"The majority of parents feel strongly that they should give local input on decisions regarding where dispensaries may open and also support limitations on how close dispensaries could be to children's areas."

Aside from the top concern involving drivers under the influence, some parents also worried about the possibility of a child finding and ingesting edible marijuana inadvertently left behind by a dispensary customer (48 percent), and teens having easier opportunities accessing marijuana (49 percent.) Other dispensary concerns included setting a bad example for kids (45 percent) and bringing violent crime to the area (35 percent).

Three quarters of parents indicated general support for legal medical marijuana, including one third of parents who support the option for children. Just 26 percent of parents opposed medical marijuana.

At the same time, most parents agreed that dispensaries should be banned within a certain distance of elementary schools, middle and high schools, and daycare centers. Forty-four percent of parents also believed dispensaries should not be close to places of worship. Support for such bans was equally strong among both mothers and fathers, younger and older parents, and parents of higher and lower income.

"Most parents seem to understand that marijuana can have legitimate medical benefits, but parents also have major concerns about the risks that medical marijuana dispensaries might pose to children," Clark says. "When it comes to where dispensaries are located, many parents feel that any area near children is too close for comfort."

Most parents (77 percent) agreed that medical marijuana dispensaries should have the same regulations as liquor stores for where they can be located. Meanwhile, 52 percent of parents said dispensaries should have the same rights as other businesses. Nearly all parents (90 percent) felt dispensaries should undergo inspections to ensure they are following all regulations.

Nearly half of parents (45 percent) said that medical marijuana is legal in their state, and 24 percent knew there was at least one medical marijuana dispensary in their community. Only 20 percent reported that their state or community has regulations about where dispensaries can be located, while 59 percent did not know if such regulations exist.

While most parents wanted to be consulted about locating a dispensary near their child's school or daycare, this may prove difficult, Clark says. There is no consistent state or local framework to regulate the location and operations of dispensaries. Some states may have added legal complexities differentiating the sale of medical versus recreational marijuana.

It may also be confusing about whether parents need to contact elected officials or commissions, and if they should focus on the state or local level when an application is filed for a new dispensary. Decisions about the location of new dispensaries could be made through a state law, a local zoning regulation, or other action.

"Parents who want to share their views about dispensaries before any open in their school's neighborhood may have limited opportunities to do so. They may not even be aware that a specific dispensary location is under consideration until the decision has already been made," Clark says.

"The lack of established standards may lead officials to enact policies that may not address parents' concerns," Clark adds. "Parents who want to provide input about local dispensaries may need to take the initiative to learn about the rules for opening a dispensary in their community and what steps they should follow to be involved in these decisions."

Climate change is shifting the energy in the atmosphere that fuels summertime weather, which may lead to stronger thunderstorms and more stagnant conditions for midlatitude regions of the Northern Hemisphere, including North America, Europe, and Asia, a new MIT study finds.

Scientists report that rising global temperatures, particularly in the Arctic, are redistributing the energy in the atmosphere: More energy is available to fuel thunderstorms and other local, convective processes, while less energy is going toward summertime extratropical cyclones -- larger, milder weather systems that circulate across thousands of kilometers. These systems are normally associated with winds and fronts that generate rain.

"Extratropical cyclones ventilate air and air pollution, so with weaker extratropical cyclones in the summer, you're looking at the potential for more poor air-quality days in urban areas," says study author Charles Gertler, a graduate student in MIT's Department of Earth, Atmospheric and Planetary Sciences (EAPS). "Moving beyond air quality in cities, you have the potential for more destructive thunderstorms and more stagnant days with perhaps longer-lasting heat waves."

Gertler and his co-author, Associate Professor Paul O'Gorman of EAPS, are publishing their results in the Proceedings of the National Academy of Sciences.

A shrinking gradient

In contrast to more violent tropical cyclones such as hurricanes, extratropical cyclones are large weather systems that occur poleward of the Earth's tropical zone. These storm systems generate rapid changes in temperature and humidity along fronts that sweep across large swaths of the United States. In the winter, extratropical cyclones can whip up into Nor'easters; in the summer, they can bring everything from general cloudiness and light showers to heavy gusts and thunderstorms.

Extratropical cyclones feed off the atmosphere's horizontal temperature gradient -- the difference in average temperatures between northern and southern latitudes. This temperature gradient and the moisture in the atmosphere produces a certain amount of energy in the atmosphere that can fuel weather events. The greater the gradient between, say, the Arctic and the equator, the stronger an extratropical cyclone is likely to be.

In recent decades, the Arctic has warmed faster than the rest of the Earth, in effect shrinking the atmosphere's horizontal temperature gradient. Gertler and O'Gorman wondered whether and how this warming trend has affected the energy available in the atmosphere for extratropical cyclones and other summertime weather phenomena.

They began by looking at a global reanalysis of recorded climate observations, known as the ERA-Interim Reanalysis, a project that has been collecting available satellite and weather balloon measurements of temperature and humidity around the world since the 1970s. From these measurements, the project produces a fine-grained global grid of estimated temperature and humidity, at various altitudes in the atmosphere.

From this grid of estimates, the team focused on the Northern Hemisphere, and regions between 20 and 80 degrees latitude. They took the average summertime temperature and humidity in these regions, between June, July, and August for each year from 1979 to 2017. They then fed each yearly summertime average of temperature and humidity into an algorithm, developed at MIT, that estimates the amount of energy that would be available in the atmosphere, given the corresponding temperature and humidity conditions.

"We can see how this energy goes up and down over the years, and we can also separate how much energy is available for convection, which would manifest itself as thunderstorms for example, versus larger-scale circulations like extratropical cyclones," O'Gorman says.

Seeing changes now

Since 1979, they found the energy available for large-scale extratropical cyclones has decreased by 6 percent, whereas the energy that could fuel smaller, more local thunderstorms has gone up by 13 percent.

Their results mirror some recent evidence in the Northern Hemisphere, suggesting that summer winds associated with extratropical cyclones have decreased with global warming. Observations from Europe and Asia have also shown a strengthening of convective rainfall, such as from thunderstorms.

"Researchers are finding these trends in winds and rainfall that are probably related to climate change," Gertler says. "But this is the first time anyone has robustly connected the average change in the atmosphere, to these subdaily timescale events. So we're presenting a unified framework that connects climate change to this changing weather that we're seeing."

The researchers' results estimate the average impact of global warming on summertime energy of the atmosphere over the Northern Hemisphere. Going forward, they hope to be able to resolve this further, to see how climate change may affect weather in more specific regions of the world.

"We'd like to work out what's happening to the available energy in the atmosphere, and put the trends on a map to see if it's, say, going up in North America, versus Asia and oceanic regions," O'Gorman says. "That's something that needs to be studied more."

AUGUSTA, Ga. (Feb. 18, 2019) - Directly activating a gene important to exciting our excitatory neurons and associated with major depression may help turn around classic symptoms like social isolation and loss of interest, at least for males, scientists report.

They looked in the prefrontal cortex, a brain area involved in complex behaviors like planning, personality and social behavior and known to have an important role in the pathogenesis of major depression, and found that making the SIRT1 gene inactive in excitatory neurons there created symptoms of depression in male mice, they report in the journal Molecular Psychiatry.

When, like in real life, stress not direct gene manipulation caused depression, a drug that activated SIRT1, reversed the symptoms in the males, says molecular behavioral neuroscientist Dr. Xin-Yun Lu.

"It has an antidepressant-like effect," says Lu, the study's corresponding author, a professor in the Department of Neuroscience and Regenerative Medicine at the Medical College of Georgia at Augusta University and Georgia Research Alliance Eminent Scholar in Translational Neuroscience.

That means drugs that activate SIRT1 and enable the usual high level of activity of these excitatory neurons might one day be an effective therapy for some with major depression, says Lu. Major depression is one of the most common mental disorders in the United States, affecting nearly 7 percent of adults, according to the National Institute of Mental Health.

The firing of excitatory neurons is definitely decreased in depression, and neurons are not communicating as they should. "It's like they are disconnected," says Lu. Problems like manic behavior and seizures, on the other hand, indicate excessive firing.

It's hard to get excited without energy, and another of SIRT1's known roles in brain cells is regulating cell powerhouses, called mitochondria. The scientists found that at least part of the way knocking out SIRT1 in males impacted the excitability of these normally excited neurons was by reducing the number of cell powerhouses and the expression of genes involved in powerhouse production.

The depressed behaviors they saw as a result are another indicator of SIRT1's importance in that region to mood regulation and how without it, there is insufficient excitation of neurons. So was the resolution of stress-induced depression in male mice when they activated SIRT1 that had been deactivated by stress, the scientists say.

They note surprise at the lack of impact in female mice since the SIRT1 variant was first identified in a large gene study of depressed women. They suspect physical differences in this front region of the brain, like differences in the numbers of neurons and synapses between males and females, could help explain the sex differences they found. Lu is already looking to see if she finds similar sex disparities in the hippocampus, another brain region important in depression as well as other conditions like Alzheimer's.

Still, depressed mice and humans act similarly, Lu says, which includes an impaired ability to feel pleasure called anhedonia. So they used the mice's usual high preference for a sweet, sucrose solution, as one way to gauge their depression.

"You give them a choice and they will drink that," she says. "But if you stress them, they won't lose their preference necessarily but it will reduce their interest." Males also forego their normal social nature and instead become loners. They even lose their interest in sex and in sniffing the females' pheromones.

Lu, who is also a pharmacologist, plans to look at existing drugs, including some older drugs never used for depression, to see if any have an impact on SIRT1 like the research drug they used.

Depression is generally considered caused by a combination of genetic and environmental factors. Lu says some individuals likely are born with the SIRT1 variant identified in genome-wide association studies, which predisposes them to depression, although environmental factors must also come into play for depression to happen. She notes that the SIRT1 variant is likely rare and only associated with depression rather than considered causative.

The prefrontal cortex is known to have a role in emotional responses and involved in controlling neurotransmitters, like serotonin, which are key to mood regulation. The severity of depression correlates with the degree of inactivity of that brain region, Lu and her colleagues write.

A 2015 study in the journal Nature reported genome-wide studies of 5,303- Chinese women with major depressive disorder and 5,337 controls identified a variant of the SIRT1 gene as one of two variants associated with the disorder. Those scientists later replicated the finding in males.

Lu notes the magic of finding it in the females in the large human study was likely because of the consistent severity of the disease and the fact that all the women were from a similar region.

DALLAS, February 18, 2019 -- Patients receiving hormone therapy as part of their gender-transition treatment had an elevated risk for cardiovascular events, including strokes, heart attacks and blood clots, according to a study published in the American Heart Association's journal Circulation.

The results are based on analysis of medical records of 3,875 Dutch individuals who received hormone treatment between 1972and 2015 as part of their gender transition.

"In light of our results, we urge both physicians and transgender individuals to be aware of this increased cardiovascular risk," said study author Nienke Nota, M.D., a researcher in the department of endocrinology at the Amsterdam University Medical Center. "It may be helpful to reduce risk factors by stopping smoking, exercising, eating a healthy diet and losing weight, if needed before starting therapy, and clinicians should continue to evaluate patients on an ongoing basis thereafter."

Past research has shown that hormone therapy increases cardiovascular risk among people receiving it to alleviate symptoms of menopause, yet research evidence remains scarce on the effects of hormone treatment in people undergoing gender transition. Even though such individuals tend to be younger than menopausal patients receiving hormone-replacement therapy, transgender people may have more psychosocial stressors and other factors that increase cardiovascular risk, the researchers said.

The analysis involved 2,517 transgender women, median age 30, who received estrogen, with or without androgen-suppressors, and 1,358 transgender men, median age 23, who received testosterone as part of their transition.

To gauge risk, the researchers determined the incidence of acute cardiovascular events--heart attacks, strokes and deep vein thromboses (blood clots). They compared the incidence of such cases in the transgender population to that reported in the general population. Transwomen were followed for an average of 9 years since start of hormone therapy, while transmen were followed for an average of 8 years after starting with hormones.

The analysis showed that transwomen -- individuals assigned male sex at birth but with female gender identity who were receiving hormones as part of their transition -- had more than twice as many strokes as women (29 versus 12) and nearly twice as many strokes as men (29 versus 16). There were five times as many deep-vein clots among transwomen (73) than women (13) and 4.5 times more than men (73 versus 16). Heart attacks occurred at more than twice the rate among transwomen (30) than women (13). Transmen--those assigned female sex at birth but who had male gender identity and received hormones -- had a more than three-fold elevation in heart-attack risk compared with women (11 versus 3).

The study was not designed to tease out the mechanism behind the increased risk. The researchers caution that their study was based solely on a review of medical records and could not account for risk factors such as smoking, psychosocial stressors, dietary and exercise habits. While those risk factors probably contribute to the increased cardiovascular risk, the researchers suggest that the hormone therapy may contribute to increased risk as well.

In previous studies it has been shown that triglyceride and insulin levels, for example, have both increased as a result of estrogen therapy and both are known to promote clogging and inflammation of the blood vessels. Additionally, estrogen therapy can render the blood more prone to clotting, which may explain the higher rate of strokes and blood clots observed in transwomen, the authors said. The rise in heart attack risk observed in transmen receiving testosterone may be explained partly by the hormone's tendency to make the blood stickier by increasing the concentration of red blood cells along with lowering the level of good cholesterol and raising the level of bad cholesterol, the research team said.

EVANSTON --- Northwestern University researchers are developing a predictive model to help NASA anticipate conflicts and communication breakdowns among crew members and head off problems that could make or break the Mission to Mars.

NASA has formalized plans to send a crewed spacecraft to Mars, a journey that could involve 250 million miles of travel. Among the worldwide teams of researchers toiling over the journey's inherent physiological, engineering and social obstacles, Northwestern professors Noshir Contractor and Leslie DeChurch, and their collaborators, are charting a new course with a series of projects focused on the insights from the science of teams and networks.

In a multiphase study conducted in two analog environments -- HERA in the Johnson Space Center in Houston and the SIRIUS mission in the NEK analog located in the Institute for Bio-Medical Problems (IBMP) in Russia -- scientists are studying the behavior of analog astronaut crews on mock missions, complete with isolation, sleep deprivation, specially designed tasks and mission control, which mimics real space travel with delayed communication.

The goal is threefold: to establish the effects of isolation and confinement on team functioning, to identify methods to improve team performance, and to develop a predictive model that NASA could use to assemble the ideal team and identify potential issues with already composed teams before and during the mission.

Contractor and DeChurch discussed their latest findings and next steps at a 10 a.m. EST, Feb. 17 press briefing at the American Association for the Advancement of Science (AAAS) annual meeting in Washington, D.C.

"It's like astronaut Scott Kelly says, 'Teamwork makes the dream work,'" said Contractor, the Jane S. and William J. White Professor of Behavioral Sciences in the McCormick School of Engineering, School of Communication and the Kellogg School of Management.

Even for an astronaut, the psychological demands of this Mars journey will be exceptional. The spacecraft will be small, roughly the size of a studio apartment, and the round-trip journey will take almost three years.

"Astronauts are super humans. They are people who are incredibly physically fit and extremely smart," said DeChurch, a professor of communication and psychology at Northwestern. "We're taking an already state-of-the-art crew selection system and making it even better by finding the values, traits and other characteristics that will allow NASA to compose crews that will get along."

Communication delays with worldwide mission controls will exceed the 20-minute mark. In that sense, the Mars mission will be like no mission that has come before.

"A lot of the past efforts to try to create models to simulate the future have run into criticism because people have said it's not really grounded in good data," Contractor said. "What we have here is unprecedented good data. We aren't talking about intuition and expert views, this model is based on real data."

The Northwestern researchers have been culling data from the Human Experimentation Research Analog (HERA) at Houston's Johnson Space Center. HERA's capsule simulator houses astronauts for up to 45 days; a mock mission control outside the capsule augments the realism with sound effects, vibrations and communication delays.

Those on the inside undergo sleep deprivation and try to perform tasks. The researchers collect moment-to-moment metrics about individual performance, moods, psychosocial adaptation and more.

The teams DeChurch and Contractor have studied experienced diminished abilities to think creatively and to solve problems, according to results from the first eight analog space crews, and are able to successfully complete tasks between 20 and 60 percent of the time.

"Creative thinking and problem solving are the very things that are really going to matter on a Mars mission," DeChurch said. "We need the crew to be getting the right answer 100 percent of the time."

The next phase of the research, just begun on Friday, Feb. 15, involves using the model to predict breakdowns and problems a new HERA crew will experience and making changes to "who works with whom, on what, when," Contractor said. "We are going to run our model to see how we can nudge the team into a more positive path and make them more successful."

The researchers are also expanding the experiment to the SIRIUS analog in Moscow, where, beginning on March 15, four Russians and two Americans, will undertake a 120-day fictional mission around the moon, and including a moon landing operation.

Contractor and DeChurch are in the midst of four NASA-funded projects exploring team dynamics and compatibility in preparation for the Mars journey.

Their NASA studies address different aspects of the crew's challenges:

The likelihood that the crew and its support teams on Earth will have good chemistry and coping mechanisms; how to predict possible crew-compatibility outcomes

Work design; structuring the workflow so that astronauts can better manage transitions from solo to team tasks

Identifying and building shared mental models, whereby a team of varied specialists can find enough common ground to effectively accomplish their tasks but not so much that they engage in "group think" or form alliances.

Contractor, a leading expert in network analysis and computational social science, leads Northwestern's Science of Networks in Communities (SONIC) research group. DeChurch, a leading expert in teamwork and leadership who leads Northwestern's Advancing Teams, Leaders, and Systems (ATLAS) lab, focuses on team performance; psychology, social interactions, and how multiteam systems best function.

"Our complementary strengths have been a winning combination for tackling the big interdisciplinary questions," said DeChurch.