Culture

Insect-sized flying robots could help with time-consuming tasks like surveying crop growth on large farms or sniffing out gas leaks. These robots soar by fluttering tiny wings because they are too small to use propellers, like those seen on their larger drone cousins. Small size is advantageous: These robots are cheap to make and can easily slip into tight places that are inaccessible to big drones.

But current flying robo-insects are still tethered to the ground. The electronics they need to power and control their wings are too heavy for these miniature robots to carry.

Now, engineers at the University of Washington have for the first time cut the cord and added a brain, allowing their RoboFly to take its first independent flaps. This might be one small flap for a robot, but it's one giant leap for robot-kind. The team will present its findings May 23 at the International Conference on Robotics and Automation in Brisbane, Australia.

RoboFly is slightly heavier than a toothpick and is powered by a laser beam. It uses a tiny onboard circuit that converts the laser energy into enough electricity to operate its wings.

"Before now, the concept of wireless insect-sized flying robots was science fiction. Would we ever be able to make them work without needing a wire?" said co-author Sawyer Fuller, an assistant professor in the UW Department of Mechanical Engineering. "Our new wireless RoboFly shows they're much closer to real life."

The engineering challenge is the flapping. Wing flapping is a power-hungry process, and both the power source and the controller that directs the wings are too big and bulky to ride aboard a tiny robot. So Fuller's previous robo-insect, the RoboBee, had a leash -- it received power and control through wires from the ground.

But a flying robot should be able to operate on its own. Fuller and team decided to use a narrow invisible laser beam to power their robot. They pointed the laser beam at a photovoltaic cell, which is attached above RoboFly and converts the laser light into electricity.

"It was the most efficient way to quickly transmit a lot of power to RoboFly without adding much weight," said co-author Shyam Gollakota, an associate professor in the UW's Paul G. Allen School of Computer Science & Engineering.

Still, the laser alone does not provide enough voltage to move the wings. That's why the team designed a circuit that boosted the seven volts coming out of the photovoltaic cell up to the 240 volts needed for flight.

To give RoboFly control over its own wings, the engineers provided a brain: They added a microcontroller to the same circuit.

"The microcontroller acts like a real fly's brain telling wing muscles when to fire," said co-author Vikram Iyer, a doctoral student in the UW Department of Electrical Engineering. "On RoboFly, it tells the wings things like 'flap hard now' or 'don't flap.'"

Specifically, the controller sends voltage in waves to mimic the fluttering of a real insect's wings.

"It uses pulses to shape the wave," said Johannes James, the lead author and a mechanical engineering doctoral student. "To make the wings flap forward swiftly, it sends a series of pulses in rapid succession and then slows the pulsing down as you get near the top of the wave. And then it does this in reverse to make the wings flap smoothly in the other direction."

For now, RoboFly can only take off and land. Once its photovoltaic cell is out of the direct line of sight of the laser, the robot runs out of power and lands. But the team hopes to soon be able to steer the laser so that RoboFly can hover and fly around.

While RoboFly is currently powered by a laser beam, future versions could use tiny batteries or harvest energy from radio frequency signals, Gollakota said. That way, their power source can be modified for specific tasks.

Future RoboFlies can also look forward to more advanced brains and sensor systems that help the robots navigate and complete tasks on their own, Fuller said.

"I'd really like to make one that finds methane leaks," he said. "You could buy a suitcase full of them, open it up, and they would fly around your building looking for plumes of gas coming out of leaky pipes. If these robots can make it easy to find leaks, they will be much more likely to be patched up, which will reduce greenhouse emissions. This is inspired by real flies, which are really good at flying around looking for smelly things. So we think this is a good application for our RoboFly."

Agility -- the ability to rapidly and tactically change speed or direction -- is an important factor in soccer performance. A new study reports that two new agility tests can successfully discriminate between youth soccer players at under-17 and under-19, with the older players showing enhanced agility. In contrast, other characteristics thought to be associated with agility, such as body dimensions and sprinting abilities, were not significantly different between the two age groups. Published in open-access journal Frontiers in Physiology, the study suggests that specific agility training could pay dividends in enhanced youth soccer player agility and performance.

The next World Cup is almost upon us, and for the duration of the tournament most people will take an interest in soccer. However, for soccer players and coaches, honing soccer skills is a year-round commitment. But what makes a good soccer player, and how can this be measured?

Sports scientists are developing tests to identify player strengths and new coaching strategies. One focus is agility, given its importance to soccer performance. Parameters thought to be linked to agility include sprinting and jumping abilities as well as body dimensions. However, most current agility tests were developed for sports other than soccer.

"During a soccer game, players frequently change their direction and speed in reaction to external factors, such as an opponent moving closer," explains Professor Damir Sekulic from the University of Split in Croatia. "A player can also pre-plan quick changes in direction speed, such as running into a free space to get open for a pass. While both reactive and pre-planned agility are important in soccer, there is a lack of soccer-specific agility tests."

Sekulic, along with Professor Haris Pojskic from Mid Sweden University and other colleagues in Croatia and Sweden, therefore set out to develop agility tests specifically for soccer players.

The researchers asked players to dribble a ball towards four plastic cones spaced widely apart. When each player approached the cones, a light turned on above one of them. The player then needed to bounce the ball off a board near the lit cone and return to the start position as quickly as possible.

The rationale behind the test is that more agile players will complete the task in a shorter time. To assess reactive agility, the researchers did not tell the players which cone would light, while to test pre-planned agility, the players knew which cone would light and so could plan their movements.

The research team used the tests to assess youth soccer players in Sweden in under-17 and under-19 divisions. As the older players had been in soccer training for longer, it was expected that they would have higher performance levels. The researchers also measured other parameters thought to be linked to agility, including sprinting/jumping abilities and body dimensions.

Players in the under-19 group showed higher reactive and pre-planned agility scores. These findings are striking, because the new agility tests were the only measurements that distinguished between the older and younger players. The other parameters, such as jumping and sprinting ability, were not significantly different between players of different ages.

"The superiority of the under-19 players in agility may be a direct consequence of their longer involvement in soccer training," says Pojskic. "Coaches who work with young soccer players should be aware that agility development between 17 and 19 years is mostly dependent on specific training for motor proficiency. There is no evidence that developing other capacities, such as sprinting or jumping, has any positive impact on agility in players of this age."

The findings suggest that specifically developing agility in youth soccer players, rather than focusing exclusively on attributes such as jumping and sprinting abilities, could enhance player agility and performance.

AUGUSTA, Ga. (May 15, 2018) - High levels of a protein activated by vitamin K and associated with cardiovascular disease when it isn't, has been found in the blood of African-Americans on dialysis, investigators report.

The work, published in the American Journal of Hypertension, indicates that these high blood levels of inactive matrix Gla protein, or MGP, may help identify those at highest risk for disease and who might benefit most from vitamin K supplementation, says Mary Ellen Fain, student at the Medical College of Georgia at Augusta University and the study's first author.

Active MGP appears to be the only natural inhibitor of vascular calcification and vitamin K the only known activator of MGP.

When MGP is active, calcium also circulating in the blood, binds to it - instead of the lining of blood vessel walls - so it gets eliminated by the body.

"We know that the lifespan of patients on hemodialysis is reduced, that cardiovascular disease accounts for about half their deaths and that vascular calcification is a key contributor," says Dr. Norman Pollock, bone biologist at MCG's Georgia Prevention Institute.

"Key questions we want to answer include exactly how vascular calcification occurs in this very high-risk population of individuals and how we might better recognize, treat and ideally prevent these unhealthy changes to their blood vessels," says Pollock, the study's corresponding author.

Inactive MGP is what's circulating in the blood, and the investigators measured those levels in 37 African-Americans on hemodialysis as well as 37 age and race matched healthy individuals. In people on hemodialysis, they also measured arterial stiffness as well as endothelial function, based on the ability of their blood vessels to perform basic functions like expand and contract in response to the body's demands.

They found mean levels of inactive MGP were 5.6 times higher than in healthy controls and those high levels correlated with increased arterial stiffness and impaired endothelial function, Fain says.

She notes that like vitamin K levels, vascular calcification is difficult to measure directly, so they measured these two related indicators of cardiovascular health.

The MCG study appears to be the first to look at the relationship between circulating levels of inactive MGP and these markers in this very high-risk group. The deleterious impact on cardiovascular health they found held even after adjusting for other established risks like diabetes and high body mass index and blood pressure.

Next steps include recruiting both black and white adults with stage 3 to 5 kidney disease who are on hemodialysis to look at the cardiovascular impact of taking a vitamin K supplement daily for two months.

Just why the balance of active versus inactive MGP is off in these patients is unknown, but these individuals may simply need more vitamin K to maintain sufficient levels of active MGP, Pollock says.

He notes that their colleagues at R&D Group VitaK, at Maastricht University in The Netherlands, have shown that kidney dialysis does not affect vitamin K levels. Higher calcium levels in the blood also are not a guarantee of vascular calcification, Fain adds.

Heart disease and kidney disease are among the leading causes of death in the United States, according to the Centers for Disease Control and Prevention. African-Americans are among those at highest risk for both, and kidney failure significantly increases the risk of heart disease.

Vascular calcification occurs most extensively in individuals with chronic kidney disease, the investigators write, particularly in those on hemodialysis, which is considered lifesaving in patients whose kidneys have failed.

Vitamin K is active only about six hours after it's consumed, and is found in green leafy vegetables like spinach, cabbage and lettuce as well as olive oil.

There's increasing evidence that the vitamin, better known for its role in bone health, has a role in cardiovascular health as well. Calcium is typically important for strong bone, and that's where we store most of it. It even normally helps blood vessels with their usual contraction and relaxation in response to your body's demands. But with vascular calcification, there is a double whammy as calcium gets pulled out of bones so they get weaker, and deposited in blood vessel walls which become stiff.

Although not yet used clinically, the circulating, inactive MGP measured in the newly published studies is widely considered an indicator of cardiovascular risk. Additionally, measuring inactive MGP levels is the only way currently available to gauge vitamin K levels, which cannot be measured directly, Pollock says.

In October 2017, Pollock and Fain published a study in The Journal of Nutrition that showed otherwise healthy teens who consumed the least vitamin K had 3.3 times higher risk of an enlargement of the pumping chamber of their hearts and that the chamber pumped out less blood.

There is a strong link between depression and anxiety disorders and autoimmune thyroiditis (AIT), a chronic thyroid condition affecting approximately 10 percent of the population. Scientists at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now proven that special treatment could help many sufferers, especially women.

Depression and anxiety are among the most common psychiatric disorders across the globe. In 2016 more than 260,000 patients were admitted to hospital for treatment in Germany alone, according to statistics from the Federal Statistics Office.

Together with Prof. Dr. Johannes Kornhuber, Chair of Psychiatry and Psychotherapy at FAU, and scientists from the Psychiatric Clinic at the University of Bonn, Dr. Teja Wolfgang Grömer, medical practitioner in Bamberg and lecturer at the Chair of Psychiatry and Psychotherapy, has now proven a strong link between depression and anxiety disorders and autoimmune thyroiditis. 'Over the years, I must have been consulted by several hundred people suffering from depression and anxiety,' reports the psychiatrist and former Max-Planck researcher. 'At the end of 2015 I noticed a marked connection between AIT and the other two conditions, especially in patients suffering from both. After realising that more than one in two people diagnosed with anxiety and depression - and only in these cases, not other conditions - also tested positive for antibodies I decided to investigate the issue in more detail.' With the help of the co-authors and a student of psychology at the University of Bamberg, Eva-Maria Siegmann, Dr. Grömer drew up a systematic overview of the current state of research and calculated the strength of the connection on the basis of statistics. For his metastudy, Dr. Grömer combined 21 independent studies based on a total of 36,174 participants. 35,168 of the participants suffered from depression and 34,094 from anxiety.

Initial diagnosis of autoimmune thyroiditis

Dr Grömer stresses that 'most patients felt a sense of relief after receiving the diagnosis, as very often they had been left with no explanation for their symptoms.' Autoimmune thyroiditis leads to a lasting inflammation of the thyroid gland. Hormones from the thyroid influence the metabolism and cellular energy balance as well as perceived energy levels and the psyche. AIT leads to specific mental symptoms, including inner unrest, tension and exhaustion. People tend to fall ill between the ages of 30 and 50, with women being affected considerably more often than men. As the disease often first becomes apparent around the same time as the menopause and tends not to cause any pain, it is easy to miss the inflammation of the thyroid gland, or misdiagnose it as 'menopausal symptoms' or depression or anxiety alone.

Widespread

The fact is that calculations have shown that patients with AIT are 3.5 times more likely to suffer from depression, or 2.3 times more likely to suffer from anxiety. This doesn't sound like much at first, but as all three disorders are very common it means that patients with AIT account for more than 40 percent of all cases of depression and 30 percent of all cases of anxiety. Dr. Grömer gives a detailed description of the disease in his article.

The article gives a description based on thorough research of the relevant literature showing how if doctors recognise the links between the disorders they can prescribe a special treatment and use antidepressants that do not affect patients' weight and the trace element selenium from an early stage. Ensuring that patients are well informed is crucial. Dr. Grömer therefore recommends screening all patients diagnosed with depression and anxiety for AIT, determining which antibodies they have. In addition, in future psychiatric research on depression or anxiety, AIT sufferers should be recognised as a separate group in order to cast more light on the connections.

Imperial College London scientists have found traces of fatty acids - key building blocks of biological cells - in Dorset's acidic streams. They say that because of the similarity of acidic streams in Dorset and on Mars, their findings hint that life might once have existed on Mars.

By applying their findings to the Red Planet, they concluded that there could be nearly 12,000 Olympic sized pools of organic matter on Mars that could represent traces of past life.

Dorset is home to highly acidic sulphur streams that host bacteria which thrive in extreme conditions. One such environment, in St Oswald's Bay, mimics the conditions on Mars billions of years ago.

Researchers treated the landscape as a template for Mars and examined the organic matter preserved in rock deposits nearby. The iron-rich mineral goethite transforms to hematite which is very common on Mars and gives the planet its red colour. If these iron-rich minerals harbour traces of life on Earth, then they may hold clues to past microbial life on the Red Planet.

Their study found that goethite in St Oswald's Bay hosted many microbes as well as traces of their fossilised organic remains.

The authors applied these results to a Martian environment: Based on how much rock is from acid environments on Mars, and assuming the concentration of fatty acids found in Martian sediments matches that of Earth, there might be up to 2.86×1010 kg of fatty acids preserved within Martin rock - equivalent to nearly 12,000 Olympic-size pools.

Previous missions to find traces of life have used heat to inspect rock for the presence of organic matter. Scientists suspect the heat might have caused minerals to react with any organic matter, explaining why we haven't yet found traces of life.

However, heating goethite or hematite does not destroy any organic matter that's there, meaning these minerals could be good life-search targets.

Co-author Professor Mark Sephton, Head of Imperial's Department of Earth Science & Engineering said: "Mars harboured water billions of years ago, meaning some form of life might have thrived there. If life existed before the water dried up, it would probably have left remains that are preserved to this day in Martian rock.

"However, we have yet to find convincing traces of organic matter that would indicate previous life on the Red Planet."

Co-author Jonathan Tan, also from the Department of Earth Science & Engineering, said: "St Oswald's Bay is a present-day microcosm of middle-aged Mars. As the acid streams dry up, like during Mars' 'drying period', they leave goethite minerals behind which preserve fatty acids that act as biological signatures."

Professor Sephton added: "Now we should let Dorset's landscape guide our life detection efforts on the Red Planet.

The authors say that if we do find traces of life, it will probably be in the form bacteria that can thrive in extreme environments - like the acid streams on Earth.

They hope to programme the next life-searching mission to Mars, Mars 2020, to search for these dried up streams and inspect the sediment for traces of fatty acids.

As historic flooding caused by climate change devastates communities in New Brunswick and British Columbia, new research from the University of Waterloo reveals the insurance industry hasn't considered a changing climate in their practices, putting homeowners at financial risk.

The study which looked at data from 178 insurers, found that most insurance companies assumed the risk to property from extreme weather is static and based their premiums on historical data. However, as extreme weather events are increasing in severity, frequency, and unpredictability, insurers have not adjusted.

"As extreme events become more frequent, insurers that ignore climate change will not put away enough money to cover their claims. To re-coup those losses, they'll have to raise rates or pull coverage from high risk areas," said Jason Thistlethwaite, a climate change economist at the University of Waterloo. "When this shift happens, thousands of people will lose coverage or it will be unaffordable."

Another finding in the report outlined how reinsurers, insurers for insurance companies, have been better at reacting and adapting to climate change-related financial risk. This dynamic could lead to significant disruption in global insurance industry.

"Some insurers are better at understanding climate change than others. These organizations will survive, and likely be able to sell climate services to their counterparts struggling to understand the problem," said Thistlethwaite. "Those that don't, will fail. Insurers are supposed to watch our backs by looking into the future and protect us from unexpected events. We pay to not worry about these things."

A full version of the study, Insurance and Climate Change Risk Management: Rescaling to Look Beyond the Horizon, was published in the British Journal of Management.

Researchers have lab-tested a molecule that can combat the common cold virus by preventing it from hijacking human cells.

Early lab-based tests with human cells have shown the molecule's ability to completely block multiple strains of cold virus, and the team hope to move to animal and then human trials. The results of initial tests are published today in the journal Nature Chemistry.

The common cold is caused by a family of viruses with hundreds of variants, making it nearly impossible to become immune to or vaccinate against all of them. On top of that, the viruses evolve rapidly, meaning they can quickly gain resistance to drugs.

For these reasons, most cold remedies rely on treating the symptoms of the infection - such as runny nose, sore throat and fever - rather than tackling the virus itself.

However a new molecule, developed by researchers at Imperial College London, targets N-myristoyltransferase (NMT), a protein in human cells. Viruses 'hijack' NMT from human cells to construct the protein 'shell', or capsid, which protects the virus genome.

All strains of the virus need this same human protein to make new copies of themselves, so the molecule should work against all of them. Additionally, the molecule also works against viruses related to the cold virus, such as polio and foot and mouth disease viruses.

The molecule targets a human protein and not the virus itself, making emergence of resistant viruses highly unlikely.

Lead researcher Professor Ed Tate, from the Department of Chemistry at Imperial, said: "The common cold is an inconvenience for most of us, but can cause serious complications in people with conditions like asthma and COPD. A drug like this could be extremely beneficial if given early in infection, and we are working on making a version that could be inhaled, so that it gets to the lungs quickly."

There have been previous attempts to create drugs that target human cells rather than the viruses, but many have the side effect of being toxic. The researchers showed that the new molecule completely blocked several strains of the virus without affecting human cells. Further study is needed to make sure it is not toxic in the body.

The research team included the labs of Professor Roberto Solari and Professor Seb Johnston at Imperial's National Heart & Lung Institute, Dr Aurelie Mousnier from Imperial and Queen's University Belfast, structural biologists at the University of York, and colleagues at the Pirbright Institute.

Professor Tate said: "The way the drug works means that we would need to be sure it was being used against the cold virus, and not similar conditions with different causes, to minimise the chance of toxic side effects."

The medicinal chemistry team in the Tate group at Imperial, led by Dr Andy Bell (who previously invented Viagra as a researcher at Pfizer), were originally looking for compounds that targeted the protein in malaria parasites. Screening large libraries of compounds, they found two hits and were surprised to discover that they worked best together.

By inventing a novel way to combine the two, they created a molecule, codenamed IMP-1088, which is more than a hundred times more potent than previous molecules targeting the protein in humans.

(Boston)-- Hospitals are continuously working to improve care transitions, the time when patients are discharged from the hospital and moved to post-acute care facilities or brought home, but there is little known about what patients and caregivers value during this time. For the first time on a large scale, researchers have investigated what patients and caregivers want from providers during a care transition. A new study from Boston Medical Center (BMC) found caring attitudes, accountability from the health system, and continuity of care were the most sought after outcomes.

Researchers, led by Suzanne Mitchell, MD, a family medicine and palliative care physician at BMC, looked at patient and caregiver responses after hospital stays to determine what values and what health services they desired most during the hospital discharge process.

The researchers designed the qualitative study to identify the care transitions outcomes most important to patients and caregivers in a clinical setting. They accomplished this by interviewing 248 patients and caregivers individually and in groups across six U.S. medical centers who had been discharged from a medical setting in the previous 90 days. Using that information, the team created a conceptual model for how care transition services and provider behavior are linked to achieve these outcomes.

Accountability, care continuity and caring attitudes were found to be the most important outcomes for patients and caregivers. When achieved, care was perceived as excellent and trustworthy, but when providers failed to meet these outcomes, care was seen as unsafe or transactional and left patients and caregivers feeling abandoned. Poor outcomes could lead to mistrust, anxiety, and confusion and can precipitate conflict, avoidable health care use and delayed or worse outcomes.

Mitchell, who is also an assistant professor of family medicine at Boston University School of Medicine, believes serious gaps exist between the services needed and the services provided during these transitions, saying "Health systems must learn how to better prepare patients and caregivers for care at home and design accessible channels for ongoing support in order to ensure the journey from hospital to home is safe and supports each person's recovery."

An article published in Nature Medicine with the collaboration of the research group of Dr. Manel Esteller, director of the Epigenetics and Cancer Biology Program of the Bellvitge Biomedical Research Institute (IDIBELL), ICREA Researcher and Professor of Genetics of the University of Barcelona, and Drs. Dave Monk and Isidre Ferrer, from the same center, shows that the inheritance of small changes in DNA alters the expression of the PM20D1 gene and is associated with an increased risk of developing Alzheimer's disease.

"Over the last seven years, we have created a detailed map of the epigenetic alterations that occur in the brain of people affected by Alzheimer's and other dementias such as those associated with the so-called Lewy bodies or Parkinson's disease. That allowed us to collaborate with Dr Johannes Gräff's group in Lausanne, who noticed how one of the molecular lesions we had discovered was caused by inheriting a variation in the DNA sequence"- states Dr. Manel Esteller, co-author of the Nature Medicine study.

"This variation is associated with the loss of activity of a neuroprotective gene called PM20D1; whoever possesses the variation has a greater probability of suffering from Alzheimer's disease, so people carrying these variants could be excellent candidates for clinical prevention trials of the disease in the future"- adds the IDIBELL researcher.

"The results obtained demonstrate the need for international scientific collaboration, mixing the different areas of experience in epigenetics, genetics, bioinformatics and neurosciences of each group. We are looking at an example of the usefulness of multidisciplinary research to tackle diseases as complex and devastating as dementia", concludes Esteller.

Alzheimer's disease is a neurodegenerative pathology increasingly frequent due to the progressive aging of the population in Western countries. There are no effective treatments for its cure and only certain drugs are able to relatively slow the progression of the disease if they are administered in the early stages. Beyond advanced age, the factors that cause it are unknown. The hereditary factor associated with high risk constitutes a minimum proportion of cases, but there appears to be a certain aggregation of cases in the same family higher than what would be expected by chance.

New research gives insight into a recent experiment that was able to manipulate an unprecedented number of atoms through a quantum simulator. This new theory could provide another step on the path to creating the elusive quantum computers.

An international team of researchers, led by the University of Leeds and in cooperation with the Institute of Science and Technology Austria and the University of Geneva, has provided a theoretical explanation for the particular behaviour of individual atoms that were trapped and manipulated in a recent experiment by Harvard University and MIT. The experiment used a system of finely tuned lasers to act as "optical tweezers" to assemble a remarkably long chain of 51 atoms.

When the quantum dynamics of the atom chain were measured, there were surprising oscillations that persisted for much longer than expected and which couldn't be explained.

Study co-author, Dr Zlatko Papic, Lecturer in Theoretical Physics at Leeds, said: "The previous Harvard-MIT experiment created surprisingly robust oscillations that kept the atoms in a quantum state for an extended time. We found these oscillations to be rather puzzling because they suggested that atoms were somehow able to "remember" their initial configuration while still moving chaotically.

"Our goal was to understand more generally where such oscillations could come from, since oscillations signify some kind of coherence in a chaotic environment - and this is precisely what we want from a robust quantum computer. Our work suggests that these oscillations are due to a new physical phenomenon that we called 'quantum many-body scar'."

In everyday life, particles will bounce off one another until they explore the entire space, settling eventually into a state of equilibrium. This process is called thermalisation. A quantum scar is when a special configuration or pathway leaves an imprint on the particles' state that keeps them from filling the entire space. This prevents the systems from reaching thermalisation and allows them to maintain some quantum effects.

Dr Papic said: "We are learning that quantum dynamics can be much more complex and intricate than simply thermalisation. The practical benefit is that extended periods of oscillations are exactly what is needed if quantum computers are to become a reality. The information processed and stored on these computers will be dependent on keeping the atoms in more than one state at any time, it is a constant battle to keep the particles from settling into an equilibrium."

Study lead author, Christopher Turner, doctoral researcher at the School of Physics and Astronomy at Leeds, said: "Previous theories involving quantum scars have been formulated for a single particle. Our work has extended these ideas to systems which contain not one but many particles, which are all entangled with each other in complicated ways. Quantum many-body scars might represent a new avenue to realise coherent quantum dynamics."

The quantum many-body scars theory sheds light on the quantum states that underpin the strange dynamics of atoms in the Harvard-MIT experiment. Understanding this phenomenon could also pave the way for protecting or extending the lifetime of quantum states in other classes of quantum many-body systems.

Washington, DC (May 14, 2018) -- In a letter to congressional leadership, the American College of Physicians (ACP) said that proposed spending cuts would damage children's access to health coverage, medical innovation, and public health. The cuts are part of the rescission package that President Trump sent to Congress in early May; the legislation based on the package includes cuts to the Children's Health Insurance Program (CHIP), the Center for Medicare and Medicaid Innovation (CMMI), the Nonrecurring Expenses Fund (NEF), and the United States Agency for International Development's (USAID) Ebola response.

In the letter, ACP detailed objections to each of the categories of cuts. ACP said that cuts to CHIP could disrupt health care coverage for children and cuts to the NEF would potentially disrupt the ability of federal agencies to administer federal health programs or respond to unforeseen contingencies in a timely manner. The letter called attention to another recent outbreak of Ebola in the Congo and said now is not the time to potentially hamper the ability of USAID to respond. The letter also reiterated ACP's strong support for CMMI's mission to test and expand innovative models of care to better align physician payment to improve quality, cost-effectiveness, and patient-centered care.

"ACP believes it would be shortsighted to cut CMMI funding when the Congressional Budget Office (CBO) has concluded that for every CMMI dollar spent, almost four are saved, thus reducing federal spending by about $34 billion over 10 years," said Ana María López, MD, MPH, FACP, president, ACP, in the letter. The letter also noted ACP's objection to funding decisions being made outside of the normal budget process. "We are also concerned that rushing through a rescissions package outside of regular order--with no hearings or testimony or markups about the impact of these cuts, as is the case for annual appropriations bills--is a poor process for Congress to establish its budgetary priorities," continued Dr. López. Finally, the letter asked Congress to look for bipartisan agreement on budget issues, similar to the federal budget that was passed earlier this year. "We urge you, as congressional leaders, to reject these proposed rescissions, and to refrain from bringing this to a vote," concluded Dr. López. "Instead, we urge you to return to seeking agreement on bipartisan ways to fund the federal government."

If Canada's Genetic Non-Discrimination Act (GNA) is overturned by a challenge from the Province of Quebec, it will open the doors to genetic discrimination, argue authors in a commentary in CMAJ (Canadian Medical Association Journal).

"The GNA is a critical law affording comprehensive protection prohibiting genetic discrimination by any individual or sector," writes Dr. Yvonne Bombard, scientist at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, with Bev Heim-Myers, chair of the Canadian Coalition for Genetic Fairness and CEO of the Huntington Society of Canada.

The act protects genetic test information from being required in a contract negotiation or by any person or service provider such as an insurer, employer, school or adoption agency. It became law in Canada in May 2017.

Although advances in genomics are helping prevent, treat and diagnose diseases, people may decline useful genomic testing as they are afraid that personal genomic information could be used to deny them insurance coverage by third parties or compromise employment opportunities. This fear can also prevent patients from participating in medical research.

"Such fear creates barriers to accessing important information that can end costly, burdensome diagnostic odysseys, guide medical management and improve a patient's quality of life," write Bombard and Heim-Myers.

The GNA makes it a criminal offence to require a person to take, or reveal results of, a genetic test. However, health care professionals are exempt if they are treating that person.

Quebec has challenged the law, arguing it is not constitutional.

"For now, the genetic test information of all people living in Canada, no matter where they live, is protected by law," state the authors. "And it is important that the GNA remains intact."

"The Genetic Non-Discrimination Act: critical for promoting health and science in Canada" is published May 14, 2018.

May 14, 2018 - For veterans undergoing surgery in the VA healthcare system, homelessness is an important risk factor for unplanned hospital readmission, reports a study in the June issue of Medical Care, published in the Lippincott portfolio by Wolters Kluwer.

Homeless veterans are more likely to be discharged to a nursing home or other residential setting after surgery, and these discharge destinations are associated with a lower risk of hospital readmission. "Our findings highlight the importance of discharging homeless veterans to supportive environments where they will receive ongoing services to stabilize their medical and caregiver needs," comments senior researcher Mary D. Hawn, MD, MPH, of VA Palo Alto (Calif.) Health Care System and Stanford University School of Medicine.

Homelessness a 'Potent Risk Factor' for Readmission in Veterans
Using a VA surgery database, the researchers analyzed approximately 232,000 surgical procedures performed in 200,000 veterans at VA hospitals between 2008 and 2014. About 5,000 of the operations - 2.1 percent - were performed in homeless patients.

The homeless veterans were younger than housed veterans: average age 56 versus 64 years. Homeless veterans had lower rates of medical diseases, but higher rates of mental health problems: about 57 percent of homeless patients had one or more psychiatric disorders.

The rate of unplanned hospital readmission within one month was 13.3 percent for homeless veterans compared to 9.3 percent of housed veterans. After adjustment for other factors, homelessness was associated with a 43 percent increase in the odds of readmission. Homeless veterans were more likely to be readmitted despite undergoing less-complex surgeries and longer postoperative hospital stays during the index admission.

After leaving the hospital, homeless veterans were more likely to be sent to a nursing home or other residential setting - reflecting the lack of an appropriate place in the community to recover after surgery. Homeless veterans with these discharge destinations had lower rates of hospital readmission, compared to those discharged "to the community." In contrast, for housed veterans, discharge to a nursing home or residential setting was associated with a higher risk of readmission - reflecting poorer medical condition than those discharged home after surgery.

Other factors associated with a higher readmission rate for homeless veterans included recent alcohol abuse and being in worse health before surgery (ASA classification). Readmission risk was higher for white versus black veterans with homelessness, and for those discharged during the summer compared to other times of year.

The findings support previous studies showing a higher readmission rate for homeless patients after hospital discharge. The risk of readmission related to homelessness for veterans appears less when compared to other groups of homeless patients. That may reflect the fact that VA patients have access to more outreach programs and face fewer barriers to healthcare, compared to homeless patients at large.

"The lack of having a place to live perpetuates hospitalizations," Dr. Hawn and coauthors write. "A holistic evaluation of homeless surgical patients, to include psychosocial support and housing needs assessment, may provide opportunities to improve patient care."

There is a cure or the nation's deadliest infectious disease, hepatitis C, but at tens of thousands of dollars per patient in upfront costs, most insurance companies can't afford to provide the treatment to all of the estimated 2.7 million to 3.9 million of Americans who are infected. This is especially true for patients on Medicaid or in the prison system, where funding has historically been restricted.

Leading experts on hepatitis C treatment policy are recommending a new novel pricing strategy, implemented at the state level, that could help many more patients access the treatment. The recommendations were published on May 14 in the Annals of Internal Medicine, and as an extended USC-Brookings Schaeffer Initiative for Health Policy report.

"These innovative therapies can cure hepatitis C, but the high costs put them out of reach for the most vulnerable populations," said Neeraj Sood, lead author on the report and an economist at the USC Schaeffer Center for Health Policy and Economics. "We wanted to come up with a better solution where we dramatically improve access to cures, control drug spending but still maintain incentives for the development of new cures."

Recognizing the important role state programs could play in this, Sood and his colleagues have developed a novel pricing strategy targeted at state policymakers. They outline an approach that leverages competition among drug manufacturers. The end result would save the state money and would ensure treatment for a larger share of the population -- all while providing incentives for future innovation in treatments.

Leveraging State Programs to Increase Access

Given current financing systems, most states can only afford to provide treatment to a small percentage of patients with hepatitis C each year. Furthermore, drug manufacturers know the only way they can increase profits is by increasing the price per pill.

"Increasing prices raises incentives for pharmaceutical innovation but limits patient access. This is the crux of the problem," said Sood, who is also a Professor and Vice Dean for Research at the USC Price School of Public Policy.

"Negotiating on revenues rather than price is the answer. Revenue-based contracting allows us to increase profits and incentives for innovation without limiting access."

Under the proposed model, states would leverage their resources to make a deal with one pharmaceutical company, offering a lump sum payment over a contracted period. The negotiated amount would be higher than the expected revenue for any one company over that timeframe, but still less than the total amount that the
Medicaid program would pay to all the drug companies producing the treatment.

In return, the company would agree to provide a 100 percent rebate on drug purchases for the population designated to receive the cure, such as Medicaid patients or prisoners with hepatitis C. The move would make the drug essentially free of additional cost. It also would give the states the opportunity to significantly expand access to the treatment while maintaining their budget.

Vulnerable Populations Still Face Significant Hurdles in Accessing Treatment

According to a 2017 report, less than 3 percent of the 700,000 people with hepatitis C in state Medicaid programs and prisons receive treatment each year. This is due in large part to restrictions that many state programs implemented that limit access to the cure by requiring patients to have reached a certain decline in liver function or have remained sober for a set timeframe.

Though not supported by clinical guidelines, these restrictions are designed to narrow access, thereby limiting the immediate impact on state budgets that might arise from guaranteeing the treatment to everyone.

The consequences of these decisions are especially concerning given the recent rise in heroin use resulting from the opioid epidemic, which has led to a significant increase in new hepatitis C infections.

"Our concern is that the public health burden of hepatitis C infections will continue to grow even though we have a cure if we don't implement innovative financing programs," said Sood.

Bottom Line: Pharmaceutical industry marketing of opioid products to physicians through nonresearch payments, which can include speaking fees and meals, was associated with greater opioid prescribing.

Why The Research Is Interesting: Many opioid-related overdose deaths involve prescription opioids, and prescription opioids can commonly be a person's first encounter on a path to illicit use. Marketing by the pharmaceutical industry to physicians is widespread but marketing of opioids and its influence on prescribing is unclear.

What (Study Methods): Linking of two U.S databases to identify all nonresearch payments from the pharmaceutical industry to physicians marketing opioid products (excluding buprenorphine hydrochloride marketed for addiction treatment) and to gather information on all claims from physicians who wrote opioid prescriptions (initial or refill) filled for Medicare beneficiaries in 2015

Authors: Scott E. Hadland, M.D., M.P.H., M.S., of Boston Medical Center, and coauthors

Study Limitations: Possibility of reverse causation because physicians who receive industry payments may be inclined to prescribe opioids; study establishes association, not cause and effect

Related Material: Two other studies, "Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs. Daily Sublingual Buprenorphine with Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial," and "Association of an Opioid Standard of Practice Intervention with Intravenous Opioid Exposure in Hospitalized Patients," also are available on the For The Media website.