Culture

DALLAS, April 2, 2018 -- Women who give birth to infants with congenital heart defects may have an increased risk of cardiovascular hospitalizations later in life, according to new research in the American Heart Association's journal Circulation.

The study of more than one million women is the first to show congenital heart defects in newborns may be a marker for an increased risk of their mothers developing heart problems, including heart attack and heart failure, years after pregnancy.

Researchers analyzed data on women who delivered infants between 1989 and 2013 in Quebec, Canada, who had critical, noncritical or no heart defects. They tracked the women up to 25 years after pregnancy for hospitalizations related to cardiovascular disease including heart attack, heart failure, atherosclerotic disorders and heart transplants.

Compared to mothers of infants without congenital heart defects, researchers found:

43 percent higher risk of any cardiovascular hospitalization in women whose offspring had critical heart defects; and

24 percent higher risk of any cardiovascular hospitalization in women whose infants had noncritical defects.

How heart defects in infants relate to post-pregnancy cardiovascular disease in their mothers is unclear, the study notes, and a genetic component cannot be excluded. In addition, because 85 percent of infants with heart defects now survive past adolescence, the psychosocial impact of congenital heart disease on caregivers may have a cumulative effect over the long term.

"Caring for infants with critical heart defects is associated with psychosocial and financial stress, which may increase the mothers' long-term risk for cardiovascular disease," said Nathalie Auger, M.D., the study's lead author and an epidemiologist at the University of Montreal Hospital Research Centre in Montreal, Quebec, Canada.

Researchers believe the study provides an opportunity for these mothers to benefit from early prevention strategies and counseling to reduce their risk of cardiovascular disease -- the leading cause of death in women.

Healthcare providers, like obstetricians, who treat and follow mothers in the early stages of dealing with children who have heart defects can help women understand and minimize their risk, Auger said.

"Those physicians are very well-positioned to inform women about this possibility, the greater risk of heart disease, and to provide recommendations for targeting other risk factors like smoking, obesity and physical activity," she said.

Some limitations of the research include the fact that women were young at the start of study, so for many, the 25-year follow-up did not extend past menopause, which excluded the highest risk period for cardiovascular disease. And, because researchers used existing medical data, they didn't have detailed risk factor information on the women, such as body weight and smoking status. These are important points that should be considered in future studies, researchers noted.

A penetrating injury from shrapnel is a serious obstacle in overcoming battlefield wounds that can ultimately lead to death.Given the high mortality rates due to hemorrhaging, there is an unmet need to quickly self-administer materials that prevent fatality due to excessive blood loss.

With a gelling agent commonly used in preparing pastries, researchers from the Inspired Nanomaterials and Tissue Engineering Laboratory have successfully fabricated an injectable bandage to stop bleeding and promote wound healing.

In a recent article "Nanoengineered Injectable Hydrogels for Wound Healing Application" published in Acta Biomaterialia, Dr. Akhilesh K. Gaharwar, assistant professor in the Department of Biomedical Engineering at Texas A&M University, uses kappa-carrageenan and nanosilicates to form injectable hydrogels to promote hemostasis (the process to stop bleeding) and facilitate wound healing via a controlled release of therapeutics.

"Injectable hydrogels are promising materials for achieving hemostasis in case of internal injuries and bleeding, as these biomaterials can be introduced into a wound site using minimally invasive approaches," said Gaharwar. "An ideal injectable bandage should solidify after injection in the wound area and promote a natural clotting cascade. In addition, the injectable bandage should initiate wound healing response after achieving hemostasis."

The study uses a commonly used thickening agent known as kappa-carrageenan, obtained from seaweed, to design injectable hydrogels. Hydrogels are a 3-D water swollen polymer network, similar to Jell-O, simulating the structure of human tissues.

When kappa-carrageenan is mixed with clay-based nanoparticles, injectable gelatin is obtained. The charged characteristics of clay-based nanoparticles provide hemostatic ability to the hydrogels. Specifically, plasma protein and platelets form blood adsorption on the gel surface and trigger a blood clotting cascade.

"Interestingly, we also found that these injectable bandages can show a prolonged release of therapeutics that can be used to heal the wound" said Giriraj Lokhande, a graduate student in Gaharwar's lab and first author of the paper. "The negative surface charge of nanoparticles enabled electrostatic interactions with therapeutics thus resulting in the slow release of therapeutics."

An experiment in Maryland designed to save health care dollars by shifting services away from expensive hospital-based care and toward less costly primary, preventive and outpatient services has yielded disappointing results.

These are the findings of two separate studies led by investigators from Harvard Medical School and the University of Pittsburgh. One study will be published in the April issue of Health Affairs, the other one appears in the February issue of JAMA Internal Medicine.

Maryland's program was rooted in the idea that paying hospitals a fixed global budget--rather than for each patient admission--would deter unnecessary admissions and provide better care outside of the hospital. Under this program, hospitals that saved money by reducing admissions would keep the savings. If hospitals exceeded their budgets, they would absorb the resulting costs.

"There is widespread interest in moving to alternative payment models that contain health care spending while still ensuring robust health outcomes," said study lead author, Eric Roberts, an assistant professor at the University of Pittsburgh Graduate School of Public Health. "Unfortunately, with the Maryland experiment we didn't find meaningful changes in care that policymakers had hoped this program would achieve."

Maryland's program was implemented in two waves: the first among rural hospitals, and the second among the remaining hospitals in the state. The two studies examine each phase in turn.

In the Health Affairs study, the researchers compared patterns of use and spending among Medicare beneficiaries served by rural Maryland hospitals with global budgets to patterns among patients served by a group of nonparticipating hospitals. After three years, the researchers found no reductions in hospital use or spending that could be linked to the global budget program.

In their JAMA Internal Medicine study, the researchers focused on the first two years of Maryland's state-wide rollout of the program, which included larger hospitals serving urban and suburban areas of the state. This study found no evidence that the global budget program was associated with reductions in hospital use or increases in primary care visits.

"When we drilled down into our data, we did not find any evidence that patterns of hospital and primary care use changed in Maryland relative to similar areas unaffected by the program," said Ateev Mehrotra, associate professor of health care policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center.

So what went wrong? One possibility is that the disappointing results may stem from complicated administrative logistics, the authors said. Also, they said, the policy changed only the way hospitals are paid, while payments to individual physicians were kept out of the budget and remained on a fee-for-service basis.

"The latter could be a big deal," Mehrotra said. "If the physician is not on board, the hospital doesn't have much control about the day-to-day decisions about how care is delivered."

Identifying alternatives to the current payment model is important to help alleviate the nation's health care spending problem, the team added.

"We believe that payment reform is critical, but we need to carefully evaluate which payment models are most effective," Mehrotra added.

The researchers emphasize that Maryland's new payment strategy still might have saved money for the state and Medicare. However, any savings did not come from changing the care that Maryland residents received, but rather from changes to hospital prices.

Maryland is now tweaking its program to include physicians. In the interim, Pennsylvania is building off Maryland's program by implementing a global budget model for rural hospitals. "Evaluating these different programs in different contexts will help policymakers better understand which payment systems work best," said Mehrotra.

Rising sea levels have worsened the destruction that routine tidal flooding causes in the nation's coastal communities. On the U.S. mainland, communities in Louisiana, Florida and Maryland are most at risk.

Stemming the loss of life and property is a complex problem. Elected officials can enact policies to try to lessen the damage of future flooding. Engineers can retrofit vulnerable buildings. But, in the face of a rising tide, changing hearts and minds might be the most formidable obstacle to decreasing the damage done by flooding.

David Casagrande, associate professor of anthropology, is exploring attitudes and perception around flood risk.

"When people's homes are damaged by flooding year after year and they are offered a buyout, why don't they leave?" asks Casagrande.

Casagrande is part of a National Science Foundation-funded, cross-disciplinary team of researchers in anthropology, hydrogeology, and planning from Lehigh, Western Illinois University and the University of California, Davis who are studying impediments to flood mitigation in the Midwest. They are identifying flood-prone locations, key individuals, and intervention strategies that lead to community-based mitigation. Their work indicates that mitigation is most likely to occur soon after a flood, and is most successful when decisions are community-based.

He is also part of a team of researchers from Washington College in Chestertown, Maryland and the State of Maryland who are looking at similar issues in Maryland's Eastern Shore region, an area that is highly vulnerable to current and future coastal hazards. According to the Eastern Shore Land Conservancy, the sea level is expected to rise by at least 1.4 feet by 2050 and possibly over 5 feet by 2100.

Casagrande and his colleagues have surveyed residents, as well as conducted in-person interviews and focus groups. He will be presenting some of his findings at the annual meeting of the Society for Applied Anthropology (SFAA). This year's meeting, Philadelphia Sustainable Futures SFAA 2018, will take place in Philadelphia, April 3-7, 2018. Casagrande will present in a session called "Sustainable Futures of Chesapeake Communities Facing Relative Sea-level Rise" on Wednesday, April 4.

From the SFAA program: "In this session, we apply ethnographic, cognitive, and linguistic perspectives on how local residents and policy-makers are communicating and making decisions (or not) about adaptation to increased flooding. Culturally informed dialogue could promote decisions that support more sustainable futures for Chesapeake communities."

"In some cases, houses on Smith Island in the Chesapeake Bay have been in families for thirteen generations," said Casagrande. "They're not going anywhere."

Casagrande employs cognitive dissonance theory to identify the rationales that residents employ to "avoid having to make really difficult decisions"--such as leaving.

Cognitive dissonance theory says that individuals have a tendency to seek consistency in their beliefs. When encountering information that does not fit in with their beliefs, individuals seek to eradicate the discomfort caused by the inconsistency--or dissonance--by changing their beliefs, changing their behavior, or rationalizing to explain the inconsistency.

One common way that residents of flood-prone communities rationalize their choice to stay is by scapegoating--or placing blame elsewhere.

"On Smith Island, for example, many people blame the U.S. Army Corps of Engineers for not doing a better job of preventing erosion," says Casagrande. "There is an erosion problem, but that is not the only challenge."

Another tactic to resolve inconsistencies is social comparison, which states that individuals tend to evaluate their own situation by comparing it to others.

In other words, according to Casagrande, residents justify their decision to stay by believing that other places are so much worse.

When Casagrande, working on a separate project, interviewed a resident of an area along the Mississippi River that had recently experienced severe flooding and a simultaneous tornado--he asked: Do you think is a dangerous place to live?

Paraphrasing the resident's response, Casagrande says: "'No! Look at California - the earthquakes, the forest fires, mud slides...' It's always worse somewhere else."

"Research participants use strategies to downplay risk and favor large-scale technological options over difficult household decisions," says Casagrande. "Many prefer to accept known risk to avoid options like relocation that engender uncertainty."

There is a positive side to engaging in this work, says Casagrande:

"We are actively helping communities mitigate as we learn how social relationships affect attitudes and actions."

Only if individuals believe they are truly at risk will they begin to take steps to prevent disaster. Individual beliefs are often formed at the community-level, and, according to this research, that is where interventions are most effective.

Weather extremes caused by climate change could raise the risk of food shortages in many countries, new research suggests.

The study, led by the University of Exeter, examined how climate change could affect the vulnerability of different countries to food insecurity - when people lack access to a sufficient quantity of affordable, nutritious food.

Scientists looked at the difference between global warming of 1.5°C and 2°C (compared to pre-industrial levels) and found that - despite increased vulnerability to food insecurity in both scenarios - the effects would be worse for most countries at 2°C.

The study looked at 122 developing and least-developed countries, mostly in Asia, Africa and South America.

"Climate change is expected to lead to more extremes of both heavy rainfall and drought, with different effects in different parts of the world," said Professor Richard Betts, Chair in Climate Impacts at the University of Exeter.

"Such weather extremes can increase vulnerability to food insecurity.

"Some change is already unavoidable, but if global warming is limited to 1.5°C, this vulnerability is projected to remain smaller than at 2°C in approximately 76% of developing countries."

Warming is expected to lead to wetter conditions on average - with floods putting food production at risk - but agriculture could also be harmed by more frequent and prolonged droughts in some areas.

Wetter conditions are expected to have the biggest impact in South and East Asia, with the most extreme projections suggesting the flow of the River Ganges could more than double at 2°C global warming.

The areas worst affected by droughts are expected to be southern Africa and South America - where flows in the Amazon are projected to decline by up to 25%.

The researchers examined projected changes in weather extremes and their implications for freshwater availability and vulnerability to food insecurity.

The team included researchers from the Met Office, the European Commission, the Technical University of Crete, Cranfield University and the Rossby Centre in Sweden.

The paper, published in a special issue of the journal Philosophical Transactions of the Royal Society A, is entitled: "Changes in climate extremes, fresh water availability and vulnerability to food insecurity projected at 1.5°C and 2°C global warming with a higher-resolution global climate model."

Tropical forests have been called the lungs of the planet. They soak up vast quantities of carbon dioxide, hold the world's greatest diversity of plants and animals, and employ millions of people. And these hot ecosystems--often a patchwork of trees and grasslands--are being deeply altered by logging and other land use change.

Now, a team of scientists have made a fundamental discovery about how fires on the edges of these forests control their shape and stability. Their study implies that when patches of tropical forest lose their natural shape it could contribute to the sudden, even catastrophic, transformation of that land from trees to grass.

The new knowledge could help protect tropical forests--and allow land managers to build new tools to predict the stability of both individual forest patches and larger regional-scale forests.

The study was published March 26 in the journal Ecology Letters.

LAW OF THE FOREST

Using high-resolution satellite data from protected forests in the savanna region of the Brazilian Cerrado, the scientists found that the shape of these natural forests follow a predictable mathematical relationship between a forest's perimeter and its area--regardless of its climate region or its size. They call this a "3/4 power law" and it roughly means the forests all tend toward shapes that are neither skinny like a line, nor round and smooth like a circle. "If a forest could grow easily in all directions, we'd expect a circle," says Laurent Hébert-Dufresne, a computer scientist at the University of Vermont who is the lead author on the new study, "but what we actually see is more dendritic, a bit like an octopus or deformed circle."

The team of six scientists--that included modelers, ecologists and physicists from UVM, the Santa Fe Institute, Stanford, Boston University, Princeton, and the University of Washington--show that the 3/4 law holds true for tiny forest fragments not much bigger than a basketball court up to large forest patches covering dozens of square miles.

The scientists combined their understanding of real-world data with the results of a new computer model to explain why this happens: fires, that burn easily in the grasslands surrounding forests--and singe the forests' wet edges--are in constant battle with the forests' expansive growth out into grasslands. This interplay at the edge between grass and forest, the scientists discovered, creates forest patches that converge on a steady-state shape.

The results of the scientists' model matched the observed results from real forests in Brazil. And an experiment the scientists ran on their model shows that the fate of forest patches over time--whether they expand or contract--is determined by their initial shape. Those with compact shapes of all sizes, over time, converge on the more octopus-like 3/4-power-scaling relationship*, while those with skinny shapes and larger perimeter-to-area ratios collapsed, disappearing into grasslands or fragmenting into very small patches.

Which means that this relationship between a forest's perimeter and its area may help predict the stability of individual forest patches. The scientists are optimistic that the study can lead to practical tools that show how far a managed forest patch deviates from this natural geometry will help to determine its stability over time.

STATE CHANGE

And the new research presents insights at a larger, regional scale into the possible fate of Brazil's forests. "Stepping back and considering the macro scale--not looking at the shape of every patch, but, instead, at the state of the entire system--the model suggests that the collapse from forest to grassland can be dramatic," says Andrew Berdahl, a researcher at the Santa Fe Institute and the senior author on the study. "These local, small-scale effects--perimeter growth and edge burning--can lead to a critical transition across a whole forest region between a forest-dominated-state and a grass-dominated-state." And once large areas of forest switch to grass it can be difficult to recover the forests. "It is like stepping off a cliff," says Berdahl. "You can't simply step back up."

Ecologists have historically looked at the elements within a forest to understand its condition--often focusing on its plants and animals--but there has been little exploration of the geometry of forests and how this might matter. The new study shows a powerful role for fire driving the shape of Brazil's tropical forests, "and we'd now like to see if this pattern holds true in other parts of the world," says UVM's Hébert-Dufresne, an assistant professor in the Department of Computer Science and part of UVM's Complex Systems Center. "Say in Africa we find that elephants pushing over trees changes the equation, or dryness in Australia--that would be very interesting." And he'd like to expand the research to see whether the relationship observed in the new model--derived from wild forests--holds true in logged and other managed forests in Brazil.

"Our fundamental point though is that a forest's shape is very important," he says, "and that its shape is directly related to its stability."

It seems simple enough: Taking a hard hit to the head can give you a concussion. But, Stanford researchers report March 30 in Physical Review Letters, in most cases, the connection is anything but simple.

Combining data recorded from football players with computer simulations of the brain, a team working with David Camarillo, an assistant professor of bioengineering, found that concussions and other mild traumatic brain injuries seem to arise when an area deep inside the brain shakes more rapidly and intensely than surrounding areas. But, they also found that the mechanical complexity of the brain means there is no straightforward relationship between different bumps, spins and blows to the head and the likelihood of injury.

"Concussion is a silent epidemic that is affecting millions of people," said Mehmet Kurt, a former postdoctoral fellow in Camarillo's lab. Kurt and Kaveh Laksari, also a former postdoctoral fellow with Camarillo, are co-lead authors on the paper. Yet exactly how concussions come about remains something of a mystery. "What we were trying to do is understand the biomechanics of the brain during an impact." Armed with that understanding, Kurt said, engineers could better diagnose, treat and hopefully prevent concussion.

Shaking the brain

In previous studies, Camarillo's lab had outfitted 31 college football players with special mouthguards that recorded how players' heads moved after an impact, including a few cases in which players suffered concussions.

Laksari and Kurt's idea was to use that data, along with similar data from NFL players, as inputs to a computer model of the brain. That way, they could try to infer what happened in the brain that led to a concussion. In particular, they could go beyond relatively simple models that focused on just one or two parameters, such as the maximum head acceleration during an impact.

The key difference between impacts that led to concussions and those that did not, the researchers discovered, had to do with how - and more importantly where - the brain shakes. After an average hit, the researchers' computer model suggests the brain shakes back and forth around 30 times a second in a fairly uniform way; that is, most parts of the brain move in unison.

In injury cases, the brain's motion is more complex. Instead of the brain moving largely in unison, an area deep in the brain called the corpus callosum ­- which connects the left and right halves of the brain - shakes more rapidly than the surrounding areas, placing significant strain on those tissues.

Further complications

Concussion simulations that point to the corpus callosum are consistent with empirical observations - patients with concussions do often have damage in the corpus callosum. However, Laksari and Kurt emphasize that their findings are predictions that need to be tested more extensively in the lab, either with animal brains or human brains that have been donated for scientific study. "Observing this in experiments is going to be very challenging, but that would be an important next step," Laksari said.

Perhaps as important as physical experiments are additional simulations to clarify the relationship between head impacts and the motion of the brain - in particular, what kinds of impacts give rise to the complex motion that appears to be responsible for concussions and other mild traumatic brain injuries. Based on the studies they have done so far, Laksari said, they know only that the relationship is highly complex.

Still, the payoff to uncovering that relationship could be enormous. If scientists better understand how the brain moves after an impact and what movement causes the most damage, Kurt said, "we can design better helmets, we can devise technologies that can do onsite diagnostics, for example in football, and potentially make sideline decisions in real time," all of which could improve outcomes for those who take a nasty hit to the head.

BALTIMORE, M.D., (April 1, 2018) -- Children with both autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are at increased risk for being diagnosed with or treated for anxiety and mood disorders, according to a study published in Pediatrics today. The study, completed by the Interactive Autism Network (IAN), is one of the largest to compare comorbidities in individuals with ASD alone to individuals with ASD and ADHD.

For the study's findings, researchers from Kennedy Krieger Institute examined the data of a cross-sectional, network-based survey of children ages 6 to 17 years with ASD who were enrolled in the Interactive Autism Network, between 2006 and 2013. Of the 3,319 children in the study, 1,503 (45.3%) had ADHD. The survey data were analyzed for parent-reported diagnosis and/or treatment of ADHD, anxiety disorder, and mood disorders. Children with ASD and ADHD had more than twice (or 2.2 times) the risk of anxiety disorder and 2.7 times the risk of other mood disorders. Researchers also found that these psychiatric conditions were more prevalent in older children.

"We have known that anxiety and mood disorders are highly prevalent in those with ASD," says Eliza Gordon-Lipkin, MD, [lead] study author and fellow, Department of Neurology and Developmental Medicine, Kennedy Krieger Institute. "This study, however, takes it another step further, providing insights on the differences between children with just ASD versus those with ASD and ADHD. What exactly happens in the human brain that causes children with ASD to have other mental health conditions is not fully understood, but we hope this study inspires other researchers to pursue the answer to this question."

According to recent statistics, ASD affects 1 in 68 children and ADHD affects 1 in 10 in the United States. Researchers and clinicians have long known that these disorders have overlapping features and can occur together, having negative developmental, cognitive, behavioral and functional implications.

"The takeaway from the study's findings, and one that both parents of children with ASD and doctors need to keep in mind, is that managing these psychiatric disorders is a dual effort. That by working closely together in monitoring a child for anxiety and mood symptoms, we can ensure early diagnosis and treatment, which is key to preserving a child's quality of life.," said Paul H. Lipkin, director of Medical Informatics and the Interactive Autism Network at Kennedy Krieger Institute.

Every year, more than 100 million people worldwide develop the sexually transmitted disease gonorrhoea, with health consequences such as infertility, transmission of the disease to newborn babies, and increased risk of HIV infections. There has been a 63 per cent rise in gonorrhoea in Australia over the past five years.

Gonorrhoea is caused by bacteria which can rapidly develop resistance to all known antibiotics - commonly called 'superbugs'. Gonorrhoea superbugs have now been detected in every Australian state and territory and are increasingly difficult to treat in the clinic.

Monash University researchers have discovered a way the gonorrhoea bacteria cleverly evade the immune system - opening up the way for therapies that prevent this process, allowing the body's natural defences to kill the bug.

Published today in PLOS Pathogens, Dr Thomas Naderer and Dr Pankaj Deo and their team from the Monash Biomedicine Discovery Institute, have discovered how the gonorrhoea-causing superbug (which is very small) creates even smaller packages of bacterial membrane blebs, termed vesicles, which attack immune cells.

Using cutting-edge super-resolution microscopy, which is able to see, and film, the most minute of events - the researchers found that these membrane vesicles interacted with the cells in the human immune system called 'macrophages', triggering these to die in an orchestrated suicide process. Macrophages are the cells within the immune system that ordinarily kill foreign invaders like bacteria and viruses, so without them the gonorrhoea bacteria can flourish.

Dr Naderer said that this new understanding of how the gonorrhoea bacteria interact and cause the death of immune system cells "may lead to strategies to combat gonorrhoea infection and its symptoms".

The research may also provide information as to how other bacteria evade the immune system and be unaffected by antibiotics. The 2016 Review on Antimicrobial Resistance Final Report and Recommendations states that antibiotic resistant infection will kill an extra 10 million people a year worldwide - more than currently die from cancer - by 2050 unless action is taken.

Read the full paper in PLOS Pathogens titled 'Outer membrane vesicles from Neisseria gonorrhoeae target PorB to mitochondria and induce apoptosis.'

AUSTIN, Texas - In one of the largest and most diverse studies of transgender youths to date, researchers led by a team at The University of Texas at Austin have found that when transgender youths are allowed to use their chosen name in places such as work, school and at home, their risk of depression and suicide drops.

"Many kids who are transgender have chosen a name that is different than the one that they were given at birth," said author Stephen T. Russell, professor and chair of human development and family science. "We showed that the more contexts or settings where they were able to use their preferred name, the stronger their mental health was."

The study in the Journal of Adolescent Health was published this week in advance of Saturday's annual Transgender Day of Visibility.

Researchers interviewed transgender youths ages 15 to 21 and asked whether young people could use their chosen name at school, home, work and with friends. Compared with peers who could not use their chosen name in any context, young people who could use their name in all four areas experienced 71 percent fewer symptoms of severe depression, a 34 percent decrease in reported thoughts of suicide and a 65 percent decrease in suicidal attempts.

Earlier research by Russell found that transgender youths report having suicidal thoughts at nearly twice the rate of their peers, with about 1 out of 3 transgender youths reporting considering suicide. In the new study, having even one context in which a chosen name could be used was associated with a 29 percent decrease in suicidal thoughts. The researchers controlled for personal characteristics and social support.

"I've been doing research on LGBT youth for almost 20 years now, and even I was surprised by how clear that link was," Russell said.

The study interviewed 129 youths in three U.S. cities, one each in the Northeast, the Southwest and the West Coast. Transgender youths are estimated to be only about 1 percent of the population and are difficult to reach, so the research team worked with community organizations serving LGBT youths and other venues to reach as diverse a population of transgender youths as possible, Russell said. He calls the sample "remarkably ethnically and geographically diverse and diverse in terms of social class."

Because many names are common to one gender, allowing transgender youths to use a chosen name is one simple step that institutions such as schools, hospitals, financial institutions, workplaces and community organizations can use to help young people affirm their gender identity, Russell said.

"It's practical to support young people in using the name that they choose," Russell said. "It's respectful and developmentally appropriate."

Amanda M. Pollitt, also of The University of Texas; Gu Li of the University of British Columbia; and Arnold H. Grossman of New York University were also authors of the paper.

The gut microbiome -- a collection of bacteria and other microbes in the gut -- could be a highly accurate predictor of hospitalizations for patients with cirrhosis, according to a recently published study led by a researcher at Virginia Commonwealth University.

The paper, which published in the journal JCI Insight in March, determined that analysis of microbial DNA and microbial RNA could be used alongside current clinical methods to more accurately predict 90-day hospitalizations. Microbial DNA analysis identifies live and dead bacterial species, while microbial RNA analysis identifies the most metabolically active microbial species.

Cirrhosis is a leading cause of increased health expenditures due to hospitalizations and of mortality worldwide, according to the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health.

"The hospitalizations that take place with cirrhosis are exorbitantly expensive," said the paper's lead author, Jasmohan Bajaj, M.D., who practices medicine and teaches at the VCU School of Medicine's Department of Internal Medicine and at the Hunter Holmes McGuire VA Medical Center. "Anything that helps us predict the likelihood of hospitalization is better than the status quo."

Bajaj and collaborators from George Mason University theorized that relative abundances of pathogenic and non-pathogenic bacteria in the gut microbiome would be accurate predictors of hospitalization because of their link with inflammation, which often leads to infection.

"One of the major sources of inflammation in patients with cirrhosis or individuals who are obese is pathogenic bacteria, so, we began looking at gut microbes," Bajaj said. "People with cirrhosis who are hospitalized tend to get a very big inflammatory surge in their body because of infections and other organ failures."

The researchers conducted a trial of patients with cirrhosis at VCU Medical Center and McGuire VA Medical Center who were classified according to cirrhosis-related complications, such as renal dysfunction and infection. Both DNA and RNA analysis were found to be equally effective at predicting hospitalization when combined with the standard predictive blood test. They also were more effective than the standard predictive blood test score alone. Researchers also found that DNA and RNA analysis identified similar beneficial bacteria but differed in the pathogenic bacteria identified in all patient groups tested.

The team is preparing for a multicenter trial with a consortium of North American research centers that would further confirm the effectiveness of microbial analysis in cirrhosis outcome prediction.

A slippery rough surface (SRS) inspired by both pitcher plants and rice leaves outperforms state-of-the-art liquid-repellent surfaces in water harvesting applications, according to a team of researchers at Penn State and the University of Texas at Dallas.

The team reports their work online today (March 30) in Science Advances, an open-access journal.

"With an estimated 4 billion people living in a situation of water scarcity during at least some part of the year, an inexpensive method for harvesting water from water vapor or from fog droplets in air could have enormous practical applications, and will help alleviate the water scarcity issues in many regions of the world," said the project's leader, Tak-Sing Wong, who is the Wormley Family Early Career Professor in Engineering and assistant professor of mechanical engineering, Penn State.

Many water-harvesting technologies are not as efficient, because when water is attracted to a hydrophilic surface, the water tends to form a sheet and clings to the surface, making it hard to remove. But Wong's post-doctoral scholar, Simon Dai, now an assistant professor at UT Dallas, was looking at combining different biological strategies to create a slippery solution for water harvesting.

"With SRS, we combined the slippery interface of a pitcher plant with the surface architecture of a rice leaf, which has micro/nanoscale directional grooves on its surface that allows water to be removed very easily in one direction but not the other," said Dai.

Dai developed a pitcher plant-inspired slippery surface with hydrophilic chemistry. At the same time, he added the directional grooves and gave the new surface a microscale roughness that increased the surface area. The rate of water and fog harvesting are directly proportional to the amount of surface area on which droplets can form. The rice leaf-inspired grooves whisk the water droplets away through capillary action or gravity.

Through experiments carried out at Penn State, the team showed that these surfaces can collect tiny water droplets from air at a rate faster than many state-of-the-art surfaces. Molecular dynamics simulations carried out at UT Dallas by Dai's colleague, Steven Nielson, explained why the hydrophilic surface was particularly good at water harvesting.

"If the SRS material is produced at scale, we estimate that we can collect over 120 liters of water per square meter of the surface per day, and we can further increase the water harvesting rate by optimizing the SRS," said Nan Sun, graduate student in Wong's group and coauthor of the paper, titled "Hydrophilic Directional Rough Surfaces for Water Harvesting."

Wong's team is currently working on optimizing and scaling up the SRS with the goal to create highly efficient water harvesting systems for providing clean water in water scarcity regions.

MADISON, Wis. -- In the search for extraterrestrial life, scientists have turned over all sorts of rocks.

Mars, for example, has geological features that suggest it once had -- and still has -- subsurface liquid water, an almost sure prerequisite for life. Scientists have also eyed Saturn's moons Titan and Enceladus as well as Jupiter's moons Europa, Ganymede and Callisto as possible havens for life in the oceans under their icy crusts.

Now, however, scientists are dusting off an old idea that promises a new vista in the hunt for life beyond Earth: the clouds of Venus.

In a paper published online today (March 30, 2018) in the journal Astrobiology, an international team of researchers led by planetary scientist Sanjay Limaye of the University of Wisconsin-Madison's Space Science and Engineering Center lays out a case for the atmosphere of Venus as a possible niche for extraterrestrial microbial life.

"Venus has had plenty of time to evolve life on its own," explains Limaye, noting that some models suggest Venus once had a habitable climate with liquid water on its surface for as long as 2 billion years. "That's much longer than is believed to have occurred on Mars."

On Earth, terrestrial microorganisms -- mostly bacteria -- are capable of being swept into the atmosphere, where they have been found alive at altitudes as high as 41 kilometers (25 miles) by scientists using specially equipped balloons, according to study co-author David J. Smith of NASA's Ames Research Center.

There is also a growing catalog of microbes known to inhabit incredibly harsh environments on our planet, including the hot springs of Yellowstone, deep ocean hydrothermal vents, the toxic sludge of polluted areas, and in acidic lakes worldwide.

"On Earth, we know that life can thrive in very acidic conditions, can feed on carbon dioxide, and produce sulfuric acid," says Rakesh Mogul, a professor of biological chemistry at California State Polytechnic University, Pomona, and a co-author on the new paper. He notes that the cloudy, highly reflective and acidic atmosphere of Venus is composed mostly of carbon dioxide and water droplets containing sulfuric acid.

The habitability of Venus' clouds was first raised in 1967 by noted biophysicist Harold Morowitz and famed astronomer Carl Sagan. Decades later, the planetary scientists David Grinspoon, Mark Bullock and their colleagues expanded on the idea.

Supporting the notion that Venus' atmosphere could be a plausible niche for life, a series of space probes to the planet launched between 1962 and 1978 showed that the temperature and pressure conditions in the lower and middle portions of the Venusian atmosphere -- altitudes between 40 and 60 kilometers (25-27 miles) -- would not preclude microbial life. The surface conditions on the planet, however, are known to be inhospitable, with temperatures soaring above 450 degrees Celsius (860 degrees Fahrenheit).

Limaye, who conducts his research as a NASA participating scientist in the Japan Aerospace Exploration Agency's Akatsuki mission to Venus, was eager to revisit the idea of exploring the planet's atmosphere after a chance meeting at a teachers' workshop with paper co-author Grzegorz S?owik of Poland's University of Zielona Góra. Slowik made him aware of bacteria on Earth with light-absorbing properties similar to those of unidentified particles that make up unexplained dark patches observed in the clouds of Venus. Spectroscopic observations, particularly in the ultraviolet, show that the dark patches are composed of concentrated sulfuric acid and other unknown light-absorbing particles.

Those dark patches have been a mystery since they were first observed by ground-based telescopes nearly a century ago, says Limaye. They were studied in more detail by subsequent probes to the planet.

"Venus shows some episodic dark, sulfuric rich patches, with contrasts up to 30-40 percent in the ultraviolet, and muted in longer wavelengths. These patches persist for days, changing their shape and contrasts continuously and appear to be scale dependent," says Limaye.

The particles that make up the dark patches have almost the same dimensions as some bacteria on Earth, although the instruments that have sampled Venus' atmosphere to date are incapable of distinguishing between materials of an organic or inorganic nature.

The patches could be something akin to the algae blooms that occur routinely in the lakes and oceans of Earth, according to Limaye and Mogul -- only these would need to be sustained in the Venusian atmosphere.

Limaye, who has spent his career studying planetary atmospheres, was further inspired to revisit the idea of microbial life in the clouds of Venus by a visit to Tso Kar, a high-altitude salt lake in northern India where he observed the powdery residue of sulfur-fixing bacteria concentrated on decaying grass at the edge of the lake being wafted into the atmosphere.

Limaye notes, however, that a part of the equation that isn't known is when Venus' liquid water evaporated -- extensive lava flows in the last billion years likely have either destroyed or covered up the planet's earlier terrestrial history.

In the hunt for extraterrestrial life, planetary atmospheres other than Earth's remain largely unexplored.

One possibility for sampling the clouds of Venus, says Limaye, is on the drawing board: VAMP, or Venus Atmospheric Maneuverable Platform, a craft that flies like a plane but floats like a blimp and could stay aloft in the planet's cloud layer for up to a year gathering data and samples.

Such a platform could include instruments like Raman Lidar, meteorological and chemical sensors, and spectrometers, says Limaye. It could also carry a type of microscope capable of identifying living microorganisms.

"To really know, we need to go there and sample the clouds," says Mogul. "Venus could be an exciting new chapter in astrobiology exploration."

The Wisconsin scientist and his colleagues remain hopeful that such a chapter can be opened as there are ongoing discussions about possible NASA participation in Russia's Roscosmos Venera-D mission, now slated for the late 2020s. Current plans for Venera-D might include an orbiter, a lander and a NASA-contributed surface station and maneuverable aerial platform.

ATLANTA--Child sexual abuse in the United States is costly, with an average lifetime cost of $1.1 million per death of female victims and $1.5 million per death of male victims, according to a new study.

Researchers measured the economic costs of child sexual abuse by calculating health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs and suicide death costs.

They estimated the total lifetime economic burden of child sexual abuse in the United States to be $9.3 billion, based on child sexual abuse data from 2015. For nonfatal cases of child sexual abuse, the estimated lifetime cost is $282,734 per female victim. There was insufficient information on productivity losses for male victims, which contributed to a lower estimated lifetime cost of $74,691. The findings are published in the journal Child Abuse & Neglect.

"This study reveals that the economic burden of child sexual abuse is substantial and signifies recognition that reducing children's vulnerability will positively and directly impact the nation's economic and social well-being and development," said Dr. Xiangming Fang, associate professor of health management and policy in the School of Public Health at Georgia State University. "We hope our research will bring attention to the need for increased prevention efforts for child sexual abuse."

The World Health Organization defines child sexual abuse as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, is not developmentally prepared or violates the laws and social taboos of society. It is the activity between a child - anyone under the age of 18 in most states - and an adult or another child who by age or development is in a position of responsibility, trust or power.

Child sexual abuse includes commercial sexual exploitation and the use of children in pornographic performance and materials. The estimated prevalence rates of exposure to child sexual abuse by 18 years old are 26.6 percent for U.S. girls and 5.1 percent for U.S. boys. International rates of exposure are often higher in low- and middle-income countries. The effects of child sexual abuse include increased risk for development of severe mental, physical and behavioral health disorders; sexually transmitted diseases; self-inflicted injury, substance abuse and violence; and subsequent victimization and criminal offending.

The researchers examined data from 20 new cases of fatal child sexual abuse and 40,387 new cases of nonfatal child sexual abuse that occurred in 2015. The data were obtained from the National Child Abuse and Neglect Data System of the Children's Bureau and child maltreatment reports issued by the U.S. Department of Health and Human Services.

Irvine, Calif., March 29, 2018 - Materials inspired by disappearing Hollywood dinosaurs and real-life shy squid have been invented by UCI engineers, according to new findings in Science this Friday.

The thin swatches can quickly change how they reflect heat, smoothing or wrinkling their surfaces in under a second after being stretched or electrically triggered. That makes them invisible to infrared night vision tools or lets them modulate their temperatures.

"Basically, we've invented a soft material that can reflect heat in similar ways to how squid skin can reflect light," said corresponding author Alon Gorodetsky, an engineering professor. "It goes from wrinkled and dull to smooth and shiny, essentially changing the way it reflects the heat."

Potential uses include better camouflage for troops and insulation for spacecraft, storage containers, emergency shelters, clinical care, and building heating and cooling systems.

"We were inspired both by science fiction and science fact - seeing dinosaurs disappear and reappear under an infrared camera in 'Jurassic World' and seeing squid filmed underwater do similar things," said Gorodetsky. "So we decided to merge those concepts to design a really unique technology."

Made of sandwiches of aluminum, plastic, and sticky tape, the material transforms from a wrinkled grey to a glossy surface when it is either pulled manually or zapped with voltage.

Products that reflect heat, such as emergency blankets, have existed for decades. But in the past several years, inventors in Gorodetsky's lab and others have pushed to create dramatically improved versions via bio-inspired engineering. One focus has been to imitate how squid and other cephalopods can nearly instantaneously change their skin to blend into their surrounding environment.

Now, he and his team have done it, creating prototypes that can next be scaled up into large sheets of commercially useable material. Patents are pending.

"It was hard, especially the first phase when we were learning how to work with the sticky material," said doctoral student Chengyi Xu, lead author. After trial-and-error processes involving thousands of attempts, he and postdoctoral scholar George Stiubianu finally saw the mirror-like coating change when they pulled it sideways.

"The whole project was so exciting." he said.

Gorodetsky praised his team, saying, "These are exactly the type of graduate students and postdocs that UCI should be recruiting. They're amazing."