Culture

BOSTON- Sepsis is a major public health problem, contributing to substantial disability, death, and healthcare costs in the United States among both adults and children. Though sepsis is the focus of worldwide prevention and quality improvement efforts, tracking sepsis rates and outcomes is challenging because a definitive diagnostic test does not yet exist. Sepsis is particularly difficult to track in infants and children because of age-related differences in responses to infection and treatment approaches.

To address the need for widespread, reliable sepsis tracking among infants and children, the Centers for Disease Control and Prevention convened a multidisciplinary pediatric working group to develop a national approach for pediatric sepsis surveillance. The working group's proposed approach is described by Heather E. Hsu, MD, MPH and colleagues in the journal Pediatrics.

The article highlights the opportunities and advantages of using electronic health record data, rather than administrative claims or chart reviews, to facilitate widespread sepsis surveillance. The authors also propose a preliminary pediatric sepsis surveillance case definition adapted to address specific differences and challenges among infants and children. In addition, the proposal includes an outline of next steps for refining and validating criteria used to estimate the national burden of pediatric sepsis and support site-specific surveillance to complement existing initiatives for improving sepsis prevention, recognition, and treatment.

"Pediatric sepsis affects millions of children worldwide every year. It is both preventable and treatable, but we need a reliable way of measuring it to know whether our efforts are working," says Hsu, a pediatrician at Boston Medical Center and assistant professor of pediatrics at Boston University School of Medicine. "What we have created is an approach that, if carried out effectively, could be used by clinicians, quality officers, policy-makers and public health officials to further drive innovation and improvements in the prevention, detection, and management of this deadly disease."

The amount of physiotherapy available following hip and knee replacements comes down to a 'postcode lottery' according to new research from the University of East Anglia.

New findings published today show that patients are more likely to receive physiotherapy after hip or knee replacement in London and the North of England. Patients in the South West are the least likely to receive physiotherapy.

The research also finds a range of other factors impacting whether patients receive physiotherapy - including how old the patient is, their gender and ethnicity.

Hip and knee replacements are two of the most common surgical procedures performed worldwide. More than 200,000 were carried out in England and Wales in 2017.

Post-operation physiotherapy is recommended for a minimum of six weeks. This can include hydrotherapy, resistance or aerobic exercise, and may be individual or group-based. But there is substantial variability in the delivery and content of physiotherapy across NHS trusts.

This is the first nationwide study to investigate and map the provision of physiotherapy after a knee or hip replacement.

The research team studied data from the UK's National Joint Registry - the largest joint replacement registry in the world.

They looked at data collected about more than 37,000 patients in their first year after surgery. They studied the amount of physiotherapy received, and compared it to factors such as the patient's level of disability, geographical location, age, social deprivation, gender and ethnicity.

Lead researcher Dr Toby Smith from UEA's School of Health Sciences, said: "Generally we found that physiotherapy provision was greater following a knee replacement compared to a hip. In the first year after the operation, 79 per cent of people who had a knee replacement received at least one physiotherapy session compared to only 53 per cent of those who had a hip replacement.

"But we found that there is substantial variation in the provision of physiotherapy nationally. And this variation is not explained by the severity of a patient's physical impairment after their operation.

"We also found that there is substantial rehabilitation inequality dependent on age - with young people receiving more physiotherapy. Women were also more likely to receive physiotherapy, as well as non-white people.

"So younger, female patients in urban areas are accessing more physiotherapy after their operations.

"What we don't know yet is exactly what the causes of this disparity are. Individual patient willingness to seek and take part in physiotherapy may be part of the problem.

"But we hope that organisations who aim for parity in service provision across the UK, such as NHS England, Nice and the Quality Care Commission, will act to correct the patient inequality we have shown."

The research was led by the University of East Anglia in collaboration with the University of Oxford, and the University of Bristol.

'Demographic and geographical variability in physiotherapy provision following hip and knee replacement. An analysis from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man' is published in the journal Physiotherapy.

Natural history collections are unique archives of biodiversity. They document how living things transform over time and what effects aspects like climate change or other man-made environmental changes have on their distribution. A good example is the decline in numbers of the European oyster (Ostrea edulis) in the North Sea, which has been continuing for over 100 years. Researchers from Kiel University (CAU), in cooperation with the NORe museum association for the North and Baltic Sea region and the Senckenberg Research Institute and Natural History Museum in Frankfurt, have now managed to shine some light on this phenomenon. They have concluded that the occurrence of the invasive American slipper limpet (Crepidula fornicata) is not one of the main causes for the European oyster dying out - unlike previously assumed. The researchers published their study in the renowned journal PLOS ONE in October.

The informative value of natural historical collections

Historical collections of the European oyster and its surrounding fauna form the basis for the new findings. The researchers investigated a total of 1,750 oysters and more than 700 slipper limpets which all found their way into the joint project's museums and the museums in Leiden and London between 1820 and 2018. "Our unique collection by Karl August Möbius was of key importance here. This collection documented the presence of the oyster throughout Europe around 1870," reported Dr Dirk Brandis, head of the Zoological Museum in Kiel and private lecturer at the CAU. Möbius conducted research in Kiel during the second half of the 19th century as a zoologist and ecologist. Based on his investigations of oyster presence in domestic waters, with the concept of biocoenosis he also discovered the mutual dependence of different life forms within a community. "We used the various historical archives to prove that the slipper limpet, which was introduced, had nothing to do with the European oyster dying out, although that has been assumed for a long time," Brandis continued.

Chronological sequence of the spread of the limpet doesn't match oyster decline

The researchers drew this conclusion from the temporal sequences, which they were now able to trace back. "Around 200 years ago, oyster fishing in the North Sea was a flourishing business," explained Dr Dieter Fiege from the Senckenberg Research Institute and Natural History Museum in Frankfurt. He continued: "In the years afterwards, however, the Ostrea edulis numbers declined continuously. It was assumed that the appearance of the invasive slipper limpet, Crepidula fornicata, was the reason behind the dramatic decrease in oysters, along with overfishing, cold winters or diseases."

In actual fact, the slipper limpet - which is native to the coastlines of North America - was introduced to Europe around 1870 but its presence could only be verified after 1934. "According to our findings, the decline in numbers of the European oyster population already began in the late 19th century, so well before the invasive spread of the slipper limpet. We were able to reconstruct this decline in detail," emphasized CAU doctoral researcher, Sarah Hayer, who is conducting research at the Zoological Museum in Kiel and who accounted for the study as the lead author. "This makes it clear that the competition by an immigrant species did not cause the European oyster to die out," added Dr Christine Ewers-Saucedo, who was chiefly responsible for collecting and analysing the data in the study at the Zoological Museum in Kiel. The real reason why the European oyster population dramatically declined in its native habitat remains unanswered.

Millions of years before Colombia won its independence from Spain at the historic Battle of Boyacá, the site was covered by an inland ocean inhabited by marine invertebrates. Researchers at the Smithsonian Tropical Research Institute (STRI) and collaborators discovered a new fossil species of comma shrimp that was remarkably well preserved in mid-Cretaceous rocks of Boyacá, now part of the Colombian Andes, allowing them to fill a 160 million-year gap in the evolution of these crustaceans.

Comma shrimp or Cumacea are small, delicate marine arthropods with unusual comma-shaped bodies. Even though they are an abundant group, with nearly 2,000 species distributed throughout the globe, they have one of the poorest fossil records among crustaceans. The discovery of over 500 individuals in Boyacá, preserved in such detail that even their eyes, antennae, mouthparts, legs, guts and hairs were easy to distinguish, was a unique opportunity.

"Cumaceans are a very special group of crustaceans with an odd comma-shaped body form," said Javier Luque, a STRI research associate and postdoctoral associate at Yale University who led the discovery. "There are eight families, over 165 genera and close to 2,000 species of living comma shrimp, and despite living in soft sediments with high potential for fossilization worldwide, none of them have known fossils. This means that we had no idea about when modern comma shrimp evolved, until now. Our new fossil discovery is one of a kind and represents the oldest modern comma shrimp known, and a first for the Neotropics."

The new genus and species--named Eobodotria muisca for the Muisca tribe, native Americans who lived in the Colombian Andes where the fossils were discovered, and reported in the journal Proceedings of the Royal Society B--dates back to between 95 and 90 million years, a time when Boyacá was largely covered by an extensive but narrow inland sea. Other ancient 'cumacean-like' fossils discovered previously have been mostly incomplete and poorly preserved specimens from the United States and Europe, and cannot be placed with confidence within the Cumacea group.

"The key morphological features that define cumaceans are simply missing from the other fossils," said Sarah Gerken, from the University of Alaska Anchorage and who coauthored the work. "The 160 million-year-old Jurassic species from France is a true cumacean, but the few specimens known are not preserved in detail to elucidate any family relationship or even determine their sex."

"Our new fossil from Colombia, represented by hundreds of individuals, is the first confirmed fossil that belongs to a living family of comma shrimp, the Bodotriidae, and dramatically extends the fossil record of the family for nearly a hundred million years," Luque said.

Another unusual aspect of the discovery was the abundance of adult males, preserved sideways, in the sample. This led the scientists to suggest that the E. muisca were searching for mates, rather than molting, when they suddenly died in the ocean.

"The fine and delicate features seen in the fossils mean the fossils are not shed outer shells or exoskeletons but corpses," Luque said.
"While it is common for adult males in shallow-water species to swarm at night in search of mates, females are not commonly found in high densities in the water column," Gerken said. "As the vast majority of the fossils are adult males, it suggests a mortality event in the water column that occurred during the night."

There is still much to uncover regarding the origins and relationships of these crustaceans, but the clear affinity of this species within a modern family provides the first evident marker for the evolution of modern comma shrimp. The discovery of this new fossil assemblage to which E. muisca belongs, in turn, is the first of its kind in northern South America, and it opens new avenues for the study of marine invertebrates in past and present tropical settings.

ROCHESTER, Minn. -- Stem cells derived from a patient's own fat offer a step toward improving -- not just stabilizing -- motor and sensory function of people with spinal cord injuries, according to early research from Mayo Clinic.

MULTIMEDIA ALERT: Video and audio are available for download on the Mayo Clinic News Network.

A clinical trial enrolled 10 adults to treat paralysis from traumatic spinal cord injury. After stem cell injection, the first patient demonstrated improvement in motor and sensory functions, and had no significant adverse effects, according to a case report published in Mayo Clinic Proceedings.

As a phase I multidisciplinary clinical trial, the study tests the safety, side effects and ideal dose of stem cells. Early trial findings show that patient response varies. The Mayo team plans to continue analyzing patient responses, and further results will be published on the other nine trial participants.

"In this case report, the first patient was a superresponder, but there are other patients in the trial who are moderate responders and nonresponders," says Mohamad Bydon, M.D., a Mayo Clinic neurologic surgeon and first author of the report. "One of our objectives in this study and future studies is to better delineate who will be a responder and why patients respond differently to stem cell injections.

"The findings to date will be encouraging to patients with spinal cord injuries, as we are exploring an increasing array of options for treatment that might improve physical function after these devastating injuries."

Between 250,000 and 500,000 people worldwide suffer a spinal cord injury each year, often with life-changing loss of sensory and motor function, according to the World Health Organization. Up to 90% of these cases are from traumatic causes.

All subjects enrolled in this study received fat-derived stem cell treatment, which is experimental and is not approved by the Food and Drug Administration (FDA) for large-scale use. However, the FDA allowed its use in this research.

In the case report, the patient, then 53, injured the spinal cord in his neck in a 2017 surfing accident. He suffered a complete loss of function below the level of injury, meaning he could not move or feel anything below his neck. He had surgery to decompress and fuse his cervical vertebrae. Over the next few months, with physical and occupational therapy, he regained limited ability to use his arms and legs, and some sensory function improved. However, his progress plateaued at six months after his injury.

The patient enrolled in the study nine months after his injury. His stem cells were collected by taking a small amount of fat from his abdomen. Over eight weeks, the cells were expanded in the laboratory to 100 million cells. Then the stem cells were injected into the patient's lumbar spine, in the lower back, 11 months after his injury.

"We want to intervene when the physical function has plateaued, so that we do not allow the intervention to take credit for early improvements that occur as part of the natural history with many spinal cord injuries. In this case, the patient was injected with stem cells nearly one year after his injury," Dr. Bydon says.

The patient was observed at baseline and at regular intervals over 18 months following injection. His physical therapy scores improved. For example, in the 10-meter walk test, the patient's baseline of 57.72 seconds improved at 15 months to 23 seconds. And in the ambulation test, the patient's baseline of 635 feet for 12.8 minutes improved at 15 months to 2,200 feet for 34 minutes.

The patient's occupational therapy scores also improved, such as grip and pinch strength, and manual dexterity. His sensory scores improved, with pin prick and light touch tests, as did his mental health score.

The stem cells migrate to the highest level of inflammation, which is at the level of spinal cord injury, but the cells' mechanism of interacting with the spinal cord is not fully understood, Dr. Bydon says. As part of the study, investigators collected cerebrospinal fluid on all of the patients to look for biological markers that might give clues to healing. Biological markers are important because they can help identify the critical processes that lead to spinal cord injury at a cellular level and could lead to new regenerative therapies.

"Regenerative medicine is an evolving field," says Wenchun Qu, M.D., Ph.D., a Mayo Clinic physiatrist and pain specialist, and senior author of the report. "Mayo's research and use of stem cells are informed by years of rigorous scientific investigation. We strive to ensure that patients who receive stem cells are fully educated in the risks, benefits, alternatives and unknowns about these therapies. Through our clinical trials with stem cells, we are learning from and improving these procedures."

Further study is needed to scientifically verify the effectiveness of stem cell therapy for paralysis from spinal cord injury, the authors note. It is uncertain when or if this procedure will have FDA approval for routine clinical care.

Osaka, Japan - One of the most astounding discoveries of recent times is just how much influence gut bacteria have on our health and well-being. In addition to extracting nutrients from food, the collective activity of these tiny organisms protects us from infection and helps regulate our immune system. However, changes in the gut microbiota have been implicated in diseases ranging from obesity and diabetes to inflammatory bowel disease and cancer.

In a study published this month in the Annals of the Rheumatic Diseases, researchers led by a team from Osaka University have found that the RA gut metagenome of the Japanese population had interesting characteristics and a population-specific pathway link with the host genome.

Rheumatoid arthritis is a common autoimmune disorder causing painful inflammation and damage to the joints of affected patients. Researchers have so far linked a whole host of genetic and environmental factors to the onset of rheumatoid arthritis, with the microbiota recently emerging as a possible contributing factor. However, while overstimulation of the immune response by specific bacteria has been implicated in the development of rheumatoid arthritis, the way in which the microbiota as a whole contributes to the pathogenesis of rheumatoid arthritis remains the subject of much debate.

"We carried out a genetic screen using whole-genome shotgun sequencing of the entire gut microbial community in patients with rheumatoid arthritis and compared it to that of healthy controls to get a better idea of which bacterial species, genes, and pathways may contribute to the onset of rheumatoid arthritis in Japanese patients," explains lead author of the study Toshihiro Kishikawa.

This screen, called a metagenome-wide association study (MWAS), showed an abundance of various bacteria belonging to the genus Prevotella in the gut microbiota of rheumatoid arthritis patients, indicating that more species than were previously thought may be involved in disease etiology. In addition, the study identified several genes and biological pathways that were significantly enriched in the rheumatoid arthritis metagenome.

"We then compared the enriched pathways in the bacterial metagenome with those shown to be enriched in the genomes of East Asian and European patients with rheumatoid arthritis," says senior author of the study Yukinori Okada. "Interestingly, while several overlapping pathways were identified between the metagenome and the host genomes, the correlation was only significant for the East Asian population, suggesting a population-specific link between the host genome and the metagenome in the pathology of rheumatoid arthritis."

"We hope that by establishing this novel link, our work will further the development of treatment strategies to combat rheumatic diseases."

Osaka, Japan - Researchers at Osaka University unveiled the most complete picture of an essential component of the bacterial flagellum to date, the "universal joint" used for transmitting rotary power. This research may help scientists design new antimicrobial agents that target this critical structure, or biomimetic self-propelled nanomachines inspired by the natural system.

Many bacteria have the ability to propel themselves toward food and away from predators using a whip-like "tail" called the flagellum. These flagella are surprisingly complex rotating machines, consisting of several interoperative assemblies and culminating in the long filament propeller outside the cell. The energy for the rotation originates in the basal body inside the cytoplasm, which serves as a motor. However, to consistently transfer torque to the filament with ever-changing orientation, a special mechanism is required, known in the engineering field as a "universal joint." This is a coupling device that connects rigid rods even when their axes are not always pointing in the same direction. Bacteria have evolved highly efficient part call the hook that acts as a minuscule universal joint much smaller than those we can fabricate.

Of course, scientists have long wondered about the exact structure of flagella, either to copy the design for futuristic robots that can move autonomously around the human body, or else for targeted attacks on bacteria with new antibiotic drugs. While most of the flagellum has been imaged using electron microscopes, it has been very difficult to capture with existing methods the fragile hook section, which is known to be a short, helical assembly that forms a supercoiled tubular structure.

Now, researchers at Osaka University have used improved techniques of electron cryomicroscopy (cryoEM) to precisely image this supercoiled section of the flagellum that has been thought extremely difficult to analyze, to a 3.6 Å resolution that allowed atomic model building. CryoEM, which was the subject of the 2017 Nobel Prize in Chemistry, allows rapidly frozen biological samples to be imaged while they are still in their natural configurations. Even so, the new analysis still required particle-level calculations to reconstruct the most likely structure from the data. "It was thought impossible to look into such a high level of detail for the structure of the hook in its functional state, but we succeeded using cryoEM single-particle analysis," first author Takayuki Kato says.

This work may have very important implications for fighting infections because the motility behavior of bacteria can greatly influence their chances of becoming virulent. "Bacterial motility is deeply involved in pathogenicity, and the revealed structure can lead directly to the development of new antibiotics," senior author Keiichi Namba explains.

CHICAGO - Cancers found in patients undergoing annual mammography screening are smaller and less advanced than those found in patients undergoing screenings every two years, according to a new study presented next week at the annual meeting of the Radiological Society of North America (RSNA).

Breast cancer is the most common non-skin cancer among women in the United States, according to the Centers for Disease Control and Prevention. It is the most common cause of death from cancer among Hispanic women, and the second most common cause of death from cancer among white and black women.

Mammography screening has helped reduce mortality from breast cancer by providing detection of cancer in its earliest stages, when treatment is more likely to be effective. Mammography's value is widely accepted among professional societies and government agencies, but there is disagreement regarding how often women should get a screening mammogram. For instance, the National Comprehensive Cancer Network recommends annual screening beginning at age 40 for women at average risk for breast cancer, while the U.S. Preventive Services Task Force says screening every two years beginning at age 50 is sufficient for most women.

"These differing recommendations lead to confusion for both referring physicians and patients," said study co-author Sarah Moorman, M.D., from the Department of Radiology at Michigan Medicine in Ann Arbor, Mich.

Dr. Moorman and colleagues recently compared breast cancer tumor characteristics and treatment regimens among women undergoing annual mammography versus those getting biennial (every two years) screening. The study group included 232 women, ages 40 to 84, who were diagnosed with breast cancer. The two groups had no significant differences in baseline characteristics such as age, menopausal status, hormone replacement use, family history and race.

Of the 232 women, 200, or 86%, underwent annual screening, defined as once every nine to 15 months, while the remaining 32 had biennial screening, or once every 21 to 27 months. Mean age at cancer diagnosis among 232 patients was 62. Almost three-quarters of the cancers were invasive.

Almost half of women in the biennial screening group (14/32; 43.8%) had late-stage cancers, compared with only a quarter of women in the annual screening group (48/200; 24.0%). Interval cancers, or cancers found between screenings, were more prevalent in the biennial screening group. More than a third of those women had interval cancers, compared with only 10.5% of women who had annual screening. Biennial screening was associated with larger tumor size.

"Screening mammography performed once a year resulted in less advanced stage disease in patients diagnosed with breast cancer," Dr. Moorman said.

The study also found that women who had biennial screening tended to have more aggressive treatment, such as chemotherapy and dissection of the axillary lymph nodes, where cancer from the breast often spreads.

"There were trends toward less frequent axillary lymph node dissection and less frequent use of chemotherapy with annual screening compared with biennial screening," Dr. Moorman said.

Dr. Moorman hopes the findings of the study will help allow informed decision-making regarding screening frequency.

CHICAGO - A procedure that applies pulses of focused ultrasound to the brain is safe and effective for reducing tremors and improving quality of life in people with essential tremor (ET) or Parkinson's disease (PD) tremor, according to a new study being presented next week at the annual meeting of the Radiological Society of North America (RSNA).

Tremors are rhythmic, involuntary muscle movements that cause shaking in one or more parts of the body, usually in the hands. They are characteristic of movement disorders like ET and PD, two progressive conditions that affect millions of people worldwide.

Previous treatment options for reducing tremors in patients who have not responded to medical therapy include deep brain stimulation, a surgical procedure that involves implanting a small electrode in the brain connected to a pulse generator that is implanted in the chest like a pacemaker.

A more recently available option is magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy, an incisionless interventional radiology procedure in which focused beams of sound energy are used to heat and destroy a small part of a structure in the brain called the thalamus. The procedure gives relief to the opposite side of the body, meaning that treatment to the right side of the brain would relieve tremors on the left side of the body, and vice versa.

As a minimally invasive approach, focused ultrasound has advantages over deep brain stimulation, including a reduced risk of complications from bleeding and infections, according to study lead author Federico Bruno, M.D., a radiologist in the Department of Biotechnological and Applied Clinical Sciences at the University of L'Aquila in L'Aquila, Italy.

"Another advantage is the immediate effect this treatment provides, unlike deep brain stimulation which requires a break-in period for the electrostimulation," he said. "Additionally, treatment with MRgFUS requires shorter hospitalization and is a fairly well-tolerated procedure even by more fragile patients."

For the new study, Dr. Bruno and colleagues enrolled 39 patients, average age 64.5 years, with disabling tremors that had not responded to treatment. The people in the study group, including 18 with ET and 21 with PD, had experienced symptoms for an average of more than 10 years.

The researchers evaluated the patients for tremor severity and quality of life before MRgFUS thalamotomy, immediately after treatment and over the course of the ensuing year.

They found that 37 of 39 patients, or 95%, had substantial and immediate reduction of tremor. These reductions in tremor were sustained in follow-up evaluations. Quality of life evaluation showed substantial improvement in both the ET and PD groups.

"The study we present reports our experience of over a year in the treatment of tremor by thalamotomy with focused ultrasound," Dr. Bruno said. "It is worth noting that we had a high number of patients with Parkinson's disease in our series, compared to previously published data, where the procedure was used mainly in the treatment of essential tremor patients."

Currently, MRgFUS thalamotomy is only available at a limited number of sites worldwide, Dr. Bruno said, but may become more widespread as research findings supporting its use are published. Improvements in neuroimaging techniques that allow for greater precision and detail in planning, implementation and monitoring over time of the treatment should also expand its availability.

"The clinical application of this technique for neurological diseases is an absolute novelty--the clinical use was approved by the FDA less than three years ago," Dr. Bruno said. "Few patients know of this treatment option so far, and there are not many specialized centers equipped with the required technology."

Future research in this area includes the possibility of treating both sides of the thalamus. MRgFUS is also being explored in areas beyond movement disorders, Dr. Bruno said. Several preclinical studies and clinical trials are looking at the technique for the treatment of other neurological conditions like neuropathic pain, epilepsy and obsessive-compulsive disorders, as well as for treatment of brain tumors.

A Queen's University Belfast researcher has developed a low cost technique to convert left over barley from alcohol breweries into carbon, which could be used as a renewable fuel for homes in winter, charcoal for summer barbecues or water filters in developing countries.

Breweries in the EU throw out around 3.4 million tons of unspent grain every year, weighing the equivalent of 500,000 elephants.

Using just 1kg of the grain, Dr Ahmed Osman from the School of Chemistry and Chemical Engineering has been able to create enough activated carbon to spread across 100 football pitches.

The results have been published in the Journal of Chemical Technology and Biotechnology.

Dr Osman explains: "There are only a few steps in our low cost and novel approach - drying the grain out and a two-stage chemical and heat treatment using phosphoric acid and then a potassium hydroxide wash, both of which are very low cost chemical solutions. This then leaves us with activated carbon and carbon nanotubes - high value materials which are very much in demand.

"Liquid forms of carbon are normally shipped to the UK from the Middle East, and solid biocarbon, in the form of wood pellets is shipped from the US and elsewhere. Using this new technique, we can utilise more locally produced resources, reduce emissions linked with the agriculture sector, and we are also creating a high-value product.

"Across the globe there is a real demand for carbon as it is used to create fuel for households, parts for water filters and charcoal for barbecues. If we are able to take something that would otherwise be a waste and turn it into a useful biofuel, it can only be a good thing for our planet. It could really help to solve global waste and energy problems."

Dr Osman adds: "The synthesis of value-added products from barley waste is a prime example of the circular economy, by taking a waste food by-products and creating a high-value product. It has benefits to the environment and society through economic and social opportunities."

The project was funded by EPSRC and The Bryden Centre at Queen's. It was an international collaboration between Queen's University Belfast, South West College and Sultan Qaboos University in Oman.

Dr Osman is hoping to explore opportunities for the commercialisation of the method in creating activated carbon and carbon nanotubes.

Queen's Univeristy's work on biofuels from waste will be featured in an upcoming major conference, Engineering the Energy Transition from 26 to 28 February 2020 in Belfast.

Natural substances with psychoactive effects have been used by people for religious, medicinal and recreational purposes for millennia. Lack of regulation has led to an increase in their availability, especially online. Some psychoactive substances may be appealing to recreational users because of the perception they are safer because they're "natural." However, these substances can produce psychedelic, stimulant, sedative, euphoric and anticholinergic symptoms, which are cause for concern.

A new study conducted by the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital found there were more than 67,300 calls to U.S. Poison Control Centers regarding exposures to natural psychoactive substances. The study looked at calls from January 2000 through December 2017, which totaled an average of 3,743 exposures each year, or approximately 10 calls every day.

"These substances have been associated with a variety of serious medical outcomes including seizures and coma in adults and children," said Henry Spiller, MS, D.ABAT, co-author of this study and director of the Central Ohio Poison Center at Nationwide Children's. The increasing rate of exposures to marijuana accounted for almost half of all natural psychoactive substance exposures and can be attributed, in part, to the increasing number of states that have legalized marijuana for medical or recreational use. "As more states continue to legalize marijuana in various forms, parents and health care providers should treat it like any other medication: locked up, away, and out of sight of children," said Spiller. "With edibles and infused products especially, curious children are mistaking them for kid-friendly candy or food, and that poses a very real risk for harm."

The study, published online today in the journal Clinical Toxicology, found that most exposures occurred among individuals older than 19 years of age (41%) and 13-19-year-olds (35%). The majority (64%) of cases occurred among males, and 91% occurred at a residence. The substances most commonly involved were marijuana (47%), anticholinergic plants such as jimson weed (21%), and hallucinogenic mushrooms (16%). Kratom, khat, anticholinergic plants, and hallucinogenic mushrooms were the substances with the highest percentages of hospital admission and serious medical outcomes.

Despite an increase in the overall rate of exposure to natural psychoactive substances, most substances showed a significant decrease in exposure rate from 2000-2017, except for marijuana (150% increase), nutmeg (64% increase), and kratom. Kratom demonstrated a nearly 5,000% increase from 2011-2017 and accounted for eight of the 42 deaths identified in this study. These findings support the need for increased efforts to prevent kratom-associated morbidity and mortality.

Of the 42 deaths identified in this study, seven were among children. Five of the deaths were to 13-19-year-olds and involved anticholinergic plants, hallucinogenic mushrooms, kava kava and marijuana. Both deaths among children 12 years and younger involved marijuana. Similar to previous studies, almost all cases among children younger than 6 years old were primarily exposures associated with exploratory behaviors. Children in this age group are mobile, curious and generally unaware of the potential danger of poisoning. Children younger than 6 years accounted for one-fifth of natural psychoactive substance cases, of which, the majority involved anticholinergic plants and marijuana.

An enormous library of products derived from more than ten thousand fungi could help us find new drugs. Researchers from the group of Jeroen den Hertog at the Hubrecht Institute, in collaboration with researchers from the Westerdijk Institute and Utrecht University, have set up this library and screened it for biologically active compounds. They tested the biological activity of these fungal products first using zebrafish embryos. The researchers chose to use zebrafish embryos, because it allows the analysis of effects on many cell types at the same time, in a working body, and because zebrafish are physiologically very similar to humans. They have already found various known compounds, among which the cholesterol lowering drug lovastatin. The library of fungal products offers ample opportunity to search for new drugs. The results of this research were published on the 26th of November in the scientific journal Scientific Reports.

Fungal products

We constantly need new therapeutic compounds in the clinic for various reasons, including our increasing age, with corresponding illnesses, and resistance to existing drugs. Fungi are an excellent, but underexplored source of these kinds of compounds, such as lovastatin, a compound produced by the fungus Aspergillus terreus and that is used as a cholesterol lowering drug. Jelmer Hoeksma, one of the researchers at the Hubrecht Institute, explains: "Every year new compounds produced by fungi are identified, but so far we have only investigated a very small subset of all existing fungi. This suggests that many more biologically active compounds remain to be discovered."

Ten thousand fungi

The collaboration with the Westerdijk Fungal Biodiversity Institute, home to the largest collection of live fungi in the world, enabled the researchers to set up a large library of filtrates derived from more than ten thousand different fungi. A filtrate contains all the products that the fungus excretes. To search for therapeutic compounds, the researchers investigated the effects of this large library of fungal products first on zebrafish embryos. The zebrafish embryos enabled the researchers to study effects on the whole body during development. Zebrafish are vertebrates that are physiologically very similar to humans and are often used to test drugs for a variety of disorders. Within a few days these embryos develop most of their organs, making biological activity of the fungal compounds readily detectable. In addition, comparison to known drugs may result in identification of new drugs and also point towards the underlying mechanisms of action of these compounds.

Pigmentation

The researchers found 1526 filtrates that contain biologically active compounds with an effect on zebrafish embryos, from which they selected 150 filtrates for further analysis. From these, they isolated 34 known compounds, including the cholesterol lowering drug lovastatin, which was produced by the fungus Resinicium furfuraceum. Until now it was unknown that this fungus produces lovastatin. In addition, the researchers found filtrates that affect pigmentation in zebrafish embryos. Other studies have shown that factors involved in pigmentation can also play a crucial role in the development of skin cancer. The researchers are currently isolating the active compounds that cause pigmentation defects in zebrafish embryos from the filtrates.

Tip of the iceberg

This study underlines the large variety of biologically active compounds that are produced by fungi and the importance of further investigating these compounds in the search for new drugs. Hoeksma: "The large library of fungal filtrates that we have set up can also be tested in many other systems, such as models for antibiotic resistance in bacteria and tumor development, making this study only the tip of the iceberg."

Let's talk about sext.

Sexting is extremely common among adults - but maybe not for the reasons you think.

New research from the Sexuality, Sexual Health & Sexual Behavior Lab in the Texas Tech University Department of Psychological Sciences shows that two-thirds of people who sext do so for non-sexual reasons.

In an analysis of the reasons people engage in sexting with their relationship partner, assistant professor Joseph M. Currin and doctoral student Kassidy Cox confirmed three main motivations found in previous research:

Some people use sexting as foreplay for sexual behaviors later on;

Some sext for the relationship reassurance they receive from their partner; and

Some sext their partner as a favor, with the expectation the favor will be returned later in a non-sexual way (such as a dinner date).

When they began the research, Currin and Cox were curious to see if one of these motivations was the most prevalent. Using data gathered online from 160 participants, ranging in age from 18-69, they performed a latent class analysis measuring sexting motivations, relationship attachments and sexual behaviors. To their surprise, they discovered three nearly equal clusters, suggesting no motivation is more common than another.

"It was intriguing that two-thirds of the individuals who engaged in sexting did so for non-sexual purposes," Cox said. "This may actually be demonstrating some individuals engage in sexting, but would prefer not to, but do so as a means to either gain affirmation about their relationship, relieve anxiety or get something tangible - non-sexual - in return."

Also surprising to the researchers was there were no significant differences in motivation based on sexual orientation, gender or age.

"This study highlighted the main reasons to date that individuals are motivated to sext, and it actually normalizes all three types of motivations," said Cox.

"As it is becoming a more accepted method of communicating one's sexual desires, we wanted to highlight how adults utilize this behavior in their relationships," Currin added. "This tells us that sexting among adults is an evolution of how we have communicated our sexual desires to our partners in the past. People used to write love poems and steamy letters, then when photography became more common place, couples used to take boudoir photos for each other."

Currin and Cox noted that their research focused on sexting between current partners in consensual relationships only.

"As with any sexual behavior, it is important and necessary to have consent to engage in sexting," Currin said. "Individuals who send unsolicited sext messages - such as images of their genitalia - are not actually engaging in sexting; they are sexually harassing the recipient."

Boulder, Colo., USA: When -- and how -- Earth's surface evolved from a hot, primordial mush into a rocky planet continually resurfaced by plate tectonics remain some of the biggest unanswered questions in earth science research. Now a new study, published in Geology, suggests this earthly transition may in fact have been triggered by extra-terrestrial impacts.

"We tend to think of the Earth as an isolated system, where only internal processes matter," says Craig O'Neill, director of Macquarie University's Planetary Research Centre. "Increasingly, though, we're seeing the effect of solar system dynamics on how the Earth behaves."

Modelling simulations and comparisons with lunar impact studies have revealed that following Earth's accretion about 4.6 billion years ago, Earth-shattering impacts continued to shape the planet for hundreds of millions of years. Although these events appear to have tapered off over time, spherule beds -- distinctive layers of round particles condensed from rock vaporized during an extra-terrestrial impact -- found in South Africa and Australia suggest the Earth experienced a period of intense bombardment about 3.2 billion years ago, roughly the same time the first indications of plate tectonics appear in the rock record.

This coincidence caused O'Neill and co-authors Simone Marchi, William Bottke, and Roger Fu to wonder whether these circumstances could be related. "Modelling studies of the earliest Earth suggest that very large impacts-- more than 300 km in diameter -- could generate a significant thermal anomaly in the mantle," says O'Neill. This appears to have altered the mantle's buoyancy enough to create upwellings that, according to O'Neill, "could directly drive tectonics."

But the sparse evidence found to date from the Archaean -- the period of time spanning 4.0 to 2.5 billion years ago -- suggests that mostly smaller impacts less than 100 km in diameter occurred during this interval. To determine whether these more modest collisions were still large and frequent enough to initiate global tectonics, the researchers used existing techniques to expand the Middle Archaean impact record and then developed numerical simulations to model the thermal effects of these impacts on Earth's mantle.

The results indicate that during the Middle Archaean, 100-kilometer-wide impacts (about 30 km wider than the much younger Chixculub crater) were capable of weakening Earth's rigid, outermost layer. This, says O'Neill, could have acted as a trigger for tectonic processes, especially if Earth's exterior was already "primed" for subduction.

"If the lithosphere were the same thickness everywhere, such impacts would have little effect," states O'Neill. But during the Middle Archean, he says, the planet had cooled enough for the mantle to thicken in some spots and thin in others. The modelling showed that if an impact were to happen in an area where these differences existed, it would create a point of weakness in a system that already had a large contrast in buoyancy -- and ultimately trigger modern tectonic processes.

"Our work shows there is a physical link between impact history and tectonic response at around the time when plate tectonics was suggested to have started," says O'Neill. "Processes that are fairly marginal today -- such as impacting, or, to a lesser extent, volcanism -- actively drove tectonic systems on the early Earth," he says. "By examining the implications of these processes, we can start exploring how the modern habitable Earth came to be."

CORVALLIS, Ore. - Scientists at Oregon State University may have proven how much people love coffee, tea, chocolate, soda and energy drinks as they validated their new method for studying how different drugs interact in the body.

In conducting mass spectrometry research, Richard van Breemen and Luying Chen worked with various biomedical suppliers to purchase 18 batches of supposedly pure human blood serum pooled from multiple donors. Biomedical suppliers get their blood from blood banks, who pass along inventory that's nearing its expiration date.

All 18 batches tested positive for caffeine. Also, in many of the samples the researchers found traces of cough medicine and an anti-anxiety drug. The findings point to the potential for contaminated blood transfusions, and also suggest that blood used in research isn't necessarily pure.

"From a 'contamination' standpoint, caffeine is not a big worry for patients, though it may be a commentary on current society," said Chen, a Ph.D. student. "But the other drugs being in there could be an issue for patients, as well as posing a problem for those of us doing this type of research because it's hard to get clean blood samples."

The study was published in the Journal of Pharmaceutical and Biomedical Analysis.

In addition to caffeine, the research also involved testing pooled serum for alprazolam, an anti-anxiety medicine sold under the trade name Xanax; dextromethorphan, an over-the-counter cough suppressant; and tolbutamide, a medicine used to treat type 2 diabetes.

All of the pooled serum was free of tolbutamide, but eight samples contained dextromethorphan and 13 contained alprazolam - possibly meaning that if you ever need a blood transfusion, your odds of also receiving caffeine, cough medicine and an anti-anxiety drug are pretty good.

"The study leads you in that direction, though without doing a comprehensive survey of vendors and blood banks we can only speculate on how widespread the problem is," said van Breemen, the director of OSU's Linus Pauling Institute. "Another thing to consider is that we found drugs that we just happened to be looking for in doing the drug interaction assay validation - how many others are in there too that we weren't looking for?"

The purpose of the study by Chen and van Breemen was to test a new method for evaluating the potential for interactions between botanical dietary supplements and drug metabolism.

The method involves rapid protein precipitation and ultra high pressure liquid chromatography and is being used to support clinical studies. In the clinical studies, participants take a drug cocktail along with a botanical supplement - hops, licorice or red clover - to see if the supplement causes any of the drugs to be metabolized differently than they otherwise would.

"Botanicals basically contain natural products with drug-like activities," van Breemen said. "Just as a drug may alter the drug-metabolizing enzymes, so can natural products. It can become a real problem when someone takes a botanical supplement and is also on prescription drugs - how do those two interact? It's not straightforward or necessarily predictable, thus the need for methods to look for these interactions. The odd thing in this case was finding all the tainted blood."

Two individual donors who agreed to abstain from caffeinated foods and beverages had to be enlisted so the research could be completed.