Culture

Robots need to know the reason why they are doing a job if they are to effectively and safely work alongside people in the near future. In simple terms, this means machines need to understand motivethe way humans do, and not just perform tasks blindly, without context.

According to a new article by the National Centre for Nuclear Robotics, based at the University of Birmingham, this could herald a profound change for the world of robotics, but one that is necessary.

Lead author Dr. Valerio Ortenzi, at the University of Birmingham argues the shift in thinking will be necessary as economies embrace automation, connectivity and digitisation ('Industry 4.0') and levels of human - robot interaction, whether in factories or homes, increase dramatically.

The paper, published in Nature Machine Intelligence, explores the issue of robots using objects. 'Grasping' is an action perfected long ago in nature but one which represents the cutting-edge of robotics research.

Most factory-based machines are 'dumb', blindly picking up familiar objects that appear in pre-determined places at just the right moment. Getting a machine to pick up unfamiliar objects,randomly presented, requires the seamless interaction of multiple, complex technologies. These include vision systems and advanced AI so the machine can see the target and determine its properties (for example, is it rigid or flexible?); and potentially, sensors in the gripper are required so the robot does not inadvertently crush an object it has been told to pick up.

Even when all this is accomplished, researchers in the National Centre for Nuclear Robotics highlighted a fundamental issue: what has traditionally counted as a 'successful' grasp for a robot might actually be a real-world failure, because the machine does not take into account what the goal is and whyit is picking an object up.

The Nature Machine Intelligence paper cites the example of a robot in a factory picking up an object for delivery to a customer. It successfully executes the task, holding the package securely without causing damage. Unfortunately, the robot's gripper obscures a crucial barcode, which means the object can't be tracked and the firm has no idea if the item has been picked up or not; the whole delivery system breaks down because the robot does not know the consequences of holding a box the wrong way.

Dr. Ortenzi and his co-authors give other examples, involving robots working alongside people.

"Imagine asking a robot to pass you a screwdriver in a workshop. Based on current conventions the best way for a robot to pick up the tool is by the handle. Unfortunately, that could mean that a hugely powerful machine then thrusts a potentially lethal blade towards you, at speed. Instead, the robot needs to know what the end goal is, i.e.,to pass the screwdriver safely to its human colleague, in order to rethink its actions.

"Another scenario envisages a robot passing a glass of water to a resident in a care home. It must ensure that it doesn't drop the glass but also that water doesn't spill over the recipient during the act of passing, or that the glass is presented in such a way that the person can take hold of it.

"What is obvious to humans has to be programmed into a machine and this requires a profoundly different approach. The traditional metrics used by researchers, over the past twenty years, to assess robotic manipulation, are not sufficient. In the most practical sense, robots need a new philosophy to get a grip."

Professor Rustam Stolkin, NCNR Director, said, "National Centre for Nuclear Robotics is unique in working on practical problems with industry, while simultaneously generating the highest calibre of cutting-edge academic research - exemplified by this landmark paper."

Chickadees can smell! That is the news from a study out of Lehigh University, the first to document naturally hybridizing songbirds' preference for the scent of their own species.

Amber Rice, an evolutionary biologist at Lehigh, studies natural hybridization-when separate species come into contact and mate-to better understand how species originate and how existing species are maintained. The two species that make up the hybridized population she studies are the black-capped chickadee and its relative the Carolina chickadee.

Rice and Ph.D. student, Alex Van Huynh, set out to test the potential for scent to act as a mate choice cue, contributing to reproductive isolation between the black-capped and Carolina chickadees who live in the "hybrid zone" in the eastern Pennsylvania region where Lehigh is located.

Huynh and Rice found that both black-capped and Carolina chickadees produce chemically distinct natural oils. Testing both males and females of both chickadee species, they found that males and females prefer the smell of their own species over the smell of the opposite species. These preferences could be impacting hybridization. Their results have been published in an article entitled: "Conspecific olfactory preferences and interspecific divergence in odor cues in a chickadee hybrid zone" in Ecology and Evolution.

"The sense of smell has been very understudied in birds, particularly songbirds, because they frequently have such impressive plumage and song variation," says Rice. "Some other recent work has documented that species of songbird can smell and prefer their species' odors, but this is the first example in currently hybridizing species that we know of."

"Our results show that not only can odor cues be used by songbirds, potentially as a mate choice cue, but that they can have ecological and evolutionary consequences for songbird species," adds Huynh.

The black-capped and Carolina chickadees interbreed with one another, but their hybrid offspring suffer fitness costs. For example, the interbred chickadees are less likely to hatch from their eggs, and they have lower cognitive abilities than pure-species birds.

Interestingly, the researchers found that the chickadees they studied do not actively avoid the smell of the other species.

"This fact may be coincident with the observation that hybridization still does indeed take place," says Huynh. "We know the hybrid zone is very small and its width is stable over time. In other words, the geographic area of hybridization is not growing or shrinking."

Birds of the same smell, tend to gel

Huynh and Rice caught wild birds from hybrid zone populations in Pennsylvania. They used gas-chromatography mass-spectrometry to analyze differences between the species in the natural oils the birds produce from their uropygial glands (also known as the preen glands). They tested for the species' odor preference using a Y-maze, measuring the amount of time a bird spends with a particular smell.

The experiments indicated a clear preference for same-species whole-body odors in both species of chickadees. These preferences were present in both male and female birds. The results, the team says, are consistent with a possible role for olfactory signaling in premating reproductive isolation in chickadees.

"Within the hybrid zone, the two species show differences in their uropygial oil chemistry as well as significant preferences for their own species over those of the other species," says Rice.

The team believes that researchers in the fields of animal behavior and chemical ecology will find their study particularly interesting. Investigating odor in future studies of songbird behavior such as mate choice, predation risk assessment, or competitive interactions, are some promising avenues for future inquiry.

A new study by QUT researchers debunks some theories of sexual economics (and wider societal thinking) when it comes to the market value of women as they age.

Researchers found older women believe they have just as much bargaining power as younger women, while men with greater educational qualifications believe they hold a market premium.

QUT behavioural economists Dr Stephen Whyte and Professor Benno Torgler, along with Professor Robert C. Brooks from the University of New South Wales, have analysed data compiled via the online 2016 Australian Sex Survey.

The study - Sexual Economic Theory & the Human Mating Market has just been published in the journal of Applied Economics.

In a partnership with Adultmatchmaker.com.au, they looked at a sample of 3,261 individual survey respondents who identified as heterosexual, bisexual or pansexual and not in a committed relationship at the time.

"Choosing a partner, someone to love, to have sex with, and possibly have children with is such a complex, increasingly non-sequential and multi-dimensional large scale decision," Dr Whyte said.

"The study explored Baumeister and Vohs' 2004 theory of sexual economics (SET) in the context of the modern dating market in which online and internet dating have begun to dominate.

"Our results showed that bisexual and pansexual women enjoy a market premium, but this is not the case for bisexual and pansexual men. The study also found that, contrary to SET's previous findings, the self-perceived market value women estimate of themselves does not diminish with the years, in fact it increases.

"There are many reasons why humans have sex; reproduction is only one of them. There are many dimensions to human sexuality and the intimate relationships we form, and equally there is no one, single favoured mating strategy."

Dr Whyte said Sexual Economic Theory was a conceptual framework used to examine human mating dynamics in the same way as any other micro level transaction or behaviour.

He added that SET was built on the assumption that sexual (reproductive) access is an intrinsically valued commodity, the supply of which is theoretically controlled by women.

"Both men and women may want sex but from an economic and evolutionary perspective, the inherent cost imbalance born by women in reproductive participation drives up their market value compared to men," said Dr Whyte.

"Unlike other market commodities such as oil or gold, an individual's reproductive or relationship value is not directly observable. Applied economics is therefore finding new and innovative ways to explore the market for human mating behaviour and reproduction despite the fact that establishing an individual's market value will always be problematic.

"Exploring human reproduction as a resource and or tradable commodity, and how we see or perceive ourselves in the interplay of mating market dynamics is interesting research for most people. After all, we are here because our parents were successful at it.

"What's really unique about the study is the exploration of different sexualities perceptions of their own attractiveness or mating market value. And particularly how that may differ between the sexes across key life stages."

DALLAS, August 12, 2019 -- Non-invasive techniques and devices for assessing blood flow and other diagnostic considerations for people with critical limb ischemia are addressed in a new scientific statement from the American Heart Association, published in the Association's flagship journal Circulation.

The statement provides perspective on the strengths and limitations of current imaging techniques, including the ankle-brachial index, toe brachial index, toe systolic pressure, transcutaneous oximetry (TcPO2) and skin perfusion pressure (SPP). It also examines tools such as the laser Doppler, speckle imaging devices and others, as well as identifying opportunities for technology improvement and reducing disparities in detection and treatment.

The authors noted sex and ethnic differences in how critical limb ischemia is diagnosed, coexisting conditions and disparities in treatment. Women are more likely to experience emergency hospitalization, have differences in blood flow, and higher disability and death rates.

Black and Hispanic patients with critical limb ischemia are more likely to have diabetes and chronic kidney disease and are more likely to develop gangrene. White patients are more likely to have ulcers and pain in their legs while at rest. Black patients are also 78% more likely to receive lower extremity amputation for critical limb ischemia compared to their white peers, even after adjustment for socioeconomic status, access to facilities with revascularization services and other factors.

Critical limb ischemia is the most severe form of peripheral artery disease (PAD), which affects an estimated 12 million Americans. It occurs when the arteries leading to the legs become narrowed or blocked. The condition can lead to gangrene, wounds that don't heal and amputations if blood flow is not returned to the limbs.

Despite the high prevalence of critical limb ischemia, strategies to assess blod flow remain limited. New technologies offer potential opportunities to improve the precision and quality of criticail limb ischemia management, with the goal of earlier detection and treatment to reduce amputations and disability as well as improving the quality of life for patients.

Researchers and caregivers have noted that excessive daytime napping can develop long before the memory problems associated with Alzheimer's disease begin to unfold. Prior studies have considered this excessive daytime napping to be compensation for poor nighttime sleep caused by Alzheimer's-related disruptions in sleep-promoting brain regions, while others have argued that the sleep problems themselves contribute to the progression of the disease. But now UC San Francisco scientists have provided a striking new biological explanation for this phenomenon, showing instead that Alzheimer's disease directly attacks brain regions responsible for wakefulness during the day.

The new research demonstrates that these brain regions (including the part of the brain impacted by narcolepsy) are among the first casualties of neurodegeneration in Alzheimer's disease, and therefore that excessive daytime napping -- particularly when it occurs in the absence of significant nighttime sleep problems -- could serve as an early warning sign of the disease. In addition, by associating this damage with a protein known as tau, the study adds to evidence that tau contributes more directly to the brain degeneration that drives Alzheimer's symptoms than the more extensively studied amyloid protein.

"Our work shows definitive evidence that the brain areas promoting wakefulness degenerate due to accumulation of tau -- not amyloid protein -- from the very earliest stages of the disease," said study senior author Lea T. Grinberg, MD, PhD, an associate professor of neurology and pathology at the UCSF Memory and Aging Center and a member of the Global Brain Health Institute and UCSF Weill Institute for Neurosciences.

Wakefulness Centers Degenerate in Alzheimer's Brains

In the new study, published August 12, 2019 in Alzheimer's and Dementia, lead author Jun Oh, a Grinberg lab research associate, and colleagues precisely measured Alzheimer's pathology, tau protein levels and neuron numbers in three brain regions involved in promoting wakefuless from 13 deceased Alzheimer's patients and seven healthy control subjects, which were obtained from the UCSF Neurodegenerative Disease Brain Bank.

Compared to healthy brains, Oh and colleagues found that the brains of Alzheimer's patients had significant tau buildup in all three wakefulness-promoting brain centers they studied -- the locus coeruleus (LC), lateral hypothalamic area (LHA), and tuberomammillary nucleus (TMN) -- and that these regions had lost as many as 75 percent of their neurons.

"It's remarkable because it's not just a single brain nucleus that's degenerating, but the whole wakefulness-promoting network," Oh said. "Crucially this means that the brain has no way to compensate because all of these functionally related cell types are being destroyed at the same time."

Oh and colleagues also studied brain samples from seven patients with progressive supranuclear palsy (PSP) and corticobasal disease (CBD), two distinct forms of neurodegenerative dementia caused by tau accumulation. In contrast to the Alzheimer's disease brains, wakefulness-promoting neurons appeared to be spared in the PSP and CBD brains, despite comparable levels of tau buildup in these tissue samples.

"It seems that the wakefulness-promoting network is particularly vulnerable in Alzheimer's disease," Oh said. "Understanding why this is the case is something we need to follow up in future research."

Studies point to role of tau protein in Alzheimer's symptoms

The new results are in line with an earlier study by Grinberg's group which showed that people who died with elevated levels of tau protein in their brainstem -- corresponding to the earliest stages of Alzheimer's disease -- had already begun to experience changes in mood, such as anxiety and depression, as well as increased sleep disturbances.

"Our new evidence for tau-linked degeneration of the brain's wakefulness centers provides a compelling neurobiological explanation for those findings," Grinberg said. "It suggests we need to be much more focused on understanding the early stages of tau accumulation in these brain areas in our ongoing search for Alzheimer's treatments."

These studies add to a growing recognition among some researchers that tau buildup is more closely linked to the actual symptoms of Alzheimer's than the more widely studied amyloid protein, which has so far failed to yield effective Alzheimer's therapies.

For instance, another recent study by the Grinberg lab measured tau buildup in the brains of patients who died with different clinical manifestations of Alzheimer's disease, including variants that involved language impairment or visual problems instead of more typical memory loss. They found that differences in local tau burden in these patients' brains closely matched their symptoms: patients with language impairments had more tau accumulation in language related brain areas than in memory regions, while patients with visual problems had higher tau levels in visual brain areas.

"This research adds to a growing body of work showing that tau burden is likely a direct driver of cognitive decline," Grinberg said.

Increased focus on the role of tau in Alzheimer's suggests that treatments currently in development at UCSF's Memory and Aging Center and elsewhere that directly tackle tau pathology have the potential to improve sleep and other early symptoms of Alzheimer's disease, in addition to holding a key to slowing the progress of the disease overall, the authors say.

An international team of researchers has revealed how aggressive pancreatic cancer cells change their environment to enable easy passage to other parts of the body (or metastasis) - the main cause of pancreatic cancer related death.

The researchers discovered that some pancreatic tumours produce more of a molecule called 'perlecan' to remodel the environment around them, which helps cancer cells spread more easily to other parts of the body, and also protects them against chemotherapy. In a mouse model, the researchers showed that lowering the levels of perlecan revealed a reduction in the spread of pancreatic cancer and improved response to chemotherapy.

Led by Associate Professor Paul Timpson, Head of the Invasion and Metastasis Laboratory, and Dr Thomas Cox, Leader of the Matrix and Metastasis Group, at the Garvan Institute of Medical Research, the research may provide a promising new path to more effective treatment options for individuals with pancreatic and other cancers.

The findings are published in the journal Nature Communications.

"Pancreatic cancer is very aggressive, and by the time most cases are diagnosed, the tumour is often inoperable," says Associate Professor Timpson. "What we've discovered in this study is a two-pronged approach for treating pancreatic cancer that we believe will improve the efficiency of chemotherapy and may help reduce tumour progression and spread."

Pancreatic cancer remodels its environment

Pancreatic cancer is one of the most lethal forms of cancer, with a five-year survival of ~9% in Australia. In its early stages, pancreatic cancers often show no obvious signs or symptoms and by the time a cancer is diagnosed, it has often begun to spread outside the pancreas.

The Garvan-led team investigated why some pancreatic cancers spread, while others appear to stay in one place. In their study, the researchers took an unconventional path - they compared the tissue around tumour cells in both metastatic (spreading) and non-metastatic (non-spreading) pancreatic cancers. This tissue - known as the 'matrix' - acts like a glue that holds different cells in an organ or in a tumour together.

Using mouse models, the team extracted fibroblasts - cells that produce most of the matrix - from spreading and non-spreading pancreatic tumours. By mixing these different fibroblasts with cancer cells, the researchers found that remarkably, cancer cells from a non-spreading tumour began to spread when mixed with fibroblasts from a spreading tumour.

"Our results suggest that some pancreatic cancer cells can 'educate' the fibroblasts in and around the tumour. This lets the fibroblasts remodel the matrix and interact with other, less aggressive cancer cells in a way that supports the cancer cells' ability to spread," says first author Dr Claire Vennin.

"This means that in a growing tumour, even a small number of aggressive metastatic cells - a few bad apples - can help increase the spread of other, less aggressive cancer cells."

A spotlight on the tumour matrix

To investigate how to stop pancreatic cancer cells from remodelling the matrix around them, the team took an even closer look at the fibroblasts.

Using state-of-the-art mass spectrometry techniques, the researchers discovered several molecules that the fibroblasts from metastatic tumours produced at significantly higher levels than the fibroblasts from non-metastatic tumours.

"What we discovered is a previously unknown set of matrix molecules that aggressive pancreatic cancer cells use to shape the tissue around them, in order to both protect them from chemotherapy and enable easier escape around the body," explains Dr Cox.

Using gene-editing techniques, the researchers reduced the levels of one of the molecules called perlecan in mouse models of aggressive metastatic pancreatic cancer. Through advanced live imaging techniques, the researchers tracked individual cancer cells and revealed that lowering the levels of perlecan not only reduced the spread of cancer cells, but that tumours also responded better to chemotherapy.

An untapped resource

"We believe that there would be important benefit in targeting the fibroblasts of a tumour in combination with targeting the cancer cells themselves with chemotherapy," says Dr Vennin. "If we can specifically target the aggressive fibroblasts in patients harbouring precise genetic changes, we can make them more susceptible to our currently approved treatments, which would significantly change how we treat this aggressive cancer."

The researchers say that targeting perlecan, or other matrix molecules that help remodel the tissue of metastatic tumours, may be effective for not just pancreatic cancer, but also prostate and breast cancers.

"Most cancer therapies today aim to target cancer cells themselves. The environment of tumours is a potential untapped resource for cancer therapy and one which we intend to explore further," says Associate Professor Timpson.

Previous studies have shown that some women who use aspirin and are later diagnosed with breast cancer may live longer, which may be related to the drug's anti-inflammatory effects on the body. However, a portion of aspirin users with breast cancer appeared to have a higher risk of mortality following breast cancer. According to a new study from researchers at the University of North Carolina at Chapel Hill Gillings School of Global Public Health, the reason for this reverse effect could be explained by DNA methylation of genes in breast cancer tumors or peripheral blood.

Methylation is a chemical modification wherein a methyl group acts like light switches along the DNA molecule, turning some genetic activity on and some off. Chemical shifts in areas of DNA that are responsible for cell death, damage and repair - such as occurs in methylation - are known contributors to the development of cancer over time. Identifying the areas where these epigenetic changes take place show promise in predicting certain risks or effective methods of treatment.

The study, published on Aug. 12 in the American Cancer Society's interdisciplinary journal CANCER, is the first to examine the effect of DNA methylation in breast tumor tissues and cells circulating in the patients' peripheral blood on the association between aspirin use and mortality in women with breast cancer.

"Chronic inflammation is a key player in the development of multiple cancer types, including breast cancer," said first author Tengteng Wang, who led this study while she was a doctoral candidate in the epidemiology department at the Gillings School. "Aspirin is a major non-steroidal anti-inflammatory drug which has anti-inflammatory properties. Given this, substantial evidence from laboratory and population studies suggests that taking aspirin may reduce the risk of developing breast cancer."

However, the association of aspirin use with death outcomes following breast cancer diagnosis remains inconclusive and inconsistent across studies, which prompted the researchers to explore whether aspirin's varying influences on breast cancer patients could be related to distinctly different DNA profiles due to methylation.

The team analyzed data from 1,266 women with breast cancer in the Long Island Breast Cancer Study who were followed for subsequent mortality. All-cause mortality after breast cancer was elevated by 67% among those who had used aspirin at least once a week for six weeks pre-diagnosis and had a methylated tumor promotor of breast cancer gene 1, known as BRCA1. Breast cancer-specific mortality decreased by 22-40% in aspirin users with unmethylated tumor promoter of BRCA1 and progesterone receptor (PR) genes, and also those with long interspersed elements-1 global hypermethylation. These results suggest real differences in breast cancer mortality risk in patient groups with these different methylation profiles in tumor tissue DNA and peripheral blood DNA.

The research team points to the need for further exploration of the potential impact - good or bad - aspirin may have on specific breast cancer patients due to their DNA methylation profiles. The findings do not indicate that anyone with elevated breast cancer risk should start taking aspirin, and people should speak to their doctors before they make changes to their medications.

"Future research designed to replicate our findings should include a larger sample size to allow examination of patterns of aspirin use, and an enlarged panel of genes to explore the role of genetic predisposition in driving overall genetic instability on survival after breast cancer diagnosis," said Wang and her mentor Marilie Gammon, a professor of epidemiology at the Gillings School and senior author on the study.

Half of key hospital doctors who are likely to be involved in responding to a major incident in the UK aren't properly prepared to do so, reveal the results of a phone survey, published in Emergency Medicine Journal.

If anything, they are less prepared than their peers were in 2006, when the last survey looking at this issue was carried out, the findings suggest.

Since 2004 all hospitals in England have been required to keep a major incident plan, or MIP for short, to respond to an incident involving a large number of casualties.

Plans cover the strategic, tactical, and operational management required, as well as key members of the response team: specialists in anaesthetics, intensive care, emergency medicine, general surgery, trauma and orthopaedics.

Recent major incidents in the UK, including the Manchester Arena bombing and the Grenfell Tower fire in London, exemplify the need for a major incident plan, say the researchers.

They wanted to find out if the relatively low levels of preparedness they found in 2006, when middle grade hospital doctors were last surveyed about this issue, had changed.

They contacted 296 specialist trainees (on call registrars) in emergency medicine, trauma and orthopaedics, anaesthetics and general surgery from 74 hospital trusts that had dealt with more than 30,000 patients in emergency care in the first three months of 2017.

Nearly two thirds (186; 63%) responded; the rest either didn't respond or didn't consent to being included in the survey. Some doctors were reluctant to discuss this issue on the phone. The highest response rate was from trauma and orthopaedics (73%), and the lowest from emergency medicine (50%).

Half the specialist on call registrar respondents (50%) hadn't read the plan at all, while around one in four (25%) had read only part of it.

Less than half the respondents (47%) knew where to find a copy of the plan; one in six (just under 18%) didn't know where to locate it, while the rest were unsure.

When asked what role they would have in a major incident response, only just over a third (36%) knew what they would be required to do. A similar proportion (37%) weren't sure; and around one in four (27%) didn't know.

Among those responding, emergency medicine doctors were, perhaps unsurprisingly, the most well prepared. But the fact that the overall situation hasn't changed in 12 years is worrying, say the researchers.

"Of concern, we found no improvement since 2006: indeed fewer individuals were confident in the role they would play if an MIP came into effect while they were on call," they note.

This is an observational study, and the findings need to be taken in light of the response rate of just under 63%, say the researchers.

And the study included only specialist registrars who would currently be expected to lead the emergency response, but major trauma centres in the UK are moving towards 24/7 consultant cover, the researchers point out.

Nevertheless, given the lack of improvement since the last survey, the researchers suggest that hospital doctors need to be better informed about their organisation's major incident plans. They suggest its inclusion in induction packs; 'disaster drills'; and role play events.

Nearly one in two swingers uses recreational drugs to intensify the experience, with women more likely to do so than either straight or bisexual men, suggest the results of a Dutch survey, published online in the journal Sexually Transmitted Infections.

But the practice is associated with a significantly heightened risk of unprotected sex, the responses show.

Swingers are couples who have sex with others and singles who have sex with them. Although they identify as straight, they also engage in same sex behaviour. The available evidence suggests that drug use among swingers is relatively common, but little is known about their beliefs and intentions around this activity.

To explore this further, the researchers analysed the responses of swingers who completed an online survey on the perceived pros and cons of recreational drug use, and its possible consequences.

The survey, which was advertised through Dutch swinger websites during May and August 2018, was completed by 1005 swingers (response rate 68%).

Over half of respondents (58%) said they engaged in swinging at least monthly; for around a third (30%) the frequency was once every 3 months. And for around one in 10 (12%) it was once or twice a year. The average age of the respondents was 47.

More than four out of 10 respondents (44%; 443) said they used drugs during sex. Among women, this proportion rose to 51% compared with 44% in bisexual men and 39% in straight men.

Among the general public, men are more likely to use drugs than women, prompting the researchers to suggest that women might use to enable them to take part in esoteric sex acts with multiple partners.

Half the respondents who said they used drugs during sex did so once a month. The most commonly used drugs were ecstasy/MDMA (92%), GHB also known as liquid ecstasy (76%), and laughing gas (69%).

More than two thirds (69%) said they had used four or more different drugs during sex in the preceding 6 months. Downing at least 3 units of alcohol during one session was reported by 42%.

For around two thirds of respondents, the reasons for using were to prolong sex (68%), increase arousal (66%), release inhibitions (64%), and intensify sensations (61%). Most described drug use as pleasurable (94%), acceptable (84%), or exciting (66%).

Unprotected sex was more common among those who were using drugs than it was among those who weren't: 46% vs 34% for vaginal sex; 22% vs 13% for anal sex. Condoms were rarely used for oral sex, irrespective of drug use.

Three quarters of the drug users had been tested for a sexually transmitted infection compared with just over half (56%) of those who didn't use during sex.

Half the respondents (47%) thought drug use during sex was "unhealthy," yet very few thought it was either "unwise" (14%) or "dangerous" (15%).

Nevertheless, one in four said that using drugs during sex had an adverse effect on their health and around one in 15 (7%) thought they might become addicted or felt uncomfortable having sex without drugs. One in five said they felt depressed in the days following drug fuelled sex. But only 4% planned to stop using altogether.

This is an observational study, and as such, can't establish cause, and the researchers had no information on the swingers who didn't respond to the survey.

"This study among a large group of swingers shows that drug use during sex is highly prevalent. [Sexual health clinics] should discuss drug use during sex among swingers and provide information on safe sex and drug use, while acknowledging the perceived benefits, such as the increased quality of sex," the researchers conclude.

Visual abstract pre-embargo link: https://bit.ly/2ywMUlI

Experiencing harm in hospital significantly increases the length of stay, length of recovery after discharge and health system costs, which amounted to more than $1 billion in Ontario in fiscal year 2015/16, according to new research in CMAJ (Canadian Medical Association Journal).

"We were able to estimate, for the first time, the total health system impact of hospital harm in Ontario," says Lauren Tessier, PhD student, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario. "This amounted to more than $1 billion in 2017 Canadian dollars and 407,696 acute hospital days -- equivalent to a 1117-bed hospital operating at 100% capacity every day for a year."

Using new hospital harm methodology developed by the Canadian Institute for Health Information (CIHI) to measure adverse events, the study provides useful information on the total cost to the health care system from a harm experienced in hospital as well as subsequent health care usage. Researchers used person-centred episodes of care (PCEs) to look at the entire use of health care services, from the adverse event in hospital through all related hospital and post-discharge care until an individual had returned to the community and was stabilized for 30 days without any further admissions. They looked at harm in four categories: health care/medication, infection, patient accidents and hospital procedures.

"The PCE methodology enables all acute and post-acute care, including hospital, physician, pharmacy and home care readmissions, to be captured in the episode of care -- an important advance, as many studies on the costs of adverse events have treated readmissions as initial admissions, leading to bias," says Tessier.

The study included 610 979 patients aged 18 to 105 years in Ontario who had an acute hospital admission between April 2015 and March 2016. Of all patients in the study, 36,004 (6%) experienced a harm during their first hospital admission during that period. The most common harm was in the health care/medication-associated conditions category, making up half (50%) of all harms. The additional length of stay for patients who experienced hospital harm ranged from 0.4 days (pregnancy PCE) to 24 days (mental health PCE). Costs ranged from $800 (pregnancy PCE) to $51,067 for an unplanned surgical PCE.

"Our finding that hospital harm significantly increases length of PCE is a novel contribution to the literature, as the PCE methodology has only recently been developed," says Tessier.

In a linked commentary, Drs. Lauren Lapointe-Shaw and Chaim Bell, internal medicine specialists, University of Toronto, Toronto, Ontario, write, "The linked study will benefit policy-makers in several ways: the authors have clarified the costs of adverse events in Canada, provided a baseline from which to assess changes over time, quantified the investment that could be justified to prevent adverse events and offered estimates to be used in economic evaluations of future interventions. Because most interventions target a particular condition, costing by type of adverse event would be a valuable addition. The substantial costs of adverse events are far-reaching and cannot be ignored. An improved understanding of their overall impact can only reinforce our efforts at preventing them."

"The impact of hospital harm on length of stay, costs of care and length of person-centred episodes of care: a retrospective cohort study" is published August 12, 2019.

People in middle-age need to keep up their physical activity levels if they are to enjoy a fit and healthy retirement - according to a new report from the University of East Anglia.

The study reveals that over-55s in particular should be doing more to keep fit as they approach retirement age - because of the physical, mental and social benefits of being active.

But health problems, not having enough time or energy because of work, and a lack of motivation are leaving many approaching retirement in poor shape.

Researchers worked in collaboration with Active Norfolk to gather insight about the relationship between retirement and physical activity.

More than 1,000 over-55s took part in an online 'Physical Activity and Retirement Transitions' survey about their physical activity levels, and expectations and experiences of retirement. The research team also held focus groups and interviews with people at retirement age about staying physically active.

Lead researcher Dr Charlotte Salter, from UEA's Norwich Medical School, said: "In England, participation in physical activity tends to decrease around the age of 55.

"Frailty and pre-frailty - the decline in health, resilience and mobility often associated with ageing - are conditions previously expected to be found in people at retirement age and over. But now these conditions affect a third of British adults aged 50-65.

"Adults are spending more years of their life working than ever before. Retiring is a life-changing event which provides all sorts of opportunities - but it coincides with declining physical activity, health and wellbeing.

"From the age of around 55, people begin thinking about retirement and making plans for their future.

"In order to enjoy a fit and healthy retirement, a really key thing is that people need to maintain their physical fitness through their fifties and beyond.

"But we found that there are many barriers to this - from poor health, lack of motivation, and the cost and availability of sports, activities and fitness classes, to not having enough time - due to work or in many cases because of caring responsibilities.

"Many respondents also felt excluded and said that sports facilities and fitness classes tended to appeal to a much younger market.

"While retirement can free up time, deteriorating health and wellbeing often become a new barrier.

"That's why it's so important to maintain fitness in the lead up to retirement.

"Supporting older adults to lead active lifestyles ahead of and at retirement could ensure people are more mobile, capable and healthier once retired.

"There is no one-size-fits all approach. But we found that activity that is combined with socialising, or other purposeful actions such as dog walking, gardening, housework, childcare or volunteering, were all good ways for over-55s to remain active.

"With an ageing population there is also an ageing workforce who need support to age, work and retire actively," she added

Recommendations

The report shows how employers and healthcare providers could do more to promote physical fitness to people over 55. And that sports centres and community fitness projects could also play more of a part in encouraging healthy ageing.

Project lead Rachel Cooke, from Active Norfolk, said: "Retirement from work is a major life transition. For many, retirement from paid employment is something to look forward to. But for others, retirement can pose many challenges including keeping physically active. It is clear from the research that retirement is a personal journey and the availability of support and opportunities to retire actively is varied.

"The results of the research highlight the potential role of physical activity providers, workplaces, and support services, such as health professionals and age-related charities, for reaching those who are working full-time, part-time, and those who are already retired. Active Norfolk will be working with our partners to influence policy and provision across these three target areas to support over-55s to be active in the lead up to and during retirement."

Other recommendations for employers include having a health and wellbeing policy that promotes physical activity, providing opportunities to be active at work such as walking groups and cycle to work schemes, developing a pre-retirement support package with advice about physical activity and encouragement to make plans to be active in retirement, and promoting a culture shift to encourage activity in later life.

Recommendations for improvements in the recreation and fitness sector include making information about opportunities to be active locally more accessible, providing better access to green spaces, providing low intensity activities at times that suit people over 55, with free taster sessions and discounts, and opportunities to socialise.

The full report as well as the key findings and recommendations are available at https://www.activenorfolk.org/parts-survey.

The research was commissioned by Active Norfolk and funded by Sport England. Other collaborators included Thrive Tribe and Norfolk County Council.

'The Physical Activity and Retirement Transitions Study (PARTS)' is published on Monday, August 12, 2019.

Researchers digging at the University of North Carolina at Charlotte's ongoing archaeological excavation on Mount Zion in Jerusalem have announced a second significant discovery from the 2019 season - clear evidence of the Babylonian conquest of the city from 587/586 BCE.

The discovery is of a deposit including layers of ash, arrowheads dating from the period, as well as Iron Age potsherds, lamps and a significant piece of period jewelry - a gold and silver tassel or earring. There are also signs of a significant Iron Age structure in the associated area, but the building, beneath layers from later periods, has yet to be excavated.

The Mount Zion Archaeological Project, co-directed by UNC Charlotte professor of history Shimon Gibson, Rafi Lewis, a senior lecturer at Ashkelon Academic College and a fellow of Haifa University, and James Tabor, UNC Charlotte professor of religious studies, has been in operation for over a decade and has made numerous significant finds relating to the ancient city's many historical periods, including the announcement made in July, 2019 on evidence concerning the sack of the city during the First Crusade. The current find is one of the oldest and perhaps the most prominent in its historical significance, as the Babylonian conquest of Jerusalem is a major moment in Jewish history.

The team believes that the newly-found deposit can be dated to the specific event of the conquest because of the unique mix of artifacts and materials found -- pottery and lamps, side-by-side with evidence of the Babylonian siege represented by burnt wood and ashes, and a number of Scythian-type bronze and iron arrowheads which are typical of that period.

Because of the site's location, various alternative explanations for the artifacts can be eliminated, the researchers argue. "We know where the ancient fortification line ran," noted Gibson, "so we know we are within the city. We know that this is not some dumping area, but the south-western neighborhood of the Iron Age city - during the 8th century BCE the urban area extended from the "City of David" area to the south-east and as far as the Western Hill where we are digging."

The ash deposits, similarly, are not conclusive evidence of the Babylonian attack in themselves, but are much more so in the context of other materials.

"For archaeologists, an ashen layer can mean a number of different things," Gibson said. "It could be ashy deposits removed from ovens; or it could be localized burning of garbage. However, in this case, the combination of an ashy layer full of artifacts, mixed with arrowheads, and a very special ornament indicates some kind of devastation and destruction. Nobody abandons golden jewelry and nobody has arrowheads in their domestic refuse."

"The arrowheads are known as 'Scythian arrowheads' and have been found at other archaeological conflict sites from the 7th and 6th centuries BCE. They are known at sites outside of Israel as well. They were fairly commonplace in this period and are known to be used by the Babylonian warriors. Together, this evidence points to the historical conquest of the city by Babylon because the only major destruction we have in Jerusalem for this period is the conquest of 587/586 BCE," he said.

The clay artifacts also help date the discovery. The lamps, Gibson notes, are the typical high-based pinched lamps of the period.

"It's the kind of jumble that you would expect to find in a ruined household following a raid or battle," Gibson said. "Household objects, lamps, broken bits from pottery which had been overturned and shattered... and arrowheads and a piece of jewelry which might have been lost and buried in the destruction."

"Frankly, jewelry is a rare find at conflict sites, because this is exactly the sort of thing that attackers will loot and later melt down."

"I like to think that we are excavating inside one of the 'Great Man's houses' mentioned in the second book of Kings 25:9," Gibson speculated. "This spot would have been at an ideal location, situated as it is close to the western summit of the city with a good view overlooking Solomon's Temple and Mount Moriah to the north-east. We have high expectations of finding much more of the Iron Age city in future seasons of work. "

The building that is apparently part of the layer remains unexcavated. "One might ask why haven't we excavated the whole building?" Gibson said. "The reason is that we are slowly taking the site down, level by level, period by period, and at the end of this last digging season two meters of domestic structures from later Byzantine and Roman periods have still to be dug above the Iron Age level below. We plan to get down to it in the 2020 season."

The unexpected and rare piece of jewelry found is apparently a tassel or earring, with a bell-shaped gold upper part. Clasped beneath is a silver part made in the shape of a cluster of grapes. Gibson noted that this discovery of jewelry "is a unique find and it is a clear indication of the wealth of the inhabitants of the city at the time of the siege." The only other discovery of jewelry in Jerusalem from this period was made many years ago in 1979 in an Iron Age tomb at Ketef Hinnom outside the city.

The researchers say that finding evidence of a critical historical event is what makes the discovery particularly exciting. Lewis, another co-director of the project, explained that "It is very exciting to be able to excavate the material signature of any given historical event, and even more so regarding an important historical event such as the Babylonian siege of Jerusalem."

By all accounts the Babylonian conquest of the city by the Neo-Babylonian king Nebuchadnezzar was ferocious and resulted in a great loss of life, with the razing of the city and the burning of houses, and the plundering and dismantling of King Solomon's Temple to God. The local ruler of the Kingdom of Judah, King Zedekiah, made an attempt to flee the city with his retinue, but was eventually caught and taken captive to Babylon.

The Hebrew Bible relates the famine and suffering that the inhabitants of Jerusalem suffered during the lengthy Babylonian siege of the city: "So the city was besieged unto the eleventh year of King Zedekiah. On the ninth day of the [fourth] month the famine was sore in the city, so that there was no bread for the people of the land. Then a breach was made in the city, and all the men of war [fled] by night by the way of the gate between the two walls.... And he [Nebuzaradan, the Babylonian captain of the guard] burnt the house of the Lord, and the King's house; and all the houses of Jerusalem, even every great man's house, burnt he with fire." (2 Kings 25: 1-9).

The Babylonian siege of Jerusalem lasted for quite a while even though many of the inhabitants wanted to give up. "King Zedekiah simply was not willing to pay tribute to Nebuchadnezzar and the direct result of this was the destruction of the city and the Temple", said Gibson.

Every year religious Jews in Jerusalem and across the world pray and fast in remembrance of the destruction of the Jewish Temple to God in Jerusalem, first by the Babylonians in 587/586 BCE, resulting in the exile of the inhabitants of the city to Babylon, and yet again in 70 CE at the hands of the Roman legions led by Titus. To remember the devastating destruction of the Temple, Jews gather in synagogues around the world and at the Western Wall plaza in Jerusalem, to pray and mourn on Tisha B' Av (the ninth day in the Hebrew month of Av) according to the Jewish calendar, which falls this year on August 11th.

The Mount Zion archaeological project is directed by Shimon Gibson and James Tabor from the College of Liberal and Arts Studies at the University of North Carolina at Charlotte, in conjunction with Rafi Lewis of Ashkelon Academic College and Haifa University, and with sponsorship from Aron Levy, John Hoffmann, Cherylee and Ron Vanderham, and Patty and David Tyler and others, and facilitated by Sheila Bishop for The Foundation for Biblical Archaeology.

The dig is also staffed by a host of volunteers, including UNC Charlotte students. The project has been a favorite summer activity of for many of UNC Charlotte's Levine Scholars Program, the university's highly selective national program for undergraduate scholars.

"Participating in the Mount Zion dig has been an amazing opportunity for the Levine Scholars," said Diane Zablotsky, director of UNC Charlotte's Levine Scholars Program. "Although they are from different backgrounds and study in different majors, they shared a unique experience that left them with a deep appreciation of archaeology, the history of Jerusalem, and broadened worldview."

The site is within the "Sovev Homot" park administered by the Israel Nature and Parks Authority. Other substantial remains of the multi-period ancient city were uncovered during the 2019 season, including vaulted basements from the time of Herod the Great, a Byzantine street which was the south-westerly continuation of the main city street known as the Cardo Maximus, and a sunken defense ditch that ran in front of the fortifications which greeted the Crusader's when they attacked Jerusalem in 1099 and hindered their assault on the city.

The complex architectural sequence of superimposed structures dating back 3000 years or so is being carefully mapped by a team of recorders and draftsmen headed by Steve Patterson. The University of North Carolina at Charlotte has been conducting archaeological excavations in Jerusalem since 2006 and much vital historical and archaeological information has been steadily extracted from the digging operations.

CHICAGO -- Having productive conversations about climate change isn't only challenging when dealing with skeptics, it can also be difficult for environmentalists, according to two studies presented at the annual convention of the American Psychological Association.

The first of the studies found that reinforcing belief and trust in science may be a strategy to help shift the views of climate change skeptics and make them more open to the facts being presented by the other side.

"Within the United States, bipartisan progress on climate change has essentially come to a standstill because many conservatives doubt the findings of climate science and many liberals cannot fathom that any rational human can doubt the scientific consensus on the issue," said Carly D. Robinson, MEd, of Harvard University, who presented the research. "These opposing perspectives do not create a starting point for productive conversations to help our country address climate change. Our goal was to find an intervention that might change the current situation."

Though previous research has shown that social pressure to disbelieve in climate change stems from the political right and that conservatives' trust in science has eroded, Robinson and her colleagues theorized that most people would find at least some branches of science credible. Leveraging those beliefs could lead climate skeptics to shift their views, they said.

"When people are faced with two or more opposing beliefs, ideas and values, it tends to create discomfort, which can lead people to becoming more open-minded about a particular issue," said Christine Vriesema, PhD, of the University of California, Santa Barbara and a co-author of the study.

The researchers surveyed nearly 700 participants from the U.S. Half were given surveys about their belief in science (e.g., "How credible is the medical data that germs are a primary cause of disease?" and "How certain are you that physicists' theory of gravity accurately explains why objects fall when dropped?") and their belief in climate science (e.g., "How credible is the climate science data that ocean temperatures are rising?" and "How certain are you that global warming explains many of the new weather patterns we are seeing today?"). The other half was only surveyed about their belief in climate science. All participants reported if they considered themselves politically liberal, moderate or conservative.

"As we predicted in our pre-registration, conservatives reported a greater belief in climate science if they were asked questions first about their belief in other areas of science," said Robinson. "For climate skeptics, it likely became awkward to report on our survey that they believed in science while at the same time, denying the findings of climate science. That dissonance led many to adjust their beliefs to show greater support for the existence of climate change."

The findings showed that beliefs in climate science are malleable and not fixed, said Robinson.

"We were pleasantly surprised that a brief, two-minute survey changed skeptics' views on climate change," said Robinson. "It is exciting to know that in real-world settings, we might be able to have more productive climate conversations by starting from a place of common belief."

The second study showed that igniting a sense of resilience and perseverance can increase action and engagement around climate change for people who work in aquariums, national parks and zoos.

"Many educators working at these institutions reported wanting to talk about climate change and visitors reported wanting to hear about it, yet many educators still felt uncomfortable bringing the topic into their conversations because they were worried about being able to communicate effectively," said Nathaniel Geiger, PhD, of Indiana University who presented the research.

The study included 203 science educators from zoos, aquariums and national parks who were part of a yearlong communication training program from the National Network of Ocean and Climate Change Interpretation designed to build participants' confidence in talking about climate change. The training consisted of study groups, group assignments, readings, discussions and weekend retreats. During the last six months of the program, participants worked to integrate what they had learned into their jobs.

Survey data were collected one month before and one month after the training program and again six to nine months later.

Geiger and his colleagues examined two components of hopeful thinking to see which one might lead to the success of the training program: agency (e.g., enthusiasm, a sense of determination) and pathways (e.g., resilience and perseverance strategies) and how those influenced participants' reports of engagement about climate change.

Participants rated their "agency thinking" (e.g., "I energetically do all I can do to discuss climate change" and "I anticipate that efforts to discuss climate change will be pretty successful") and their "pathways thinking" (e.g., "I can think of many ways to discuss climate change") in each survey. The science educators also reported the frequency with which they discussed climate change with the general public and visitors to their institutions, ranging from never to daily.

Geiger and his team found that pathways thinking was more successful at inspiring conversations about climate change than agency.

"Our findings suggested that portions of the training that taught how to persevere and be resilient in the face of difficult climate change conversations may have been the most effective at promoting discussion," Geiger said.

The training program also increased the frequency with which the science educators spoke about climate change with visitors, from less than once per month prior to the training to more than two or three times per month afterward, he said.

"We found it uplifting that the training program showed such a robust effect at promoting these difficult discussions," said Geiger. "We believe that climate change advocates and educators will find this work helpful toward meeting their goal of crafting more effective training programs to boost climate change engagement."

COLUMBUS, Ohio - Disease-causing air pollution remains high in pockets of America - particularly those where many low-income and African-American people live, a disparity highlighted in research presented at the annual meeting of the American Sociological Association in New York.

The nation's air on the whole has become cleaner in the past 70 years, but those benefits are seen primarily in whiter, higher-income areas, said Kerry Ard, an associate professor of environmental sociology at The Ohio State University, who will present her research today (Aug. 10, 2019.)

Ard used a variety of detailed data sources to examine air pollution and the demographics of the people who lived in 1-kilometer-square areas throughout a six-state region from 1995 through 1998. These are the four years after President Bill Clinton's 1994 executive order that focused attention on the environmental and health effects of federal actions on minority and low-income populations. The act's goal was "achieving environmental protection for all communities."

The six-state area analyzed in the Ohio State study, home to many aging and shuttered industrial plants, includes Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin. These states make up the U.S. Environmental Protection Agency region with the highest level of unequal distribution of air toxins between whites and African-Americans.

In the four years included in her analysis, Ard found persistent air pollution hot spots that did not improve.

"We're seeing that these pollution hot spots are the same, year after year, and every time they are in low-income communities - often communities of color. This has implications for a wide array of health disparities - from preterm births and infant mortality to developmental delays in childhood, to heart and lung disease later in life," Ard said.

"Our results do not support that there was a perceivable mitigation of this gap after the executive order. In fact, we found that for every 1 percent increase in low-income African Americans living in an area, the odds that an area would become a hot spot grew significantly. This was also true, but to a lesser extent, for increases in low-income white populations."

Previous research has shown that despite widespread reductions in air pollution, blacks are still experiencing twice the health risk from air pollution than whites.

This isn't particularly surprising given that many blacks moved north toward industry - and jobs - during the Great Migration of African Americans from southern rural states, Ard said. Though many of the older, more-harmful plants have closed, others remain open and are often grandfathered into older regulatory standards that aren't as strict as those imposed on newer companies, she said.

Ard said that efforts to control pollution aren't going far enough to begin to eliminate the air-quality disparities and the health inequities to which they contribute. Ard, who is part of Ohio State's Institute for Population Research, recently published a textbook chapter focusing on this work.

"We really need to look at older industrial plants and how they are being regulated and how enforcement is happening in these areas," she said.

Air pollution is known to cause an array of health problems, but even those links aren't as well-understood as they should be because most efforts focus generically on fine particulate matter or on single toxins, rather than combinations that have the potential to inflict more harm, Ard said. Fine particulate matter refers to small, lightweight particles in the air that easily make their way into the lungs and sometimes the bloodstream and are known to trigger and worsen a host of diseases. But what, specifically, is in that matter is significant, and should be analyzed to steer policies aimed at protecting human health, Ard said.

In addition to tightening up air-quality standards for all polluters - and specifically going after the worst chemicals or combinations of chemicals - policymakers should consider efforts such as replanting trees in blighted areas in an effort to improve air quality, Ard said.

Patients with type 2 diabetes improve their ability to regulate blood sugar levels if they eat food with a reduced carbohydrate content and an increased share of protein and fat. This is shown by a recent study conducted at Bispebjerg Hospital in collaboration with, among other partners, Aarhus University and the Department of Nutrition, Exercise and Sports at the University of Copenhagen. The findings are contrary to the conventional dietary recommendations for type 2 diabetics.

Nutritional therapy is important to treat the type 2 diabetes optimally, but the recommendations are unclear. According to the Danish Health Authority, up to 85% of newly diagnosed patients with type 2 diabetes are overweight, and they are typically advised to follow a diet focused on weight loss: containing less calories than they burn, low fat content and a high content of carbohydrates with a low 'glycaemic index' (which indicates how quickly a food affects blood sugar levels).

Reduced carbohydrate content - increase in protein and fat

A central aspect in the treatment of type 2 diabetes is the patient's ability to regulate their blood sugar levels, and new research now indicates that a diet with a reduced carbohydrate content and an increased share of protein and fat improves the patient's ability to regulate his or her blood sugar levels compared with the conventional dietary recommendations. In addition, it reduces liver fat content and also has a beneficial effect on fat metabolism in type 2 diabetics.

"The purpose of our study was to investigate the effects of the diet without 'interference' from a weight loss. For that reason, the patients were asked to maintain their weight. Our study confirms the assumption that a diet with a reduced carbohydrate content can improve patients' ability to regulate their blood sugar levels - without the patients concurrently losing weight," explains Senior Consultant, DMSc Thure Krarup, MD, from the Department of Endocrinology at Bispebjerg Hospital. He continues: "Our findings are important, because we've removed weight loss from the equation. Previous studies have provided contradictory conclusions, and weight loss has complicated interpretations in a number of these studies."

New dietary recommendations for type 2 diabetics in future

Based on the growing body of evidence, we might rethink the dietary recommendations for patients with type 2 diabetes, stresses Thure Krarup:

"The study shows that by reducing the share of carbohydrates in the diet and increasing the share of protein and fat, you can both treat high blood sugar and reduce liver fat content. Further intensive research is needed in order to optimise our dietary recommendations for patients with type 2 diabetes," says Thure Krarup, stressing that the findings should be confirmed in large-scale, long-term controlled trials.

The findings of the study have been published in the article "A carbohydrate-reduced high-protein diet improves HbA1c and liver fat content in weight stable subjects with type 2 diabetes: a randomized controlled trial" in the renowned scientific journal 'Diabetologia'.

Summary: What did the study show?

A diet with a reduced carbohydrate content, high protein content and moderately increased fat content improves glycaemic control (the ability to regulate blood sugar) by reducing blood sugar after meals and 'long-term blood sugar' (measured by 'HbA1c', which is a blood test used to measure the average blood sugar level over approximately the past two months).

A diet with a reduced carbohydrate content, a high protein content and a moderately increased fat content reduces liver fat content.

A diet with a reduced carbohydrate content may be beneficial to patients with type 2 diabetes - even if it does not lead to weight loss.

About the study

The study forms part of CutDM, which - supported by a grant of DKK 4 million from Arla Food for Health - examines whether a diet with reduced carbohydrate content and increased protein and fat content improves type 2 patients' blood sugar regulation.

28 patients with type 2 diabetes participated in the study over a total period of 12 weeks. For six weeks, the patients were given a conventional diabetes diet with a high carbohydrate content, and, for the other six weeks, they were given a diet with a reduced carbohydrate content, high protein content and moderately increased fat content. The patients were given the diet types in random order.