Culture

Existing gender categories in sport should perhaps be abandoned in favour of a more "nuanced" approach in the new transgender era, University of Otago researchers say.

The International Olympic Committee (IOC) guidelines that allow male-to-female transgender athletes to compete in the women's category at the elite level has raised significant debate since being introduced in 2015. A recent case of New Zealand weightlifter Laurel Hubbard, a transwomen competing in the 2018 Commonwealth Games, has polarised opinions about the inclusion of transwomen in women's sport.

Bioethicist, Associate Professor Lynley Anderson, says that in discussing this topic we need to consider the principles of inclusion and fairness.

Associate Professor Anderson and Dr Taryn Knox from the Dunedin Bioethics Centre, together with Otago physiologist Professor Alison Heather investigate the ethics and science around the IOC's decision in research published in the latest issue of the Journal of Medical Ethics.

They explain the recent IOC guidelines allow transwomen to compete in the women's division if (amongst other things) their testosterone is held below 10nmol/L.

Professor Heather says this is significantly higher than that of cis-women [whose sex and gender align as female].

"Science demonstrates that high adult levels of testosterone, as well as permanent testosterone effects on male physiology during in utero and early development, provides a performance advantage in sport and that much of this male physiology is not mitigated by the transition to a transwoman," she says.

Far from arguing that transwomen be excluded, the authors are in favour of a radical change to what they describe as "the outdated structure of the gender division currently used in elite sport".

They consider possible solutions in their research however, some options value inclusion more than fairness and vice versa. The potential solutions include excluding transwomen from competing in the women's division, creating a third division for transwomen and intersex women and calculating a handicap for transwomen based on their testosterone levels - similar to that used in golf.

Their preferred option is an extension of this with a proposed algorithm that could account for a range of parameters, both physical and social, including pyshiological parameters, gender identity and could include socioeconomic status.

Associate Professor Anderson says it is important to both extend and celebrate diversity while maintaining fairness for cis-women in sport.

"To be simultaneously inclusive and fair at the elite level some innovative thinking is required, rather than attempting to shoehorn people into either 'male' or 'female'.

"Perhaps the male/female binary should be reconsidered in favour of something more nuanced and useful?," she questions.

Podcast post-embargo link: https://soundcloud.com/cmajpodcasts/181613-five

Worried about peanut allergies in children? A practice article in CMAJ (Canadian Medical Association Journal) outlines five things to know about early introduction of peanuts in infants to reduce the risk of peanut allergy.

Infants who are fed peanut protein regularly have a lower risk of peanut allergy.

To prevent peanut allergy, peanut protein (such as peanut butter or powdered puff) may be introduced at home for most babies between 4 and 6 months as one of the first foods.

Babies with severe eczema are more likely to have peanut allergy, and those with no or only mild eczema are best-suited for peanut introduction in the home.

Infants with risk factors for peanut allergy, such as severe eczema, egg allergy or both, should be seen by a specialist before peanut introduction.

To reduce the risk of peanut allergy, 8 grams of peanut protein (1 heaped teaspoon of peanut butter) should be eaten at least twice a week.

New research shows dramatically rising visits to emergency departments (ED) related to alcohol, especially for women, with a 175% increase in alcohol-related visits from young people aged 25 to 29. The article, published in CMAJ (Canadian Medical Association Journal), shows increases in ED visits related to alcohol that are occurring much faster than overall ED usage.

"These increases are consistent with data showing increasing average weekly alcohol consumption in Ontario and higher rates of binge drinking across Canada during the study period, particularly in women," says lead author Dr. Daniel Myran, a family physician and public health resident at the University of Ottawa, Ottawa, Ontario.

The study included 765 346 ED visits by 480 611 people (32% from women) in Ontario, Canada's largest province, because of alcohol between 2003 and 2016. Some findings:

Women who visited the ED due to alcohol were more likely to be under the legal drinking age of 19 years (17%) than men (9%).

The highest rates of alcohol-related visits were in women aged 15 to 24 and men aged 45 to 54.

In people aged 25 to 29, alcohol-related visits increased 240% in women and 145% in men.

ED visits for alcohol resulted in higher rates of hospital admission (13%) than general ED visits (10%).

Neighbourhoods in the lowest income bracket had more than twice the number of ED visits for alcohol compared with those in the highest income bracket.

"Since 2007, the rates of emergency department visits due to alcohol by women under legal drinking age has surpassed that of underage men," says Dr. Myran, who is also training at The Ottawa Hospital and Bruyère Research Institute in public health. "We need a better understanding of youth- and gender-specific risk factors for alcohol harms to curb these increases."

These findings are consistent with data showing increases in alcohol-related ED visits in the United States (47% between 2006 and 2014) and England (51% between 2002 and 2014). Data from the United States have also shown widening disparities in harms from alcohol between high- and low-income individuals. While data from this study also highlight the disproportionate health burden that alcohol causes on lower-income individuals, this disparity has not grown over time. The Canadian study differs in that there is less heavy drinking in lower-income groups in Canada than in the US, possibly because of policies that have prevented the sale of low-cost alcohol in Canada.

"There may be an increasing need for supports and services for people, especially young people, with high-risk alcohol consumption, particularly in light of recent changes to how alcohol is sold in Ontario, including making alcohol cheaper and easier to purchase," says Dr. Myran.

The study was funded by Bruyère Research Institute through the Big Data Research Program and by ICES, which is funded by the Ontario Ministry of Health and Long-Term Care. The ICES uOttawa subunit is also supported by The Ottawa Hospital Foundation and the University of Ottawa.

To minimize harms "the federal and provincial governments should employ a public health approach to maximize benefits and minimize harms," writes Dr. Sheryl Spithoff, Department of Family and Community Medicine, Women's College Hospital, Toronto, in a related commentary. "Alcohol should be available for sale only within licensed and strictly monitored facilities with limited hours. Taxes and price minimums should be used to reduce alcohol-related harms. The increase in tax revenues could be used to fund essential provincial programs."

CHAPEL HILL, North Carolina - Researchers at the UNC Lineberger Comprehensive Cancer Center have discovered a hyperactive cell signal that contributes to tumor growth in an aggressive blood cancer. They also developed an experimental therapeutic to block the signal and slow tumor growth.

The researchers reported in the journal Proceedings of the National Academy of Sciences they identified a novel therapeutic target for primary effusion lymphoma, a type of non-Hodgkin lymphoma caused by infection with the Kaposi's sarcoma-associated herpesvirus, also known as human herpesvirus-8.

"We found a protein called Tyro3 that's highly upregulated and expressed in a subtype of non-Hodgkin lymphoma, called primary effusion lymphoma," said UNC Lineberger's Blossom Damania, PhD, vice dean for research in the UNC School of Medicine, the Cary C. Boshamer Distinguished Professor of Microbiology and Immunology, and co-director of the UNC Lineberger virology and global oncology programs. "We also developed a compound that targeted Tyro3, and we found that it killed primary effusion lymphoma cells and tumors."

Primary effusion lymphoma is a highly aggressive subtype of non-Hodgkin lymphoma, a type of blood cancer involving abnormally growing white blood cells.

"Patients with primary effusion lymphoma have a poor prognosis with a median survival time of approximately six months post-diagnosis," said Jason Wong, the paper's first author and a graduate student in the UNC School of Medicine Department of Microbiology and Immunology. "Since current treatment options can be ineffective, finding new therapeutic targets is a high priority.

In their recent study, Damania and her colleagues searched for cell signals called kinases that were hyperactive in primary effusion lymphoma, as well as in other types of non-Hodgkin lymphoma. They collaborated with UNC Lineberger's Gary Johnson, PhD, Kenan Distinguished Professor in the UNC School of Medicine, to characterize the activity of the kinase signals in the cancer cells. Kinases help to control cell signaling, telling cells to grow and divide. Their studies showed that Tyro3 kinase was uniquely hyperactive in primary effusion lymphoma cells compared with normal cells, and they found it could activate a pathway that promotes the cancer's survival.

When they treated the cells with a compound they developed, UNC3810A, they saw a dose-dependent activation of cell death and significant suppression of tumor growth. The compound was developed in the lab of UNC Lineberger's Xiaodong Wang, PhD, research associate professor in the UNC Eshelman School of Pharmacy and medicinal chemistry director of the UNC Center for Integrative Chemical Biology and Drug Discovery.

"UNC3810A was used as an in vivo tool compound to understand the biological roles of Tyro3 in primary effusion lymphoma in this study," Wang said. "The work towards optimizing UNC3810A to preclinical candidate will be continued in my lab."

"We identified a new target in a subtype of non-Hodgkin lymphoma, and this target is also upregulated in other types of cancers besides lymphomas, and so potentially the drug we developed can be used for multiple cancers," Damania said.

As political leaders debate the merits of a future Medicare for All system in the U.S., some analysts predict that implementing universal coverage could cause a sharp, unaffordable increase in hospital use and costs, overwhelming the system. But new research by a team at Harvard Medical School and The City University of New York at Hunter College, published today in the Annals of Internal Medicine, contradicts that assumption, finding that past insurance expansions did not result in a net increase in hospital use. Instead, researchers found a redistribution of care, with increases in hospital care among those newly insured that was offset by small decreases among healthier and wealthier Americans.

The study examined changes in hospital use among those who gained coverage -- as well as those whose coverage remained unchanged -- after the implementation of Medicare and Medicaid in 1966 and the Affordable Care Act (ACA) in 2014. Each of those programs provided new coverage to about 10% of the U.S. population, about the same share expected to gain coverage under a Medicare for All program. The researchers analyzed large national surveys from both the Medicare/Medicaid and ACA eras, and examined hospital use before and after the coverage expansions. Hospital admissions averaged 12.8 for every 100 persons in the three years before Medicare, and 12.7 per 100 in the four years after Medicare's implementation. Similarly, the hospital admission rate was statistically unchanged in the wake of the ACA, averaging 9.4 admissions per 100 in the six years before the ACA coverage expansion and 9.0 per 100 in the two years' afterward.

While the study found no overall change in hospital use, the coverage expansions redistributed care. Medicare increased hospital admissions by 3.7 per 100 among the elderly, and by 0.7 per 100 among the poorest one-third of the population, i.e., the groups that gained new coverage. In contrast, hospitalizations fell slightly (about 0.5 per 100) for younger and wealthier individuals. After the ACA, admissions rose by 1.5 per 100 among sicker Americans, but fell by 0.6 per 100 among those in good health. The researchers also found a slight shift of hospital care toward the poor after the ACA.

Dr. Steffie Woolhandler, a study author and distinguished professor of public health at CUNY's Hunter College who is also on the faculty at Harvard Medical School commented: "The good news is that even big coverage expansions didn't increase hospitalizations overall, indicating that universal coverage won't cause a surge in care, and that Medicare for All is affordable. On the other hand, it implies that overturning the ACA would deprive millions of needed care without saving any money."

The researchers hypothesized that the limited supply of hospital beds constrained the overall use of hospitals when coverage was expanded. They noted that many previous studies, such as the Rand and Oregon Health Insurance Experiments, only examined the effects of greater coverage for the newly insured, not changes among those whose coverage was unchanged, nor the societal effects of expanded coverage.

"We've long known that when people get new or better coverage, they use more health care," said senior author Dr. David Himmelstein, a distinguished professor of public health at CUNY's Hunter College and lecturer in medicine at Harvard Medical School. "What we didn't know is what happens to those who were already well-insured, and how this plays out society-wide given the limited number of hospital beds, doctors and nurses," he stated. "Our data shows that if you sensibly control hospital growth, you can cover everybody without breaking the bank."

Lead author Dr. Adam Gaffney, instructor in medicine at Harvard Medical School and a pulmonary and critical care physician at Cambridge Health Alliance, suggested that the small reductions in hospitalizations among healthier and wealthier individuals are unlikely to be harmful. "We know that the well-insured often receive unnecessary hospitalizations," said Dr. Gaffney. "While defibrillator implants and coronary artery stents can be lifesaving, thousands of patients each year get these and other procedures even when they offer no benefit," he added, pointing to an Institute of Medicine study that found that nearly one-third of medical spending is wasted. "The fact that coverage expansions shift hospital care to those who need it, and reduce care for groups currently getting excessive and possibly harmful interventions, means that universal coverage could help everyone," he stated.

Berkeley -- Before bite-sized crustaceans like crayfish, shrimp and prawns land on our dinner plates, they first have to get fat themselves -- and it turns out they relish the freshwater snails that transmit the parasite that causes schistosomiasis, the second most devastating parasitic disease worldwide, after malaria.

New research led by University of California, Berkeley, scientists provides a roadmap for how entrepreneurs can harness freshwater prawns' voracious appetite for snails to reduce the transmission of these parasites, also known as "blood flukes," while still making a profit selling the tasty animals as food.

The study, which appears in the journal Nature Sustainability, shows how small-scale farming of freshwater prawns -- also known as aquaculture -- could be a win-win for communities in emerging and developing economies where schistosomiasis is common.

"River prawns are common aquaculture products in settings around the world, and we know these organisms are voracious predators of the snails that transmit schistosomiasis," said UC Berkeley's Christopher Hoover, a doctoral student in the School of Public Health's Division of Environmental Health Sciences who led the study. "What has not been clear is if we could marry the economic benefits of prawn aquaculture with the disease-control activity of the prawns."

Aquaculture is growing rapidly in settings around the world and has the potential to alleviate mounting pressures on wild fisheries. Freshwater prawns are already being produced in aquaculture systems around the world, from Louisiana to Thailand to Senegal and beyond.

In these aquaculture systems, juvenile prawns are first raised in hatchery facilities, then stocked in waterways where schistosomiasis is transmitted, and finally harvested once they reach a marketable size. As the prawns grow, they feed on the snails that carry the schistosome parasite.

The parasite is incapable of infecting the prawns themselves, and schistosomiasis is not transmitted via ingestion, so raising, harvesting and consuming prawns cannot pass along the disease.

The researchers used economic and epidemiologic modeling to pinpoint the optimal points at which to stock and harvest the prawns, with the joint goals of reducing schistosomiasis transmission and generating revenue from selling harvested prawns.

"Our results show that there are highly beneficial configurations of prawn aquaculture systems that minimize tradeoffs between generating revenue from harvesting prawns and reducing schistosomiasis transmission," Hoover said. "We can design systems to maximize profit while having a substantial impact on disease reduction, potentially helping to lift populations out of poverty in emerging and developing economies."

Schistosomiasis, also known as "snail fever," affects around 250 million people a year and kills as many as 200,000. The disease is primarily spread when people come in contact with contaminated water. While drugs are available to treat the disease, they're not enough in some settings. Because drug treatments only address the human component of the parasite's transmission cycle, people are left vulnerable to reinfection, even soon after treatment.

By acting on the environmental component of the transmission cycle -- the intermediate host snail population -- prawn-based interventions can complement drug treatment, yielding greater population benefits.

The model showed that, to reduce parasite loads, introducing native prawns to infected waterways was comparable to the standard approach of widescale administration of schistosomiasis-fighting drugs, and that it could decrease the parasite burden to nearly zero after 10 years.

Prawns may have environmental benefits, as well, including substituting for chemical pesticides to control snail populations and restoring native biodiversity in areas where native prawn species have been decimated by dams.

"Chris' research contributes a new tool to our global efforts to combat schistosomiasis," said Justin Remais, head of the Division of Environmental Health Sciences and co-senior author of the study. "Poverty and schistosomiasis are intrinsically linked, and transmission of the parasite is known to stunt growth and cognitive development in children and to prevent adults from working, reinforcing poverty. By targeting transmission of the parasite itself, while also supporting a locally-sourced production system where economic benefits accrue to the community, this approach has great potential to supplement ongoing disease control campaigns that generally rely on drug treatment alone."

It seems like a great idea: Pay teachers more if their students learn more. But does it work?

Though teacher incentive programs are growing in popularity, no one knows for sure if they have a positive effect on student achievement, or if they are worth the extra expenditure of precious state education funds. A new study by an economist at the University of California, Riverside shows that, if properly designed, teacher incentive programs can both improve student achievement in some subjects and be cost-effective.

Studies of existing and experimental teacher incentive programs have shown mixed results, raising student test scores in some cases but not in others. Researchers think the discrepancy has to do with how programs are designed. Programs that reward teachers as a group encourage free-riding and do not improve student achievement. Programs that compensate teachers individually also have little to no effect on student achievement.

Ozkan Eren, an associate professor of economics at UC Riverside, examined a hybrid teacher incentive program that combines individual and group incentives called the Teacher Advancement Program, or TAP. One of the nation's largest education programs, TAP combines mentorship and ongoing professional growth with instructional accountability and performance-based compensation, often in high-need urban schools.

Clusters of less experienced teachers meet daily with highly skilled teachers to learn new instructional strategies and receive individual coaching. Teachers are evaluated multiple times during the school year over almost 20 different areas of effective instructional practice. Finally, teachers are eligible for additional compensation based on their performance in the classroom as well as their students' performance. Teachers receive separate bonuses for teaching practices and teaching outcomes.

Eren examined data obtained from the state of Louisiana for 40 schools that implemented TAP from 2005-11. He found no improvement in math test scores the first year, but steady and dramatic improvement by the third year. Social studies saw similar, although statistically insignificant test score improvement while English and science showed no improvement. He found evidence that other factors, such as changes in the composition of the teaching staff, were not responsible for the improvement. A survey of teachers also indicated that many had changed their teaching practices as a result of the program, contributing to its success.

The program's benefits exceeded the costs. The total average cost of TAP in Louisiana is roughly $350 to $400 per student. Eren used a standard formula to estimate future earnings based on the assumption that only a quarter of the test score gain reflects real learning and found that TAP could result in a rise in potential earnings of about $945,000 per school year for math. This was cost-effective even if only math test scores improved.

The study concluded that a hybrid structure involving both individual and group incentives can have good results. Multiple and understandable performance metrics, combined with regular feedback to teachers, may also make incentive programs more effective. Finally, rewards should be strong enough to entice teachers to adjust their teaching practices.

The paper, "Teacher Incentives and Student Achievement: Evidence from an Advancement Program," is published in the Journal of Policy Analysis and Management.

Combining novel theoretical and experimental approaches, researchers from the University of Michigan (USA), Kookmin University (South Korea), the University of Konstanz (Germany) and the Okinawa Institute of Science and Technology Graduate University (Japan) have successfully measured and described the thermal conductance of single-molecule junctions - a key quantity in nanoscale transport phenomena that has so far eluded direct experimental determination. A joint paper entitled "Thermal Conductance of Single-Molecule Junctions" has been published online in the journal Nature on 17 July 2019.

"The control of heat transport at the molecular scale is a key factor in the development of nanostructured materials and technologies such as molecular electronics, thermally conductive polymers and thermoelectric energy-conversion devices", explains Associate Professor Fabian Pauly, a theoretical condensed matter physicist and the leader of the Quantum Transport and Electronic Structure Theory Unit at Okinawa Institute of Science and Technology Graduate University. Fabian Pauly, who is also a Principal Investigator at the University of Konstanz's Collaborative Research Centre 767 "Controlled Nanosystems: Interaction and Interfacing to the Macroscale", contributed the theoretical models to the experimental breakthrough.

In short molecules, thermal energy transfer is believed to be determined by phase-coherent, ballistic processes as compared to incoherent and diffusive ones in conventional macroscopic systems. "The problem is that while a range of other single-molecule-level transport properties have been successfully measured in the past, thermal conductance has proven difficult to determine due to considerable challenges associated with detecting extremely small heat currents at picowatt resolution", Fabian Pauly continues.

Experimental breakthrough

Scientists from the Department of Mechanical Engineering at the University of Michigan managed to successfully measure thermal transport through single-molecule junctions for the very first time. They applied a custom-developed calorimetric-scanning-thermal-microscopy technique to prototypical thiol-terminated alkane molecules which were provided by researchers from the Department of Chemistry at Kookmin University in South Korea. Working in an ultra-high vacuum environment, the US team used a self-assembled monolayer of alkane molecules to facilitate the formation of single-molecule junctions between a gold-coated microscope tip and a gold substrate. The transfer of heat from the heated tip to the cold substrate, which was kept at room temperature throughout, allowed the researchers to determine the resulting thermal conductance, which was found to originate from the vibrations of atoms, also called phonons. A sophisticated averaging technique was required to measure the small quantity.

The theory behind the experiments

As Fabian Pauly points out: "Previous theoretical work conducted in my group made predictions on the size of thermal conductance values for various single-molecule junctions, providing important information to our experimental colleagues regarding the measurement resolution required to achieve successful quantification". Combining nonequilibrium Green's function techniques with density functional theory in custom-developed code, Fabian Pauly and his doctoral student Jan Klöckner, who is based at University of Konstanz, were able to compute the thermal conductance due to phonons for junction geometries containing alkane molecules of variable length.

The experiments with such molecules that were conducted at the University of Michigan yield strong experimental evidence in support of the theorists' assumptions of a phase-coherent transport regime. "In other words, heat transport in alkane-based single-molecule junctions is virtually independent of length", explains Jan Klöckner, who helped to develop the ab initio simulations used to understand the experimental data.

These insights do not only resolve the longstanding problem of determining thermal conductance at the single-molecule level experimentally. They will also enable systematic studies of thermal transport through other one-dimensional systems such as polymer chains: "Having shown that heat transport at the molecular scale is length-independent, we must now try to find out how we can enhance or reduce it. Ultimately, what we hope to do in the future is to identify ways of controlling the flow of heat by molecular design", concludes Fabian Pauly.

Simulations from researchers in Japan provide new insights into the reactions occurring in solid-oxide fuel cells by using realistic atomic-scale models of the active site at the electrode based on microscope observations as the starting point. This better understanding could give clues on ways to improve performance and durability in future devices.

Extremely promising for the clean and efficient electricity generation, solid-oxide fuels cells produce electricity through the electrochemical reaction of a fuel with air, and they have already begun to find their way into homes and office buildings throughout Japan.

In a typical fuel cell, oxygen molecules on one side of the fuel cell first receive electrons and break up into oxide ions. The oxide ions then travel through an electrolyte to the other side of the device, where they react with the fuel and release their extra electrons. These electrons flow through outside wires back to the starting side, thereby completing the circuit and powering whatever is connected to the wires.

Although this overall reaction is well known and relatively simple, the reaction step limiting the overall rate of the process remains controversial because the complicated structures of the electrodes--which are generally porous materials as opposed to simple, flat surfaces--hinder investigation of the phenomena at the atomic level.

Since detailed knowledge about the reactions occurring in the devices is vital for further improving the performance and durability of fuel cells, the challenge has been to understand how the microscopic structures--down to the alignment of the atoms at the different interfaces--affect the reactions.

"Computer simulations have played a powerful role in predicting and understanding reactions that we cannot easily observe on the atomic or molecular scale," explains Michihisa Koyama, the head of the group that led the research at Kyushu University's INAMORI Frontier Research Center.

"However, most studies have assumed simplified structures to reduce the computational cost, and these systems cannot reproduce the complex structures and behavior occurring in the real world."

Koyama's group aimed to overcome these shortcomings by applying simulations with refined parameters to realistic models of the key interfaces based on microscopic observations of the actual positions of the atoms at the active site of the electrode.

Leveraging the strength of Kyushu University's Ultramicroscopy Research Center, the researchers carefully observed the atomic structure of thin slices of the fuel cells using atomic-resolution electron microscopy. Based on these observations, the researchers then reconstructed computer models with the same atomic structures for two representative arrangements that they observed.

Reactions between hydrogen and oxygen in these virtual fuel cells were then simulated with a method called Reactive Force Field Molecular Dynamics, which uses a set of parameters to approximate how atoms will interact--and even chemically react--with each other, without going into the full complexity of rigorous quantum chemical calculations. In this case, the researchers employed an improved set of parameters developed in collaboration with Yoshitaka Umeno's group at the University of Tokyo.

Looking at the outcome of multiple runs of the simulations on the different model systems, the researchers found that the desired reactions were more likely to occur in the layers with a smaller pore size.

Furthermore, they identified a new reaction pathway in which oxygen migrates through the bulk layers in a way that could potentially degrade performance and durability. Thus, strategies to avoid this potential reaction route should be consider as researchers work to design improved fuel cells.

"These are the kinds of insights that we could only get by looking at real-world systems," comments Koyama. "In the future, I expect to see more people using real-world atomic structures recreated from microscope observations for the basis of simulations to understand phenomena that we cannot easily measure and observe in the laboratory."

Tsukuba, Japan - Hearing loss is the world's fourth-leading cause of years lived with disability. The condition may worsen an array of mental, physical, and social complications. As over 90% of hearing loss is age-related, its burden is notably growing amid aging populations.

Hearing ability is integrally tied with communication, and hearing loss leads to communication barriers. This in turn increases stress and restricts the ability to venture outdoors. It may also be tied with cognitive decline and dementia.

A team of Japanese researchers centered at the University of Tsukuba sought to shed further light on the relation of hearing loss and other illnesses among older people. They examined three key areas and found hearing loss had a clear link with all three, especially memory loss. The researchers reported their findings in the journal, Geriatrics & Gerontology International.

The team took advantage of the large-scale 2016 Comprehensive Survey of Living Conditions of Japan, a nationwide, population-based cross-sectional questionnaire of more than 220,000 households. From this, they targeted 137,723 survey respondents aged 65 or older and without dementia. The survey's self-reported responses on conditions including hearing loss allowed valuable comparisons to be made.

"Japan is the world's most rapidly aging country, and this is a large and compelling data set of its citizens," lead author Masao Iwagami says. "It was a solid foundation for examining correlations between hearing loss and three key problems: outdoor activity limitations, psychological distress, and memory loss."

About 9% of the 137,723 survey respondents examined had reported hearing loss. Their responses also showed the condition increased with age. The researchers further adjusted and refined their analysis to account for factors such as smoking, alcohol intake, and income. The differences between those with and without hearing loss were quite telling.

Of those reporting limitations in outdoor activities such as shopping or travel, 28.9% of those with hearing loss were affected vs. just 9.5% of those without. For psychological distress it was 39.7% vs 19.3%. For memory loss, the gap was the most profound: 37.7% vs 5.2%. These patterns were similar irrespective of age or sex.

"Hearing loss takes an enormous toll on older people in so many ways, physically and mentally, while limiting activities of daily living," study co-author Yoko Kobayashi says. "Greater awareness of the burden of hearing loss will help improve their quality of life. Measures such as hearing aids and social support by volunteers in the community can also provide them with assistance."

A joint research group including Ryo Yoshida (Professor and Director of the Data Science Center for Creative Design and Manufacturing at the Institute of Statistical Mathematics [ISM], Research Organization of Information and Systems), Junko Morikawa (Professor at the School of Materials and Chemical Technology, Tokyo Institute of Technology [Tokyo Tech]), and Yibin Xu (Group Leader of Thermal Management and Thermoelectric Materials Group, Center for Materials Research by Information Integration, Research and Services Division of Materials Data and Integrated System [MaDIS], NIMS) has demonstrated the promising application of machine learning (ML) -- a form of AI that enables computers to "learn" from given data -- for discovering innovative materials.

Reporting their findings in the open-access journal npj Computational Materials, the researchers show that their ML method, involving "transfer learning", enables the discovery of materials with desired properties even from an exceeding small data set.

The study drew on a data set of polymeric properties from PoLyInfo, the largest database of polymers in the world housed at NIMS. Despite its huge size, PoLyInfo has a limited amount of data on the heat transfer properties of polymers. To predict the heat transfer properties from the given limited data, ML models on proxy properties were pre-trained where sufficient data were available on the related tasks; these pre-trained models captured common features relevant to the target task. Re-purposing such machine-acquired features on the target task yielded outstanding prediction performance even with the exceedingly small datasets, as if highly experienced human experts can make rational inferences even for considerably less experienced tasks. The team combined this model with a specially designed ML algorithm for computational molecular design, which is called the iQSPR algorithm previously developed by Yoshida and his colleagues. Applying this technique enabled the identification of thousands of promising "virtual" polymers.

From this large pool of candidates, three polymers were selected based on their ease of synthesis and processing.

Tests confirmed that the new polymers have a high thermal conductivity of up to 0.41 Watts per meter-Kelvin (W/mK). This figure is 80 percent higher than that of typical polyimides, a group of commonly used polymers that have been mass-produced since the 1950s for applications ranging from fuel cells to cookware.

By verifying the heat transfer properties of the computationally designed polymers, the study represents a key breakthrough for fast, cost-effective, ML-supported methods for materials design. It also demonstrates the team's combined expertise in data science, organic synthesis and advanced measurement technologies.

Yoshida comments that many aspects remain to be explored, such as "training" computational systems to work with limited data by adding more suitable descriptors. "Machine learning for polymer or soft material design is a challenging but promising field as these materials have properties that differ from metals and ceramics, and are not yet fully predicted by the existing theories," he says.

The study is a starting point for the discovery of other innovative materials, as Morikawa adds: "We would like to try to create an ML-driven high-throughput computational system to design next-generation soft materials for applications going beyond the 5G era. Through our project, we aim to pursue not only the development of materials informatics but also contribute to fundamental advancement of materials science, especially in the field of phonon engineering."

After several years of theorizing and experimenting, an international team of researchers including scientists at Okinawa Institute of Science and Technology Graduate University (OIST) has finally succeeded in measuring how heat passes between two gold electrodes through a single molecule. They report their findings in Nature on July 17, 2019.

Around 2000, scientists first measured how electrons flow through single molecules. Other properties, such as how molecules emit light, have also been studied. But quantifying the heat transfer, or thermal conductance, at the molecular scale remained a persistent challenge because of the high measurement resolution required.

To achieve this elusive goal, the international team of collaborators had to work on both an experimental and a theoretical level.

Scientists at University of Michigan developed a setup called a scanning thermal microscope, which positions a single alkane molecule between a gold-coated probe and a gold layer. The gold probe is heated and then held above a cold gold substrate in such a way that the alkane molecule forms a link between the probe tip and substrate layer. Due to the difference in temperature, heat passes from the hot gold to the cold gold through the molecule. The alkane molecules employed were synthesized by scientists at Kookmin University, South Korea.

Thermal conduction is a process most of us are familiar with, and heat can be transported in various ways. Here, the heat was carried by the vibrations of atoms in the alkane molecule, which the scanning thermal microscope could detect.

OIST's Leader of the Quantum Transport and Electronic Structure Theory Unit, Prof. Fabian Pauly, and his PhD student Jan Klöckner, were the theorists on the paper.

While each measurement takes only seconds, the microscope gathers averages over many trials to determine the thermal conductance of a single molecule.

The scientist used alkane molecules of different lengths. Previously, Pauly's group made predictions on the size of thermal conductance values for such single molecule-junctions. The predictions provided important information for the experimentalist in the study regarding the measurement resolution needed.

"Having shown that heat transport at the molecular scale is rather length-independent, we must now try to find out how we can enhance or reduce it," Pauly said. "Ultimately, what we hope to do in the future is to identify ways of controlling the flow of heat by molecular design."

The ability to regulate how much heat passes through a material requires a detailed understanding of heat flow at the molecular scale, Pauly explained. "For example, to characterize the efficiency of thermoelectric devices, which can be used to convert heat into electrical energy, the thermal conductance has to be known."

The research spans several different fields of science. The lead authors on the paper, Prof. Pramod Reddy and Prof. Edgar Meyhofer of University of Michigan, are mechanical engineers. The other corresponding authors, Prof. Sung-Yeon Jang of Kookmin University and OIST's Prof. Fabian Pauly, are a chemist and a theoretical physicist, respectively.

The experimental and theoretical tools that the international team has developed pave the way for scientists to study how heat moves at the molecular scale, and hopefully to find new ways of controlling this flow by the design of new molecular structures.

National Institute of Health researchers have reported the largest genomic study of type 2 diabetes (T2D) in sub-Saharan Africans, with data from more than 5,000 individuals from Nigeria, Ghana and Kenya. Researchers confirmed known genomic variants and identified a novel gene ZRANB3, which may influence susceptibility to the disease in sub-Saharan African populations. The gene could also influence the development of T2D in other populations and inform further research.

In a study published in the journal Nature Communications, researchers analyzed genomic data available on participants through the Africa America Diabetes Mellitus study, the single largest diabetes genomic association study conducted on the continent. Using the information available from 5,231 people, they found many genomic variants to be significantly associated with T2D.

The findings replicate results for many of the variants which other research studies have already implicated in T2D in mostly European ancestry populations. The work was funded by the National Human Genome Research Institute (NHGRI), the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of the Director at the National Institutes of Health.

"Africa is the original cradle of all humanity, to which all humans can trace their genetic origin," said Francis S. Collins, M.D., Ph.D., co-author of the paper and senior investigator with the NHGRI Medical Genomics and Metabolic Genetics Branch. "Thus, studying the genomes of Africans offers important opportunities to understand genetic variation across all human populations."

To better understand how ZRANB3 was involved in T2D, the researchers studied its effects on zebrafish pancreas. The pancreas is one of the key organs involved in T2D, because their β-cells release insulin as a response to rising glucose in the bloodstream.

"In the early days of large-scale genomic studies, we did not know the effect of genes we found through our statistical tests," said Dr. Adebowale Adeyemo, NHGRI researcher and first author of the paper. "But with the availability of new genomic tools, our next step was to ask: What does ZRANB3 do? How does it confer risk for T2D, and by what mechanisms does it act? That is the knowledge that will help the results become actionable for patients."

Working with Dr. Norann Zaghloul of the University of Maryland, the researchers used a CRISPR-Cas9 DNA editing system to make the ZRANB3 gene inoperative in zebrafish (called a 'knockout'). They also used biological tools to reduce the expression of the ZRANB3 gene in different zebrafish. In both cases, researchers observed a reduction in β-cell numbers in the developing zebrafish embryo. They realized it was because the β-cells were being destroyed when the ZRANB3 gene was inactive.

To follow up on these results and identify the consequence of such β-cell death, the researchers took β-cell cells from mice and performed a similar knockdown of the ZRANB3 gene as in the zebrafish model. They found that cells with ZRANB3 knockdown released much less insulin in the presence of high glucose than normal mouse β-cells.

Although the role of ZRANB3 in T2D was discovered in African populations (which have been vastly underrepresented in genomics research), it is possible that the same gene may also influence the development of T2D in other populations as scientists study the biology of this gene further, according to the researchers.

This is because the function of genes is, for the most part, universally same. However, differences in sequence variations in a gene as well as how they interact with lifestyle, behavior and other factors may influence the impact of a gene on disease in a given population.

"The findings of this study further demonstrate why it is important to study all human populations. By doing so, we have the opportunity to make novel discoveries that will not only help the specific population but also people all around the globe," said Dr. Charles Rotimi, senior author of the paper. "The biology then becomes generalizable, and that much more impactful."

The next steps for the researchers will be to return to the human participants who have T2D as well as the variant for ZRANB3. The question is: could the presence of the ZRANB3 variant in T2D patients help predict whether these individuals will require insulin early in the course of their diabetes treatment? Providing insulin to such people early may be advantageous because that could help delay the exhaustion of their β-cells over time. This could someday be a simple, yet vastly effective way of treating T2D in a personalized manner.

PHILADELPHIA -- Music is a viable alternative to sedative medications in reducing patient anxiety prior to an anesthesia procedure, according to a Penn Medicine study published today in the journal Regional Anesthesia & Pain Medicine.

A peripheral nerve block procedure is a type of regional anesthesia - done in the preoperative area under ultrasound guidance - that blocks sensations of pain from a specific area of the body. The procedure is routinely performed for a variety of outpatient orthopedic surgeries, such as hip and knee arthroscopies and elbow or hand surgeries. To reduce anxiety, which can lead to prolonged recovery and an increase in postoperative pain, patients commonly take sedative medications, like midazolam, prior to the nerve block procedure. Yet, the medications can have side effects, including breathing issues and paradoxical effects like hostility and agitation. In this study, researchers found a track of relaxing music to be similarly effective to the intravenous form of midazolam in reducing a patient's anxiety prior to the procedure.

"Our findings show that there are drug-free alternatives to help calm a patient before certain procedures, like nerve blocks," said the study's lead author Veena Graff, MD, an assistant professor of Clinical Anesthesiology and Critical Care. "We've rolled out a new process at our ambulatory surgical center to provide patients who want to listen to music with access to disposable headphones. Ultimately, our goal is to offer music as an alternative to help patients relax during their perioperative period."

While research has shown music can help reduce a patient's anxiety prior to surgery, previous studies have primarily focused on music vs. an oral form of sedative medications, which are not routinely used in the preoperative setting. In this study - the first to compare music medicine with an intravenous form of sedative medication - researchers aimed to measure the efficacy of music in lowering a patient's anxiety prior to conducting a peripheral nerve block.

The team randomly assigned 157 adults to receive one of two options three minutes prior to the peripheral nerve block: either an injection of 1-2 mg of midazolam, or a pair of noise canceling headphones playing Marconi Union's "Weightless," - an eight-minute song, created in collaboration with sound therapists, with carefully arranged harmonies, rhythms, and bass lines designed specifically to calm listeners down. Researchers evaluated levels of anxiety before and after the use of each method, and found similar changes in the levels of anxiety in both groups.

However, the team noted that patients who received midazolam reported higher levels of satisfaction with their overall experience and fewer issues with communication. Researchers attribute these findings to a number of factors, including the fact they used noise canceling headphones, didn't standardize the volume of music, and didn't allow patients to select the music.

Microbes are master chefs of the biomolecular world; collectively, they harbor the ability to produce a vast array of unknown substances, some of which may have therapeutic or other useful properties. In searching for useful products, a team of chemists at Illinois have discovered a whole new class of microbial recipes.

"The kind of reactions that these enzymes are doing are mind-boggling . . . when we first saw them, we were scratching our heads," said Howard Hughes Medical Institute (HHMI) Investigator Wilfred van der Donk, who led the study. "Then we had to painstakingly prove that the reactions we thought the enzymes were doing, are indeed carried out."

Van der Donk, who is also the Richard E. Heckert Endowed Chair in Chemistry, and his colleagues at Illinois collaborated with the laboratory of HHMI Investigator and University of California, Los Angeles Professor of Biological Chemistry and Physiology Tamir Gonen to confirm their findings, which were published this week in Science. The work was supported by HHMI and the National Institutes of Health.

First author Chi Ting and van der Donk are members of a research team at the Carl R. Woese Institute for Genomic Biology that aims to discover new natural products--the potentially useful substances produced by microbes--by exploring their genomes, a strategy called genome mining.

"Genome mining allows you to start looking for compounds where you have absolutely no idea what they are going to be," van der Donk said. "Many labs in [our team] are trying to find new antibiotics by genome mining . . . you look for unusual things where we don't know what is being made, and then you try to make the compound in a friendly organism."

Cells use special chemical ingredients called amino acids to create proteins, which are the main structure and internal machinery of living things. Proteins are long chains made up of the twenty different types of amino acids; peptides are shorter chains. Some types of microbial natural products are formed from small peptides embellished with aftermarket chemical parts.

Proteins and most peptides are assembled by ribosomes, giant cellular machines that act like pastry chefs at a bakery. Following the recipes written in genes, ribosomes can link together any sequence of amino acids; ribosomes are efficient and versatile. Other peptide-based natural products are made by teams of specialized enzymes, which act like a home baker with a favorite recipe learned by heart--these enzymes don't follow a template, instead creating the same types of linkages and modifications over and over to make just one product.

"In natural product biosynthesis, both pathways are used to make natural products," van der Donk said. "And now we stumbled across something that has features from both."

The researchers made their unexpected discovery while examining a cluster of genes found in the bacterium Pseudomonas syringae, which infects plants. They had found that their cluster of genes included one that held the information for a peptide made by a ribosome, while another coded for an enzyme that could add another amino acid onto the peptide chain. The pastry chef was assembling a dough to make bread, but handing it over to a home baker to finish preparation.

"In retrospect it's just a really clever way of doing things," van der Donk said. "Having an enzyme that can do this to a pre-existing peptide means that now . . . you can use it as a scaffold and just keep making the natural product time and time again."

The type of synthetic process they discovered in Pseudomonas works this way because once the new amino acid is added to the peptide, it is modified in a series of steps and then broken off, returning the original ribosomally-created peptide back to the starting step. In this way, it is a bit like sourdough starter. As long as it remains active, it doesn't need to be recreated from scratch to make each subsequent batch of bread.

To fully describe their natural product and its synthesis, van der Donk's team wanted to get a better look at its structure. However, the molecule proved too unstable to use traditional techniques. The researchers reached out to Gonen, whose lab had recently applied a cutting-edge approach--using electron microscopy on flash-frozen microcrystals of purified substances--to the determination of the structures of small molecules.

"Once you've made the natural product, now you need to figure out what it is . . . Our collaborators wanted to show the utility of this method for an unknown molecule of natural origins," van der Donk said. "This was really a win-win situation for both labs. I think the whole natural products community probably will want to start using this technique."

Now that van der Donk and his team are aware of the existence of this alternative pathway for synthesis, they have already found other examples of similar mechanisms, including the production of an anti-tumor compound by a soil microbe. In addition to expanding the ability to recognize gene clusters that make promising natural products, the researchers are excited about finding new ways to put pathway to use.

"We're also excited as to how we might be able to use this for synthetic biology," van der Donk said. "Because the overhead, the amount of resources that have to go in to make a natural product, is fairly low here. You make this peptide, a few enzymes, and out comes rolling an anti-tumor compound . . . There's a lot of interest right now in engineering bacteria to have anti-cancer activity, and this is relatively low-hanging fruit with respect to making the organism make the molecules for you."