Culture

CORVALLIS, Ore. - Large-scale land transactions in which nations sell huge, publicly owned parcels to foreign and domestic corporations negatively affect local women more than men, a new study by Oregon State University shows.

The findings are important because the transactions, also known as land grabs, are occurring at a pace and scale that are unprecedented - at least 45 million hectares, and possibly as many as 200 million, have changed hands over the past decade, mainly in lower-income countries, OSU College of Forestry researcher Reem Hajjar said.

"Governments try to frame it as development of marginal or underutilized land," said Hajjar, assistant professor of forest ecosystems and society. "They say 'we're going to boost production, we're going to feed the country.' What we find is that these large-scale land transactions actually take food away from their own countrymen and women because the most successful transactions end up going to cash crops for export, like mango and sugar, resulting in poorer nutrition in the local area."

The large-scale land transactions, known as LSLTs, are not always for agricultural reasons. Tourism, commercial forestry, mining and even "green grabs" or "blue grabs" - land and water resources being acquired for environmental purposes - are other motivators for transactions that change residents' tenure over land and forests - the right to access, benefit from and/or control land-related resources.

In many places local communities have insecure tenure rights, meaning their customary or traditional rights over lands may not be recognized by statute, making it easier for governments to appropriate and sell off those lands to corporations.

Hajjar, collaborating with researchers at the University of Michigan, Arizona State University, the University of Copenhagen, and the Ethiopian Environment and Forest Research Institute, analyzed four LSLTs in western Ethiopia. They found that women in communities that lost access to lands suffered effects that were "more adverse and more severe" compared to the effects on men.

Big transactions tended to cause three main changes in land ownership and use in the study areas: Relocation and decrease in size of individually held private lands, where villagers plant crops for subsistence and to sell; loss of communal grazing lands; and loss of forests, either through deforestation by the investor or through the resettlement of villagers and their agricultural lands into forested areas. Compensation to villagers who lost land often didn't materialize.

Post-transaction, both women and men were left with few choices beyond working as day laborers on investors' lands to generate income to buy food they were no longer able to grow themselves, Hajjar said.

"People were transformed from being mostly self-sufficient, small-scale agriculture entrepreneurs into wage laborers," she said. "And jobs that were promised on the transacted lands were usually less abundant and less permanent than expected. Many husbands had to find work in town, leaving women to handle agricultural tasks on the increasingly small parcels of land the households still owned."

Women were also still expected to fulfill all of their previous domestic responsibilities, such as collecting firewood - which had to be done at sites significantly farther away following the land transactions - cooking, cleaning, and caring for children.

"With the men gone, women now raise children alone, adding to their daily labor burden," Hajjar said. "Female-headed households are particularly affected since the older male children leave home in search of work. The decrease in household-owned land that stems from the large-scale land transactions has shifted household labor in a way that has increased the burden on women, who have to work both as wage laborers while also juggling a bigger workload at home."

Women also bore the brunt of the transactions' impacts on community members' physical health.

"The subsequent decreases in food availability hit women harder because they're primarily responsible for providing food for their household," Hajjar said. "Women will often respond to shortages by eating less to ensure men and children are fed. Loss of communal grazing lands often meant that households would go with less meat and dairy products since they couldn't support livestock on remaining lands."

Evidence for the ancient, 1.2 billion years old, meteorite strike, was first discovered in 2008 near Ullapool, NW Scotland by scientists from Oxford and Aberdeen Universities. The thickness and extent of the debris deposit they found suggested the impact crater - made by a meteorite estimated at 1km wide - was close to the coast, but its precise location remained a mystery.

In a paper published today in Journal of the Geological Society, a team led by Dr Ken Amor from the Department of Earth Sciences at Oxford University, show how they have identified the crater location 15-20km west of a remote part of the Scottish coastline. It is buried beneath both water and younger rocks in the Minch Basin.

Dr Ken Amor said: 'The material excavated during a giant meteorite impact is rarely preserved on Earth, because it is rapidly eroded, so this is a really exciting discovery. It was purely by chance this one landed in an ancient rift valley where fresh sediment quickly covered the debris to preserve it.

'The next step will be a detailed geophysical survey in our target area of the Minch Basin.'

Using a combination of field observations, the distribution of broken rock fragments known as basement clasts and the alignment of magnetic particles, the team was able to gauge the direction the meteorite material took at several locations, and plotted the likely source of the crater.

Dr Ken Amor said: 'It would have been quite a spectacle when this large meteorite struck a barren landscape, spreading dust and rock debris over a wide area.'

1.2 billion years ago most of life on Earth was still in the oceans and there were no plants on the land. At that time Scotland would have been quite close to the equator and in a semi-arid environment. The landscape would have looked a bit like Mars when it had water at the surface.

Earth and other planets may have suffered a higher rate of meteorite impacts in the distant past, as they collided with debris left over from the formation of the early solar system.

However, there is a possibility that a similar event will happen in the future given the number of asteroid and comet fragments floating around in the solar system. Much smaller impacts, where the meteorite is only a few meters across are thought to be relatively common perhaps occurring about once every 25 years on average.

It is thought that collisions with an object about 1 km (as in this instance) across occur between once every 100,000 years to once every one million years - but estimates vary.

One of the reasons for this is that our terrestrial record of large impacts is poorly known because craters are obliterated by erosion, burial and plate tectonics.

The following papers will be presented at the ADA conference in San Francisco and published simultaneously in either The Lancet or The Lancet Diabetes & Endocrinology journals. All papers are under embargo until the stated time. Contact details for corresponding authors are provided in the Articles and linked Comments. Funding information is listed on the first page of each Article.

Embargo: 16.45hrs [UK time] / 8.45am [San Francisco time] Saturday 8th June 2019
The Lancet: Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31271-1/fulltext

Embargo: 16.45hrs [UK time] / 8.45am [San Francisco time] Sunday 9th June 2019
The Lancet Diabetes and Endocrinology: Durability of insulin degludec plus liraglutide versus insulin glargine U100 as initial injectable therapy in type 2 diabetes (DUAL VIII): a multicentre, open-label, phase 3b, randomised controlled trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30184-6/fulltext

Embargo: 20.00hrs [UK time] / 12.00 (midday) [San Francisco time] Sunday 9th June 2019
The Lancet Diabetes and Endocrinology: Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30192-5/fulltext

Embargo: 20.00hrs [UK time] / 12.00 (Midday) [San Francisco time] Sunday 9th June 2019
The Lancet Diabetes and Endocrinology: Efficacy and safety of oral semaglutide with flexible dose adjustment versus sitagliptin in type 2 diabetes (PIONEER 7): a multicentre, open-label, randomised, phase 3a trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30194-9/fulltext

Embargo: 22.15hrs [UK time] / 2.15pm [San Francisco time] Sunday 9th June 2019
The Lancet Diabetes and Endocrinology: Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30180-9fulltext **Please note this hyperlink will go live after the embargo lifts on the morning of Monday 10th June UK time**

Embargo: 00.30hrs [UK time] Monday 10th June / 16.30pm [San Francisco time] Sunday 9th June 2019
The Lancet: Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31149-3/fulltext

Embargo: 00.30hrs [UK time] Monday 10th June / 16.30pm [San Francisco time] Sunday 9th June 2019
The Lancet: Dulaglutide and renal outcomes in type 2 diabetes:an exploratory analysis of the REWIND randomised, placebo-controlled trial

Once the embargo lifts, please use this link as the one above will be deactivated: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31150-X/fulltext

A simple tweak to the sleeping patterns of 'night owls' - people with extreme late sleeping and waking habits - could lead to significant improvements in sleep/wake timings, improved performance in the mornings, better eating habits and a decrease in depression and stress.

New international research by the Universities of Birmingham and Surrey in the UK, and Monash University in Australia, showed that, over a three-week period, it was possible to shift the circadian rhythm of 'night owls' using non-pharmacological and practical interventions.

The study, published in Sleep Medicine today (INSERT DATE), showed participants were able to bring forward their sleep/wake timings by two hours, while having no negative effect on sleep duration. In addition, participants reported a decrease in feelings of depression and stress, as well as in daytime sleepiness.

"Our research findings highlight the ability of a simple non-pharmacological intervention to phase advance 'night owls', reduce negative elements of mental health and sleepiness, as well as manipulate peak performance times in the real world," lead researcher Dr Elise Facer-Childs from Monash University's Turner Institute for Brain and Mental Health said.

'Night owls' are individuals whose internal body clock dictates later-than-usual sleep and wake times - in this study participants had an average bedtime of 2.30am and wake-up time of 10.15am.

Disturbances to the sleep/wake system have been linked to a variety of health issues, including mood swings, increased morbidity and mortality rates, and declines in cognitive and physical performance.

"Having a late sleep pattern puts you at odds with the standard societal days, which can lead to a range of adverse outcomes - from daytime sleepiness to poorer mental wellbeing," study co-author Dr Andrew Bagshaw from the University of Birmingham said.

"We wanted to see if there were simple things people could do at home to solve this issue. This was successful, on average allowing people to get to sleep and wake up around two hours earlier than they were before. Most interestingly, this was also associated with improvements in mental wellbeing and perceived sleepiness, meaning that it was a very positive outcome for the participants. We now need to understand how habitual sleep patterns are related to the brain, how this links with mental wellbeing and whether the interventions lead to long-term changes."

Twenty-two healthy individuals participated in the study. For a period of three weeks participants in the experimental group were asked to:

Wake up 2-3 hours before regular wake up time and maximise outdoor light during the mornings.

Go to bed 2-3 hours before habitual bedtime and limit light exposure in the evening.

Keep sleep/wake times fixed on both work days and free days.

Have breakfast as soon as possible after waking up, eat lunch at the same time each day, and refrain from eating dinner after 7pm.

The results highlighted an increase in cognitive (reaction time) and physical (grip strength) performance during the morning when tiredness is often very high in 'night owls', as well as a shift in peak performance times from evening to afternoon. It also increased the number of days in which breakfast was consumed and led to better mental well-being, with participants reporting a decrease in feelings of stress and depression.

"Establishing simple routines could help 'night owls' adjust their body clocks and improve their overall physical and mental health. Insufficient levels of sleep and circadian misalignment can disrupt many bodily processes putting us at increased risk of cardiovascular disease, cancer and diabetes," Professor Debra Skene from the University of Surrey said.

Dr Facer-Childs said 'night owls', compared to 'morning larks', tended to be more compromised in our society due to having to fit to work/school schedules that are out of sync with their preferred patterns.

"By acknowledging these differences and providing tools to improve outcomes we can go a long way in a society that is under constant pressure to achieve optimal productivity and performance," she said.

This intervention could also be applied within more niche settings, such as industry or within sporting sectors, which have a key focus on developing strategies to maximise productivity and optimise performance at certain times and in different conditions.

Hamilton, ON (June 9, 2019) - A clinical trial that followed more than 9,900 people in 24 countries has found that the drug dulaglutide reduced cardiovascular events and kidney problems in middle-aged and older people with Type 2 diabetes.

During more than five years of follow-up, cardiovascular events like heart attacks and strokes were reduced by 12% in people taking dulaglutide compared to people taking a placebo. This effect was seen in both men and women with or without previous cardiovascular disease.

In addition, during the same period, the drug reduced the development of kidney disease by 15%.

The trial was led by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences. Two papers describing the cardiovascular and kidney results of the trial were published today in the journal The Lancet from the study called the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial.

"Compared to others, people with diabetes have twice the rate of cardiovascular events like heart attacks and strokes, and up to 40% of people with diabetes develop kidney disease," said Hertzel C. Gerstein, principal investigator for the study, professor of medicine at McMaster and deputy director of the PHRI.

"The REWIND trial shows that dulaglutide can safely reduce these events while improving diabetes control and modestly lowering weight and blood pressure in middle-aged people with Type 2 diabetes."

Nearly one in five people over the age of 60 have diabetes and most have Type 2 diabetes. Altogether, nearly ten per cent of adults are living with diabetes, including 425 million people worldwide; 100 million in the U.S., and three million people in Canada.

Dulaglutide is a glucagon-like peptide-1 receptor agonist that is injected once per week. It is approved for glucose lowering and works by helping the pancreas release the right amount of insulin when blood sugar levels are high, slowing the emptying of the stomach after a meal, and reducing appetite and weight.

Gerstein pointed out the trial participants were very similar to the sorts of people with diabetes who are seen in medical practice. Participants were followed for a median of 5.4 years, much longer than previous trials, and more than 46 per cent of participants were women. Less than a third of participants had previous cardiovascular disease.

The drug was well tolerated, modestly reduced weight, low-density lipoprotein (LDL) cholesterol and blood pressure, and modestly increased heart rate. Gastrointestinal side effects including constipation or diarrhea were reported more frequently in participants taking dulaglutide (47%) compared to placebo (34%).

Baltimore (June 9, 2019) - Many Americans get less than the recommended amount of sleep, and many do not consume the recommended amounts of important vitamins and minerals. A new study suggests the two factors may be connected.

The research is based on data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of U.S. adults. Compared with people who got more than seven hours of sleep per night--the amount the Centers for Disease Control and Prevention recommends for adults--scientists found that people who got fewer than seven hours of sleep per night on average consumed lower amounts of vitamins A, D, and B1, as well as magnesium, niacin, calcium, zinc and phosphorus.

The study also found a greater number of nutrients were associated with poor sleep in women than in men. This number was reduced if women took dietary supplements, suggesting that supplements can help fill the gaps where a person's diet is not providing the necessary nutrients.

"This work adds to the body of growing evidence associating specific nutrient intakes with sleep outcomes," said lead study author Chioma Ikonte, director of nutrition science at Pharmavite, LLC. "Our findings suggest that individuals with short sleep duration might benefit from improving their intake of these nutrients through diet and supplementation."

Ikonte will present the research at Nutrition 2019, the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore. In addition to the findings on sleep duration, the research suggests nutrients may also play a role in sleep disorders, poor sleep quality and trouble falling asleep.

Micronutrients are vitamins and minerals that our bodies require but do not produce. As a result, they must come from our diet. Globally, billions of people suffer from at least one micronutrient deficiency.

Previous studies have demonstrated important roles for micronutrients in growth and development, disease prevention and healing, and normal bodily functions, including sleep. Magnesium, for example, helps the body produce melatonin and other compounds involved in sleep. Some studies suggest zinc plays a role in sleep regulation.

However, the researchers cautioned that the study was a retrospective analysis, not a randomized controlled study, so cannot prove cause and effect.

"Whether chronic short sleep causes nutrient insufficiency or the nutrient insufficiency causes short sleep still needs to be determined," said Ikonte. "A clinical study that investigates [impacts of] supplementation with these nutrients on sleep outcomes is needed to demonstrate cause and effect."

Pharmavite, LLC is a company that sells dietary supplements.

Chioma Ikonte will present this research on Sunday, June 9, from 1:45 - 2:45 p.m. in the Baltimore Convention Center, Halls A-B (poster #400) (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

Baltimore (June 9, 2019) - Tuberculosis (TB) remains one of the deadliest infectious diseases in low income countries, with around 1.6 million people dying of the disease each year. In a new study, researchers show that sun-exposed oyster mushrooms offer a readily available source of vitamin D that can help TB patients respond better to anti-TB drugs by improving immune response.

"TB is becoming more difficult to fight due to the emergence of drug-resistant strains, creating an urgent need for new treatments that can support first-line drugs," said TibebeSelassie Seyoum Keflie, a doctoral fellow at University of Hohenheim, Germany. "This source of vitamin D is ideal for low income countries because mushrooms can easily be distributed and administered in a safe, low-cost, easy-to-replicate manner."

Keflie, who performed the research with Hans Konrad Biesalski, will present the research at Nutrition 2019, the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore.

Studies have shown that vitamin D induces the body to form an antimicrobial compound that attacks the bacterial cause of TB. Although sun exposure can boost a person's vitamin D levels, it must be obtained through diet when sun exposure is scarce.

The researchers used oyster mushrooms because they offer a cheap, safe and readily available source of vitamin D that is easily absorbed by the body. Although fresh oyster mushrooms contain almost no vitamin D, the fungus produces it the after exposure to sunlight much like the human body.

"This is the first time that vitamin D derived from oyster mushrooms exposed to sun has been shown to be a potential adjunctive therapy for TB," said Keflie. "With educational outreach, it might be possible to teach people with TB to irradiate their own mushroom for a brief period before cooking."

For the study, the researchers gave a group of TB patients sandwich bread containing 146 micrograms of vitamin D from sun-exposed oyster mushrooms every morning during the first four months in which they received an anti-TB drug.

At the end of the four months, 95 percent of patients receiving the fortified bread were classified with the lowest TB severity score on a scale of 1 to 5. The treatment group had significantly higher vitamin D levels compared to patients not receiving the bread, with more than a third of them no longer showing a vitamin D deficiency. The researchers also observed that patients who consumed the fortified bread had significant improvements in immunological responses over the four months.

The researchers plan to carry out additional investigations on the interactions of vitamin D and immunological responses in larger and more diverse groups of TB patients. They are also developing different mushroom drying methods to determine how to achieve the highest levels of vitamin D.

TibebeSelassie Seyoum Keflie will present this research on Sunday, June 9, from 3:45 - 4 p.m. in the Baltimore Convention Center, Room 319/320 (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

Baltimore (June 8, 2019) - The beverages we drink represent a substantial source of our daily calories and nutrients, yet standardized methods for tracking beverage consumption have been limited. In the latest and most comprehensive assessment of worldwide beverage consumption, researchers report substantial differences in the beverages consumed by different demographic groups in 185 countries.

"These preliminary data derived from the Global Dietary Database project can help inform nutrition transitions over time, the impacts of these beverages on global health, and targeted dietary policy to improve diet and health," said lead study author Laura Lara-Castor, a doctoral student in the Friedman School of Nutrition Science and Policy at Tufts University. Lara-Castor will present the research at Nutrition 2019, the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore.

"Notably, sugar-sweetened beverage and fruit juice intake was highest in the Latin American region, where both commercial and homemade sugar-sweetened beverages and fruit drinks are widely consumed," said Lara-Castor. "Milk intake was highest in the high-income region (including countries such as Sweden, Iceland and Finland) where dairy farming is more widespread and dairy consumption has been traditionally a major part of the diet."

The research is based on 2015 data from more than 1,100 surveys representing 6.78 billion people worldwide, along with data on beverage availability and other information.

The researchers found consumption of sugar-sweetened beverages was highest in Mexico, where the average adult drank more than 19 ounces per day (equivalent to roughly 2.5 cups per day), followed by Suriname and Jamaica, where adults drank nearly 15 ounces per day. The lowest intake was in China, Indonesia and Burkina Faso.

Fruit juice intake was highest in Colombia (about 11 ounces or 1.4 cups per day) and the Dominican Republic (nearly 10 ounces per day) and lowest in China, Portugal and Japan.

Milk consumption was highest in Sweden (more than 10 ounces or 1.3 cups per day), followed by Iceland and Finland, where adults drank just over 9 ounces per day, on average. China, Togo and Sudan showed the lowest average milk intake.

Within regions and countries, beverage consumption was generally highest among younger people, those who had attained a higher education level and those living in urban areas.

Continuous glucose monitoring (CGM) evaluations in islet transplant recipients who have been insulin independent for an average of 10 years show near-normal glycemic profiles and time-in-range metrics, according to data presented by the Diabetes Research Institute at the University of Miami Miller School of Medicine. The findings, which were accepted as a late-breaking poster at the American Diabetes Association (ADA) 79th Scientific Sessions, June 7 - 11, 2019 in San Francisco, CA, demonstrate that islet transplantation can be a successful long-term cell therapy for select patients with type 1 diabetes.

The DRI team evaluated five of its adult subjects who received intrahepatic (in the liver) islet transplants between 2002 - 2010 and have since remained insulin independent for seven to 16+ years. During their last study follow-up, the subjects completed a 7-day, non-blinded CGM to assess their glycemic profiles. Compared to current recommended CGM goals for adults with type 1 diabetes on a hybrid closed-loop system, all patients demonstrated improved CGM time-in-range, reduction in glucose variability, and prevention of hypoglycemia. A sampling of the results is as follows:

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CGM Glucose Range
CGM % Time-in-Range recommended goals for hybrid closed-loop system
CGM % Time-in-Range in DRI islet transplant subjects with long-term insulin independence

(mg/dL)

70-180
≥70
96.4

≤3
0.9

≤1
0.1

In addition, time in the more stringent glucose range of 70-140 mg/dL was 83.1%, with a mean sensor glucose (SG) value of 116 mg/dL and an average HbA1c of 5.7%. The ADA's recommended HbA1c goal is

"Using continuous glucose monitoring, we now have the ability to accurately evaluate patients' glucose profiles and their variability. The CGM data we have obtained from our islet transplant patients clearly demonstrates that islet transplantation can result in glucose levels that are close to those in people who do not have type 1 diabetes, even 10 years or more after undergoing the cell-replacement procedure," said David Baidal, M.D., assistant professor of medicine and member of the DRI's Clinical Islet Transplant Program. One of the principal investigators of the study, Dr. Baidal is presenting the results at the ADA conference.

"Although not all subjects remain insulin independent, like the subjects described in this presentation, after an islet transplant a significant number of them continue with excellent graft function for over 10 years that allows them to have near-normal glucose metabolism in the absence of severe hypoglycemia on small doses of insulin," said Rodolfo Alejandro, M.D., director of the Clinical Cell Transplant Program and also a principal investigator of the study. Dr. Alejandro will be presenting these results at the upcoming 17th World Congress of the International Pancreas & Islet Transplant Association, July 2-5, 2019 in Lyon, France.

"This report confirms the superiority of transplantation of insulin-producing cells compared to insulin therapy, with glucose control results that were even better than the goals of CGM in hybrid closed-loop systems. Hopefully, this will be of assistance in bringing islet transplantation closer to FDA approval, allowing the treatment to be made available to U.S. patients, as has already been the case in several other countries, for many years," said Camillo Ricordi, M.D., Stacy Joy Goodman Professor of Surgery and director of the Diabetes Research Institute, who was recently named the world's leading expert in islet transplantation by Expertscape. Dr. Ricordi is well-known for inventing the machine (Ricordi Chamber) that made it possible to isolate large numbers of islet cells from the human pancreas and for performing the first series of successful clinical islet transplants that reversed diabetes after implantation of donor purified islets into the liver of recipients with diabetes.

In type 1 diabetes, the insulin-producing islets cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed some patients to live without the need for insulin injections after receiving a transplant of donor cells. Some patients who have received islet transplants have been insulin independent for more than a decade, as DRI researchers have published. Currently, islet transplantation remains an experimental procedure limited to a select group of adult patients with type 1 diabetes.

In 2016, the National Institutes of Health-sponsored Clinical Islet Transplantation Consortium reported results from its Food and Drug Administration (FDA)-authorized Phase 3 multi-center trial, of which the DRI was a part, indicating that islet transplantation was effective in preventing severe hypoglycemia (low blood sugar levels), a particularly feared complication in type 1 diabetes that can lead to seizures, loss of consciousness and even death. The study was a significant step toward making islet transplantation an approved treatment for people with type 1 diabetes and reimbursable through health insurance, as it is in several other countries around the world.

(Glasgow, 8 June, 2019) A new blood test could become clinical practice within five years, reducing the need for a liver biopsy in the management of paediatric Non-Alcoholic Fatty Liver Disease (NAFLD), as a major new international paediatric liver registry collaboration yields early results [1].

Researchers are today presenting findings, at the 52nd Annual Meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition, which indicate that blood tests could replace the need for a liver biopsy in children suffering with NAFLD. Currently, if a doctor is concerned a child has scarring or inflammation of the liver they may recommend a liver biopsy. The study looked at 67 children with NAFLD and found that different types of fats in the blood were associated with features of fatty liver on liver biopsy, allowing researchers to determine the presence of inflammation and scarring - also known as non-alcoholic steatohepatitis and fibrosis.

Non-Alcoholic Fatty Liver Disease affects around one in 10 children [2] and is the most common paediatric liver disorder [3]. It can progress to advanced scarring (cirrhosis), liver failure, and liver cancer. Despite this, the natural history of the condition is poorly understood and there are currently no approved treatments or drugs in clinical trials for children. In response to this, researchers from across Europe have come together to pool resources in order to better understand the condition and how to treat it.

Liver biopsy is currently the most accurate test for NAFLD and the only method routinely used in practice for assessing the presence of scarring or inflammation [4,5]. However, biopsy is invasive, resource intensive, costly, prone to sampling error and carries a small risk of significant complications [6]. Therefore, the availability of an accurate and non-invasive marker to replace the need for liver biopsy, both in routine practice and in a clinical trial setting, is a major breakthrough for children, parents and healthcare professionals.

To date, all European drug trials [7,8] and assessments of non-invasive markers [9] in paediatric NAFLD have been single-centre studies, which limits the generalisability of findings. This is particularly pertinent given the variation in clinical practice at different centres.

This research is the first major finding to be reported from the European Paediatric Non-Alcoholic Fatty Liver Disease Registry (EU-PNALFD registry), an international collaboration of 11 specialist and non-specialist centres in six European countries, led by Dr. Jake Mann. When fully operational, the registry will have enrolled up to 2,000 children, including 500 with biopsy-proven paediatric NAFLD, and follow-up will continue for up to 30 years.

Commenting on the findings, registry co-ordinator Dr. Jake Mann said:

"It is early days but the results of the research are promising and could help shift the way we understand and manage paediatric NAFLD: saving resources, time, and stress for children and their parents. The new multi-centre registry provides us with an opportunity to tackle these challenges. The EU-PNAFLD registry will facilitate recruitment into interventional clinical trials as well as imaging, biomarker, and translational studies, plus allow greater understanding of the long-term natural history of NAFLD. The ultimate aim is to understand the condition sufficiently to intervene and slow disease progression so we can reduce the number of patients requiring liver transplantation later in life."

Alison Taylor Chief Executive of the Children's Liver Disease Foundation (CLDF) added:

"It is great to hear that the registry, supported through CLDF research funds is already yielding such fantastic insights to improve the diagnosis and care of children affected by NAFLD. In particular, it is wonderful to see such progression in the development of non-invasive tests which will positively impact children, young people and their families at a time that is incredibly stressful. We know that further significant developments in care will come via the European Paediatric Non-Alcoholic Fatty Liver Disease Registry (EU-PNALFD registry) and we are proud to be supporting the initiative."

Taking a daily vitamin D supplement does not prevent type 2 diabetes in adults at high risk, according to results from a study funded by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The Vitamin D and Type 2 Diabetes (D2d) study enrolled 2,423 adults and was conducted at 22 sites across the United States. These findings were published June 7 in the New England Journal of Medicine and presented at the 79th Scientific Sessions of the American Diabetes Association in San Francisco.

D2d is the largest study to directly examine if daily vitamin D supplementation helps keep people at high risk for type 2 diabetes from developing the disease. The study included adults aged 30 or older and assigned participants randomly to either take 4,000 International Units (IU) of the D3 (cholecalciferol) form of vitamin D or a placebo pill daily. All study participants had their vitamin D levels measured at the start of the study. At that time, about 80% of participants had vitamin D levels considered sufficient by U.S. nutritional standards.

"Observational studies have reported an association between low levels of vitamin D and increased risk for type 2 diabetes," said Myrlene Staten, M.D., D2d project scientist at NIDDK. "Additionally, smaller studies found that vitamin D could improve the function of beta cells, which produce insulin. However, whether vitamin D supplementation may help prevent or delay type 2 diabetes was not known."

The study screened participants every three to six months for an average of 2.5 years to determine if diabetes had developed. Researchers then compared the number of people in each of the two study groups that had progressed to type 2 diabetes. At the end of the study, 293 out of 1211 participants (24.2%) in the vitamin D group developed diabetes compared to 323 out of 1212 (26.7%) in the placebo group - a difference that did not reach statistical significance. The study was designed to detect a risk reduction of 25% or more.

D2d enrolled a diverse group of participants with a range of physical characteristics, including sex, age, and body mass index, as well as racial and ethnic diversity. This representation helps ensure that the study findings could be widely applicable to people at high risk for developing type 2 diabetes.

"In addition to the study's size, one of its major strengths is the diversity of its participants, which enabled us to examine the effect of vitamin D across a large variety of people," said lead author Anastassios G. Pittas, M.D., principal investigator from Tufts Medical Center, Boston. "When the study ended, we found no meaningful difference between the two groups regardless of age, sex, race or ethnicity."

More than 50% of adults in the United States take nutritional supplements and use of vitamin D has increased substantially over the last 20 years. Because of these trends, the study also evaluated the safety of taking 4,000 units of vitamin D daily -- greater than the average daily recommended dose of 600-800 IUs a day, but within limits deemed appropriate for clinical research by the Institute of Medicine. The researchers saw no difference in the number and frequency of predicted side effects such as high blood calcium levels and kidney stones when they compared the vitamin D and placebo groups.

"As we learned from the NIDDK-funded Diabetes Prevention Program (DPP), type 2 diabetes is not a foregone conclusion, even for those at high risk for the disease," said NIDDK Director Griffin P. Rodgers, M.D. "While we continue to search for new ways to prevent the disease, we know that lifestyle change or the drug metformin remain effective methods to prevent type 2 diabetes. We encourage the 84 million U.S. adults at high risk for developing type 2 diabetes to explore options like the CDC's National DPP, available to communities throughout the country."

D2d (ClinicalTrials.gov No. NCT01942694) was supported under NIH award U01DK098245, primarily funded by NIDDK, with additional support from the NIH Office of Dietary Supplements and the American Diabetes Association. Support in the form of educational materials was provided by the National Diabetes Education Program, a joint program of the NIH and Centers for Disease Control and Prevention.

Although artificial intelligence (AI) often comes to mind when we think of the future of work, there is also a vibrant conversation about the structure of work and where work is going to be completed.

The gig economy refers to a work context that consists primarily of short-term independent freelance workers contracting with organizations or selling directly to the market. The gig economy has become an increasingly popular topic of conversation with estimates placing the number of gig workers in the U.S. economy between 19.1 to 56.7 million individuals. Related to the future of work, this topic was recently identified as #4 on the Society for Industrial and Organizational Psychology's (SIOP) 2019 Top Ten Workplace Trends: http://ow.ly/m2aF50uy8A1

The newest white paper, "The Gig Economy: An Overview and Set of Recommendations for Practice," fits the broader discussion about the future of work. Research suggests future work is going to be highly individualized with more talent entering the "gig economy" and choosing--and in some cases, being pushed--to work independent of traditional organizations. We can attribute this sudden eruption of the gig economy mostly to online marketplaces where organizations of all sizes, as well as individuals, can post short-term, project-based work and workers can either, depending on the site and level of skill required, immediately take the project or independently bid on it.

Written by SIOP member Emily D. Campion, assistant professor at Old Dominion University, this white paper provides an overview to help organizations and individuals understand the gig economy and answers several pressing questions related to the gig economy. It offers a set of recommendations for organizations seeking to utilize this form of employment as well as for individuals who are currently employed or seeking to be employed with the gig economy.

SAN ANTONIO - Preliminary results from a new study suggest that there is a dose-response relationship between insufficient sleep and mental health symptoms in collegiate students, including varsity athletes.

Results show that in adjusted models, insufficient sleep was associated with all mental health variables, and a dose-response relationship resulted when insufficient sleep was treated as categorical. With every additional night of insufficient sleep, the risk of experiencing mental health symptoms increased on average by more than 20% - including an increased risk of 21% for depressed mood, 24% for hopelessness, 24% for anger, 25% for anxiety, 25% for desire to self-harm, 28% for functional problems, and 28% for suicide ideation.

"It was really surprising to see how strongly insufficient sleep was associated with a wide variety of mental health symptoms among college students," said lead author Thea Ramsey, an undergraduate student at the University of Arizona in Tucson. "Also, it was intriguing that while student-athletes experienced on average fewer nights of insufficient sleep and better mental health, the relationship between insufficient sleep and mental health was as strong or stronger in athletes compared to non-athletes."

Data were aggregated from the 2011-2014 waves of the National College Health Assessment, conducted by the American College Health Association. The analysis involved 110,496 individuals who provided complete data, including 8,462 varsity athletes. Insufficient sleep was assessed as the number of nights students did not "get enough sleep so that you felt rested when you woke up." Mental health symptoms were assessed as the presence of symptoms in the past 30 days. Adjusted models controlled for age, sex, race/ethnicity, and survey year. Additional models included controls for insomnia and depressed mood.

"The fact that sleep health was so strongly related to mental health is important since the majority of college students don't get the recommended amount of sleep needed for optimal health and functioning," said senior author Michael Grander, Ph.D., advisor to Ramsey and director of the Behavioral Sleep Medicine Clinic at the University of Arizona. "So, these young adults aren't sleeping enough, and not only does that increase their likelihood for things like worse academic performance and health, but it also takes a toll on their mental health as well."

According to the authors, mental health efforts on campuses should focus on achieving sufficient sleep.

The American Academy of Sleep Medicine recommends that adults 18 years and older should sleep 7 or more hours per night on a regular basis to promote optimal health. However, insufficient sleep is common among college students, and especially among those who are athletes. A previous study of collegiate athletes at one university found that 39% regularly slept less than 7 hours on weeknights.

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Tuesday, June 11, in San Antonio at SLEEP 2019, the 33rd annual meeting of the Associated Professional Sleep Societies LLC (APSS), which is a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

SAN ANTONIO - Preliminary results from a new study indicate that a mere 1% of U.S. social service policies impacting children include material regarding healthy sleep education and promotion.

Results show that healthy sleep was included in only seven of 513 (1%) of the policies targeted in the review of the following social service programs: Special Supplemental Nutrition (WIC), Healthy Start, Head Start, Children's Health Insurance and Medicaid, Child Welfare, and Juvenile Justice. While Healthy Start provided the most mentions (four) of healthy sleep in manualized educational information related to infant safe sleep, no other programs provided healthy sleep education or promotion for older children above 5 years of age. Child Welfare and Juvenile Justice policy advised on compliance-driven sleep standards, such as providing available space and beds to children and youth.

"We were surprised at the scarcity of healthy sleep-related information in the current social policies impacting vulnerable children in the United States," said principal investigator and lead author Abhishek Pandey, M.D., a physician scientist and affiliated faculty at the University of South Florida in Tampa. "No studies have previously examined these programs through a social justice policy lens and identified ways to promote healthy sleep."

Pandey conducted the study with co-principal investigator Kerry Littlewood, Ph.D., who is also faculty at the University of South Florida School of Social Work. Other collaborators were: Lawrence Cooper, LCSW, The Children's Home; Shima Carter, MSW, AAJ Research & Evaluation; Michelle Rosenthal, Ph.D., Data with Purpose; and Rusty Bennett, Ph.D., MSW, Collaborative Solutions, Inc.

Littlewood and Carter conducted a thematic and content analysis of 513 administrative program policies and manuals from large social service systems with programs serving more than 22.3 million vulnerable children and families facing adverse childhood experiences and health disparities. Their analysis assessed for the inclusion of healthy sleep education or promotion methods.

The authors also used Bardach's eightfold path method of policy analysis to examine policy options related to healthy sleep promotion and identify targets for intervention. They determined that the most viable touchpoints for sleep promotion in child-related social policy are benefit re-enrollment, intake, home visits, home safety assessments, family team meetings, and case closure visits.

According to the authors, they coined the "Sleep Promotion Policy Practice" as a strategy to encourage healthy sleep practice in policies, procedures, guidelines, manuals, supplemental documents and other information that provides guidance to front-line social workers, who tend to get very little guidance on how to promote healthy sleep among the vulnerable children and families they serve.

"These results impact the most vulnerable, low-income children and families, who are often experiencing trauma," said Pandey. "Intentionally integrating healthy sleep education and promotion into existing programs may be an essential intervention for trauma-informed care. Future studies could use the policy recommendations of this study to improve the integration of healthy sleep into our training and Sleep Promotion Policy Practice."

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Sunday, June 9, in San Antonio at SLEEP 2019, the 33rd annual meeting of the Associated Professional Sleep Societies LLC (APSS), which is a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

Last year at SLEEP 2018 in Baltimore, Pandey presented data from a study showing that there are no state child welfare administrative policies specifically promoting healthy sleep.

Older forests in eastern North America are less vulnerable to climate change than younger forests - particularly for carbon storage, timber production, and biodiversity - new University of Vermont research finds.

The study, to be published in Global Change Biology's June 12 edition, analyzed how climate change is expected to impact forests across the eastern United States and Canada. It found that increased forest age reduces the climate sensitivity of forest carbon, timber, and biodiversity to projected increases in temperature and precipitation. In other words, increased age helps to safeguard forests from climate change.

"This study shows that older forests in the Upper Midwest to New England are uniquely resilient to climate," says Dominik Thom, lead author and postdoctoral researcher in UVM's Rubenstein School of Environment and Natural Resources and Gund Institute for Environment. "Our finding that essential services are better protected against climate change by older forests is a milestone in the debate on how to prepare our forests for the uncertain environmental conditions ahead."

Analyzing large amounts of field data from 18,500 forest plots - from Minnesota to Maine, and Manitoba to Nova Scotia - the study identifies priority regions for forest climate adaption efforts. Younger forests east and southeast of the Great Lakes were less resilient to climate change, showing projected declines in carbon storage, timber and biodiversity.

"Our study identifies opportunities to make forest management more adaptive to global change," says William Keeton, forestry professor in UVM's Rubenstein School and Gund Institute. "This could include enhancing older forest conditions on landscapes within reserves, for example, and using extended cutting cycles and restorative forestry practices in working forests."

While the study found that forests' climate resiliency increased with age, scientists often characterize older forests as over the age of 150 years. Older forests are more structurally complex, with trees growing at multiple heights and larger canopy gaps, which free up growing space and increasing light availability for a mix of species.

"This research presents new and entirely novel findings that are sure to push the needle in our understanding of forest dynamics," says William Keeton. "The types of ecosystem services and biodiversity provided on forested landscapes today are likely to change dramatically into the future, both as forests age and our climate changes -- a message relevant to anyone interested in forests."

The study highlights the promise of experimental efforts at UVM to accelerate old-growth forest conditions by mimicking natural forest disturbances.