Body

Researchers observed seasonal variations in the risk of the hypertensive disorders of pregnancy--including gestational hypertension and preeclampsia--in a study of Danish women. In the Acta Obstetricia et Gynecologica Scandinavica study, the highest risk for hypertensive disorders was seen in pregnancies conceived during spring and summer.

Of 50,665 women included in the study, 8.5% were diagnosed with a hypertensive disorder of pregnancy. There appeared to be increasing risk when conceiving during the spring and early summer, peaking midsummer, and subsequently decreasing steadily during the autumn to reach a low by winter. Seasonal variations in vitamin D levels may help to explain these findings.

"Our results are of great interest, as vitamin D may have caused the observed seasonal variation in the hypertensive disorders. It has long been assumed that vitamin D affects the pathogenesis of hypertensive disorders of pregnancy--including preeclampsia--and our results support this hypothesis," said lead author Christine Rohr Thomsen, of Aarhus University Hospital, in Denmark.

Higher levels of abdominal fat were linked with reduced cognitive function in a Clinical Obesity study of older Asians with type 2 diabetes--even in individuals with normal weight.

In the 677-participant study, higher abdominal fat--or visceral adiposity--was associated with lower scores related to memory and language.

"Preserved cognitive functioning is important in the execution of complex task such as diabetes self-care management. Therefore, assessment of visceral adiposity and interventions that target visceral adiposity may help to prevent cognitive decline in older patients with diabetes and reduce the global burden of dementia in ageing populations," the authors wrote.

Use of the pain medication tramadol was linked with a higher risk of hip fractures compared with the use of other pain medications in an analysis of a patient database from the United Kingdom.

The analysis, which is published in the Journal of Bone and Mineral Research, compared tramadol use with codeine, naproxen, ibuprofen, celecoxib, and etoricoxib use among adults aged 50 years or older.

During one-year follow-up, 518 hip fractures occurred among 146,956 patients taking tramadol, corresponding to approximately one additional new hip fracture per 1000 person-years relative to taking codeine (3.7 vs. 2.9, respectively). Likewise, up to 1.5 additional new fractures per 1000 person-years occurred with tramadol than with naproxen, ibuprofen, celecoxib, and etoricoxib.

"Considering the significant impact of hip fracture on morbidity, mortality, and healthcare costs, our results point to the need to consider tramadol's associated risk of fracture in clinical practice and treatment guidelines," said corresponding author Guanghua Lei, MD, PhD, of Xiangya Hospital, Central South University.

WASHINGTON - A teenage girl with no hint of prior asthma or respiratory illness began to feel hoarseness in her throat and a feeling that she needed to clear her throat frequently. Within a few weeks, her hoarseness and throat-clearing worsened with early morning voice loss and feeling as if food were lodged in her throat. She started having trouble swallowing and began to avoid food all together.

Her pediatrician prescribed loratadine for suspected allergies to no avail. Days later, an urgent care center prescribed a three-day course of prednisone. For a few days, she felt a little better, but went back to feeling like she was breathing "through a straw." After going to an emergency room with acute respiratory distress and severe difficulty swallowing, staff tried intravenous dexamethasone, ampicillin/sulbactam, and inhaled racemic epinephrine and arranged for transfer.

When she arrived at Children's National Hospital, a multidisciplinary team continued the detective work with additional testing, imaging and bloodwork.

Examining her throat confirmed moderate swelling and a partially obstructed airway draped with thick chartreuse-colored mucus. The teen had no history of an autoimmune disorder, no international travel and no exposure to animals. She had no fever and had received all her scheduled immunizations.

"With epiglottitis - an inflammation of the flap found at the base of the tongue that prevents food from entering the trachea - our first concern is that an underlying infection is to blame," says Michael Jason Bozzella, D.O., MS, a third-year infectious diseases fellow and lead author of the case report published Feb. 5, 2020, in Pediatrics. "We tested her specimens in a number of ways for a host of respiratory pathogens, including human rhino/enterovirus, respiratory syncytial virus, influenza, Epstein-Barr virus, Streptococcus and more. All negative. We also looked for more atypical infections with bacteria, like Arcanobacterium, Mycoplasma and Gonorrhea. Those were all negative as well," Dr. Bozzella adds.

She slowly improved during a seven-day initial hospital stay, though soon returned for another six-day hospital stay after it again became excruciatingly painful for her to swallow.

Every throat culture and biopsy result showed no evidence of fungal, bacterial or viral infection, acid-fast bacilli or other malignancy. But in speaking with doctors, the teen had admitted to using candy-and fruit-flavored e-cigarettes three to five times with her friends over the two months preceding her symptoms. The last time she vaped was two weeks before her unusual symptoms began.

According to the Centers for Disease Control and Prevention, 2,668 people in the U.S. have been hospitalized for e-cigarette or vaping product use-associated lung injury, as of Jan. 14, 2020. The Children's National case report's authors say the increasing use of vaping products by teenagers highlights the potential for unknown health risks to continue to grow.

"This teenager's use of e-cigarettes is the most plausible reason for this subacute epiglottitis diagnosis, a condition that can become life-threatening," says Kathleen Ferrer, M.D., a hospitalist at Children's National and the case report's senior author. "This unusual case adds to a growing list of toxic effects attributable to vaping. While we normally investigate infectious triggers, like Streptococci, Staphylococci and Haemophilus, we and other health care providers should also consider e-cigarettes as we evaluate oro-respiratory complaints."

CLEVELAND, Ohio (February 5, 2020)--Hormone therapy has proven to slow down heart fat deposition and the progression of atherosclerosis, depending on the type of hormone therapy and route of administration. A new study compared the effects of conjugated equine estrogens (CEE) and 17β-estradiol and contrasted oral and transdermal delivery to determine their effectiveness in preventing heart disease. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

As women progress through the menopause transition, not only are they likely to accumulate more abdominal visceral fat, but fat deposition around the heart also increases. Heart fat deposition has been linked to atherosclerosis progression, which also increases between perimenopause and postmenopause.

A new study evaluated recently menopausal women who participated in the Kronos Early Estrogen Prevention Study (KEEPS) trial. Its purpose was to evaluate how various forms of estrogen, specifically oral CEE and transdermal 17β-estradiol, affected heart fat accumulation and atherosclerosis progression as measured by the thickness of the lining of the carotid arteries.

According to study results, when compared with transdermal estradiol, oral CEE appears to slow down the adverse effects of increasing paracardial adipose tissue on the progression of atherosclerosis. The researchers concluded that more study is required to confirm whether these results are specific to oral CEE or to the oral route of administration.

Study results appear in the article "Atherosclerosis progression in recently menopausal women: impact of menopausal hormone therapy: The KEEPS trial."

"This study shows a distinct effect of hormone therapy on the link between heart fat deposits and atherosclerosis progression, based on the type of estrogen or the route of administration used. Additional research is needed to allow clinicians to individualize hormone therapy prescribing to optimize benefit and minimize risk," says Dr. Stephanie Faubion, NAMS medical director.

Many children don't get enough exercise and as a result often have health problems such as being overweight and having high blood pressure. A research team from Martin Luther University Halle-Wittenberg (MLU) and the Medical School Berlin (MSB) has found that simple methods can be used to combat this. They integrated high-intensity interval training (HIIT) into standard physical education and observed improvements in children's health within a very short period of time.

High-intensity interval training (HIIT) alternates short phases of intense physical exercise with recovery periods. "The more intense the exercise, the greater the effects seem to be, even in children," says Dr Sascha Ketelhut from the Institute of Sports Science at MLU. It is not about how long you exercise, but rather about how intensively you exercise within a short period of time. "Interestingly, this form of intermittent exercise is precisely how children move naturally," says Ketelhut. Children do not have a natural propensity to go jogging for long distances. Instead, constantly alternating between intensive periods of exertion and short phases of recovery, like in games such as tag, is more in keeping with how children naturally move and play.

The effects of HIIT have been well studied in adults, but little research has been done on children outside of competitive sports. Therefore, a research team led by Ketelhut integrated the method into the regular physical education of third graders. For the first 20 minutes, normal physical education lessons were replaced by activities involving intense movement, such as relay races with short sprints or circuit training, which was repeatedly punctuated by short recovery periods. "We tried to select intensive forms of exercise that were also fun," says Ketelhut. The training sessions were often accompanied by music and choreography. The study only ran for three months but was able to produce noticeable outcomes during this time. Both endurance performance and blood pressure improved significantly during the trial period. Ketelhut believes that this will also help prevent long-term health issues. "High blood pressure as a child often leads to high blood pressure as an adult."

According to Ketelhut, the results support the idea of integrating HIIT into regular physical education lessons since the training method is effective and suitable for children, and it motivates them to exercise. The training can easily be incorporated into a standard sports curriculum as it is not very time-consuming.

A study by researchers from the Department of Psychiatry at the University of Granada (UGR) has analysed the effects of a gluten-free diet and a casein-free diet (that is, one with no milk protein) on the behavior of children diagnosed with autism-spectrum disorders.

Given the limitations of attempts to treat such disorders, many families turn to alternative therapies. Among these, gluten- and casein-free diets implemented as a therapeutic approach in autism-spectrum disorders have been the subject of significant interest and controversy in scholarly research. Some authors have found such diets to have favourable effects on the symptoms of autism, while others--particularly the more recent studies--have found no conclusive results.

Research conducted at the UGR reaffirms that gluten- and casein-free diets are not helpful as a standardised treatment for all children diagnosed with an autism-spectrum disorder. It may be that those cases with associated gastrointestinal disorders may benefit from such an approach.

Beta-casomorphin is a peptide (amino acid binding), so-called for its morphine-like opioid activity, which is formed in the intestine due to abnormal digestion of cow's milk protein (casein). People with autism-spectrum disorders may present an abnormal porosity in the intestinal barrier that enables beta-casomorphin to penetrate the barrier, enter the blood circulation and, from there, reach the central nervous system, producing a toxic effect. Some scientists who have identified peptiduria (the abnormal presence of peptides in the urine) in children with autism-spectrum disorders have detected a reduction of these peptides in subjects who have followed the gluten- and casein-free diet.

The primary aim of this research was twofold: to determine if gluten- and casein-free diets decrease behavioural disorders among children and adolescents diagnosed with autism-spectrum disorders; and to examine whether there is a link between possible behavioural changes after implementing this diet and levels of beta-casomorphin found in urine.

Two studies and a sample of over 60 young people

The UGR research comprised two studies. First, a pilot clinical assay was carried out on 28 children and adolescents diagnosed with autism-spectrum disorders, who followed a gluten-free diet for three months and then switched to a casein-free diet for a further three months.

Next, a second study was initiated, funded by the Spanish Association of Child and Adolescent Psychiatry (AEPNyA), in which 37 children and adolescents diagnosed with autism-spectrum disorders participated. This sample followed the same procedure, except for a longer duration (one special diet for six months, then the other special diet, again for six months). Variables relating to the efficacy, risk, and safety of following these diets were studied.

In neither of the two studies (3 + 3 months vs. 6 + 6 months) were significant changes detected either in the behavioural scales or in the beta-casomorphin levels in urine after the subjects had followed the gluten-free and the casein-free diet.

The principal investigator on this project, Pablo José González Domenech, of the Department of Psychiatry of the UGR, notes that further research is necessary. In addition to eliminating gluten and casein for a sufficient period of time (at least six months), future studies should include placebo and double-blind elements, as well as other biological markers to better define the subjects who may benefit from these diets.

To identify potential users, it would be interesting to include among the evaluation criteria measurements of intestinal permeability, examinations of intestinal bacterial populations, and gastrointestinal enzymatic and inflammatory activity, and to conduct brain imaging tests for the study of possible structural and functional changes.

According to the World Health Organization, malaria is responsible for over 400,000 deaths each year. Despite the progress made in fighting the disease in recent decades, some populations remain particularly vulnerable. One such population is pregnant women.

In the areas of the world where malaria is endemic, people acquire immunity throughout their childhood, meaning that they are generally protected against its most severe outcomes once they reach adulthood. However, pregnant women are an exception because the red blood cells infected with the Plasmodium falciparum parasite responsible for malaria accumulate in the placenta, promoting anemia and gestational hypertension. The disease is also linked to a higher risk of spontaneous abortion, premature birth and intrauterine growth delays which lead to low birth weight and a high rate of neonatal mortality. In Sub-Saharan Africa, 11 million pregnant women were infected with malaria in 2018, with around 900,000 of their babies born underweight.

To tackle this public health problem, a team of researchers from Inserm and Université de Paris led by CNRS Research Director Benoît Gamain has spent the past two decades developing a vaccine for gestational malaria. The goal is to prevent the deaths of up to 10,000 mothers and 200,000 babies each year. "Developing an effective vaccine for young women before their first pregnancy is a priority if we are to reduce malaria-related mortality. An effective strategy could focus on a population similar to that targeted by HPV vaccination, for example, before the women become sexually active", emphasizes Benoît Gamain.

A safe and effective vaccine

Called PRIMVAC, the vaccine had recently been produced in large quantities in accordance with current regulations. In a clinical trial published in Lancet Infectious Diseases, the researchers provide data on its safety and ability to induce an appropriate immune response, up to 15 months after the initial vaccination.

The vaccine was evaluated in 68 non-pregnant women aged 18 to 35 at the Cochin Pasteur Clinical Investigation Center in Paris, then at the National Center for Research and Training on Malaria (CNRFP) in Ouagadougou, Burkina Faso. The participants were randomly assigned to 4 cohorts, receiving the vaccine at various doses, on 3 occasions over a period of 3 months. These women were then monitored for 15 months in order to identify and treat any side effects and study the immune response induced by the vaccination.

The results of this study show that PRIMVAC is well tolerated. In addition, the researchers have shown that vaccine can produce an immune response, with the production of antibodies in 100% of women vaccinated after only two injections. The antibodies produced are capable of both recognizing the parasitic antigen on the surface of the infected red blood cells and inhibiting their adhesive capacity, which is responsible for their accumulation in the placenta.

"We were able to show that the vaccine is well tolerated, at all the tested doses. The side effects observed were mainly pain at the injection site. We also revealed that the quantity of antibodies generated by the vaccine increases after each vaccination and that they persist for several months. It therefore appears that the vaccine has the capacity to trigger a lasting and potentially protective immune response", underlines Gamain.

Studying this immune response on the longer term will be the subject of future clinical trials. The researchers want to continue monitoring the 50 Burkinabe volunteers in order to evaluate whether the immune response induced by the vaccination is maintained until their first pregnancy.

OAK BROOK, Ill. (February 4, 2020) - In a special report published today in the journal Radiology, researchers describe CT imaging features that aid in the early detection and diagnosis of Wuhan coronavirus.

"Early disease recognition is important not only for prompt implementation of treatment, but also for patient isolation and effective public health surveillance, containment and response," said the study's lead author, Michael Chung, M.D., assistant professor in the Department of Diagnostic, Interventional and Molecular Radiology in the Mount Sinai Health System in New York, N.Y.

On December 31, 2019, the World Health Organization (WHO) learned of several cases of a respiratory illness clinically resembling viral pneumonia and manifesting as fever, cough, and shortness of breath. The newly discovered virus emerging from Wuhan City, Hubei Province of China, has been temporarily named "novel coronavirus" (2019-nCoV). This new coronavirus belongs to a family of viruses that include Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

The outbreak is escalating quickly, with thousands of confirmed 2019-nCoV cases reported globally. On January 30, the U.S. reported the first confirmed instance of person-to-person spread of the virus.

In this retrospective case series, Dr. Chung and colleagues set out to characterize the key chest CT imaging findings in a group of patients infected with 2019-nCoV in China with the goal of familiarizing radiologists and clinical teams with the imaging manifestations of this new outbreak.

From January 18, 2020, until January 27, 2020, 21 patients admitted to three hospitals in three provinces in China with confirmed 2019-nCoV infection underwent chest CT. The 21 patients consisted of 13 men and 8 women ranging in age from 29 to 77 years old, with a mean age of 51.2 years. All patients were confirmed positive for infection via laboratory testing of respiratory secretions.

For each of the 21 patients, the initial CT scan was evaluated for the following characteristics: (1) presence of ground-glass opacities, (2) presence of consolidation, (3) number of lobes affected by ground-glass or consolidative opacities, (4) degree of lobe involvement in addition to overall lung "total severity score," (5) presence of nodules, (6) presence of a pleural effusion, (7) presence of thoracic lymphadenopathy (lymph nodes of abnormal size or morphology), and (8) presence of underlying lung disease such as emphysema or fibrosis. Any other thoracic abnormalities were also noted.

The analysis showed that 2019-nCoV typically manifests on CT with bilateral ground-glass and consolidative pulmonary opacities. Nodular opacities, crazy-paving pattern, and a peripheral distribution of disease may be additional features helpful in early diagnosis. The researchers also noted that lung cavitation, discrete pulmonary nodules, pleural effusions and lymphadenopathy are characteristically absent in cases of 2019-nCoV.

Follow-up imaging in seven of eight patients showed mild or moderate progression of disease as manifested by increasing extent and density of airspace opacities.

Dr. Chung cautioned that absence of abnormal CT findings upon initial examination does not rule out the presence of 2019-nCoV.

"Our patient population is unique from other published series on the Wuhan coronavirus in that three of our patients had normal initial chest CTs," he said. "One of these patients progressed three days later and developed a solitary nodular ground-glass lesion in the right lower lobe, indicating this pattern may represent the very first radiologically visible manifestation of disease in some patients infected with Wuhan coronavirus."

He added that a second patient had a normal follow-up chest CT four days after her initial normal imaging exam.

"This suggests that chest CT lacks complete sensitivity and does not have a perfect negative predictive value," Dr. Chung said. "We can't rely on CT alone to fully exclude presence of the virus."

This finding may be related to the fact that infection with 2019-nCoV is characterized by an incubation period of several days, and there may be a phase where viral infection manifests with symptoms prior to visible abnormalities on CT.

The researchers note that further study is required to understand how patients fare after treatment but suggest that experience and imaging findings from MERS and SARS epidemics might be helpful in managing the current outbreak.

Surgeons at UT Southwestern Medical Center have developed a process to determine the best approach for single breast reconstruction that involves mapping out prior to surgery which blood vessels to use in lower abdominal tissue to minimize the chances of complications or undesirable outcomes including partial tissue death known as fat necrosis, which can cause local pain and lumpiness. The results were published last month in the Journal of Reconstructive Microsurgery.

At UT Southwestern, before surgery patients routinely undergo computed tomographic angiography (CTA), a procedure that maps out where major blood vessels run in the abdomen. Typically, breast reconstructive surgeons use CTA to decide prior to surgery which blood vessels to use and assess the quality and caliber of the vessels. The UT Southwestern team uses these CTA maps to preplan both the blood vessels and the overall design of the pedicle flap that ultimately translates into shaping a breast that the patient will be happy with.

"Now we use the CTA results to have a conversation with the patient in clinic," says Sumeet S. Teotia, M.D., an associate professor of plastic surgery at UT Southwestern Medical Center and director of the breast-reconstruction program at UT Southwestern's Harold C. Simmons Comprehensive Cancer Center. "Reviewing the scans helps the patient see what we may encounter in surgery and gives them confidence going into the procedure. Potentially, we can reduce and even avoid long-term complications."

According to the experts, single breast reconstruction using one's own abdominal tissue can be particularly challenging in trying to match the existing breast in size and shape. This becomes more challenging in patients who do not have enough tissue in their abdomen for reconstruction, those whose intact breast is large or sags, or patients who have large abdominal scars. But mapping out which blood vessels need to be cut and reconnected and how to approach cutting the abdominal flap might be the trickiest part.

The team reviewed surgical approaches and results from patients at UT Southwestern who underwent so-called free flap breast reconstruction procedures from 2009-2017 and identified 512 patients, 150 of whom were included in this study. The mean age of this patient group was 57 and mean BMI was 27. Seventy-five patients underwent bilateral, single flap reconstruction and 75 underwent conjoined, stacked double-pedicle flap reconstruction. Most of these patients, 81 percent, underwent delayed reconstruction. The team found that the patients who underwent conjoined stacked double-pedicle flap reconstruction involved fewer blood vessels but also experienced less fat necrosis, 2.7 percent versus 14.4 percent in single flap reconstruction.

"The CTA scan allows us to visuospatially create a model of the breast in advance so we can be faster in the operating room. The surgeons still visually confirm the scan results during surgery, assuring a high degree of reliability," Teotia explains. "Our algorithm allows us to be anatomically strategic in choosing the best blood supply for that particular tissue; it is important to have optimal blood supply for the best results, which ultimately translates into an improved outcome and breast shape."

UCLA bioengineers and colleagues at UNC School of Medicine and MIT have further developed a smart insulin-delivery patch that could one day monitor and manage glucose levels in people with diabetes and deliver the necessary insulin dosage. The adhesive patch, about the size of a quarter, is simple to manufacture and intended for once-a-day use.

The study, published in Nature Biomedical Engineering, describes research conducted on mice and pigs. The research team, led by Zhen Gu, PhD, professor of bioengineering at the UCLA Samueli School of Engineering, is applying for FDA approval of clinical trials in humans. Gu and colleagues conducted the initial successful tests of the smart insulin patch in mice in 2015 in North Carolina.

"Our main goal is to enhance health and improve the quality of life for people who have diabetes," said Gu, a former professor in the UNC/NCSU Joint Department of Biomedical Engineering. "This smart patch takes away the need to constantly check one's blood sugar and then inject insulin if and when it's needed. It mimics the regulatory function of the pancreas but in a way that's easy to use."

The adhesive patch monitors blood sugar, or glucose. It has doses of insulin pre-loaded in very tiny microneedles, less than one-millimeter in length that deliver medicine quickly when the blood sugar levels reach a certain threshold. When blood sugar returns to normal, the patch's insulin delivery also slows down. The researchers said the advantage is that it can help prevent overdosing of insulin, which can lead to hypoglycemia, seizures, coma or even death.

"It has always been a dream to achieve insulin-delivery in a smart and convenient manner," said study co-author John Buse, MD, PhD, director of the UNC Diabetes Center and the North Carolina Translational and Clinical Sciences (NC TraCS) Institute at the University of North Carolina at Chapel Hill School of Medicine. "This smart insulin patch, if proven safe and effective in human trials, would revolutionize the patient experience of diabetes care."

Insulin is a hormone naturally produced in the pancreas helps the body regulate glucose, which comes from food-consumption and provides the body with energy. Insulin is the molecular key that helps move glucose from the bloodstream to the cells for energy and storage. Type 1 diabetes occurs when a person's body does not naturally produce insulin. Type 2 diabetes occurs when the body does not efficiently use the insulin that is produced. In either case, a regular dosage of insulin is prescribed to manage the disease, which affects more than 400 million people worldwide.

The treatment for the disease hasn't changed much in decades in most of the world. Patients with diabetes draw their blood using a device that measures glucose levels. They then self-administer a necessary dose of insulin. The insulin can be injected with a needle and syringe, a pen-like device, or delivered by an insulin pump, which is a portable cellphone-sized instrument attached to the body through a tube with a needle on the end. A smart insulin patch would sense the need for insulin and deliver it.

The microneedles used in the patch are made with a glucose-sensing polymer that's encapsulated with insulin. Once applied on the skin, the microneedles penetrate under the skin and can sense blood sugar levels. If glucose levels go up, the polymer is triggered to release the insulin. Each microneedle is smaller than a regular needle used to draw blood and do not reach as deeply, so the patch is less painful than a pin prick. Each microneedle penetrates about a half millimeter below the skin, which is sufficient to deliver insulin into the body.

In the experiments, one quarter-sized patch successfully controlled glucose levels in pigs with type I diabetes for about 20 hours. The pigs weighed about 55 pounds on average.

"I am glad the team could bring this smart insulin patch one more step close to reality, and we look forward to hopefully seeing it move forward to someday help people with diabetes," said Robert Langer, ScD, the David H. Koch Institute Professor at MIT and one of the paper's co-authors.

The technology has been accepted into the U.S. Food and Drug Administration's Emerging Technology Program, which provides assistance to companies during the regulatory process. The researchers are applying for FDA approval for human clinical trials, which they anticipate could start within a few years. The team envisioned that the smart microneedle patch could be adapted with different drugs to manage other medical conditions as well.

Despite claims that owning a gun makes a person feel safer and sleep easier, gun owners don't actually sleep any better than non-gun owners, according to a new study by University of Arizona researcher Terrence Hill.

Gun owners also aren't any happier than those who don't own guns, Hill found in a second study. That's surprising, he says, given that gun owners often say that their guns make them feel safe, secure and protected, and those feelings are generally associated with happiness.

The findings help researchers better understand the relationship between gun ownership and personal well-being, an area where research is currently lacking, said Hill, an associate professor of sociology in the College of Social and Behavioral Sciences.

"We want to understand gun owners' subjective experiences," Hill said. "We're trying to understand when guns promote individual well-being, if at all, and that will add to the discussion of the role of guns in our society."

Hill is quick to acknowledge that certain individuals may indeed experience greater happiness or better sleep as the result of owning a gun. However, that doesn't seem to hold true for the general population of gun owners.

"It's possible that an individual can be comforted by their weapon and that their weapon can make them happier and less afraid, but we're finding that that's not so common that it can be observable at a population level," Hill said. "We're not saying there's anything wrong with guns. We're just saying that they may not be benefiting people's personal lives in the way some people claim."

Happiness Findings Span Nearly Three Decades

The happiness study, published in the journal SSM - Population Health, is based on an analysis of 27 years of data from the National Opinion Research Center's General Social Survey, collected between 1973 and 2018.

While the data initially seemed to point to a positive relationship between gun ownership and happiness, that relationship disappeared when researchers factored respondents' marital status into their analysis. It turned out gun owners were more likely to be married, and being married - not gun ownership - was driving happiness.

When the researchers considered marital status and other variables such as race, religion and education in their analysis, gun owners and non-gun owners exhibited similar levels of happiness.

"Gun owners will often tell you that guns help them to feel safe, secure and protected. They will also tell you that guns empower them and make them feel independent and strong. They also talk about how just holding and handling guns is pleasurable," Hill said. "If guns do make people feel safe, secure and protected, if they are empowering, if they are contributing to feelings of pleasure, then they should promote happiness, but we don't find any evidence of that. That calls into question whether or not these are real feelings that gun owners have, or are they just part of the culture of owning a gun?"

There was one sub-group of gun owners that did show greater happiness. Hill found that gun ownership was associated with greater happiness among people who identified as Democrats, but not among people who identified as Republican or Independent, although that trend has been declining over time.

One possible explanation for the difference could be that Democrats and Republicans may own guns for different reasons, Hill said.

"Some people use guns to enhance a recreational lifestyle - for activities like target shooting - and this might promote happiness because it enhances a lifestyle," Hill said. "Gun owners who identify as more liberal or democratic may be more likely to use guns for that reason as opposed to emphasizing self-defense. There is previous research that shows Democrats are less likely than Republicans to own a gun for protection."

Commercial Products Promise Gun Owners Better Sleep

The sleep study, published in the journal Preventive Medicine, was based on four years of data collected for the General Social Survey between 2010 and 2018. The data showed no difference between gun owners and non-gun owners in terms of their level of sleep disturbance.

The researchers also looked at how participants felt about the safety of their neighborhoods. When they compared sleep disturbance in gun owners and non-gun owners who lived in dangerous neighborhoods, they again saw no difference.

"We found that gun ownership was no consolation for living in a dangerous neighborhood in terms of the sleep disturbance outcome," Hill said.

Hill said the idea that guns can help people sleep better at night is often presented by interest groups, popular culture and even commercial products, such as bedside gun holsters or special pillows with gun compartments that allow people to sleep with or near their weapon. As a medical sociologist, Hill said it's his job to question those types of claims through research.

"Whenever people start to promote a certain type of lifestyle - like a type of exercise or a diet - public health is there to test it," he said. "We think if anybody makes a claim about how guns are good for people's health and wellbeing, those claims should be formally tested with empirical data. We need to test those claims like we would test any dietary or exercise recommendation."

Hill says he hopes his continued research on guns and personal well-being will encourage greater public conversation about the role of guns in society.

"Public health research has shown that guns are associated with thousands of preventable injuries and premature deaths, and the health care costs of those injuries and deaths can reach into the billions. Nobody questions that anymore," Hill said. "But there's not much research out there on the personal well-being side of owning guns. We want people to start talking more about the role of guns in people's personal lives, and, ultimately, this is a broader question for society about the value of guns in our lives. The question really is: Do guns make our personal lives better?"

A newly published study in JAMA shows that people with neurological disorders have a 75% higher suicide rate than people with no neurological disorders. Still, suicide deaths are rare events. While the suicide rate for the general population is around 20 per 100,000, the rate for people with neurological disorders is around 40 per 100,000 person-years. The study is based on the data covering the entire population of Denmark and followed over 37 years.

The researchers found that one out of 150 persons diagnosed with a neurological disorder dies by suicide. For severe neurological diseases, such as Huntington's, one out of 61 diagnosed went on to die by suicide. This study is the most comprehensive assessment of neurological disorders' link to suicide conducted to date.

- This is the first time we have examined this many different neurological disorders to gain a more detailed understanding of when risk of suicide is pronounced. These insights can help us shape dedicated preventive effort says Dr. Annette Erlangsen, lead author and senior researcher at Danish Research Institute for Suicide Prevention (DRISP).

As much as 5 times higher suicide rates

The study shows that people who have been diagnosed with amyotrophic lateral sclerosis (ALS) or Huntington's disease have a particular high risks, as the suicide rate associated with these disorders is 4-5 times higher than in the general population.

Furthermore, people who have been exposed to traumatic brain injury, multiple sclerosis, or epilepsy have a suicide rate, which is double the level of the one found among those with no such disorders.

- There may be several and co-exiting explanations for the excess suicide rate. People may have difficulties understanding and coming to terms with the consequences of a newly diagnosed chronical disorder. In addition, mental disorders as well as social and relationship factors may play a role, explains Dr. Elsebeth Stenager, a professor in social psychiatry at University of Southern Denmark.

Changes in risk

Often risk of suicide has been associated with psychiatric mental but this new study shows that also neurological disorders are linked to an elevated suicide rate. It is even possible that undiagnosed mental disorders may account for some of this excess risk.

- The elevated risk appears at different stages during the course of the disorders. For example, people with dementia were found to have a 2-3 time higher suicide rate during the first three months after being diagnosed. On the other hand, people who had been diagnosed with dementia more than a year ago were found to have a lower suicide rate than the general population, explains Dr. Egon Stenager, a clinical professor in neurology at University of Southern Denmark.

He and the research team cannot yet explain why these differences in risk of suicide are observed. However, it seems to be related to the type of disorder, the progress of the disease and what treatment options exist.

Development of preventive initiatives

The research team behind the study consisted of international experts on neurology, psychiatry, and suicide prevention. By using unique linkable, Danish record data, it was possible to calculate exact suicide rates for rate disorders, such as ALS and Huntington's disease. It is expected that the findings will be of great benefit for future interventions.

Further analyses will be needed to identify how risks of suicide may best be address for individual disorders. Annette Erlangsen explains that the goal for this first step was to identify, which disorders ought to be addressed by preventive efforts. The next steps are to consider at what time and how intervention should be offered.

Facts:

The study is based on data covering 7.3 Danes during 1980-2016.

The research team linked data on hospital contacts, causes of death and socio-demographic information for the entire population of Denmark.

Some of the neurological disorders that were examined:

Head injury

Apoplexy

Epilepsy

Polyneuropathy

Myasthenia gravis

Parkinson

Multiple Sclerosis

Centrale nervous system infections

Meningitis

Encephalitis

Amyotrophic lateral sclerosis (ALS)

Huntington's disease

Dementia

Intellectual disabilities

In the first comprehensive study mapping global patterns of stillbirth rates, University of Saskatchewan (USask) researchers have found that pregnant women who are poor and have lower access to education and employment are more likely to experience a child's death at delivery.

"Our research offers a better understanding of where stillbirth rates are higher, and what the social causes underlying stillbirths are, not just taking into account the medical factors as most studies do," said USask community health and epidemiology researcher Nazeem Muhajarine, whose findings have been recently published in Nature Scientific Reports.

The model developed by the USask researchers shows that stillbirths are more likely in countries where gender inequality is high--where women experience financial challenges and have less access to education and employment opportunities compared to men.

While stillbirth rates are relatively understudied, according to the World Health Organization every year almost three million children reportedly die before or at delivery, but the majority of these deaths are preventable.

"Many mothers-to-be experience stillbirths around the world and this loss takes a personal toll on the families and the women who are preparing to give birth and see their dreams dashed. We hope we will help these women with our research," said Muhajarine.

Focusing on data from 194 countries, Muhajarine and his PhD student Daniel Adeyinka's model shows which social causes in addition to gender inequality have a potential link to stillbirth rates worldwide. They found that stillbirths rates are more likely in countries where pregnant women have higher rates of anemia (iron deficiency caused by low nutrition), limited pre-birth healthcare, and lack of access to skilled professionals such as nurses, midwives or doctors for delivering the babies.

"We hope that our study will provide policy makers with information for improving women's social conditions so that fewer and fewer women will experience stillbirths around the world," said Adeyinka.

The USask model, which used novel artificial intelligence software, also mapped the "hot spots" of highest stillbirth rates, a cluster of 37 countries in Africa and Southern Asia. Nigeria and Pakistan led with 43 deaths for every 1,000 children born. This is an average four times higher than the 2030 national target of 12 deaths per 1,000 births of the World Health Assembly Every Newborn Action Plan (WHA ENAP). The researchers also identified "cold spots" of low stillbirth rates, mostly in in Canada, Europe and Northern Asia, oscillating between one and 12 deaths per 1,000 births.

"A cultural change is needed in 'hot spot' countries around women's conditions," said Muhajarine. "Not only should we offer better hospital services and more access to skilled healthcare professionals, but we also need to make sure that women and girls have access to enough food, better education and work opportunities, and are not married off too early."

Muhajarine and Adeyinka ran simulations to predict how to improve children's survival at birth, especially in "hot spot" countries. The researchers found that to decrease stillbirths worldwide by 44 per cent would require improving women's access to education and by 51 per cent, and improving mothers' nutrition by 59 per cent compared to current worldwide rates.

The researchers also recommend that pregnant women should have more access to pre-birth health services and skilled healthcare professionals at delivery--an average increase of 27 per cent on healthcare services and 26 per cent on access compared to current rates.

Adeyinka will apply this study to design recommendations that could inform policy makers in Nigeria, his home country, where stillbirths are the second highest in the world.

"The time to act is now," said Adeyinka. "Stillbirths are more expensive than successful deliveries. On top of saving lives, if we lower stillbirths, the money could be invested in improving mothers and children's health and on the healthcare system as a whole, including in Nigeria."

New Orleans, LA - A study analyzing LSU Health's Louisiana Tumor Registry and other NCI-designated tumor registry data found that by the time recommended screening for colorectal begins, cancers have already spread in a high percentage of people. Results report that the rate of colorectal cancer incidence increased by 46.1% from 49 to 50 years of age (the age recommended to start routine colorectal cancer screening) and that 92.9% of the cases of colorectal cancer diagnosed at age 50 were invasive (localized, regional or distant stage.) The study is published in JAMA Network Open, available here.

"The findings of this study indicate that the burden of early-onset of colorectal cancer incidence for 45-49-year olds has been underestimated because asymptomatic colorectal cancers were not detected due to lack of screening," notes Xiao-Cheng Wu, M.D., Professor and Director of the Louisiana Tumor Registry at LSU Health New Orleans School of Public Health.

Data from the National Cancer Institute's Surveillance, Epidemiology & End Results (SEER) 18 registries, representing 28% of the U.S. population, were used to conduct a cross-sectional study of colorectal cancer incidence rates from January 1, 2000, to December 31, 2015, in 1-year age increments (ages 30-60 years) stratified by US region (South, West, Northeast and Midwest), sex, race, disease stage, and tumor location. Statistical analysis was conducted from November 1, 2018, to December 15, 2019. LSU Health New Orleans' Louisiana Tumor Registry is one of the 18 SEER registries. The research team, led by Dr. Jordan Karlitz of the Southeast Louisiana Veterans Health Care System and Tulane University, along with LSU Health New Orleans Louisiana Tumor Registry staff, analyzed a total of 170,434 cases of colorectal cancer. They found steep increases in the incidence of colorectal cancers from 49 to 50 years of age.

The U.S. Preventive Services Task Force recommends screening beginning at age 50.

"As the diagnosis of many of these colorectal cancers was delayed to ages after 50, advanced stage was more likely present at diagnosis," adds Dr. Wu. "This study provides useful evidence for improving colorectal cancer screening policy."