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Boston, MA -- At least one in five cases of infertility remain unexplained. Male factors contribute to about half of these cases and, much of the time, men lack a specific causal diagnosis for their infertility. Researchers estimate that genetics could explain up to 50 percent of these cases, but many of the genes involved in male infertility remain unknown. A new study led by investigators at Brigham and Women's Hospital identifies a genetic abnormality that may be at fault. Investigators have found that a genetic rearrangement and variants affecting a gene known as SYCP2 are associated with low sperm count and report the first cases implicating the gene in four men with infertility.The team's findings are published in the American Journal of Human Genetics.

"We hope that our evidence will contribute to this gene being in panels for diagnosis of male infertility," said corresponding author Cynthia Morton, PhD, medical geneticist at the Brigham. "Infertility is a big problem for young people, and 40 to 72 percent of men lack a diagnosis. This means that we have a lot of gene finding to do. My lab has a longstanding interest in studying individuals who have a balanced chromosome rearrangement where two chromosome segments swap places. In this case, it led us to an important discovery."

Morton, former graduate student and first author Samantha Schilit, PhD, and colleagues from Harvard Medical School and Wesleyan University began the work that would lead them to SYCP2 when a physician referred a case to them. Known as DGAP230, the subject was studied as part of the Developmental Genome Anatomy Project (DGAP), an initiative Morton began in 1999 to understand the genetic basis of birth defects and underlying molecular basis of development. By age 28, DGAP230 had a two-year history of infertility and severely low sperm count. By analyzing his chromosomes, Schilit, Morton and colleagues found that the subject had a balanced chromosomal rearrangement on chromosomes 20 and 22. The team discovered that this genetic abnormality led to a 20-fold increase in the activity of SYCP2. Through a series of elegant experiments involving yeast and cellular models, the researchers went about analyzing the impact of this change in SYCP2 activity.

"Balanced chromosomal rearrangements in infertile men are rarely followed up beyond reporting a risk for segregation of unbalanced gametes, which can lead to recurrent miscarriage. This work shows that a chromosomal rearrangement may also disrupt or dysregulate genes important in fertility, and therefore should be considered," said Schilit.

In addition, the researchers looked for other cases of SYCP2 contributing to male infertility. To do so, they collaborated with investigators at the University of Münster who had enrolled men with infertility in a separate study. The team's search revealed three men with loss-of-function variants in SYCP2. Disruptions in SYCP2 were far more frequent among men with infertility than in the general population.

Morton notes that while the discoveries about SYCP2 may help inform diagnosis, implications for treatment remain to be determined.

"A diagnosis can be therapeutic in itself -- even if there isn't something that can be done to correct it. It ends the search for the underlying issue and opens the door for enrolling in clinical trials," said Morton. "And I believe there is good reason to be optimistic; we now have better tools for discovery and can begin on the path toward therapy."

BOSTON - In response to the pressing public health issue of vaping, clinicians of all disciplines are being asked to address this issue with youth, families and community members, despite minimal youth-focused screening or treatment guidelines. Physicians from Boston Medical Center and the University of Montreal have developed a set of recommendations that provide important insights about how clinicians can best screen, counsel and treat youth for vaping. Published in the Journal of Adolescent Health, the recommendations were created based on existing resources for nicotine dependence. Well-studied models used for screening youth for tobacco, including tools such as Screening to Brief Intervention (S2BI) and the Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD) can be adapted to inquire about e-cigarettes and other vaping products.

Given the quickly-evolving vaping products, the guidelines emphasize the importance of providers speaking with their patients using youth-friendly terminology when asking them about vaping (using terms like pods, mods, vapes and vape pens - and not simply "e-cigarettes"). It is also important to ask about the products that youth are using (brands like JUUL are known to contain a high concentration of nicotine), where they were purchased (illicit products have a higher risk of associated health risks), and what substances are in the product (nicotine, tetrahydrocannabinol [THC], and/or flavoring). This is especially important given a new harm attributed to vaping, seizures, which is described in the same issue of the Journal of Adolescent Health.

"Staying informed on recent developments, asking the right questions, and offering effective intervention to youth who vape is suggested for all clinicians to help mitigate the impacts of the vaping crisis," said Scott Hadland, MD, MPH, MS, a pediatrician and addiction specialist at Boston Medical Center's Grayken Center for Addiction who is the paper's corresponding author. He is also an assistant professor of pediatrics at Boston University School of Medicine.

The context of vaping, intensity and frequency of use is important to fully understand the extent of health risks and to address treatment options for those that are experiencing cravings and withdrawal. More serious symptoms such as loss of control, social impairment, unsafe use, or physiological dependence are associated with a diagnosis of a moderate or severe substance use disorder (SUD). Earlier identification and treatment is important, as severe SUD may be more difficult to treat and require multiple approaches and interventions.

The commentary highlights a five-step algorithm that is suggested for counselling youth on their substance use. Clinicians should be routinely asking all youth if they vape, advise them to quit, assess their motivations and readiness to quit, assist their cessation effort, and arrange for ongoing follow-up.

"The greater the number of attempts to quit, the higher the chances of success," said Nicholas Chadi, MD, MPH, an adolescent medicine expert at the University of Montreal and contributing author to the commentary. "Regular and ongoing follow-up is important for identifying relapse, providing positive reinforcement and revisiting the treatment plan".

The guidelines recommend that nicotine replacement therapies can be included in a comprehensive vaping cessation plan that should be created with and for the patient. Medications for nicotine cravings and withdrawal have typically been underused in youth, despite the fact that nicotine replacement therapy is encouraged by national pediatric societies like the American Academy of Pediatrics and the Canadian Paediatric Society for adolescents under 18 years old who are regular nicotine users. Unfortunately, there are currently no medications with established efficacy for managing cannabis withdrawal among youth who vape.

Researchers at the Icahn School of Medicine at Mount Sinai have discovered a way to move precision immunotherapy forward by using genomics to inform immunotherapy for multiple myeloma, a blood cancer, according to a study published in Clinical Cancer Research, a journal of the American Association for Cancer Research, in December.

This is the first study to experimentally determine which byproducts from the mutation of tumors (known as neoantigens) have the ability to provoke the immune system into recognizing and killing cancer cells in multiple myeloma patients. The results provide the foundation for using neoantigen-targeting strategies such as cancer vaccines in future trials for multiple myeloma patients. Multiple myeloma is a malignancy of plasma cells affecting 30,000 people a year.

Next-generation sequencing data was analyzed to describe the landscape of neoantigens in 184 patients, and researchers identified neoantigen-specific immune cells triggered by immunotherapy. Additionally, they showed an increase in neoantigens in patients who had relapsed myeloma versus new patients, which may indicate potential for greater immune responses to immunotherapy in these patients. The study also identifies common neoantigens between patients, which could lead to new vaccine therapies.

"Tumor neoantigens represent excellent targets for immunotherapy, due to their speci?c expression in cancer tissue," said Samir Parekh, MD, Associate Professor of Oncological Sciences and Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine. "Until now, there has been no direct evidence that DNA mutations induce neoantigen-speci?c T-cell responses following immunotherapy in multiple myeloma."

Stemming from this research, co-author Nina Bhardwaj, MD, PhD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine, and colleagues are pursuing a clinical trial investigating the safety and responsiveness of a personalized neoantigen vaccine for the treatment of cancers including multiple myeloma.

The ERA-EDTA Registry collects data on renal replacement therapy (RRT) from the national and regional renal registries in Europe and from countries bordering the Mediterranean. For the 2017 Annual Report, data sets from 53 national or regional renal registries in 37 countries were compiled. A total population of 694,024,000 people was analyzed.

The Registry's 2017 Annual Report [1] shows that, out of nearly 700 million people, 88,453 individuals began renal replacement therapy (RRT) in 2017, which is a proportion of 127 per million people (pmp). The mean age of these patients starting RRT was 63.4 years, whereby roughly a fifth (17,935 patients) had diabetes mellitus as primary renal disease. The incidence rate varied considerably among countries - the Kosovo had an adjusted incidence rate of 429 pmp, Greece 223 pmp, France 174 pmp, Switzerland 99 pmp and Estonia only 68 pmp. These differences can be explained partly because of differences in national resources that are available for RRT. A large part, however, is caused by differences in general population health and availability of preventive measures between countries across Europe.

85% of all patients started RRT with hemodialysis, 11% peritoneal dialysis and only 4% received a transplant right at the start of RRT and could thereby avoid a period on dialysis. "This is sad", explains Professor Ron Gansevoort, Press Officer of the ERA-EDTA. "Kidney transplantation is the best renal replacement therapy from the medical point of view. Transplanted patients suffer from less comorbidities than dialysis patients and have a better outcome. Furthermore, transplanted patients experience a higher quality of life in general - with fewer complications and no need for strenuous treatment for more than four hours three days a week." The main reason why patients cannot be transplanted right away is the scarcity of donor organs, which is dramatic in many European countries. "ERA-EDTA's mission has always been to bring the best treatment to kidney patients. We therefore put a lot of effort into improving the situation. Together with EKHA (European Kidney Health Alliance), we have already addressed EU health policy and asked for a joint Pan-European information campaign. However, the results have been quite meagre so far."

The small number of patients who receive a transplantation right away is not the only alarming fact revealed by the ERA-EDTA Registry data. "We also observe a rising incidence", explains Professor Gansevoort. "In 2016, 121 pmp started renal replacement, in 2017 this number rose to 127 pmp." The main reason is the demographic shift, the mean age of the general population is growing, and kidney diseases often occur in elderly people. "The risk of chronic kidney disease increases with age, so what we see here is not an abnormal development per se, but it is nevertheless a challenge we have to cope with. We have not seen an end to the demographic shift yet - people are still getting older."

The number of patients in need of RRT will rise accordingly, too, thus posing a major challenge to our health systems: The annual costs per patient for hemodialysis (HD) are, for example, up to US$ 59,000 in Germany, US$ 84,000 in Belgium or US$ 71,000 in France [2]. Strengthening prevention strategies for kidney disease, therefore, is not only in the interest of each patient who might be saved from needing renal replacement therapy, but is also in the interest of policymakers. "It is high time that the focus is put on the rising incidence of end stage chronic kidney disease", concludes Professor Gansevoort.

WHAT:

More than 20% of pregnant women beginning anti-HIV treatment were prescribed an antiretroviral treatment that did not meet federal guidelines for use during pregnancy, according to an analysis funded by the National Institutes of Health. The study was led by Kathleen M. Powis, M.D., of Massachusetts General Hospital, Boston. It appears in JAMA Network Open.

The researchers analyzed data on women enrolled from 2008-2017 in the Surveillance Monitoring for ART Toxicities in HIV Uninfected Children Born to HIV Infected Women (SMARTT) study. Conducted in 18 U.S. research hospitals, SMARTT enrolled women living with HIV during pregnancy or at delivery. They compared each woman’s HIV treatment regimen to the U.S. Centers for Disease Control and Prevention’s treatment guidelines, which classify treatment as preferred (safe for pregnant women), alternative (no known safety concerns in pregnancy), insufficient data for use in pregnancy, and not recommended for pregnancy except in special circumstances.

Of 1,867 women who began anti-HIV treatment before pregnancy, only 925 (49.5%) were prescribed regimens designated as preferred or alternative. Another 492 (26.4%) were prescribed regimens with insufficient data, and 136 (7.3%) were prescribed regimens not recommended for use during pregnancy. Of 452 women who began treatment during pregnancy, 91 (20.1%) were prescribed therapies with insufficient data or that were not recommended. The study authors called for additional studies to determine reasons why prescribing practices for pregnant women living with HIV may not align with current treatment guidelines.

Funding for the study was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases, Office of AIDS Research, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, and National Institute on Alcohol Abuse and Alcoholism.

WHO:

Denise Russo, Ph.D., in the NICHD Maternal and Pediatric Infectious Disease Branch, is available for comment.

ARTICLE:

Powis, K.M. Antiretroviral prescribing practices among pregnant women living with HIV in the United States, 2008-17. JAMA Network Open. 2019.

WHAT:
An experimental Zika vaccine lowered levels of virus in pregnant monkeys and improved fetal outcomes in a rhesus macaque model of congenital Zika virus infection, according to a new study in Science Translational Medicine. The research was conducted by scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and their collaborators from the University of California, Davis; Duke University; and the University of California, Los Angeles. NIAID scientists developed the experimental vaccine and currently are evaluating it in a Phase 2 human clinical trial. The vaccine uses a small circular piece of DNA, or plasmid, containing genes that encode Zika virus surface proteins to induce an immune response.

Zika virus is primarily transmitted to humans by Aedes mosquitoes; it also can be transmitted through sex. The virus can cause serious birth defects in babies born to mothers who become infected during pregnancy. Ideally, the authors note, a Zika vaccine would be given to adolescents and adults of childbearing age before pregnancy to prevent congenital Zika syndrome.

Large outbreaks of Zika virus in the Americas in 2015 and 2016 led to thousands of cases of congenital Zika syndrome, prompting NIAID scientists to quickly develop and begin clinical trials of the NIAID DNA Zika vaccine. While clinical trials can yield data on safety and how the vaccine performs in recipients, due to the diminished incidence of Zika, conducting a clinical trial that would determine the vaccine's ability to prevent adverse fetal outcomes has been logistically difficult. Therefore, researchers developed a macaque model of congenital Zika syndrome to provide another way to evaluate the experimental vaccine.

Their study compared outcomes in 12 unvaccinated pregnant macaques and 13 macaques vaccinated before pregnancy. All macaques were exposed to Zika virus a total of three times during the first and second trimesters. Vaccinated animals had a significant reduction in the amount of Zika virus in the blood and in the length of time virus was detectable compared to unvaccinated animals. The vaccinated group was significantly less likely to transmit Zika virus to the fetus, whereas persistent Zika virus infection in unvaccinated macaques was associated with fetal infection. No cases of early fetal loss occurred in the vaccinated group, which also had no evidence of damage to either the placenta or the fetal brain.

The study suggests that sterilizing immunity--an immune response that prevents infection entirely, with no detectable virus--may not be required for significant protection against congenital Zika syndrome, according to the authors. They note that the ability of a vaccine to prevent persistent Zika virus infection may be an important consideration for future clinical research. Meanwhile, the animal model can be used to learn more about Zika virus transmission from mother to fetus and possible intervention strategies.

AUSTIN, Texas - Lowering exposure to allergens from mice may lead to improved lung growth for children with asthma living in low-income neighborhoods, helping them avoid lung ailments and possibly live longer, according to newly published research in The Journal of Allergy and Clinical Immunology. An allergen is any substance that can cause an allergic reaction.

"To our knowledge, this appears to be the first study to suggest that a sustained reduction in an indoor allergen - in this case a pest allergen, mouse allergen - may lead to improved lung growth among children with asthma living in low-income neighborhoods," said Elizabeth Matsui, M.D., MHS, director of clinical and translational research and a professor in the departments of Population Health and Pediatrics at Dell Medical School at The University of Texas at Austin.

Asthmatic children who reside in low-income neighborhoods often live amid mouse-allergen-laden dust caused by unaddressed rodent infestations. Matsui's research team tracked 350 low-income, mostly minority children ages five to 17 for a year and found a strong association between mouse allergen exposure and lung function growth.

Lung Function Can Affect Lifespan

"This study has important implications for children with asthma living in homes that are in poor physical condition, which promotes mouse infestation and similar problems with other pests, such as cockroaches," she said. "It suggests that these exposures could cause ongoing lung damage, putting them at greater risk of decreased lung health in adulthood."

Lower lung function among adults is a risk factor for COPD (chronic obstructive pulmonary disease) and a shorter lifespan, so it's possible that this exposure has implications for longevity, though this was not a finding from the current study, Matsui added.

The study suggests reducing indoor allergen exposure "could produce long-term lung function growth benefits in children similar to benefits seen from improvements in air pollution."

For households affected with mouse allergens, Matsui recommends:

Setting traps

Inspecting for and sealing cracks or holes in walls

Carefully cleaning eating areas

Storing food in chew-proof, sealed containers

Washing bed linens in hot water every two weeks

Using allergen-proof mattresses and pillow cases

All children involved in the study tested positive beforehand for mouse allergy, had high levels of mouse allergens in their homes, and had experienced uncontrolled asthma leading to an emergency room or urgent care visit, overnight hospital stay or oral steroid burst treatment during the previous 12 months. In some low-income neighborhoods, as many as half of children with uncontrolled asthma are allergic to mice and have high levels of mouse allergens in their homes.

Researchers performed pre- and postbronchodilator spirometry at the beginning of the study and at six and 12 months to assess improvement in asthma patients. Mouse allergens in the home were measured every three months.

Follow-Up Studies

Matsui outlined several areas where follow-up studies could build on this research and its findings. One is to track these 350 children, who were living in Baltimore and Boston between December 2010 and August 2014, into adulthood and see whether the study findings hold. Another is to see whether the findings apply to other allergens from sources such as cockroaches, pets, dust mites, mold and pollutants such as secondhand smoke. A third study idea is to test and assess various ways to sustainably reduce mouse allergen exposure.

More broadly, future research should focus on the population health implications of poor housing conditions. "What are the long-term population effects of living in poor housing conditions that promote pest infestations on lung health?" Matsui asked. "And if there are long-term population effects, as suggested by this study, what are effective strategies for mitigating these effects?"

LOS ANGELES (Dec. 19, 2019) — Gastroesophageal reflux disease (GERD), a digestive disorder that causes heartburn and other uncomfortable symptoms, may affect nearly a third of U.S. adults each week, and most of those who take certain popular medications for it still have symptoms, according to a new Cedars-Sinai study.

Also known as acid reflux, GERD is caused by gastric acid from the stomach flowing back up into a person's food pipe, or esophagus. This backup can happen when the lower esophageal sphincter, a muscle that briefly opens to let food into the stomach and closes to take food inside, relaxes too often or too long. Besides causing the burning sensation in the throat and chest known as heartburn, GERD can damage tissues and cause food to be regurgitated.

For their research, published today in the journal Gastroenterology, investigators conducted an online survey of more than 71,000 people age 18 or over across the U.S., asking them if they experienced specific GERD symptoms and how often, and if they were taking drugs for it.

"Our study is among the largest and most diverse population-based studies on gastrointestinal symptoms ever conducted," said Brennan Spiegel, MD, MSHS, director of Cedars-Sinai's Health Service Research, professor of Medicine and corresponding author of the journal article. Most previous published research on GERD, which found a somewhat lower incidence of the disease than this study did, was conducted within limited geographic areas or with a less representative sampling of U.S. adults, he explained.

An important feature of the new study was its finding that more than half of GERD patients who took popular over-the-counter drugs known as proton pump inhibitors, designed to reduce the amount of acid in the stomach, still reported persistent symptoms.

The survey also indicated that certain categories of people, including younger people, women, Latinos, and people with irritable bowel syndrome or Crohn's disease, were less likely to respond to proton pump inhibitors.

"Given the significant effect of GERD on quality of life for millions of Americans, further research and development of new therapies are needed to help patients whose disease does not respond to proton pump inhibitors," said Spiegel, who also directs the Cedars-Sinai Center for Outcomes Research and Education.

The investigators conducted their nationwide survey in October and November 2015 using MyGiHealth, a mobile app that asked respondents to select any symptoms they had experienced in the past week or "ever experienced." Investigators measured the severity of patients' symptoms, using validated questionairres from the National Institutes of Health. The symptoms included GERD-relevant ones -- such as heartburn, acid reflux, or gastroesophageal reflux -- plus other general gastrointestinal symptoms such as abdominal pain, constipation and nausea.

Out of 71,812 people who responded to the survey, 44.1% reported experiencing GERD symptoms in the past and 30.9% in the last week. More than a third of the GERD sufferers said they were currently on therapy, mostly involving proton pump inhibitors. Of those taking daily proton pump inhibitors, 54.1% reported persistent GERD symptoms.

"The MyGiHealth digital platform allowed us to efficiently recruit a large, highly diverse, representative population in a very short period of time," said Christopher Almario, MD, MSHPM, assistant professor of Medicine at Cedars-Sinai. Yet it also carried potential limitations because individuals with limited computer skills or poor access to the internet may be underrepresented, he explained. In addition, since the study was described as a "GI Survey" to potential respondents, it may have led to overestimating GERD prevalence since those without gastrointestinal issues may have opted not to complete the survey.

A study led by researchers from KK Women's and Children's Hospital (KKH) has found evidence that pregnant women who consume more of their daily food intake after 7.00pm, and who consume lower quality diets during pregnancy, are more than three times more likely to experience postpartum weight retention of five kilogrammes or more, 18 months after giving birth.

The study was published in the journal, 'Nutrients' in November 2019* and drew data from a large scale birth cohort study, GUSTO (Growing Up in Singapore Towards healthy Outcomes)^.

Lead Author of the study, Dr Loy See Ling, Research Fellow, Department of Reproductive Medicine, KKH, said, "Our research, based on multi-ethnic Asian women, shows that although predominantly night eating and lower diet quality have been independently linked with weight gain, practising night eating along with low diet quality demonstrated the greatest likelihood of substantial postpartum weight gain and retention even after 18 months."

There is evidence to show that retaining more weight after the first year of giving birth is associated with higher body mass index even at 15 years postpartum.** Weight retention after childbearing also appears to be more harmful than weight gain in other stages of life as the retained body fat is typically deposited in the abdomen (visceral fat) rather than in other parts of the body.*** This phenomenon has a profound effect not only on the mother's lifelong health including metabolic and cardiovascular disease consequences, but also on subsequent pregnancies and the future health of her child.****

Overall, 16 per cent of the 687 pregnant women involved in the study gained and retained five kilogrammes or more at 18 months after giving birth. It was also found that a stronger likelihood of postpartum weight retention was observed when predominantly night eating was practised together with a higher diet quality, whereas those practising predominantly day eating with lower diet quality showed a weaker association with postpartum weight retention. However, this finding needs further investigation and confirmation due to the modest number of women within the group of night eating with higher diet quality.

Co-author of the study, Associate Professor Fabian Yap, Head and Senior Consultant, Endocrinology Service, Department of Paediatrics, KKH, suggests that night eating may be potentially more damaging than lower diet quality in contributing to substantial postpartum weight retention. "Our body systems have evolved to metabolise food during the day and rest during the night. Hence, consuming more calories at night than day mismatches our body's natural body time clock by disrupting the metabolic rhythm in various organs such as liver, stomach, pancreas, fat tissue, resulting in disruption of energy metabolism. The consumption of more calories at night is also closely linked with a later bedtime and hence, associated with overweightness and obesity."

In view of the study's results, Associate Professor Fabian Yap and Dr Loy See Ling recommend that pregnant women adopt the following interventions during their pregnancy to ensure an adequate nutrient supply for both mother and
baby as well as to prevent undesirable weight
gain and retention after birth:

Adopt good diet during pregnancy. Eat more whole grains, fruits, vegetables and low-fat dairy products. Cut down on fatty, salty and sugary foods.

Change meal times to earlier in the day or have lighter foods at night. Eat meals at regular times of the day.

University of Queensland researchers have combined quantum liquids and silicon-chip technology to study turbulence for the first time, opening the door to new navigation technologies and improved understanding of the turbulent dynamics of cyclones and other extreme weather.

Professor Warwick Bowen, from UQ's Precision Sensing Initiative and the Australian Research Council Centre of Excellence for Engineered Quantum Systems said the finding was "a significant advance" and provided a new way to study turbulence.

"Turbulence is often described as the oldest unsolved problem in physics," Professor Bowen said.

"Our finding allows us to observe nanoscale quantum turbulence, which mirrors the sort of behaviour you see in cyclones.

Artists' impression of quantum vortices in a liquid. These are the quantum equivalent of vortices in water or a tornado. Their interactions cause dynamics analogous to that of a cyclone. Image: Christopher Baker"This advance is enabled by the properties of quantum liquids, which are fundamentally different to everyday liquids."

Professor Bowen said it was postulated more than 50 years ago that the turbulence problem could be simplified using quantum liquids.

"Our new technique is exciting because it allows quantum turbulence to be studied on a silicon chip for the first time," he said.

The research also had implications in space, where quantum liquids are predicted to exist within dense astrophysical objects.

"Our research could help to explain how these objects behave," Dr Bowen said.

Dr Yauhen Sachkou, the paper's lead author, said rotating neutron stars lost angular momentum in fits and starts.

"The way this occurs is thought to hinge on quantum turbulence," Dr Sachkou said.

Dr Christopher Baker, who co-led the research, said the finding made possible silicon-chip based accelerometers with sensitivity far beyond current state of the art.

"In quantum liquids, atoms behave more like waves than particles," Dr Baker said.

"This allows us to build laser-like sensors from atoms."

A new report from the National Toxicology Program (NTP) suggests that traffic-related air pollution increases a pregnant woman's risk for dangerous increases in blood pressure, known as hypertension.

NTP scientists evaluated published research on the link between traffic-related air pollution, or TRAP, and hypertensive disorders broken down by pollutant measurements of TRAP, such as particulate matter (PM2.5). PM is the term for a mixture of solid particles and liquid droplets found in the air, and PM2.5 refers to fine inhalable particles, with diameters that are generally 2.5 micrometers or smaller. The average human hair is about 70 micrometers in diameter, about 30 times larger than the largest fine particle.

"What we found when we reviewed the literature is that exposure to PM2.5 from traffic emissions was associated with development of hypertensive disorders in pregnant women," said Brandy Beverly, Ph.D., lead scientist and researcher at the National Institute of Environmental Health Sciences, part of the National Institutes of Health. "When these women are exposed to PM2.5 during their entire pregnancy, the likelihood of developing preeclampsia increases by about 50%."

Other components of TRAP that NTP evaluated included nitrogen oxides, carbon monoxide, black carbon, and elemental carbon, along with parameters like traffic density and mothers' proximity to main roads.

For example, the literature suggests that women who live within a quarter of a mile of a major roadway or in high traffic density regions may be at an increased risk for developing hypertensive disorders of pregnancy.

TRAP comes from the combustion of fossil fuels by motor vehicles. These vehicle emissions are mixtures of gases and particles that are easily inhaled and have adverse health effects. TRAP is known to be a major risk factor for cardiovascular disease, including hypertension.

Hypertensive disorders of pregnancy complicate more than 10% of pregnancies worldwide and are a leading cause of maternal and fetal illness and death. According to the American College of Obstetrics and Gynecology, mothers with hypertension during pregnancy are more likely to have a pre-term delivery. Their infants are at greater risk for low birthweight and a range of long-term health problems associated with pre-mature birth.

"Hypertensive disorders of pregnancy refer to a range of clinical conditions, all of which include high blood pressure during pregnancy," said Beverly. "The disorders are classified into four distinct types, based on differences in the timing and onset of the symptoms."

Pregnant women may experience four types of hypertensive disorders:

Gestational hypertension, or high blood pressure, in the second half of pregnancy.

Preeclampsia, or high blood pressure with protein in urine or impaired liver or kidney function, in the second half of pregnancy. If preeclampsia worsens and causes seizures, it becomes eclampsia - a serious condition for mother and child with the potential to be fatal.

Chronic hypertension, or high blood pressure before pregnancy or early in pregnancy, that continues throughout pregnancy.

Chronic hypertension with preeclampsia, or high blood pressure before pregnancy or early in pregnancy, that continues throughout pregnancy and is complicated by new onset protein in the urine or impaired liver or kidney function.

Using their standard four-tier scale to classify human hazards, NTP looked at the combined evidence from the individual components and concluded that TRAP is a presumed human hazard for hypertensive disorders during pregnancy, though they weren't able to distinguish between the four types of disorders. The scale ranges from the highest hazard rating of "known", followed by "presumed", then "suspected", and finally, "not classifiable".

NTP conducted the systematic review of published research on hypertensive disorders in pregnant women and its link to TRAP after receiving a nomination from several pediatricians to evaluate the connection between emerging issues associated with air pollution and children's health.

NTP scientists performed a comprehensive literature search and reviewed hundreds of studies with potentially relevant data. Overall, they evaluated 18 human observational studies and one animal study that specifically addressed hypertension during pregnancy and TRAP. Usually, experimental animal data add confidence in the conclusions; unfortunately, the limited number of animal studies that assessed the impact of environmental exposures during pregnancy is a research gap.

The evaluation underwent external peer review involving experts from academia and industry, who evaluated NTP's draft conclusions and agreed unanimously with NTP's final conclusion.

WINSTON-SALEM, N.C. - Dec. 18, 2019 - Which of the two most common bariatric surgeries - gastric sleeve or gastric bypass - has the highest subsequent risk of additional operations or procedures?

According to a study published in the current issue of JAMA Network Open, gastric bypass surgery is associated with a slightly higher risk of returning to the operating room or having other types of interventions, such as endoscopy.

"If you're having bariatric surgery and trying to decide between a sleeve and a bypass, this may be really important to know," said Kristina H. Lewis, M.D., corresponding author of the study and assistant professor of epidemiology and prevention at Wake Forest Baptist Health.

The study used a nationwide U.S. commercial insurance claims database to study adults age 18 to 64 who underwent a first Roux-en-y gastric bypass (bypass) or vertical sleeve gastrectomy (sleeve) procedure between January 2010 and June 2017.

The research team analyzed data from 4,476 patients undergoing bypass and 8,551 patients undergoing sleeve to determine the primary outcome of any abdominal operative intervention after the initial procedure. Patients were followed for up to four years after surgery.

The team found that bypass patients were about 20% more likely to have additional operations on their abdomen than a similar group of sleeve patients. In addition, endoscopies also were more common among bypass patients. By four years out, the researchers estimated that 26.5% of bypass patients had an endoscopy procedure compared to 18% of sleeve patients.

"Although bypass surgery is more effective for weight loss and diabetes remission, patients should be aware that it may be associated with a slightly higher risk of undergoing additional procedures later," Lewis said.

"We already have strong evidence that bariatric surgery is the most effective weight loss intervention for patients with severe obesity, and surgery is definitely much safer than it used to be. But patients still have to balance the pros of having surgery against potential complications, and this may be especially important when choosing between bariatric surgery types. This decision - sleeve vs. bypass - will depend on a patient's goals for surgery and his or her particular health concerns."

Walking and cycling to work were associated with fewer heart attacks across 43 million adults in England, according to a new national study.

Co-authored by Alistair and Jonny Brownlee, Olympic-medal winning triathletes and alumni of the University of Leeds, the research suggests that active travel could provide important health benefits.

In areas where walking or cycling to work were more common in 2011, the incidence of heart attacks decreased for both men and women across the following two years.

The researchers acknowledged that the big risk factors for heart disease are a lack of exercise, being overweight, smoking and diabetes.

After adjusting for these, the researchers found that active commuting was linked with additional health benefits in some cases. For women who walked to work there was an associated 1.7% reduction in heart attacks the following year. For men who cycled to work there was also an associated 1.7% reduction in heart attacks the following year.

The research, led by the University of Leeds, was published today in the European Journal of Preventive Cardiology.

Co-author Alistair Brownlee, double Olympic triathlon champion with British Triathlon, said: "Our study at the University of Leeds shows that exercise as a means of commuting to work is associated with lower levels of heart attack. The benefits of regular exercise are numerous and we support initiatives to help everyone become and stay active."

The Government has recognised the potential of active transport to help tackle physical inactivity, climate change, air pollution and congestion. Despite this, the proportion of people who exercise as part of their commute remains low.

The study looked at the 2011 UK Census data, which included 43 million people aged 25-74 years employed in England, and found that 11.4% were active commuters. Walking was more popular than cycling (8.6% vs. 2.8%).

Lead author Professor Chris Gale, Consultant Cardiologist, from the University of Leeds' Institute for Cardiovascular and Metabolic Medicine, said: "Whilst we cannot conclusively say that active travel to work lowers the risk of heart attack, the study is indicative of such a relationship.

"Greater efforts by national and local policy makers to improve the uptake of cycling and walking to work are likely to be rewarded by future improvements in population-based health.

"The effect of active commuting is fairly modest when compared with the stronger determinants of cardiovascular health such as smoking, obesity, diabetes, and regular exercise. However, this study clearly suggests that exercising on the way to work has the potential to bring nationwide improvements to health and wellbeing."

Active commuting was defined as people who reported their main mode of transport to work as either 'bicycle' or 'on foot' in the UK Census.

Rates of active travel varied significantly between local authorities across England, with as few as 5% of people walking or cycling to work in some authorities, compared to as many as 41.6% in other areas.

There was also a sex difference for active travel in the 2011 Census data, with more men cycling to work than women (3.8% vs. 1.7%), but more women walking to work than men (11.7% vs. 6.0%).

The research was funded in part by the British Heart Foundation.

In July, the Transport Select Committee published a report on active travel, concluding that walking and cycling have not been given enough attention by policymakers and current targets are not ambitious enough.

The Government's current aim is to double the number of people cycling by 2025.

Chris Heaton-Harris MP, Cycling and Walking Minister, said: ""Active travel has clear benefits - both for people and the environment - and this research provides further compelling evidence to encourage more people to travel by bike or on foot.

"To help get more people walking and cycling, we have invested £2 billion over five years.

"On top of this, we are providing a £350 million Cycling Infrastructure Fund to increase provision for separated bike lanes on main roads, which will let thousands exercise safely as part of their daily commute."

Leeds City Council is one of many local authorities attempting to encourage people to walk and cycle more regularly, and in August this year Alistair Brownlee became Leeds' first Active Travel Ambassador.

He said: "I think it's so important that we encourage people to travel as actively as they can. It benefits their health, their psychology, as well as helping the environment.

"We need to see vast improvements in cycling and walking infrastructure to help make people more confident in their routes, and encourage them away from relying on private cars."

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation said: "Finding time to exercise can be tricky given our increasingly busy and often sedentary lives. But exercising doesn't have to involve a pricey gym membership or hours spent on a treadmill.

"Upgrading your commute - by swapping the gas pedal for a bike pedal - is a great way to get your heart pumping on a daily basis. If that's not an option, parking a few streets away or getting off the bus a few stops early can help pave the way to a longer, healthier life."

Boston, MA - About half of the adult U.S. population will have obesity and about a quarter will have severe obesity by 2030, according to a new study led by Harvard T.H. Chan School of Public Health.

The study also predicts that in 29 states, more than half of the population will have obesity, and all states will have a prevalence of obesity higher than 35%. The study's researchers estimate that, currently, 40% of American adults have obesity and 18% have severe obesity.

The study will be published in the December 19, 2019 issue of the New England Journal of Medicine.

The researchers said the predictions are troubling because the health and economic effects of obesity and severe obesity take a toll on several aspects of society. "Obesity, and especially severe obesity, are associated with increased rates of chronic disease and medical spending, and have negative consequences for life expectancy," said Steven Gortmaker, professor of the practice of health sociology at Harvard Chan School and senior author of the study.

For the study, the researchers used self-reported body mass index (BMI) data from more than 6.2 million adults who participated in the Behavioral Risk Factor Surveillance System Survey (BRFSS) between 1993 and 2016. Body mass index (BMI) is calculated by dividing a person's weight in kilograms by the square of their height in meters. Obesity is defined as a BMI of 30 or higher, and severe obesity is a BMI of 35 or higher.

Self-reported BMIs are frequently biased, so the researchers used novel statistical methods to correct for this bias.

The large amount of data collected in the BRFSS allowed the researchers to drill down for obesity rates for specific states, income levels, and subpopulations.

The results showed that by 2030, several states will have obesity prevalence close to 60%, while the lowest states will be approaching 40%. The researchers predicted that nationally, severe obesity will likely be the most common BMI category for women, non-Hispanic black adults, and those with annual incomes below $50,000 per year.

"The high projected prevalence of severe obesity among low-income adults has substantial implications for future Medicaid costs," said lead author Zachary Ward, programmer/analyst at Harvard Chan School's Center for Health Decision Science. "In addition, the effect of weight stigma could have far-reaching implications for socioeconomic disparities as severe obesity becomes the most common BMI category among low-income adults in nearly every state."

Ward and his co-authors said that the study could help inform state policy makers. For example, previous research suggests that sugar-sweetened beverage taxes have been an effective and cost-effective intervention for curtailing the rise in obesity rates. "Prevention is going to be key to better managing this epidemic," said Ward.

Parkinson's patients' motor and non-motor symptoms were improved with a weekly exercise regimen that included physical and cognitive tasks, according to new research presented today (18 December) at The Physiological Society early career conference, Future Physiology 2019: Translating Cellular Mechanisms into Lifelong Health Strategies.

Parkinson's Disease is a chronic neurodegenerative disease that can lead to disability and make it harder to lead an active lifestyle. Previous research has shown that either physical or cognitive exercises are effective at improving and sustaining cognitive and/or physical function in people with Parkinson's.

However, doing different types of exercise (e.g. circuit training also including cognitive challenges), may be more beneficial in improving motor and non-motor symptoms.

Researchers at the University of Kent studied Parkinson's patients that performed a weekly multi-modal regime (physical and cognitive exercises). This group participated in weekly exercise sessions for over a year and were assessed every four months for at least a year (some participants continued on for two or three years).

This once-a-week exercise programme with both physical and cognitive exercises for Parkinson's disease patients showed an improvement specifically in one-minute sit-to-stand tests and a cognitive test called MiniMental but no other significant changes (i.e. no decline) in cognitive and physical health. This is especially positive as Parkinson's is a degenerative disease, so the expected outcome, without any interventions, for these symptoms, would be a decline.

These findings are important because they could allow Parkinson's disease patients to see improvements in their symptoms by correctly tailoring their exercise regimens to include both physical and cognitive exercise.

Anna Ferrusola-Pastrana, a researcher who was involved with the work said:

"Finding the right set of exercises, both cognitive and physical, to improve Parkinson's treatment is an important step towards giving Parkinson's patients a better quality of life. This research is working towards honing this set of exercises, which can then potentially be performed by patients, with or without assistance at home."