Culture

Physicians have long known that necrotizing enterocolitis (NEC), a potentially lethal inflammatory condition that destroys a premature infant's intestinal lining, is often connected to the development of severe brain injury in those infants who survive. However, the means by which the diseased intestine "communicates" its devastation to the newborn brain has remained largely unknown.

Now, working with mice, researchers at Johns Hopkins Medicine and the University of Lausanne in Switzerland have identified that missing link -- an immune system cell that they say travels from the gut to the brain and attacks cells rather than protect them as it normally does.

The team's findings are published Jan. 6, 2021, in the journal Science Translational Medicine.

Seen in as many as 12% of infants weighing less than 3.5 pounds at birth, NEC is a rapidly progressing gastrointestinal emergency in which bacteria invade the wall of the colon and cause inflammation that can ultimately destroy healthy tissue at the site. If enough cells become necrotic (die) so that a hole is created in the intestinal wall, bacteria can enter the bloodstream and cause life-threatening sepsis.

In a 2018 mouse study, researchers at Johns Hopkins Medicine and the Fred Hutchinson Cancer Research Center found that animals with NEC make a protein called toll-like receptor 4 (TLR4) that binds to bacteria in the gut and precipitates the intestinal destruction. They also determined that TLR4 simultaneously activates immune cells in the brain known as microglia, leading to white matter loss, brain injury and diminished cognitive function. What wasn't clear was how the two are connected.

For this latest study, the researchers speculated that CD4+ T lymphocytes -- immune system cells also known as helper T cells -- might be the link. CD4+ T cells get their "helper" nickname because they help another type of immune cell called a B lymphocyte (or B cell) respond to surface proteins -- antigens -- on cells infected by foreign invaders such as bacteria or viruses. Activated by the CD4+ T cells, immature B cells become either plasma cells that produce antibodies to mark the infected cells for disposal from the body or memory cells that "remember" the antigen's biochemistry for a faster response to future invasions.

CD4+ T cells also send out chemical messengers that bring another type of T cell -- known as a killer T cell -- to the area so that the targeted infected cells can be removed. However, if this activity occurs in the wrong place or at the wrong time, the signals may inadvertently direct the killer T cells to attack healthy cells instead.

"We knew from comparing the brains of infants with NEC with ones from infants who died from other causes that the former had accumulations of CD4+ T cells and showed increased microglial activity," says study senior author David Hackam, M.D., Ph.D., surgeon-in-chief at Johns Hopkins Children's Center and professor of surgery at the Johns Hopkins University School of Medicine. "We suspected that these T cells came from the NEC-inflamed regions of the gut and set out to prove it by using neonatal mice as a model of what happens in human infants."

In the first of a series of experiments, the researchers induced NEC in infant mice and then examined their brains. As expected, the tissues showed a significant increase in CD4+ T cells as well as higher levels of a protein associated with increased microglial activity. In a follow up test, the researchers showed that mice with NEC had a weakened blood-brain barrier -- the biological wall that normally prevents bacteria, viruses and other hazardous materials circulating in the bloodstream from reaching the central nervous system. This could, the researchers surmised, explain how CD4+ T cells from the gut could travel to the brain.

Next, the researchers determined that accumulating CD4+ T cells were the cause of the brain injury seen with NEC. They did this first by biologically blocking the movement of the helper T cells into the brain and then in a separate experiment, neutralizing the T cells by binding them to a specially designed antibody. In both cases, microglial activity was subdued and white matter in the brain was preserved.

To further define the role of CD4+ T cells in brain injury, the researchers harvested T cells from the brains of mice with NEC and injected them into the brains of mice bred to lack both T and B lymphocytes. Compared with control mice that did not receive any T cells, the mice that did receive the lymphocytes had higher levels of the chemical signals which attract killer T cells. The researchers also observed activation of the microglia, inflammation of the brain and loss of white matter -- all markers of brain injury.

The researchers then sought to better define how the accumulating CD4+ T cells were destroying white matter -- actually a fat called myelin that covers and protects neurons in the brain, and facilitates communication between them. To do this, they used organoids, mouse brain cells grown in the laboratory to simulate the entire brain. Brain-derived CD4+ T cells from mice with NEC were added to these laboratory "mini-brains" and then examined for several weeks.

Hackam and his colleagues found that a specific chemical signal from the T cells -- a cytokine (inflammatory protein) known as interferon-gamma (IFN-gamma) -- increased in the organoids as the amount of myelin decreased. This activity was not seen in the organoids that received CD4+ T cells from mice without NEC.

After adding IFN-gamma alone to the organoids, the researchers saw the same increased levels of inflammation and reduction of myelin that they had seen in mice with NEC. When they added an IFN-gamma neutralizing antibody, cytokine production was significantly reduced, inflammation was curtailed and white matter was partially restored.

The researchers concluded that IFN-gamma directs the process leading to NEC-related brain injury. Their finding was confirmed when an examination of brain tissues from mice with NEC revealed higher levels of IFN-gamma than in tissues from mice without the disease.

Next, the researchers investigated whether CD4+ T cells could migrate from the gut to the brain of mice with NEC. To do this, they obtained CD4+ T cells from the intestines of infant mice with and without NEC. Both types of cells were injected into the brains of infant mice in two groups -- one set that could produce the protein Rag1 and one that could not. Rag1-deficient mice do not have mature T or B lymphocytes.

The Rag1-deficient mice that received gut-derived helper T cells from mice with NEC showed the same characteristics of brain injury seen in the previous experiments. T cells from both mice with and without NEC did not cause brain injury in mice with Rag1, nor did T cells from mice without NEC in Rag1-deficient mice. This showed that the gut-derived helper T cells from mice with NEC were the only ones that could cause brain injury.

In a second test, gut-derived T cells from mice with and without NEC were injected into the peritoneum -- the membrane lining the abdominal cavity -- of Rag1-deficient mice. Only the intestinal T cells from mice with NEC led to brain injury.

This finding was confirmed by genetically sequencing the same portions from both the brain-derived and gut-derived T lymphocytes from mice with and without NEC. The sequences of the helper T cells from mice with NEC, on average, were 25% genetically similar while the ones from mice without NEC were only 2% alike.

In a final experiment, the researchers blocked IFN-gamma alone. Doing so provided significant protection against the development of brain injury in mice with severe NEC. This suggests, the researchers say, a therapeutic approach that could benefit premature infants with the condition.

"Our research strongly suggests that helper T cells from intestines inflamed by NEC can migrate to the brain and cause damage," says Hackam. "The mouse model in our study was previously shown to closely match what occurs in humans, so we believe that this is the likely mechanism by which NEC-related brain injury develops in premature infants."

Based on these findings, Hackam says measures for preventing this type of brain injury, including therapies to block the action of INF-gamma, may be possible.

DURHAM, N.C. -- Before the pandemic, one-third of U.S. households with children were already "net worth poor," lacking enough financial resources to sustain their families for three months at a poverty level, finds new research from Duke University.

In 2019, 57 percent of Black families and 50 percent of Latino families with children were poor in terms of net worth. By comparison, the rate for white families was 24 percent.

"These 'net worth poor' households have no assets to withstand a sudden economic loss, like we have seen with COVID-19," said Christina Gibson-Davis, co-author of the study and professor of public policy and sociology at Duke University's Center for Child and Family Policy. "Their savings are virtually nil, and they have no financial cushion to provide the basics for their children."

The study is among the first to consider family poverty in terms of assets, not income. Using 1989-2019 data from the Survey of Consumer Finances, researchers analyzed net worth and income data from more than 19,000 U.S. households with children under age 18.

Among households with children, net worth poverty has been steadily rising over the past 30 years, the authors found. In 2019, a two-parent, two-child household was deemed to be net-worth poor if they had less than $6,500 in assets - or less than one-fourth of the federal poverty line.

Families in that category - those with perilously low levels of net worth -- outnumbered families who were poor based on income.

"Uncovering this aspect of poverty, which hinges on wealth, is game-changing," said Lisa Gennetian, co-author of the study and associate professor of early learning policy studies at Duke's Sanford School of Public Policy.

"Most policies focus on income and families meeting their day-to-day needs," Gennetian said. "These efforts are important. But our findings suggest that they are not helping families increase savings that help set children up for success."

Notably, Black and Latino families were twice as likely to experience net worth poverty than to have poverty-level incomes.

"Reducing one kind of poverty isn't helpful if another one is taking its place," said Lisa Keister, study co-author and a professor of sociology at Duke. "Being net worth poor likely limits parents' abilities to invest in their kids and shapes how they think about their kids' future."

The new research appears in the Journal of Marriage and Family.

"Even before the pandemic, many families with children were in a precarious situation," Gibson-Davis said. "Things are not going to get better in the wake of COVID-19."

Given a list of cities and the distances between each pair of cities, how do you determine the shortest route that visits each city exactly once and returns to the starting location? This famous problem is called the "traveling salesman problem" and is an example of a combinatorial optimization problem. Solving these problems using conventional computers can be very time-consuming, and special devices called "quantum annealers" have been created for this purpose.

Quantum annealers are designed to find the lowest energy state (or "ground state") of what's known as an "Ising model." Such models are abstract representations of a quantum mechanical system involving interacting spins that are also influenced by external magnetic fields. In the late 90s, scientists found that combinatorial optimization problems could be formulated as Ising models, which in turn could be physically implemented in quantum annealers. To obtain the solution to a combinatorial optimization problem, one simply has to observe the ground state reached in its associated quantum annealer after a short time.

One of the biggest challenges in this process is the transformation of the "logical" Ising model into a physically implementable Ising model suitable for quantum annealing. Sometimes, the numerical values of the spin interactions or the external magnetic fields require a number of bits to represent them (bit width) too large for a physical system. This severely limits the versatility and applicability of quantum annealers to real world problems. Fortunately, in a recent study published in IEEE Transactions on Computers, scientists from Japan have tackled this issue. Based purely on mathematical theory, they developed a method by which a given logical Ising model can be transformed into an equivalent model with a desired bit width so as to make it "fit" a desired physical implementation.

Their approach consists in adding auxiliary spins to the Ising model for problematic interactions or magnetic fields in such a way that the ground state (solution) of the transformed model is the same as that of the original model while also requiring a lower bit width. The technique is relatively simple and completely guaranteed to produce an equivalent Ising model with the same solution as the original. "Our strategy is the world's first to efficiently and theoretically address the bit-width reduction problem in the spin interactions and magnetic field coefficients in Ising models," remarks Professor Nozomu Togawa from Waseda University, Japan, who led the study.

The scientists also put their method to the test in several experiments, which further confirmed its validity. Prof. Togawa has high hopes, and he concludes by saying, "The approach developed in this study will widen the applicability of quantum annealers and make them much more attractive for people dealing with not only physical Ising models but all kinds of combinatorial optimization problems. Such problems are common in cryptography, logistics, and artificial intelligence, among many other fields."

In the future, the Antarctic could become a greener place and be colonised by new species. At the same time, some species will likely disappear. 25 researchers recently presented these and many other findings in a major international project, in which they analysed hundreds of articles on the Antarctic published in the past ten years. By doing so, the team have provided an exceptionally comprehensive assessment of the status quo and future of Antarctica and the Southern Ocean that surrounds it.

Never before have researchers arrived at so many new findings on the biological and biochemical processes at work in the Antarctic than in the past ten years. Now 25 experts, led by the Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research (AWI), have analysed and compiled these findings in the project "AnT-ERA". Having ultimately processed several hundred articles on the Antarctic, the team have now distilled the content into ten core messages addressing a broad range of aspects, e. g. ocean acidification, biodiversity, and the significance of sea ice for various organisms. "If you look at the timeframe from 1970 to the present, roughly 80 percent of all academic publications on biology and biochemistry in the Antarctic were released between 2010 and 2020. That's what moved us to condense this enormous amount of knowledge into a single article," says marine biologist and project coordinator Julian Gutt from the AWI. The project outcomes have just been published in the journal Biological Reviews.

Increased biodiversity

One major finding is that the waters of the Antarctic are very likely to grow warmer due to climate change, which in turn increases the probability that plant and animal species from warmer regions will migrate to the Antarctic. In this regard, not just the temperature, but also the future sea-ice cover will be crucial. For example, in the decades to come, the experts expect to see a more intense greening of ice-free coastal areas during the southern summer, as new mosses or lichens migrate. Initially, there will likely be a rise in biodiversity. However, a prolonged warming would have grave consequences for those species that are adapted to extremely low temperatures. "We believe these species will retreat to the last remaining extremely cold regions of the Antarctic," says Gutt. "That also means we'll need to protect the regions in order to save these species."

Learning to live in acidic waters?

When it comes to ocean acidification, the study's forecast is bleak: by the end of the century, the experts expect the waters of the Antarctic to be extensively acidified. "There can be no doubt that especially those organisms that form calcareous shells are going to have serious problems," Gutt explains. "We can't yet say for certain if they will all go extinct, or if some species will manage to adapt their metabolisms to the new conditions." A surprising finding from research conducted in the past ten years: the ostensibly docile organisms that live on the floor of the Antarctic Ocean, e.g. some sponges and ascidians, respond rapidly to improved conditions - by growing quickly or reproducing intensively. The downside: they are equally sensitive to poor environmental conditions. Given the major changes that climate change will entail, these species could also be in danger.

Whereas the Antarctic Peninsula, which extends into the South Atlantic, has been warming for some time now, in the past three years the warming, and therefore the loss of sea ice, has spread to East Antarctica. The experts can't yet say whether this is the beginning of a long-term trend, or only a short-term variation. In either case, this change in the physical environmental parameters is troubling, because it could have a substantial impact on the future development of life in the Southern Ocean.

How much CO2 can the Antarctic swallow?

It also remains unclear whether or not the loss of sea ice will mean that the waters of the Antarctic, due to intensified algal growth, absorb more carbon dioxide from the atmosphere. Principally speaking, most experts assume that algal growth increases when sea ice retreats, because the algae e. g. are exposed to more sunlight. Since algae absorb carbon dioxide from the atmosphere via photosynthesis when they grow, this process can improve the ocean's absorption of CO2. For some time now, simple forecasts have indicated that the algae in Antarctic waters may absorb ca. 25 ¬¬percent more CO2 if they become completely ice-free in future southern summers. Yet the current study shows that these blanket statements are problematic. According to Gutt: "The publications we analysed make it clear that the situation varies considerably, depending on the geography. But at least we now know which waters and which parameters we need to focus on to find the answers."

Clear-cut messages

The experts chiefly attribute the fact that so many new insights have been gathered in recent years to technological advances - e. g. in molecular biological methods, new ships and stations, and remotely operated underwater vehicles, some of which can even navigate below the ice. In addition, new numerical and conceptual models are helping us to understand interconnections in the ecosystem. In Julian Gutt's view, the study's greatest contribution is the fact that the 25 authors successfully agreed upon ten core messages that succinctly convey the central findings and offer a glimpse of the future.

Smoking is associated with an increased risk of COVID-19 symptoms and smokers are more likely to attend hospital than non-smokers, a study has found.

The study published today in Thorax, by researchers from King's College London, investigates the association between smoking and the severity of the COVID-19.

Researchers analysed data from the ZOE COVID Symptom Study App. Of the participants of the app, 11% were smokers. This is a lower proportion than the overall UK population of 14.7%, however, it reflects the demographics of the self-selected sample of the ZOE COVID Symptom Study.

While more than a third of users reported not feeling physically well during the period of study (24th March and April 2020), current smokers were 14% more likely to develop the classic triad of symptoms suggesting diagnosis of COVID-19: fever, persistent cough and shortness of breath - compared to non-smokers.

Current smokers were also more likely to have a higher symptom burden than non-smokers. Smokers were 29% more likely to report more than five symptoms associated with COVID-19 and 50% more likely to report more than ten, including loss of smell, skipping meals, diarrhoea, fatigue, confusion or muscle pain. A greater number of symptoms suggested more severe COVID-19.

Additionally, current smokers who tested positive for SARS-CoV-2 were more than twice as likely as non-smokers to attend hospital.

The researchers recommended that a smoking cessation strategy be included as an element to address COVID-19, as smoking increased both the likelihood of symptomatic disease and disease severity. Reduction in smoking rates could also reduce the health system burden from other smoking-related conditions that require hospitalisation.

Dr Mario Falchi, lead researcher and Senior Lecturer at King's College London said: "Some reports have suggested a protective effect of smoking on COVID-19 risk. However, studies in this area can easily be affected by biases in sampling, participation and response. Our results clearly show that smokers are at increased risk of suffering from a wider range of COVID-19 symptoms than non-smokers".

Claire Steves, lead researcher, consultant physician and Reader at King's College London, said: "As rates of COVID-19 continue to rise and the NHS edges towards capacity, it's important to do all we can to reduce its effects and find ways to reduce hospital admissions. Our analysis shows that smoking increases a person's likelihood to attend hospitals, so stopping smoking is one of the things we can do to reduce the health consequences of the disease."

A new review by Swansea University reveals there is widespread belief, around the world, in a teaching method that is not only ineffective but may actually be harmful to learners.

For decades educators have been advised to match their teaching to the supposed 'learning styles' of students. There are more than 70 different classification systems, but the most well-known (VARK) sees individuals being categorised as visual, auditory, read-write or kinesthetic learners.

However, a new paper by Professor Phil Newton, of Swansea University Medical School, highlights that this ineffective approach is still believed by teachers and calls for a more evidence-based approach to teacher-training.

He explained that various reviews, carried out since the mid-2000s, have concluded there is no evidence to support the idea that matching instructional methods to the supposed learning style of a student does improve learning.

Professor Newton said: "This apparent widespread belief in an ineffective teaching method that is also potentially harmful has caused concern among the education community."

His review, carried out with Swansea University student Atharva Salvi, found a substantial majority of educators, almost 90 per cent, from samples all over the world in all types of education, reported that they believe in the efficacy of learning styles

But the study points out that a learner could be a risk of being pigeonholed and consequently lose their motivation as a result.

He said: "For example, a student categorized as an auditory learner may end up thinking there is no point in pursuing studies in visual subjects such as art, or written subjects like journalism and then be demotivated during those classes.."

An additional concern is the creation of unwarranted and unrealistic expectations among educators.

Professor Newton said: "If students do not achieve the academic grades they expect, or do not enjoy their learning; if students are not taught in a way that matches their supposed learning style, then they may attribute these negative experiences to a lack of matching and be further demotivated for future study."

He added: "Spending time trying to match a student to a learning style could be a waste of valuable time and resources."

The paper points out that there are many other teaching methods which demonstrably promote learning and are simple and easy to learn, such as use of practice tests, or the spacing of instruction, and it would be better to focus on promoting them instead.

In the paper, published in journal Frontiers in Education the researchers detail how they conducted a review of relevant studies to see if the data does suggest there is confusion.

They found 89.1 per cent of 15,045 educators believed that individuals learn better when they receive information in their preferred learning style.

He said: "Perhaps the most concerning finding is that there is no evidence that this belief is decreasing."

Professor Newton suggests history is repeating itself: "If educators are themselves screened using learning styles instruments as students then it seems reasonable that they would then enter teacher-training with a view that the use of learning styles is a good thing, and so the cycle of belief would be self-perpetuating."

The study concludes that belief in matching instruction to learning styles is remains high.

He said: "There is no sign that this is declining, despite many years of work, in the academic literature and popular press, highlighting this lack of evidence.

However, he also cautioned against over-reaction to the data, much of which was derived from studies where it may not be clear that educators were asked about specific learning styles instruments, rather than individual preferences for learning or other interpretations of the theory.

"To understand this fully, future work should focus on the objective behaviour of educators. How many of us actually match instruction to the individual learning styles of students, and what are the consequences when we do? Should we instead focus on promoting effective approaches rather than debunking myths?"

Researchers who studied antibody and immune cell responses in more than 180 men and women who had recovered from COVID-19 report these patients' immune memory to the virus - across all immune cell types studied - was measurable for up to 8 months after symptoms appeared. The results indicate "that durable immunity against secondary COVID-19 disease is a possibility in most individuals," the authors say. As the number of daily COVID-19 cases worldwide continues to mount, whether an initial infection with SARS-CoV-2 leads to long-lasting protective immunity against COVID-19 remains a question. Studying the nature of the humoral response to the virus, which includes an antibody response, and of the cellular immune response, which includes B cells and T cells, over periods of six months after symptoms start could help inform protective immunity's duration. To do this, Jennifer Dan and colleagues recruited more than 180 men and women from the United States who had recovered from the disease. The majority had had mild symptoms that did not require hospitalization, though 7% were hospitalized. Most subjects provided a blood sample at a single time point, between six days and eight months after symptoms took hold, though 43 samples were provided at 6 months or more following symptom onset. In 254 total samples from 188 COVID-19 cases, Dan and colleagues tracked antibodies, B cells (which produce more antibodies), and two types of T cells (which kill cells that are infected). Antibodies, including to viral spike protein components, only exhibited modest declines at six to eight months after symptom onset. T cells, meanwhile, showed only a slight decay in the body, while B cells that recognized features of the SARS-CoV-2 virus grew in number in some cases, the authors say. While the authors caution that "direct conclusions about protective immunity cannot be made on the basis of [their findings] because mechanisms of protective immunity against SARS-CoV-2 or COVID-19 are not defined in humans," they also say that several "reasonable interpretations" can be made from their study. These include support for resting immune memory compartments potentially contributing "in meaningful ways to protective immunity against pneumonia or severe secondary COVID-19," the authors write.

Scientists have uncovered why a food-ingredient-based pesticide made from safflower and cottonseed oils is effective against two-spotted spider mites that attack over a thousand species of plants while sparing the mites' natural predators.

An international team of scientists has uncovered how a bio-pesticide works against spider mites while sparing their natural predators.

The findings, published in the journal Engineering in Life Sciences on October 7, 2020, could present farmers and gardeners with an eco-friendly alternative to synthetic pesticides.

Food ingredients have long been used as alternative pesticides against arthropod pests, such as insects, ticks, and mites, because they tend to be less toxic to mammals and pose less impact to the environment. The way bio-pesticides work - often through physical properties instead of chemical ones - also reduces the likelihood that the targeted pest will develop resistance to the pesticide, in turn reducing the need to use greater quantities of the pesticide or develop new ones.

One such bio-pesticide, made from safflower and cottonseed oils--which takes the brand name Suffoil--has been known to be effective against two-spotted spider mites (Tetranychus urticae), a species of arachnid that attacks more than 1,100 species of plants. Suffoil has no effect on another species of mite (Neoseiulus californicus) that naturally preys on the spider mite.

A spider mite normally hatches by cutting the eggshell, or "chorion," with its appendages as it rotates in the egg. The rotation in turn helps it cut more of the chorion and eases hatching. The spider mite embryo also uses silk threads surrounding the eggs, woven by its parent to house the eggs on the underside of leaves, which may act as leverage to aid this rotation.

To understand how Suffoil works against spider mites, the researchers dipped spider mite eggs in Suffoil and examined them using powerful microscopes. They also used spider mite eggs dipped in water as a control group.

They found that Suffoil partly covered the surface of spider mite eggs and the surrounding silk threads. More importantly, they observed that the embryonic rotational movement essential for hatching was absent or stopped in the Suffoil-covered eggs. It appears that the oil seeps into the eggs through the cut chorion, making the inside too slick for the embryo to rotate, thus preventing the embryo from hatching properly.

"The bio-pesticide works by preventing the spider mite embryo from rotating within its eggshell for hatching," said Takeshi Suzuki, a bio-engineer at Tokyo University of Agriculture and Technology (TUAT) and senior author of the study.

"It may also weaken the toughness of silk threads and reduce the anchoring effect of the egg on the substrate," said Suzuki.

The findings also offer an explanation as to why Suffoil has no effect on the spider mites' natural predators - they don't use rotation to hatch out of their eggs. This means that Suffoil may be used in conjunction with the spider mites' natural predators.

CLEVELAND, Ohio (January 5, 2021)--Sexual dysfunction often accompanies the menopause transition. Yet, not all women experience it the same. A new study identified the determinants that affect a woman's risk of sexual dysfunction and sought to determine the effectiveness of hormone therapy in decreasing that risk and modifying sexual behavior. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Although hot flashes easily rank as the most common symptom of menopause, the transition is often accompanied by other issues, including changes that affect a woman's libido, sexual satisfaction, and overall sexual behavior. Because hormone therapy is the most-effective treatment option to help women manage menopause symptoms, it was the focus of a new study designed to determine why some women experience greater sexual dysfunction than others.

The study involving more than 200 women aged 45 to 55 years found that women with secondary and higher education and a greater number of lifetime sexual partners were less likely to experience sexual dysfunction. In contrast, women with more anxious behaviors during sexual activity and those with more severe menopause symptoms were more at risk for sexual dysfunction.

Hormone therapy was not found to mitigate the risk for sexual dysfunction, nor did it play a major role in determining sexual behaviors. However, women using hormone therapy typically had higher body esteem during sexual activities; better sexual function in all domains, except for desire/interest; better quality of relationships; and fewer sexual complaints (other than arousal problems) than those women who do not. Of importance to helping maintain a woman's sexual function were positive sexual experiences, attitudes about sex, body image, and relationship intimacy.

Results are published in the article "Sexual behaviors and function during menopausal transition--does menopausal hormone therapy play a role?"

"These results are consistent with the findings of prior studies and emphasize that factors other than use of hormone therapy, such as higher importance of sex, positive attitudes toward sex, satisfaction with one's partner, and fewer genitourinary symptoms associated with menopause appear to be protective and are linked to better sexual function across the menopause transition," says Dr. Stephanie Faubion, NAMS medical director.

CLEVELAND, Ohio (January 5, 2021)--Fiber is a commonly recommended part of a healthy diet. That's because it's good for your health in so many ways--from weight management to reducing the risk of diabetes, heart disease, and some types of cancer. A new study also finds that it might be linked with a reduced risk of depression, especially in premenopausal women. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Depression is a common and serious mental health condition that not only affects a person's ability to perform daily activities but can also lead to suicide. It's estimated that more than 264 million people worldwide have depression, with numbers increasing over time. This debilitating condition is much more common in women, and there are a number of theories as to why this is the case. Changes in hormone levels in perimenopausal women have been linked to depression.

Because of the serious consequences and prevalence of depression, numerous studies have been undertaken to evaluate treatment options beyond the use of antidepressants. Lifestyle interventions, including diet, exercise, and mindfulness, may help to reduce the risk for depression. In this new study involving more than 5,800 women of various ages, researchers specifically sought to investigate the relationship between dietary fiber intake and depression in women by menopause status. Dietary fiber is found mainly in fruit, vegetables, whole grains, and legumes.

Previous studies have already suggested the benefits of fiber for mental health, but this is the first known study to categorize the association in premenopausal and postmenopausal women. It also included a broader range of ages in participants and involved women who underwent natural, as well as surgical, menopause.

The study confirmed an inverse association between dietary-fiber intake and depression in premenopausal women after adjusting for other variables, but no significant difference was documented in postmenopausal women. Research has suggested that estrogen depletion may play a role in explaining why postmenopausal women don't benefit as much from increased dietary fiber, because estrogen affects the balance of gut microorganisms found in premenopausal and postmenopausal women. The link between dietary fiber and depression may be partially explained by gut-brain interactions, because it is theorized that changes in gut-microbiota composition may affect neurotransmission. Fiber improves the richness and diversity of gut microbiota.

Results are published in the article "Inverse association between dietary fiber intake and depression in premenopausal women: a nationwide population-based survey."

"This study highlights an important link between dietary fiber intake and depression, but the direction of the association is unclear in this observational study, such that women with better mental health may have had a healthier diet and consumed more fiber, or a higher dietary fiber intake may have contributed to improved brain health by modulating the gut microbiome or some combination. Nonetheless, it has never been more true that 'you are what you eat,' given that what we eat has a profound effect on the gut microbiome which appears to play a key role in health and disease," says Dr. Stephanie Faubion, NAMS medical director.

As children undergo treatment for cancer, they may miss school and risk falling behind in their education. An analysis published in Pyscho-Oncology has examined the educational support programs provided to children with cancer.

The analysis looked at several different peer programs, teacher programs, and school re-entry programs. School re-entry programs appeared to provide a promising structure for future educational support programs.

The authors of the analysis recommend strategies for developing and evaluating educational support that adheres to the Psychosocial Standards of Care in pediatric oncology developed in 2015.

From 2007 to 2016, food insecurity--or limited access to nutritious foods because of a lack of financial resources--increased significantly from 5.5% to 12.4% among older US adults, and the increase was more pronounced among individuals with lower income. The findings come from a study published in the Journal of the American Geriatric Society.

The study, which drew from data from National Health and Nutrition Examination Surveys, also found that older adults who had food insecurity tended to have lower quality diets.

"Our results provide further evidence that food insecurity is a serious health concern among older adults. Continued investment in public health programs and policies are needed to simultaneously improve food security and nutritional intake for older Americans, all of which has become more urgent during the current COVID-19 pandemic," said co-author Cindy Leung, ScD, MPH, of the University of Michigan, Ann Arbor.

Antibiotics are not necessary for patients after most routine endoscopic sinus surgeries despite the common practice to prescribe them, according to a team led by researchers at Massachusetts Eye and Ear.

In a new randomized controlled trial, patients who underwent endoscopic sinus surgery had no differences in outcomes including symptoms and infections whether they took an antibiotic or placebo after surgery. The only reported difference in outcomes was in side effects, with patients in the antibiotic group 10 times more likely to report symptoms like diarrhea.

The trial's findings were published December 19 in IFAR: International Forum of Allergy & Rhinology.

"For routine sinus surgery, antibiotics are unnecessary and may cause more complications like gastrointestinal side effects" said study co-senior author Eric H. Holbrook, MD, director of the Division of Rhinology at Mass Eye and Ear and Associate Professor of Otolaryngology-Head and Neck Surgery at Harvard Medical School. "There have been studies that have suggested antibiotics might help or maybe they don't, and we sought to clear that up through a rigorous randomized trial."

Randomized trial compared antibiotics and placebo

The researchers embarked on a randomized placebo-controlled trial in 2013 when they started enrolling patients at Mass Eye and Ear undergoing uncomplicated endoscopic sinus surgery. Patients without evidence of active infection during surgery were randomized to receive either a one-week regimen of an antibiotic or placebo afterwards.

A total of 77 patients (out of 134 enrolled) who met the study criteria were included in the final analysis: 37 received antibiotics and 40 did not. Patients were examined one week and six weeks after surgery.

Patients in both groups reported improvements in sinus symptoms after surgery, however there were no statistically significant differences reported in rates of infection nasal symptoms between the two groups. More than 24 percent of patients in the antibiotic group reported diarrhea compared to 2.5 percent in the placebo group.

While previous studies have looked at this issue of the utility of antibiotics after sinus surgery, there had been minimal, mixed data. This is the first study to have utilized a randomized trial to assess antibiotics on a one-week treatment duration on well-validated patient outcomes.

"Our findings suggest that otolaryngologists can rethink the practice of routinely prescribing antibiotics after endoscopic sinus surgery," said study co-senior author Stacey T. Gray, MD, director of the Sinus Center at Mass Eye and Ear and an Associate Professor of Otolaryngology-Head and Neck Surgery at Harvard Medical School. "Antibiotics should still be considered when the benefits outweigh the risks, including complex surgical procedures are performed or if the patient is at greater risk for developing an infection."

Antibiotics often prescribed after sinus surgery without evidence

More than 250,000 sinus surgeries occur each year for treating chronic sinus infections that don't respond to other medical treatment. In endoscopic sinus surgery, a scope and surgical tools are inserted into the nose to widen or open the normal drainage pathways that connect the sinuses to the nasal cavity. For people with chronic or recurrent infections, those openings can be too swollen for proper drainage.

It has long been debated whether antibiotics are routinely needed immediately after endoscopic sinus surgery to reduce risk of postoperative infections and decrease swelling, and optimize patient outcomes. A majority of sinus surgeons surveyed in previous studies reported giving antibiotics post-operatively.

Antibiotic resistance has been a long-cited concern throughout health care, especially when treating sinus infections. Unnecessary antibiotic prescriptions can also increase health care costs and impact quality of life due to related side effects.

This study only looked at routine endoscopic sinus surgery and not those that use dissolvable nasal packing, which can be a future area of study.

WEST LAFAYETTE, Ind. - A novel form of a drug used to treat osteoporosis that comes with the potential for fewer side effects may provide a new option for patients.

The work is supported by the National Institutes of Health and is published in Biophysical Journal.

Purdue University innovators developed a stabilized form of human calcitonin, which is a peptide drug already used for people with osteoporosis. Researchers at Purdue created a prodrug form of the peptide hormone to increase its effectiveness as an osteoporosis treatment.

In humans, calcitonin is the hormone responsible for normal calcium homeostasis. When prescribed to osteoporosis patients, calcitonin inhibits bone resorption, resulting in increased bone mass.

Unfortunately, human calcitonin undergoes fibrillation in aqueous solution, leading to reduced efficacy when used as a therapeutic. As a substitute, osteoporosis patients are prescribed salmon calcitonin. It does not fibrillate as rapidly but suffers from low potency and the potential for several adverse side effects.

"The technology can help make these calcitonin drugs safer and more effective," said Elizabeth Topp, a Purdue professor of physical and industrial pharmacy. "Our approach will increase the therapeutic potential of human calcitonin, promising a more effective option to replace salmon calcitonin for osteoporosis and related disorders."

To decrease the fibrillation propensity and increase the therapeutic benefit of human calcitonin, Purdue researchers phosphorylated specific amino acid residues.

"Many promising new peptide drugs tend to form fibrils," Topp said. "This technology provides a way to stabilize them in a reversible way so that the stabilizing modification comes off when the drug is given to the patient."

Sweden kept preschools, primary and lower secondary schools open during the spring of 2020. So far, little research has been done on the risk of children being seriously affected by COVID-19 when the schools were open. A study from Karolinska Institutet in Sweden has now shown that one child in 130,000 was treated in an intensive care unit on account of COVID-19 during March-June. The study has been published in New England Journal of Medicine.

So far, more than 80 million people have become ill with COVID-19 and globally, almost two million people have died from the disease. Many countries have closed down parts of society in order to reduce the spread of infection. One such measure has been to close schools.

According to the United Nations body UNESCO, schools in 195 countries have been fully or partially closed. Even now, hundreds of millions of children around the globe are unable to go to their schools because of enforced closures.

In Sweden, distance learning was put in place for upper secondary schools but not for preschools, primary or lower secondary schools which instead remained open.

So far, there have been no data on how open schools affect the risk of children being seriously affected by COVID-19. Because of that, researchers at Karolinska Institutet have conducted a registry study to find out how many children aged 1-16 years were treated in an intensive care unit for COVID-19 or for multi-inflammatory syndrome (MIS-C) which has been linked to COVID-19.

Between 1 March and 30 June 2020, 15 children with COVID-19 or MIS-C were treated in intensive care units in Sweden.

"That is the equivalent of 0.77 intensive care patients per 100,000 children in that age group. Four of the children had underlying diseases. None of the children died within two months after their period of intensive care," says Jonas F. Ludvigsson, paediatrician at Örebro University Hospital, Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and the first author of the study.

Seven of the 15 children had MIS-C. Four children needed invasive mechanical ventilation. The most common length of time in an intensive care unit was four days.

"It is very gratifying that serious COVID-19, defined here as needing treatment in an intensive care unit, is so rare among children despite schools being open during the pandemic. The next step will be to follow up the children who were treated in an intensive care unit for COVID-19 to see if they have recovered fully. My gut feeling is that children who have been seriously ill because of MIS-C seem to recover fully eventually," says Jonas F. Ludvigsson.

This study was made possible through collaboration between the Swedish Intensive Care Registry and the Swedish Paediatric Rheumatology Registry. Jonas F. Ludvigsson is managing an unrelated study on behalf of the Swedish Quality Registry for IBD, SWIBREG. There are no other reported conflicts of interests.