Culture

Siberian primrose, a species protected under the Habitats Directive of the European Union, spread northward from southern areas to the current Bothnian Bay as well as, through another route, to northern Norway with the gradually receding ice after the Ice Age. Compared to today, the warming of the climate was very slow at the time.

"Siberian primrose is specialised in growing on seashore meadows with low vegetation, which in Finland are formed by the post-glacial isostatic rebound. The species benefits from the lack of strong competitors and grazing that keeps the vegetation low," says Marko Hyvärinen, director of the Botany Unit of the Finnish Museum of Natural History, University of Helsinki.

In 2013, researchers at the Universities of Helsinki and Oulu planted both the Norwegian and Finnish varieties (Primula nutans ssubp. finmarchicha var. finmarchica and var. jokelae) at five different botanic gardens: in their home environments in Svanvik, northern Norway, and in Oulu, northern Finland, as well as in Rauma and Helsinki further south in Finland and in Tartu, Estonia.

As expected by the researchers, both varieties fared poorer in the southern gardens compared to Oulu and Svanvik, indicating that a warmer climate may be fatal for the species if it is incapable of adapting or relocating.

"We were surprised, however, by our finding that the Finnish populations were more successful in northern Norway than in Oulu - even more successful than the Norwegian variety there, in its home environment," says Postdoctoral Researcher Maria Hällfors from the Research Centre for Ecological Change at the Faculty of Biological and Environmental Sciences, University of Helsinki.

"This indicates that global warming already affects this plant species. We can only speculate how many other species are suffering from changes to their environment, if they, too, are unable to keep up with climate change," Hällfors says.

The researchers suggest that the poor adaptability of Siberian primrose in relation to global warming may contribute to the demise of these populations.

"Siberian primrose has no natural dispersal route further north. One way to help species like this to survive current and future challenges would be to relocate them, by human hand, further north. In other words, species could be protected by what is known as assisted migration," Hällfors contemplates.

Another option is to ensure that species have sufficiently large high-quality habitats to preserve populations at a viable level. This would ensure enough genetic variation within the populations, that is, different individuals that have a higher probability to posit characteristics that are suitable in the new conditions.

"In any case, investments in ex situ conservation, or the conservation of species outside their natural habitat, are needed. As an example, seeds of a species can be stored in a seed bank from where the species could be re-introduced to nature." Hällfors notes.

The risk of death is high for people who visit the emergency department (ED) for alcohol use, and the risk increases with frequency, according to a new study in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191730.

Alcohol is a major cause of disease and death worldwide. In Canada alone, hospital admissions for alcohol-related conditions outnumber those for heart attacks, and alcohol-related harms cost about $14.6 billion annually, with $3.3 billion in health care costs.

The study included people aged 16 years and older who had at least 2 ED visits for mental and behavioural issues related to alcohol within a 12-month period between January 2010 and December 2016. It included 25 813 people, of whom two-thirds (17 020) had 2 ED visits within 1 year, 22% (5704) had 3 or 4 visits, and 12% (3089) had 5 or more visits.

For people with 2 or more alcohol-related ED visits in a 12-month period, 1 in 20 would die within a year of their last ED visit. For people with 5 or more visits, the risk of death doubled.

More than two-thirds of people with 5 or more alcohol-related visits were male (71.5%), almost half (46.5%) were aged 45-64 years, and the majority (89.6%) lived in urban centres, with 40% of those coming from the lowest-income neighbourhoods.

"Our study shows a high mortality rate in relatively young, mostly urban, lower-income individuals with frequent alcohol-related ED visits," says Dr. Paul Kurdyak, senior author and scientist at ICES and the Centre for Addiction and Mental Health (CAMH). "These visits should be seen as critical opportunities for intervention on a high-risk population to reduce avoidable mortality."

The majority of deaths were from accidental poisoning, suicide and trauma, as well as diseases of the digestive system.

The authors urge more action to support this vulnerable population and save lives.

"A combination of high mortality and low hospital admission rates suggests that frequent emergency department visits in this population signal an unmet need. Given our cohort's relatively young age, effective interventions have the potential to prevent premature mortality and reduce hospital use," conclude the authors.

Social needs--such as food and economic insecurity, poor housing and neighborhood conditions, and lack of access to transportation--were common in a group of African American cancer survivors in Detroit, and they were associated with lower health-related quality of life (HRQOL). The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society (ACS).

Among cancer survivors, HRQOL--or individuals' perceived well-being regarding their mental, physical, and social health status--tends to be significantly lower among African Americans compared with other groups. Investigators looked to see if social needs may play a role in this disparity.

The analysis included 1,754 participants in the Detroit Research on Cancer Survivors (ROCS) cohort, a population-based study of African American survivors of breast, colorectal, lung, and prostate cancer. Social needs related to food insecurity, utility shut-offs, housing instability, not getting health care due to cost or lack of transportation, and negative perceptions of neighborhood safety. HRQOL was measured using a questionnaire called the Functional Assessment of Cancer Therapy-General (FACT-G).

Researchers found that more than one-third (36.3 percent) of survivors reported social needs, including 17.1 percent who reported two or more. Prevalence of social needs ranged from 8.9 percent for utility shut-offs to 14.8 percent for food insecurity. Social needs that were linked with a low HRQOL score in the FACT-G questionnaire included not getting care due to lack of transportation, housing instability, food insecurity, feeling unsafe in the neighborhood, utility shut-offs, and not getting care due to cost.

Lead author Theresa Hastert, PhD, of the Karmanos Cancer Institute and Wayne State University School of Medicine in Detroit, noted that a link between social needs and lower HRQOL among cancer survivors is not surprising; however, the association had not been quantified before. Additionally, the study was conducted in a population of African American cancer survivors, a population that is often underrepresented in cancer research. The prevalence of social needs in this population may be higher than in cancer survivors more broadly; however, the results likely apply to other populations as well.

"My hope is that these findings raise awareness among cancer care providers and cancer researchers that many patients face substantial social and financial difficulties and that these have real impacts on patients' health-related quality of life on top of cancer and cancer treatment," Dr. Hastert said. "Cancer care and survivorship settings may represent an opportunity to screen for social needs, to connect patients and survivors with programs and services to address those needs, and to implement innovative interventions to reduce health disparities by addressing social needs among Black cancer survivors. These findings also highlight the need for and importance of having a social safety net in advancing population health and health equity."

OVER-45s are at a higher risk of contracting STIs than ever before because of society's unwillingness to talk about middle-aged and older people having sex, a new report has found.

A study undertaken by the University of Chichester, alongside organisations in the UK, Belgium, and Netherlands, revealed negative attitudes and limited knowledge towards the age group's sexual health needs is associated with a generation unaware of the dangers of unprotected intercourse.

It also found that over-45s living in socially and economically-disadvantaged areas are at particularly risk of contracting sexually-transmitted infections with little awareness of available healthcare services and limited access to doctors and nurses.

The report is part of the SHIFT project: a three-year initiative which aims to develop a training model that can be used by professionals working in healthcare to improve the sexual health and wellbeing of middle-aged and older people across the UK and Europe.

University of Chichester senior lecturer Dr Ian Tyndall, who is leading the project's evaluation, said that major changes in sexual behaviour in recent decades has seen increasing numbers of sexually active older-people.

"Over-45s at most risk are generally those entering new relationships after a period of monogamy, often post-menopause, when pregnancy is no longer a consideration, but give little thought to STIs," he added. "Given improvements in life expectancy, sexual healthcare needs to improve its intervention for older adults and vulnerable groups to provide a more utilised, knowledgeable, compassionate, and effective service."

The three-year SHIFT study was launched in 2019. Following a 2.5million grant from the EU Interreg 2Seas programme, its intention is to address growing rates of STIs in over-45s and improve engagement of older people in sexual health services, including those facing socioeconomic disadvantage.

The latest SHIFT report included around 800 participants across the south coast of England and northern regions of Belgium and the Netherlands, nearly 200 of which face socioeconomic disadvantage. Initial findings have highlighted four critical areas where, the researchers believe, an intervention can address the gaps in current healthcare provision: awareness, access, knowledge, and stigma.

Awareness: The results showed that a significant number of participants were unaware of the risks of STI, while 46 per cent did not know the location of their nearest healthcare centre. Researchers did, however, find that social media was the most effective tool for encouraging engagement with sexual health services - ahead of leaflets or GP appointments.

Knowledge: The participants highlighted that their health professionals, including doctors and nurses, lacked sufficient sexual health knowledge - and consequently only half had a recent STI test. There is therefore an "urgent need" to create a tailored training programme to increase understanding in the wider healthcare workforce, the researchers wrote.

Stigma: Shame was identified as the biggest barrier to accessing sexual healthcare services, according to the report. A number of participants felt that sexual health has become a "dirty" term which is discouraging people from attending regular check-ups.

Access: Limited information around the location of sexual health centres and restricted opening times were a consistent problem for many participants. Others living in more rural locations also mentioned that growing costs of public transport was a barrier to appointments.

Fellow SHIFT researcher Dr Ruth Lowry added: "It is clear from the numbers reporting fear of being judged by important others who know them and by health professionals that stigma remains a crucial barrier to address in any sexual health promotion intervention.

"The findings have also shown that groups with one or more socio-economic disadvantages, such as homeless people, sex workers, non-native language speakers and migrants, are at even greater risk of being unaware of their sexual health and unable to access the appropriate services."

The SHIFT partners intend to have an effective intervention ready by 2021, after which it will be rolled out to healthcare professionals, with the research published in 2022. It intends to reach as many as 150,000 people across the south coast of the UK, France, Belgium, and the Netherlands.

The survey was distributed prior to the Covid-19 pandemic, while focus groups and interviews are taking place via video calls to navigate restrictions in jurisdictions across participating countries.

To find out more about the SHIFT project go to http://www.interreg2seas.eu/en/shift.

The World Health Organization developed the new Labour Care Guide to support clinicians in providing good quality, women-centred care during labour and childbirth. In a study published in Birth, researchers evaluated the usability, feasibility, and acceptability of the new Labour Care Guide for maternity care providers in six countries.

The guide is a next-generation partograph--a paper-based graphical record of key maternal and fetal data during labour. For the study, 136 doctors, midwives, and nurses in 12 health facilities across Argentina, India, Kenya, Malawi, Nigeria, and Tanzania applied the Labour Care Guide in managing labour and birth in 1,226 low-risk women.

Most women (91.6%) had a spontaneous vaginal birth, and two cases of stillbirths (1.63 per 1,000 births) occurred. Providers were highly satisfied with the Guide, and they identified some design improvements to improve its usability. Providers described it as supporting precise and meticulous monitoring during labour, encouraging critical thinking in labour management, and improving the provision of woman-centred care.

"We successfully demonstrated that the World Health Organization's Labour Care Guide can be used to support women-centred care in a range of settings, including settings where resources are somewhat limited," said corresponding author Dr. Joshua Vogel, PhD, MBBS, of the Burnet Institute, in Australia.

A team led by researchers at Baylor College of Medicine and Rice University has developed artificial intelligence (AI) models that help them better understand the brain computations that underlie thoughts. This is new, because until now there has been no method to measure thoughts. The researchers first developed a new model that can estimate thoughts by evaluating behavior, and then tested their model on a trained artificial brain where they found neural activity associated with those estimates of thoughts. The theoretical study appears in the Proceedings of the National Academy of Sciences.

"For centuries, neuroscientists have studied how the brain works by relating brain activity to inputs and outputs. For instance, when studying the neuroscience of movement, scientists measure muscle movements as well as neuronal activity, and then relate those two measurements," said corresponding author Dr. Xaq Pitkow, assistant professor of neuroscience at Baylor and of electrical and computer engineering at Rice. "To study cognition in the brain, however, we don't have anything to compare the measured neural activity to."

To understand how the brain gives rise to thought, researchers first need to measure a thought. They developed a method called "Inverse Rational Control" that looks at a behavior and infers the beliefs or thoughts that best explain that behavior.

Traditionally, researchers in this field have worked with the idea that animals solve tasks optimally, behaving in a way that maximizes their net benefits. But when scientists study animal behavior, they find that this is not always the case.

"Sometimes animals have 'wrong' beliefs or assumptions about what's going on in their environment, but still they try to find the best long-term outcomes for their task, given what they believe is going on around them. This could account for why animals seem to behave suboptimally," said Pitkow, who also is a McNair Scholar at Baylor, co-director of Baylor's Center for Neuroscience and Artificial Intelligence and member of the Rice Neuroengineering Initiative.

For example, consider an animal that is hunting and hears many noises it associates with prey. If one potential prey is making all the noises, the optimal behavior for the hunter is to consistently target its movements to a single noise. If the hunter mistakenly believes the noises are coming from many different animals, it may choose a suboptimal behavior, like constantly scanning its surroundings to try and pinpoint one of them. By acting according to its belief or assumption that there are many potential prey nearby, the hunter is behaving in a way that is simultaneously 'rational' and 'suboptimal.'

In the second part of the work, Pitkow and his colleagues developed a model to relate the thoughts that were identified using the Inverse Rational Control method to brain activity.

"We can look at the dynamics of the modeled thoughts and at the dynamics of the brain's representations of those thoughts. If those dynamics run parallel to each other, then we have confidence that we are capturing the aspects of the brain computations involved in those thoughts," Pitkow said. "By providing methods to estimate thoughts and interpret neural activity associated with them, this study can help scientists understand how the brain produces complex behavior and provide new perspectives on neurological conditions."

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.

1. Type O and Rh negative blood groups associated with slightly lower risk for SARS-CoV-2 infection

A person's blood type may affect their risk for SARS-CoV-2 infection and for developing severe COVID-19-related illness. A population-based retrospective cohort study is published in Annals of Internal Medicine.

Researchers from ICES in Toronto studied 225,556 persons who had an ABO blood group test from January 2007 to December 2019, and had a SARS-CoV-2 lab test subsequently to determine whether ABO and Rh blood groups are associated with risk for SARS-CoV-2 infection and severe COVID-19 illness. The population-based study was conducted in Ontario Canada, which has universal health care and widespread SARS-CoV-2 testing. The authors found that O and Rh? blood groups were associated with a slightly lower risk for SARSCoV-2 infection as well as severe COVID-19 illness or death. The authors wonder whether similar differences will be seen within ongoing clinical trials studying the therapeutic efficacy of SARS-CoV-2 immunotherapy or vaccination. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-4511.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Joel Ray, MD, MSc, can be reached through Deborah Creatura at deborah.creatura@ices.on.ca.

2. If licensed soon, a SARS-CoV-2 vaccine would be an unprecedented achievement

The development of a safe and effective vaccine for SARS-CoV-2 is a crucial global health goal, but anticipated success rates and timelines for COVID-19 vaccine development vary.

Researchers from McGill University reviewed trials testing viral vaccines that had not advanced to phase 2 between January 2005 and March 2020 on ClinicalTrials.gov, and tracked the progress of each vaccine from phase 1 through to FDA licensure to estimate timelines and probabilities of success for recent vaccine candidates. Ultimately, they found success probabilities and timelines varied widely across different vaccine types and diseases. If a SARS-CoV-2 vaccine is licensed within 18 months of the start of the pandemic, it will mark an unprecedented achievement for noninfluenza viral vaccine development. The findings are published in Annals of Internal Medicine. Read the full text: xhttps://www.acpjournals.org/doi/10.7326/M20-5350.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Jonathan Kimmelman, PhD, can be reached at jonathan.kimmelman@mcgill.ca.

3. Surviving COVID-19 patients may benefit from home health care after hospital discharge

Survivors of COVID-19 are a vulnerable population and may require further hospitalization, but little is known about recovery after hospital discharge. Authors from the University of Pennsylvania Schools of Nursing and Medicine, Villanova University Fitzpatrick College of Nursing, and the Visiting Nurse Service of New York describe the home health recovery of patients with COVID-19 and risk factors associated with rehospitalization or death.

The researchers studied 1,409 patients with COVID-19 admitted to home health care (HHC) after hospitalization. After an average of 32 days in HHC, 94 percent of patients were discharged and most achieved statistically significant improvements in symptoms and function. These findings suggest that acute care providers might carefully consider which COVID-19 survivors would benefit from HHC after hospitalization. They call for further research to determine longer-term outcomes of CO VID-19 and to target extra attention to patients with risk factors. The findings are published in Annals of Internal Medicine. Read the full text: xhttps://www.acpjournals.org/doi/10.7326/M20-5206.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the lead author, Kathryn H. Bowles, BSN, MSN, PhD, please contact Ed Frederico at efed@nursing.upenn.edu. To speak with someone from the Visiting Nurse Service of New York, please contact Caren Browning at caren.browning@kingcompr.com. To speak with someone at Penn Medicine, please contact Holly Auer at Holly.Auer@pennmedicine.upenn.edu. To reach someone at Villanova, please email Ann McKenzie at ann.mckenzie@villanova.edu or Carita Geib at carita.geib@villanova.edu.

Mothers leave their mark on their children in many ways - and Australian researchers have discovered a protein called SMCHD1 is involved in this 'imprinting' process.

SMCHD1 switches certain genes off, altering how a cell behaves. The new research has revealed that when an egg cell (or oocyte) is fertilised by a sperm, the egg cell's SMCHD1 lingers within the developing embryo, switching off at least 10 different genes and impacting the embryo's development - which could potentially have a lifelong impact on the offspring.

The research was published in eLife by a WEHI team led by Ms Iromi Wanigasuriya, Dr Quentin Gouil and Professor Marnie Blewitt, in collaboration with WEHI's Dr Matthew Ritchie, Dr Heather Lee from the University of Newcastle and Associate Professor Karla Hutt from Monash Biomedicine Discovery Institute.

At a glance

Some genes have different expression, depending on whether they have been inherited from the mother or father - a phenomenon called genomic imprinting

WEHI researchers have discovered that the protein SMCHD1 is involved in genomic imprinting, with protein from the mother lingering in an embryo and switching ten genes off

The discovery sheds new light on how genomic imprinting occurs, and may reveal new clues to how SMCHD1 contributes to certain developmental and degenerative disorders.

Imprinted genes

We inherit all our genes from our parents - and there are a few genes that behave differently in offspring, depending on whether they are inherited from the mother or the father. This phenomenon is called 'genomic imprinting', and is seen in some genetic diseases, said Ms Wanigasuriya, who undertook the research as a PhD student at WEHI.

"Genomic imprinting occurs because of 'epigenetic marks' on DNA that impact how genes can be used," she said. "When a sperm fertilises an egg, both cells' DNA carries epigenetic marks from the parent to the child, which in some cases have been linked to long-term health impacts," she said. "It is known that proteins found within the egg (proteins that we get from our mum) help to protect these imprinted genes during early embryo development. Therefore, these egg cell proteins can have either a long or a short-term impact on the health of the embryo.".

Professor Blewitt's research team has been studying the SMCHD1 protein, which uses epigenetic modification to 'switch off' or silence certain genes.

"We investigated whether a mother's SMCHD1 protein could be transferred into a newly formed embryo, and how this impacted the expression of imprinted genes," Ms Wanigasuriya said. "Using advanced microscopy to follow a fluorescently tagged version of SMCHD1, we could see that the maternal SMCHD1 protein persisted within embryos for at least five cell divisions. The mother's SMCHD1 altered the imprinted gene expression - potentially leaving a lasting legacy in the offspring."

Understanding SMCHD1

Dr Gouil said the research revealed a critical window of time in early embryonic development during which the mother's SMCHD1 could silence the expression of target genes.

"Using powerful new genomic analysis techniques, we were able to identify ten genes that were switched off by maternal SMCHD1 in the early embryo. This is the first time SMCHD1 from the egg has been identified as having a role in imprinting," he said.

"While the effects we discovered were subtle, we know that events occurring in early embryonic development can have long-term effects on health. As well as extending our understanding of genomic imprinting, this research adds an extra dimension to the many ways we know parents can impact their offspring's health."

Professor Blewitt said the research also helped to explain recently discovered roles of SMCHD1 in certain diseases including developmental disorders such as Prader-Willi Syndrome (PWS) and Bosma arhinia microphthalmia syndrome (BAMS), as well as facioscapulohumeral muscular dystrophy (FSHD), a form of muscular dystrophy.

"Studying SMCHD1 in early embryos has uncovered new gene targets that this protein silences," she said. "This could explain how changes in SMCHD1 activity contribute to diseases. We are currently leading a proprietary drug discovery effort at WEHI to leverage our knowledge around SMCHD1 and design novel therapies to treat developmental and degenerative disorders. This research broadens our understanding of how these novel drug candidates might impact gene expression."

Machine learning could teach us how to make the manufacturing of materials cleaner and more sustainable by taking a holistic view to identify the greenest production method, suggest KAUST researchers.

The quest for sustainability means that scientists worldwide are developing advanced materials to help address issues, including carbon capture, water desalination and energy storage, says Rifan Hardian, a postdoc in Gyorgy Szekely's lab. "Although these materials show promising performance, the materials themselves are often produced in unsustainable ways--using harsh conditions, toxic solvents and energy-intensive processes that generate excessive waste--potentially creating more environmental problems than they solve," Hardian says.

In collaboration with Xiangliang Zhang and his team, Szekely and Hardian have been investigating a more sustainable approach to materials development, called design of experiments (DoE). "Unlike conventional approaches to materials optimization, which vary one factor at a time, DoE is a systematic approach that allows multiple factors to be varied simultaneously," Hardian says.

DoE theoretically allows variables--such as reactant and solvent choice, reaction time and reaction temperature--to be optimized all at once. The procedure cuts the number of experiments conducted and also potentially identifies the greenest possible way to make a material. However, it is challenging to optimize each variable to identify the best reaction protocol from such sparse experimental data. "This is where machine learning comes in," Hardian says.

Machine learning is a form of artificial intelligence that can learn patterns from a limited number of data points to fill in the blanks in the data. "This way, one can view the entire experimental space and pick the one reaction condition that best fits the desired results," Hardian says.

The team combined DoE and machine learning to identify a sustainable method for making a popular metal organic framework (MOF) material called ZIF-8. "ZIF-8 has great potential in applications, such as gas separation, catalysis, heavy metal removal and environmental remediation," Hardian says. The team optimized 10 variables in the electrochemical synthesis of ZIF-8, identifying a high-yielding process that used water as a solvent and generated minimal waste. "Thanks to machine learning, we developed a holistic view of the variables' interactions and identified many unexpected correlations that could have been missed if we had followed a conventional approach," Hardian says.

The next milestone will be to apply DoE and machine learning to large-scale materials production, Szekely says. "Ultimately, our aim is to turn the futuristic vision of an autonomous laboratory system, which can continuously run and self-optimize reaction conditions, into a reality," he says.

A new technique to make cheaper more efficient biological enzyme hybrids could have valuable applications in future water recycling, targeted drug manufacturing and other industries, Flinders University green chemistry researchers say in a new publication.

The model enzyme system, which immobilises a catalyst enzyme hybrid for continuous flow use in the high-speed vortex fluidic device, showed a 16-fold increase in its efficiency, the researchers say in American Chemical Society journal, ASC Applied Materials & Interfaces.

Flinders Professor of Clean Technology Colin Raston, from the Flinders Institute for Nanoscale Science and Technology, with collaborator Professor Greg Weiss at University of California Irvine and other researchers around the world, have extensively used the vortex fluidic device in a wide range of applications - many of which promise to open new frontiers in clean manufacturing and even new industries.

Lead author on the new paper, Flinders University research associate Dr Xuan Luo, says the cost and limited life of enzymes hinders development of enzyme-based biosensors and most enzymes are made inactive during the assay process so cannot be separated for reuse.

"We used an inorganic composite to trap the enzyme on the surface of the vortex fluidic device, essentially making a 'mini factory' where the enzyme was reused under continuous flow," Dr Luo says.

"The technique uses the minimum amount of enzyme, which is less expensive, and monitors the reaction in real-time, also saving time and money on reagents."

Professor Raston, a finalist for South Australian Scientist of the Year 2020, says the paper demonstrates four applications of the vortex fluidic device - fabrication, immobilisation, continuous flow and real-time monitoring.

"In this study, we were able to generate and immobilise laccase nanoflowers into silica hydrogel to greatly simplify the fabrication process, and allow saving of both time and money, along with the ability to reuse the enzyme for further reactions," says co-author Professor Raston says.

"The next steps will be to test the model system with actual samples such as wastewater, and also use this same immobilisation system with other enzymes to see if their efficiency is increased."

The paper describes the immobilisation of hybrid protein-Cu3(PO4)2 nanoflowers to create a new laccase nanoflower immobilisation platform, LNF@silica, which subsequently increased the enzyme efficiency by 16 times and allowed assay monitoring in real-time.

An England-wide case-control study led by Queen Mary University of London has shown that, despite major improvements in diagnostic techniques and treatments, mammography screening continues to play an important role in lowering the risk of dying from breast cancer.

The study of over 23,000 women showed a 37% reduction in breast cancer mortality for women screened at least once, corresponding to approximately nine breast cancer deaths prevented between ages 55 and 79 for every 1000 women attending screening at ages 50-69. The effect of screening within the NHS Breast Screening Programme in England is stronger and longer lasting in women aged 65 or over, but it remains highly relevant for younger women.

Corresponding author Professor Stephen Duffy from Queen Mary University of London said: "The NHS Breast Screening Programme is doing its job in reducing the risk of death from breast cancer. Our results indicate that the benefit persists for 3-4 years in women aged under 65, so slippage of the three-year interval would be unsafe for these women.

"In the current Covid crisis, efforts to reinstate the breast screening programme should continue apace. If difficult decisions about delivery of the programme have to be made in the future, it may be appropriate to consider different intervals between screens for different age groups."

Compared with people who ate meat, vegans with lower calcium and protein intakes on average, had a 43% higher risk of fractures anywhere in the body (total fractures), as well as higher risks of site-specific fractures of the hips, legs and vertebrae, according to a study published in the open access journal BMC Medicine. Vegetarians and people who ate fish but not meat had a higher risk of hip fractures, compared to people who ate meat. However, the risk of fractures was partly reduced once body mass index (BMI), dietary calcium and dietary protein intake were taken into account.

Dr Tammy Tong, Nutritional Epidemiologist at the Nuffield Department of Population Health, University of Oxford, and the lead author said: "This is the first comprehensive study on the risks of both total and site-specific fractures in people of different diet groups. We found that vegans had a higher risk of total fractures which resulted in close to 20 more cases per 1000 people over a 10-year period compared to people who ate meat. The biggest differences were for hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat, equivalent to 15 more cases per 1000 people over 10 years."

A team of researchers at the Universities of Oxford and Bristol, UK analysed data from nearly 55,000 people in the EPIC-Oxford study, a prospective cohort of men and women living in the UK, who were recruited between 1993 and 2001, many of whom do not eat meat. Prospective cohort studies identify a group of people and follow them over a period of time to understand how certain factors (in this case diet) may affect certain outcomes (in this case fracture risk).

Out of the 54,898 participants included in the present study, 29,380 ate meat, 8,037 ate fish but not meat, 15,499 were vegetarians, and 1,982 were vegans when they were recruited. Their eating habits were assessed initially at recruitment, then again in 2010. Participants were followed continuously for 18 years on average, until 2016 for the occurrence of fractures. During the time of the study, 3,941 fractures occurred in total, including 566 arm, 889 wrist, 945 hip, 366 leg, 520 ankle and 467 fractures at other main sites, defined as the clavicle, ribs and vertebrae.

In addition to a higher risk of hip fractures in vegans, vegetarians and pescetarians than the meat eaters, vegans also had a higher risk of leg fractures and other main site fractures. The authors observed no significant differences in risks between diet groups for arm, wrist or ankle fractures once BMI was taken into account. The authors found that the differences in risk of total and site-specific fractures was partly reduced once BMI, dietary calcium and dietary protein intake had been taken into account.

Dr Tong said: "Previous studies have shown that low BMI is associated with a higher risk of hip fractures, and low intakes of calcium and protein have both been linked to poorer bone health. This study showed that vegans, who on average had lower BMI as well as lower intakes of calcium and protein than meat eaters, had higher risks of fractures at several sites. Well-balanced and predominantly plant-based diets can result in improved nutrient levels and have been linked to lower risks of diseases including heart disease and diabetes. Individuals should take into account the benefits and risks of their diet, and ensure that they have adequate levels of calcium and protein and also maintain a healthy BMI, that is, neither under nor overweight."

The authors caution that they were unable to differentiate between fractures that were caused by poorer bone health (such as fractures due to a fall from standing height or less) and those that were caused by accidents because data on the causes of the fractures were not available. No data were available on differences in calcium supplement use between the different diet groups, and as in all dietary studies the estimates of nutrients such as dietary calcium or dietary protein are subject to measurement error. As the study predominantly included white European participants, generalisability to other populations or ethnicities may be limited, which could be important considering previously observed differences in bone mineral density and fracture risks by ethnicity, according to the authors.

More studies are needed from different populations, including from non-European populations, as well as cohorts with a larger proportion of men to explore possible differences in risk by sex, as around three-quarters of participants in the EPIC-Oxford cohort are women.

VIRTUAL MEETING (CST), November 22, 2020 -- Wear a mask. Stay six feet apart. Avoid large gatherings. As the world awaits a safe and effective vaccine, controlling the COVID-19 pandemic hinges on widespread compliance with these public health guidelines. But as colder weather forces people to spend more time indoors, blocking disease transmission will become more challenging than ever.

At the 73rd Annual Meeting of the American Physical Society's Division of Fluid Dynamics, researchers presented a range of studies investigating the aerodynamics of infectious disease. Their results suggest strategies for lowering risk based on a rigorous understanding of how infectious particles mix with air in confined spaces.

Research early in the pandemic focused on the role played by large, fast-falling droplets produced by coughing and sneezing. However, documented super-spreader events hinted that airborne transmission of tiny particles from everyday activities may also be a dangerous route of infection. Fifty-three of 61 singers in Washington state, for example, became infected after a 2.5-hour choir rehearsal in March. Of 67 passengers who spent two hours on a bus with a COVID-19-infected individual in Zhejiang Province, China, 24 tested positive afterward.

William Ristenpart, a chemical engineer at the University of California, Davis, found that when people speak or sing loudly, they produce dramatically larger numbers of micron-sized particles compared to when they use a normal voice. The particles produced during yelling, they found, greatly exceed the number produced during coughing. In guinea pigs, they observed influenza can spread through contaminated dust particles. If the same is true for the SARS-CoV-2, the researchers said, then objects that release contaminated dust--like tissues--may pose a risk.

Abhishek Kumar, Jean Hertzberg, and other researchers from the University of Colorado, Boulder, focused on how the virus might spread during music performance. They discussed results from experiments designed to measure aerosol emission from instrumentalists.

"Everyone was very worried about flutes early on, but it turns out that flutes don't generate that much," said Hertzberg. On the other hand, instruments like clarinets and oboes, which have wet vibrating surfaces, tend to produce copious aerosols. The good news is they can be controlled. "When you put a surgical mask over the bell of a clarinet or trumpet, it reduces the amount of aerosols back down to levels in a normal tone of voice."

Engineers led by Ruichen He at the University of Minnesota investigated a similar risk-reduction strategy in their study of the flow field and aerosols generated by various instruments. Although the level of aerosols produced varied by musician and instrument, they rarely traveled more than a foot away. Based on their findings, the researchers devised a pandemic-sensitive seating model for live orchestras and described where to place filters and audience members to reduce risk.

While many formerly officebound employees continue to work from home, employers are exploring ways to safely reopen their workplaces by maintaining sufficient social distance between individuals. Using two-dimensional simulations that modeled people as particles, Kelby Kramer and Gerald Wang from Carnegie Mellon University identified conditions that would help avoid crowding and jamming in confined spaces like hallways.

Traveling to and from office buildings in passenger cars also poses an infection risk. Kenny Breuer and his collaborators at Brown University performed numerical simulations of how air moves through passenger car cabins to identify strategies that may reduce infection risk. If air enters and exits a room at points far away from passengers, then it may reduce the risk of transmission. In a passenger car, they said, that means strategically opening some windows and closing others.

MIT mathematicians Martin Bazant and John Bush proposed a new safety guideline built on existing models of airborne disease transmission to identify maximum levels of exposure in a variety of indoor environments. Their guideline depends on a metric called "cumulative exposure time," which is determined by multiplying the number of people in a room by the duration of the exposure. The maximum depends on the size and ventilation rate of the room, the face covering of its occupant, the infectiousness of aerosolized particles, and other factors. To facilitate easy implementation of the guideline, the researchers worked with chemical engineer Kasim Khan to design an app and online spreadsheet that people can use to gauge the risk of transmission in a variety of settings.

As Bazant and Bush wrote in a forthcoming paper on the work, staying six feet apart "offers little protection from pathogen-bearing aerosol droplets sufficiently small to be continuously mixed through an indoor space." A better, flow-dynamics-based understanding of how infected particles move through a room may ultimately yield smarter strategies for reducing transmission.

VIRTUAL MEETING (CST), November 22, 2020 -- Eric Hester has spent the last three years chasing icebergs. A mathematics graduate student at the University of Sydney in Australia, Hester and researchers at Woods Hole Oceanographic Institution in Massachusetts are studying how the shape of an iceberg shapes the way it melts.

"Ice deforms as it melts," said physical oceanographer Claudia Cenedese, who has worked with Hester on the project. "It makes these very weird shapes, especially on the bottom, like the way the wind shapes a mountain on a longer time scale."

At the 73rd Annual Meeting of the American Physical Society's Division of Fluid Dynamics, Hester presented results from his group's experiments aimed at understanding how melting alters the face-changing boundary of a shrinking iceberg--and how those alterations in turn affect the melting.

The dynamics of iceberg melt is missing from most climate models, Cendese said. Including them could help with prediction: icebergs pump fresh water from ice sheets into oceans, boosting communities of living organisms. Icebergs are the dominant source of freshwater in the fjords of Greenland--and a significant contributor to freshwater loss in Antarctica. Icebergs play a critical role in the climate, Cenedese said, and shouldn't be neglected in models. The physics of melting ice is well understood, and some models simulate it accurately, she said. Others don't. "But what you can't do in those simulations is change the shape of the ice."

Icebergs form with a wide range of shapes and sizes, Hester said, and distinct thermodynamic processes affect different surfaces. The base, submerged in water, doesn't melt in the same way as the side. "And each face doesn't melt uniformly," added Cenedese.

Hester conducted his experiments by submerging a dyed block of ice in a flume with a controlled flow of water passing by, and watching it melt. He and his colleagues found that the side facing a current melts faster than sides that run parallel to flow. By combining experimental and numerical approaches, Hester and his collaborators charted the relative influences of factors like relative water velocity and aspect ratio, or the proportion of height to width on a side. Not surprisingly, they found that the bottom had the slowest melt rate.

Cenedese said Hester's project brings together collaborators from a range of disciplines and countries, and that a diverse collaboration was needed for such an interdisciplinary project. "Working in isolation isn't as productive in this case."

Other studies discussed at the conference focused on ice formation, rather than melting. During a session on particle-laden flows, engineer Jiarong Hong from the St. Anthony Falls Laboratory at the University of Minnesota, in Minneapolis, discussed results from experiments showing how turbulence influences both the speed and distribution of snow as it falls and settles. The findings could also help scientists better understand precipitation, Hong said.

Another project, presented by physicist Chao Sun from Tsinghua University in China and his group during a session on convection and buoyancy-driven flows, focused on ice formation in lakes.

Working on a grant from the Natural Science Foundation of China with Ziqi Wang from Tsinghua University, Enrico Calzavarini from the University of Lille in France, and Federico Toschi from Eindhoven University of Technology in the Netherlands, Sun showed how the formation of ice on a lake is closely tied to the fluid dynamics of the water beneath.

A lake may possess layers of water of differing densities and temperatures. "The water density anomalies can induce elaborate fluid dynamics beneath a moving ice front and can drastically change system behaviors," said Sun. "This has often been ignored in previous studies."

Sun's group combined physical experiments, numerical simulations, and theoretical models to investigate the connection between the ice and (turbulent) convective flows. They identified four distinct regimes of different flow dynamics, each of which interacts with other layers and the ice in its own ways. Even with that complexity, though, the group developed an accurate theoretical model that could be used in future studies.

"It made a fair prediction of ice layer thickness and of icing time," said Sun.

Since the formation and melting of ice plays such a critical role in the climate, he said, a better understanding of the fluid dynamics behind the process could help researchers identify and study accurately the markers of a warming world. "The time for ice to form and melt, for example, could potentially provide an indicator of climate change."

Structuring negotiations between insurers and providers, standardizing fee-for-service payments and negotiating prices can lower the United States' health care spending by slowing the rate at which healthcare prices increase, according to a Rutgers study.

The study, published in the journal Health Affairs, examined how other high-income countries that use a fee-for-service model regulate health care costs.

Although the United States has the highest health care prices in the world, the specific mechanisms commonly used by other countries to set and update prices are often overlooked. In most countries with universal health insurance, physicians are paid on a fee-for-service basis, yet health care prices there are lower than in the U.S.
To lower health care spending, American policymakers have focused on eliminating fee-for-service reimbursement, which provides an incentive for performing additional services rather than setting up price negotiations to address the main factor that drives health care spending.

U.S. policy makers emphasize the need to reduce the volume of care that the system provides, but prior research shows that U.S. health care expenditures are higher than in other countries because of the price, not the volume, of services.

The researchers compared policies in France, Germany and Japan where payers and physicians engage in structured fee negotiations and standardized prices in systems where fee-for-service is the main model of outpatient physician reimbursement. They interviewed 37 stakeholders and health policy experts in those three countries to understand the process for creating physician fee schedules and updates, to learn about recent policy changes in physician payment and to identify the remaining challenges in the use of fee-for-service payment to physicians.

"The parties involved, the frequency of fee schedule updates and the scope of the negotiations vary, but all three countries attempt to balance the interests of payers with those of physician associations," said lead author Michael K. Gusmano, lead study author and a professor at the Rutgers School of Public Health and research scholar at The Hastings Center.

Expanding public insurance and creating universal health care coverage for U.S. residents have been popular - even more so during the COVID-19 pandemic. However, addressing the price of health care is crucial for making universal coverage affordable.

The use of fee-for-service physician payment does create issues, but marking fee-for-service as the major cause of high health care spending in the United States is problematic, especially as countries with lower prices and expenditures use fee-for-service systems, while also providing universal health care to its residents. France, Germany and Japan limit the incomes of physicians by standardizing and adjusting the fees they are paid while using a variety of approaches to limit the volume of services provided.

According to Gusmano -- who is also a member of the Rutgers Institute for Health, Health Care Policy and Aging Research and Rutgers Global Health Institute -- regardless of whether the United States will pursue fundamental policy changes such as Medicare for All or incremental expansion of the Affordable Care Act, both would require that policy makers address health care prices.