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University of Sussex quantum physicists have developed an algorithm which helps early quantum computers to perform calculations most efficiently

The team used their model to calculate the expected computational power of early quantum computers

Their research highlights a fundamental advantage of the 'trapped ion' approach over other methods

Quantum physicists at the University of Sussex have created an algorithm that speeds up the rate of calculations in the early quantum computers which are currently being developed. They have created a new way to route the ions - or charged atoms - around the quantum computer to boost the efficiency of the calculations.

The Sussex team have shown how calculations in such a quantum computer can be done most efficiently, by using their new 'routing algorithm'. Their paper "Efficient Qubit Routing for a Globally Connected Trapped Ion Quantum Computer" is published in the journal Advanced Quantum Technologies.

The team working on this project was led by Professor Winfried Hensinger and included Mark Webber, Dr Steven Herbert and Dr Sebastian Weidt. The scientists have created a new algorithm which regulates traffic within the quantum computer just like managing traffic in a busy city. In the trapped ion design the qubits can be physically transported over long distances, so they can easily interact with other qubits. Their new algorithm means that data can flow through the quantum computer without any 'traffic jams'. This in turn gives rise to a more powerful quantum computer.

Quantum computers are expected to be able to solve problems that are too complex for classical computers. Quantum computers use quantum bits (qubits) to process information in a new and powerful way. The particular quantum computer architecture the team analysed first is a 'trapped ion' quantum computer, consisting of silicon microchips with individual charged atoms, or ions, levitating above the surface of the chip. These ions are used to store data, where each ion holds one quantum bit of information. Executing calculations on such a quantum computer involves moving around ions, similar to playing a game of Pacman, and the faster and more efficiently the data (the ions) can be moved around, the more powerful the quantum computer will be.

In the global race to build a large scale quantum computer there are two leading methods, 'superconducting' devices which groups such as IBM and Google focus on, and 'trapped ion' devices which are used by the University of Sussex's Ion Quantum Technology group, and the newly emerged company Universal Quantum, among others.

Superconducting quantum computers have stationary qubits which are typically only able to interact with qubits that are immediately next to each other. Calculations involving distant qubits are done by communicating through a chain of adjacent qubits, a process similar to the telephone game (also referred to as 'Chinese Whispers'), where information is whispered from one person to another along a line of people. In the same way as in the telephone game, the information tends to get more corrupted the longer the chain is. Indeed, the researchers found that this process will limit the computational power of superconducting quantum computers.

In contrast, by deploying their new routing algorithm for their trapped ion architecture, the Sussex scientists have discovered that their quantum computing approach can achieve an impressive level of computational power. 'Quantum Volume' is a new benchmark which is being used to compare the computational power of near term quantum computers. They were able to use Quantum Volume to compare their architecture against a model for superconducting qubits, where they assumed similar levels of errors for both approaches. They found that the trapped-ion approach performed consistently better than the superconducting qubit approach, because their routing algorithm essentially allows qubits to directly interact with many more qubits, which in turn gives rise to a higher expected computational power.

Mark Webber, a doctoral researcher in the Sussex Centre for Quantum technologies, at the University of Sussex, said:

"We can now predict the computational power of the quantum computers we are constructing. Our study indicates a fundamental advantage for trapped ion devices, and the new routing algorithm will allow us to maximize the performance of early quantum computers."

Professor Hensinger, director of the Sussex Centre for Quantum Technologies at the University of Sussex said:

"Indeed, this work is yet another stepping stone towards building practical quantum computers that can solve real world problems."

Professor Winfried Hensinger and Dr Sebastian Weidt have recently launched their spin-out company Universal Quantum which aims to build the world's first large scale quantum computer. It has attracted backing from some of the world's most powerful tech investors. The team was the first to publish a blue-print for how to build a large scale trapped ion quantum computer in 2017.

New research by the University of Minnesota and the University of Washington finds that every six additional ICU beds or seven additional non-ICU beds filled by COVID-19 patients leads to one additional COVID-19 death over the following week.

"A spike in hospitalization naturally leads to more deaths, but these deaths may not only come from those who are hospitalized, but also from those who should have been hospitalized but were not," said co-author Anirban Basu, a UW professor of health economics.

Results of the study, published in the Journal of General Internal Medicine, show the impact of ICU bed use remains fairly constant as ICU bed availability changes. These effects are also in line with recent literature estimates for the mortality among COVID-19 patients receiving critical care, that show mortality rates increase as ICUs fill up.

What was surprising, Basu explained, was the effect of non-ICU beds. For additional seven hospitalized patients not in intensive care, one would expect about 0.5 deaths over the next seven days based on general data put out by CDC. However, this new research finds that the total number of COVID-19 deaths actually occurring is much higher.

"This may indicate that constraints in available capacity of non-ICU beds may have a spillover effect to non-hospitalized patients. In fact, the study found that the effect of non-ICU beds rises steadily as more and more non-ICU beds are occupied by COVID-19 patients," said Basu, who is also director of the CHOICE Institute at the UW School of Pharmacy.

For example, when 20% of non-ICU hospital beds are occupied by COVID-19 patients, an additional seven COVID-19 admissions to non-ICU beds will produce two additional COVID-19 deaths over the next seven days.

"Even when, say, 80% of non-ICU beds are still available, a further increase in COVID-19 admissions leads to significantly more numbers of deaths than what we would expect from only the hospitalized patients. This may be because the health care delivery within a hospital is not only driven by hospital beds but also personnel and COVID-specific supplies, which may be stretched thin, and affecting COVID-19 admission policies of the hospitals."

Consequently, Basu said, efforts to "flatten the curve" -- that is, reduce or stop the increase of people infected with the novel coronavirus through public health measures such as mask-wearing and physical distancing -- are more important than simply keeping hospitals from becoming overwhelmed. Failure to flatten the curve, even before hospitals reach capacity, is killing more people than just those who end up in hospital beds.

"These results have very important implications as large numbers of students head back to schools and colleges across the nation and resistance to public health measures continues to stymie efforts to reduce the number of infected," Basu said.

"Our study quantifies the relationship between COVID-19 deaths and COVID-19 hospitalizations using actual data," write the study authors. "These estimates provide a better understanding of the projections of the COVID-19 pandemic in the USA especially when states are gearing up to restart economic activities and provide important practice insights for hospitals in terms of assessment of hospital bed and ICU bed capacity and preparedness."

The human microbiota plays an important role in health and well-being by assisting in digestion, producing nutrients, resisting invading pathogens and regulating metabolism and the immune system.

We use antimicrobial (AM) drugs to treat common infections even though they have an immediate effect on microbial diversity and composition.

Most of the studies have earlier focused on faecal (gut) microbiota, but microbes in other niches of the body have also showed importance for human health and well-being.

The Finnish Health in Teens study (Fin-HIT) is a cohort study including over 11 000 Finnish adolescents. In the most recent Fin-HIT study researchers tried to find the associations of lifelong AMs use with saliva microbiota diversity and composition in preadolescents. They used data from 808 randomly selected children in the Fin-HIT cohort with objective register data on AM purchases from the Social Insurance Institution of Finland (KELA).

On average, the children had 7.4 AM purchases during their lifespan until on average 12 years. The four most commonly used AMs were amoxicillin (43.7 %), azithromycin (24.9 %), amoxicillin-clavulanate (18.7 %) and phenoxymethylpenicillin (6.8 %).

Researchers showed in the study that frequent use of antimicrobial drugs shifted bacterial profiles in saliva. The frequent use of any AMs affected saliva microbiota.

"Microbial composition differed between high, medium and low users of AMs. These effects are also gender- and AM-dependent," says Sajan Raju, Post Doctoral Researcher at University of Helsinki.

The strongest effect with azithromycin, especially in girls

Azithromycin is used for example to middle ear infections, strep throat and pneumonia. According to the study, azithromycin had the strongest associations to shifts in bacterial profiles: each course decreased the microbiota diversity. This was more strongly observed in girls than in boys.

"Our findings emphasize a concern for high azithromycin use, which substantially impaired the bacterial diversity and affected composition as well," says Raju.

In boys, amoxicillin affected the microbial composition more than in girls. As well as azithromycin, amoxicillin is also widely used to middle ear infections and strep throat. The use of amoxicillin and amoxicillin-clavulanate was associated with the largest decrease in abundance of Rikenellaceae family.

AM use in general was associated with a decrease of Paludibacter and pathways related to amino acid degradations.

Unforeseen health impacts in the future?

The contribution of lifelong AM use on saliva microbiota is unknown and AM use might have unforeseen health impacts in the future.

"It can have health impacts such as inducing obesity or antibiotic resistant bacteria," says Raju.

The majority of children (85 %) in the study were exposed to AMs during the first three years of life.

In the study the researchers could not confirm that the purchased AMs were taken. Neither the dental status of the adolescents was not assessed in the study.

When algae and bacteria with different swimming gaits gather in large groups, their flocking behaviour diminishes, something that may reduce the risk of falling victim to aquatic predators. This finding is presented in an international study led from Lund University in Sweden.

Flocking behaviour arises seemingly spontaneously in a group of independent individuals without a clear leader. This behaviour occurs among many types of organisms, from bacteria to mammals and humans. In a new study published in Physical Review Letters, researchers at Lund University examined the flocking behaviour of two different types of microorganism. By studying the backwashes - fluid flows - created around the organisms as they swim, the researchers have been able to find out how they affect each other.

"We have looked at a mixture of two types of swimmers. Those that use 'breaststroke', namely certain types of algae, and those that swim with a 'propeller' behind them, like most bacteria", says Joakim Stenhammar, chemistry researcher at Lund University.

Previous research has shown that microorganisms with the same swimming technique can sense, and are affected by, each other's fluid flows. This means they can move in a synchronised way over long length scales several times faster than an individual bacterium can swim.

However, in the new study the Lund researchers could establish through using computer simulations and theoretical models that this flocking behaviour completely disappears when microorganisms with different swimming styles are mixed.

"Their collective fluid flows then behave as though the individuals could not sense each other's presence. You could say that the microorganisms gain a cloak of invisibility", says Joakim Stenhammar.

The new study is an important piece of the puzzle in understanding how flocking behaviour works in biological systems. Now the work will continue with the study of increasingly detailed models of how actual microorganisms behave. This will enable comparisons between the theoretical results and experimental observations.

"On a biological level there may be advantages from symbiotic ecosystems in which bacteria and algae live together. The suppression of flocking behaviour may reduce the risk of being eaten, as many aquatic predators sense the fluid flows to localise prey", concludes Joakim Stenhammar.

A team of researchers at the Max Planck Institute for Chemical Ecology in Jena, Germany, has discovered that strigolactones, a class of novel plant hormones, mediate the fine-tuning of the production plant defensive substances in the stem of plants of the wild tobacco species Nicotiana attenuata. In a cooperative project with partners in China and Korea, they found that strigolactones and their crosstalk with other hormones involved in plant defense were crucial for tobacco plants' ability to tolerate insects that live inside the stem. Plants that are no longer able to produce strigolactones also have altered concentrations of jasmontates and auxins and consequently a reduced resistance against the stem-boring larvae of the weevil Trichobaris mucorea (PLOS Biology, DOI: 10.1371/journal.pbio.3000830, August 2020).

Not only animals, but also plants have different hormones that control various processes in the body. One class of these signaling substances that were only recognized as hormones quite recently are strigolactones. In plants, they are involved in shoot formation inhibit further branching of the stem. As scientists at the Max Planck Institute for Chemical Ecology have now discovered, a change in the signaling pathway of strigolactones influences processes regulated by other plant hormones, and - as a consequence - a plant's defense against herbivores.

Observations from the field and in the glasshouse were the starting point for the investigations. "In the field, we noticed that when the pith-feeding larvae of the weevil Trichobaris mucorea attacked tobacco plants, the stems turn red. In the glasshouse, the stems of transgenic lines impaired in strigolactone biosynthesis and signaling turned red too. Since strigolactones influence branching in plants and the root-shoot junction of a plant is the initial entry place where the weevil larva makes its way into the pith of stem, we wanted to know how these hormones affect weevil resistance in tobacco," said Ming Wang, one of the study leaders.

The red coloring of the stems is caused by anthocynanins, which may also have a defensive function, but are likely involved in the indirect defense of the plants by sending a visual signal to predators of the herbivores. The increased production of the red pigments as well as higher concentrations of other defensive substances, the phenolamides, is due to the increased activity of another group of important plant hormones: the jasmonates. Genetically modified plants that were unable to produce strigolactones, as well as metabolic analyses - i.e. the measurement of the activity of individual metabolic pathways - should now provide information about the role and interaction of the hormones with regard to the resistance to the weevil.

Decreased resistance to stem-boring weevil larvae despite increased jasmonate concentrations

Particularly surprising, however, was the significantly increased concentration of jasmonates in plants in which the strigolactone signaling pathway had been silenced. "The higher levels of jasmonates in the mutants as well as the increased synthesis of the red anthocyanin pigments should have indicated a stronger defense against herbivores. However, plants lacking strigolactones were significantly more susceptible to Trichobaris mucorea attack. Given the commonly-held knowledge that plant defenses are positively regulated by jasmonate signaling, this apparent disconnect was particularly intriguing," first author Suhua Li summarizes important results of the study.

Strigolactone-impaired mutants showed a number of metabolic changes: Apart from an over-accumulation of anthocyanins and phenolamides, the absence of strigolactones also affected the production of nicotine, another important defense substance in tobacco. This work breaks new ground by showing how strigolactone interacts with jasmonate and auxin signaling to provide the particular changes in plant metabolites. The special mixture of these metabolites determine - like a cocktail drug therapy developed against diseases - resistance against the attacking herbivore. The work also provides a higher resolution answer to how strigolactone signaling interacts with particularly variable elements of jasmonate signaling: the JAZ proteins, repressors of the jasmonate signaling pathway.

Studies of plant-insect interactions have so far mainly focused free-living folivores. The weevil Trichobaris mucorea, however, lives "endophytically", i.e. it spends most of its four-month life cycle - the entire larval stage, pupation and the early adult stage before mating - inside the stem of an annual tobacco plant where it feeds on the pith. Apart from the red coloring of the stem, there are hardly any visible signs of an attack by this herbivore from the outside. All you may see is an exit hole in the stem it leaves behind after abandoning its nursery in the already withering plant. However, the relatively long life inside the plant means that the plant has to tolerate this enemy rather than defend itself like against a leaf-feeding insect, which it could fend off with defensive substances.

Defense versus tolerance

The results of the study demonstrate that although strigolactones do not directly regulate defenses against the weevil, they indirectly use the existing hormonal regulatory networks, here via jasmonates and auxins, to produce defensive substances that enable the plant to tolerate this herbivore inside its stem.

"In short, "defenses" damage the herbivores, while "tolerance" traits decrease the damage that herbivore attack causes. It is in the realm of "tolerance" traits that makes the discovery that these hormones fine-tune plant defense via their crosstalk with other hormones, such as jasmonates and auxins, so exciting," says Ian Baldwin, director of the Department of Molecular Ecology where the investigations have been carried out.

The researchers propose that strigolactones in the plant represent a kind of switch between defense against and tolerance of herbivores, a hypothesis that - if confirmed - would also offer new interesting approaches for plant breeding.

The intervertebral discs connect the vertebrae and give the spine its mobility. The disc consists of a cartilaginous fibrous ring and a gelatinous core as a buffer. It has always been assumed that only humans and other mammals have discs. A misconception, as a research team under the leadership of the University of Bonn has now discovered: Even Tyrannosaurus rex could have suffered a slipped disc. The results have now been published in the journal "Scientific Reports".

Present-day snakes and other reptiles do not have intervertebral discs; instead, their vertebrae are connected with so-called ball-and-socket joints. Here, the ball-shaped end surface of a vertebra fits into a cup-shaped depression of the adjacent vertebra, similar to a human hip joint. In-between there is cartilage and synovial fluid to keep the joint mobile. This evolutionary construction is good for today's reptiles, because it prevents the dreaded slipped disc, which is caused by parts of the disc slipping out into the spinal canal.

"I found it hard to believe that ancient reptiles did not have intervertebral discs," says paleontologist Dr. Tanja Wintrich from the Section Paleontology in the Institute of Geosciences of the University of Bonn. She noticed that the vertebrae of most dinosaurs and ancient marine reptiles look very similar to those of humans - that is, they do not have ball-and-socket joints. She therefore wondered whether extinct reptiles had intervertebral discs, but had "replaced" these with ball-and-socket joints in the course of evolution.

Comparison of the vertebrae of dinosaurs with animals still alive today

To this end, the team of researchers led by Tanja Wintrich and with the participation of the University of Cologne and the TU Bergakademie Freiberg as well as researchers from Canada and Russia examined a total of 19 different dinosaurs, other extinct reptiles, and animals still alive today. The researchers concluded that intervertebral discs not only occur in mammals. For these investigations, vertebrae still in connection were analyzed using various methods.

Surprisingly, Dr. Wintrich has now also been able to demonstrate that remnants of cartilage and even other parts of the intervertebral disc are almost always preserved in such ancient specimens, including marine reptiles like ichthyosaurs and dinosaurs like Tyrannosaurus. She then traced the evolution of the soft tissues between the vertebrae along the family tree of land animals, which 310 million years ago split into the mammalian line and the dinosaur and bird line.

Intervertebral discs emerged several times during evolution

It was previously unknown that intervertebral discs are a very ancient feature. The findings also show that intervertebral discs evolved several times during evolution in different animals, and were probably replaced by ball-and-socket joints twice in reptiles. "The reason why the intervertebral disc was replaced might be that it is more susceptible to damage than a ball-and-socket joint," says Dr. Wintrich. Nonetheless, mammals have always retained intervertebral discs, repeating the familiar pattern that they are rather limited in their evolutionary flexibility. "This insight is also central to the medical understanding of humans. The human body is not perfect, and its diseases reflect our long evolutionary history," adds paleontologist Prof. Dr. Martin Sander from the University of Bonn.

In terms of research methods, the team drew not only on paleontology, but also on medical anatomy, developmental biology and zoology. Under the microscope, dinosaur bones cut with a rock saw and then ground very thinly provide information comparable to histological sections of fixed and embedded tissue of extant animals. This makes it possible to bridge the long periods of evolution and identify developmental processes. Prof. Sander remarks: "It's truly amazing that the cartilage of the joint and apparently even the disc itself can survive for hundreds of millions of years."

Dr. Wintrich, who now works at the Institute of Anatomy of the University of Bonn, is pleased about the cooperation between the fields that has made this interdisciplinary understanding possible in the first place: "We found that even Tyrannosaurus rex was not protected against slipped discs." Only bird-like predatory dinosaurs then evolved ball-and-socket joints as well and saddle joints, still seen in today's birds. Likewise, such ball-and-socket joints were a decisive advantage for the stability of the spine of the largest dinosaurs, the long-necked dinosaurs.

This bridge between paleontology and medicine is seminal in Germany. The anatomist Prof. Dr. Karl Schilling from the University of Bonn, who was not involved in the new study, reports: "In the USA, in contrast, dinosaur researchers and evolutionary biologists are often closely involved in medical training, especially in anatomy and embryology. This gives young doctors a perspective that is becoming increasingly important in a rapidly changing environment."

August 24, 2020 - As the COVID 19 pandemic continues, business leaders face critical decisions on how to safely reopen and resume operations. A set of general guidelines for Safely Returning America to Work was published by the Journal of Occupational and Environmental Medicine, official journal of the American College of Occupational and Environmental Medicine (ACOEM). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Guidance regarding return-to-work decision-making from a worker-safety and medical perspective incorporating the principles of risk, capacity, and tolerance is critical," according to Part I of the ACOEM Guidance Document, providing general guidance for employers reopening amid the challenges of COVID-19. Posted online today, the new document will appear in the journal's September issue.

The guidance was prepared by ACOEM Return to Work (RTW) Work Group under the auspices of the Council on OEM Practice. Topic areas include:

The Context of Returning to Business. Whether they have continued to operate or are transitioning to re-opening, employers must create and communicate clear policies. Occupational and environmental medicine (OEM) physicians can provide "clear routes" to meeting challenges such as COVID 19 screenings, exposure assessments, and RTW clearances. With experience in organizational behavior, OEM specialists can also lend insights into behavioral issues and interpersonal conflicts that may occur during reopening.

Clinical Manifestations of COVID-19. The guidance addresses the now-familiar clinical findings and potential complications of COVID 19, as well as the course of recovery and rehabilitation. OEM physicians can provide advice on the care of workers recovering from illness, including possible work accommodations, as well as the mental health impact of COVID-19.

Developing a Successful RTW Policy. Employers will need to make plans to protect returning employees, including policies for dealing with infected and exposed workers, asymptomatic employees, and screening/surveillance policies. The occupational risk pyramid developed by the Occupational Safety and Health Administration (OSHA) provides a basis for assessing exposure risks associated with various job tasks.

Pre-/Re-Opening Actions. The ACOEM guidance outlines the hierarchy of controls for re-opening, emphasizing physical distancing, environmental adaptation, and education strategies. It outlines practical considerations in RTW strategy, including steps to reduce the risk of viral transmission, maintain employee mental health, and protect vulnerable populations. OEM professionals will play key roles in COVID 19 testing and interpretation.

After Opening. Good communication is essential throughout the re-opening process, with an emphasis on safety and monitoring practices. Re-opening plans will be influenced by the course of the pandemic, governmental decisions, and company leadership. Experience from other countries that are further along in reopening may provide important lessons on how to proceed.

RTW After Infection. COVID-19 testing and evaluation will have important implications for RTW after infection. OEM physicians can provide information and support for dealing with issues involving infected or exposed employees. Work-relatedness will take on special importance in workers' compensation cases involving COVID 19.

Industry-Specific Guidance. Different industries face unique challenges in re-opening, and OEM physicians will play an important role in interpreting and applying guidance in various settings. Part II of the ACOEM Guidance Document, to be published later this year, will provide more in-depth information on industry-specific concerns.

As for all articles related to COVID 19, both parts of the ACOEM Guidance Document will be made freely available on the journal website. Online versions will be updated as new information becomes available, including lessons learned from businesses that have successfully reopened.

Click here to read "Safely Returning America to Work Part I: General Guidance for Employers."

Housing programs adopted during the New Deal increased segregation in American cities and towns, creating racial disparities that continue to characterize life in the 21st century, finds a new study by New York University sociologist Jacob Faber.

"New Deal housing policies encouraged racial segregation and their substantial impact on American cities and towns can still be seen today," says Faber, whose research appears in the American Sociological Review.

The findings come weeks after the Trump Administration eliminated a program created in 2015, the Affirmatively Furthering Fair Housing rule, that was designed to combat racial segregation in suburban housing.

While scholars have long placed blame on the federal government for sowing the seeds of racial inequality thorough segregationist housing policies initially developed during the New Deal and expanded in subsequent decades, there was little empirical evidence connecting these policies to either contemporary patterns of segregation or to changes over time in those patterns.

The American Sociological Review study is the first to estimate the effects of early-20th-century housing policies on subsequent segregation patterns.

Today's practice of American homeownership stems from government programs adopted during the New Deal. The Home Owners Loan Corporation (HOLC)--and later the Federal Housing Administration and GI Bill--expanded home-buying opportunity, but were marked by segregationist practices.

"Through mechanisms such as redlining, these policies fueled White suburbanization and Black ghettoization, while laying the foundation for the racial wealth gap," explains Faber, an associate professor at NYU's Robert F. Wagner Graduate School of Public Service and the university's Department of Sociology.

The study examined a century of U.S. census data for more than 650 cities, along with other archival data documenting government redlining practices. The multi-decade investigation showed that cities that were HOLC-appraised became more segregated than those that were not. Notably, the gap emerged during America's suburbanization boom of the 1940s and 1950s and remained through the first decade of the 21st century.

In 2010, Black residents living in HOLC-appraised cities, which include large cities (e.g., New York and Chicago) as well as small towns (e.g., Fairfield, Ala., La Grange, Ill., New London, Ct., Newport News, Va., and Woburn, Mass.), were more isolated from White residents compared to Blacks living in non-appraised cities, such as Elizabeth, NJ. The effect of these programs was much larger among cities and towns in the South, which were slow to adopt fair housing legislation.

"The long-term impact of these policies is a reminder of the intentionality that shaped racial geography in the United States and the scale of intervention that will be required to disrupt the persistence of segregation," observes Faber.

A new two-stage surgical approach for cancer prevention is highly acceptable among premenopausal women at high risk of ovarian cancer, according to research led by Queen Mary University of London.

For women at high risk of ovarian cancer, the standard preventive practice is to offer removal of both the fallopian tubes and ovaries, but the surgery induces menopause in women who have not yet reached this stage of life. Early menopause is associated with side effects like increased risk of heart-disease, osteoporosis, neurocognitive decline and sexual-dysfunction. Hence, some women at high risk of ovarian cancer delay surgery until after they reach menopause. During this period they remain at much higher risk of ovarian cancer.

A proposed alternative is a two-step surgical protocol, which delays the induced menopause caused by the removal of the ovaries. In this protocol, the fallopian tubes are removed as an initial step to offer some risk reduction, and ovary removal is delayed until a later stage when women have reached menopause. This procedure provides some ovarian cancer risk reduction while avoiding detrimental consequences of premature surgically-induced menopause.

69 per cent interested in new surgical option

In the multicentre UK study, published in the British Journal of Obstetrics and Gynaecology and funded by the Rosetrees Trust and Barts Charity, researchers examined the acceptability of the proposed alternative two-step surgical protocol. The 638 study participants were all at increased risk of ovarian cancer; 346 had undergone standard risk reducing surgery, and 337 had not.

Among those who had undergone standard preventive surgery, 9.4 per cent of premenopausal and 1.2 per cent of postmenopausal women regretted their decision. Of premenopausal women who had not undergone standard surgery, 69 per cent found it acceptable to participate in a research study offering the proposed new surgical option. 38 per cent of women who had undergone standard surgery would have potentially (in hindsight) opted for the new two-step operation. The new two-step surgical protocol was particularly acceptable to women concerned about the sexual dysfunction side effects of ovary removal.

Patients sought for clinical trial into new surgery protocol

Lead researcher Professor Ranjit Manchanda from Queen Mary University of London and Barts Health NHS Trust said: "Undergoing an operation to prevent ovarian cancer can be a complex decision making process. Although removal of tubes and ovaries prevents ovarian cancer, it can lead to early surgical menopause which has significant detrimental consequences on long-term health. A number of women opt to delay or decline preventive surgery as a result.

"The new two-step operation offers additional options for women (who may have not undergone surgical prevention) to reduce their ovarian cancer risk while avoiding the negative impact of early menopause. Our study shows a large proportion of eligible women wish to consider this. UK women who wish to do so now have the option of joining the PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal) study (http://www.protector.org.uk)."

Dr Faiza Gaba from Queen Mary University of London added: "While hormone replacement therapy (HRT) has been shown to mitigate some symptoms, it does not appear to alleviate sexual-dysfunction or increase satisfaction levels following standard preventive surgery involving removal of ovaries. However HRT-use in breast cancer unaffected women undergoing premenopausal removal of their ovaries is essential to reduce the risk of heart disease, osteoporosis and neurocognitive decline. The new two-step surgery offers further options to women considering surgical prevention."

Treatments designed around women's individual needs and choices

Dr Vineeth Rajkumar, Head of Research at Rosetrees Trust said: "Rosetrees Trust is delighted to have supported Professor Manchanda's study, which has paved the way for a clinical trial that could make a difference to thousands of women at risk of ovarian cancer."

Victoria King, Director of Grants at Barts Charity added: "Barts Charity is proud to support the PROTECTOR trial, a trial which could make a huge difference to women with increased risk of ovarian cancer. It is hugely important to us that it carries the potential for better informed decision-making for women themselves and treatments designed around women's individual needs and choices."

New York, NY (August 24, 2020) -- Mount Sinai scientists have identified two markers of inflammation that reliably predict the severity of COVID-19 cases and likelihood of survival, providing a foundation for a diagnostic platform and therapeutic targets, according to a study published in Nature Medicine in August.

The researchers studied four proteins known as cytokines that circulate in blood and are commonly associated with infections, and found that two of them, called IL-6 and TNF-α, were able to predict which patients were likely to develop more severe forms of COVID-19 and die. The scientists established that the levels of IL-6 and TNF-α in serum, when measured at admission to the hospital, were elevated in patients who fared the worst, a finding that was independent of the patients' other underlying medical conditions, of demographics such as age and sex, and of other standard clinical biomarkers of disease severity such as low blood oxygen saturation and common markers related to inflammation, iron levels, and blood clotting issues.

This study suggests that these cytokines should be monitored in the treatment of COVID-19 patients to help select those who should enter clinical trials and receive specific drugs that can target them, the researchers say.

"We propose that serum IL-6 and TNF-? levels should be considered in the management and treatment of COVID-19 patients to stratify prospective clinical trials, guide resource allocation, and inform therapeutic options," said lead researcher Sacha Gnjatic, PhD, Associate Director of the Human Immune Monitoring Center at Mount Sinai; Associate Professor of Medicine, Oncological Sciences and Pathology, at the Icahn School of Medicine at Mount Sinai; and a member of the Precision Immunology Institute and The Tisch Cancer Institute at Mount Sinai. "We also propose that patients with high IL-6 and TNF-? levels should be assessed for combinatorial blockade of pathogenic inflammation in this disease. Drugs blocking these cytokines are either FDA-approved or in clinical trials."

When the pandemic began, Mount Sinai scientists promptly implemented a rapid test to measure the levels of four cytokines associated with pathogenic inflammation, which were suspected to cause severity in COVID-19 patients. In just one month, cytokine blood levels were tested in 1,484 patients upon admission to Mount Sinai Health System's hospitals, and patients were followed for up to 41 days.

Thanks to an emergency authorization from the New York State Department of Health, the test was allowed to be placed in the hospital's electronic medical record system where doctors order standard blood tests and medicines for patients, allowing for the rapid collection of a large amount of samples. Results were available in three hours, leading researchers to believe it could be implemented in a clinical setting to stratify patients and determine treatments in almost real time.

The results from the tests showed that the risk of death in patients with elevated IL-6 or TNF-α was twofold or higher, even when considering other known risk factors. Scientists then validated their predictive model using samples from an additional cohort of 231 hospitalized COVID-19 patients.

The researchers looked at how various treatments attempted in a subset of these patients affected the cytokines they measured. They found that treatments recently found to benefit COVID-19 patients, such as the antiviral remdesivir or the corticosteroid dexamethasone, could lower the levels of the cytokines.

Based on these results, scientists propose that monitoring COVID-19 patients for these cytokines can help determine their prognosis, and that any treatment should be potentially administered in the context of cytokine measurements, since it affects outcome.

The researchers propose that these findings also call for the use of drugs targeting IL-6 and TNF-α by themselves or combined at the same time, to be tested for their potential benefit based on elevated starting levels.

Monitoring the levels of IL-6 and TNF-a before and during experimental treatments such as anti-cytokine antibodies or corticosteroids will be useful to establish a predictive and prognostic value for these potential biomarkers.

A new study by researchers at MassBiologics of UMass Medical School published in Nature Communications suggests that COVID specific IgA monoclonal antibodies may provide effective immunity in the respiratory system against the novel coronavirus - a potentially critical feature of an effective vaccine.

Yang Wang, MD, PhD, deputy director for product discovery at MassBiologics and associate professor of medicine, and colleagues describe the discovery and characterization of a cross-reactive human monoclonal antibody (MAB) to SARS-CoV-2 spike proteins which blocks ACE2 receptor binding on the mucosal tissue of the respiratory tract - potentially preventing or limiting SARS-CoV-2 infection causing COVID-19 disease.

Like scientists around the world, the research leadership at MassBiologics started talking about what became known as SARS-CoV-2 within days of the first cases of when the novel coronavirus were first reported. MassBiologics was in a unique position to respond, and those early discussions have resulted in the discovery of a novel approach to prevent and treat SARS-CoV-2 infection.

The origins of this rapid and important discovery go back 16 years, when MassBiologics developed an IgG monoclonal antibody that was effective against a similar virus, SARS (that was SARS-CoV, the first severe acute respiratory syndrome caused by a novel coronavirus). That first SARS virus caused alarming illness, but then disappeared; MassBiologics, which was ready at the time to initiate a clinical trial, saved the research materials associated with that work.

When SARS-CoV-2 was recognized and began to spread, MassBiologics researchers realized that that first MAB might help with this new infection. They launched the process of resurrecting the old SARS program, retrieving frozen hybridoma cells that had been developed 16 years earlier, thawing them and determining if what worked for one novel coronavirus would work for another. Although there was 90 percent similarity between the two coronaviruses, the monoclonal antibody exhibited no binding to the current coronavirus. MassBiologics then evaluated another MAB from that earlier work, which was also only weakly effective.

Undeterred, Wang and colleagues thought about their experience with a separate research program to develop "secretory IgAs (sIgA)," antibodies that play a crucial role in immunity on mucosal surfaces. MassBiologics has been investigating sIgA in the GI tract as a possible therapeutic to prevent gastrointestinal infections. Would similar anti-SARS-CoV-2 sIgA produce passive mucosal immunity in the respiratory tract, where COVID-19 disease is incredibly damaging? The approach worked, producing an antibody with binding affinity and neutralization activity. This antibody was designated MAb362.

"We were excited to learn that antibodies to SARS-CoV-2 are more effective in binding to and neutralizing the virus when they are in the sIgA isotype of antibody, compared to the usual circulating IgG antibodies," said Mark Klempner, MD, executive vice chancellor for MassBiologics and professor of medicine. "In nature, sIgA antibodies coat mucosal surfaces like the respiratory, GI and GU tracts, where they are stabilized by the mucous layer on these surfaces. There, they perform the important function of preventing binding of a pathogen to host cells, thus preventing infection."

Based on these results, MassBiologics worked with Celia Schiffer, PhD, the Gladys Smith Martin Chair in Oncology, professor of biochemistry & molecular pharmacology, and director of the Institute for Drug Resistance, and her then-graduate student, Shurong Hou, who has since completed her studies and earned her PhD, to see if they could understand the nature of the effect of the IgA antibody. Drs. Schiffer and Hou found MAb362 shared a highly similar framework with MAb 80R, another SARS-CoV antibody with a crystal structure in complex with SARS-CoV. A molecular model revealed a highly conserved protective epitope within the receptor-binding domain of the S protein. MAb362 neutralizes authentic SARS-CoV-2 virus by directly out-competing the S protein's binding to hACE2 receptors.

"So our search -which started during a coffee break conversation," said Klempner, "has resulted in a unique IgA antibody that could potentially be applied through mucosal administration, in combination with other systemically administrated therapeutics for direct mucosal protection."

August 24, 2020 - Three popular complementary and integrative health (CIH) therapies - yoga, tai chi, and meditation - lead to significant improvements in key outcomes perceived by Veterans receiving care in the Veterans Health Administration (VA) system, suggests a study in a special September supplement to Medical Care. The journal is published in the Lippincott portfolio by Wolters Kluwer.

"[O]ur study showed that meditation, tai chi, and yoga appear to improve overall physical and mental health and reduced perceived stress," according to the new research, led by Dr. A. Rani Elwy of the VA Center for Healthcare Organization and Implementation Research at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass, and an Associate Professor in the Warren Alpert Medical School of Brown University.

Published today, the special issue of Medical Care documents progress toward implementing CIH therapies throughout the VA system - part of efforts to promote a "Whole Health" approach in VA care. As required by the 2016 Comprehensive Addiction and Recovery Act (CARA), the VA has expanded research and education on CIH programs, focusing on the impact on pain, mental health, and chronic illness.

Improvements in Patient-Reported Outcomes with CIH Therapies
Dr. Elwy and colleagues performed a 12-month survey study to examine the impact on CIH therapies on 119 veteran's self-reported health and well-being. These Veterans completed 401 surveys over five different time point during the study. The surveys focused on patient-reported outcomes (PROs) - an important target for efforts to improve healthcare, focusing on the most important problems and outcomes identified by patients themselves.

Overall, Veterans in the study reported using 14 different CIH therapies. Yoga was the most popular, with nearly half of Veterans participating. This was followed by meditation, acupuncture, and tai chi. Three CIH therapies were associated with significant improvements in PROs:

Yoga was related to decreases in perceived stress.
Tai chi was linked to improvements in overall physical and mental health functioning, anxiety levels, and ability to participate in social role activities.
Meditation was also associated with improvements in physical functioning.

None of the CIH therapies resulted in improvement in Veterans' pain intensity or level of engagement in their health care. Larger studies with longer follow-up times may be needed to show significant effects on these outcomes, according to Dr. Elwy and coauthors. They conclude: "It is time to focus on health and well-being, as defined by Veterans, and reaching these goals must include participation in CIH treatment approaches."

More Progress in CIH Implementation and Research at the VA
Titled The Implementation of Complementary and Integrative Health Therapies in the Veterans Health Administration, the new supplement presents 11 original research papers and commentaries on the VA's progress in implementing and evaluating the impact of CIH therapies on Veterans' health outcomes. Dr. Elwy and Dr. Stephanie L. Taylor of the HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, Greater Los Angeles VA Medical Center are the supplement Guest Editors.

The special issue papers address strategies to build support for and implement CIH programs, to evaluate their effectiveness, and to promote their long-term sustainability. "We already know that CIH therapies are effective for the treatment of Veterans' chronic pain, posttraumatic stress, depression, and other chronic conditions," Drs. Elwy and Taylor write. "Now we need to develop, test, and use effective strategies to increase CIH use and sustainment."

In a commentary, Alison Whitehead and Dr. Benjamin Kligler of the VA Office of Patient-Centered Care and Cultural Transformation state: "As the VA continues to develop new and better ways of making CIH approaches available to all Veterans, and to collect data on the outcomes of this expanded access for Veterans and employees, we hope to demonstrate to the rest of the U.S. healthcare system how an emphasis on whole person care and self-management skills should become the new standard across the industry."

PITTSBURGH, Aug. 24, 2020 - Hepatocytes -- the chief functional cells of the liver -- are natural regenerators, and the lymph nodes serve as a nurturing place where they can multiply. In a new study published online and appearing in a coming issue of the journal Liver Transplantation, researchers at the University of Pittsburgh School of Medicine showed that large animals with ailing livers can grow a new organ in their lymph nodes from their own hepatocytes. A human clinical trial is next.

"It's all about location, location, location," said senior author Eric Lagasse, Pharm.D., Ph.D., associate professor of pathology at Pitt "If hepatocytes get in the right spot and there is a need for liver functions, they will form an ectopic liver in the lymph node."

The cells of the liver normally replenish themselves, but need a healthy, nurturing environment to regenerate. However, in end-stage liver disease, the liver is bound up by scar tissue and too toxic for the cells to make a comeback.

"The liver is in a frenzy to regenerate," said Lagasse, who also is a member of the McGowan Institute for Regenerative Medicine and the Pittsburgh Liver Research Center. "The hepatocytes try to repair their native liver, but they can't and they die."

Nearly a decade ago, Lagasse noticed that if he injected healthy liver cells into the lymph nodes of a mouse, they would flourish, forming an auxiliary liver to take over the tasks of the animals' genetically induced malfunctioning liver.

But mice are small. Lagasse and colleagues needed to show that a large animal could grow a meaningful mass of secondary liver tissue to overcome liver disease.

To mimic human liver disease in pigs, the researchers diverted the main blood supply from the liver, and at the same time, they removed a piece of healthy liver tissue and extracted the hepatocytes. Those liver cells were then injected into the abdominal lymph nodes of the same animal they came from.

All six pigs showed a recovery of liver function, and close examination of their lymph nodes revealed not only thriving hepatocytes, but also a network of bile ducts and vasculature that spontaneously formed among the transplanted liver cells.

The auxiliary livers grew bigger when the damaged tissue in the animals' native liver was more severe, indicating that the animals' bodies are maintaining an equilibrium of liver mass, rather than having runaway growth akin to cancer.

These findings bolster the results of another recent study, in which Lagasse and colleagues at Mayo Clinic showed that healthy liver tissue grown in the lymph nodes of pigs with a genetic liver defect spontaneously migrated to the animals' livers, where they replaced diseased cells and cured the animals' liver disease.

So, regardless of the cause of liver disease, from hepatitis to alcoholism, Lagasse expects growing auxiliary livers in the lymph nodes will help.

A team of archeologists from Siberian Federal University and Novosibirsk State University provided a detailed reconstruction of a technology that was used to carve ornaments and sculptures from mammoth ivory. The team studied a string of beads and an ancient animal figurine found at the Paleolithic site of Ust-Kova in Krasnoyarsk Territory. Over 20 thousand years ago its residents used drills, cutters, and even levelling blades. The unusual features of some of the items showcased the mastery of the craftsmen. The new data obtained by the scientists will help study the relations between the residents of different Siberian sites. The article about the study was published in the highly respected journal Archaeological Research in Asia.

The Ust-Kova site is located in Kezhemsky District of Krasnoyarsk Territory at the mouth of the Kova river. Archaeologists from Krasnoyarsk have been working there since the middle of the 20th century, but the major part of the excavation work took place between 1980 and 2000. Based on the results of radiocarbon dating, the site is considered to be over 20 thousand years old. Of all findings from Ust-Kova, scientists consider animal figurines the most interesting. They also found various ornaments and tools made from mammoth ivory. However, until recently the technology of their manufacture has been unknown.

"We studied several mammoth ivory items found at Ust-Kova: a mammoth figurine, a seal sculpture, and bracelets and beads of different sizes that were created around 24 thousand years ago. Our group was supervised by Prof. L.V. Lbova, a PhD in History, from the Department of Archeology and Ethnography of Novosibirsk State University. We conducted detailed microscopic analysis of each object to identify the tools used in their manufacture by the markings they left," said Prof. Nikolay Drozdov, a PhD in History, representing Siberian Federal University.

After processing the microscopic images of the mammoth figurine with DStretch, the team was able to reconstruct the ancient technology in every detail. The image showed markings that were left by different tools. According to the scientists, at first a craftsman had to break a mammoth tusk down into segments. After that smaller plates were turned into beads: the master cut them into rectangles and made a hole in the center of each piece using a stone drill. Bigger parts were used to create animal sculptures. To depict a mammoth, the craftsman outlined a head and legs with a levelling blade and then removed the excess of the bone with a cutter. After the figurine was finished, it was decorated with a pattern to imitate eyes and hair.

The team also analyzed the chemical composition of the findings. The scientists were especially interested in the traces of dark-red pigment on the surface of the sculpture. It turned out that ancient craftsmen used to paint many of their items with manganese and magnesium (presumably, they were extracted from salt rocks situated not far from the site). The mammoth figurine was painted with a red pigment on one side and with a black one on the other. In the mythology of the Ust-Kuva people red was a symbol of life and black meant death. The researchers also found several layers of pigment on the beads. They assumed that the ornaments had been in use for many years and had to be regularly repaired.

The study can help better understand the relationships between different tribes and territories. Now scientists will be able to compare tools from different sites by various parameters. This will show whether distant tribes were in contact with each other and also help identify individual styles of ancient master carvers.

University of Queensland researchers have developed biosensors that use nanoengineered porous gold which more effectively detect early signs of disease, potentially improving patient outcomes.

Most diagnostic methods use costly materials and are time-consuming and expensive to run, but PhD candidate Mostafa Masud and research supervisors Professor Yusuke Yamauchi and Dr MD Shahriar Hossain have developed a cheaper, faster and ultrasensitive biosensor for point-of-care testing.

Mr Masud said the most exciting thing about the project was that it broke through some of the current limitations associated with early detection of diseases. s

"This new diagnostic technique allows for direct detection of disease-specific miRNA, which wasn't previously possible," Mr Masud said.

"This is especially important for patients at an early stage of a disease such as cancer, who do not have detectable amounts of other biomarkers, but may have a detectable quantity of exosomal miRNA biomarker.

The platform was nanoengineered by the team to read samples of blood, urine, saliva or plasma through a surface covered in a gold film, which has millions of tiny pores.

The method used to create these highly-engineered porous films has been published in the prestigious science journal Nature Protocols following 15 years of research, ushering in a new era of opportunity for nanoporous materials research and technology development.

The team is continuing to develop this platform, and plans for it to be available to medical practitioners in the next five years.

"Doctors will be able to use our platform to take a small fluid sample from a patient and test for diseases instantly, for around one quarter of the cost of other diagnostic techniques," Professor Yamauchi said.

The researchers said the technology would be easy to use and particularly useful in remote locations and developing countries where rapid and early diagnostics were critical, especially in the case of viral infections.