Earth

Unauthorized immigrants who receive liver transplants in the United States have comparable three-year survival rates to U.S. citizens, according to a study by researchers at UC San Francisco. Yet access to life-saving organs for this population varies widely by state, in part due to a medical misperception that undocumented migrants face a higher risk of transplant failure.

The findings appeared online Sept. 20, 2019, in Hepatology.

"Our results bring much-needed scientific evidence to a politically and medically divisive issue and shed light on disparities due to policy and provider attitudes," said corresponding author Brian P. Lee, MD, MPH, a gastroenterology and hepatology fellow at UCSF. "This could have considerable implications for the estimated 6,500 unauthorized immigrants in the United States who have end-stage renal disease and also may be relevant for other organ-transplant patients. We hope this will prompt appropriate action on national transplant policy."

An estimated 11 million foreign-born, non-citizens reside illegally in the United States and generally pay Social Security taxes. They account for about 3 percent of all deceased organ donors, but less than 0.5 percent of the recipients.

The United Network of Organ Sharing (UNOS) has no guidelines regarding liver transplant access for unauthorized immigrants, leaving transplant centers to establish their own policies. In 2012, UNOS began requiring liver transplant centers to record patients' citizen and residency status to better understand transplant tourism. Federal and state legislation also has been introduced that proposes specifically limiting organ transplant access for unauthorized immigrants. However, studies of this population group are sparse, partly due to difficulties identifying patients in medical registries.

In the Hepatology study, Lee and Norah Terrault, MD, MPH, a former UCSF professor of medicine who is now at the University of Southern California (USC), reviewed UNOS records of all U.S. liver transplant recipients between March 2012 and December 2018. They used Pew Research Center data to estimate the population of unauthorized immigrants in each state and by country of origin.

Of 43,192 recipients, 99.6 percent (43,026) were U.S. citizens and 0.4 percent (166) were unauthorized immigrants. The most common countries of origin were Mexico (52 percent), Guatemala (7 percent), China (6 percent), El Salvador (5 percent) and India (5 percent), rates similar to that of the overall U.S. immigrant population.

Compared to U.S residents, unauthorized immigrants were younger (49 years old vs. 58 years old), more frequently Hispanic (59 percent vs. 14 percent) and Asian (16 percent vs. 4 percent), had high school or below as the highest level of education (62 percent vs. 45 percent), and were covered by Medicaid (51 percent vs. 14 percent). They also were sicker, with a higher transplant score, and more likely to be on dialysis (31 percent vs. 15 percent), which suggests access to transplant late into their disease, Lee said.

Most transplants for these patients occurred in California (78 patients, 47 percent) and New York (30 patients, 18 percent), roughly twice their representation in the local populations (27 percent in California, 7 percent in New York), and almost a quarter of them occurred at USC (31) and UCSF (10). By contrast, the proportion of liver transplants for unauthorized immigrants was lower than their relative populations in Texas and Florida, highlighting a disparity in access across the country, Lee said. These differences corresponded to states favoring or resisting Medicaid expansion for transplant coverage.

A risk analysis found similar graft and patient survival rates for unauthorized immigrants as U.S. citizens, with one- and three-year survival rates of 95 percent and 88 percent, respectively, in unauthorized immigrants and 92 percent and 85 percent among residents.

"Given these findings of acceptable survival outcomes among unauthorized immigrants, concern for worse survival should not be used as a reason to deny access to liver transplant," Lee said. "Continued financial support after transplant also can be a barrier in this group, but those means are confirmed beforehand and also not a reason for denial."

In recently published studies, researchers at Lund University and Skåne University Hospital in Sweden have produced new prediction models for improved personalised treatment of lymph nodes in breast cancer patients. The latest results that have now been published in Clinical Cancer Research and BMC Cancer show that up to one in every three operations could be avoided.

Breast cancer is the most common tumour disease in women, and it is estimated that one in every eight women in the Western world will suffer from the disease during their lifetime.

"It is well known that knowledge of the spread of breast cancer to the axillary lymph nodes provides important information on the course of the disease, and lymph nodes are routinely removed for investigation. Around 70 per cent of patients are found to have healthy lymph nodes, and surgery could be avoided if they could instead be assessed in a different way", says Lisa Rydén, professor of surgery with a focus on breast cancer at Lund University and consultant at Skåne University Hospital.

Gene expressions from approximately 3 000 breast tumours have been studied together with other tumour- and patient-related factors concerning the link between the spread of disease to the lymph nodes. The results were published in Clinical Cancer Research, and showed that the size of the tumour and the invasion of cancer cells into vessels were significant factors in predicting the spread of disease.

In patients with hormone-sensitive breast tumours (approximately 80 per cent of all breast cancer), a developed prediction model, based on the tumour's genetic profile and routinely collected data on tumour characteristics, was able to identify 6-7 per cent more women with healthy lymph nodes than other models.

"It would therefore be possible to reduce the number of lymph node operations by up to 30 per cent in this group if the model were used to predict the spread of disease to the lymph nodes", noted the authors of the article.

Through artificial neural networks, three prediction models have been produced in a separate study published in BMC Cancer; one to identify healthy lymph nodes (where diagnostic surgery could potentially be avoided), one to identify limited disease in the lymph nodes (where the removal of a small number of diagnostic lymph nodes is sufficient) and one for widespread lymph node disease indicating more extensive surgery or primary oncological treatment with chemotherapy. This study also showed that the prediction model for healthy lymph nodes could have reduced the number of surgical interventions by 30 per cent.

"The results indicate that we may be a step closer to more personalised surgical treatment by using the prediction models as a decision support tool. In order to ascertain the results for clinical use, further studies are required on other patient material to be able to confirm the reliability and precision of the models and independently evaluate our results", concludes Lisa Rydén.

In Japan Science and Technology Agency's Strategic Basic Research Programs, Associate Professor Toshiaki Kato and Professor Toshiro Kaneko of the Department of Electronic Engineering, Graduate School of Engineering, Tohoku University succeeded in clarifying a new synthesis mechanism regarding transition metal dichalcogenides (TMD)1), which are semiconductor atomic sheets having thickness in atomic order.

Because it is difficult to directly observe the aspect of the growing process of TMD in a special environment, the initial growth process remained unclear, and it has been desirable to elucidate a detailed mechanism of synthesis to obtain high-quality TMD.

An in-situ observing synthesis method2) has been developed by our research group to examine the growth aspect of TMD as a real-time optical image in a special high temperature atmosphere of about 800°C in the presence of corrosive gases. In addition, a synthesis substrate, which is a mechanism to control diffusion during the crystal growth of a precursor3), has been developed in advance; further, it has been clarified that the growing precursor diffuses a distance about 100 times larger than in conventional semiconductor materials. It was also demonstrated that nucleation occurs due to the involvement of the precursor in a droplet state. Furthermore, by utilizing this method, a large-scale integration of more than 35,000 monolayer single crystal atomic sheets has been achieved on a substrate in a practical scale (Figure 1).

Utilizing the results of the present research, the large-scale integration of atomic-order thick4) semiconductor atomic sheets can be fabricated and is expected to be put into practical use in the field of next-generation flexible electronics.

This study reports on a novel method for enhancing corrosion resistance via reduced availability of dissolved oxygen in the cathodic reactions which could be obtained through metabolic processes of aerobic Bacillus subtilis natto in the presence of organic carbon sources. In addition, the approach is beneficial in facilitating the formation of calcium carbonate which seals cracks accompanied by the self-healing of concrete.

Corrosion of steel bars in concrete leads to a decrease in the durability of reinforced concrete. The corrosion processes can be explained by electro-chemical reactions taking place in anodic and cathodic regions. The latter reaction requires oxygen and water, which is an electrolyte that can support the flow of electrons.

Dissolved oxygen in pore solution is often a controlling factor determining the rate of the corrosion process of steel bars in concrete. The properties are essentially associated with the permeability of dissolved oxygen in the pore solution. This could be affected by the metabolic activities of aerobic Bacillus subtilis natto mixed in cementitious mixtures. Bacillus subtilis natto is resistant to unfavourable environmental conditions, including salinity and extreme pH, through the formation of an endospore at times of nutritional stress until conditions become favourable.

Electro-chemical measurements were carried out to examine the corrosion processes by the AC impedance method, half-cell potential measurements, and macrocell corrosion measurements using zero-resistance ammeters. Cathodic polarization curves were measured at 28 and 91 days before and after the specimens were exposed to chloride induced corrosion tests through dry and wet cycles.

The results indicate that the rate of oxygen permeability inferred based on limiting current density is substantially lower in the case of mortar specimens mixed with the Bacillus subtilis natto. This can be explained by the fact that the dissolved oxygen is consumed by the oxidation of organic matter, a process initially catalyzed by Bacillus subtilis natto present in mortar mixtures during the monitoring periods. Based on the results obtained, the addition of a culture solution containing Bacillus subtilis natto reacting with dissolved oxygen resulted in higher resistance against corrosion processes, which was confirmed by the results of half-cell potential and microcell and macrocell corrosion current density. There is a strong possibility that the reduced dissolved oxygen in the pore solution through the aerobic processes could enhance corrosion resistance in cracked mortar specimens.

Leesburg, VA, September 20, 2019--According to an ahead-of-print article published in the December issue of the American Journal of Roentgenology (AJR), lifetime-certified diagnostic radiologists whose Maintenance of Certification (MOC) was not mandated by the American Board of Radiology (ABR) were far less likely to participate in ABR MOC programs--especially general radiologists and those working in smaller, nonacademic practices in states with lower population densities.

Defining diagnostic radiologists as those whose only ABR certificate is in diagnostic radiology, lead author Andrew B. Rosenkrantz of NYU Langone Medical Center and colleagues cross-referenced Medicare and Medicaid data with ABR's own public search engine to determine that 11,479 of 20,354 total diagnostic radiologists (56.4%) participated in MOC.

Although diagnostic radiologists with time-limited certificates nearly universally participate in ABR MOC--99.6% (10,058/10,099)--participation rates were only 13.9% (1421/10,225) among the cohort with lifetime ABR certificates.

"Many opinions have been expressed regarding MOC in radiology," says Rosenkrantz, the 2017 ARRS Leonard Berlin Scholar. "But there is actually very little public data on the matter. Through this work, we hope to bring objective findings to help inform the discussions."

The rates of nonmandated participation were higher (all p

State-level rates of nonmandated participation varied from 0.0% (South Dakota, Montana) to 32.6% (Virginia) and positively correlated with state population density (r = 0.315).

Women are quicker to take cover or prepare to evacuate during an emergency, but often have trouble convincing the men in their life to do so, suggests a new University of Colorado Boulder study of how gender influences natural disaster response.

The research also found that traditional gender roles tend to resurface in the aftermath of disasters, with women relegated to the important but isolating role of homemaker while men focus on finances and lead community efforts.

Even agencies charged with providing assistance still, at times, ask to speak to the "man of the house," the researchers found.

"We found that there are many barriers that disadvantage women in the event of a disaster, leaving them behind when it comes to decision-making and potentially slowing down their recovery," said lead author Melissa Villarreal, a PhD student in the Department of Sociology and research assistant at the Natural Hazards Center.

For the study, co-authored by Texas A&M University Assistant Professor Michelle Meyer and published in the journal Disasters, the researchers analyzed in-depth interviews with 33 women and 10 men across two Texas towns. Some were from Granbury, which in 2013 was hit by an EF-4 tornado that killed six and cut a mile-wide swath of destruction, damaging 600 homes. Others were from West, where an explosion at a fertilizer company that same year killed 15 and destroyed 100 homes.

Residents were asked about their experiences in the midst of and the year after the disaster. While the circumstances surrounding the events were very different, common gender-influenced patterns emerged.

"We often assume that men and women are going to respond the same way to these kinds of external stimuli but we are finding that's not really the case," said Meyer, director of the Hazard Reduction and Recovery Center at Texas A&M.

In one interview, a Granbury woman recounted hunkering down in the closet with her children, pleading with her husband - who was looking out the window at the tornado - to come in and join them. In another case, a woman resisted her husband's plan to get in the car and drive away from the storm, preferring to shelter in place. She ultimately deferred, and they ended up stuck in the car, the children in the back seat, being jostled by the wind as the tornado whipped through.

"Women seemed to have a different risk perception and desire for protective action than the men in their lives, but men often determined when and what type of action families took," Villareal wrote. "In some cases, this put women and their families in greater danger."

The findings are the latest in a series of studies that have found that women tend to have a higher perception of risk, but because they are framed as "worriers," they are sometimes not taken seriously.

Women in the new study also complained that recovery organizations tended to call the men of the household to find out where to direct aid, even when women had filled out the forms requesting it.

"Eliminating the male head-of-household model is crucial for speeding overall household recovery," the authors conclude.

During recovery, women were often charged with "private sphere" tasks like putting the house back together and caring for children while schools were closed, but they often felt excluded from leadership roles in community recovery projects.

"If your perspective is not taken into consideration and you feel isolated, that can impede your mental health recovery," said Villareal.

She recently embarked on a separate study, set in Houston, looking at the unique challenges Mexican immigrant populations are facing in the aftermath of Hurricane Harvey, which hit the region in 2017.

Ultimately, she would like to see government agencies consider gender differences when crafting disaster warnings and prioritize providing childcare post-disaster so that women can play a greater role in community efforts.

"If we can put racial and gender forms of bias aside and listen to all the people tell their stories about what is affecting them, that could go a long way in helping communities recover," said Villarreal.

Walking may be a key clinical tool in helping medics accurately identify the specific type of dementia a patient has, pioneering research has revealed.

For the first time, scientists at Newcastle University have shown that people with Alzheimer's disease or Lewy body dementia have unique walking patterns that signal subtle differences between the two conditions.

The research, published today in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, shows that people with Lewy body dementia change their walking steps more - varying step time and length - and are asymmetric when they move, in comparison to those with Alzheimer's disease.

It is a first significant step towards establishing gait as a clinical biomarker for various subtypes of the disease and could lead to improved treatment plans for patients.

Useful diagnostic tool

Dr Ríona McArdle, Post-Doctoral Researcher at Newcastle University's Faculty of Medical Sciences, led the Alzheimer's Society-funded research.

She said: "The way we walk can reflect changes in thinking and memory that highlight problems in our brain, such as dementia.

"Correctly identifying what type of dementia someone has is important for clinicians and researchers as it allows patients to be given the most appropriate treatment for their needs as soon as possible.

"The results from this study are exciting as they suggest that walking could be a useful tool to add to the diagnostic toolbox for dementia.

"It is a key development as a more accurate diagnosis means that we know that people are getting the right treatment, care and management for the dementia they have."

Current diagnosis of the two types of dementia is made through identifying different symptoms and, when required, a brain scan.

For the study, researchers analysed the walk of 110 people, including 29 older adults whose cognition was intact, 36 with Alzheimer's disease and 45 with Lewy body dementia.

The participants took part in a simple walking test at the Gait Lab of the Clinical Ageing Research Unit, an NIHR-funded research initiative jointly run by Newcastle Hospitals NHS Foundation Trust and Newcastle University.

Participants moved along a walkway - a mat with thousands of sensors inside - which captured their footsteps as they walked across it at their normal speed and this revealed their walking patterns.

People with Lewy body dementia had a unique walking pattern in that they changed how long it took to take a step or the length of their steps more frequently than someone with Alzheimer's disease, whose walking patterns rarely changed.

When a person has Lewy body dementia, their steps are more irregular and this is associated with increased falls risk. Their walking is more asymmetric in step time and stride length, meaning their left and right footsteps look different to each other.

Scientists found that analysing both step length variability and step time asymmetry could accurately identify 60% of all dementia subtypes - which has never been shown before.

Further work will aim to identify how these characteristics enhance current diagnostic procedures, and assess their feasibility as a screening method. It is hoped that this tool will be available on the NHS within five years.

Pioneering study

Dr James Pickett, Head of Research at Alzheimer's Society, said: "In this well conducted study we can see for the first time that the way we walk may provide clues which could help us distinguish between Alzheimer's disease and Lewy body dementia.

"This research - funded by the Alzheimer's Society - is pioneering for dementia. It shows promise in helping to establish a novel approach to accurately diagnose different types of dementia.

"We know that research will beat dementia, and provide invaluable support for the 850,000 people living with the condition in the UK today. It's now vital that we continue to support promising research of this kind.

"We look forward to seeing larger, longer studies to validate this approach and shed light on the relationship between a person's gait and dementia diagnosis."

Dementia describes different brain disorders that triggers loss of brain function and these conditions are usually progressive and eventually severe.

It is estimated by the Alzheimer's Society that people living with dementia in the UK will rise to more than one million by 2025.

Future research at Newcastle University will look at alternative methods to assess walking as part of the €50 MOBILISED-D digital monitoring project, which aims to develop a system of small sensors that can be worn on the body during daily routine to assess how well you walk - a sign of health and wellbeing.

Living with Lewy body dementia

Father-of-four and grandfather-of-two John Tinkler has lived with Lewy body dementia for the past three years.

The 70-year-old, of Langley Park, County Durham, was diagnosed after starting to experience difficulties walking when he began to shuffle his feet and would regularly trip over.

John, his wife, Jenny, 59, and the rest of their family, have learned to cope with the difficult diagnosis and have had to adapt their lifestyles accordingly.

Jenny, a physiotherapist, said: "Since John's diagnosis things have been difficult and, over the years, he has deteriorated to the point where he fatigues easily, which affects his mobility, balance and coordination, and he is now struggling to get out of an armchair. In addition to this, he has joint pain and muscle cramps.

"When we were asked if John would like to take part in the Newcastle University research we didn't hesitate to say 'yes' because it's important that people do their bit to help research.

"The findings of the study are exciting because it can help lead to a definitive diagnosis of the subtype of dementia, which will allow patients to be on the right management programme as early as possible.

"If patients and their families know the specific type of dementia they are dealing with, this enables there to be a greater understanding of the specific needs of the person living with the condition.

"We are extremely lucky to live in an area where research into ageing is among the best there is. It would be fantastic if a screening tool like this was available within the NHS for dementia patients."

WOODS HOLE, Mass. -- In early October 2016, a tropical storm named Nicole formed in the middle of the Atlantic Ocean. It roamed for six days, reaching Category 4 hurricane status with powerful 140 mile-per hour-winds, before hitting the tiny island of Bermuda as a Category 3.

Hurricanes like Nicole can cause significant damage to human structures on land, and often permanently alter terrestrial landscapes. But these powerful storms also affect the ocean.

Scientists have a good understanding of how hurricanes impact the surface layer of the ocean, the sunlit zone, where photosynthesis can occur. Hurricanes' strong winds churn colder water up from below, bringing nutrients such as nitrogen and phosphorus to the surface and stimulating short-lived algae blooms. However, until recently, we didn't know much about how hurricanes impact the deep ocean.

A new study of Hurricane Nicole by researchers at the Marine Biological Laboratory (MBL), Woods Hole, and the Bermuda Institute of Ocean Sciences (BIOS) has provided novel insight on those impacts. Nicole had a significant effect on the ocean's carbon cycle and deep sea ecosystems, the team reports.

Studying the deep ocean

The Oceanic Flux Program (OFP) has been continuously measuring sinking particles, known as marine snow, in the deep Sargasso Sea since 1978. It's the longest-running time series of its kind.

Before hitting Bermuda, Hurricane Nicole passed right through the OFP site, about 50 miles southeast of Bermuda. This gave the scientists a unique opportunity to study how hurricanes impact the deep ocean.

To study the deep ocean, the OFP strings scientific equipment, including sediment traps, at various depths on a mooring line that extends up from a 2,000-pound anchor situated on the seafloor (2.8 miles below the surface).

Key findings

In the new study, published in Geophysical Research Letters, MBL and BIOS scientists provide the first direct evidence that hurricanes affect the ocean's biological pump, a process in which living organisms transfer carbon from the surface to the deeper ocean layers and the seafloor.

High-velocity winds associated with Hurricane Nicole generated intense surface-ocean cooling and strong currents and underwater waves, some of which lasted more than two weeks. This significantly accelerated the biological pump, with the currents pushing nutrients into the surface layer, triggering an algae bloom.

The supercharged biological pump then rapidly funneled the organic material from the hurricane-induced algae bloom down into the deep ocean. This provided a big boost of food for marine life in the deep ocean where light doesn't reach.

The scientists found substantial increases in fresh organic materials in sediment traps at 4,900 feet and 10,500 feet below the surface. Algae growth measurements at the OFP site after Hurricane Nicole's passage were among the highest observed in October over the last 25 years.

"The surface and the deep ocean are really well connected in the aftermath of these powerful storms," explained Rut Pedrosa Pàmies, a biogeochemist and oceanographer at MBL's Ecosystems Center and first author of the study. "The material that is reaching those depths is crucial for the deep-ocean ecosystem."

Long-term implications

Since 1980, seven Category 3 or greater hurricanes have passed within 186 miles of Bermuda. These hurricanes affected a total of more than 32,800 square miles of surface water, an area greater than the state of Maine.

Current climate models indicate that hurricane intensity could increase as human-induced global warming continues. This could expand the area of ocean disturbed by hurricanes, with implications for the ocean's biogeochemical cycles and deep-ocean ecosystems.

Earth's last frontier

Due to the extreme conditions of the deep ocean, this remarkable biome has been notoriously difficult for scientists to study. Additionally, due to difficulties of shipboard data collection in extreme weather conditions, the direct impacts of hurricanes are not well understood. Sediment traps like those used by the OFP are crucial to understanding their influence on the deep ocean.

When the OFP began in 1978, scientists were only able to collect a single cup of sinking particles every two months. "Now, we have biweekly sample resolution and sediment traps at three depths," Pedrosa Pàmies said.

With the proliferation of new equipment and technologies to study the deep ocean, understanding this last frontier is finally within reach.

MADISON -- Few things on earth strike fear into the hearts of men more profoundly than hair loss. But reversing baldness could someday be as easy as wearing a hat, thanks to a noninvasive, low-cost hair-growth-stimulating technology developed by engineers at the University of Wisconsin-Madison.

"I think this will be a very practical solution to hair regeneration," says Xudong Wang, a professor of materials science and engineering at UW-Madison.

Wang and colleagues published a description of the technology in the journal ACS Nano.

Based on devices that gather energy from a body's day-to-day motion, the hair-growth technology stimulates the skin with gentle, low-frequency electric pulses, which coax dormant follicles to reactivate hair production.

The devices don't cause hair follicles to sprout anew in smooth skin. Instead they reactivate hair-producing structures that have gone dormant. That means they could be used as an intervention for people in the early stages of pattern baldness, but they wouldn't bestow cascading tresses to someone who has been as bald as a billiard ball for several years.

Because the devices are powered by the movement of the wearer, they don't require a bulky battery pack or complicated electronics. In fact, they're so low-profile that they could be discreetly worn underneath the crown of an everyday baseball cap.

Wang is a world expert in the design and creation of energy-harvesting devices. He has pioneered electric bandages that stimulate wound-healing and a weight-loss implant that uses gentle electricity to trick the stomach into feeling full.

The hair-growth technology is based on a similar premise: Small devices called nanogenerators passively gather energy from day-to-day movements and then transmit low-frequency pulses of electricity to the skin. That gentle electric stimulation causes dormant follicles to "wake up."

"Electric stimulations can help many different body functions," says Wang. "But before our work there was no really good solution for low-profile devices that provide gentle but effective stimulations."

Because the electric pulses are incredibly gentle and don't penetrate any deeper than the very outermost layers of the scalp, the devices don't seem to cause any unpleasant side effects. That's a marked advantage over other baldness treatments, like the medicine Propecia, which carries risks of sexual dysfunction, depression and anxiety.

What's more, in side-by-side tests on hairless mice, the devices stimulated hair growth just as effectively as two different compounds found in baldness medicines.

"It's a self-activated system, very simple and easy to use," says Wang. "The energy is very low so it will cause minimal side effects."

From 2000 to 2018, the proportion of pathogens that infect farmyard chickens and pigs and that are also significantly resistant to antibiotics grew, a new study shows. In the study, which also reveals certain new and emerging hotspots of resistance around the world, the authors evaluated the development of drug-resistant pathogens in developing countries, where trends in antimicrobial resistance (AMR) are otherwise poorly documented. The vast majority of antimicrobials is used to maintain the health and productivity of animals raised for food, particularly in developing low- and middle-income countries seeking to satiate their growing appetite for diets high in animal protein. However, while large-scale antimicrobial use has enabled intensive animal production, it has also led to an increase in the appearance of antimicrobial-resistant infectious diseases in animals, which do occasionally make the jump to humans. "Through misuse and overuse of antimicrobials, AMR has become an urgent global priority which necessitates international collaboration," writes Catrin Moore in a related Perspective. Thomas Van Boeckel and colleagues analyzed 901 point-prevalence surveys of pathogens in developing countries to map the occurrence of drug-resistant strains in populations of common indicator pathogens, such as E. coli and Salmonella. Van Boeckel et al. discovered a clear increase in the proportion of resistant pathogen strains in both chickens and pigs. Furthermore, the authors identified geographic "hotspots" of antimicrobial resistance; according to the results, China and India - home to more than half of the world's pigs and chickens - were the largest hotspots. Newly emerging hotspots in Brazil and Kenya were also noted. "Regions affected by the highest levels of AMR should take immediate actions to preserve the efficacy of antimicrobials that are essential in human medicine, by restricting their use in animal production," the authors say.

Philadelphia, September 19, 2019 - About one in three diabetic patients develops diabetic retinopathy (DR), which can impair vision and lead to blindness. A new study in The American Journal of Pathology, published by Elsevier, provides clear evidence that high glucose increases the levels of enzymatic precursor--lysyl oxidase propeptide (LOX-PP)--that promotes cell death, which was verified in an animal model of diabetes. These findings may help develop novel DR treatments by targeting LOX-PP or its metabolites.

'We found that hyperglycemic and diabetic conditions increased LOX-PP levels," explained lead investigator Sayon Roy, PhD, of the Departments of Medicine and Ophthalmology at Boston University School of Medicine, Boston, MA, USA. "LOX-PP may induce cell death by compromising a cell survival pathway, and in retinas of diabetic rats, increased LOX-PP contributed to retinal vascular cell death associated with DR. Administration of recombinant LOX-PP alone was sufficient to induce cell death. This report shows novel functionality of LOX-PP in mediating cell death under high glucose condition in retinal endothelial cells as well as in diabetic animals."

Studies in pancreatic and breast cancer cells suggest that LOX-PP overexpression may trigger cell death. The researchers therefore studied the role of LOX-PP in the retinal tissue. The retinal blood vessels of normal and diabetic rats and normal rats administered artificially synthesized LOX-PP (recombinant LOX-PP, rLOX-PP) directly into the eye, were examined. Changes associated with DR such as swelling, blood vessel leakage, blockage or thickening of vascular walls, and histologic indicators such as acellular capillaries (AC) and pericyte loss (PL) were studied.

More AC and PL were observed in the retinas of diabetic rats compared to controls. In non-diabetic rats, injection of rLOX-PP directly into the eye also increased the number of ACs and PLs compared to rats receiving a control injection.

The effect of high glucose on retinal endothelial cells grown in culture was also studied. Adding glucose to the cell cultures up-regulated LOX-PP expression and reduced AKT (protein kinase B) activation. Cells exposed to rLOX-PP alone exhibited increased cell death along with decreased AKT phosphorylation. The present study provides clear evidence that high glucose increases LOX-PP levels, which in turn promotes cell death. Furthermore, LOX-PP appears to induce cell death by compromising a pathway involved in cell survival.

"DR is the leading cause of blindness in the working age population," noted Dr. Roy. "Unfortunately, there is no cure for this devastating ocular complication. Our findings suggest a novel mechanism for high glucose-induced cell death involving LOX-PP, which may be a therapeutic target in preventing retinal vascular cell loss associated with DR."

LOX is an extracellular enzyme responsible for cross-linking collagen and elastin molecules to form a stable extracellular matrix. The role of the LOX propeptide, LOX-PP, is less understood, although it may play a role in keeping LOX in an inactive state.

An internationally respected group of scientists have urgently called on world leaders to accelerate efforts to tackle climate change. Almost every aspect of the planet's environment and ecology is undergoing changes in response to climate change, some of which will be profound if not catastrophic in the future.

According to their study published in Science today, reducing the magnitude of climate change is also a good investment. Over the next few decades, acting to reduce climate change is expected to cost much less than the damage otherwise inflicted by climate change on people, infrastructure and ecosystems.

"Acting on climate change" said lead author, Prof Ove Hoegh-Guldberg from the ARC Centre for Excellence in Coral Reef Studies at the University of Queensland in Australia "has a good return on investment when one considers the damages avoided by acting."

The investment is even more compelling given the wealth of evidence that the impacts of climate change are happening faster and more extensively than projected, even just a few years ago. This makes the case for rapidly reducing greenhouse gas emissions even more compelling and urgent.

Prof Hoegh-Guldberg explained the mismatch. "First, we have underestimated the sensitivity of natural and human systems to climate change, and the speed at which these changes are happening. Second, we have underappreciated the synergistic nature of climate threats - with the outcomes tending to be worse than the sum of the parts. This is resulting is rapid and comprehensive climate impacts, with growing damage to people, ecosystems, and livelihoods."

For example, sea-level rise can lead to higher water levels during storm events. This can create more damage. For deprived areas, this may exacerbate poverty creating further disadvantage. Each risk may be small on its own, but a small change in a number of risks can lead to large impacts.

Prof Daniela Jacob, co-author and Director of Climate Services Centre (GERICS) in Germany is concerned about these rapid changes - especially about unprecedented weather extremes.

"We are already in new territory" said Prof Jacob, "The 'novelty' of the weather is making our ability to forecast and respond to weather-related phenomena very difficult."

These changes are having major consequences. The paper updates a database of climate-related changes and finds that there are significant benefits from avoiding 2oC and aiming to restrict the increase to 1.5oC above pre-industrial global temperatures.

Prof Rachel Warren from the Tyndall Centre at the University of East Anglia in the UK assessed projections of risk for forests, biodiversity, food, crops and other critical systems, and found very significant benefits for limiting global warming to 1.5oC rather than 2oC.

"The scientific community has quantified these risks in order to inform policy makers about the benefits of avoiding them," Prof Warren stated.

Since the Paris Agreement came into force, there has been a race to quantify the benefits of limiting warming to 1.5oC so that policy makers have the best possible information for developing the policy required for doing it.

Prof Warren continued. "If such policy is not implemented, we will continue on the current upward trajectory of burning fossil fuels and continuing deforestation, which will expand the already large-scale degradation of ecosystems. To be honest, the overall picture is very grim unless we act."

A recent report from the United Nations projected that as many as a million species may be at risk of extinction over the coming decades and centuries. Climate change is not the only factor but is one of the most important ones.

The urgency of responding to climate change is at front of mind for Prof Michael Taylor, co-author and Dean of Science at the University of the West Indies. "This is not an academic issue, it is a matter of life and death for people everywhere. That said, people from small island States and low-lying countries are in the immediate cross-hairs of climate change."

"I am very concerned about the future for these people," said Professor Taylor.

This urgency to act is further emphasized by the vulnerability of developing countries to climate change impacts as pointed out by Francois Engelbrecht, co-author and Professor of Climatology at the Global Change Institute of the University of the Witwatersrand in South Africa.

"The developing African countries are amongst those to be affected most in terms of impacts on economic growth in the absence of strong climate change mitigation," Prof Engelbrecht explains.

Prof Hoegh-Guldberg reiterated the importance of the coming year (2020) in terms of climate action and the opportunity to strengthen emission reduction pledges in line with the Paris Agreement of 2015.

"Current emission reduction commitments are inadequate and risk throwing many nations into chaos and harm, with a particular vulnerability of poor peoples. To avoid this, we must accelerate action and tighten emission reduction targets so that they fall in line with the Paris Agreement. As we show, this is much less costly than suffering the impacts of 2oC or more of climate change."

"Tackling climate change is a tall order. However, there is no alternative from the perspective of human well-being - and too much at stake not to act urgently on this issue."

Quantum mechanics and the general theory of relativity form the bedrock of the current understanding of physics - yet the two theories don't seem to work together. Physical phenomena rely on relationship of motion between the observed and the observer. Certain rules hold true across types of observed objects and those observing, but those rules tend to break down at the quantum level, where subatomic particles behave in strange ways.

An international team of researchers developed a unified framework that would account for this apparent break down between classical and quantum physics, and they put it to the test using a quantum satellite called Micius. They published their results ruling out one version of their theory on Sept 19th in Science.

Micius is part of a Chinese research project called Quantum Experiments at Space Scale (QUESS), in which researchers can examine the relationship with quantum and classical physics using light experiments. In this study, the researchers used the satellite to produce and measure two entangled particles.

"Thanks to the advanced technologies made available by Micius, for the first time in human history, we managed to perform a meaningful quantum optical experiment testing the fundamental physics between quantum theory and gravity," said Jian-Wei Pan, paper author and director of the CAS center for Excellence in Quantum Information and Quantum Physics at the University of Science and Technology of China

The theory Pan and the team tested was that the particles would decorrelate from one another as they passed through separate gravitational regions of Earth. The different gravitational pulls would force a quantum interaction that behaved as classical relativism would - the particle in less gravity would move with less constraint than the one in stronger gravity.

According to Pan, this "event formalism" attempts to present a coherent description of quantum fields as they exist in exotic spacetime, which contains closed time-like curves, and ordinary space time. Event formalism standardized behavior across quantum and classical physics.

"If we did observe the deviation, it would mean that event formalism is correct, and we must substantially revise our understanding of the interplay between quantum theory and gravity theory," Pan said. "However, in our experiment, we ruled out the strong version of event formalism, but there are other versions to test."

The researchers did not see the particles deviate from the expected interactions predicted by the quantum understanding of gravity, but they plan to test a version of their theory that allows for a little more flexibility.

"We ruled out the strong version of event formalism, but a modified model remains an open question," Pan said.

To test this version, Pan and the team will launch a new satellite that will orbit 20 to 60 times higher than Micius to test a wider field of gravity strength.

The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.

To meet this growing demand, animal husbandry has been intensified, with among other things, an increased reliance on the use of antimicrobials. Farmers use antimicrobials to treat and prevent infections for animals raised in crowded conditions but these drugs are also used to increase weight gain, and thus improve profitability.

This excessive and indiscriminate use of antimicrobials has serious consequences: the proportion of bacteria resistant to antimicrobials is rapidly increasing around the world. Drugs are losing their efficacy, with important consequences for the health of animals but also potentially for humans.

Mapping resistance hotspots

Low- and middle income countries have limited surveillance capacities to track antimicrobial use and resistance on farms. Antimicrobial use is typically less regulated and documented there than in wealthy industrialized countries with established surveillance systems.

The team of researchers led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich, has recently published a map of antimicrobial resistance in animals in low- and middle-income countries in the journal Science.

The team assembled a large literature database and found out where, and in which animals species resistance occurred for the common foodborne bacteria Salmonella, E. coli, Campylobacter and Staphylococcus.

According to this study, the regions associated with high rates of antimicrobial resistance in animals are northeast China, northeast India, southern Brazil, Iran and Turkey. In these countries, the bacteria listed above are now resistant to a large number of drug that are used not only in animals but also in human medicine. An important finding of the study is that so far, few resistance hotspots have emerged in Africa with the exception of Nigeria and the surroundings of Johannesburg.

The highest resistance rates were associated with the antimicrobials most frequently used in animals: tetracyclines, sulphonamides, penicillins and quinolones. In certain regions, these compounds have almost completely lost their efficacy to treat infections.

Alarming trend in multi-drug resistance

The researchers introduced a new index to track the evolution of resistance to multiple drugs: the proportion of drugs tested in each region with resistance rates higher than 50%. Globally, this index has almost tripled for chicken and pigs over the last 20 years. Currently, one third of drugs fail 50% of the time in chicken and one quarter of drug fail in 50% of the time in pigs.

"This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy," Van Boeckel says. This will affect the sustainability of the animal industry and potentially the health of consumers.

It is of particular concern that antimicrobial resistance is rising in developing and emerging countries because this is where meat consumption is growing the fastest, while access to veterinary antimicrobials remains largely unregulated. "Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side," the ETH researcher says.

Input from thousands of studies

For their current study, the team of researchers from ETH, Princeton University and the Free University of Brussels gathered thousands of publications as well as unpublished veterinary reports from around the world. The researchers used this database to produce the maps of antimicrobial resistance.

However, the maps do not cover the entire research area; there are large gaps in particular in South America, which researchers attribute to a lack of publicly available data. "There are hardly any official figures or data from large parts of South America," says co-author and ETH postdoctoral fellow Joao Pires. He said this surprised him, as much more data is available from some African countries , despite resources for conducting surveys being more limited than in South America.

Open-access web platform

The team has created an open-access web platform resistancebank.org (LINK) to share their findings and gather additional data on resistance in animals. For example, veterinarians and state-authorities can upload data on resistance in their region to the platform and share it with other people who are interested.

Van Boeckel hopes that scientists from countries with more limited resources for whom publishing cost in academic journal can be a barrier will be able to share their findings and get recognition for their work on the platform. "In this way, we can ensure that the data is not just stuffed away in a drawer" he says, "because there are many relevant findings lying dormant, especially in Africa or India, that would complete the global picture of resistance that we try to draw in this first assessment. The platform could also help donors to identify the regions most affected by resistance in order to be able to finance specific interventions.

As meat production continues to rise, the web platform could help target interventions against AMR and assist a transition to more sustainable farming practices in low- and middle-income countries. "The rich countries of the Global North, where antimicrobials have been used since the 1950s, should help make the transition a success," says Van Boeckel.

An internationally respected group of scientists is calling on world leaders to urgently accelerate efforts to tackle climate change.

Almost every aspect of the environment and ecology is changing in response to global warming. Some of these changes will be profound, if not catastrophic, in the future.

According to a new study published in Science today reducing the magnitude of climate change is good investment. Acting over the next few decades to reduce the rate of change is expected to cost much less than the damage otherwise inflicted--on people, infrastructure and ecosystems--by not taking action.

"Acting on climate change has a good return on investment when one considers the damage avoided," said lead author Prof Ove Hoegh-Guldberg, Deputy Director of the ARC Centre for Excellence for Coral Reef Studies (Coral CoE) at the University of Queensland (UQ).

Climate change impacts are now occuring faster and are more extensive than previously projected. This makes the case for rapidly reducing greenhouse gas emissions even more compelling and urgent.

Prof Hoegh-Guldberg explained the mismatch. "First, we underestimated the sensitivity of natural and human systems to climate change and the speed at which these changes are happening," he said.

"Second, we underappreciated the synergistic nature of climate threats with the outcomes tending to be worse than the sum of the parts. This results in rapid and comprehensive climate impacts with growing damage to people, ecosystems, and livelihoods."

For example, sea-level rise can lead to higher water levels during storm events and exacerbate the resulting damage. In already deprived areas this may intensify poverty, creating further disadvantage.

"Each risk may be small on its own but a small change in a number of risks can lead to large impacts," Prof Hoegh-Guldberg said.

Prof Daniela Jacob, co-author and Director of Climate Services Centre (GERICS) in Germany is concerned about these rapid changes--especially in regards to unprecedented weather extremes.

"We are already in new territory," Prof Jacob said.

"The 'novelty' of the weather is making our ability to forecast and respond to weather-related phenomena very difficult."

Such rapid changes are already having major consequences. The study points to significant benefits in avoiding global warming of 2oC and aiming to restrict the increase to 1.5oC above pre-industrial temperatures.

Prof Rachel Warren from the Tyndall Centre in the UK assessed projections of risk for forests, biodiversity, food, crops and other critical systems.

"The scientific community has quantified these risks in order to inform policy makers about the benefits of avoiding them," Prof Warren said.

Since the Paris Agreement came into force there has been a race to quantify the benefits of limiting warming to 1.5oC, so policy makers have the best possible information for developing the policy required to meet this target.

"If such policy is not implemented we will continue on the current upward trajectory of burning fossil fuels and continuing deforestation, which will expand the already large-scale degradation of ecosystems," Prof Warren said.

"To be honest, the overall picture is very grim unless we act."

A recent report from the United Nations projected that as many as a million species may be at risk of extinction over the coming decades and centuries. Climate change is not the only factor--but is one of the most important ones.

The urgency of responding to climate change is also front of mind for Prof Michael Taylor, co-author and Dean of Science at the University of the West Indies.

"This is not an academic issue--it is a matter of life or death for people everywhere," Prof Taylor said.

"People from small island States and low-lying countries are in the immediate cross-hairs of climate change," he said.
"I am very concerned about the future for these people."

This urgency to act is further emphasised by the vulnerability of developing countries to climate change impacts as highlighted by Prof Francois Engelbrecht, co-author from the Global Change Institute of the University of the Witwatersrand in South Africa.

"The developing African countries are amongst those most affected in terms of projected impacts on economic growth in the absence of strong climate change mitigation," Prof Engelbrecht said.

Prof Hoegh-Guldberg reiterated the importance of the coming year (2020) in terms of climate action and the opportunity to strengthen emission reduction pledges in line with the Paris Agreement of 2015.

"Current emission reduction commitments are inadequate and risk throwing many nations into chaos and harm, with a particular vulnerability of poor peoples," Prof Hoegh-Guldberg said.

"To avoid this, we must accelerate action and tighten emission reduction targets so that they fall in line with the Paris Agreement," he said.

"This is much less expensive than suffering the impacts of 2oC or more of climate change."

"Tackling climate change is a tall order. However, there is no alternative from the perspective of human well-being and there is too much at stake not to act urgently on this issue."