Earth

Cyanide and carbon monoxide are both deadly poisons to humans, but compounds containing iron, cyanide, and carbon monoxide discovered in carbon-rich meteorites by a team of scientists at Boise State University and NASA may have helped power life on early Earth. The extraterrestrial compounds found in meteorites resemble the active site of hydrogenases, which are enzymes that provide energy to bacteria and archaea by breaking down hydrogen gas (H2). Their results suggest that these compounds were also present on early Earth, before life began, during a period of time when Earth was constantly bombarded by meteorites and the atmosphere was likely more hydrogen-rich.

"When most people think of cyanide, they think of spy movies - a guy swallowing a pill, foaming at the mouth and dying, but cyanide was probably an essential compound for building molecules necessary for life," explained Dr. Karen Smith, senior research scientist at Boise State University, Boise, Idaho. Cyanide, a carbon atom bound to a nitrogen atom, is thought to be crucial for the origin of life, as it is involved in the non-biological synthesis of organic compounds like amino acids and nucleobases, which are the building blocks of proteins and nucleic acids used by all known forms of life.

Smith is lead author of a paper on this research published June 25 in Nature Communications. Smith, along with Boise State assistant professor Mike Callahan, a co-author on the paper, developed new analytical methods to extract and measure ancient traces of cyanide in meteorites. They found that the meteorites containing cyanide belong to a group of carbon-rich meteorites called CM chondrites. Other types of meteorites tested, including a Martian meteorite, contained no cyanide.

"Data collected by NASA's OSIRIS-REx spacecraft of asteroid Bennu indicate that it is related to CM chondrites," said co-author Jason Dworkin of NASA's Goddard Space Flight Center in Greenbelt, Maryland. "OSIRIS-REx will deliver a sample from Bennu to study on Earth in 2023. We will search for these very compounds to try to connect Bennu to known meteorites and to understand the potential delivery of prebiotic compounds such as cyanide, which may have helped start life on the early Earth or other bodies in the solar system."

Cyanide has been found in meteorites before. However, in the new work, Smith and Callahan were surprised to discover that cyanide, along with carbon monoxide (CO), were binding with iron to form stable compounds in the meteorites. They identified two different iron cyano-carbonyl complexes in the meteorites using high-resolution liquid chromatography-mass spectrometry. "One of the most interesting observations from our study is that these iron cyano-carbonyl complexes resemble portions of the active sites of hydrogenases, which have a very distinct structure," Callahan said.

Hydrogenases are present in almost all modern bacteria and archaea and are widely believed to be ancient in origin. Hydrogenases are large proteins, but the active site - the region where chemical reactions take place - happens to be a much smaller metal-organic compound contained within the protein, according to Callahan. It is this compound that resembles the cyanide-bearing compounds the team discovered in meteorites.

An enduring mystery regarding the origin of life is how biology could have arisen from non-biological chemical processes. The similarities between the active sites in hydrogenase enzymes and the cyanide compounds the team found in meteorites suggests that non-biological processes in the parent asteroids of meteorites and on ancient Earth could have made molecules useful to emerging life.

"Cyanide and carbon monoxide attached to a metal are unusual and rare in enzymes. Hydrogenases are the exception. When you compare the structure of these iron cyano-carbonyl complexes in meteorites to these active sites in hydrogenases, it makes you wonder if there was a link between the two," Smith added. "It's possible that iron cyano-carbonyl complexes may have been a precursor to these active sites and later incorporated into proteins billions of years ago. These complexes probably acted as sources of cyanide on early Earth as well."

The strongest genetic risk factor for Alzheimer's disease is the apolipoprotein E type 4 allele (ApoE ε4). Research presented by Manish Paranjpe at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) used positron emission tomography (PET) to show that women who are ApoE ε4 carriers and already experiencing mild cognitive impairment are more susceptible than men to tau accumulation in the brain.

"Sex plays an important role in Alzheimer's disease risk, with females having a higher lifetime risk of developing the disease and an increased vulnerability to genetic risk factors," points out Yun Zhou, who led the project at the Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine. He explains, "This is the first study to demonstrate that sex modulates the effect of ApoE ε4 on brain tau depositing, measured using 18F-AV-1451-PET imaging, in the entorhinal cortex, amygdala, parahippocampal gyrus, and posterior cingulate of the brains of patients with mild cognitive impairment (MCI). Strikingly, females experience greater ApoE ε4-associated increases in brain tau deposition in these regions compared to their male counterparts."

This cross-sectional study involved 131 cognitively normal (CN) elderly controls (66 women) and 97 MCI subjects (39 women) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The mean age of all was 77. Preprocessed 18F-AV-1451 PET images, T1-weighted structural MRI scans and demographic information were included. After downloading pre-processed images from ADNI, a partial volume correction method was applied on all PET images (improving spatial resolution and contrast), and structural MRIs were used for PET spatial normalization. All statistical analyses were performed after controlling for baseline age and education.

In addition to finding women with the ApoE ε4 mutation more susceptible than men to tau accumulation, Zhou notes: "Our study also confirmed that sex does not modulate the ApoE ε4-associated tau deposition in the brains of cognitively normal elderly individuals, and it extends our understanding of how sex modulates the ApoE ε4 effect on tau deposition in the brains of individuals at the early stage of Alzheimer's disease."

Paranjpe adds, "Our results have implications for clinical trials, biomarkers, and therapeutic development in Alzheimer's. In designing clinical trials aimed at an MCI cohort, potentially our study suggests that the dosage of anti-tau antibodies should be modified by ApoE ε4-sex group. Moreover, we hope that insights from our work will shed light on potential treatments for Alzheimer's disease, including sex-specific tau-targeted and ApoE-targeted drug development."

Research presented at the Society of Nuclear Medicine and Molecular Imaging's 2019 Annual Meeting shows that molecular imaging with 18F-FDG positron emission tomography/computed tomography (PET/CT) can evaluate tuberculosis at the molecular level, effectively identifying diseased areas and guiding treatment for patients.

According to the World Health Association, tuberculosis is one of the top 10 causes of death worldwide. Although the disease is curable and preventable, in areas with high rates of tuberculosis, it contributes to significant morbidity, mortality and an increased risk of transmission from infected individuals. Tuberculosis most frequently involves the lungs; however involvement of tissues and organs other than the lungs is referred to as extra-pulmonary tuberculosis.

"Extra-pulmonary tuberculosis presents a particular challenge as the disease site is often not accessible for performing an invasive diagnosis. The physician thus relies on the clinical diagnosis for initiating treatment as well as deciding the duration of therapy, which can be difficult," said Bhagwant R. Mittal, MD, DNB, professor and department head of nuclear medicine at the Postgraduate Institute of Medical Education and Research in Chandigarh, India. "In our study, we aimed to evaluate the utility of 18F-FDG PET/CT in the initial diagnosis and response assessment of patients with extra-pulmonary tuberculosis."

Ninety-three patients with extra-pulmonary tuberculosis were prospectively enrolled in the study prior to the initiation of treatment. The patients underwent 18F-FDG PET/CT imaging as a baseline, and then received follow-up imaging after two months and after treatment completion. Follow-up scans were categorized into three groups: complete metabolic response (no abnormal lesions), residual disease (persistent lesions, but no new lesions) and disease progression (new lesions compared to the baseline scan).

In the baseline scans, 176 lesion sites were detected among the 93 study participants. The most common sites included the lymph nodes and central nervous system. Two month follow-up scans were performed on 47 patients, and 21.2 percent were classified as having complete metabolic response, 72.3 percent had residual disease and 6.4 percent were characterized as having disease progression. A final scan was conducted post-treatment and, of the 28 patients imaged, 28.6 percent had complete metabolic response, 53.6 percent of patients showed residual disease and 17.8 percent had disease progression. During the course of the study, 12.9 percent of patients died. Of these deaths, the patients who fell in the disease progression category had the highest mortality rate--60 percent.

"This study has the potential to change the way we manage tuberculosis patients. Our results show that 18F-FDG PET/CT provides a whole-body survey and identifies the disease sites in various organs and tissues in a single study. This helps to provide an early estimation of disease extent, and in suspected cases, helps to identify accessible biopsy sites for obtaining tissue diagnosis," Mittal said. "Further, follow-up scans can point towards response to treatment and thus suggest predict a more accurate outcome."

NEW YORK, June 24, 2019 -- Quantum computers, which use light particles (photons) instead of electrons to transmit and process data, hold the promise of a new era of research in which the time needed to realize lifesaving drugs and new technologies will be significantly shortened. Photons are promising candidates for quantum computation because they can propagate across long distances without losing information, but when they are stored in matter they become fragile and susceptible to decoherence. Now researchers with the Photonics Initiative at the Advanced Science Research Center (ASRC) at The Graduate Center, CUNY have developed a new protocol for storing and releasing a single photon in an embedded eigenstate -- a quantum state that is virtually unaffected by loss and decoherence. The novel protocol, detailed in the current issue of Optica, aims to advance the development of quantum computers.

"The goal is to store and release single photons on demand by simultaneously ensuring the stability of data," said Andrea Alù, founding director of the ASRC Photonics Initiative and Einstein Professor of Physics at The Graduate Center. "Our work demonstrates that is possible to confine and preserve a single photon in an open cavity and have it remain there until it's prompted by another photon to continue propagating."

The research team used quantum electrodynamics techniques to develop their theory. They investigate a system composed of an atom and a cavity -- the latter of which is partially open and therefore would normally allow light trapped in the system to leak out and be quickly lost. The research team showed, however, that under certain conditions destructive interference phenomena can prevent leakage and allow a single photon to be hosted in the system indefinitely. This embedded eigenstate could be very helpful for storing information without degradation, but the closed nature of this protected state also creates a barrier to exterior stimuli, so that single photons also cannot be injected into the system. The research team was able to overcome this limitation by exciting the system at the same time with two or more photons.

"We proposed a system that acts as a closed box when excited by a single photon, but it opens up very efficiently when we hit it with two or more photons," said Michele Cotrufo, first author of the paper and a postdoctoral fellow with the ASRC Photonics Initiative. "Our theory shows that two photons can be efficiently injected into the closed system. After that, one photon will be lost and the other will be trapped when the system closes. The stored photon has the potential to be preserved in the system indefinitely."

In realistic systems, additional imperfections would prevent perfect confinement of photons, but the research team's calculations showed that their protocol outperforms previous solutions based on a single cavity.

The authors also showed that the stored excited photon can later be released on demand by sending a second pulse of photons.

The team's finding has the potential to solve critical challenges to quantum computing, including the on-demand generation of entangled photonic states and quantum memories. The group is now exploring avenues to experimentally verify their theoretical work.

DENVER--Today, the research journal Obesity published the study "Development of Obesity Competencies for Medical Education: A Report from the Obesity Medicine Education Collaborative" which outlines the first set of obesity-focused competencies to improve obesity medicine education for physicians and advanced healthcare providers. The 32 competencies were developed by The Obesity Medicine Education Collaborative (OMEC), an intersociety initiative spearheaded by the Obesity Medicine Association (OMA), The Obesity Society (TOS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

Until now, many early career level healthcare professionals did not have an objective, measurable method for evaluating and improving the quality of obesity-related education and training. The ultimate goal of these new competencies is to introduce obesity medicine education early and ensure physicians and healthcare professionals are adequately equipped to treat obesity when they begin their medical careers.

"The launch of the OMEC competencies represents the essential step forward in helping our medical schools, residency/fellowship programs, advanced practitioner training programs, and currently practicing physicians implement, assess, and improve their understanding of the disease of obesity and their ability to deliver excellent obesity care," said Deborah Bade Horn, DO, MPH, MFOMA, past President of the OMA and co-chair for OMEC. "These obesity-focused competencies will create a new generation of providers that demonstrate excellence in the management of the disease of obesity."

The Collaborative used the Six Core Domain Competencies of the Accreditation Council for Graduate Medical Education as a guiding framework to develop the competencies. The core domains used and the number of competencies for each domain include Practice-Based Learning and Improvement (5); Patient Care and Procedural Skills (5); System-Based Practice (4); Medical Knowledge (13); Interpersonal and Communication Skills (3); and Professionalism (2) for a total of 32 competencies.

The competencies can be applied to the assessment of learners within a training program, or assessment of existing or planned curricula. They can also be used in the assessment of non-training educational environments, like hospital and healthcare networks to improve the obesity treatment knowledge levels of practicing physicians.

"For years, obesity has been misunderstood," said Wendy Scinta, MD, MS, FOMA, President of the OMA. "The goal of our multi-disciplinary and multi-society effort is to remove bias and ensure obesity is appropriately understood as a disease by healthcare professionals in medical school, residencies, fellowships and beyond. These competencies set the bar for obesity education and will immensely benefit patients with obesity and their providers."

Formed in March 2016, the OMEC steering committee consisting of OMA, TOS and ASMBS members joined representatives from 12 additional organizations to form working groups. Group members collaborated to develop the competencies with specific measurement benchmarks to facilitate performance assessment. The draft competencies, along with a vetting survey, were sent out to 19 related organizations for external review. A final document of the competencies and associated benchmarks were completed in early 2019; since finalization, the competencies have been endorsed by 20 U.S. and global professional societies and organizations.

"Obesity is one of the most pressing medical problems of the twenty-first century, since it is linked to the development of heart disease, diabetes and cancer among multiple other health conditions," said Ethan Lazarus, MD, FOMA, Vice President of the OMA. "In spite of this, education regarding obesity is minimal in medical provider training programs, a finding confirmed by a 2016 American Medical Association report which found that obesity training is inconsistent and incomprehensive. OMEC represents a big step forward in filling these significant educational gaps and is provided as a free tool that can be used at all levels of medical education."

Research presented at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) describes a new class of radiopharmaceuticals, named radiohybrids (rh), that offer a fresh perspective on cancer imaging and radioligand therapy (theranostics). In addition, the technology encompasses a highly innovative and efficient isotopic labelling method to facilitate broad application.

"Similar to hybrid cars that are driven by either a combustion engine or an electric engine (one is switched on, while the other is switched off), we have designed for the very first time radiopharmaceuticals with two 'nuclear engines' or isotopes," explains Alexander Wurzer at Technical University Munich in Garching, Germany. "For PET (positron emission tomography) imaging, the diagnostic isotope is radioactive (e.g., fluorine-18), while the therapeutic isotope is silent; for radioligand therapy the situation is vice versa."

A unique feature of such rhPSMA-ligands is that both fluorine and the metal are always present, but only one of them is present as a radioactive isotope (e.g., [18F,natLu]rhPSMA or [19F,177Lu]rhPSMA). "We have also created radiohybrids that offer a choice between two independent imaging isotopes, such as fluorine-18 (18F) or gallium-68 (68Ga), thus allowing for the optimal selection of the radioisotope by individual hospitals worldwide, in consideration of the local clinical infrastructure and isotope availability. Since these pairs of molecules are identical, they represent chemical monozygotic twins, which enables identical imaging with both of the chemical twins."

Prostate cancer is the most commonly diagnosed cancer among men in the United States, other than skin cancer. According to the American Cancer Society, approximately 175,000 new cases of prostate cancer are diagnosed and more than 31,500 men die from the disease annually in the United States. For this study, prostate-specific membrane antigen (PSMA) was targeted. The researchers developed a platform technology that allows for fast and efficient labeling of peptide and peptide-like radiopharmaceuticals with either fluorine-18 (18F) or radiometals and then synthesized and evaluated several novel rhPSMA ligands.

Testing with six different rhPSMA ligands was carried out on prostate cancer tumor-bearing mice. Based on their high affinity, fast internalization and excellent biodistribution, the DOTA- and DOTAGA-derived inhibitors, rhPSMA-7 and 10, were found to be the most promising candidates for first in human proof-of-concept.

That proof-of-concept was performed using [18F,natGa]rhPSMA-7 PET imaging in a patient suffering from metastatic, castration-resistant prostate cancer. The results showed fast blood clearance, almost no activity transfer into the bladder during imaging; and the radiohybrid compound demonstrated high-contrast PET imaging of lymph nodes and bone metastasis.

Hans-Jürgen Wester, principal investigator of that study, points out, "This unique class of molecular agents opens new pathways for powerful and cost-effective imaging and treatment. Consequently, the first radiohydrid radiopharmaceuticals have been designed to target PSMA - for imaging with high sensitivity and high specificity, as well as effective treatment of prostate cancer, one of the most important cancer types."

Wester adds, "Based on the promising results obtained with the first [18F][natGa]rhPSMA-imaging agent in proof-of-concept studies in prostate cancer patients, we have already started to broaden this concept to the development of drugs for other important cancer targets, such as somatostatin, bombesin, chemokine and cholecystokinin receptors, to mention only a few." He explains, "The medium-term objective of these efforts is to promote the PET isotope with the best availability, decay properties and positron energy, fluorine-18, for application in the rapidly growing and important field of theranostics."

New prostate cancer research shows that adding an interim scan during therapy can help guide a patient's treatment. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging of patients with metastatic castration-resistant prostate cancer after two cycles of lutetium-177 (177Lu)-PSMA radioligand therapy has shown a significant predictive value for patient survival. The research was presented at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

According to the National Cancer Institute, currently the five-year survival rate for men with metastatic prostate cancer is 30.5 percent. Early assessment of treatment effectiveness is essential to providing optimal care.

In phase 2 trials, 177Lu-PSMA therapy has shown promising results in treating patients with metastatic castration-resistant prostate cancer. The therapy typically involves a preliminary PSMA PET scan to identify patients who are eligible for the treatment. While interim PET scans have shown high predictive value for lymphoma patients, this concept has not been previously explored in prostate cancer patients undergoing 177Lu-PSMA therapy.

The retrospective analysis was conducted at Klinikum rechts der Isar hospital, Technical University Munich, Germany including patients who underwent gallium-68 (68Ga)-PSMA11 PET/CT at baseline and after two cycles of 177Lu-PSMA RLT under a compassionate use program.

Instead of standardized uptake value, which is the parameter generally used in such analyses, researchers used qPSMA, an in-house developed software, to evaluate the whole-body tumor burden. "Tumor response was assessed by the changes in PSMA-avid tumor volume from baseline to the second PSMA PET using three classification methods," explained Andrei Gafita, MD. "Subsequently, we found that tumor response assessed on interim PSMA PET after two RLT cycles was associated with overall survival."

Gafita stated, "Our results therefore show that interim PSMA PET can be used for therapeutic response assessment in patients undergoing 177Lu-PSMA RLT. Furthermore, occurrence of new lesions in PSMA PET is a prognostic factor for disease progression and could be included in defining tumor response based on PSMA PET imaging."

"While further analyses involving clinical parameters are warranted," Gafita adds, "this analysis paves the way for use of interim PSMA PET in a prospective setting during 177Lu-PSMA radioligand therapy."

Young women who undergo radiation therapy to treat a pediatric brain tumor are more likely to suffer from long-term cognitive impairment than male survivors, according to a study by Georgia State University researchers.

"Some of the survivors are doing quite well, going on to graduate degrees or medical school, " said Tricia King, professor of psychology and neuroscience and senior author of the study. "Others are quite devastated by the treatments. So, there's a huge range in outcomes and we are trying to look at the various factors involved that may explain these differences."

"People are living longer in part because of advancements in diagnoses and treatment. Instead of research focused only on whether or not someone lives, we are now looking at the quality of survival. What's happened now is the push for precision medicine that will provide individualized treatment to optimize outcomes. Our team is interested in identifying critical factors that may contribute to better long-term outcomes of survivors."

Tanya Panwala, lead author of the study, said the researchers focused on sex differences.

"That was something that was very understudied in the research," said Panwala, who recently graduated from Georgia State after working as an undergraduate researcher in King's lab.

The team recruited 45 adult survivors of posterior fossa childhood brain tumors and had them complete a series of standardized tests to measure intelligence, attention, working memory and independent-living skills. Posterior fossa tumors, which are in or near the bottom of the skull, are the most common form of brain tumors in children, accounting for as much as 55 percent overall.

The tests showed female survivors were more affected by radiation therapy than their male counterparts in basic life skills such as reading, memory, social interactions, self-care and cognitive processing speed.

"We found that females were more negatively affected by the life-saving radiation treatments than males," King said. "This showed up in their activities of daily living in the community. So, the more challenging, higher-order skills that people need to be contributing members of society is disrupted and more so for females that had radiation than the male survivors."

The research points to the need for future studies to investigate the mechanisms for these sex differences in order to best personalize treatment plans, King said.

"Because there are sex-specific differences in survivors, these get washed out when you just look at the group of tumor survivors as a whole," King said. "To advance science, we really need to look at these groups separately. There's lots of hypotheses of why that may be, but we need to look at the biological factors that are making females more vulnerable to life-saving radiation treatment."

You see an object, you think of its name and then you say it. This apparently simple activity engages a set of brain regions that must interact with each other to produce the behavior quickly and accurately. A report published in eNeuro shows that a reliable sequence of neural interactions occurs in the human brain that corresponds to the visual processing stage, the language state when we think of the name, and finally the articulation state when we say the name. The study reveals that the neural processing does not involve just a sequence of different brain regions, but instead it engages a sequence of changing interactions between those brain regions.

"In this study, we worked with patients with epilepsy whose brain activity was being recorded with electrodes to find where their seizures started. While the electrodes were in place, we showed the patients pictures and asked them to name them while we recorded their brain activity," said co-corresponding author Dr. Xaq Pitkow, assistant professor of neuroscience and McNair Scholar at Baylor College of Medicine and assistant professor of electrical and computer engineering at Rice University.

"We then analyzed the data we recorded and derived a new level of understanding of how the brain network comes up with the right word and enables us to say that word," said Dr. Nitin Tandon, professor in the Vivian L. Smith Department of Neurosurgery at McGovern Medical School at The University of Texas Health Science Center at Houston.

The researchers' findings support the view that when a person names a picture, the different behavioral stages - looking at the image, thinking of the name and saying it - consistently correspond to dynamic interactions within neural networks.

"Before our findings, the typical view was that separate brain areas would be activated in sequence," Pitkow said. "But we used more complex statistical methods and fast measurement methods, and found more interesting brain dynamics."

"This methodological advance provides a template by which to assess other complex neural processes, as well as to explain disorders of language production," Tandon said.

Bottom Line: The current immigration policy environment in America appears to be associated with reported adverse mental health outcomes among U.S.-born children of Latinx immigrants. Data were used from a group of 397 U.S.-born adolescents with at least one immigrant parent from a long-term study of Mexican farmworker families in the Salinas Valley of California. Researchers examined associations between adolescent self-reported concerns about immigration policy collected at age 16 on an assessment tool and changes in their mental and physical health before (when they were 14) and in the first year after the 2016 election (when they were 16). Nearly half of the Latinx adolescents were worried at least sometimes about the personal consequences of U.S. immigration policy, family separation because of deportation, and being reported to the immigration office. High (versus low or moderate) scores on the assessment about concerns over immigration policy were associated with higher anxiety and worse sleep scores. A limitation of the study to consider is that researchers didn't know the immigration status of parents.

Author: Brenda Eskenazi, Ph.D., of the University of California, Berkeley, and coauthors

(doi:10.1001/jamapediatrics.2019.1475)

Editor's Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

ANN ARBOR--Some patients feel shame, anxiety or fear immediately before seeing their doctor, making them tense. But if they can relax and become calm, patients will likely pay attention to and better comprehend health messages, suggests a new University of Michigan study.

Researchers tested whether increasing one's positive self through meditation can lessen the patient's negative feelings prior to getting the health information.

"An intense negative emotion can lead to a patient to focus on only one or two pieces of information and gloss over other important details from health messages," said Koji Takahashi, a psychology graduate student and study's lead author.

The findings came from four studies involving nearly 1,450 adults divided in groups. Some meditated or listened to audio that instructed breathing exercises and relaxation. Others simply listened to historical information.

After completing the listening task, all participants read information about flu, cancer, HIV, herpes and gonorrhea.

Participants who relaxed reported paying more attention to the health messages, the study showed. The meditation created a positive, low arousal affect, which enabled them to retain the information, said Allison Earl, assistant professor of psychology and study's co-author.

"A negative affect drives attention away from unpleasant or threatening information," she said.

This doesn't mean you won't be scared or embarrassed in the doctor's office, "but you'll be able to handle the information better by being in a calmer mood," Earl said.

The researchers recommend that people use their time wisely in the waiting room by meditating or listening to calming music, not simply watching television or playing on their cell phones.

In addition, if patients do not believe they can relax, they might consider taking a family member or friend to the appointment to take notes during the doctor's consultation, Takahashi said.

Researchers noted that this study only focused on adults receiving written health messages; the findings should not be extrapolated beyond this without further research.

TROY, N.Y. -- Increased solar radiation penetrating through the damaged ozone layer is interacting with the changing climate, and the consequences are rippling through the Earth's natural systems, effecting everything from weather to the health and abundance of sea mammals like seals and penguins. These findings were detailed in a review article published today in Nature Sustainability by members of the United Nations Environment Programme's Environmental Effects Assessment Panel, which informs parties to the Montreal Protocol.

"What we're seeing is that ozone changes have shifted temperature and precipitation patterns in the southern hemisphere, and that's altering where the algae in the ocean are, which is altering where the fish are, and where the walruses and seals are, so we're seeing many changes in the food web," said Kevin Rose, a researcher at Rensselaer Polytechnic Institute who serves on the panel and is a co-author of the review article.

The 1987 Montreal Protocol on Substances that Deplete the Ozone Layer -- the first multilateral environmental agreement to be ratified by all member nations of the United Nations -- was designed to protect Earth's main filter for solar ultraviolet radiation by phasing out production of harmful manmade substances, such as the chlorofluorocarbons class of refrigerants. The treaty has largely been considered a success, with global mean total ozone projected to recover to pre-1980 levels by the middle of the 21st century. Earlier this year, however, researchers reported detecting new emissions of ozone depleting substances emanating from East Asia, which could threaten ozone recovery.

While ozone depletion has long been known to increase harmful UV radiation at the Earth's surface, its effect on climate has only recently become evident. The report points to the Southern Hemisphere, where a hole in the ozone layer above Antarctica has pushed the Antarctic Oscillation -- the north-south movement of a wind belt that circles the Southern Hemisphere -- further south than it has been in roughly a thousand years. The movement of the Antarctic Oscillation is in turn directly contributing to climate change in the Southern Hemisphere.

As climate zones have shifted southward, rainfall patterns, sea-surface temperatures, and ocean currents across large areas of the southern hemisphere have also shifted, impacting terrestrial and aquatic ecosystems. The effects can be seen in Australia, New Zealand, Antarctica, South America, Africa, and the Southern Ocean.

In the oceans, for example, some areas have become cooler and more productive, where other areas have become warmer and less productive.

Warmer oceans are linked to declines in Tasmanian kelp beds and Brazilian coral reefs, and the ecosystems that rely on them. Cooler waters have benefitted some populations of penguins, seabirds, and seals, who profit from greater populations of krill and fish. One study reported that female albatrosses may have become a kilogram heavier in certain areas because of the more productive cooler waters linked to ozone depletion.

Rose also pointed to subtler feedback loops between climate and UV radiation described in the report. For example, higher concentrations of carbon dioxide have led to more acidic oceans, which reduces the thickness of calcified shells, rendering shellfish more vulnerable to UV radiation. Even humans, he said, are likely to wear lighter clothes in a warmer atmosphere, making themselves more susceptible to damaging UV rays.

The report found that climate change may also be affecting the ozone layer and how quickly the ozone layer is recovering.

"Greenhouse gas emissions trap more heat in the lower atmosphere which leads to a cooling of the upper atmosphere. Those colder temperatures in the upper atmosphere are slowing the recovery of the ozone layer," Rose said.

As one of three scientific panels to support the Montreal Protocol, the Environmental Effects Assessment Panel focused in particular on the effects of UV radiation, climate change, and ozone depletion. Thirty-nine researchers contributed to the article, which is titled "Ozone depletion, ultraviolet radiation, climate change and prospects for a sustainable future." Rose, an aquatic ecologist, serves on the aquatic ecosystems working group, which is one of seven working groups that are part of the panel.

"This international collaboration focusing on a pressing problem of global significance exemplifies the research vision of The New Polytechnic at Rensselaer," said Curt Breneman, dean of the Rensselaer School of Science."

WASHINGTON -- High schoolers who take music courses score significantly better on exams in certain other subjects, including math and science, than their non-musical peers, according to a study published by the American Psychological Association.

"In public education systems in North America, arts courses, including music courses, are commonly underfunded in comparison with what are often referred to as academic courses, including math, science and English," said Peter Gouzouasis, PhD, of the University of British Columbia, an author of the study of more than 100,000 Canadian students. "It is believed that students who spend school time in music classes, rather than in further developing their skills in math, science and English classes, will underperform in those disciplines. Our research suggests that, in fact, the more they study music, the better they do in those subjects."

The research was published in the Journal of Educational Psychology.

The researchers examined school records for all students in British Columbia who started the first grade between 2000 and 2003; completed the last three years of high school; had completed at least one standardized exam for math, science or English (10th or 12th grade); and for whom they had appropriate demographic information (e.g., gender, ethnicity, neighborhood socioeconomic status).

Of the more than 112,000 student records studied, approximately 13% of the students had participated in at least one music course in grade 10, 11 or 12. Qualifying music courses included concert band, conservatory piano, orchestra, jazz band, concert choir and vocal jazz. General music or guitar courses did not qualify as they required no previous music experience and, in the case of general music, did not require music-making or practice, according to Gouzouasis and his co-authors, Martin Guhn, PhD and Scott Emerson, MSc, also from the University of British Columbia.

"Students who participated in music, who had higher achievement in music, and who were highly engaged in music had higher exam scores across all subjects, while these associations were more pronounced for those who took instrumental music rather than vocal music," he said. "On average, the children who learned to play a musical instrument for many years, and were now playing in high school band and orchestra, were the equivalent of about one academic year ahead of their peers with regard to their English, mathematics and science skills, as measured by their exam grades."

Apart from the strength of the associations, the researchers were most surprised by the consistency of the associations across all three subject areas (math, science and English). These associations continued to be significant even when the researchers controlled for demographic factors such as gender, ethnicity, socioeconomic background and prior achievement on similar exams in seventh grade.

Gouzouasis believes that some skills learned in band, orchestra, and conservatory music lessons transfer very broadly to adolescents' learning in school.

"Learning to play a musical instrument and playing in an ensemble is very demanding. A student has to learn to read music notation, develop eye-hand-mind coordination, develop keen listening skills, develop team skills for playing in an ensemble and develop discipline to practice. All those learning experiences play a role in enhancing children's cognitive capacities and their self-efficacy," he said. "We think that the effects we see are partly a result of the fact that children engaging in school music over many years mostly receive quality music instruction and need to master the high expectations of performing at a high school band or orchestra level. In fact, it is that high levels of music engagement for which we saw the strongest effects."

The researchers hope that their findings are brought to the attention of students, parents, teachers and administrative decision-makers in education, as many school districts over the years have emphasized numeracy and literacy at the cost of other areas of learning, particularly music.

"Often, resources for music education - including the hiring of trained, specialized music educators, and band and orchestral instruments - are cut or not available in elementary and secondary schools. The argument has frequently been that we need all our money to focus on math, science and English," said Gouzouasis. "The irony is that music education - multiple years of high-quality instrumental learning and playing in a band or orchestra or singing in a choir at an advanced level - may be the very thing that improves all-around academic achievement and an ideal way to have students learn more holistically in schools."

Parent-child discussions about sexual health and sexual identity are complicated, particularly with a male teen who identifies as gay, bisexual, or queer (GBQ). New research from the University of Pennsylvania shows that even as parents become savvier in these conversations, departing from gender stereotypes and embracing more accepting attitudes, factors beyond the home will still affect the message parents convey and their child hears.

"We like to think about these conversations as an exchange between two people, the child and the parent. Unfortunately, they don't live in a silo," says Dalmacio Dennis Flores, an assistant professor in Penn's School of Nursing and lead researcher on the work. "Fifty years after Stonewall, they're still part of a larger heteronormative system that they both must navigate."

The latest findings, published in the American Journal of Sexuality Education, stem from earlier research Flores conducted at Duke University. For the initial study, he interviewed 30 15- to 20-year-old males who identified as gay, bisexual, or queer about how they discuss sex and health with their parents. Despite frustration or confusion over what they may have learned at home, 29 of 30 participants still said they preferred their parents be their initial source of sexual health information.

For the current work, Flores, with colleagues from the University of Illinois at Chicago and the Medical University of South Carolina, dove into what might affect communication about sexual health between parents and a gay, bisexual, or queer son. The researchers found that a whole host of factors, from siblings and peers to mass media and religion, can reinforce heteronormative ideas, even when parents try not to.

Flores offers an example to explain. Consider a family with two brothers; the older sibling is straight, and the younger sibling is gay. One parent talks to the older son about using condoms to prevent unwanted pregnancy, and, though the information isn't targeted at the younger son, he takes it in regardless. "It negates whatever inclusivity the younger son might hear later on," Flores says. "He hears the message first about not getting a girl pregnant, and it privileges a certain narrative." The message, that a condom is only for pregnancy prevention, may also inadvertently minimize its value in regard to male-to-male sexual behaviors.

"Parents need to be mindful of what they say to other children in the house," Flores notes. "Is it consistent with what I might tell my other child if I find out he's gay? What messages do they hear at a friend's house? What messages do they see on TV?"

Religion can add an extra layer of complication, particularly if the family follows one that's not inclusive of all sexual orientations. In such cases, Flores recommends parents take the time to explain their nuanced views, that they may not adhere to a blanket belief. "Just having one-time caveats with kids makes a whole lot of difference for someone who is perhaps questioning his sexual orientation, who is insecure, who is wrestling with the idea of whether he is 'normal,'" he says. "That's where parents occupy a significant position."

This research only considers the perspective of male children, a limitation Flores says he hopes to change by incorporating information from parents in two ongoing studies. It also only focused on cisgender, school-going male adolescents, excluding large swaths of the GBQ adolescent population. "My hunch is that these findings are applicable across the board," he says, to transgender people and queer females, but he doesn't yet have the data to support it. Perhaps that will come in the near future.

For now, he says he wants to keep encouraging parents to have inclusive dialogues with their LGBTQ children, which is anecdotally getting better but still has room to improve.

"Traditional ideas about masculinity are still pervasive. Everything around their kids' life still reinforces them. If parents can counter those and are purposeful in not perpetuating traditional masculinity, that would be a huge reassuring influence for their gay, bisexual, and queer children," Flores says. "This is the new parenting charge."

For the first time, scientists have been able to study how well synthetic bone grafts stand up to the rigors and 'strains' of life, and how quickly they help bone re-grow and repair.

Researchers led by Dr Gianluca Tozzi, at the University of Portsmouth, are the first to examine the strains between bone and graft from animal models in 3D and in microscopic detail.

Dr Tozzi hopes this window on to living bone grafts will help scientists find ways to improve the body's ability to regrow its own bone, and more chance surgeons can predict the success of a synthetic graft.

He said: "Every three seconds a person breaks a bone due to increased bone fragility. Fragile bones break easily and are also more difficult to repair, particularly when the defect area is extended. It's vital we understand what is happening where bone meets graft so we can better engineer sophisticated replacement materials.

"Bones are very complex biological tissues and a synthetic bone substitute needs to have specific requirements to allow blood supply and encourage new bone growth.

"In this sense, the new generation of synthetic grafts have the potential to be resorbed by the body in time, allowing gradual bone regeneration in the defect site. However, biomaterials that degrade too quickly don't allow enough time for the new bone to grow, and grafts that degrade too slowly can cause mechanical instability to the implantation site. It's important to get it right."

Millions of people a year in the UK are given a bone graft. They're commonly used in the spine, hip, knee and ankle. Their role is bridge gaps in a broken bone that are too large for the bone to close on its own. They're also used in dental implants, to help teeth attach to the jawbone.

Some grafts can be made using a fragment of the patient's own bone or other sources, but this is more invasive and can cause adverse reactions. Therefore, it's becoming increasingly common for grafts to be made by synthetic materials, including glass, ceramics and even, in very small joints, plaster of Paris.

Dr Tozzi and colleagues have been using synchrotron X-ray computed tomography (SR-XCT) at the Diamond Light Source and in lab-based systems at the Zeiss Global Centre at the University of Portsmouth to better understand the performance of graft materials and their ability to promote bone healing.

In a recently published study in ACS Biomaterials Science & Engineering, they examined the micromechanics and microdamage evolution of four different bone-biomaterial systems combining high-resolution synchrotron tomography, in situ mechanics and digital volume correlation.

Dr Tozzi said: "It's essential we are able to look at the interface between bone and graft and judge their load-bearing capability in order to understand both biological integration and structural integrity of the intervention.

"By carrying out time-lapse experiments of such constructs, we could observe damage progression and see, for the first time, how strain could be used to understand and potentially predict clinical outcome of biomaterials in a living body, improving our knowledge significantly."