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WASHINGTON -- When it comes to buying probiotics, many product labels do not give consumers enough information to make an informed decision, according to a research team led by Georgetown University Medical Center.

In their study, published in the Journal of General Internal Medicine, investigators found that of 93 different bottles of probiotics purchased from four large national probiotic retailers in the Washington, DC area, only 33 (35%) could be linked to medical efficacy as supported by clinical evidence. The researchers point out that the other 65% of products might be supported by clinical studies, but they were not able track down the evidence given insufficient labeling.

The researchers considered a product supported by evidence if the product label disclosed the strain of bacteria or yeast designation(s), the strain was said to be present at a beneficial dose, and at least one controlled human study supported use of the probiotic was listed on PubMed, a web-based search engine for biomedicine and health studies.

"The higher number of strains, higher dose or greater cost were not associated with evidence," says the study's senior investigator, Dan Merenstein, MD, professor of family medicine and director of research programs for the Department of Family Medicine at Georgetown University School of Medicine.

The good news? "It may be counterintuitive to consumers, but we found that products with fewer strains and lower cost were more likely to be supported by evidence we could trace," he says.

The caveat is that "consumers will have to do legwork themselves to figure out the best product to buy," Merenstein says. None of the 33 bottles linked to evidence that the probiotics inside were clinically beneficial had any mention of those studies on the label.

"I think it's a lot to expect consumers to check the evidence, but trustworthy guides can help them find products backed by evidence," he says. "Companies could greatly help this process by labeling products with strain designations, dose at expiration, and with proper indication of usage."

In 2014, a group of experts, two of which are authors on this paper, affirmed the definition of probiotics to be "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host."

The robust use of probiotics has led to a number of studies that have found several strains work as intended, but additional studies have shown other strains don't work better than a placebo. Manufacturers are required to demonstrate that commercial probiotics are safe for the intended consumer and are labeled in a truthful and not misleading fashion.

Of the 93 products examined, 67 were judged to be "unique" based on distinct strain composition. Further, any products that did not disclose strains on labels were considered unique since the precise composition could not be determined. But evidence could not be traced to many of the high-dose, multiple-species, and more expensive products, Merenstein says. Some such products listed some strains that are known to be beneficial, but since the dose of the strain was not disclosed, researchers could not determine if such strains were present at an efficacious dose.

Preschool children with community-acquired pneumonia often receive unnecessary tests and treatment at outpatient clinics and emergency departments, according to a nationally representative study led by Todd Florin, MD, MSCE, from Ann & Robert H. Lurie Children's Hospital of Chicago. While most cases of community-acquired pneumonia in young children are caused by viruses, for which antibiotics provide no benefit, antibiotics were prescribed in nearly 74 percent of outpatient visits. Chest x-rays were obtained in 43 percent of visits, despite guidelines against routine use for young children with pneumonia in an outpatient setting. Findings were published in the Journal of the Pediatric Infectious Diseases Society.

"It is concerning that so many young children with community-acquired pneumonia are receiving antibiotics that are not needed," says Dr. Florin, who heads the Grainger Initiative in Pediatric Emergency Medicine Research at Lurie Children's and is Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "In addition to going against evidence and clinical guidelines, overuse of antibiotics contributes to antibiotic resistance, which threatens future availability of effective treatments for bacterial infections, while also leading to antibiotic-associated side effects that can range from mild to life-threatening."

Community-acquired pneumonia is one of the most common infections in children, accounting for about 1.5 million healthcare visits each year in the United States.

In 2011, clinical guidelines for pediatric community-acquired pneumonia were issued by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. These groups recommend against routine chest x-ray, complete blood count and blood cultures, as well as against routine antibiotics for preschool children treated as outpatients.

To evaluate the effect of this guideline, Dr. Florin and colleagues examined national data representing an estimated 6.3 million visits to outpatient clinics and emergency departments during 2008-2015 by children 1 to 6 years of age with community-acquired pneumonia. They found that high use of non-recommended diagnostic tests and antibiotics persisted over the entire study period, and that the 2011 guidelines had no impact on practice.

"Focused quality-improvement efforts are needed to increase guideline adherence to ensure that these children are receiving appropriate, evidence-based care," says Dr. Florin. "We especially need to focus on reducing antibiotic overuse, which is critically important."

"Smart glass," an energy-efficiency product found in newer windows of cars, buildings and airplanes, slowly changes between transparent and tinted at the flip of a switch.

"Slowly" is the operative word; typical smart glass takes several minutes to reach its darkened state, and many cycles between light and dark tend to degrade the tinting quality over time. Colorado State University chemists have devised a potentially major improvement to both the speed and durability of smart glass by providing a better understanding of how the glass works at the nanoscale.

They offer an alternative nanoscale design for smart glass in new research published June 3 in Proceedings of the National Academy of Sciences. The project started as a grant-writing exercise for graduate student and first author R. Colby Evans, whose idea - and passion for the chemistry of color-changing materials - turned into an experiment involving two types of microscopy and enlisting several collaborators. Evans is advised by Justin Sambur, assistant professor in the Department of Chemistry, who is the paper's senior author.

The smart glass that Evans and colleagues studied is "electrochromic," which works by using a voltage to drive lithium ions into and out of thin, clear films of a material called tungsten oxide. "You can think of it as a battery you can see through," Evans said. Typical tungsten-oxide smart glass panels take 7-12 minutes to transition between clear and tinted.

The researchers specifically studied electrochromic tungsten-oxide nanoparticles, which are 100 times smaller than the width of a human hair. Their experiments revealed that single nanoparticles, by themselves, tint four times faster than films of the same nanoparticles. That's because interfaces between nanoparticles trap lithium ions, slowing down tinting behavior. Over time, these ion traps also degrade the material's performance.

To support their claims, the researchers used bright field transmission microscopy to observe how tungsten-oxide nanoparticles absorb and scatter light. Making sample "smart glass," they varied how much nanoparticle material they placed in their samples and watched how the tinting behaviors changed as more and more nanoparticles came into contact with each other. They then used scanning electron microscopy to obtain higher-resolution images of the length, width and spacing of the nanoparticles, so they could tell, for example, how many particles were clustered together, and how many were spread apart.

Based on their experimental findings, the authors proposed that the performance of smart glass could be improved by making a nanoparticle-based material with optimally spaced particles, to avoid ion-trapping interfaces.

Their imaging technique offers a new method for correlating nanoparticle structure and electrochromic properties; improvement of smart window performance is just one application that could result. Their approach could also guide applied research in batteries, fuel cells, capacitors and sensors.

"Thanks to Colby's work, we have developed a new way to study chemical reactions in nanoparticles, and I expect that we will leverage this new tool to study underlying processes in a wide range of important energy technologies," Sambur said.

YANGON, Myanmar (June 4, 2019) - Frogs need elephants. That's what a new WCS-led study says that looked at the role of water-filled elephant tracks in providing predator-free breeding grounds and pathways connecting frog populations.

Publishing in the journal Mammalia, the researchers found that rain-filled tracks of Asian elephants (Elephas maximus) were filled with frog egg masses and tadpoles. The tracks can persist for a year or more and provide temporary habitat during the dry season where alternate sites are unavailable. Trackways could also function as "stepping stones" that connect frog populations.

This study was made available online in September 2018 ahead of final publication in print in May 2019.

The researchers made their observations in Myanmar's Htamanthi Wildlife Sanctuary.

Elephants are widely recognized as "ecosystem engineers," where they extensively modify vegetation through browsing, trampling, and seed dispersal, and convert large amounts of plant biomass into dung that is an important nutrient input for terrestrial and aquatic systems. At smaller scales, local plant species richness is enhanced when elephants open gaps in the forest canopy, browsing damage to trees creates refuges for small vertebrates (lizards and small mammals), and dung piles provide food for a diversity of beetles.

However, most research on ecosystem engineering by elephants has focused on savanna elephants (Loxodonta Africana) and to a lesser extent, forest elephants (Loxodonta cyclotis) in Africa; the role of Asian elephants as ecosystem engineers is much less well-known. Asian elephants are considered Endangered by IUCN due to habitat loss, poaching and retribution for crop raiding and human/elephant conflict.

Said Steven Platt, Associate Conservation Herpetologist with WCS's Myanmar Program and lead author of the study: "Elephant tracks are virtual condominiums for frogs. This study underscores the critical role wildlife play in ecosystems in sometimes unexpected ways. When you lose one species, you may be unknowingly affecting others, which is why protecting intact ecosystems with full assemblages of wildlife is so important."

Key points:

Faecal transplants from young mice replenishes the gut microbiome and boosts the gut immune system in older mice.

The study demonstrates that the decline in the gut immune response due to age is not irreversible and that it can be boosted in older individuals.

The gut microbiome could be a target for the treatment of a range of age-associated symptoms to facilitate healthy ageing.

Faecal transplants from young to aged mice can stimulate the gut microbiome and revive the gut immune system, a study by immunologists at the Babraham Institute, Cambridge, has shown. The research is published in the journal Nature Communications today.

The gut is one of the organs that is most severely affected by ageing and age-dependent changes to the human gut microbiome have been linked to increased frailty, inflammation and increased susceptibility to intestinal disorders. These age-dependent changes to the gut microbiome happen in parallel with a decrease in function of the gut immune system but, until now, it was unknown whether the two changes were linked.

"Our gut microbiomes are made up of hundreds of different types of bacteria and these are essential to our health, playing a role in our metabolism, brain function and immune response," explains lead researcher Dr Marisa Stebegg. "Our immune system is constantly interacting with the bacteria in the gastrointestinal tract. As immunologists who study why our immune system doesn't work as well as we age, we were interested to explore whether the make-up of the gut microbiome might influence the strength of the gut immune response."

Co-housing young and aged mice (mice naturally like to sample the faecal pellets of other mice!) or more directly performing faecal transfer from young to aged mice boosted the gut immune system in the aged mice, partly correcting the age-related decline.

"To our surprise, co-housing rescued the reduced gut immune response in aged mice. Looking at the numbers of the immune cells involved, the aged mice possessed gut immune responses that were almost indistinguishable from those of the younger mice." commented Dr Michelle Linterman, group leader in the Immunology programme at the Babraham Institute.

The results show that the poor gut immune response is not irreversible and that the response can be strengthened by challenging with appropriate stimuli, essentially turning back the clock on the gut immune system to more closely resemble the situation in a young mouse.

The results of the study have relevance for treating age-related symptoms, confirming a link between the effects of the ageing immune system and age-associated changes in the gut microbiome. By demonstrating the effectiveness of interventions that have a positive impact on the composition of the gut microbiome, this research suggests that faecal transplants, probiotics, co-habitation and diet might all prove to be ways to facilitate healthy ageing.

An ample buffet of freshwater food, brought on by climate change, is altering the life history of one of the world's most important salmon species.

Sockeye salmon in Alaska's Bristol Bay region are skipping an entire year in freshwater because climate change has produced more favorable conditions in lakes and streams, which allow the young fish to grow and put on weight much faster. Previously, these fish would spend up to two years in their birth lakes before heading to the ocean, where they feed and reach maturity two to three years later. Now they are more likely to head out to sea after only one year.

These findings were published May 27 in Nature Ecology & Evolution by University of Washington researchers.

"Climate change is literally speeding up the early part of their lifecycle across the whole region," said senior author Daniel Schindler, a UW professor in the School of Aquatic and Fishery Sciences. "We know climate warming is making rivers more productive for the food juvenile salmon eat, meaning their growth rate is speeding up. That puts the salmon on a growth trajectory that moves them to the ocean faster."

But this "jumpstart" in freshwater doesn't necessarily benefit salmon in the long run. The same fish are now spending an extra year in the ocean, taking longer to grow and mature. This extra year at sea is likely caused by climate stressors, as well as other fish: In the ocean, wild sockeye compete for food with close to 6 billion hatchery-raised salmon released each year throughout the North Pacific Ocean. That number has grown steadily since the 1970s, when only half a billion hatchery salmon were released.

"Hatchery fish have really changed the competitive environment for juvenile salmon in the ocean," said lead author Timothy Cline, a postdoctoral researcher at the University of Michigan who completed this work as a doctoral student at the UW. "In Bristol Bay, the habitat is totally intact and fisheries management is excellent, but these fish are living in lakes warming with climate change, then competing with other salmon for food in the ocean."

The researchers drew on nearly 60 years of Bristol Bay sockeye data to tease out these changes over time, including information gathered by scientists and students in the UW's Alaska Salmon Program. Close to half of the world's wild sockeye is caught from this region, and more than 40 million fish usually return each year to Bristol Bay's nine river systems to spawn.

Higher temperatures in the region have caused lakes and rivers to warm up earlier each spring, fueling the growth of tiny plankton that young sockeye eat. This extra food essentially fattens up the fish a year earlier, triggering their migration to the ocean.

This trend could negatively impact the resiliency of the Bristol Bay sockeye population, the authors said. Before, not every fish in a particular "age class" would migrate to the ocean in the same year, and any given year would see fish of different ages moving out to sea. This diversity of ages has helped the species navigate risks and survive.

But now, most sockeye are migrating at the same time, as 1-year-olds. This could devastate an entire age class if the ocean conditions happen to be poor one year. Additionally, scientists don't know how many salmon the North Pacific can actually support.

"With climate change, is there a limit to how productive the ocean will become? We just don't know where there's a tipping point, especially as we fill the ocean with hatchery competitors," Schindler said. "We need to be really cognizant about overstressing the marine resources that support wild salmon."

Co-author on the study is Jan Ohlberger, a research scientist at the UW School of Aquatic and Fishery Sciences.

The study was funded by the National Science Foundation and the Gordon and Betty Moore Foundation.

Hartford, CT - Weight-based victimization among sexual and gender minority youth is associated with increased odds of alcohol use, binge drinking, marijuana use, and cigarette use, reports a new study from researchers at the Rudd Center for Food Policy and Obesity and the Department of Human Development and Family Sciences at the University of Connecticut, in collaboration with the Human Rights Campaign.

Research has found that weight-based victimization contributes to poor health in youth, including substance use and poorer emotional well-being. However, the harms of weight-based victimization have received almost no attention in LGBTQ youth, despite their high rates of obesity and high risk for victimization and psychological distress.

"The absence of research on weight-based victimization in this vulnerable population is concerning, and so our study aimed to look at how weight-based victimization is related to health behaviors of sexual and gender minority adolescents," says Rebecca Puhl, Deputy Director of the UConn Rudd Center, Professor of Human Development and Family Sciences at the University of Connecticut, and the study's lead author.

The study, published in Health Psychology, reports on findings from over 9,000 LGBTQ adolescents across the country who completed questionnaires examining their experiences of victimization, health, family relationships, and school experiences.

Study findings showed that LGBTQ youth who reported being teased or bullied about their weight had increased risk of alcohol use, binge drinking, marijuana use, cigarette use, as well as poorer self-rated health, higher depressive symptoms, and lower self-esteem. These findings persisted regardless of adolescents' demographic characteristics, body weight, sexual identity, gender identity, and sexual or gender minority victimization.

The study also found that sources of weight-based victimization (peers and family members) contribute to these health consequences in different ways. LGBTQ adolescents who were teased about their weight from family members had increased substance use behaviors and poorer self-rated health and mental health, while adolescents who reported weight-based teasing from peers had increased odds of binge drinking in the last 30 days, cigarette use, and poorer mental health.

"These findings suggest the importance of considering weight-based bullying in the broader context of understanding health of sexual and gender minority adolescents, as well as the importance for increased awareness of these issues among healthcare professionals working with this adolescent population," says Ryan Watson, Assistant Professor of Human Development and Family Studies at the University of Connecticut and co-author of the study.

"Clinicians and other health care providers should assess victimization experiences of these youth - not only in the context of their sexual or gender identity - but also in the context of their body weight," says Puhl.

Patient-reported outcome (PRO) data indicates that partial breast irradiation (PBI) is more convenient than whole breast irradiation (WBI) for women with breast cancer who do not receive adjuvant chemotherapy. These participants on the NRG Oncology clinical trial NSABP B-39/RTOG 0413 also experienced less post-treatment fatigue and slightly poorer cosmesis at 36 months following treatment, whereas cosmesis was equivalent at 36 months in women who received chemotherapy and PBI or WBI. These outcomes were presented at the American Society of Clinical Oncology (ASCO) Annual Meeting and the abstract was designated as a "Best of ASCO" abstract.

In December 2018, NRG Oncology presented the results of NSABP B-39/RTOG 0413 comparing PBI and WBI after lumpectomy in women with breast cancer at the San Antonio Breast Cancer Symposium (SABCS). Although these 10-year results did not show equivalence of PBI to WBI in controlling ipsilateral breast tumor recurrence in this patient population due to clinically small differences, data suggested that PBI could still be considered an acceptable alternative to WBI for certain women. This trial included a prospective substudy for PROs that evaluated breast cancer treatment outcomes including cosmesis, function, and pain, as well as fatigue, and is the subject of the current ASCO presentation.

"While PBI recurrence outcomes were statistically inferior to WBI on the NRG Oncology NSABP B-39/RTOG 0413 trial, it is still crucial that we measure how PBI compares to WBI in terms of quality of life (QOL) for women. As there were only slight clinical outcome differences between these two treatments, some women could still derive benefit from PBI treatment in terms of outcomes such as cosmesis or fatigue," stated Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the University of California, Los Angeles Jonsson Comprehensive Cancer Center and lead author of the NRG Oncology NSABP B-39/RTOG 0413 abstract.

950 patients enrolled in the QOL substudy for NRG Oncology NSABP B-39/RTOG 0413 had follow up data and, of these patients, 446 received chemotherapy, while 504 did not receive chemotherapy. In non-chemotherapy patients, PBI did not meet the criteria for cosmesis equivalence, but caused less fatigue and was rated more convenient than WBI. In patients who received chemotherapy, PBI participants reported equivalent cosmesis to WBI. In both treatment groups, PBI patients reported less pain at the end of treatment, and treatment related symptoms were worse with WBI.

Countries' essential medicines lists vary from one another and from the World Health Organization's (WHO) model list, pointing to a potential need for greater care in selecting medicines that best meet the health care priorities of a population, suggests a study led by Toronto's St. Michael's Hospital.

Published in the World Health Organization Bulletin, the research analyzes 137 countries that use essential medicines lists to inform government and health-care institutions in determining which medicines to fund, stock, prescribe and dispense.

Dr. Nav Persaud, a scientist at St. Michael's Hospital's MAP Centre for Urban Health Solutions, and a team of researchers from Oxford University and the WHO, found that countries' lists varied from one another and from the WHO's model list of medications. These differences were often not explained by the basic characteristics of countries, such as region and size of economy, or differences in health needs. Of the 2,068 unique medicines identified by Dr. Persaud and his team, most were listed by only 10 per cent of the countries.

"Countries must select medicines for their essential medicines lists appropriately, in order to facilitate sustainable, equitable access to medicines, and to promote their appropriate use," said Dr. Persaud. "Differences between lists that are not explained by country characteristics may represent opportunities for improvement."

Differences between national lists also extended to countries that are geographically close and similar, inconsistent with the researchers' expectation that countries with similar health-care needs, expenditures and status would select similar medicines.

In addition to a lack of consistency between countries, medicines listed by some countries had been withdrawn by others due to harmful effects, the team found.

To identify patterns, Dr. Persaud and his team also compared each of the national lists with the WHO's model list of essential medicines. They found disparities, with most national lists containing more than 200 differences when compared with the WHO's model list.

Further research may identify explanations, such as differences in the processes for selecting appropriate and effective medicines, said Dr. Persaud.

"Such information may help governments decide if medicines on their lists should be removed or if other medicines should be added," he said. "These results may identify opportunities to improve essential medicines lists and promote appropriate use of medicines in support of universal health coverage."

Dr. Persaud and his team compiled their results into an interactive online database. Countries can now see how their essential medicines lists differ from other countries by visiting essentialmeds.org.

Survey finds 20.5% of doctors are aware of whether feedback has been left by patients about them

GPs view online feedback as mostly negative, although previous research shows it tends towards the positive

Majority of doctors did not encourage patients to leave feedback

Researchers led by University of Warwick argue ratings and feedback websites would be easiest ways to source patient feedback

Around one in five doctors are aware of patient feedback about themselves on review and ratings websites, according to a new survey of health professionals.

Their answers also reveal that GPs felt strongly that online feedback is negative, particularly on social media.

The new study led by the University of Warwick, published today (3 June) in the Journal of Health Services Research & Policy, demonstrates that health service staff are cautious about using online feedback due to assumptions that it will be overwhelmingly negative, potentially missing opportunities to improve care.

Healthcare services use a number of methods to collect information on patient experiences, including surveys and Patient Participation Groups, and policymakers have pushed for greater use of online feedback in addition to traditional sources.

The research is based on a survey of 1001 registered doctors in primary and secondary care and 749 nurses and midwives in the UK. It examined their experience and attitude towards online sources of patient feedback, on sites such as I Want Great Care, NHS Choices (now the NHS website) and Care Opinion.

It found that just 27.7% of doctors and 21% of nurses were aware of feedback online about an episode of care that they had been involved in, while only 20.5% of doctors and 11.1% of nurses were aware of feedback about them as an individual specifically.

Dr Helen Atherton, from Warwick Medical School, said: "We saw a lack of awareness from healthcare professionals of when feedback had been left about the care they delivered, whether as an individual or team. Overall, awareness and use by doctors is low. But we are seeing that doctors are much more negative about online feedback than nurses, and more so with GPs.

"There's a real need that if NHS organisations are collecting this data that they need to be communicating it to frontline staff, because it's pointless for the patients if their message isn't getting through."

The majority of doctors did not encourage patients to leave feedback and only 38% felt that it was useful in improving services. This is despite previous research showing that online feedback tends to be generally positive towards the health service. The survey also highlighted that healthcare staff were more wary of feedback on social media, with 65.4% of doctors feeling that feedback on social media is generally negative.

Dr Atherton adds: "Previous research in this area by our team shows that it tends to be more positive than people think. Healthcare organisations should be putting protocols in place for this feedback and developing plans for what to do with it. If healthcare professionals are aware of it and take control of the process a little more by actively soliciting it then it's more likely to be useful to them. There are positive examples of how commentary left by NHS patients on review sites have led to changes in the health service.

"Professionals were more wary of social media than they were of ratings and review websites so these are probably the easiest ways to source feedback in practice. You know where your patient is going and you can pick up comments and act on them, something that is more difficult with social media."

Results from the first experimental arm using veliparib as part of total neoadjuvant therapy (induction chemotherapy followed by chemoradiotherapy and surgery; TNT) in patients with locally advanced rectal adenocarcinoma on the NRG Oncology Phase II clinical trial NRG-GI002 were recently presented at the American Society of Clinical Oncology (ASCO) Annual Meeting. Results were reported on the primary endpoint of pathological regression via the neoadjuvant rectal cancer (NAR) score, a short-term clinical trial surrogate endpoint.

After treatment with a combination chemotherapy regimen called mFOLFOX6, researchers combined veliparib, a poly (ADP-ribose) polymerase (PARP) inhibitor or a drug that kills cancer cells by blocking a protein called PARP, with another chemotherapy drug named capecitabine, and radiotherapy in patients who had locally advanced Stages 2 or 3 rectal cancer. Patients on the control arm got the same therapy with the omission of veliparib. In the first experimental arm of NRG-GI002, veliparib was added to radiotherapy and chemotherapy treatment regimens because PARP inhibitors, like veliparib, have been shown to enhance the effectiveness of radiotherapy by interfering with a patient's DNA repair mechanisms and thus killing or reducing tumor cells or the amount of normal tissue that needs to be removed. Results from the overall study demonstrate that the TNT approach of therapy is safe and associated with high rates (>90%) of chemotherapy completion. However, the addition of veliparib did not demonstrate a significant improvement in reducing the amount of cancer present at the time of surgery. The primary endpoint of the mean Neoadjuvant Rectal (NAR) Score (lower number reflects more downstaging) was 12.6 for the control arm and 13.7 for the experimental arm (p=0.69). There were numerically more patients who achived a pCR with veliparib, though (22% vs. 34%; p=0.14). This first experimental arm results demonstrated that the addition of veliparib was associated with more short-term side effects and reduced completion of chemoradiation (85% vs. 70%; p=0.026). The most common, grade 3 and 4 side effects that were experienced on the first NRG-GI002 experimental arm included diarrhea and cytopenias. Importantly, these side effects did not appear to negatively impact short term patient outcomes.

"NRG-GI002 is intended to serve as a platform to test novel agents, such as veliparib, or other novel hypotheses using a total neoadjuvant treatment for rectal cancer as part of a phase II clinical trial platform," stated Thomas J. George, MD, FACP, of University of Florida Health Cancer Center and lead author of the abstract for NRG-GI002. "The goal of this study was to build upon the encouraging results seen with veliparib in the phase I trial that produced few dose-limiting toxicities. Our randomized phase II trial combined 400mg PO BID veliparib with chemoRT followed by surgery to observe improvement in patients' NAR score that would translate into improved disease free and overall survival. Unfortunately, we did not see an improvement with the use of veliparib. However and very importantly, we have now established that TNT can be safely and successfully delivered to patients with locally advanced rectal cancer. This ensures all patients get the treatments they need and gives us many opportunities to further improve care for this group of patients."

Future direction on this trial includes continued analysis of secondary endpoints and biomarkers to determine which specific patients achieved benefit from the addition of veliparib and why. An ongoing second experimental arm is observing the impact of the monoclonal antibody pembrolizumab in combination with capecitabine and radiotherapy after induction mFOLFOX6 to determine if immunotherapy is also a safe, effective option for treating locally advanced rectal cancer. This second arm has completed enrollment with results eagerly awaited. Additional arms are in active development with the goal of improving outcomes for patients with this disease.

New research published today in the journal Antiquity reveals that ancient faeces from the prehistoric village of Çatalhöyük have provided the earliest archaeological evidence for intestinal parasite infection in the mainland Near East.

People first gave up hunting and gathering and turned to farming in the Near East, around 10,000 years ago. The settlement of Çatalhöyük is famous for being an incredibly well preserved early village founded around 7,100 BC. The population of Çatalhöyük were early farmers, growing crops such as wheat and barley, and herding sheep and goats.

"It has been suggested that this change in lifestyle resulted in a similar change in the types of diseases that affected them. As the village is one of the largest and most densely populated of its time, this study at Çatalhöyük helps us to understand that process better," says study lead Dr Piers Mitchell of Cambridge's Department of Archaeology.

The toilet was first invented in the 4th millennium BC in Mesopotamia, 3000 years later than when Çatalhöyük flourished. It is thought the people living at Çatalhöyük either went to the rubbish tip (midden) to open their bowels, or carried their faeces from their houses to the midden in a vessel or basket to dispose of them.

"We would expect this to have put the population at risk of diseases spread by contact with human faeces, and explains why they were vulnerable to contracting whipworm," says the study first author Marissa Ledger.

"As writing was only invented 3000 years after the time of Çatalhöyük, the people were unable to record what happened to them during their lives. This research enables us for the first time to imagine the symptoms felt by some of the prehistoric people living at Çatalhöyük who were infected by this parasite."

To look for the eggs of intestinal parasites, Cambridge researchers Mitchell, Ledger and Evilena Anastasiou used microscopy to study preserved pieces of human faeces (coprolites) from a rubbish tip, and soil formed from decomposed faeces recovered from the pelvic region of burials. The samples dated from 7,100-6150 BC.

To determine whether the coprolites excavated from the midden were from human or animal faeces, they were analysed for sterols and bile acids at the University of Bristol Mass Spectrometry Facility by Helen Mackay, Lisa Marie Shillito, and Ian Bull. This analysis demonstrated that the coprolites were of human origin.

Further microscopic analysis showed that eggs of whipworm were present in two of the coprolites, demonstrating that people from the prehistoric village were infected by this intestinal parasite.

"It was a special moment to identify parasite eggs over 8000 years old," said study co-author Evilena Anastasiou.

Whipworms are 3-5cm in length, and live on the lining of the intestines of the large bowel. Adult worms can live for 5 years. Male and female worms mate and their eggs are mixed in with the faeces. Whipworm is spread by the contamination of food or drink from human faeces that contain the worm eggs. A heavy infection with whipworm can lead to anaemia, diarrhoea, stunted growth and reduced intelligence in children.

"Now we need to find ancient faecal material from prehistoric hunter gathers in the Near East, to help us understand how this change in lifestyle affected their diseases." added Mitchell.

Child deaths have fallen in Brazil following complete smoking bans in public places, according to a new study.

Its authors, from Imperial College London, the Brazilian National Cancer Institute (INCA), and Erasmus Medical Centre in the Netherlands, estimate that strengthening smoke-free legislation between 2000 and 2016 in Brazil averted over 15,000 deaths in children under one year old.

The new research is published today, World Health Organisation World No Tobacco Day, in the journal Tobacco Control.

Children are particularly harmed from exposure to smoke. In the womb, it affects foetal development and can increase the risk of pre-term birth or low birth-weight. Infants and children exposed to second-hand smoke have a higher risk of respiratory infections, asthma, and sudden infant death.

The new research is the first to analyse the impact of different types of smoking bans on child health in a middle-income country. Its authors argue that governments elsewhere should act to strengthen smoke-free legislation, to help protect children's' lives. Only 20 percent of the world's population is covered by complete smoking bans. ?

In 2014, Brazil implemented comprehensive smoke-free legislation across the country, banning smoking in all public areas that were partly or completely enclosed, including bars and restaurants. The study found this was associated with a 5.2 per cent reduction in infant mortality and a 3.4 per cent reduction in neonatal mortality, after taking into account underlying trends and other factors which could affect child health.

The researchers also found complete bans were more effective than partial ones in reducing infant deaths. Prior to 2014, 17 states in Brazil introduced partial bans - for example allowing smoking rooms and smoking in partially-enclosed restaurants and bars - and nine adopted complete bans, covering all partly or completely enclosed public areas. Partial legislation was associated with a 3.3 per cent reduction in infant mortality, but no significant change in neonatal mortality.??

Scientists think that smoking bans reduce infant deaths by reducing the incidence of health problems directly linked to smoke exposure or smoking during pregnancy, such as sudden infant death syndrome and respiratory infections.

The differences in legislation in the different parts of Brazil before 2014 enabled the researchers to analyse how the trends in infant mortality rates varied as different types of smoke-free legislation came into play. Using the exact timings of the legislation allowed them to attribute changes in child health to smoking legislation rather than some other factor, such as a change in healthcare policy.

Dr Thomas Hone, the lead author on the study from the School of Public Health at Imperial College London, said: "You can see from Brazil's example how much of a difference we can make to children's health by completely banning smoking in public places. Unfortunately most of the world's people still aren't covered by comprehensive smoking bans. It's appalling that so many babies and children are being harmed by second-hand smoke when a relatively easy measure could help to prevent this."

Dr Andre Szklo from the Brazilian National Cancer Institute, said: "Children have the right to be protected against the harms caused by smoking. We call on governments around the world to introduce comprehensive smoke-free laws to protect child health."

Across Brazil, reductions in childhood deaths were greater in areas that were poorer or had lower levels of education, suggesting the smoking ban also contributed to reductions in health inequalities in Brazil.

To reach their conclusions, the researchers looked at data on all live births, infant deaths and neonatal deaths in Brazil between 2000 and 2016.

The world’s top 10 crops — barley, cassava, maize, oil palm, rapeseed, rice, sorghum, soybean, sugarcane and wheat — supply a combined 83 percent of all calories produced on cropland. Yields have long been projected to decrease in future climate conditions. Now, new research shows climate change has already affected production of these key energy sources — and some regions and countries are faring far worse than others.

Published in PLOS ONE, the University of Minnesota-led study, conducted with researchers from the University of Oxford and the University of Copenhagen, used weather and reported crop data to evaluate the potential impact of observed climate change. The researchers found that:

observed climate change causes a significant yield variation in the world's top 10 crops, ranging from a decrease of 13.4 percent for oil palm to an increase of 3.5 percent for soybean, and resulting in an average reduction of approximately one percent (-3.5 X 10e13 kcal/year) of consumable food calories from these top 10 crops;

impacts of climate change on global food production are mostly negative in Europe, Southern Africa, and Australia, generally positive in Latin America, and mixed in Asia and Northern and Central America;

half of all food-insecure countries are experiencing decreases in crop production — and so are some affluent industrialized countries in Western Europe;

contrastingly, recent climate change has increased the yields of certain crops in some areas of the upper Midwest United States.

“There are winners and losers, and some countries that are already food insecure fare worse,” says lead author Deepak Ray of the University of Minnesota’s Institute on the Environment, whose high-resolution global crop statistics databases have also been used to help to identify how global crop production changes over time. These findings indicate which geographical areas and crops are most at risk, making them relevant to those working to achieve the U.N. Sustainable Development Goals of ending hunger and limiting the effects of climate change. Insights like these lead to new questions and crucial next steps.

Global map of changes in wheat yield on average annually. Units are measured by tons per hectare per year. Figure credit: Deepak Ray.

“This is a very complex system, so a careful statistical and data science modeling component is crucial to understand the dependencies and cascading effects of small or large changes,” says co-author Snigdhansu Chatterjee of the University of Minnesota’s School of Statistics.

The Institute’s Global Landscapes Initiative, whose contributors to this study included Ray, Paul West and James Gerber, has previously produced global scale findings that have been put to use by international organizations such as the U.N., World Bank and Brookings in evaluation of global food security and environmental challenges. The scholars say this report has implications for major food companies, commodity traders and the countries in which they operate, as well as for citizens worldwide.

“The research documents how change is already happening, not just in some future time,” says Ray.

New Rochelle, NY, May 30, 2019--The body's endocannabinoid system, due to the critical role it plays in regulating neurotransmitter signaling, is an enticing target for drug development against disorders associated with anxiety, stress, and repetitive behaviors, such as obsessive-compulsive disorder (OCD). A comprehensive new review article that provides an overview of this complex system, endogenous and exogenous cannabinoids, results of animal studies and human trials to date, and recommendations for future directions is published in Cannabis and Cannabinoid Research, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Click here to read the full-text article free on the Cannabis and Cannabinoid Research website through June 30, 2019.

The article entitled "The Endocannabinoid System: A New Treatment Target for Obsessive Compulsive Disorder?" was coauthored by Reilly Kayser, MD, Ivar Snorrasson, PhD, Margaret Haney, PhD, and H. Blair Simpson, MD, PhD, Columbia University Vagelos College of Physicians and Surgeons, and Francis Lee, MD, PhD, Weill Cornell Medical College, (New York, NY). The researchers present the evidence that links the endocannabinoid system to the pathology underlying OCD. They also explore the potential for targeting this system to relieve symptoms of OCD and related disorders such as anxiety, tic, and impulse control disorders. The review includes and extensive overview of cannabinoids made by the body, and exogenous cannabinoids, including phytocannabinoids found in the marijuana plant and purified and synthetic cannabinoids.

Based on both animal study data showing anti-anxiety and anti-compulsive effects of cannabinoid agents and on preliminary human clinical trial data, the authors suggest that continued pharmaceutical development is warranted. Which cannabinoid agents to test and how to measure their effects will be among the important questions to consider in designing future studies.

"Is there a place for cannabinoid-based medicines in psychiatry? Evidence from animal and human studies points to the endocannabinoid system as an important regulator of emotionality, but how can we exploit this knowledge for therapy? This review article offers a critical assessment of the evidence, focused on obsessive compulsive disorder, and clues to future research," says Editor-in-Chief Daniele Piomelli, PhD, University of California-Irvine, School of Medicine.