Culture

HOUSTON - (July 13, 2020) - Bird poop may pose more health risks than people realize, according to Rice University environmental engineers who study antibiotic resistance.

Their study found high levels of genes that encode antibiotic resistance harbored by opportunistic pathogens in the droppings of common urban ducks, crows and gulls.

The study led by postdoctoral research associate Pingfeng Yu of Rice's Brown School of Engineering appears in the Elsevier journal Environmental Pollution. Yu is a member of the lab of civil and environmental engineer and co-author Pedro Alvarez.

Previous studies determined bird-carried antibiotic resistant genes (ARGs) and bacteria (ARBs) can be transferred to humans through swimming, contact with feces or impacted soil or inhalation of aerosolized fecal particles. Studies have also analyzed bird feces found near ARG hotspots like wastewater treatment plants and drainage from poultry farms.

But the Rice study digs deeper to quantify the abundance, diversity and seasonal persistence of ARGs.

"We still do not fully understand what factors exert selective pressure for the occurrence of ARGs in the gastrointestinal system of wild urban birds," Alvarez said. "Residual antibiotics that are incidentally assimilated during foraging is likely one of these factors, but further research is needed to discern the importance of other potential etiological factors, such as bird diet, age, gut microbiome structure and other stressors."

The team that included lead authors Huiru Zhao, a student at Nankai University in China, and Rice graduate student Ruonan Sun compared "freshly deposited" samples from each species found around Houston during the winter and summer months to samples from poultry and livestock known to carry some of the same mutations.

They found that ARGs in all of the species, regardless of season, encoded significant resistance to tetracycline, beta-lactam and sulfonamide antibiotics. The researchers were surprised to see the relatively high abundance of ARGs were comparable to those found in the fresh feces of poultry occasionally fed with antibiotics.

They also found intI1, an integron that facilitates rapid bacterial acquisition of antibiotic resistance, was five times more abundant in the birds than in farm animals.

"Our results indicate that urban wild birds are an overlooked but potentially important reservoir of antimicrobial resistance genes, although their significance as vectors for direct transmission of resistant infections is possible but improbable due to low frequency of human contact," Alvarez said.

The team also looked for ARGs in soil up to 1 inch deep around bird deposits and discovered they are "moderately persistent" in the environment, with half-lives of up to 11.1 days.

Of the three species, crows showed a significantly lower level of ARGs during the summer compared to ducks and gulls, they reported.

"That's probably due to differences in their ecological niches, foraging patterns and gut microbiome," Sun said. "Crows are omnivores and feed on abundant natural food with less anthropogenic contaminations in the summer. In addition, the composition of their gut microbiome impacts ARG dissemination and enrichment in vivo, and therefore influences ARG levels in the excreted bird feces."

The researchers found that opportunistic pathogens including bacteria that cause urinary tract infections, sepsis and respiratory infections were common in the feces of all of the birds, and another associated with food poisoning was detected in samples collected during the winter.

Winter feces, they wrote, contained more of the bad bacteria that may also harbor ARGs, possibly due to lower sunlight inactivation and differences in moisture levels and temperature.

"Our study raises awareness to avoid direct contact with bird droppings in urban public areas, especially for vulnerable or sensitive populations," Yu said. "Meanwhile, regular cleaning should also help to mitigate associated health risks."

Prolonged exposure to loud noise is more than annoying?it is bad for human health. Beyond the obvious potential damage to hearing, chronic noise exposure has also been linked to adverse cardiovascular effects, such as increased risks of heart attacks and strokes.

Now, for the first time, researchers have provided a causal estimate linking high-level noise exposure to another key health challenge: low birth weight (

Health economists from Lehigh University, Lafayette College and the University of Colorado, Denver were able to pinpoint a causal link by studying residential neighborhoods impacted by recent changes in airplane flight patterns going in and out of Newark Liberty International Airport, one of the largest airports in the United States.

Muzhe Yang, who holds the Francis J. Ingrassia ?75 and Elizabeth McCaul Endowed Professorship in Lehigh's Department of Economics, along with Laura Argys from University of Colorado, Denver and Susan Averett from Lafayette College, used unique birth records from 2004 to 2016 containing information on mothers' home addresses and National Transportation Noise data providing measured noise levels at exact locations. Their analysis revealed an increase of 1.6 percentage points--or 22 percent--in the risk of having a low birth weight baby among mothers living close to the airport, in the direction of the runway, exposed to noise levels over the 55 dB threshold (the threshold used by the EPA and the WHO for the protection of public health), and during the period when the new flight pattern changes were more actively implemented at the airport.

Their paper describing these results, "Residential Noise Exposure and Health: Evidence from Aviation Noise and Birth Outcomes," was published online Friday in the Journal of Environmental Economics and Management.

"Our findings have important policy implications regarding the trade-off between flight pattern optimization and human health," says Yang. "This is especially important given the long-term negative impact of low birth weight on a range of later-life outcomes such as lifetime earnings, educational achievement and long-term health."

Unintended Consequences

The changes in flight patterns around the Newark airport, as well as many airports in the United States, were triggered by a Federal Aviation Administration (FAA) air traffic control initiative called the Next Generation Air Transportation System, known as NextGen. Designed to reduce flight time and save fuel, one component of NextGen employs precision satellite monitoring instead of old-fashioned radar to guide airplanes. These satellite-designed optimum routes are made to be more direct. The use of satellite monitoring allows for more planes in the air, safely spaced and flying closer together, so more planes can use the same route.

Usage of these new routes by more and more aircraft and the adoption of a gradual descent approach?resulting in planes coming in to land at lower altitudes-have exposed residents living in areas under the satellite-designed routes to, as one resident impacted by changes in Arizona told CBS News, "a constant barrage of airplanes flying over their homes."

NextGen provided the researchers with a rare circumstance to study the causal effect of noise pollution on birth weight, in which noise exposure is close to being randomly assigned because residents were caught off-guard. The implementation of NextGen by the FAA was exempted by the U.S. Congress from normal environmental impact reviews and public hearings. The randomness and the sharp change in noise exposure are important to ensure that the estimated effect of noise pollution on birth weight is not confounded by other factors that are related to both noise pollution and fetal health, such as air pollution. This study focuses on mothers living close to the airport, where air pollution is likely to be evenly distributed while sharp changes in noise pollution exist.

"The National Transportation Noise data provided a map that revealed sharp changes in noise exposure in areas near the airport," says Yang. "We find that NextGen indeed created a narrow band around the runways, which is a noise pollution corridor. We argue that conditional on those who already live close to the airport, the redistribution of aviation noise, due to NextGen, occurred in a way that is outside of the residents' control--since the NextGen's implementation was exempted from public hearings."

Furthermore, by focusing on those living close to the airport, the research team argues that "people probably do not have the knowledge about the exact landing and takeoff paths of aircraft, or they may think they will be exposed to similar levels aviation noise since landing and takeoff paths, prior to NextGen, were less concentrated." Thus, there is a plausibly exogenous variation in noise exposure among those living near the airport--whether or not the mother lives inside the noise pollution corridor can be random. In their study they focus on mothers living within 5 miles of the airport.

"We hope our study helps people recognize the adverse effect of noise exposure on fetal health," says Yang, "as well as the urgency of finding solutions to the problem of excessive noise endured by communities overflown by aircraft using satellite-designed optimum routes."

URBANA, Ill. - Food additives get a bad rap, but a natural ingredient from orange peels and apple skins, pectin, is a thickener safely added to many food products, most notably jellies. The additive is also the subject of a University of Illinois experiment highlighting both the power and the challenges of public-private partnerships in university research.

The experiment, recently published in Regulatory Toxicology and Pharmacology, was pretty simple. It showed neonatal pigs tolerated milk replacer with pectin included at 0.2%. The research was done at the request of and with funding from formula manufacturer Mead Johnson Nutrition (now a division of RB), who hoped to prove the safety of the natural food additive for infants against a backdrop of new European standards.

Translating basic science into actionable industry and practitioner insights is part of the DNA of the College of Agricultural, Consumer and Environmental Sciences (ACES) at Illinois. From the college's perspective, public-private partnerships help industry and the public by providing unbiased, transparent science to back up or refute industry claims and practices. These partnerships also give ACES students opportunities to work within the industry landscape before entering the workforce.

"What's beautiful about these public-private partnerships is their ability to more quickly create what's needed on the front lines of agriculture and other industries," says ACES Dean Kim Kidwell. "When industry is talking directly to our talented scientists and students, innovation is inevitable."

Ryan Dilger, study co-author and associate professor in the Department of Animal Sciences at Illinois acknowledges there can be a negative public perception about university scientists working with private companies. "It's tricky, but for us, it's always science first."

In 2015, Mead Johnson approached Dilger with a proposal that would fund construction of a new research center to study infant brain and gut development using the neonatal pig as a preclinical model. Within the scientific community, piglets are accepted as a more informative proxy for human infants than mice and rats. That's because, to a much greater degree than rodents, piglet digestive systems, behavioral responses, and brain development mirror those of human babies.

Dilger worked with neonatal piglets prior to 2015, but he knew having a dedicated building to conduct the research was a major boon with benefits that would go far beyond Mead Johnson's investment.

"We work with other partners using that same infrastructure. Every company we work with makes investments in the tools we need to do cutting-edge research, which then everybody gets access to," Dilger says. "We don't like exclusivity. Public-private investments build up our capacity as university scientists to be steadfast in an ever-changing world."

The partnership with Mead Johnson also led Stephen Fleming, a former doctoral student working with Dilger and co-author on the pectin study, to identify hurdles facing private companies who want to work with university scientists. To address the issue, Fleming and Dilger launched a startup company to help companies traverse the intricacies of the university research landscape. They call it Traverse Science.

"There was no service we knew of, especially in the biological sciences, connecting students and faculty with commercial presences who need help or expertise to perform and publish basic research. Traverse Science does that in the context of food and nutrition," Fleming says.

He points to a growing industry trend to downsize in-house research and development capacity, relying instead on university researchers or contract research organizations. Traverse Science, part of the EnterpriseWorks Incubator at the University of Illinois Research Park, connects companies with Illinois experts and offers project administration, data analysis, and publication services.

"We exist so scientists can focus on the science and business can keep moving forward," Fleming notes. "We think science should enable business, not slow it down."

Many university scientists working with industry are motivated to infuse more transparent, high-quality, peer-reviewed science into product claims, industry practice, and policy.

"Conducting practical research studies is something we want to continue to promote through ACES and Traverse. We want to hold industry to the high standards of our scientific training for the benefit of the public," Dilger says. "We'll always be scientists first."

ITHACA, N.Y. - A single protein derived from a common strain of bacteria found in the soil will offer scientists a more precise way to edit RNA.

The protein, called AcrVIA1, can halt the CRISPR-Cas13 editing process, according to new research from Cornell, Rockefeller University and the Memorial Sloan Kettering Cancer Center published in the journal Science July 3.

"We're expanding our scientific toolbox to effectively use a CRISPR without causing side effects," said co-author Martin Wiedmann, Ph.D. '97, the Gellert Family Professor in Food Safety and director of Cornell's Food Safety Laboratory and Milk Quality Improvement Program. "Thanks to this bacterium, we're getting a chance to turn off and on our ability to make changes to RNA."

CRISPR, or the clustered regularly interspaced short palindromic repeats, is a laboratory mechanism that can act like microscopic scissors and precisely edit the genes contained in DNA. Among the half-dozen types of CRISPRs in use today, CRISPR-Cas13 can edit RNA, which until now had lacked a brake in the editing process.

Since SARS-CoV-2, the coronavirus that causes the COVID-19 disease, is an RNA virus, this new editing accessory may be useful to coronavirus researchers, the scientists said.

Lead author Alex Meeske, postdoctoral researcher in the lab of senior author Luciano Marraffini, professor at Rockefeller University, had suspected that a protein (bacteriophage) housed in Listeria could be useful for RNA editing.

At the start of this study, Meeske reached out to Wiedmann, a food safety expert, to obtain genetic bacterial samples from his food pathogen collection. Doctoral candidate in the Wiedmann laboratory Jingqiu Liao narrowed down the prospects from about 1,500 bacterial candidates to 62 strains.

The Wiedmann lab transferred those samples to Rockefeller, where intern Alice Cassel sequenced the 62 strains and isolated 20 candidate proteins.

One strain stood out: Listeria seeligeri, a harmless bacteria found everywhere in the soil. Unlike its fierce cousin - the foodborne pathogen L. monocytogenes - it does not cause human disease.

The Rockefeller scientists found that the protein AcrVIA1 - derived from L. seeligeri - instantly stopped the CRISPR editing process. "AcrVIA1 can be very useful in controlling application of Cas13. Anything that the Cas13 edits, this anti-CRISPR protein can shut off," Meeske said. "It's a 'kill switch' you can use during the CRISPR editing process, and it has become an additional tool we have at our disposal."

Wiedmann explained that scientists can now work on RNA problems with more exacting means. "This tool gives us more precision," he said.

The paper, "A Phage-Encoded Anti-CRISPR Enables Complete Evasion of Type VI-A CRISPR- 2 Cas Immunity," was co-written by senior author Dinshaw J. Patel and Ning Jia, both of Memorial Sloan Kettering, and Albina Kozlova of Rockefeller.

CHICAGO--- Patients who died from COVID in 2020 were almost 12 times more likely to die in a medical facility than patients who died from any cause in 2018, reports a new Northwestern Medicine study.

This the first study to look at place of death for patients with COVID-19 and how these distributions compare to previous trends in location of death for non-COVID-19 illnesses.

The paper was published July 9 in the Journal of the American Geriatrics Society.

"Where you die is important and reflects end-of-life quality for the patient and the family," said lead author Dr. Sadiya Khan, assistant professor of preventive medicine in epidemiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "The patients dying of COVID-19 in medical facilities may not have any family with them because of visitor restrictions.

"A loved one dying alone takes a huge mental toll on families," Khan said. "It impairs the family's ability to grieve and cope with the loss. For patients, we've all thought about how terrible it would be to have to die alone. This is the horror happening to thousands of people in medical facilities where no family member or loved one is able to be present with them during their final moments on earth."

The new study analyzed data from the Centers for Disease Control and Prevention for deaths related to COVID-19 from February 1, 2020, to May 23, 2020, and found 68.7% of patients who die of COVID-19 died in medical facilities, 22.7% in nursing homes, 5.2% at home and 1.9% in hospice facilities. When compared with 2018 deaths due to all causes over a similar time period, 35.7% of deaths took place in medical facilities, 19.1% in nursing homes, 31.1% at home, and 7.9% in hospice facilities.

There was significant variability across states, with some states having a much higher proportion of nursing home deaths (e.g. Minnesota, 60%) and home deaths (e.g. New York, 8%) deaths.

"High rates of nursing home deaths in several states reveal a highly vulnerable population and the inability to optimize resources such as PPE (personal protection equipment) to prevent infection transmission these high-risk locations," Khan said. "It's especially important as nursing homes are reopening to visitors and may be exposing residents, especially in areas where there are increasing rates of cases."

But nursing home statistics in the study only capture a glimpse of the high proportion of deaths linked to these facilities. It doesn't include people who contracted COVID-19 in a nursing home and were transferred to a hospital or staff who got it working there.

To address the heightened risk in nursing homes, Khan suggests access to adequate PPE for staff and universal testing/screening of people before they are allowed to enter the facilities, even if they don't have symptoms.

To support lonely COVID-19 patients in hospital beds and nursing homes, Khan said these facilities need a virtual infrastructure.

"We can't just rely on individual's iPhones and iPads," Khan said. "There is a land line phone in every room, why couldn't we have a virtual phone in every room or access to face-to-face communication for each patient and their families?"

"These results highlight yet another way that COVID-19 has impacted the health care system," said first author Dr. Sarah Chuzi, a Northwestern Medicine fellow in cardiovascular diseases. "While recent research shows U.S. deaths in medical facilities are decreasing and deaths at home and in hospice facilities are increasing, the burden of deaths attributed to COVID-19 may reverse these overall trends.

"End-of-life care is a hugely important but understudied aspect of medicine. We wanted to ensure this aspect of patient-centered care was acknowledged and studied in order to motivate efforts to improve our current system," Chuzi added.

A University of Cincinnati researcher is advising against using two widely available sterilization methods to clean disposable surgical masks and N95 respirators for reuse in the midst of the coronavirus pandemic.

Scarcity of personal protection equipment in medical settings has led many health systems to consider sterilizing and reusing masks developed initially as disposable items, says Sergey Grinshpun, PhD, director of the University of Cincinnati Center for Health-Related Aerosol Studies and professor in the UC Department of Environmental and Public Health Sciences.

The Centers for Disease Control and Prevention (CDC) has allowed reuse of N95 facepiece respirators as a crisis capacity strategy.

Grinshpun tested two brands of N95 respirators along with two types of surgical masks -- one with high filtration and one with low-filtration abilities -- using an autoclave, an apparatus that works similar to a pressure cooker to sterilize items by using steam, heat and pressure during a specific time frame.

"The question for us was, what will happen with the performance of these N95 respirators and the surgical masks after they have spent minutes or longer in the autoclave and to what extent will the heat or steam destroy the structure of the filter making the items less useful," says Grinshpun.

Grinshpun also used another decontamination method which employed soaking the respirators and surgical masks in a 70% ethanol treatment for two hours and then drying the devices before their reuse. Alcohol is readily available in hospital settings and utilized for instrument sterilization.

Tests were conducted with disinfection treatments applied up to five times to simulate reusage that might occur in a healthcare setting.

"It almost didn't matter how often we decontaminated the protective devices-- once, twice or five times -- since the major damage inflicted on the performance characteristics of the items followed the first test," explains Grinshpun. "You are going to lose in performance if these masks or respirators are sterilized using either of these treatments. Of course, quantitatively, the effect differs for different devices."

The findings of the study are available online in the Journal of Hospital Infection. Co-authors of the study include Michael Yermakov, MD, senior research associate in the UC Department of Environmental and Public Health Sciences, and Marat Khodoun, PhD, research associate professor in the UC Department of Internal Medicine.

The study found that neither sterilization in an autoclave nor alcohol treatment caused visible damages to the surgical masks. The 3M 8210 N95 respirator revealed physical damages after implementing a single autoclave disinfection such as partial disintegration of the soft sealing material around the nose clip, and, importantly, loss of strap elasticity, which made this respiratory protective device not reusable.

Meanwhile, testing of the remaining 3M 1870 N95 respirator produced notable, but moderate damage and some detachment along with a minor deformation of the nose foam after a single and multiple autoclaving.

Experimental design of the study included testing each protective device by mounting it on a frame designed to utilize the entire effective filtration area. An air flow rate through the system was chosen to mimic breathing of a health care worker under a moderate and a strenuous workload. To simulate contamination of the test protective devices the items were soiled with protein.

"When multiple sterilizations were applied, facepieces were soiled before each autoclave treatment to mimic the device usage in air environments contaminated with protein that may be associated with emission of pathogenic virions by infected persons," according to the study. Researchers chose to perform five soil and sterilization cycles to simulate a daily reuse of the filtering facepiece over a period of five days.

Grinshpun also says that N95 respirators and some surgical masks rely on fibers that have an electrostatic charge which allows them to capture small particles and protect the wearer. Autoclaving and alcohol treatment weaken this electrostatic charge.

"What happens when you subject something to alcohol, heat or steam?" asks Grinshpun. "These fibers will lose, maybe not entirely, but at least some of their electric charge. This has a detrimental effect on the filter performance so that these protective devices may not be able to capture aerosol participles, including coronaviruses, as efficiently anymore."

For some N95 respirators their collection efficiency can drop below their certification level of 95% for the most penetrating particle sizes, says Grinshpun.

He adds that performance of surgical masks changes as a result of autoclaving, whether the mask is soiled or not, with the effect being more pronounced for devices which had poor initial filtration capabilities.

He says instead of using autoclaving or ethanol alcohol to disinfect face masks and N95 respirator facepieces, alternative options such as ultraviolet light may be explored. Grinshpun's study did not look at UV primarily because the investigators intended first to examine methods that are readily available in hospitals.

"We anticipated that UV-based and probably other techniques may be almost as efficient as autoclaving and ethanol treatment in inactivating pathogens but at the same time would not damage the fibers of protective detectives so that the particle collection efficiency will not suffer," says Grinshpun. "Similar studies can and should be conducted with alternative decontamination methods."

"The question of how the disinfection treatments impact the performance and integrity of respiratory protective devices remains important for as long as healthcare workers have to reuse these devices due to their shortage of personal protective equipment," says Grinshpun.

Astrophysicists from Far Eastern Federal University (FEFU, Russia), South Korea, and the USA appear in Monthly Notices of the Royal Astronomical Society, suggesting carbon indicates time comets have spent in the Solar System -- the less carbon, the longer they have been in the proximity of the Sun. The proof is their study of the comet ATLAS (C/2019 Y4) approaching the Earth in May 2020 and disintegrated with displaying a major outbreak of the carbonaceous particles.

FEFU astrophysicists, Ekaterina Chornaya and Anton Kochergin joined an international team to analyze the composition of dust particles in the coma, i.e. shell, and tail of Comet ATLAS (C/2019 Y4). According to the researchers, the levels of carbonaceous matter inside the comet were very high.

The team suggest that the amount of carbon in the comas of other comets can indicate the time spent by them in the Solar System. The more carbon a comet coma contains, the less it has been around the Sun, and vice versa.

Comet ATLAS approached the Earth in May 2020 drawing a major interest among the researchers from all over the world, having disintegrated almost literally in front of their eyes.

"ATLAS was expected to be the brightest comet of 2020, visible from the Earth with a naked eye. However, instead of observing the comet itself, we witnessed its disintegration. Luckily, we had begun photometric and polarimetric studies before the process started, and because of that, we are able to compare the composition of the coma before and after the disintegration. In the course of disintegration we noticed a dramatic growth of the positive polarization branch which, according to modeling, is consistent with a high concentration of carbonaceous particles," said Ekaterina Chornaya, a postgraduate at the School of Natural Sciences, FEFU.

According to Ekaterina, Comet ATLAS was a long-period comet -- it used to enter the Solar System once in 5,476 years. Long-period comets approach the Sun only occasionally and therefore are rarely subject to heating. Researchers are especially interested in these comets, as they contain a lot of preserved primordial matter, ancient elements that were formed in the early days of the Solar System. Under the influence of solar radiation, the primordial matter starts to evaporate, and that is when the researchers on the Earth get a chance to study it. In short-period comets that approach the Sun frequently the volume of the primordial matter is very low.

Scientists from all over the world study and compare the physical and chemical composition of dust particles from the comas of comets to learn more about the evolution of the Solar System. To do so, they analyze the ability of such particles to absorb, refract, and polarize light.

According to Ekaterina Chornaya, the polarimetric response of the particles from Comet ATLAS matches that of one of the brightest comets in the history of Earth -- Comet Hale-Bopp, or C/1995 O1 (though several epoch suggest that ATLAS is closer to Comet Hyakutake, or C/1996 B2).

The members of the research team represented the School of Natural Studies of FEFU, the College of Humanities of Kyung Hee University (South Korea), the Department of Astronomy and Space Sciences of Kyung Hee University (South Korea), Institute of Applied Astronomy of the Russian Academy of Sciences, and the Institute of Space Sciences (USA).

July 13, 2020 - Specialized mental health units (MHUs) may be critical to managing the high rates of serious mental illness in incarcerated populations. But research data on unit characteristics, services provided, and outcomes achieved by MHUs in correctional facilities are scarce, according to a report in the July/August issue of Harvard Review of Psychiatry. The journal is published in the Lippincott portfolio by Wolters Kluwer.

With the scarcity of formal, peer-reviewed studies, Clinical Psychology PhD student Talia Cohen, Rakesh Karmacharya, MD, PhD, and colleagues of McLean Hospital, Belmont, Mass., took a different approach to gathering further information on MHUs in US correctional facilities: they Googled it. "Our gathering and collating the published and publicly available information on these 317 units will help bridge the gap in the literature on MHUs and help facilitate the development of additional MHUs," the researchers write.

Google Search Yields Valuable Data on MHUs in Correctional Facilities

Estimates suggest that 20 percent of inmates in jails and 15 percent of inmates in state prisons may have serious mental illness. Many patients, especially those with psychotic disorders, first receive psychiatric treatment after being incarcerated.

"The incarceration of mentally ill patients, who are often imprisoned due to issues related to untreated mental illness, is a major public health issue," the authors write. They set out to perform the first comprehensive compilation and description of MHUs in US correctional facilities.

But a preliminary review of health and criminal justice databases found "scant data": just 11 peer-reviewed articles were identified. To bridge the gap, Ms. Cohen, Dr. Karmacharya and colleagues performed a methodical, in-depth Google search of publicly available sources, including government websites, newspaper articles, and legal reports that led to the identification of 317 MHUs across the United States.

Although the available data varied, the authors analyzed the characteristics of the identified US MHUs:

About 80 percent of units were located in prisons, rather than jails or other settings. About three-fourths served male inmates only.
About half of units offered groups or programs to inmates, one-third provided individual therapy, and less than one-fourth provided both group and individual services.
Just over half of MHUs had dedicated mental health staff, while about one-fourth provided mental health training to correctional officers.
Some units were developed in partnership with other government agencies, nonprofit organizations, or universities. Funding for MHUs came from a variety of sources, most often state budgets or legislation.
Information on the outcomes of mental health care was available for 38 MHUs, most of which reported reductions in violence and injuries. "The reports from these units show promising results for the benefits of implementing MHUs but also demonstrate the urgent need to conduct implementation and effectiveness trials for them," the researchers write.

Based on their experience, the authors make recommendations for creating a successful therapeutic environment at MHUs. They believe that units should be small, serving no more than 40 inmates. For the MHUs identified in the review, average unit size was 73 beds.

Units should offer groups and programming plus individual therapy, should have a trained and dedicated clinical staff, and should provide mental health training to correctional officers, the researchers believe. Only 12 (3.8%)of the MHUs identified in the review met all of these criteria.

While acknowledging the limitations of the evidence in their wide-ranging review, including the use of largely non-peer-reviewed sources, the researchers hope the findings will provide useful descriptive information on MHUs in the United States. The authors conclude: "Future research should collect systematized data from correctional facilities with MHUs in order to get a more comprehensive picture of the programs and to evaluate the effectiveness and feasibility of these treatment units."

NEW YORK, NY (July 13, 2020)--Memories linked with strong emotions often become seared in the brain.

Most people can remember where they were on 9/11, or what the weather was like on the day their first child was born. Memories about world events on Sept 10, or lunch last Tuesday, have long been erased.

Why are memories attached to emotions so strong?

"It makes sense we don't remember everything," says René Hen, PhD, professor of psychiatry and neuroscience at Columbia University Vagelos College of Physicians and Surgeons. "We have limited brain power. We only need to remember what's important for our future wellbeing."

Fear, in this context, is not just a momentary feeling but a learning experience critical to our survival. When a new situation makes us fearful, the brain records the details in our neurons to help us avoid similar situations in the future, or use appropriate caution.

What's still a mystery is why these memories, recorded by the brain's hippocampus, become so strong.

To find out, Hen and Jessica Jimenez, an MD/PhD student at Columbia, placed mice into new, frightening environments and recorded the activity of hippocampal neurons that reach out to the brain's fear center (the amygdala). The neurons' activity was also recorded a day later when the mice tried to retrieve memories of the experience.

Unsurprisingly, neurons that respond to the frightening environment send that information to the brain's fear center.

"What was surprising was that these neurons were synchronized when the mouse later recalled the memory," Hen says.

"We saw that it's the synchrony that is critical to establish the fear memory, and the greater the synchrony, the stronger the memory," Jimenez adds. "These are the types of mechanisms that explain why you remember salient events."

How and when synchronization occurs is still unknown, but the answer could reveal the inner workings of the brain that create lifelong memories and lead to new treatments for posttraumatic stress disorder.

"In people with PTSD, many similar events remind them of the original frightening situation," Hen says, "and it's possible that synchronization of their neurons has become too strong."

"We're really trying to dig into the mechanisms of how emotional memories form to find better treatments for people with PTSD and memory disorders in general."

Biological membranes play important roles in shaping the cell, sensing the external environment, molecule transport, and generating energy for life. One of the most significant biological membranes are the thylakoid membranes produced in plants, algae and cyanobacteria, which carry out the light reactions of photosynthesis.

Researchers at the University of Liverpool have uncovered the molecular architecture and organisational landscape of thylakoid membranes from a model cyanobacterium in unprecedented detail. The study, which is published in Nature Plants, could help researchers find new and improved artificial photosynthetic technologies for energy production.

Professor Luning Liu, who led the study, explained: "Cyanobacteria perform plant-like photosynthesis. Hence, thylakoid membranes from laboratory-grown cyanobacteria are the ideal model system for studying and tuning plant photosynthesis."

The researchers used state-of-the-art atomic force microscopy (AFM) to probe the structures and organisation of photosynthetic proteins within the thylakoid membranes. The results reveal how thylakoid membranes modulate the abundance of different photosynthetic proteins and form structurally variable complexes to adapt to the changing environments.

Dr Longsheng Zhao, the first author of this paper, said: "We observed that different protein complexes have their specific locations in the thylakoid membranes. We also visualised that distinct photosynthetic complexes can be close to each other, indicating that these photosynthetic complexes can form 'supercomplex' structures to facilitate electron transport between these protein complexes."

Professor Luning Liu, added: "The development of structural biology approaches has greatly improved our understanding of individual photosynthetic complexes. However, these techniques have limitations for studying membrane multi-protein assembly and interactions in their native membrane environment. Our research has proved the power and potential of AFM in exploring complex, dynamic membrane structures and transient protein assembly."

The researchers hope their ongoing work could help find solutions to modulate the photosynthetic efficiency of crop plants to boost plant growth and productivity.

Highlights:
* Study estimated the cost-effectiveness of esketamine, a novel intranasally dosed antidepressant for patients with treatment-resistant depression
* Researchers employed a decision-analytic model to simulate the effects of treatment with esketamine versus oral antidepressants from both societal and health care sector perspectives
* Study concluded that the price of esketamine must fall by more than 40% to be cost-effective for management of treatment-resistant depression in the United States

A paper authored by researchers from McLean Hospital has determined that esketamine, a nasal spray to treat severe depression, is currently too expensive for widespread use. Titled "Cost-Effectiveness of Esketamine Nasal Spray for Patients With Treatment-Resistant Depression in the United States," the paper was published on July 7 in Psychiatric Services.

The study compared the costs and benefits of esketamine, an antidepressant approved by the U.S. Food and Drug Administration (FDA) last year for use in treatment-resistant major depressive disorder. Unlike ketamine, a drug delivered intravenously to treat severe depression, esketamine is a nasal spray.

Lead author Eric L. Ross, MD, reported that "most medications don't work as well for people with treatment-resistant depression." However, he said, "Esketamine has been effective in a population where many other treatments haven't worked."

Ross said, "I want people to use esketamine, but it's important that it be cost-effective. I don't want it to put a real strain on our mental health care system."

To estimate the cost-effectiveness of the drug, Ross and his colleagues used a "decision-analytic model" to simulate the effects of treatment with esketamine versus oral antidepressants over five years. The model looked at both societal and health care sector perspectives of using the drug.

Ross explained that the study built on previous investigations of esketamine but added information about cost. Also, he said, the model accounted for issues such as "How much does it cost to have uncontrolled depression?" and "How much does it impact your quality of life?"

The simulations found that, over five years, esketamine was projected to improve quality of life by increasing time in remission for patients. Societal costs and health care sector costs, however, were projected to go up substantially. The authors estimated a greater than 95% likelihood that intranasal esketamine would not be cost-effective in the United States, according to commonly applied standards. Also, they concluded that the price of esketamine must fall by more than 40% from its current price of approximately $240 per dose to be cost-effective for the management of treatment-resistant depression in the U.S.

"Esketamine is too expensive, but it does work," Ross asserted. "The question now is 'How do we get the price down?'"

Ross said that he hopes the paper will encourage policymakers, insurers, and health care leaders to work to reduce the price of esketamine and make it more available to those in need. "At the end of the day, it's not about saving money," he said. "The goal is to make sure we're getting the most clinical benefit we can for the money we spend."

A new study from the University of Georgia finds that users of public insurance are paying more for bariatric weight loss surgery compared to private insurance patients.

The study, which published recently in Clinical Obesity, is the first to break down surgeries by insurance payer type - public versus private insurance - to better understand the economic burden on patients and U.S. health care system overall.

"Bariatric surgery is becoming more common, but there's increasing evidence that bariatric surgery is not happening consistently across all payer types, and there might be cost differences by payer type," said lead study author Janani Thapa, an assistant professor of health policy and management in UGA's College of Public Health.

These differences could point to inequities in health care access that make it more difficult for patients who have Medicaid or Medicare to qualify or pay for bariatric surgery when they need it.

Obesity rates are highest among low-income Americans; this also tends to be a group with less access to obesity treatment options, including bariatric surgery.

"The hoops that they have to jump through may be more [than others] to access the surgery," said Thapa, "and that was our motivation to look into this."

The team analyzed a national dataset of hospitalized patients from 2011 to 2014, looking for trends in bariatric surgery use, costs across insurance types and other demographic factors.

They found obesity diagnoses and surgeries grew among all patients over that time. This could explain why they also found that average national costs associated with bariatric surgery increased, said Thapa.

But they also found that while on average individual patients are paying less for the surgery, the overall cost burden was highest for publicly insured patients. The average cost per surgery was highest among Medicare patients.

Thapa says they can't say why that is, but "as soon as we talk about public insurance, it is taxpayer money that is paying for the surgery," she said.

The next step, the authors said, is to investigate the long-term health outcomes and medical costs of the weight loss surgery.

Despite the study's focus on one clinical intervention, Thapa and her co-authors still advocate for prevention as the best way to reduce the burden of obesity on individuals and the system.

RESEARCH TRIANGLE PARK, N.C. (July 13, 2020) - Providing clean water to Soldiers in the field and citizens around the world is essential, and yet one of the world's greatest challenges. Now a new super-wicking and super-light-absorbing aluminum material developed with Army funding could change that.

With funding from the Army Research Office, an element of the U.S. Army Combat Capabilities Development Command's Army Research Laboratory, researchers at the University of Rochester have developed a new aluminum panel that more efficiently concentrates solar energy to evaporate and purify contaminated water.

"The Army and its warfighters run on water, so there is particular interest in basic materials research that could lead to advanced technologies for generating drinking water," said Dr. Evan Runnerstrom, program manager at ARO. "The combined super-wicking and light-absorbing properties of these aluminum surfaces may enable passive or low-power water purification to better sustain the warfighter in the field."

The researchers developed a laser processing technology that turns regular aluminum pitch black, making it highly absorptive, as well as super-wicking (it wicks water uphill against gravity). They then applied this super absorptive and super-wicking aluminum for this solar water purification.

The technology featured in Nature Sustainability, uses a burst of femtosecond (ultrashort) laser pulses to etch the surface of a normal sheet of aluminum. When the aluminum panel is dipped in water at an angle facing the sun, it draws a thin film of water upwards over the metal's surface. At the same time, the blackened surface retains nearly 100-percent of the energy it absorbs from the sun to quickly heat the water. Finally, the wicking surface structures change the inter-molecular bonds of the water, increasing the efficiency of the evaporation process even further.

"These three things together enable the technology to operate better than an ideal device at 100 percent efficiency," said Professor Chunlei Guo, professor of optics at University of Rochester. "This is a simple, durable, inexpensive way to address the global water crisis, especially in developing nations."

Experiments by the lab show that the method reduces the presence of all common contaminants, such as detergent, dyes, urine, heavy metals and glycerin, to safe levels for drinking.

The technology could also be useful in developed countries for relieving water shortages in drought-stricken areas, and for water desalinization projects, Guo said.

Using sunlight to boil has long been recognized as a way to eliminate microbial pathogens and reduce deaths from diarrheal infections, but boiling water does not eliminate heavy metals and other contaminants.

Solar-based water purification; however, can greatly reduce these contaminants because nearly all the impurities are left behind when the evaporating water becomes gaseous and then condenses and gets collected.

The most common method of solar-based water evaporation is volume heating, in which a large volume of water is heated but only the top layer can evaporate. This is obviously inefficient, Guo said, because only a small fraction of the heating energy gets used.

A more efficient approach, called interfacial heating, places floating, multi-layered absorbing and wicking materials on top of the water, so that only water near the surface needs to be heated. But the available materials all have to float horizontally on top of the water and cannot face the sun directly. Furthermore, the available wicking materials become quickly clogged with contaminants left behind after evaporation, requiring frequent replacement of the materials.

The aluminum panel the researchers developed avoids these difficulties by pulling a thin layer of water out of the reservoir and directly onto the solar absorber surface for heating and evaporation.

"Moreover, because we use an open-grooved surface, it is very easy to clean by simply spraying it," Guo said. "The biggest advantage is that the angle of the panels can be continuously adjusted to directly face the sun as it rises and then moves across the sky before setting - maximizing energy absorption."

The Army and Guo are exploring transition opportunities to further develop this technology within DOD laboratories and private industry.

WASHINGTON--Adopting a plant-based diet can help promote healthful aging and mitigate the global burden of disease, according to an editorial published in the Journal of the American College of Nutrition.

Researchers with the Physicians Committee for Responsible Medicine reviewed clinical trials and epidemiological studies related to aging and found that while aging increases the risk for noncommunicable chronic diseases, healthful diets can help. The editorial shows that plant-based diets can reduce the risk of diseases such as type 2 diabetes, cancer, and heart disease by almost 50% and could cut cardiometabolic-related deaths in the United States by half.

"Modulating lifestyle risk factors and adopting a healthful diet are powerful tools that may delay the aging process, decrease age-associated co-morbidities and mortality, and increase life expectancy," write the authors.
The authors cite studies showing that plant-based diets rich in fruits, vegetables, grains, and legumes:

Reduce the risk of developing metabolic syndrome and type 2 diabetes by about 50%.

Reduce the risk of coronary heart disease events by an estimated 40%.

Reduce the risk of cerebral vascular disease events by 29%.

Reduce the risk of developing Alzheimer's disease by more than 50%.

May reduce the risk for cognitive diseases such as Alzheimer's disease by almost 50%.

The researchers also note that plant-based diets have been tied to increased life expectancy, as evidenced by the world's "Blue Zones," where populations subsist mostly on plant-based foods rich in phytochemicals and antioxidants that have been associated with longer life expectancy.

"The global population of adults 60 years old or older is expected to double from 841 million to 2 billion by 2050, presenting clear challenges for our health care system," says study author Hana Kahleova, MD, PhD, director of clinical research for the Physicians Committee. "Fortunately, simple diet changes can go a long way in helping populations lead longer, healthier lives."

The authors also note that these improvements in health will reduce health care costs caused by chronic diseases. According to the Centers for Disease Control and Prevention, lifestyle-related chronic diseases are the leading cause of death and disability in the United States, accounting for the majority of the nation's annual $3.5 trillion in health care spending.

In a new JAMA editorial, a Boston University School of Public Health (BUSPH) researcher and a health research journalist outline common ways that media, governments, and industry and academic public relations press releases have incompletely and misleadingly reported coronavirus research, and how they can do better.
"The COVID-19 pandemic has created perhaps the most challenging time for science communication in decades. Races are underway in parallel: to find answers to perplexing coronavirus questions, to announce research findings to clinical and scientific colleagues, and to report those findings to a confused and concerned global audience," write Dr. Richard Saitz, professor and chair of community health sciences at BUSPH, and Gary Schwitzer, founder and publisher of HealthNewsReview.org.
"There are no winners in these races if harm--even though unintentional--is wrought by the dissemination of hurried, incomplete, biased misinformation," they write. "Trust in science, medicine, public relations and journalism may be in jeopardy in the intersection where these professions meet."
By way of example, Saitz and Schwitzer describe how three drugs--remdesivir, dexamethasone, and hydroxychloroquine--have been touted as COVID cures, without explanations of the limits of the evidence. These rushed and incomplete announcements have led, among other consequences, to shortages, government stockpiling, and a baffled public: In the case of hydroxychloroquine, they write, "News stories and social media reports took readers on a roller coaster ride, alternately reporting efficacy, lack of efficacy, and harm, reporting dutifully on the results of each latest study."
Instead, Saitz and Schwitzer recommend greater caution and more detail, including highlighting limitations, specifying patient populations, and describing new findings in the larger context of previous research. It may be a hard pill to swallow, but, they write, "It is important that complexity be mentioned and considered even if it is not popular among layperson readers."