Culture

Researchers at the University of Sydney have produced hard data that demonstrates collaborating with Indigenous peoples changed the outcome of a scientific research project. It is the first empirical evidence that culturally diverse teams produce improved results in conservation research.

Dr Georgia Ward-Fear, a conservation biologist and herpetologist (amphibians and reptiles), said this was the first published study to measure the scientific contribution that Indigenous peoples bring to a research project, beyond the moral or ethical value.

"This is of major importance for Indigenous peoples around the world," Dr Ward-Fear said. "Traditional owners often don't have a voice in science. This is a case study for Indigenous groups globally to hold up and say 'we deserve a voice' and 'we deserve input into research'."

James 'Birdy' Birch, a leading ranger from the Balanggarra Aboriginal Corporation in the Kimberley said: "The university-educated scientists have research tools, data and methods that work for them. But we have every-day lived experience. We have knowledge of the land and the animals passed down over thousands of years. If we put these skills together, it paints a clearer picture."

Working with traditional owners of the land

Dr Ward-Fear, from the School of Life and Environmental Sciences, and her team have been working in the Kimberley, a remote area of northern Western Australian. Her conservation work involves protecting large goannas from the devastating impacts of invasive, poisonous cane toads.

Over 18 months, teams made up of a Western scientist and an Indigenous ranger would set out at daybreak to find and capture the goannas - which can grow up to 1.7 metres in length and weigh more than six kilograms. They fitted the lizards with radio transmitters and then released them and trained them to avoid eating the large toads. They did this by approaching the animal in the field, and feeding the goanna a small toad, large enough to make them sick but not kill them. This put the lizards off eating the toads once the invasion arrived.

The aversion training, developed with Emeritus Professor Rick Shine, has been hugely successful and is now being rolled out on a large scale via the Cane Toad Coalition, a consortium of scientists, government authorities, conservation groups and the Australian Research Council.

But Dr Ward-Fear said the success of the initial project would not have been possible without the input of the Balanggarra Rangers, who are traditional owners of the land.

"Working with Indigenous rangers, you get to see their unique skillsets. Once we showed that the trial worked, I was curious to see whether this contributed to the success of the study in a way we could quantify," Dr Ward-Fear said.

"Even though we worked in teams and had the same opportunity to spot the lizards, there were significant differences in the animals that the rangers spotted," Dr Ward-Fear said. "The rangers have amazing observation skills and ability to see animals in a landscape. They could see the shape of a goanna when they were not moving, were in the shade or dappled light or from much further away. The Western scientists tended to see animals that were closer, out in the open or moving."

Published today in Conservation Letters, the study found the Indigenous rangers were able to find and collect a subset of large varanid lizards (goannas) that Western scientists were unable to spot. Importantly, these lizards displayed different behavioural profiles throughout the study: they were more 'shy' than the bolder lizards foraging in broad daylight; and they also learned the aversion technique better than the braver lizards.

"These ranger-spotted animals responded better to the conservation technique and they actually drove the significant result of the study," Dr Ward-Fear said. "If we hadn't worked with rangers and we hadn't collected that subsample of animals then our results wouldn't have been significant."

Local knowledge

James 'Birdy' Birch is the head ranger with the Balanggarra Rangers. He said the rangers had unique skills to offer the scientists.

"We had access to country for a start," Mr Birch said. "We knew where the goannas were and we caught over 100 of them. We just had a keen eye. We could see them miles away.

"My rangers all grew up on this country hunting for goanna with their parents. It is knowledge passed down for thousands of years."

Mr Birch believes science can benefit from combining the two "ways of looking".

"You've got the Western way of looking with all the tools and the data, and you've got the Indigenous way of looking at things. Together, Western science and Indigenous knowledge, they complement each other. We've got our skills and you guys have got your skills, we can put them together and find out so much, we were amazed by the results."

Dr Ward-Fear said the scientific community already knows it is ethical to work with the traditional owners of the land. "But now we know there is ethical and scientific value in working together in meaningful collaborations," she said.

Orlando, Fla. (April 8, 2019) - The Dusky Arion slug produces a defensive glue that fouls the mouthparts of any would-be predator. Two new studies reveal more about how this glue achieves its strong sticking power and flexibility, insights that could be used to create better medical adhesives.

"Typical sutures like staples and stitches often lead to scarring and create holes in the skin that could increase the chance of infection after surgery," said Rebecca Falconer, who conducted one of the studies. "Understanding the roles of adhesive proteins in the slug glue would aid in the creation of a medical adhesive that can move and stretch yet still retain its strength and adhesiveness."

Falconer and Christopher Gallego-Lazo, undergraduate researchers in the lab of Andrew Smith, PhD, at Ithaca College, will present their research at the American Society for Biochemistry and Molecular Biology annual meeting during the 2019 Experimental Biology meeting to be held April 6-9 in Orlando, Fla.

Falconer analyzed 11 proteins unique to the slug glue that were previously identified by Smith's research team. Using recombinant DNA technology, she produced abundant amounts of each protein for analysis. The techniques she developed could also be used to reproduce the proteins for a manmade glue.

The analysis revealed that some of the proteins tend to bind to themselves or with other proteins to form a three-dimensional network. These findings suggest that this oligomerization may be required for some of the proteins to be most functional.

Gallego-Lazo's study focused on understanding the double network structure that makes the slug glue highly deformable but able to withstand large amounts of force. The glue has a stiff protein network that uses sacrificial bonds to absorb energy, protecting an intertwined deformable network of carbohydrates.

Gallego-Lazo discovered that changing specific chemical bonds within the slug glue's protein network modified the glue's strength. These bonds can be reformed naturally, enabling the glue to deform while maintaining its strength.

"Few studies on biological adhesives have identified the exact nature of the bonds holding the glue together," said Gallego-Lazo. "This knowledge can guide the development of an organic synthetic adhesive that would reduce the risk of infection and scarring compared to stitches and staples and could be applied rapidly and simply."

Rebecca Falconer and Christopher Gallego-Lazo will present the findings from 11:45 a.m.-1 p.m. Monday, April 8, in Exhibit Hall-West Hall, Orange County Convention Center (E148 631.15 poster) (abstract) (E149 631.16 poster) (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

Shark and ray species commonly caught in the Mediterranean and Black seas are not being reported in official statistics, new research from the Sea Around Us initiative at the University of British Columbia shows.

A new study published in Marine Policy reveals that 97 per cent of the sharks and rays caught and brought to market domestically by fleets from the European, North African and Middle Eastern countries that surround these seas are not reported by species.

"The Mediterranean and Black Seas have historically harboured a high diversity and abundance of sharks and rays, but now between between 53 per cent and 71 per cent of them face an elevated risk of extinction," said Madeline Cashion, lead author of the study, who carried out the research at the Sea Around Us initiative at UBC's Institute for the Oceans and Fisheries.

By not keeping track of the different species of sharks and rays that they are bringing to port, countries may be further threatening those already at risk.

"Part of the problem is that many sharks and rays in the region are caught as bycatch in fisheries targeting other species and are brought to port either because there is a small market for them or because, by law, they cannot be thrown back at sea," Cashion said. "If neither fishers nor authorities keep detailed records of what is being caught, then it's very difficult to detect declines and design effective measures to protect threatened species."

Despite the lack of reporting, Cashion found in her research that sharks and rays have become increasingly rare following centuries of exploitation and the more recent expansion and intensification of fisheries in the Mediterranean, in particular of the non-European ones. In many cases, catch data is the only source of information to know if species still exist where they were historically found.

"The problem is that detailed catch data is hard to come by because species identification can be very tricky," Cashion said. "Good reporting relies on the financial and logistical support of governments and fisheries management organizations. Fishers can't be expected to take it on alone."

Given the threats posed by the fishing industry to at-risk sharks and rays due to the lack of specific information, the researchers call for a better implementation of existing data collection and reporting policies.

They also call for official statistics to start accounting for fish that are caught and thrown back into the ocean and those that are caught incidentally.

"To understand the real trends of shark and ray exploitation and abundance, we need to know what is discarded at sea because not all species survive after being pulled up by a net," said Daniel Pauly, co-author of the study and the Sea Around Us Principal Investigator. "For example, 98 per cent of scalloped hammerheads die but when it comes to thornback rays, only 2 per cent of them perish. We just need to know what is being caught."

WASHINGTON -- When people feel that their own good impressions of themselves are at risk, they may try to increase their savings, according to research published by the American Psychological Association.

"People who are insecure about their lives and the broader world save as a means of securing their future in anticipation of a possible emergency," said Yael Steinhart, PhD, of Tel-Aviv University and lead author of the study.

The findings were published in the Journal of Personality and Social Psychology.

Personal savings in the United States have decreased, according to the U.S. Bureau of Economic Analysis. As of January 2018, the average annual personal savings rate was 3.2 percent, down from an average of 8.26 percent during the prior 60 years.

Steinhart and her co-author, Yuwei Jiang, PhD, of The Hong Kong Polytechnic University, conducted a series of experiments involving 2,410 U.S. and Israeli citizens and analyzed data from a nationally representative survey of 1,200 people in the Netherlands. While specifics differed slightly, the experiments were all designed to examine the relationship between self-image threats, or something that challenged the positive perceptions that people have about themselves (e.g., that they are smart), and the tendency to save money.

In all cases, the researchers found that people who experienced self-image threats had a greater intent to save money. This may be because participants preferred to save money to reduce their worries and anxiety and to gain assurance about the future, according to Steinhart.

"Saving constitutes an important measure of economic well-being," said Steinhart. "A person's welfare should increase as they save more, because saving offers a sense of security about the future."

In one experiment, participants played a Sudoku computer game. They were then randomly told that their score put them in the top, middle or bottom third of all the players. They were also asked to rate their saving tendencies by completing a questionnaire and reporting the amount they would save if they received $1,250. People who were told their scores were in the bottom third, and thus experienced a high self-image threat, reported more savings than those who were told they scored in the middle or upper third.

Another experiment looked at the influence of social connections. Participants described an event in which they felt bad or good about themselves and indicated the number of friends they met with and talked to on the phone in an average week. The researchers also asked them to quantify their number of friends based on whether they had a few or many.

Participants then imagined they received $500 and indicated how much of that they would deposit in a savings account. Those who had more social connections, and felt better about those connections, tended to save less money.

"Friends may substitute for money as a psychological resource and buffer individuals from anxiety about the future," said Steinhart.

Orlando, Fla. (April 7, 2019)--A new study suggests that sunscreen protects the skin's blood vessel function from harmful ultraviolet radiation (UVR) exposure by protecting dilation of the blood vessels. Perspiration on the skin may also provide protection to the skin's blood vessels from sun damage. The findings will be presented today at the American Physiological Society's (APS) annual meeting at Experimental Biology 2019 in Orlando, Fla.

UVR from the sun has been well-documented as a contributing factor to skin cancer and premature skin aging. UVR has also been found to reduce nitric oxide-associated dilation of skin blood vessels (vasodilation) by reducing the amount of nitric oxide available in the skin. Nitric oxide is a compound essential for blood vessel health. Vasodilation of the skin's blood vessels plays an important role in regulating body temperature and responding to heat stress, both locally in the skin and throughout the body.

Researchers from Pennsylvania State University studied the effect of UVR exposure with sunscreen or sweat on nitric oxide's ability to promote vasodilation of skin blood vessels. Healthy young adults with light-to-medium skin tone were exposed to UVR on one arm while the other arm served as a control and did not receive UVR treatment. The dosage of UVR was roughly equivalent of spending an hour outside on a sunny day, but without the reddening of sunburn. Three sites on the UVR-exposed arm of each participant were randomly assigned one of three treatments:

one site received UVR only,

a second site received UVR with a chemical sunscreen on the skin, and

a third site received UVR with simulated sweat on the skin.

The UVR-only site was found to have less nitric oxide-associated vasodilation than in the control arm. However, the sunscreen- and sweat-treated sites did not show these reductions in nitric oxide-associated vasodilation. "Further, when sunscreen was applied prior to UVR, UVR exposure actually augmented [nitric oxide-associated vasodilation] compared to [the control arm], or when sweat was on the skin," the research team wrote. "The presence of sunscreen or sweat on the skin may play a protective role against this effect [of UVR]."

"For those who spend a lot of time working, exercising or participating in other various activities outdoors, using sunscreen may protect not only against skin cancer, but also against reductions in skin vascular function," wrote S. Tony Wolf, MA, first author of the study.

Orlando, Fla. (April 7, 2019) - Researchers are reporting new findings on how bacteria involved in gum disease can travel throughout the body, exuding toxins connected with Alzheimer's disease, rheumatoid arthritis and aspiration pneumonia. They detected evidence of the bacteria in brain samples from people with Alzheimer's and used mice to show that the bacterium can find its way from the mouth to the brain.

The bacterium, Porphyromonas gingivalis, is the bad actor involved in periodontitis, the most serious form of gum disease. These new findings underscore the importance of good dental hygiene as scientists seek ways to better control this common bacterial infection.

"Oral hygiene is very important throughout our life, not only for having a beautiful smile but also to decrease the risk of many serious diseases," said Jan Potempa, PhD, DSc, a professor at the University of Louisville School of Dentistry and head of the department of microbiology at Jagiellonian University in Krakow, Poland. "People with genetic risk factors that make them susceptible to rheumatoid arthritis or Alzheimer's disease should be extremely concerned with preventing gum disease."

While previous researchers have noted the presence of P. gingivalis in brain samples from Alzheimer's patients, Potempa's team, in collaboration with Cortexyme, Inc., offers the strongest evidence to date that the bacterium may actually contribute to the development of Alzheimer's disease. Potempa will present the research at the American Association of Anatomists annual meeting during the 2019 Experimental Biology meeting, held April 6-9 in Orlando, Fla.

The researchers compared brain samples from deceased people with and without Alzheimer's disease who were roughly the same age when they died. They found P. gingivalis was more common in samples from Alzheimer's patients, evidenced by the bacterium's DNA fingerprint and the presence of its key toxins, known as gingipains.

In studies using mice, they showed P. gingivalis can move from the mouth to the brain and that this migration can be blocked by chemicals that interact with gingipains. An experimental drug that blocks gingipains, known as COR388, is currently in phase 1 clinical trials for Alzheimer's disease. Cortexyme, Inc. and Potempa's team are working on other compounds that block enzymes important to P. gingivalis and other gum bacteria in hopes of interrupting their role in advancing Alzheimer's and other diseases.

The researchers also report evidence on the bacterium's role in the autoimmune disease rheumatoid arthritis, as well as aspiration pneumonia, a lung infection caused by inhaling food or saliva.

"P. gingivalis's main toxins, the enzymes the bacterium need to exert its devilish tasks, are good targets for potential new medical interventions to counteract a variety of diseases," said Potempa. "The beauty of such approaches in comparison to antibiotics is that such interventions are aimed only at key pathogens, leaving alone good, commensal bacteria, which we need."

P. gingivalis commonly begins to infiltrate the gums during the teenage years. About one in five people under age 30 have low levels of the bacterium in their gums. While it is not harmful in most people, if it grows to large numbers the bacteria provoke the body's immune system to create inflammation, leading to redness, swelling, bleeding and the erosion of gum tissue.

Making matters worse, P. gingivalis even causes benign bacteria in the mouth to change their activities and further increase the immune response. Bacteria can travel from the mouth into the bloodstream through the simple act of chewing or brushing teeth.

The best way to prevent P. gingivalis from growing out of control is by brushing and flossing regularly and visiting a dental hygienist at least once a year, Potempa said. Smokers and older people are at increased risk for infection. Genetic factors are also thought to play a role, but they are not well understood.

Jan Potempa will present this research on Sunday, April 7, from 1-1:30 p.m. in Room W208A, Orange County Convention Center (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

Orlando, Fla. (April 7, 2019)--Estradiol is a commonly prescribed estrogen therapy. Previous research has found that rats treated with the hormone experience an increase in sugar consumption. But according to new research, blocking the body's opioid receptors can reverse this effect. The findings will be presented today at the American Physiological Society's (APS) annual meeting at Experimental Biology 2019 in Orlando, Fla.

Estradiol is a naturally occurring estrogen hormone and common medication used in various hormone treatments, such as menopausal hormone therapy and birth control. Previous studies by this research team found giving estradiol replacement in a rat model of menopause caused the rats to consume more of an offered sugar solution.

Because the opioid system is known to contribute to overindulgence of highly palatable foods, the researchers decided to examine its role in estradiol's impact on sugar intake. Rats were assigned to either estradiol treatment or a control. Researchers then continuously infused rats with either naltrexone, which blocks opioid receptors, or saline. In a second experiment, the research team injected naltrexone or DAMGO, a synthetic compound that stimulates the opioid system, into an area of the brain associated with reward (the nucleus accumbens). In the first experiment, naltrexone treatment reversed the estradiol-related increase in sugar consumption. Injection of DAMGO stimulated sugar intake in both treated and control rats, but the effect was smaller in estradiol-treated rats than in control rats. These suggests that the opioid system plays a role in the estrogen-induced enhancement of sugar intake, but opioid receptors in the nucleus accumbens is not likely to be directly involved in the estrogen-induced enhancement of sugar intake.

Lead author Kurumi Iida noted that these findings suggest that extra sugar intake caused by estradiol "is possibly mediated by the opioid system." However, a potential site of the action for this phenomenon remains unknown.

Kurumi Iida, an undergraduate student at Nara Women's University in Nara, Japan, will present "Involvement of the opioid system in the 17β-estradiol-induced enhancement of sucrose intake in ovariectomized rats" Sunday, April 7, at a poster session in West Hall B of the exhibit hall of the Orange County Convention Center.

A clinical review, published today (Saturday 6 April 2019) for the BMJ, provides new interim advice for doctors and clinicians in prescribing cannabis-based products and cannabinoids to treat certain conditions.

Since a policy change in November 2018, specialist doctors registered with the General Medical Council (GMC), have been permitted to prescribe new medicines which derive from cannabis. Yet, research into these products has, to date, been limited creating an 'information vacuum' about these medicines, their benefits or harms.

A new review authored by leading scientists and clinicians from the University of Bath and University College London (UCL) points to the array of different cannabis-based products and cannabinoids available, and a clear need to educate both patients and clinicians into what these different products do and how they might help.

In particular, it points to important differences between products containing THC (the main psychoactive and intoxicating constituent of cannabis) versus CBD (the non-intoxicating element). Although in certain medicines CBD and THC are combined for clinical benefit, in others these components can work independently, playing different roles in improving certain symptoms.

For example, several studies have found that a combination of THC and CBD can alleviate symptoms of chronic pain, while CBD alone may be effective for treatment-resistant epilepsy. By contrast THC alone may be effective for treating nausea and vomiting caused by chemotherapy. THC and CBD are both 'cannabinoids' that act in different ways on the body's endogenous cannabinoid system.

The cannabis plant produces over 144 different cannabinoids such as THC or CBD. Some medicinal products contain THC and/or CBD derived from the cannabis plant, while others contain synthetically produced cannabinoids. CBD is also available in non-medicinal products such as oils and tinctures.

Lead author, Dr Tom Freeman of the University of Bath's Addiction and Mental Health Group explains: "In this complex and rapidly evolving field, there are several different cannabis-based and cannabinoid medicinal products. These differ in their THC and CBD content, who can prescribe them, and the conditions they may be used to treat. Here we provide an update for clinicians in advance of forthcoming NICE guidelines.

"A key message is that CBD products widely sold online and in health food shops lack quality standards and should not be treated as medicinal products."

Research on cannabis was previously restricted because it was listed in Schedule 1, implying that it had no medical value. Cannabis was recently moved to Schedule 2 in the UK.

Dr Freeman adds: "Research on unlicensed cannabis products has been limited to date. The rescheduling of cannabis and allocation of dedicated UK research funding will improve the evidence we have to guide clinical decision-making."

Co-author, Dr Michael Bloomfield Head of Translational Psychiatry at University College London (UCL) added: "There have been leaps and bounds in our scientific knowledge in recent years, which combined with confusing claims about the medicinal uses of these drugs can be potentially perplexing for doctors and patients. We hope that our new guidance is helpful to doctors and patients worldwide. Much more research is needed into this new class of medicine."

Co-author Dr Chandni Hindocha of the Clinical Psychopharmacology Unit at UCL added: "Resources must be made available to update and educate clinicians about cannabis and cannabinoid based medicines. We would like to encourage doctors to maintain a compassionate and evidence-based approach when engaging with their patients in this rapidly developing field, in order to provide the best standard of care."

Orlando, Fla. (April 6, 2019) - Acetaminophen -- a commonly used pain reliever and fever reducer -- is the leading cause of quickly developing, or acute, liver failure in the U.S. Findings from a new mouse study suggest that treatments that increase levels of the protein thrombospondin-1 could help the liver recover from an overdose of acetaminophen.

"The only treatment available now for acetaminophen overdose must be administered early, before significant liver injury occurs," said Matthew McMillin, PhD, who performed the research. "We are working to identify new drug targets to improve treatment options and reduce the need for liver transplantation, which is often the only option for patients with acute liver failure due to drug toxicity."

McMillin, an assistant professor at the University of Texas at Austin and research biologist at Central Texas Veterans Health Care System, will present the research at the American Society for Investigative Pathology annual meeting during the 2019 Experimental Biology meeting to be held April 6-9 in Orlando, Fla.

McMillin and his colleagues found that mice with acute liver failure from acetaminophen toxicity had higher levels of thrombospondin-1 than mice with normal liver function. When they administered acetaminophen to genetically modified mice that lack thrombospondin-1, the liver injury and loss of liver function was more severe compared to unmodified mice. The researchers also observed impaired liver regeneration and increased cell death in the mice without thrombospondin-1.

"Our study is the first to investigate thrombospondin-1 during acetaminophen toxicity," said McMillin. "We were able to identify cell communication pathways that do not work properly during acetaminophen-induced liver injury and thus lead to worse outcomes."

Next, the researchers plan to give mice different drug treatments that manipulate thrombospondin-1 to find out which treatment might be suited for potential clinical studies. They also plan to examine patients with acetaminophen-induced acute liver failure to determine if their thrombospondin-1 findings from mice hold true in people.

Matthew McMillin will present this research on Saturday, April 6 at 7 p.m. during the Experimental Biology Welcome Reception in Valencia Ballroom ABCD, Orange County Convention Center and on Monday, April 8, from 11:45 a.m.-12:45 p.m. in room Exhibit Hall-West Hall B (poster A62 662.62 ) (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

ARLINGTON, Virginia, April 6, 2019 -- Heart attack victims over age 65 are less likely than younger patients to receive timely percutaneous coronary intervention to open their blocked heart arteries, according to preliminary research presented at the American Heart Association's Quailty of Care and Outcomes Research Scientific Sessions 2019, a premier global exchange of the latest advances in quality of care and outcomes research in cardiovascular disease and stroke for researchers, healthcare professionals and policymakers.

In the study, older heart attack patients suffered more complications, such as shock and heart failure, had longer hospital stays and an increased chance of death. Despite staying in the hospital on average a half-day longer, older patients had lower total charges, something the researchers said could be attributed to the lack of undergoing more costly interventions such as percutaneous coronary intervention (PCI).

PCI, often referred to as angioplasty, is a non-surgical procedure used to treat narrow or blocked coronary arteries. During the procedure, special tubing with an attached deflated balloon is inserted into the blockage and the balloon is inflated to push open the blockage. Sometimes a stent may be placed during the procedure to keep the blood vessel open.

"Our study found that seniors were less likely to undergo PCI for a heart attack and if they do receive the procedure it's not within the optimal time for the best possible outcome," said Wojciech Rzechorzek, M.D., lead study author and a resident at Mount Sinai St. Luke's and Mount Sinai West Hospital in New York. "Their prognosis is worse than for younger patients with the same conditions, and this lack of treatment or delay in treatment could be a factor."

Researchers used the 2014 Nationwide Inpatient Sample to review records of 115,042 heart attack patients, 54 percent of whom were over 65.

The average age of the older group was 78. They were more likely than their younger counterparts to have high blood pressure, heart failure, chronic kidney disease and diabetes.

Researchers found, compared to younger patients, older patients were:

34 percent less likely to receive PCI to open blocked arteries;

36 percent less likely to have a stent inserted to keep the artery open after the blockage is removed;

34 percent less likely to have stents placed within 48 hours.

There appeared to be no difference between the two groups in the use of drugs or surgery to open blocked arteries.

Older patients were more likely to fare worse. Compared to younger counterparts they were:

62 percent more likely to develop heart failure;

28 percent more likely to go into shock;

21 percent more likely to experience cardiac arrest; and

10 percent more likely to need assistance from a breathing machine.

Despite older patients having to stay in the hospital longer, their adjusted total hospital charges were lower by approximately $3,231 per stay compared to younger patients.

"I am surprised that the costs of stay are lower despite the increased length of stay, but this could be primarily driven by decreased use of PCI, which is an expensive procedure," Rzechorzek said.

The researchers said because this was a retrospective analysis based on a very limited data set, further research is needed.

"Elderly patients are underrepresented in clinical trials, and we need more prospective studies evaluating the impact of PCI on outcomes," Rzechorzek said.

Researchers have known for decades that inflammation accompanies Alzheimer's disease (AD) brain lesions. Several early studies suggested that "super-aspirins" or Nonsteroidal anti-inflammatory drugs (NSAID) could help avoid the disease. However, after clinical trials showed that NSAIDs don't help patients who already have AD symptoms, doctors wondered whether these drugs could still be helpful to people who were at risk of developing the disease, but weren't yet showing symptoms.

To test this hypothesis, researchers at McGill University's Faculty of Medicine developed a new approach to AD prevention trials, and used it to test whether the common NSAID naproxen could indeed stop the disease in its tracks, before people developed AD symptoms. Sadly, the results were not encouraging, according to research published in the April 5, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"To give the NSAID story one more chance to end well, we enrolled trial participants at the earliest stages of disease development, before they exhibited cognitive impairment," explains Dr. John Breitner, Professor of Psychiatry at McGill and the study's senior author. "The resulting trial, known as INTREPAD, examined the effects of naproxen in people who had a strong family history of AD but 'squeaky-clean' memory and other cognitive abilities."

Developing a new method to assess effectiveness

Many researchers have noted the special challenge of measuring disease development at a time when they could not rely on symptoms to assess effects of a treatment. To deal with this challenge the McGill team collaborated in developing a new Alzheimer Progression Score (APS) that was shown elsewhere to predict the onset of clinical disease over the coming decade or more. The APS measures the early development of disease by combining many little changes into a composite score.

Applying the APS to a trial sample of 200 people (100 assigned to naproxen and 100 to placebo), the INTREPAD results showed real changes over the two-year trial period. However, there was no evidence that the APS change was reduced in those taking naproxen. "The usual side effects were there," notes Pierre- François Meyer, a PhD candidate in Dr. Breitner's lab and the study's first author, "but there was not the slightest suggestion of any benefit."

"We think this is the end of the road for the use of NSAIDs for treatment or prevention of Alzheimer's disease, and it suggests a need for caution about using other anti-inflammatory drugs for this purpose," adds Dr. Breitner, who is Founding Director of the Centre for Studies on Prevention of Alzheimer's Disease at the Research Centre of the Douglas Mental Health University Institute. "The world desperately needs a way to prevent this horrible disease," he says, "and many other avenues are being investigated." In this process, researchers argue ever more strongly for the importance of publishing negative or "null" trial results like this one.

Although the majority of patients who have blood cancers are older adults, they make up only a small percentage of participants in the clinical trials that lead to new therapies. That's because the standard research methods used in oncology (cancer medicine) are not ideal for identifying certain vulnerabilities linked to aging, such as having multiple chronic diseases and being frail.

To help remedy that situation, the American Society of Clinical Oncology (ASCO) issued a guideline recommending that older adults who have cancer receive a geriatric assessment to see if they are at increased risk for experiencing side effects from medication and other complications from cancer and its treatment. Recently, a team of researchers examined older adults who have cancer to see whether their ability to manage daily activities as measured by these assessments was linked to staying alive longer. The team published their study in the Journal of the American Geriatrics Society.

A key part of the geriatric assessment is to determine how well an older adult performs the basic activities of daily living (ADLs). These include bathing, dressing, getting themselves from a chair to the bed (and vice versa), eating, grooming, and using the toilet. The geriatric assessment also takes into account an older adult's ability to perform instrumental activities of daily living (IADLS), or activities necessary for them to live on their own in the community. These activities include shopping, preparing meals, housework, taking medication, and handling their finances.

The researchers studied how performing daily activities was linked to survival and also to the use of medical care for adults living with cancer and aged 75 years and older. The researchers suspected that being unable to perform their daily activities would mean higher rates of death and unexpected visits to the Emergency Department (ED) and admissions to the hospital.

Participants included 464 people who on average were nearly 80 years old; 65 percent were male. All the participants were treated for blood cancers, including leukemia, multiple myeloma, and lymphoma, at the Dana-Farber Cancer Institute in Boston. About 38 percent of the participants had an aggressive form of blood cancer.

Of the participants, 11 percent reported they had trouble with at least one ADL and almost 27 percent had trouble performing at least one IADL.

The researchers also looked at a group of 318 participants who had visited the ED or had unplanned hospitalizations. Of them, 17 percent had at least one ED visit and 19 percent had at least one unplanned hospitalization. The five most common causes of hospitalization were pneumonia, fever, sepsis (the medical term for a blood infection), pain, and congestive heart failure.

For their main findings, the researchers reported that participants who had trouble performing at least one IADL had a higher risk for death, ED visits, and unplanned hospitalizations. This risk was not affected by how old they were, whether they had other chronic illnesses, how aggressive their cancers were, or the intensity of their cancer treatment.

What's more, the researchers found that many of the patients who were dependent in performing their IADLS (meaning they relied on help from others) also had higher rates of age-related conditions, such as memory issues, problems with mobility, and feelings of loneliness or depression. The researchers concluded from their study that it is not only important to ask about function for older adults with blood cancer but to also screen for age-related conditions that could limit functioning. Treating these other conditions to improve function might help older adults better tolerate the stress of blood cancers and their treatment, the researchers suggested.

PHILADELPHIA (April 5, 2019) -Breastfeeding is an accepted practice for millions of women worldwide and strongly endorse by the World Health Organization. To provide appropriate counseling about human milk and breastfeeding, it is important to understand cultural beliefs and customs related to the practice.

Understanding Orthodox Jewish customs regarding breastfeeding is especially important for health care providers because the Orthodox population in the United States is growing. Orthodox women get married younger and have twice as many children as non-Orthodox Jews. Some of these families are at higher risk for conceiving infants with genetic disorders, who may require special care and continued hospitalization after the mother has been discharged.

In a new article published in The American Journal of Maternal/Child Nursing, nurse researchers examine Orthodox Jewish practices related to the provision of human milk and breastfeeding for a sick newborn. The article guides nurses in providing culturally competent lactation education, and evidence based guidance to meet the individual needs of each Orthodox Jewish infant and family. It is critical for the family to have conversations with their Rabbi ideally before delivery or at time of birth to determine needs for saving colostrum and milk, as well as, milk expression during Shabbat or religious holidays.

"Personalized, culturally and religiously tailored care, education, and counseling can ensure that Orthodox mothers are able to meet their personal breastfeeding goals even if their infant requires hospitalization at birth," says Diane L. Spatz, PhD, RN-BC, FAAN, the Helen M. Shearer Term Professor of Nutrition at University of Pennsylvania School of Nursing (Penn Nursing), one of the article's co-authors.

April 5, 2019 -- Even tiny amounts of gluten in foods are troublesome for people with celiac disease, and restaurants may be the hardest places to avoid the protein, finds a study by Benjamin Lebwohl, MD, MS, Celiac Disease Center at NY-Presbyterian Hospital and assistant professor of medicine and epidemiology at Columbia Mailman School. More than half of gluten-free pizza and pasta dishes in restaurants tested positive for the presence of gluten; about one-third of supposedly gluten-free foods had detectable gluten. Results are published in the American Journal of Gastroenterology.

"Patients have long suspected that gluten contamination in restaurant foods is a frequent occurrence, and these results support that," said Lebwohl. "Our findings suggest that pizza, pasta and foods served at dinner were more likely to have a problem."

Lebwohl used data uploaded by users of the portable device Nima Gluten Sensor which restaurant patrons use to test foods. The manufacturer supplied 5,624 food tests by 804 users over 18 months. The research showed 32 percent of tests revealed detectable gluten in dishes that were supposed to be gluten-free.

Gluten-free pasta samples were positive in 51 percent of tests; gluten-free pizza contained gluten for 53 percent. Gluten was detected in 27 percent of breakfasts, 29 percent of lunches and 34 percent of dinners.

There are limitations to the data, notes Lebwohl. "Users may have uploaded results that surprised them the most." Also, the device is very sensitive. To be labeled gluten-free in the U.S., a product must contain less than 20 parts per million. "The device can detect levels as low as 5 to 10 ppm, which most do not consider clinically significant, so a 'gluten found' result does not necessarily mean 'unsafe for celiac disease.' The device also does not detect certain forms of gluten, such as fermented gluten. So both false positives and false negatives will affect this estimate."

Lebwohl suspects that gluten-free foods are inadvertently contaminated, and "the solution may be better education for food preparers."

With new genome analysis tools, scientists have made significant advances in our understanding of modern humans' origins and ancient migrations.

But trying to find ancient DNA, let alone prove that the ancient DNA is ancestral to a population living today is extremely challenging.

A new study in Molecular Biology and Evolution (MBE) adds to this understanding by reconstructing artificial genomes with the analyses of the genome of 565 contemporary South Asian individuals to extract ancient signals that recapitulate the long history of human migration and admixture in the region.

"All in all, our results provide a proof-of-principle for the feasibility of retrieving ancient genetic signals from contemporary human subjects, as if they were genomes from the past embedded in amber," said Luca Pagani, the research coordinator of the study.

The study was led by Burak Yelmen and Mayukh Mondal from the Institute of Genomics of the University of Tartu, Estonia and coordinated by Luca Pagani from the same institution and from the University of Padova, Italy.

"The genetic components we managed to extract from modern genomes are invaluable, given the shortage of ancient DNA available from South Asian human remains, and allow us to elucidate the genetic composition of the ancient populations that inhabited the area," said Burak Yelmen, co-first author of the study.

While studying the mixing events that brought ancient human populations to form contemporary South Asians, the researchers also noted that some portion of the genomes had not mixed as expected, as if the genetic variants that evolved in South Asia or the ones that arrived from West Eurasia were important for adapting to the local lifestyle through admixture.

"Among these variants, we found genes important for immunity and for dietary changes, as one may expect for human populations adapting to new sets of pathogens or food," said Mayukh Mondal, joint first author of this work.

The human evolution of skin pigmentation also revealed many genetic variants for the population studied.

"Intriguingly we also noted that some genetic variants implicated in the skin pigmentation of West Eurasians were under opposite selective forces, some becoming highly frequent and others being almost lost after the admixture events. Skin pigmentation is surely a fascinating and complex subject and we are still trying to understand what, if any, would be the adaptive implications of the signal we detected."

The study will add to the growing picture of the diversity of South Asians, and future studies of modern human population origins.

"These signals can complement the picture emerging from the booming field of ancient DNA by providing high quality genomic sequences especially for areas of the world where archaeological human remains are scarce or poorly preserved."