Culture

Destinations in nature, such as a lakeside or a walking trail, are the most commonly perceived environmental features motivating older adults to engage in outdoor mobility. In a study conducted at the University of Jyväskylä, Finland, it was however observed that reporting a motivating feature did not necessarily mean the same thing as being more physically active.

Environmental features perceived as motivating for outdoor mobility and levels of physical activity were investigated alongside the neighbourhood types in which the older adults lived. Based on these findings, it could be seen that environmental features associated with higher levels of physical activity differed between neighbourhood types. Differences existed especially between densely populated and sparsely populated areas.

"In densely populated areas destinations close to nature were associated with older adults' brisk physical activity," says PhD student Kirsi Keskinen. "Yet in sparsely populated areas, perceiving features that improved pedestrian infrastructure close to home were important for reporting higher levels of physical activity."

Peaceful walkways, even sidewalks, and street lighting are examples of features that make an environment more walking friendly for older adults. They are also features that commonly differ in their amounts between densely and sparsely populated areas.

"The specific conditions of a neighborhood type should be considered when planning measures to promote older adults' physical activity," Keskinen concludes.

For the research, 848 people between the ages of 75 and 90 living in Jyväskylä and Muurame, Finland, were interviewed about their physical activity, perceived environmental features that attracted to outdoor mobility, and health and socioeconomic factors. Characteristics of neighborhood types were retrieved from geospatial data.

This study is part of the project Geographic characteristics, outdoor mobility and physical activity in old age (GEOage) conducted in the University of Jyväskylä's Faculty of Sport and Health Sciences and in the Gerontology Research Center. The research has been financially supported by the Foundation for Municipal Development, the Finnish Cultural Foundation, the Finnish Ministry of Education and Culture, the Academy of Finland, and the European Research Council.

Some call it baby fat. But recent research has shown that adults have it too--which is a good thing. Brown fat, the so-called good fat that can protect against obesity and associated health risks, like cardiovascular disease and diabetes, is located in small pockets throughout the body. Most mammals use brown fat (and its closely related cousin beige fat) to stay warm.

"In mice and humans, if you have more brown or beige fat, you are more protected from metabolic disease," says Liangyou Rui, Louis G. D'Alecy Collegiate Professor of Physiology at U-M Medical School, whose lab studies the molecular and physiological mechanisms of obesity, diabetes and fatty liver disease.

In a new study published in Nature Communications, Rui, first author Lin Jiang, Ph.D. and their colleagues reveal a pathway by which the hormone leptin contributes to weight loss.

Leptin regulates body weight by controlling appetite and energy expenditure, but exactly how has been a mystery. What is known, says Rui, is that leptin activates brown and beige fat. The new study elucidates a molecular accelerator of leptin action in the brain called Sh2b1.

His team has found that Sh2b1 in the hypothalamus, an important brain region controlling body temperature and hunger among other functions, promotes the stimulation of the sympathetic nervous system. The sympathetic nervous system sends signals to brown and beige fat to activate it, thus maintaining body weight and metabolism.

The team demonstrated this proof-of-principle by creating two mouse models. Mice that lacked the Sh2b1 gene in the leptin receptor neurons "had an incredibly reduced sympathetic drive to the brown/beige fat and reduced capability to promote energy expenditure," says Rui.

This reduced the ability of brown fat to be metabolized into heat, lowering the mice's core body temperature. What's more, the mice also developed obesity, insulin resistance and a fatty liver. In contrast, mice with extra expression of Sh2b1 in their brains were protected from obesity.

"No one knew that Sh2b1 in the brain controls the sympathetic nervous system or was required for leptin to activate brown fat to increase energy expenditure," notes Rui. As for how this finding could be applied to humans, he says the hope is to eventually find a way to increase expression of Sh2b1 or its ability to enhance leptin signaling and fat burning.

Despite intensive research effort, the process of metastasis, which allows carcinoma cells to leave the tumor of origin, to migrate and to grow tumors within other organs, is still the leading cause of mortality for cancer patients. It is acknowledged that the acquisition of migrating capacities by cancer cells relies on a process called Epithelial to Mesenchymal Transition (EMT). During this process, cancer cells lose their ability to attach to other cells, become independent cells and gain abilities to migrate, thus switching from an epithelial state to a so-called mesenchymal state. However, this process seems to rarely complete, as many cancer cells maintain properties of both epithelial and mesenchymal cells. These hybrid cells may be the most dangerous ones, as they appear to survive treatments with chemotherapeutic drugs and to cause new tumors. A very large number of molecules or signals inside the cell has been shown to control this process. In addition, cells in the neighborhood of tumor cells, as well as the web of proteins on which cells are seated, called the extracellular matrix, send a multitude of signals to tumor cells to cause or prevent the EMT process. Yet it remains to be uncovered which of these molecular signals should be targeted to alt metastasis, to kill hybrid cancer cells and to prevent the formation of new tumors.

The large number of signals involved in metastasis is now far beyond the capability of any researcher to be integrated in order to predict how a cell will behave. To get around this problem, the research's groups lead by Claudine Chaouiya and Florence Janody at Instituto Gulbenkian de Ciências (IGC) and Instituto de Investigação e Inovação em Saúde (i3S) have built a virtual computational cell, with numerous molecules interacting with each other. This virtual cell can become epithelial, mesenchymal or hybrid cancer cell. It is also under the influence of many signals coming from outside the cell. According to Claudine Chaouiya "computational models permit to perform virtual experiments that are cheaper and faster than experiments with alive cells, to test hypotheses and to make predictions". Predictions given by the virtual cell were tested using alive human and canine cells. Among these predictions, Chaouiya and Janody research teams confirmed that hybrid cancer cells expressing the oncogene Src become mesenchymal if they are seated on a more rigid extracellular matrix.
They have also discovered that, as predicted by the virtual cell, mesenchymal cancer cells expressing the oncogene Src become hybrid cancer cells when they contain the RPTP-kappa molecule, which connects cells to each other. Florence Janody explains that "experiments combining virtual and alive cells allowed us very efficiently to propose new ways by which we could prevent metastasis and the formation of new tumors".

This study demonstrates that collaborative efforts between mathematicians and biologists bring up a very powerful plan of attack to explain the behavior of cancer cells. This work has permitted to discover molecules and signals in the cell environment, which instruct cancer cells to migrate and invade the body. These signals could be used as targets for developing therapeutic strategies against cancer cells with these behaviors.

The idea of a complex spider society--in which thousands of spiders live, hunt, and raise their young together in a single colony--is unsettling to many of us. We are perhaps lucky then that this scene is relatively rare among arachnids. Among the 40,000 known species of spiders, the vast majority live solitary lives and will often show aggression toward other spiders they encounter, even within their own species. There are fewer than 25 known species of social spiders, distributed broadly across 6 different families and 9 different genera. Not only do these spiders live in social groups, but they produce populations that grow over time as new offspring are added to the nest, enabling the capture of increasingly large prey as the colony expands, and even give rise to new daughter colonies. As social creatures ourselves, humans have long been interested in the evolutionary innovations that enable social cooperation. In a new article in Genome Biology and Evolution titled "Comparative genomics identifies putative signatures of sociality in spiders", researchers provide one of the first glimpses into the genetic underpinnings for how a solitary spider evolves into a social one.

The research, led by Dr. Chao Tong, a postdoc in the lab of Dr. Timothy Linksvayer at the University of Pennsylvania, represents one of the first comparative genomic studies to be conducted in spiders. According to Dr. Tong, "The high complexity and large size of spider genomes has constrained the development of genomic resources for spiders." Because of this, earlier studies compared individual spider genomes to insect genomes and sought mainly to identify venom and silk genes. In the new study, however, a curiosity about the genetic basis of social life led Dr. Tong and his colleagues to compare the genomes of 7 spider species: two social species in the genus Stegodyphus that evolved sociality independently, and five solitary species in the genera Parasteatoda, Acanthoscurria, Nephila, Loxosceles, and Latrodectus.

The analysis revealed a number of interesting findings. First, rapidly evolving genes in the two social species were involved not only in behavior but also in immunity, indicating that group living may require better defenses against pathogens that spread more easily in dense social groups. In contrast, genes that were rapidly evolving in the solitary species were enriched for energy metabolism processes. Dr. Tong notes that this is the opposite pattern from what is observed in social insects such as bees and ants, in which metabolic genes evolve more rapidly. Still, in both insects and spiders, there appear to be metabolic differences between solitary and social organisms that may reflect differences in hunting and feeding behaviors.

In addition, the researchers found that the genomes of the two social spiders exhibited a higher rate of evolution overall than those of the solitary species. While this might reflect a greater number of genes under positive selection, the authors are quick to point out that this pattern may also stem from demographic features that characterize social spiders, such as a female-skewed sex ratio (social spiders have more female offspring than males) and high levels of inbreeding. Perhaps most interesting of all, the new study identified a set of rapidly evolving genes that showed brain-specific expression and were enriched for social behavioral processes. These genes represent top candidates for those that influence social behavior and may have been involved in the evolution of spider sociality.

The researchers note an important limitation of their analysis: since the two social spiders they studied are from the same genus and they did not have access to a solitary spider from this genus, it is difficult to untangle which patterns are directly related to sociality and which may simply characterize spiders in the genus Stegodyphus--both social and non-social species. Thus, the group has already started their next comparative genomics project to verify the above patterns in a larger set of species, including more social spiders and their solitary relatives within the same genus. Realizing that the success of this endeavor may require establishing new collaborations due to the scarcity of spider genomic resources, Dr. Tong would like to put out a call to other researchers: "We welcome samples from other researchers, as we want to include as many spiders as possible in future studies, including social, subsocial, and solitary spider samples from multiple genera."

A study published in the JAMA Otolaryngology-Head & Neck Surgery examines the effect of Medicaid expansion on head and neck cancer patients, finding that the expansions under the Affordable Care Act (ACA) were associated with improved access to care for these patients and selective Medicaid expansion may worsen existing regional disparities in terms of access to care and outcomes.

Medicaid expansion refers to a provision in the ACA that called for expansion of Medicaid eligibility to cover more low-income Americans. It was determined that each state would decide whether to participate in the expansion - accept federal funds - or not. As of 2020, 37 states including the District of Columbia accepted Medicaid expansion. South Carolina is one of 14 states that has not. As a result, there are gaps in coverage for adults who have incomes above Medicaid eligibility limits yet still below the poverty level, exacerbating challenges with access to care, which is vital in the early detection of cancer.

"We performed the study because delivering timely head and neck cancer care is critical for optimal outcomes," said Evan Graboyes, M.D., a researcher at Hollings Cancer Center at the Medical University of South Carolina and senior author on the study. The surgeon at MUSC Health specializes in the treatment of head and neck cancers.

The team analyzed data from a national sample of nearly 91,000 adults with newly diagnosed head and neck cancer who were identified from the National Cancer Database. In this observational study, researchers examined the effect that Medicaid expansion, as part of the ACA, had on the patients' stages of cancer at the time of diagnosis as well as treatment delays for these patients.

Medicaid expansions are known to increase the percentage of patients getting treatment who have localized (stages I or II) cancer at diagnosis for cancers such as colon and breast cancer that have screening tests. Graboyes said the researchers wanted to know the effect of Medicaid expansions on head and neck cancer, which lacks a screening test, he said.

The study showed in states that expanded Medicaid as part of the ACA, patients with head and neck cancer were more likely to be diagnosed with localized (stages I to II) cancer and initiate treatment in a timelier fashion than patients in nonexpansion states. Because of the strong association with a particular stage at diagnosis and the timely treatment that leads to survival for head and neck cancer, the study suggests that Medicaid expansion that offers insurance coverage may help to improve outcomes for these patients.

"I hope that the data we produce gets referenced and is used by policy makers in the future," Graboyes said.

Helmneh Sineshaw, M.D., lead author on the study and a principal scientist at the American Cancer Society, said the study found that Medicaid expansion provided a huge benefit to those who didn't have access to insurance, leading to earlier diagnosis and timely treatment.

"What we find is that patients, in states that expanded Medicaid, had a greater chance of being diagnosed early, whereas patients living in nonexpansion states were likely to be diagnosed in a more advanced stage," Sineshaw said.

Graboyes said delays in the delivery of head and neck cancers are a key driver of suboptimal survival for patients with head and neck cancers and contribute to racial disparities in mortality. Head and neck cancers are rising in number and carry a high mortality rate, with black patients even more likely to die from it.

This study adds to a growing portfolio of other health disparity studies by Graboyes and colleagues, including:

A 5-year $1.2 million grant from the National Cancer Institute awarded in 2019 to decrease mortality and racial disparities in survival for head and neck cancer patients by developing innovative interventions to improve the timeliness, equity and quality of care delivery.

A 2018 study in JAMA Otolaryngology-Head & Neck Surgery that found that ensuring head and neck cancer patients receive postoperative radiotherapy within six weeks of their surgical procedure maximizes their chances of a cure.

Graboyes said more research is needed to understand more fully how changes in insurance coverage affects patients with head and neck cancer. Although there is a strong relationship between the patient's stage at diagnosis and timely treatment, the current study does not address whether Medicaid expansion is associated with fewer recurrences or better survival since there has not been enough time since the implementation of Medicaid expansion to answer this question.

Another limitation of the current study is that it did not analyze how Medicaid expansion was associated with changes in the cost of treatment for head and neck cancer patients. More research is needed to understand the relative costs of expansion of Medicaid provisions as compared to the assumed cost savings of catching and treating head and neck cancers in a more localized stage (I to II) versus advanced stages (III to IV), he said.

"The study is an important first step in understanding how insurance coverage affects health care delivery for patients with head and neck cancer, particularly those who, due to lack of insurance coverage, are more likely to present with advanced disease and experience treatment delays."

Cross-border regions have great potential for cooperation, yet very few border regions are integrated, a new study from the University of Eastern Finland shows. Conducted by Dr Francesco Cappellano and Professor Teemu Makkonen at the University of Eastern Finland's Karelian Institute, the study sheds light on the fact that although there is plenty of talk about promoting integration in cross-border regions, the reality is very different. In the border region of Cascadia that connects Seattle in the US with Vancouver in Canada, economic cooperation has been modest despite local decision-makers' high regard of it. The region has a long history of initiatives geared towards supporting cross-border cooperation, but visible results remain few and far between.

Published in Planning Practice & Research, the study was carried out within the Cross-Border Fellowship programme funded by the Western Washington University in the US and the University of Victoria in Canada.

Cross-border cooperation has very little concrete evidence to show for

The study analysed concrete outcomes of cross-border cooperation by using survey and statistical data. In particular, the researchers focused on innovation cooperation, i.e. cooperation in science, research and product development, as measured by the number of co-publications, co-patents and networking. The study shows that in Cascadia, the cross-border network of cooperation is very sparse, which can be seen in the scarcity of concrete collaborative scientific outcomes and patents. According to the researchers, this can be considered surprising.

"The economic profiles of Seattle and Vancouver are very similar, and increasingly close collaboration between the two is encouraged. This should foster cross-border cooperation, but it is still very seldom that partners are sought from across the border," Dr Cappellano says.

The situation is not unique nor specific to border regions in North America alone. Professor Makkonen has observed similar development also in European border regions.

"Although cross-border cooperation in the European Union and in its adjacent areas is supported by, e.g., the Interreg and ENI programmes, the outcomes have remained modest in terms of cooperation in science, research and product development. For instance, patents filed as a result of cross-border cooperation are rare."

Cross-border cooperation in the Öresund region connecting Sweden and Denmark is often regarded as a textbook example of well-functioning innovation cooperation. According to Professor Makkonen, however, this cooperation is not very impressive considering the resources, except in certain specific fields of medicine.

The findings of the study highlight the fact that although there is plenty of talk about promoting integration in cross-border regions, concrete outcomes remain few and far between.

"The current relations between the EU and Russia, and the coronavirus pandemic, put the sustainability of cross-border cooperation to test. How to maintain cooperation even at current levels is a cause of concern," Professor Makkonen says.

A paper published in the academic journal Neuro-Oncology by NF experts has demonstrated an increased understanding of low grade gliomas (LGG) occurring in children and adults with NF1. While the biology of LGG has become better known over the past decade, the complexities of these tumors have inhibited practical application of this knowledge to NF1 related LGGs, which can potentially impact close to a third of NF1 patients. According to Dr. Roger Packer, the Gilbert Family Foundation consensus conference held last year with NF1 and LGG experts was aimed at pulling together NF and low grade glioma experts to assess whether new therapeutic strategies could be developed for patients with LGG.

The paper can be accessed here: https://bit.ly/2UvCnD1

In response to the timing of the meeting, Dr. Packer said that "the LGG Synodos teams, funded by CTF had collaborated to analyze for the first time in NF history a large enough number of specimens to draw some important conclusions which probably will have implications in how LGG patients will be treated going forward."

Researchers from the University of British Columbia (UBC) and the Central South University (CSU) in China have for the first time identified a gene that increases the risk of Alzheimer's disease.

In the study, published recently in the journal JCI Insight, the researchers found two mutations in the gene endothelin-converting enzyme 2 (ECE2) which impaired its ability to break down amyloid beta protein. These mutations were present significantly more often in people with Alzheimer's than in controls--suggesting that the genetic variants in ECE2 could be causing, or at least contributing to, Alzheimer's symptoms.

"Since amyloid beta protein is unique to Alzheimer's disease, the majority of drug development was targeted here," says Dr. Weihong Song, who is the Canada Research Chair in Alzheimer's disease, Jack Brown and Family Professor, and director of UBC's Townsend Family Laboratories. "If we can prevent amyloid beta protein build-up or at least find a way to get rid of some of it, we could prevent and treat the disease."

Song's laboratory at UBC collaborated with Dr. Lu Shen's team at Xiangya Hospital at CSU for the study. The study's lead author is Dr. Xinxin Lio who completed a joint PhD at UBC and CSU.

The scientists looked at 741 people with late-onset Alzheimer's and compared them to controls. Unlike early-onset which affects people as young as 30, late-onset Alzheimer's is the most common form of this disease, generally affecting individuals after the age of 65.

Song's lab focuses its efforts on looking at the role amyloid beta protein plays in Alzheimer's. It's well established that increased production (or reduced degradation) of amyloid beta protein results in the formation of neuritic plaques in the brain, which is a hallmark of Alzheimer's disease neuropathology.

The team injected the mutated forms of the ECE2 gene into mice. They found mice with the mutation had increased levels of amyloid beta protein and plaque formation, and also exhibited some signs of Alzheimer's such as memory loss. When they expressed the wildtype form of the gene in the mice (i.e. the non-mutated form), amyloid beta protein levels decreased and the mice recovered some of their learning and memory deficits.

"These findings mean that ECE2 is a risk gene for people to develop Alzheimer's later in life," says Song. "Moving forward, we can try to target this gene and increase its expression as a way to treat Alzheimer's."

The researchers are now screening further for genetic mutations in a larger dataset as a way to validate these findings and to search for other variants in the ECE2 gene that could be contributing to Alzheimer's symptoms.

WASHINGTON--In patients with diabetes, loss of the gland that helps lubricate the eye may be a sign of elevated blood glucose levels, according to research accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting. The study will be published in a special supplemental section of the Journal of the Endocrine Society.

Meibomian glands in the eyelid play a role in tear film production and tear film stabilization.

"In this small study, we found that loss of meibomian glands occurred more frequently with elevated hemoglobin A1c, perhaps due to microischemia, or damage to the small blood vessels, of the eyelids," said co-author Gloria Wu, M.D., adjunct faculty at the University of California, San Francisco in San Francisco, Calif. "Loss of meibomian glands may suggest the need for A1c testing to track average blood glucose levels during the past two to three months and additional monitoring in individuals with diabetes."

Individuals with diabetes often complain of dry eye and eye pain. Infrared images of the eyelid may help characterize dry eye in individuals with diabetes, and new infrared photography techniques have recently enabled meibomian glands to be easily photographed.

To study meibomian gland loss in patients with diabetes as well as dry eye, Wu and her colleagues conducted a retrospective electronic health record chart review of patients with type 2 diabetes and of patients who did not have diabetes and were diagnosed with "dry eye" between 2017 and 2019. The participants were between the ages of 18 and 90, and those with diabetes had A1c levels higher than 5.7%. The researchers analyzed participants' A1c levels and reviewed their infrared eyelid photos.

For each participant, the researchers averaged the percentage of the meibomian glands that were lost in both eyes. Of the 60 patients with diabetes, 35 of 37 with A1c levels higher than 6.6% had more than 40 percent loss of the meibomian glands. In comparison, 12 of 23 diabetes patients who had more controlled A1c levels of less than 6.5% had lost less of the meibomian glands.

Of the 60 control patients, 41 of 50 patients with A1c levels lower than 5.5% had minimal loss of the meibomian glands. Seven of 10 control patients with A1c levels higher than 5.6 percent had greater loss of the meibomian glands.

"It can be useful to check the eyelids of individuals with diabetes who complain of dry eye," Wu said. "It is important for people with diabetes and their family members to consider that dry eye and painful 'sand in the eyes' feelings may mean they should check their blood sugar and see an ophthalmologist about their eye health, including their eyelids."

Certain smartphones have cameras capable of capturing images to gauge eyelid health, including the Samsung Galaxy 10S and iPhone models 10, Xs and 11, Wu said.

"We used an infrared camera in this study, but patients can examine their own eyelids, using selfie and black-and-white settings on their smartphone," she said. "This technique gives patients and health care workers, including those in community and rural health clinics, one more way to control diabetes."

Better glucose control can help people with diabetes who have a common type of stroke to preserve their cognitive function, according to a study accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting. The abstract will be published in a special supplemental issue of the Journal of the Endocrine Society.

"As the population is aging, the prevalence of diabetes and stroke is increasing, and both diseases are risk factors for cognitive dysfunction and dementia," said lead study author Tali Cukierman-Yaffe, M.D., M.Sc., a physician and researcher at the Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Tel Aviv, Israel. "Identifying modifiable risk factors that are associated with cognitive dysfunction in people with type 2 diabetes who experience a lacunar stroke has major public health implications."

Lacunar strokes are a common type of stroke that occurs deep in the brain. A lacunar stroke occurs when an artery that provide blood to the brain's deep structures is blocked.

Cukierman-Yaffe and her colleagues conducted a post-hoc analysis of data from 942 people 30 years of age or older with diabetes who had a lacunar stroke and participated in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. The researchers examined hemoglobin A1c, a glucose control index that provides an estimate of average glucose levels in the three months prior to blood test, and scores on the Cognitive Assessment Screening Instrument (CASI) score over time among participants.

Better glucose control at baseline and during follow-up was associated with greater cognitive function and less cognitive decline, while worse glucose control was linked with poorer cognitive function and steeper cognitive decline. Every 1% increase in baseline A1C was linked with a 0.06 lower standardized CASI z-score. Higher baseline A1C values were linked with lower cognitive scores over time, and a 1% increase in A1C over time corresponded to a CASI score decrease of 0.021 during follow-up.

All these numbers remained statistically significant after the authors adjusted for age, sex, education, race, depression, hypertension, hyperlipidemia, body mass index, cardiovascular disease, obstructive sleep apnea, diabetic retinopathy, nephropathy, insulin use, and white matter abnormalities.

"Intervention studies are needed to investigate whether tighter glucose control may slow the rate of cognitive decline in this population," Cukierman-Yaffe said.

WASHINGTON--Patients with type 1 diabetes who use Medtronic's MiniMedTM 670G insulin pump system are able to maintain blood glucose levels in the targeted range over 71% of the time, according to a study that analyzed some 6 million days of real-world data. Results of the industry-supported study were accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting, and will be published in a special supplemental issue of the Journal of the Endocrine Society.

In patients with diabetes, the current goal is to be in the target glucose range of 70-180 mg/dL over 70% of the time.

"Real-world experience does not necessarily live up to the results seen in a clinical trial that recruits highly motivated participants and who are under close supervision," said study principal investigator Robert Vigersky, M.D., chief medical officer of Medtronic Diabetes, Northridge, Calif. "Our results demonstrate that the glycemic [blood glucose] control using the MiniMedTM 670G in the real world is excellent and mirrors the results of the small pivotal trials that led to the system's approval."

Sometimes called an "artificial pancreas," the MiniMed TM 670G system is the first hybrid closed-loop system approved by the U.S. Food and Drug Administration (FDA) for people with type 1 diabetes, Vigersky said. This system consists of an insulin pump with a tiny insulin infusion catheter worn under the skin and a small continuous glucose monitor (CGM) also worn under the skin, whose sensor measures glucose levels every five minutes and sends the result to the pump. The pump then automatically adjusts the amount of insulin given every 5 minutes. The MiniMed TM 670G gained approval in 2016 for people ages 14 and older and in 2018 for children ages 7 to 13 years, he said.

Since then, use of the MiniMed TM 670G has grown to more than 180,000 Americans, according to the study abstract. Many patients have uploaded their sensor glucose data from their devices to a web database called CareLink to track their glycemic control and share their data with their physicians.

In this study, the researchers analyzed information uploaded to the CareLink database from March 2017 to July 2019 by 118,737 persons with type 1 diabetes using the MiniMed TM 670G.

Overall, the percentage of time spent within the target glucose range of 70 to 180 mg/dL was 71.3%, Vigersky reported.

Additionally, the researchers assessed the impact of the system's AutoMode insulin delivery feature in a subgroup of 51,254 individuals who had at least seven days of sensor glucose readings for both Auto Mode turned on and turned off (manual mode). In that subgroup, the percent of time in target glucose range increased from 60.9% in manual mode to 69.9% in Auto Mode, the investigators reported. Both the time spent below (low blood sugar) and above the target glucose range (high blood sugar) decreased in AutoMode, Vigersky said.

Medtronic Diabetes funded the study.

Last month, the U.S. Food & Drug Administration announced Medtronic had recalled MiniMed 670G insulin pumps that have a broken or missing retainer ring following reports that a broken or missing part could lead to incorrect dosing. Insulin pumps with the retainer ring intact do not need to be returned to Medtronic.

What The Study Did: This observational study analyzed data from about 2,900 older residents of Stockholm to examine the association between long-term exposure to air pollution and the risk of developing dementia, along with what role cardiovascular disease might have.

Authors: Giulia Grande, M.D., of the Karolinska Institutet and Stockholm University in Stockholm, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamaneurol.2019.4914)

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

An industrial process that currently consumes vast amounts of energy in petrochemical plants around the globe could be replaced by an alternative process so efficient that it requires no heating or elevated pressure.

Niveen Khashab from KAUST's Advanced Membranes and Porous Materials Center and her colleagues have developed a new way to separate derivates of benzene called xylenes.

"Discussions with industry to implement the technology are already underway," Khashab says.

Xylenes come in three different forms, known as isomers, which differ from each other only in the location of a single carbon atom. Xylenes are used in many large-scale applications, including in polymers, plastics and fibers, and as fuel additives, but many uses rely on just one of the three isomers. Because the isomers are so similar, their physical properties, such as boiling point, are very close, which makes separating them energetically expensive.

"Every year, the global energy costs of separating these isomers using distillation is about 50 gigawatts, enough to power roughly 40 million homes," says Gengwu Zhang, a postdoc in Khashab's team and first author of the study. "We wanted to develop a method with high efficiency and low energy consumption to separate and purify these isomers for the petrochemical industry."

To draw apart the xylene isomers, Khashab and her team used doughnut-shaped molecules called cucurbiturils. The hole in the middle of these molecules can host smaller molecules inside it. The hole in the middle of cucurbit[7]uril is the ideal size for hosting the ortho-isomer of xylene, the team showed. Using a process called liquid-liquid extraction, the team used cucurbit[7]uril to separate ortho-xylene from the other isomers. "We could separate ortho-xylene with more than 92 percent specificity after one extraction cycle," Zhang says. "Unlike previous methods, our method is performed under ambient temperature and pressure, which means very low energy consumption and easy operation," he adds.

The whole process was designed to be readily adopted in the existing plants of petrochemical companies, Khashab explains. "Liquid-liquid extraction towers are already used in industry and so it is relatively easy to incorporate our material in this setup," she says. In addition, cucurbit[7]uril is inexpensive, commercially available or easily made, and highly stable compared to most porous materials.

"We have already shown that we can separate xylene from commercial oil samples at scales of up to 0.5 liters," Khashab adds. "We are in touch with Saudi Aramco to take this process to industrial implementation."

The team is also examining other applications for this separation process, Zhang says.

PRINCETON, N.J.--While some are relying on friends and neighbors to help them get groceries, the poor may need to put themselves at risk for COVID-19 by venturing out on public transportation to get supplies. Depending on where they live, they may trust no one else to help out.

This is true in areas with the highest levels of income inequality, according to a paper to be published in Nature Human Behaviour, where the poor are less likely to rely on their community for support due to shame or embarrassment.

Look at New Haven, Connecticut, as an example. Part of the city is a wealthier University area, and the other part is primarily low-income. It would be rare, the research suggests, for someone from the lower-income areas to ask those in the University section for help -- especially now as the coronavirus continues to spread.

The findings illustrate why policymakers and researchers should move beyond a sole focus on helping low-income individuals and instead look at ways to develop stronger communities.

"If I'm poor, it exacerbates my need to rely on community, but what does it mean if I don't trust my community? It means that there is no way for me to get what I need without putting myself in danger. This can have disastrous long-term effects among the poor," said study lead author Jon Jachimowicz, assistant professor of business administration, at Harvard University.

"Our work shows that hardship increases for low-income individuals by reducing their ability to rely on their community as a buffer against financial and other related difficulties," said co-author Elke Weber, Gerhard R. Andlinger Professor in Energy and the Environment and professor of psychology and public affairs at Princeton University's Woodrow Wilson School of Public and International Affairs. "This suggests that stimulus measures designed to address the economic and social fallout of the coronavirus should focus on reducing the existing income and wealth gap in our country."

The study was an interdisciplinary effort led by psychologists and economists using data analysis strategies across disciplines.

The team also included co-lead author Barnabas Szaszi of Eotvos Lorand University, Marcel Lukas of Heriot-Watt University, David Smerdon of the University of Cambridge, and Jaideep Prabhu of the University of Cambridge.

The researchers conducted eight studies looking at more than one million people across the United States, Australia, and Uganda. Their work included an instrumental variable analysis, lab experiments, online studies, and field work.

In the first four studies, the team established empirical support for their hypothesis that greater income inequality hits the poor the hardest. Their findings were as expected: Across all countries, the greater the economic inequality, the harder the financial hardship for those with the lowest incomes.

In the next four studies, they investigated the main driver behind this effect, finding strong evidence supporting their claim: Higher economic inequality weakens the perception of a community buffer, which is a key source of support for low-income people.

The researchers estimated this lack of support comes at a cost $6,587. This means that a person earning $36,587 in New Haven, where there is greater income inequality, experiences the same financial hardship as someone making $30,000 in a more homogenous income area like Princeton.

So, why do low-income people feel they can't ask community members for support? Many people hit by money problems worry about what others would think, so they don't ask for help. The researchers actually found that the higher the income inequality in an area, the more distrustful the poor are of those in their community.

Other factors are also perpetuating cycles of poverty in these places. One is a person's need to display his or her wealth for reasons of status through physical objects like a fancy car, which further indebts them. In other cases, people overwhelmed by destitution may resort to negative behaviors like taking out payday loans to cover the bills, which only worsens their financial situation.

All of this supports the strengthening of local communities, the researchers said. Programs like the YMCA are extremely beneficial, and community investment funds could further empower towns with the greatest income disparity. Infrastructure also matters; a city's walkability can bond neighbors together. In light of COVID-19, stimulus bills could help address some of these issues, while financially helping the most vulnerable.

"At a time when the coronavirus crisis puts a premium on cooperation and community support, our policymakers need to be aware of the social and economic conditions that eat away at such support, especially for the most vulnerable among us, the poor," Weber said.

The results do not shed light on how economic inequality affects people at median income levels, so the researchers encourage further work in this area. It is possible that the availability of liquid assets and other kinds of wealth could help in times of need, the researchers said.

In Jessica Barnes' palm is an ancient, coin-sized mosaic of glass, minerals and rocks as thick as a strand of wool fiber. It is a slice of Martian meteorite, known as Northwest Africa 7034 or Black Beauty, that was formed when a huge impact cemented together various pieces of Martian crust.

Barnes is an assistant professor of planetary sciences in the University of Arizona Lunar and Planetary Laboratory. She and her team chemically analyzed the Black Beauty meteorite and the infamous Allan Hills 84001 meteorite - controversial in the 1990s for allegedly containing Martian microbes - to reconstruct Mars' water history and planetary origins.

Their analysis, published today in Nature Geoscience, showed that Mars likely received water from at least two vastly different sources early in its history. The variability the researchers found implies that Mars, unlike Earth and the moon, never had an ocean of magma completely encompassing the planet.

"These two different sources of water in Mars' interior might be telling us something about the kinds of objects that were available to coalesce into the inner, rocky planets," Barnes said. Two distinct planetesimals with vastly different water contents could have collided and never fully mixed. "This context is also important for understanding the past habitability and astrobiology of Mars."

Reading the Water

"A lot of people have been trying to figure out Mars' water history," Barnes said. "Like, where did water come from? How long was it in the crust (surface) of Mars? Where did Mars' interior water come from? What can water tell us about how Mars formed and evolved?"

Barnes and her team were able to piece together Mars' water history by looking for clues in two types, or isotopes, of hydrogen. One hydrogen isotope contains one proton in its nucleus; this is sometimes called "light hydrogen." The other isotope is called deuterium, which contains a proton and a neutron in the nucleus; this is sometimes referred to as "heavy hydrogen." The ratio of these two hydrogen isotopes signals to a planetary scientist the processes and possible origins of water in the rocks, minerals and glasses in which they're found.

Meteorite Mystery

For about 20 years, researchers have been recording the isotopic ratios from Martian meteorites, and their data were all over the place. There seemed to be little trend, Barnes said.

Water locked in Earth rocks is what's called unfractionated, meaning it doesn't deviate much from the standard reference value of ocean water - a 1:6,420 ratio of heavy to light hydrogen. Mars' atmosphere, on the other hand, is heavily fractionated - it is mostly populated by deuterium, or heavy hydrogen, likely because the solar wind stripped away the light hydrogen. Measurements from Martian meteorites - many of which were excavated from deep within Mars by impact events - ran the gamut between Earth and Mars' atmosphere measurements.

Barnes' team set out to investigate the hydrogen isotope composition of the Martian crust specifically by studying samples they knew were originated from the crust: the Black Beauty and Allan Hills meteorites. Black Beauty was especially helpful because it's a mashup of surface material from many different points in Mars' history.

"This allowed us to form an idea of what Mars' crust looked like over several billions of years," Barnes said.

The isotopic ratios of the meteorite samples fell about midway between the value for Earth rocks and Mars' atmosphere. When the researchers' findings were compared with previous studies, including results from the Curiosity Rover, it seems that this was the case for most of Mars' 4 billion-plus-year history.

"We thought, ok this is interesting, but also kind of weird," Barnes said. "How do we explain this dichotomy where the Martian atmosphere is being fractionated, but the crust is basically staying the same over geological time?"

Barnes and her colleagues also grappled with trying to explain why the crust seemed so different from the Martian mantle, the rock later which lies below.

"If you try and explain this fairly constant isotopic ratio of Mars' crust, you really can't use the atmosphere to do that," Barnes said. "But we know how crusts are formed. They're formed from molten material from the interior that solidifies on the surface."

"The prevailing hypothesis before we started this work was that the interior of Mars was more Earthlike and unfractionated, and so the variability in hydrogen isotope ratios within Martian samples was due to either terrestrial contamination or atmospheric implantation as it made its way off Mars," Barnes said.

The idea that Mars' interior was Earthlike in composition came from one study of a Martian meteorite thought to have originated from the mantle - the interior between the planet's core and its surface crust.

However, Barnes said, "Martian meteorites basically plot all over the place, and so trying to figure out what these samples are actually telling us about water in the mantle of Mars has historically been a challenge. The fact that our data for the crust was so different prompted us to go back through the scientific literature and scrutinize the data."

The researchers found that two geochemically different types of Martian volcanic rocks -enriched shergottites and depleted shergottites - contain water with different hydrogen isotope ratios. Enriched shergottites contain more deuterium than the depleted shergottites, which are more Earth-like, they found.

"It turns out that if you mix different proportions of hydrogen from these two kinds of shergottites, you can get the crustal value," Barnes said.

She and her colleagues think that the shergottites are recording the signatures of two different hydrogen - and by extension, water - reservoirs within Mars. The stark difference hints to them that more than one source might have contributed water to Mars and that Mars did not have a global magma ocean.