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For many patients with a bicuspid aortic valve that needs replacing, transcatheter aortic valve replacement (TAVR) appears to be a safe treatment option with low complication rates, according to a study published in JACC: Cardiovascular Interventions. The study found patients with bicuspid valves who were at increased risk for surgery had a 30-day and one-year mortality rate and stroke rate that was similar to patients with the more common tricuspid valves.

An estimated 2% of the U.S. population has an aortic valve with two leaflets (bicuspid) instead of three (tricuspid). The aortic valve is a one-way valve between the heart and the aorta, the main artery from the heart that distributes oxygen-rich blood to the body. The leaflets, or flaps, normally open widely and close securely to regulate blood flow. This allows blood to flow from the heart to the aorta and prevents blood from flowing backwards into the heart. Having a bicuspid valve requires regular monitoring by a physician since it can lead to an increased risk of heart valve complications. Prior research has shown that up to 20% of people with a bicuspid valve will need replacement at some point.

"No one's valve works as well at age 70 as it does at age 20, but in patients with a bicuspid aortic valve, it's more likely to wear out and require replacement," said study lead author John K. Forrest, MD, director of the Structural Heart Disease Program at Yale University School of Medicine and Yale New Haven Hospital.

Since studies of TAVR have traditionally excluded bicuspid patients, until now it has not been known how these patients fare when they are treated with the procedure. To answer this question, the researchers used data from the STS/ACC TVT Registry, which collects data of all commercial TAVR cases in the U.S. They analyzed 932 patients with bicuspid valve disease who underwent TAVR with one of two valves, the Evolut R or Evolut PRO, between July 2015 and September 2018.

The patients in the study were at increased surgical risk, based on a number of factors including their age and whether they had medical conditions such as diabetes, prior surgery, stroke or peripheral vascular disease. The majority of bicuspid patients in this study were at intermediate or high surgical risk.

These patients were compared to similar patients with tricuspid valve disease who underwent TAVR during that same time period. The study found similar rates of death from any cause at 30 days (2.6% vs. 1.7%) and one year (10.4% vs. 12.1%), as well as the rate of stroke at 30 days (3.4% vs. 2.7%) and one year (3.9% vs. 4.4%).

In the last decade, TAVR has become an increasingly popular way to replace aortic valves. TAVR is a minimally invasive procedure in which a catheter is used to deliver a replacement valve to the site of the old valve, thus avoiding open-heart surgery. While initially reserved for patients whose poor health makes an open-heart valve replacement too risky, recent studies have shown that in patients with tri-leaflet aortic stenosis, TAVR is a viable option even for low-risk patients.

"This study suggests TAVR is a viable option for patients with bicuspid valve disease who are at increased surgical risk," Forrest said. "It will be very important to continue to monitor these patients to see how the valves perform in 10 or 15 years."

What The Study Did: Researchers looked at trends in diversity by sex and race/ethnicity among applicants to U.S. surgical residency and fellowship programs from 2008-2018 to see if diversity was increasing.

Authors: Issam Koleilat, M.D., of the Montefiore Medical Center in New York, 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/jamasurg.2020.1018)

Editor's Note: The article includes conflict of interest 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.

PHILADELPHIA -- The majority of commercially insured patients who visited the emergency department (ED) for an opioid overdose didn't receive the timely follow-up care known to help prevent a future overdose or death, according to a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania. Of nearly 6,500 patients treated in EDs nationwide for an overdose or other opioid-related medical complications, only 16 percent accessed opioid use disorder (OUD) medications or another form of treatment within three months of the ED visit. The study was published today in JAMA Network Open.

The lack of care was most pronounced among black patients, who were half as likely to receive post-overdose treatment as whites, even after adjusting for type of overdose (prescription or heroin), and other clinical characteristics. Timely follow-up treatments are known to significantly reduce the risk of death among patients suffering from opioid use disorders who are admitted to the ED.

"The ED encounter has been seen as a critical opportunity to engage a patient and connect them to the right care that gives them the best chance for recovery," said the study's first author Austin Kilaru, MD, an emergency department physician and a fellow in the National Clinician Scholars Program at Penn. "However, even with commercially insured patients, who likely have superior ability to access care, we see these low treatment rates, particularly for minorities. There's more work to be done, and these findings give us a comprehensive picture of the gaps and disparities that could help inform those efforts moving forward."

The team analyzed administrative insurance claims under a large commercial insurer filed between October 2011 and September 2016. Researchers defined follow-up treatments as the prescription of medication for opioid use disorder (MOUD)--buprenorphine and naltrexone--or an outpatient or inpatient opioid treatment encounter, which could include behavioral health services or primary care visits. While the study did include two MOUDs shown to reduce the risk of death and overdoses, it did not capture the use of methadone, another common MOUD, because the insurer did not cover it at the time.

Of the 6,451 adult patients treated in EDs nationwide, 4,555 overdosed from prescription opioids and 1,896 overdosed from heroin. Nearly 75 percent of the patients identified as non-Hispanic white and about 10 percent identified as black. Within that group, only 1,069 received follow-up care after being discharged from the ED. Most notably, black patients were half as likely to obtain treatment following overdose compared with white patients (6.1 percent versus 12.1 percent). Hispanic and female patients were also less likely to receive treatments.

Researchers found that patients who had received treatment prior to being admitted to ED were more likely to receive follow-up care. In fact, more than 62 percent of patients who had received prior treatment for an overdose received the follow-up care. Among patients who did not receive treatment 90 days prior to the ED visit (5,769), only about 10 percent--or 643--received follow-up care.

The findings demonstrate that there are barriers to follow-up care beyond being underinsured or uninsured and other factors limiting access that warrant further attention.

Increased adoption of pathways to initiate buprenorphine in the ED, more coordinated communication between EDs and outpatient clinics, and direct conversations between physicians and patients around treatments may help improve that access. These interventions, the authors said, must seek to reduce racial, ethnic, and gender disparities to ensure expanded and equitable access to treatment following overdose.

Since the study time period ended, some hospitals across the country have implemented changes to help address this issue. For example, Penn established its Center for Opioid Recovery and Engagement (CORE), which has helped improve the pathway to recovery for many patients, regardless of insurance status, by implementing such efforts and more.

"The period after an overdose is so high risk that we need to be able to use that key window of opportunity," Kilaru said. "Payers and policymakers should push for strategies that encourage, help, and incentivize health systems to deliver the timely follow-up care we know can save more lives."

What The Study Did: Clinical characteristics of patients with asymptomatic or symptomatic COVID-19 are described in this case series from Wuhan, China.

Authors: Yong Xiong, Ph.D., of Wuhan University in China, 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/jamanetworkopen.2020.10182)

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

What The Viewpoint Says: How psychiatrists can contribute to diminish the effects of the COVID-19 pandemic is discussed.

Authors: Jurjen J. Luykx, M.D., Ph.D., of University Medical Center Utrecht and Utrecht University in the Netherlands, 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/jamapsychiatry.2020.1225)

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

A new understanding of our planet's deepest earthquakes could help unravel one of the most mysterious geophysical processes on Earth.

Deep earthquakes -- those at least 300 kilometers below the surface -- don't typically cause damage, but they are often widely felt. These earthquakes can provide vital clues to understanding plate tectonics and the structure of the Earth's interior. Due to the extremely high temperature and pressures where deep earthquakes occur, they likely stem from different physical and chemical processes than earthquakes near the surface. But it's hard to gather information about deep earthquakes, so scientists don't have a solid explanation for what causes them.

"We can't directly see what's happening where deep earthquakes occur," said Magali Billen, professor of geophysics in the UC Davis Department of Earth and Planetary Sciences.

What's driving deep earthquakes?

Billen builds numerical simulations of subduction zones, where one plate sinks below another, to better understand the forces controlling plate tectonics. Her recent work helps explain the distribution of deep earthquakes, showing that they most often strike in regions of "high strain" where a sinking tectonic plate bends and folds.

"These models provide compelling evidence that strain rate is an important factor in controlling where deep earthquakes occur," she said.

The new understanding that deformation is a major factor in deep earthquakes should help scientists resolve which mechanisms trigger deep earthquakes and can provide new constraints on subduction zone structure and dynamics, Billen said.

"Once we understand deep earthquake physics better, we will be able to extract even more information about the dynamics of subduction, the key driver of plate tectonics," she said.

Her findings were published May 27 in the journal Science Advances.

New way to study deep earthquakes

Deep earthquakes occur in subduction zones -- where one of the tectonic plates floating on the surface of the Earth dives under another and is "subducted" into the mantle. Within the sinking slabs of crust, earthquakes cluster at some depths and are sparse in others. For example, many slabs exhibit large gaps in seismic activity below 410 kilometers in depth.

The gaps in seismicity line up with regions of the slab that are deforming more slowly in the numerical models, Billen said.

"Deformation is not the same everywhere in the plate," Billen said. "That's really what's new here."

Billen's research was not originally intended to investigate deep earthquakes. Rather, she was trying to understand the slow back-and forth motion of deep ocean trenches, where plates bend downward in subduction zones.

"I decided out of curiosity to plot the deformation in the plate, and when I looked at the plot, the first thing that popped in my mind was 'wow, this looks like the distribution of deep earthquakes,'" she said. "It was a total surprise."

Mimicking the deep Earth

Billen's model incorporates the latest data about phenomena such as the density of minerals, different layers in the sinking plate, and experimental observations of how rocks behave at high temperatures and pressures.

"This is the first model that really brings together the physical equations that describe the sinking of the plates and key physical properties of the rocks," Billen said.

The results cannot distinguish between possible causes for deep earthquakes. However, they do provide new ways to explore what causes them, Billen said.

"Taking into account the added constraint of strain-rate should help to resolve which mechanisms are active in the subducting lithosphere, with the possibility that multiple mechanisms may be required," she said.

The project was supported by a fellowship from the Alexander von Humboldt Foundation and an award from the National Science Foundation. The Computational Infrastructure for Geodynamics supports the CitcomS software used for the numerical simulations.

Electronic Cigarettes Trigger an Inflammatory Response That May Set the Stage for Gum Disease

The oral microbiomes of 25 otherwise healthy participants who use e-cigarettes daily closely match those seen in patients with gum disease, a new study shows. The results suggest that e-cigarettes trigger a proinflammatory response, coating commensal bacteria in the mouth with a layer of slime that makes them unrecognizable to the body and prevents the sequential colonization of other bacteria that form a healthy community. Sukirth Ganesan and colleagues conclude that the glycerol/glycol vehicle in e-cigarettes appears to drive these changes. E-cigarettes have grown wildly popular among Americans, with six percent of the country's population - including 2.5 million high schoolers - puffing on the products nine years after their introduction to the United States. But while these e-cigarettes contain potentially toxic substances, including volatile organic compounds and metals, much remains unknown their long-term effects on human health. To gain insight into how e-cigarettes affect the oral microbiome, Ganesan et al. recruited 123 otherwise healthy individuals, including 25 smokers, 25 nonsmokers, 20 e-cigarette users, 25 former smokers currently using e-cigarettes, and 28 smokers who also use e-cigarettes. They created a catalog of bacterial genes in the microbial communities of e-cigarette users based on plaque samples collected from their teeth, finding that variations arose based on the duration of e-cigarette use, but were not tied to variations in the concentration of nicotine or the type of flavoring. The researchers also observed that while both smoking and e-cigarette use cause inflammation, they do so through different molecular pathways. "I am hoping this research will drive some level of policymaking about the harm we are seeing," said Purnima Kumar, a coauthor of the study, in an interview, challenging the popular perception that e-cigarettes provide a safer alternative to smoking. "If we can see changes in people who are otherwise healthy and have nothing wrong with them, then we should start seriously considering why would you put their lives and their wellbeing at risk."

Melanoma is a malignant tumour resulting from the transformation of melanocytes, the cells in the skin that undertake to synthesise melanin, a complex polymer which protects us from the negative effects of solar radiation. Although melanoma is the least common among skin cancers, it is the one with the highest mortality rate, largely because of its high potential for metastasis.

Once a patient has been diagnosed with advanced-stage melanoma, an assessment is made as to whether he or she stands to benefit from adjuvant therapy with BRAF inhibitors. To do this, clinical laboratories analyse whether or not the patient has a specific mutation in the BRAF gene, specifically the BRAF-V600E mutation, which is one of the most common in melanoma and is regarded as a "driver" mutation, in other words, a mutation that provides an advantage in the onset of tumour transformation and growth.

However, it is becoming increasingly clear that tumours are highly heterogeneous and that there are subpopulations of cells with different mutations and behaviours within the same tumour. "So we believe that quantifying the mutation provides much more information that just trying to detect it (positive or negative). This quantification can be made by means of biopsies using a novel technique known as digital PCR," explained Arrate Sevilla, a researcher in salonsoLab (Evolutionary Human Biology Group), in the UPV/EHU's Department of Genetics, Physical Anthropology and Animal Physiology.

In the study the mutational load was analysed in biopsies of 78 patients and the load of the BRAF-V600E mutation was found to inversely correlate with the stage of the patients, which suggests that it could be useful as a prognosis marker. But in addition, the most interesting thing is that in patients in stage II it correlated inversely with the development of metastasis. That means that the patients who had developed metastasis also tended to have a lower percentage of the mutation in their primary tumours. So by means of predictive analyses based on machine learning, the mutational load of BRAF-V600E was found to be capable of categorizing stage II patients under metastatic and non-metastatic ones in a slightly more accurate way than the routinely used marker: the Breslow thickness marker.

According to the analyses made by this group, which besides the UPV/EHU has had the intervention of scientists from the Biocruces Bizkaia Institute, Onkologikoa and Ikerbasque, the mutation load appears to be linked to the prognosis. "In stage II patients, at least, it could be a predictor of progress to metastasis," said Sevilla.

These results are preliminary ones, so this possible marker would need to be validated in a much bigger cohort of patients. "However, we believe that our discovery is on the right track, it is novel and opens up the door to additional studies on the evolutionary mechanisms of this tumour," added the researcher.

Kyoto, Japan -- A staple in every science classroom is the periodic table of elements, and for many it is their first introduction to the vast mysteries of the natural world.

Now physicists from Kyoto University have unveiled a new table that provides a different perspective on the building blocks of the universe. While the traditional table is based on the behavior of electrons in an atom, this new table is based on the protons in the nucleus.

"The periodic table of the elements is one of the most significant achievements in science, and in its familiar form it is based on the shell structure of electron orbitals in atoms," explains Yoshiteru Maeno, one of the co-developers of the new table.

"But atoms are comprised of two types of charged particles that designate each element: electrons orbiting the core and protons in the core itself."

The team's new 'Nucletouch' table -- also available as a 3D model -- was announced recently in the journal Foundations of Chemistry.

Over 150 years have passed since Dmitri Mendeleev discovered the periodic law that lead him to propose the classic periodic table. He even had the foresight to add space for elements that were still unknown in his time.

"Fundamentally, it comes down to the electrons in each atom. Atoms are considered to be stable when electrons completely fill their 'shell' of orbits around the nucleus," continues Maeno.

"So-called 'noble gases', inert elements such as helium, neon, and argon, rarely react with other elements. Their most stable electron numbers are 2, 10, 18, 36, and so on."

Maeno decribes these as atomic 'magic numbers', and importantly the same principle can also be applied to protons. Imagining that protons in a nucleus exist in 'orbits' may seem like a stretch, but the discovery of the concept was awarded the 1963 Nobel prize in physics.

Protons have different stable magic numbers: 2, 8, 20, 28, and so on. Among these are familiar elements such at helium, oxygen, and calcium. The Nucletouch table places these 'magic nuclei' at its center, providing a new perspective on the elements.

"Similar to electrons, when nuclear orbits are filled with protons, they form stable nuclei, analogous to the noble-gas elements," says collaborator Kouichi Hagino.

"In our nuclear periodic table, we also see that nuclei tend to be spherically-shaped near the magic numbers, but deformed as you move away from them."

The team made the table to highlight alternative ways to illustrate the laws of nature, and hopes that enthusiasts and academics alike will find something to enjoy and learn from this fresh new look at an old friend.

A re-analysis of dinosaur skulls from northern Alaska suggests they belong to a genus that lived over a broad latitudinal range extending into the Arctic.

The plant-eating, broad-beaked dinosaurs that lived in northern Alaska some 69 million years ago belong to the genus Edmontosaurus, and not to the genus recently proposed by scientists in 2015. The finding suggests this group of dinosaurs existed over a broad latitudinal range, extending from northern Colorado all the way up into the Arctic.

The research was conducted as part of a Perot Museum of Nature and Science's project, joined by Hokkaido University and Okayama University, and published in the journal PLOS ONE.

The Liscomb Bonebed quarry in northern Alaska is rich in dinosaur fossils belonging to the family Hadrosauridae. Biological classifications, or taxonomy, of the hadrosaurid dinosaur found there has puzzled scientists since the 1980s. Scientific consensus eventually classified them as the genus Edmontosaurus, until a group of scientists proposed that the Alaskan hadrosaurids represent a unique genus and species, and named Ugrunaaluk in 2015. However, other scientists questioned the validity of the taxon.

The incompleteness and the immaturity of the Alaskan hadrosaurine fossils make their classification difficult. To overcome this problem, Ryuji Takasaki, former Ph.D. student at Hokkaido University, and his colleagues in Japan and the US specifically examined skull bones. This minimized danger of mixing bones of the two hadrosaurid clades known from the same site: Hadrosaurinae and Lambeosaurinae. Bones from body parts of immature hadrosaurine and lambeosaurine dinosaurs cannot be readily distinguished from each other.

The team compared the skull bones of Hadrosaurinae with those of other hadrosaurines, especially with known Edmontosaurus from lower latitude North America. They found enough evidence to suggest that the Liscomb Bonebed hadrosaurine bones previously named Ugrunaaluk are likely to represent an immature form of the genus Edmontosaurus.

"We recommend the conservative approach of referring them to Edmontosaurus until further discoveries of more mature individuals from the area can resolve the issue," says Takasaki.

Clarifying the taxonomy of the Liscomb Bonebed hadrosaurines can help scientists understand how they lived and evolved. "Re-attribution of the Alaskan hadrosaurines to Edmontosaurus suggests they lived over a broad range of latitudes extending from northern Colorado to northernmost Alaska," says Takasaki. The few anatomical differences among Edmontosaurus, despite of their broad range, suggest they did not evolve much in order to adapt. A small temperature gradient over that area at that time could be one reason to establish the small differences, according to the researchers.

Moreover, Yoshitusugu Kobayashi at Hokkaido University Museum, a co-author of this paper, recently named a new genus species Kamuysaurus japonicus in Hokkaido, Japan, which belongs to Edmontosaurini as Edmontosaurus does. "Taken these studies together, this group of hadrosaurs, the Edmontosaurini, were widely distributed in the northern circum-Pacific region, meaning that they were incredibly successful dinosaurs," Kobayashi commented. "It's fascinating to think they likely used the ancestral Bering Land Bridge between Asia and North America for migration in a manner similar to mammoths, woolly rhinoceroses, and early humans."

POSTECH Professor Seung-Ki Min’s joint research team identifies the mechanism behind the reduction in precipitation after volcanic eruptions

Volcano-induced El Niño amplifies the reduction in precipitation. Safety of geoengineering that mimic volcanoes is not guaranteed.

Climate change is occurring all over the globe as 1°C increase in Earth’s surface temperature has led to the sea level rise, abrupt melting of the Arctic sea ice, and the increase in extreme weather events such as heat waves, droughts, and floods. To accurately predict the anthropogenic climate changes under the increase in greenhouse gases, it is important to understand the effects of natural factors such as solar and volcanic activities. A recent study has shown how global precipitation decreases when volcanoes erupt in the tropics.

Professor Seung-Ki Min and Dr. Seungmok Paik of Division of Environmental Science and Engineering at POSTECH and researchers from the French National Centre for Scientific Research, Swiss Federal Institute of Technology in Zurich, and University of Edinburgh have released new findings that the El Niño induced by volcanic eruptions plays a key role in the decrease in global precipitation. So far, studies have shown that volcanic activity reduces precipitation across the globe, but its specific mechanism had been unclear. These research results were recently published in Science Advances, a sister journal of Science.

During the two to three years following Mount Pinatubo’s eruption in 1991, the average global temperature fell by about 0.2 degrees. This is because the massive dust including sulfur dioxide emitted by the eruption reflected the light from the sun and blocked its heat from reaching the Earth’s surface. Volcanic activities, along with this cooling effect, reduce the global terrestrial precipitation but its amplitude greatly varies depending on climate model simulations. For the first time, the joint research team confirmed that the main factor for the drop in precipitation after volcanic eruptions is the difference in El Niño’s response.

El Niño is a natural climate variability that occurs every three to eight years, with weakened trade winds in the equatorial Pacific Ocean and warmer sea surface temperatures in the equatorial eastern Pacific, causing extreme weather conditions across the globe including drought and heavy rains. Under El Niño’s influence, precipitation reduction occurs especially in the global monsoon regions, including Southeast Asia, India, South Africa, Australia and northern South America.

The team compared several climate model simulations and found that El Niño appeared in the year following a volcanic eruption in most models, with a significant drop in precipitation around the global monsoon region. In particular, the strength of El Niño was different for each simulation, and the stronger the El Niño, the more pronounced the reduction in precipitation occurred. The research team also found that the stronger the volcanic forcing and the greater the warm water volume in the western Pacific Ocean, a stronger El Niño developed, which in turn intensified the reduction in precipitation.

Public parks are many things to many people: a space devoid of domestic chores and patriarchal expectations, a spot to cultivate friendship or love, a place where you can experience a feeling of freedom that is absent elsewhere, an opportunity to &laquovisit» trees from a country you have not seen in a long time, a way of being part of a group while sitting alone on your bench - or even the perfect setting for running a small business to help you get by. Public parks are all this and much more if we're to believe the inhabitants of four Asian mega-cities - Chennai, Singapore, Manila and Shanghai - who were interviewed as part of a recently-published study. Green spaces, we learn, do much more than simply benefit biodiversity and health: they also meet numerous other essential human needs that open the door to sustainable well-being, a concept based on a combination of personal well-being and the necessities of sustainable development.

"There are many theories that try to define human well-being,» begins Marlyne Sahakian, a professor in the Department of Sociology in UNIGE's Faculty of Social Sciences and the study's first author. &laquoInstead of using subjective notions such as happiness, we used a list of nine 'protected needs' that has recently been developed by colleagues from the University of Basel. These needs correspond to what society can offer the population through the public sector. This list of protected needs is the result of an analysis of the scientific literature and was validated among the Swiss population and by panels of experts."

The nine capital needs

In concrete terms, the list is made up of the following nine items: (1) the availability of goods that satisfy vital needs; (2) turning your own idea of everyday life into reality; (3) living in a pleasant environment; (4) growing as a person; (5) self-determination; (6) doing activities that you value; (7) being part of a community; (8) taking part in decisions about the future of society; and (9) being protected by society.

Armed with this list, researchers from the four Asian cities, co-signatories of the study, asked residents about their use of public parks and the benefits they derived from them. An analysis of their responses first showed that ordinary people can assess their well-being using these protected needs, making the distinction between what they need and what they want. "This suggests that meeting human needs is a societal goal that can be discussed by diverse groups of people around the world," says Professor Sahakian before adding: "This has implications for city planning measures designed to ensure everyone's sustainable well-being for today and tomorrow. In the cities of South Asia in particular, parks - which offer a naturally cool, shaded microclimate - are a precious alternative to other leisure spaces, such as air-conditioned shopping centres."

Inclusion rather than exclusion

The research, which was supported by the Swiss Network for International Studies, also found that the use of green spaces fulfils all the protected needs to a certain degree. Three of these needs (3, 4 and 7) however, have a score that is significantly higher than the others.

"Going to the park is a social activity that requires more than just a green space, argues Professor Sahakian. People do different kinds of things in parks to meet the same need, such as exercising, chatting with other people, reading a book, meeting a group or learning about biodiversity. These are very inclusive spaces, where there is ready access for everyone, unlike what happens in shopping centres, which can operate quite a strong form of social segregation. In the immediate context of a post-COVID-19 environment, where public spending will probably be more limited than before, it is all the more important to maintain the infrastructure of the parks (water access points, toilets, trails, etc.) and to ensure access so that they can continue to meet everyone's needs."

When people are highly confident in a decision, they take in information that confirms their decision, but fail to process information which contradicts it, finds a UCL brain imaging study.

The study, published in Nature Communications, helps to explain the neural processes that contribute to the confirmation bias entrenched in most people's thought processes.

Lead author, PhD candidate Max Rollwage (Wellcome Centre for Human Neuroimaging at UCL and Max Planck UCL Centre for Computational Psychiatry & Ageing Research) said: "We were interested in the cognitive and neural mechanisms causing people to ignore information that contradicts their beliefs, a phenomenon known as confirmation bias. For example, climate change sceptics might ignore scientific evidence that indicates the existence of global warming.

"While psychologists have long known about this bias, the underlying mechanisms were not yet understood.

"Our study found that our brains become blind to contrary evidence when we are highly confident, which might explain why we don't change our minds in light of new information."

For the study, 75 participants conducted a simple task: they had to judge whether a cloud of dots was moving to the left or right side of a computer screen. They then had to give a confidence rating (how certain they were in their response), on a sliding scale from 50% sure to 100% certain.

After this initial decision, they were shown the moving dots again and asked to make a final decision. The information was made even clearer the second time and could help participants to change their mind if they had initially made a mistake. However, when people were confident in their initial decision, they rarely used this new information to correct their errors.

25 of the participants were also asked to complete the experiment in a magnetoencephalography (MEG) brain scanner. The researchers monitored their brain activity as they processed the motion of the dots.

Based on this brain activity, the researchers evaluated the degree to which participants processed the newly presented information. When people were not very confident in their initial choice, they integrated the new evidence accurately. However, when participants were highly confident in their initial choice, their brains were practically blind to information that contradicted their decision but remained sensitive to information that confirmed their choice.

The researchers say that in real-world scenarios where people are more motivated to stand by their beliefs, the effect may be even stronger.

Senior author Dr Steve Fleming (Wellcome Centre for Human Neuroimaging at UCL, Max Planck UCL Centre for Computational Psychiatry & Ageing Research and UCL Experimental Psychology) said: "Confirmation bias is often investigated in scenarios that involve complex decisions about issues such as politics. However, the complexity of such opinions makes it difficult to disentangle the various contributing factors to the bias, such as wanting to maintain self-consistency with our friends or social group.

"By using simple perceptual tasks, we were able to minimise such motivational or social influences and pin down drivers of altered evidence processing that contribute to confirmation bias."

In a previous, related study, the research team had found that people who hold radical political views - at either end of the political spectrum - aren't as good as moderates at knowing when they're wrong, even about something unrelated to politics.

Because the neural pathways involved in making a perceptual decision are well understood in such simple tasks, this makes it possible for researchers to monitor the relevant brain processes involved. The researchers highlight that an understanding of the mechanism that causes confirmation bias may help in developing interventions that could reduce people's blindness to contradictory information.

Max Rollwage added: "These results are especially exciting to me, as a detailed understanding of the neural mechanisms behind confirmation bias opens up opportunities for developing evidence-based interventions. For instance, the role of inaccurate confidence in promoting confirmation bias indicates that training people to boost their self-awareness may help them to make better decisions."

A recent study among 3- to 7-year-old children showed that children's motor skills benefitted if a child was older and participated in organised sports. Additionally, the study provided information about the importance of temperament traits for motor skills. More specifically, traits such as activity and attention span persistence were found to be positively associated with motor skills. This was a rather novel result, as the association between motor skills and temperament during early childhood is not yet widely understood.

In essence, motor skills comprise locomotor, ball and balance skills, all of which are present in everyday life tasks like running, climbing, throwing and drawing. Adequate motor skills enable participation in typical games and types of playing for different ages and developmental phases, for example, in tag, running and ball games.

"Even though motor skills develop as a function of age, skill development still needs to be stimulated consciously," says Donna Niemistö, a PhD student from the Faculty of Sport and Health Sciences, University of Jyväskylä. "Motor skills do not develop without practising, thus skills need reinforcement through repetition of the skills. Motor skill development is greatly supported when the child is moving in multiple ways. In a current study we found more evidence that participation in organised sports can be useful to gain more opportunities to practise and repeat essential movements."

Temperament and its traits refer to a child's biological and individual characteristics, such as the biological way of reacting to one's surroundings. Temperament is rather stable over time. To date, there have been only a handful of studies concerning young children's motor skills and temperament traits, even though in older age groups, more research is already available.

"Children who tend to have an active type of temperament, as well as children who show persistency when faced with challenges can be motivated and persistent in learning and rehearsing motor tasks. Therefore, these findings were expected and logical. A child with an active temperament can react more rapidly. Consequently, the child will get more opportunities to move along with increased repetitions. Without noticing, the child will also gain more opportunities to perform motor tasks."

Additionally, the capacity to maintain attention is equally important for skill acquisition.

"To learn new skills, one must be able to concentrate and maintain focus even though the skill may, at first, feel challenging or even difficult," continues Niemistö.

Both temperament traits can influence the development of motor skills. Therefore, it is important that parents as well as early educators and teachers are aware of these individual factors in case they want to encourage and support their children's motor skill development.

"For example, there is no need to emphasize for an active child to be more active," Niemistö explains. "However, with an active child, a parent could guide the child to maintain focus and attention, despite possible distractions in the surroundings."

Motor skills were assessed with two internationally well-known measurements. The first assessment tool measured the locomotor and ball skills and the second one the balance and coordination skills of the child. As the chosen assessment tools measured divergent aspects of motor development, differences between associated factors related to motor skills were also found.

"The development of balance and coordination skills was better in those children who were described as more emotionally regulated," says Niemistö. "On the other hand, locomotor skills were better in children whose parents had higher educational level and the development of ball skills benefitted if children had free access to sport facilities in nearby surroundings."

The Skilled Kids study, conducted at the University of Jyväskylä from 2015 to 2017, had a geographically representative study sample of 945 children and their families from 37 different childcare centres in Finland. Children's temperament traits and participation in organized sports were assessed using a parental questionnaire.

What is the origin of the asteroids Bennu and Ryugu, and of their spinning-top shape? An international research team led by Patrick Michel, a CNRS researcher at the Laboratoire Lagrange (CNRS/Observatoire de la Côte d'Azur/Université Côte d'Azur) and Ronald-Louis Ballouz from the University of Arizona, proposes an answer to this question in an article published in Nature Communications on May 27, 2020. Numerical simulations of large asteroid disruptions, such as those that take place in the asteroid belt between Mars and Jupiter, show that during such events, fragments are ejected and then reaccumulate forming aggregates, some of which have a spinning-top shape. The simulations also show that Bennu and Ryugu may have formed from the disruption of the same parent asteroid even though their levels of hydration are different. The scientists conclude that the overall properties of these asteroids could directly result from the disruption of their parent body. The analysis of return samples from Ryugu and Bennu by the Hayabusa2 (JAXA) and OSIRIS-REx (NASA) spacecraft will allow us to verify this by measuring precisely their composition and by determining their formation age.