Culture

Despite a national opioid-related overdose epidemic that continues to claim tens of thousands of lives annually, a new nationwide study shows that a scant proportion of hospitalized patients with opioid use disorder receive proven life-saving medications both during and after they're discharged.

The study published in the Journal of General Internal Medicine.

"It really paints a bleak picture of the current state of affairs about the treatment of people with opioid use disorder nationwide," said lead author Kelsey Priest, Ph.D., M.P.H., a health systems researcher and current M.D./Ph.D. student in the Oregon Health & Science University School of Medicine.

The study plumbed an extensive database of patients in the Department of Veterans Affairs health care system. Researchers identified more than 12,000 patients across 109 hospitals who were hospitalized for various reasons but also had underlying opioid use disorder during the fiscal year ending in 2017.

The researchers identified 10,969 patients who had opioid use disorder at the time they were hospitalized but weren't receiving treatment. Of those patients, only 203 - 2% - received a medication to treat opioid use disorder while they were in the hospital and were subsequently linked to care after their discharge. That's important because findings from an earlier study from OHSU showed that patients who received medication such as buprenorphine in the hospital are twice as likely to continue their therapy after discharge.

"This is a huge missed opportunity," said co-author Honora Englander, M.D., associate professor of medicine in the OHSU School of Medicine.

Englander is director of an in-hospital intervention program that OHSU started in 2015.

Project IMPACT, or Improving Addiction Care Team, brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. The program is a rare exception, although part of a small but growing cohort of hospitals nationwide implementing these services. The need for these interventions is clear based on the study published today.

"Hospitalization is a reachable moment to initiate and coordinate therapy to treat substance use disorder," Englander said. "This study shows that in the VA - which most likely out-performs other U.S. hospitals - life-saving, evidence-based treatment is rarely prescribed."

Opioid agonist therapies available in the hospital include methadone or buprenorphine. Both relieve withdrawal symptoms and pain, normalizing brain function by acting on the same targets in the brain as prescription opioids or heroin.

A University of Cincinnati researcher says a study of COVID-19 patients shows loss of the sense of smell is most likely to occur by the third day of infection with the novel virus. Most of these patients are also experiencing a loss of the sense of taste.

The prospective, cross sectional telephone study examined characteristics and symptoms of 103 patients who were diagnosed with COVID-19 over a six-week period at Kantonsspital Aarau in Aarau, Switzerland. Patients were asked how many days they had COVID-19 symptoms and also asked to describe the timing and severity of loss or reduced sense of smell along with other symptoms.

At least 61% of the patients reported reduced or lost sense of smell, says Ahmad Sedaghat, MD, PhD, an associate professor in the UC College of Medicine's Department of Otolaryngology-Head and Neck Surgery and an UC Health physician specializing in diseases of the nose and sinuses, who was the principal investigator of the study. The mean onset for reduction or loss in the sense of smell was 3.4 days.

The findings are available online in the scholarly journal Otolaryngology-Head and Neck Surgery. The first author of the research is Marlene Speth, MD, at the Switzerland hospital.

"We also found in this study that the severity of the loss of smell is correlated with how bad your other COVID-19 symptoms will be," says Sedaghat. "If the anosmia, also known as loss of smell, is worse, the patients reported worse shortness of breath and more severe fever and cough."

"Should that concern patients?" says Sedaghat. "The relationship between decreased sense of smell and the rest of the COVID-19 is something to be aware of. If someone has a decreased sense of smell with COVID-19 we know they are within the first week of the disease course and there is still another week or two to expect."

Sedaghat says an experimental antiviral drug, remdesivir, developed by Gilead Sciences to initially treat Ebola, is showing some promise in treating COVID-19 patients. It has been granted emergency approval by the U.S. Food and Drug Administration to treat severely ill COVID-19 patients, since a National Institutes of Health-sponsored clinical trial showed that patients experienced a shorter recovery time when taking remdesivir compared to a placebo.

Sedaghat says that having an available antiviral treatment for COVID-19 may mean it's much more important to have an indicator of prognosis and how far the disease has progressed in patients.

"Antiviral medications have historically worked best when given early during a viral infection. The same is hypothesized to be true for remdesivir," says Sedaghat. "Our study indicates that a decreased sense of smell may be an indicator of patients early in the disease course as well as those who may go on to develop more severe symptoms, like shortness of breath, later on. "Once remdesivir becomes more widely available, decreased sense of smell may therefore identify patients who would be excellent candidates for the medication," he says.

Sedaghat cautions that while the loss of smell is an indicator of COVID-19, it's not the only factor. "When you start to experience serious symptoms of COVID-19 which include shortness of breath and respiratory distress, that's when you should become alarmed," he adds.

The study also found that younger patients and women in the study were also more likely to experience a decreased loss of smell, says Sedaghat.

Also, about 50% of study patients experienced a stuffy nose and 35% experienced a runny nose. Sedaghat says this is important because previous studies indicated that these nasal symptoms were rare in COVID-19 and these symptoms were attributed to allergy and not the novel coronavirus.

"This just means that greater awareness is needed of COVID-19's nasal symptoms so people are not running around sneezing in public and thinking it is okay since this is just allergies," says Sedaghat. "It very well could be COVID-19 and wearing masks as protective gear for others you encounter is a good idea."

Sedaghat says understanding more about loss of smell and COVID-19 is important for a public health perspective.

"No one is going to die because of a loss of the sense of smell and it's not the symptom that will kill anyone," says Sedaghat. "However, it is important because it helps us to identify these COVID-19 patients as asymptomatic carriers so they don't spread the disease to others. Now we can potentially identify them early during the disease to start antiviral medications and ultimately maximize our ability to effectively treat these patients."

Washington State legalized cannabis sales to adults in 2012, the first U.S. state to do so. Yet little is known about how police, who are on the front lines of implementing the law, experience legalization. A new study evaluated the effects of legalizing cannabis on police officers' law enforcement efforts in Washington. The study found that officers in that state, although not supportive of recriminalization, had a variety of concerns, from worries about the effect on youth to increases in impaired driving. The study can inform other states' efforts to address legalization.

Conducted by researchers at Washington State University (WSU), the study appears in Justice Evaluation Journal, a publication of the Academy of Criminal Justice Sciences.

"The trend both nationally and internationally is toward greater decriminalization, medicalization, and legalization of cannabis," says Mary Stohr, professor of criminal justice and criminology at WSU, who led the study. "Because this represents a significant policy shift in the war on drugs, which focused on the volume of arrests and prosecutions of marijuana use and sales, it is imperative that we listen to the voices of police in a state like Washington for insight into areas of impact."

To determine how the change in law affected law enforcement, researchers held focus groups to speak with 48 police officers from nine police, sheriff, and tribal agencies around Washington in 2017 and 2018. Officers came from rural, suburban, urban, and college agencies, as well as agencies with statewide jurisdiction and a Native American tribe. While the officers represented a mix of ages, genders, races and ethnicities, years on the job, and types of experience, most were White males with more than five years of experience in police work.

Among the questions asked were ones that attempted to determine how marijuana possession was handled by the police prior to and after legalization, whether and how officers' jobs have changed since legalization, and whether legalization has made things easier or more challenging for police agencies.

The study found that while police officers were not necessarily opposed to the law, they expressed concerns about a variety of issues, including:

Youth access and use: With legalization, youth have easier access to marijuana and the use of the substance is therefore normalized, officers said.

Lack of appropriate educational programs: In the runup to legalization, the state did not develop adequate educational programs to inform youth about the dangers of marijuana, many officers said.

Increases in drugged driving: Officers expressed concern about the challenge of legalization for traffic law enforcement and safety, saying they struggled with how to manage potential cannabis DUI cases and were encountering more impaired drivers.

Prosecutors' reluctance to charge offenders: Cannabis remains illegal outside of regulatory confines, but officers noted the reluctance of some prosecutors to bring charges after legalization because of the risk of the charges being dismissed.

Lack of police preparation for legalization: While some officers said their agencies had prepared them, others said they had not received sufficient training on how to manage incidents involving cannabis since legalization within regulatory boundaries.

The impact on police workload: Despite claims that legalization would allow officers to reallocate resources from cannabis enforcement, most officers said legalization had not reduced their workload.

Asked to provide guidance for agencies in other states that would soon operate in a legalized environment for marijuana, the officers called for broad public educational programs (emphasizing juveniles and drivers and how the law affects them), more research on the effects of cannabis and impairment from the drug, and expanded officer training (especially on the regulatory rules governing growing cannabis). They also suggested that base pay for officers be increased, given the increasing role they play now that cannabis is legal.

"The purpose of our study was to add a key stakeholder's voice to the conversation--that of police officers," notes Craig Hemmens, professor of criminal justice and criminology at WSU, who coauthored the study. "Officers in other states may find their thoughts useful as they transition to legalization."

In terms of limitations, the authors say that while the group of officers they interviewed was robust, their findings are not necessarily generalizable to all law enforcement officers in Washington. In addition, the authors note the tendency of members of focus groups to censor their comments because they are with fellow officers.

Infants spend most of their first year of life asleep. Those hours are prime time for brain development, when neural connections form and sensory memories are encoded.

But when sleep is disrupted, as occurs more often among children with autism, brain development may be affected, too. New research led by the University of Washington finds that sleep problems in a baby's first 12 months may not only precede an autism diagnosis, but also may be associated with altered growth trajectory in a key part of the brain, the hippocampus.

In a study published May 7 in the American Journal of Psychiatry, researchers report that in a sample of more than 400 6- to 12-month-old infants, those who were later diagnosed with autism were more likely to have had difficulty falling asleep. This sleep difficulty was associated with altered growth trajectories in the hippocampus.

"The hippocampus is critical for learning and memory, and changes in the size of the hippocampus have been associated with poor sleep in adults and older children.

However, this is the first study we are aware of to find an association in infants as young as 6 months of age," said lead author Kate MacDuffie, a postdoctoral researcher at the UW Autism Center.

As many as 80% of children with autism spectrum disorder have sleep problems, said Annette Estes, director of the UW Autism Center and senior author on the study. But much of the existing research, on infants with siblings who have autism, as well as the interventions designed to improve outcomes for children with autism, focus on behavior and cognition. With sleep such a critical need for children -- and their parents -- the researchers involved in the multicenter Infant Brain Imaging Study Network, or IBIS Network, believed there was more to be examined.

"In our clinical experience, parents have a lot of concerns about their children's sleep, and in our work on early autism intervention, we observed that sleep problems were holding children and families back," said Estes, who is also a UW professor of speech and hearing sciences.

Researchers launched the study, Estes said, because they had questions about how sleep and autism were related. Do sleep problems exacerbate the symptoms of autism? Or is it the other way around -- that autism symptoms lead to sleep problems? Or something different altogether?

"It could be that altered sleep is part-and-parcel of autism for some children. One clue is that behavioral interventions to improve sleep don't work for all children with autism, even when their parents are doing everything just right. This suggests that there may be a biological component to sleep problems for some children with autism," Estes said.

To consider links among sleep, brain development and autism, researchers at the IBIS Network looked at MRI scans of 432 infants, surveyed parents about sleep patterns, and measured cognitive functioning using a standardized assessment. Researchers at four institutions -- the UW, University of North Carolina at Chapel Hill, Washington University in St. Louis and the Children's Hospital of Philadelphia -- evaluated the children at 6, 12 and 24 months of age and surveyed parents about their child's sleep, all as part of a longer questionnaire covering infant behavior. Sleep-specific questions addressed how long it took for the child to fall asleep or to fall back asleep if awakened in the middle of the night, for example.

At the outset of the study, infants were classified according to their risk for developing autism: Those who were at higher risk of developing autism -- about two-thirds of the study sample -- had an older sibling who had already been diagnosed. Infant siblings of children with autism have a 20 percent chance of developing autism spectrum disorder -- a much higher risk than children in the general population.

A 2017 study by the IBIS Network found that infants who had an autistic older sibling and who also showed expanded cortical surface area at 6 and 12 months of age were more likely to be diagnosed with autism compared with infants without those indicators.

In the current study, 127 of the 432 infants were identified as "low risk" at the time the MRI scans were taken because they had no family history of autism. They later evaluated all the participants at 24 months of age to determine whether they had developed autism. Of the roughly 300 children originally considered "high familial risk," 71 were diagnosed with autism spectrum disorder at that age.

Those results allowed researchers to re-examine previously collected longitudinal brain scans and behavioral data and identify some patterns. Problems with sleep were more common among the infants later diagnosed with autism spectrum disorder, as were larger hippocampi. No other subcortical brain structures were affected, including the amygdala, which is responsible for certain emotions and aspects of memory, or the thalamus, a signal transmitter from the spinal cord to the cerebral cortex.

The UW-led sleep study is the first to show links between hippocampal growth and sleep problems in infants who are later diagnosed with autism.

Other studies have found that "overgrowth" in different brain structures among infants who go on to develop those larger structures has been associated, at different stages of development, with social, language and behavioral aspects of autism.

While the UW sleep study found a pattern of larger hippocampal volume, and more frequent sleep problems, among infants who went on to be diagnosed with autism, what isn't yet known is whether there is a causal relationship. Studying a broader range of sleep patterns in this population or of the hippocampus in particular may help determine why sleep difficulties are so prevalent and how they impact early development in children with autism spectrum disorder.

"Our findings are just the beginning -- they place a spotlight on a certain period of development and a particular brain structure but leave many open questions to be explored in future research," MacDuffie said.

A focus on early assessment and diagnosis prompted the UW Autism Center to establish an infant clinic in 2017. The clinic provides evaluations for infants and toddlers, along with psychologists and behavior analysts to create a treatment plan with clinic- and home-based activities -- just as would happen with older children.

The UW Autism Center has evaluated sleep issues as part of both long-term research studies and in the clinical setting, as part of behavioral intervention.

"If kids aren't sleeping, parents aren't sleeping, and that means sleep problems are an important focus for research and treatment," said MacDuffie.

The authors note that while parents reported more sleep difficulties among infants who developed autism compared to those who did not, the differences were very subtle and only observed when looking at group averages across hundreds of infants. Sleep patterns in the first years of life change rapidly as infants transition from sleeping around the clock to a more adult-like sleep/wake cycle. Until further research is completed, Estes said, it is not possible to interpret challenges with sleep as an early sign of increased risk for autism.

AUSTIN, Texas - A mother's use of antidepressants during pregnancy does not appear to increase her child's risk for autism, according to a new meta-analysis by Jeffrey Newport, M.D., published in The American Journal of Psychiatry.

Newport is director of the Women's Reproductive Mental Health program at UT Health Austin's Mulva Clinic for the Neurosciences and a professor of psychiatry at Dell Medical School at The University of Texas at Austin.

He examined 14 studies, many of which identified a connection between prenatal antidepressant use and autism. However, Newport says that research failed to account for ascertainment bias, which occurs when one group of patients or subjects is tested more frequently than others.

In the analysis, Newport found the root of bias is limited access to health care among ethnic minority and immigrant mothers.

"In these studies, immigrant and Latina mothers consistently had both lower rates of antidepressant treatment and lower rates of autism diagnosis in their children," Newport said. "This is not surprising, as these minority groups are known to have poorer access to health care, including treatment for depression and careful diagnostic assessment of concerning behaviors in a child."

Newport discovered that family-based studies eliminated the bias problem by comparing children with antidepressant exposure or autism diagnosis with their siblings who did not have antidepressant exposure or autism. With the ethnic bias eliminated, the family-based studies revealed no association between prenatal antidepressant use and autism.

"This should remind us that although insurance databases and national registries have the advantage of huge numbers of participants, their data is not collected to answer research questions, but to manage business and clinical concerns," Newport said. "Thankfully, the results of this meta-analysis show that with thoughtful study designs, researchers can overcome the biases often encountered when using such databases."

Researchers from University of California Irvine published a new paper in the Journal of Marketing that finds that marketing mix elements mitigate sacrifice, which serves to engage individuals in the donation task and thereby increase the likelihood that they will continue.

The study forthcoming in the Journal of Marketing is titled "Help Me Help You!: Employing the Marketing Mix to Alleviate Experiences of Donor Sacrifice" and is authored by Tonya Bradford and Naja Boyd.

Nonprofits contribute significant value to society with the support from the individuals who contribute to them. This study suggests that managers consider the composite of sacrifices required from individuals as they proceed through each phase of donation and employ the marketing mix to proactively and compassionately address the various types of sacrifice that emerge. The researchers use the topic of living organ donation, an extreme type of sacrifice, to explore this concept more fully.

The study identifies actions for managers to employ the marketing mix--product, place, price, promotion, people, and process--to address the types of sacrifices (psychic, pecuniary, physical) identified in the donation process. Also included are general considerations for organizations. Product is reflected most clearly in a nonprofit organization's mission statement and manifests in the offering the donation supports. Place focuses on how disparate entities are integrated to support an individual's escalation of commitment from interested to committed as well as the delivery of the offering. Price is the component that conveys the costs incurred by donors to provide the contributions. Promotion is most often found in messages educating and persuading potential donors about the importance of the offering. An organization's people are an important factor in the entirety of the process and guide donors throughout the process.

Donation is the manifestation of the process component that includes the steps required for individuals to transform from potential to actual donor. The process we define is comprised of three phases. In the deliberation phase, individuals considering the opportunity are more involved in moving the process forward with some input from the organization. Within the decision phase, there is a balance of influence between individuals and organizations. As individuals move to the donation phase, the balance of influence shifts toward the organization. Thus, an awareness of the process and perceptions of the organization to which individuals are contributing is also important. Bradford explains, "It is imperative that organizations understand what they are asking of donors and how donors may experience sacrifice. It is also important for donors to experience a degree of success, particularly when they are not able to readily observe the outcomes of their donations. Therefore, the processes through which donors contribute should provide them with satisfaction that is in some way commensurate with the sacrifices they make." Importantly, process and people influence each phase of the donation experience and should be audited regularly to ensure that the interfaces between them and each phase, as well as the other marketing mix components, are integrated.

The integration of each of the six marketing mix elements is more likely to result in an environment where individuals feel their donations are valued and respected. Each marketing mix element should be aligned to engender the desired response to the organization: that of converting an individual into a volunteer. The study notes that marketing mix elements mitigate sacrifice, which serves to engage individuals in the donation task and thereby increase the likelihood that they will continue. For organizations where donation may continue, the enactment of such sacrifices is likely to engender loyalty and continuity.

Organizations are not static as evident in alterations to their operations, offerings, and positioning. Similarly, nonprofit organizations may adjust their offerings to remain relevant to those they serve, thereby maintaining or growing their client base. Boyd adds, "It is important that nonprofit organizations assess how those changes may impact the degree of sacrifice required for existing and potential donors and operationalize the marketing mix to address those sacrifices. Deft employment of the marketing mix to extend the tenure of donors may lead to other organizational benefits such as confidence in operational projections, service stability, and reduction in delivery service cost."

Though these findings emerged from a particular type of donation, they are relevant to organizations that depend on contributions borne of sacrifice (e.g., hosts for foreign exchange students, families to adopt children, hospice care providers, or those offering compassionate care to individuals in crisis).

Researchers from University of Groningen, University of Mannheim, and SAP Germany published a new paper in the Journal of Marketing that explores the potential benefits of winning back lost customers and the best strategies for accomplishing that goal.

The study forthcoming in the Journal of Marketing is titled "Tolerating and Managing Failure: An Organizational Perspective on Customer Reacquisition Management" and is authored by Arnd Vomberg, Christian Homburg, and Olivia Gwinner.

Do attempts to regain lost customers pay off? Experts report that the costs of reaching out to lost customers are generally far lower than the costs of contacting new customers. In addition, the chance of winning back a lost customer is up to eight times greater than of acquiring a new customer. In recognition of these advantages, McDonald's announced plans to invest from $150,000 to $700,000 per location in the U.S. to win back lost customers.

However, experts also report that customers can defect strategically. Customers defect because they anticipate improved offers such as lower prices from competitors. In such a scenario, a firm's win-back activities could unnecessarily lower firm revenues. In addition, resources are misallocated if win-back offers to defected customers provoke negative attitudes in loyal customers (e.g., feelings of unfairness if loyal customers pay higher prices than defected customers).

Using a cross-industry data set, the research team reports that reacquisition increases firm profits. The positive outcomes of customer reacquisition such as increased revenues more than offset the costs of customer reacquisition management such as price concessions.

However, the study also demonstrates that managers need to understand the important role that a company's culture plays in effective customer win-back. While winning back lost customers can lead to increased profits, win-back processes are often unpleasant for employees. Vomberg explains that "Employees likely perceive customer defection as an undesirable occurrence. Usually, employees do not freely and deliberately discuss their mistakes. They may fear blame from colleagues or punishment by superiors. Thus, company cultures that reward success and punish failures can instill reluctance in employees to address customer defections."

The study demonstrates that successful customer reacquisition management requires a failure-tolerant organizational culture that encourages a constructive treatment of failures. In failure-tolerant cultures, employees feel free to voice ideas, discuss customer defections openly, and assume responsibility for the reacquisition process. Such feelings of responsibility spur employees to work harder, be more creative, and act unconventionally when reacquiring customers. As a result, employees address more defections and increase win-back success.

However, failure tolerance can also have a boomerang effect: High levels of failure tolerance reduce win-back success. Highly failure-tolerant cultures can induce laxness in employees. Once employees have internalized a tolerance for failure, they may make decisions with less due diligence and effort, provoking more and increasingly severe failures in customer relationships. More and increasingly severe failures can create irrecoverable damage to win-back success.

Win-back guidelines also increase win-back success. Such guidelines establish and enforce strict formal rules and procedures that employees must follow when reacquiring customers. These guidelines help employees detect customer defection, formulate expected actions, and outline monitoring activities to ensure learning for future reacquisition attempts. Homburg adds, "Importantly, formal reacquisition guidelines do not conflict with motivational effects that failure tolerance raises in employees. Instead, the guidelines help unfold the full potential of failure tolerant cultures. In other words, such guidelines help employees structure the otherwise unstructured context of customer reacquisition management."

These findings have managerial implications. First, even if customer acquisition and retention management are well-established in company practice, managers should stimulate reacquisition activities. Addressing failures, shortcomings, and defections is likely less appealing than acquiring new customers, so win-back endeavors must be encouraged. Second, to benefit from reacquisition activities, Gwinner suggests that "... managers organize for customer reacquisition management. Managers need to establish cultures that are open to failure. However, managers need to be aware that failure tolerance can create "too-much-of-a-good-thing" so that high levels of failure tolerance reduce reacquisition performance. Thus, managers also need to recognize that failure tolerance is not a substitute for management." Third, currently only few companies have comprehensive reacquisition guidelines in place. Because those guidelines steer employees towards successful win-back and also amplify the performance effects of failure-tolerance cultures, managers should establish reacquisition guidelines.

Communications between two human or animal individuals conventionally depend on sensory systems for vision, audition, olfaction, or touch. Science fiction has popularized the potentials of directly transmitting information between brains for locomotor control. For example, in the 2009 film Avatar, humans use their minds to remotely control the brains of Na'vi-human hybrids to navigate in the real world. Several recent studies proposed the possibility of retrieving electrophysiological signals from one brain to influence the neuronal activity in another brain through electrical or transcranial magnetic stimulation, suggesting the exciting concept of direct information exchange between brains through the Brain-to-Brain interfaces (BtBIs). However, BtBIs have thus far required the use of demanding techniques for long-term, multi-channel recordings to decode the information from an encoder individual, and has been limited by low rates of information transmission to a target neural circuit. Multi-channel single-unit recordings are technically challenging and often lack cell-type specificity. EEG recording are inaccessible to subcortical areas to precisely decode specific intention. Moreover, EEG recordings of steady-state visually evoked potentials require external visual stimulation to generate the brain activity rather than the internal neural activity. Another challenge lies in the need of feeding the electrophysiological information, once decoded, into correct cell types and neural circuits in the target brain. Due to these technical limitations, the information transfer rates were often in the low range of 0.004-0.033 bits/s. Using a BtBI to control locomotion appears to be particularly difficult, since locomotion involves frequent starts, stops, and continuous changes in velocity at a sub-second scale.

Recently, Dr. Minmin Luo's lab published a research article entitled "An Optical Brain-to-brain Interface Supports Rapid Information Transmission for Precise Locomotion Control" in journal Science China Life Sciences. In this work, the authors established an optical BtBI that supports rapid information transmission for precise locomotion control, thus providing a proof-of-principle demonstration of fast BtBI for real-time behavioral control.

In this study, the authors demonstrated an optical BtBIs that used fiber photometry to record the population Ca2+ signals of NI neurons from the Master mouse, and then transformed the signals to blue laser pulses, and finally delivered the laser pulses into the NI of the Avatar mouse (Figure 1A, B). This optical BtBI directed the Avatar mice to closely mimic the locomotion of their Masters with information transfer rate about three two orders of magnitude higher than previous BtBIs (Figure 1C-E).

This study emphasize the importance of choosing appropriate neural circuits and of choosing suitable circuit-probing technologies when building a high-performance BtBI. First, the choice of brain structures is important for implementing task-relevant BtBIs. Here the authors collected neuronal signals that precisely report locomotor state and control locomotor speed from the genetically-identified NMB neurons in the NI of the pons. Second, the choice of fiber photometry of Ca2+ signals offers several advantages: 1) it stably records the population neuronal activity of specific cell-type that performs similar functions; 2) it has high signal-to-noise ratio (SNR); 3) it is easy to implement, since it bypasses the challenging task of multi-channel single-unit recording from behaving animals and obviates the need for the extensive decoding of information from large datasets. Finally, the authors used optogenetic stimulation, which also enjoys the advantage of fine-tuning the activity of a genetically defined set of neurons in a given brain area.

In summary, this study demonstrated an optical brain-to-brain interface that supports rapid information transmission for precise locomotion control, and represented a major step toward realizing the full potential of BtBIs.

Additive manufacturing is a technique in which the final three-dimensional object is produced by successively adding new layers of building material to those that have already been deposited. Recently, the commercially available 3D printers have been experiencing rapid development and so do the 3D-printers materials, including transparent media of high optical quality. These advancements open up new possibilities in many fields of science and technology including biology, medicine, metamaterials studies, robotics and micro-optics.

Researchers from the Faculty of Physics, University of Warsaw, Poland, have designed tiny lenses (with dimensions as small as a fraction of the human hair diameter) that can easily be manufactured by laser 3D printing technique on top of various materials, including fragile novel 2D graphene-like materials. The presented lenses increase the extraction of light emitted from semiconductor samples and reshape its outgoing part into an ultra-narrow beam. Thanks to this property, there is no longer a need for including a bulky microscope objective in the experimental setup when performing optical measurements of single nanometre-sized light emitters (like quantum dots), which up to now could not be avoided. A typical microscope objective used in such a study has roughly a handbreadth size, weights up to one pound (half a kilogram) and must be placed at a distance of about one-tenth of an inch (few millimetres) from the analysed sample. These impose significant limitations on many types of modern experiments, like measurements in pulsed high magnetic fields, at cryogenic temperatures or in microwave cavities, which on the other hand can easily be lifted by the presented lenses.

High speed of the 3D-printing technique makes it very easy to produce hundreds of microlenses on one sample. Arranging them into regular arrays provides a convenient coordinate system, which accurately specifies the location of a chosen nanoobject and allows for its multiple measurements in different laboratories all over the world. The invaluable opportunity of coming back to the same light emitter allows for much more time-efficient research and hypothesis testing. Specifically, one can entirely focus on designing and performing a new experiment on the nanoobject studied before, instead of carrying out a time-consuming investigation of thousands of other nanoobjects before eventually finding an analogue to the previous one.

The shape of the proposed microlenses can easily be adapted to the so-called 2.5D microfabrication technique. The objects satisfying its prerequisites can be produced over large-scale surfaces by pressing a patterned stamp against the layer of material they are supposed to be made of. The 2.5D fabrication protocol is especially attractive from the viewpoint of potential applications of the microlenses, as can be readily up-scaled which is an important factor in possible future industrial use.

Physics and Astronomy first appeared at the University of Warsaw in 1816, under the then Faculty of Philosophy. In 1825 the Astronomical Observatory was established. Currently, the Faculty of Physics' Institutes include Experimental Physics, Theoretical Physics, Geophysics, Department of Mathematical Methods and an Astronomical Observatory. The research covers almost all areas of modern physics, on scales from the quantum to the cosmological. The Faculty's research and teaching staff includes ca. 200 university teachers, of which 78 are employees with the title of professor. The Faculty of Physics, University of Warsaw, is attended by ca. 1000 students and more than 170 doctoral students.

COLUMBUS, Ohio - There are a lot of health concerns that come with pregnancy, and the COVID-19 pandemic has created additional fears about risks for both mom and baby.

A new national survey conducted by The Ohio State University Wexner Medical Center confirms these fears, finding that nearly 80% of respondents would be concerned about themselves or an expectant mother in their life in the midst of the current COVID-19 outbreak, with almost half expressing fear of going to a scheduled prenatal appointment. Among the more than 2,000 respondents, 51% would be concerned about sending their child to daycare or a babysitter and over 45% would be concerned about visiting public places while pregnant and after their baby is born.

Parents today have an endless amount of information at their fingertips. It can be hard for families to know which sources to trust and which to ignore.

"We always encourage pregnant women to trust websites that are reliable and that are supported by medical professionals as being accurate and informative," said Dr. Jonathan Schaffir, OB/GYN at The Ohio State Wexner Medical Center.

While concerns about COVID-19 are valid and precautions should be taken, it's also important to manage these fears and ensure proper care. Medical offices are taking many extra steps for the safety of their patients and staff, such as wearing masks, face shields and gloves and wiping down surfaces between patients.

"We've also taken a close look at limiting appointments and determining the minimum number of visits and tests that women need in pregnancy to ensure they and their baby are healthy and well cared for," Dr. Schaffir said. "So it's important for women to know that when we say you need to come in to the office or the hospital, that really is the case."

Schaffir and many other OB/GYNs offer telehealth appointments for visits that don't require any testing or procedures, and this area of medicine is expected to expand even after the threat of COVID-19 subsides.

While some pregnant women may be concerned about their babies born at this particular time, it's important to remember that, according to the , COVID-19 is transmitted through droplets in the air and not through the bloodstream. Because of this, babies can't be infected through the placenta.

"Women can rest assured that their babies aren't going to contract the virus while they're inside their wombs," Dr. Schaffir said. "However, it's important for pregnant women to continue practicing social distancing, frequent hand washing and avoiding touching their faces."

Spoiling foods, souring wine and worsening wounds have a common culprit -- a process called oxidation. Although the ill effects of these chemical reactions can be curtailed by antioxidants, creating a sturdy platform capable of providing prolonged antioxidant activity is an ongoing challenge.

Researchers at Texas A&M University might have solved this problem with their new antioxidant mats. Made from an intertwined network of ultra-fine strands of a polymer and an antioxidant found in red wine, the researchers said these mats are strong, stable and capable of delivering antioxidant activity for prolonged periods of time.

"Our innovation is that we have fine-tuned the steps needed to spin defect-free, ultra-microscopic fibers for making high-performing antioxidant mats," said Adwait Gaikwad, a graduate student in Professor Svetlana Sukhishvili's laboratory in the College of Engineering and a primary author of the study. "Each fiber is intermolecularly linked to several antioxidant molecules, and so the final mat, which is made of millions and millions of such fibers, has enhanced antioxidant functionality."

A description of their study was published in the February issue of the journal ACS Applied Materials & Interfaces.

Although oxidation is a common natural phenomenon, this chemical reaction can be detrimental if left unchecked. For example, in alcoholic beverages, too much oxidation leads to the formation of acetaldehyde from alcohol, altering the drink's taste, color and aroma. In the body, oxidative stress causes a buildup of free radicals that can harm healthy cells and body tissue.

However, oxidative reactions can be kept in control by the action of antioxidants. These compounds readily combine with ambient oxygen or donate electrons to neutralize charged radicals. Of the many antioxidants, a molecule found in red wine called tannic acid is particularly attractive because it is also antibacterial and antiviral. The researchers said these remarkable properties are due to the presence of groupings of atoms called polyphenols within tannic acid's molecular structure.

"Polyphenols are natural organic compounds that are also known for their antioxidant properties," said Hanna Hlushko, also a graduate student in Sukhishvili's laboratory and a primary author of the study. "Turns out that the tannic acid is replete with these polyphenol motifs, which make it an efficient binding partner to many molecules and a great scavenger of free radicals."

In past studies, antioxidants were blended into synthetic mats. Put simply, in this technique, mats are made by first mixing a polymer and antioxidants together and then flattening them into a sheet. But the researchers said these mats have lower functionality because the surface area for antioxidant activity is limited.

And so, to increase the surface area for antioxidant activity, they created an antioxidant mesh made with ultrafine fibers of polymer and tannic acid. Thus, each strand of this mesh-like mat could contribute to antioxidant activity. Furthermore, unlike the earlier blending technique, they chose a polymer that could hold on to molecules of tannic acid by making hydrogen bonds, thereby increasing the overall strength of the final mat.

To make these fibers, the researchers filled a syringe with tannic acid, a polymer called polyvinylpyrrolidone and a combination of solvents. Then, as they squeezed the mixed polymer-antioxidant solution out of the syringe, they applied a voltage of 16 kilovolts between the tip of the syringe and a spinning drum collector located a short distance away. This extremely high voltage pulled the polymer into nanofibers as it traveled from the syringe to the collection drum. At the end of the spinning process, they had an interwoven, nanofiber mat.

When the researchers examined these mats under a high-power electron microscope, they found that the nanofibers were without any defect that could compromise the mat's mechanical properties. Also, they showed that these mats are stable at the pH of water and can provide sustained antioxidant activity by releasing tannic acid continuously for around 20 days.

They also noted that the hydrogen bonds between polyvinylpyrrolidone and tannic acid increased the strength of their mats by up to 10-fold more than mats spun from polyvinylpyrrolidone fibers alone. Thus, the nanofiber design made the mats mechanically strong and yet gave them cloth-like flexibility to wrap around objects.

"We have created antioxidant mats with a high surface area, robust mechanical properties and the ability to provide long-term antioxidant protection," Gaikwad said. "Also, the release of tannic acid is on-demand -- the hydrogen bonds hold the antioxidants in the material until there is an external stimulus, like pH. These properties make our mats suitable for diverse applications, from bandages for wound-healing to inner linings of containers for food storage."

Stanford engineers have taken a big step toward making it practical for electric cars to recharge as they speed along futuristic highways built to "refuel" vehicles wirelessly.

Although wireless charging pads already exist for smartphones, they only work if the phone is sitting still. For cars, that would be just as inconvenient as the current practice of plugging them in for an hour or two at charging stations.

Three years ago, Stanford electrical engineer Shanhui Fan and Sid Assawaworrarit, a graduate student in his lab, built the first system that could wirelessly recharge objects in motion. However, the technology was too inefficient to be useful outside the lab.

Now, in Nature Electronics, the two engineers demonstrate a technology that could one day be scaled up to power a car moving down the road. In the nearer term, the system could soon make it practical to wirelessly recharge robots as they move around in warehouses and on factory floors -- eliminating downtime and enabling robots to work almost around the clock.

"This is a significant step toward a practical and efficient system for wirelessly re-charging automobiles and robots, even when they are moving at high speeds," Fan said. "We would have to scale up the power to recharge a moving car, but I don't think that's a serious roadblock. For re-charging robots, we're already within the range of practical usefulness."

Wireless chargers transmit electricity by creating a magnetic field that oscillates at a frequency that creates a resonating vibration in magnetic coils on the receiving device. The problem is that the resonant frequency changes if the distance between the source and receiver changes by even a small amount.

In their first breakthrough three years ago, the researchers developed a wireless charger that could transmit electricity even as the distance to the receiver changes. They did this by incorporating an amplifier and feedback resistor that allowed the system to automatically adjusts its operating frequency as the distance between the charger and the moving object changed.

But that initial system wasn't efficient enough to be practical. The amplifier uses so much electricity internally to produce the required amplification effect that the system only transmitted 10% of the power flowing through the system.

In their new paper, the researchers show how to boosts the system's wireless-transmission efficiency to 92%. The key, Assawaworrarit explained, was to replace the original amplifier with a far more efficient "switch mode" amplifier. Such amplifiers aren't new but they are finicky and will only produce high-efficiency amplification under very precise conditions. It took years of tinkering, and additional theoretical work, to design a circuit configuration that worked.

The new lab prototype can wirelessly transmit 10 watts of electricity over a distance of two or three feet. Fan says there aren't any fundamental obstacles to scaling up a system to transmit the tens or hundreds of kilowatts that a car would need. He says the system is more than fast enough to re-supply a speeding automobile. The wireless transmission takes only a few milliseconds -- a tiny fraction of the time it would take a car moving at 70 miles an hour to cross a four-foot charging zone. The only limiting factor, Fan said, will be how fast the car's batteries can absorb all the power.

The wireless chargers shouldn't pose a health risk, said Assawaworrarit, because even ones that are powerful enough for cars would produce magnetic fields that are well within established safety guidelines. Indeed, the magnetic fields can transmit electricity through people without them feeling a thing.

Though it could be many years before wireless chargers become embedded in highways, the opportunities for robots and even aerial drones are more immediate. It's much less costly to embed chargers in floors or on rooftops than on long stretches of highway. Imagine a drone, says Fan, that could fly all day by swooping down occasionally and hovering around a roof for quick charges.

Who knows? Maybe drones really could be practical for delivering pizza.

Scientists have discovered the world's oldest known example of a squid-like creature attacking its prey, in a fossil dating back almost 200 million years.

The fossil was found on the Jurassic coast of southern England in the 19th century and is currently housed within the collections of the British Geological Survey in Nottingham.

In a new analysis, researchers say it appears to show a creature - which they have identified as Clarkeiteuthis montefiorei - with a herring-like fish (Dorsetichthys bechei) in its jaws.

They say the position of the arms, alongside the body of the fish, suggests this is not a fortuitous quirk of fossilization but that it is recording an actual palaeobiological event.

They also believe it dates from the Sinemurian period (between 190 and 199 million years ago), which would predate any previously recorded similar sample by more than 10 million years.

The research was led by the University of Plymouth, in conjunction with the University of Kansas and Dorset-based company, The Forge Fossils.

It has been accepted for publication in Proceedings of the Geologists' Association and will also be presented as part of Sharing Geoscience Online, a virtual alternative to the traditional General Assembly held annually by the European Geosciences Union (EGU).

Professor Malcolm Hart, Emeritus Professor in Plymouth and the study's lead author, said: "Since the 19th century, the Blue Lias and Charmouth Mudstone formations of the Dorset coast have provided large numbers of important body fossils that inform our knowledge of coleoid palaeontology. In many of these mudstones, specimens of palaeobiological significance have been found, especially those with the arms and hooks with which the living animals caught their prey.

"This, however, is a most unusual if not extraordinary fossil as predation events are only very occasionally found in the geological record. It points to a particularly violent attack which ultimately appears to have caused the death, and subsequent preservation, of both animals."

In their analysis, the researchers say the fossilised remains indicate a brutal incident in which the head bones of the fish were apparently crushed by its attacker.

They also suggest two potential hypotheses for how the two animals ultimately came to be preserved together for eternity.

Firstly, they suggest that the fish was too large for its attacker or became stuck in its jaws so that the pair - already dead - settled to the seafloor where they were preserved.

Alternatively, the Clarkeiteuthis took its prey to the seafloor in a display of 'distraction sinking' to avoid the possibility of being attacked by another predator. However, in doing so it entered waters low in oxygen and suffocated.

A study in the May 6th issue of Nature indicates the increase in rainfall forecast by global climate models is likely to hasten the release of carbon dioxide from tropical soils, further intensifying global warming by adding to human emissions of this greenhouse gas into Earth's atmosphere.

Based on analysis of sediments cored from the submarine delta of the Ganges and Brahmaputra rivers, the study was conducted by an international team led by Dr. Christopher Hein of William & Mary's Virginia Institute of Marine Science. Collaborators include Drs. Valier Galy of the Woods Hole Oceanographic Institution, Muhammed Usman of the University of Toronto, and Timothy Eglinton and Negar Haghipour of the Swiss Federal Institute of Technology in Zurich (ETH Zurich). Major funding was provided by the U.S. National Science Foundation.

"We found that shifts toward a warmer and wetter climate in the drainage basin of the Ganges and Brahmaputra rivers over the last 18,000 years enhanced rates of soil respiration and decreased stocks of soil carbon," says Hein. "This has direct implications for Earth's future, as climate change is likely to increase rainfall in tropical regions, further accelerating respiration of soil carbon, and adding even more CO2 to the atmosphere than that directly added by humans."

Soil respiration refers to release of carbon dioxide by microbes as they decompose and metabolize leaf litter and other organic materials on and just below the ground surface. It's equivalent to the process in which larger multicellular animals--from snails to humans--exhale CO2 as a byproduct of metabolizing their food. Roots also contribute to soil respiration at night, when photosynthesis shuts down and plants burn some of the carbohydrates they produced during daylight.

Sediment cores reveal link between precipitation, soil age

The team's study is based on detailed analysis of three sediment cores collected from the ocean floor seaward of the mouth of the Ganges and Brahmaputra rivers in Bangladesh. Here, the world's largest delta and submarine fan were built by the prodigious volume of sediments eroded from the Himalayas. The two rivers carry more than a billion tons of sediment to the Bay of Bengal each year, more than five times that of the Mississippi River.

The cores record the environmental history of the Ganges-Brahmaputra drainage basin during the 18,000 years since the last Ice Age began to wane. By comparing radiocarbon dates of bulk sediment samples from these cores with samples from organic molecules known to be derived directly from land plants, the researchers were able to gauge changes though time in the age of the sediments' parent soils.

Their results showed a strong correlation between runoff rates and soil age--wetter epochs were associated with younger, rapidly respiring soils; while drier, cooler epochs were linked to older soils capable of storing carbon for longer periods.

The wetter periods themselves correlate with the strength of the Indian summer monsoon, the primary source of precipitation across India, the Himalayas, and south-central Asia. The researchers confirmed changes in monsoon strength using several independent lines of paleoclimatic evidence, including analysis of oxygen-isotope ratios from Chinese cave deposits and the skeletons of open-ocean phytoplankton.

Small changes, big effects

The magnitude of the correlation discovered by Hein and colleagues corresponds to a near doubling in the rate of soil respiration and carbon turnover in the 2,600 years following the end of the last Ice Age, as India's summer monsoon strengthened. "We found that a small increase in precipitation values corresponds to a much larger decrease in soil age," says Hein.

An earlier paper by Hein, Galy, and colleagues reported a threefold increase in annual rainfall in the Ganges-Brahmaputra river basin since the last Ice Age. This new study shows that upturn in precipitation led to a halving of soil age due to more rapid soil turnover.

Hein says "small changes in the amount of carbon stored in soils can moreover play an outsized role in modulating atmospheric CO2 concentrations and, therefore, global climate, as soils are a primary global reservoir of this element."

The current concentration of carbon dioxide in Earth's atmosphere--416 parts per million--equates to about 750 billion tons of carbon. Earth's soils hold around 3,500 billion tons--more than four times as much.

Previous research has highlighted the threat that global warming poses to the permafrost soils of the Arctic, whose widespread thawing is thought to be releasing up to 0.6 billion tons of carbon to the atmosphere each year.

"We've now found a similar climate feedback in the tropics," says Hein, "and are concerned that enhanced soil respiration due to greater precipitation--itself a response to climate change--will further increase concentrations of CO2 in our atmosphere."

What The Study Did: The intensive care unit and inpatient bed needs for patients with coronavirus disease 2019 (COVID-19) in two cities in China are described and compared to estimate the peak number of intensive care unit beds needed in U.S. cities if an outbreak equivalent to that in Wuhan occurs.

Authors: Ruoran Li, M.Phil., of the Harvard T.H. Chan School of Public Health in Boston, 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.2020.8297)

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