Culture

LA JOLLA, CALIF. - July 16, 2021 - An international research group, led by Jamey Marth, Ph.D., a professor at Sanford Burnham Prebys, has shown that the Neuraminidase 3 (Neu3) enzyme is responsible for the onset and progression of colitis--a chronic digestive disease caused by inflammation of the colon. The study, recently published in the Proceedings of the National Academy of Sciences, was performed in a model of recurrent human food poisoning previously linked with the condition. The findings represent a scientific advance toward a targeted therapy to help the millions of people worldwide affected by the disorder.

"Our new research demonstrates how increased activity of Neu3--an enzyme found in the gut--triggers an inflammatory cascade that leads to disease," says Marth. "Prior to this study, we knew that a neuraminidase enzyme was involved, but didn't know the source of the enzyme.

"This study pinpoints Neu3 as the protein that triggers onset and progression of colitis," adds Marth. "In the absence of Neu3, disease onset and progression do not occur, indicating that the enzyme may be a valuable therapeutic target."

Previously, the Marth laboratory developed a unique model of colitis based on recurrent human food poisoning, which can identify environmental sources of disease. The (mouse) model reflects how humans may contract colitis following repeated, mild infections of Salmonella enterica Typhimurium (ST), a common human food poisoning pathogen.

"We're now looking at an intrinsic mechanism of protein aging and turnover that's being modified by a foodborne pathogen," says Marth. "The pathogen targets the protein aging process in the intestinal tract, thereby diminishing the expression of a key anti-inflammatory enzyme that would normally prevent the onset of colitis and inflammatory bowel diseases (IBDs).

"That enzyme is intestinal alkaline phosphatase (IAP), which detoxifies bacterial toxins, and its augmentation is also the rationale for current clinical trials in the treatment of colitis and sepsis.

"The problem starts when the ST pathogen is ingested and triggers our immune system to 'amp up' Neu3 neuraminidase expression," adds Marth. "Increased activity of Neu3 leads to a reduced life span of IAP, and that impairs the ability to detoxify a damaging endotoxin normally found among bacteria in the gut--and this leads to chronic gut inflammation."

Inhibiting Neu3 with the antiviral drug Relenza (used to treat influenza) broke that chain, reduced inflammatory cytokine expression and prevented severe colitis. However, current neuraminidase inhibitors such as Relenza and Tamiflu are optimized for viral and bacterial neuraminidases and would need further development to be clinically effective against the human form of Neu3.

"We had to increase the oral dose of Relenza well above that recommended for use in humans," says Marth. "It worked without apparent side effects; however, a new generation of neuraminidase inhibitors that target the mammalian enzyme is needed. Several research groups are now focusing on developing clinically relevant inhibitors.

"We were rather surprised that the culprit turned out to be Neu3, as many bacteria in the gut are capable of synthesizing their own neuraminidase enzymes," Marth notes. "Based on the genetic proof in our study, inhibiting Neu3 would be expected to have a positive therapeutic impact. But there's also another option: augmenting IAP appears to be equally beneficial. Perhaps a dual approach including both oral Neu3 inhibition and oral IAP augmentation simultaneously could be even more effective at reducing inflammation and preventing the onset of colitis."

PHILADELPHIA - People who struggle with serious mental illnesses are more likely to die early - about 10 to 30 years early - than those without mental illness from any cause. Many factors contribute to this disparity including poor access to care, undetected health conditions and difficulty managing chronic health conditions. Addressing physical illness in those with serious mental illness has been a major challenge. To address this, researchers tested a peer-led intervention called the Bridge that helps patients with mental illness prioritize their health, access health care and develop skills to self-manage their health. The approach showed a 50% reduction in emergency room use for those in the intervention group.

"Many people de-prioritize their health when faced with other crises, or more immediate issues," says Erin Kelly, PhD, assistant professor in the department of Family and Community Medicine at Thomas Jefferson University.
"There are many barriers to regular medical care for people with mental illness. We developed and evaluated one intervention aimed at relieving some of those barriers."

The study was published in the journal Psychiatric Services.

The researchers evaluated the impact of the Bridge program, a six-month intervention led by trained peers --those who had lived experiences with mental illness. The peer facilitators guide participants through a three-phase process, which they call the "for them, with them, by them."

In the first phase, the peer health navigator helped participants to set health and wellness goals, showed participants how to make appointments for routine or specialty care, and coached them through stressful aspects of the process in one-on-one sessions. In the second phase, participants gradually take over and self-manage all aspects of their health and health care, until they are independently able to manage as much as they can on their own (the third phase). Peers who deliver the interventions are certified peer specialists who first complete a four-day training course on the Bridge intervention as well as 8-12 weeks of supervised coaching. Supervisors are also trained in a one-day session to ensure that they understand how to evaluate performance and support the intervention.

In this study, Dr. Kelly, together with collaborators from University of Southern California, University of California, Los Angeles, and Pacific Clinics examined whether the Bridge intervention changed how participants made use of health services in a large health system in Southern California between March 2014 and September 2015.

Looking at Medicaid data of the 144 of 151 participants analyzed in the study (primarily Latinx and Black participants), the researchers found participants in the Bridge program used the emergency room 2.5 times less often than those in a waitlist control group over six months. "This is important because we often see high rates of emergency department visits in patients with severe mental illnesses," says Dr. Kelly.

Participants also reported using routine health care more frequently, and reported more confidence in their ability to manage their health, better relationships with primary care providers, reduced pain and increased detection of chronic health conditions.

"People with severe mental illnesses encounter multiple challenges accessing health care," say Dr. Kelly, "Therapists often have little training on how to handle chronic disease, and physicians often have little training in terms of treating patients with severe mental illnesses. Our intervention provides a trustworthy bridge between the two."

This program is not yet available in the Philadelphia area but could be an important addition to health care post-COVID-19, as many people have avoided routine care and may be missing important screenings or have deprioritized their health due to other stressors.

People with learning disabilities with covid-19 are five times more likely to be admitted to hospital and eight times more likely to die compared with the general population of England, finds a study published by The BMJ today.

Risks were particularly high for those with severe to profound learning disability, Down's syndrome and cerebral palsy.

The researchers say prompt access to covid-19 testing and healthcare is warranted for this group, and prioritisation for covid-19 vaccination and other targeted preventive measures should be considered.

Emerging evidence has shown that people with learning disability are at higher risk from covid-19 related death compared with the general population. But results from existing studies on other covid-19 outcomes are often complicated by factors such as deprivation and underlying conditions (comorbidities).

A lack of clarity also exists on the increased risk of covid-19 deaths among people with milder learning disability.

To explore this further, a team of UK researchers set out to describe the risk of covid-19 related hospital admissions and deaths among children and adults with learning disability in England compared with the general population.

Their results are based on electronic health records for more than 17 million people registered with a general practice in England linked to hospital admission and mortality data.

Data for 14,312,023 adults and 2,627,018 children were analysed across both waves of the covid-19 pandemic: wave 1 (registered with a general practice as of 1 March 2020 and followed until 31 August 2020); and wave 2 (registered 1 September 2020 and followed until 8 February 2021).

Among 90,307 adults on the learning disability register, 538 (0.6%) had a covid-19 related hospital admission; there were 222 (0.25%) covid-19 related deaths and 602 (0.7%) non-covid deaths.

Among adults not on the register, 29,781 (0.2%) had a covid-19 related hospital admission; there were 13,737 (0.1%) covid-19 related deaths and 69,837 (0.5%) non-covid deaths.

After taking account of potentially influential factors, such as age, sex, ethnicity, and geographical location, adults on the learning disability register had a 5-fold higher risk of covid-19 related hospital admission and an 8-fold higher risk of covid-19 related death than adults not on the register.

Rates were higher among those with severe to profound learning disability than those with milder learning disability, and among those in residential care.

Similar patterns were seen for children, but the authors stress that absolute risks of covid-19 hospital admission and death among children were small.

These are observational findings and the authors point to some limitations, such as focusing only on severe covid-19 outcomes and being unable to identify everyone with a learning disability from medical records alone. Nevertheless, results were similar after further analyses, and are consistent with the existing literature, suggesting that they are robust.

The findings also highlight gaps in learning disability registers, limiting the reach of the vaccination programme, prompting a call for greater efforts to update and maintain accurate registers so that all eligible individuals can benefit.

Besides vaccination, efforts should continue to protect people with learning disability from covid-19 adverse outcomes, and more research on the excess covid-19 risks among people with Down's syndrome and cerebral palsy are needed, they conclude.

This study makes an important contribution to the evidence on how the pandemic has affected this vulnerable group, say researchers in a linked editorial.

Ken Courtenay at the Royal College of Psychiatrists and Vivien Cooper at the Challenging Behaviour Foundation, point to "a hidden calamity" taking place among people with learning disabilities, and say "reasonable adjustments should be made to ensure that information about the pandemic and risk of infection are accessible, and that practical support is provided to protect people and manage risks."

What's more, they say worrying attitudes and prejudices about the value of the lives of people with learning disabilities have surfaced during the pandemic, while the covid-19 vaccination programme also disadvantaged people with learning disabilities, prioritising people according to age rather than severity of comorbid disorders.

"Before the next pandemic, investment in research is essential, to help us understand the risks faced by people with learning disabilities and how best to protect them from the high risks of hospital admission and death from covid-19," they write. "People with learning disabilities have the same rights as everyone else, including the right to good health and to be safe from harm."

BOSTON - Over the last decade, investigators at Beth Israel Deaconess Medical Center (BIDMC) have been at the forefront of the effort to identify the small population of neurons deep within the brain that cause hunger, but precisely how these cells and the unpleasant feeling of hunger they cause actually drive an animal to find and eat food remained unclear.

Now, a study published in the journal Nature sheds new light on this long-standing question. Led by Bradford B. Lowell, MD, PhD, of the Division of Endocrinology at BIDMC, the study makes use of a genetically engineered mouse model developed at BIDMC to reveal the complex interplay among the neurons that govern hunger, behavior and learning.

"Our discovery provides the answer to this important question of how we learn to seek and consume food and how hunger enhances the learning of tasks oriented towards acquiring food," said Lowell, who is also a professor of medicine at Harvard Medical School. "With additional work, our discovery could ultimately shed light into what goes wrong in disorders of hunger such as obesity and anorexia nervosa."

Focusing on the AgRP hunger neurons -- the small sub population of neurons found in the brain's hypothalamus responsible for creating the sensation of hunger after periods of deprivation -- Lowell and colleagues used the BIDMC-developed mouse model to investigate the neurons' activity. The mouse model -- on which more than 100 scientific papers have been published -- allows researchers to switch AgRP neurons on and off, determine what activates or inactivates them, and map their connections to other regions of the brain.

"Using this model, we and others discovered some time ago that these neurons are turned on by fasting, causing hunger, and that artificially turning them on in a recently fed mouse that otherwise would not eat, causes huge amounts of food to be eaten, as if the mouse had not eaten in days," said first author Janet Berrios, PhD, postdoctoral fellow at BIDMC.

Moreover, just the presence of food or a cue linked to the presence of food will instantaneously inhibit the neuron's activity, easing the unpleasant hunger sensation. If food isn't eaten in a short period of time, however, neuronal activity rebounds, restoring hunger to its previous levels.

In the present study, the team trained the engineered mice to recognize a food cue by associating a light with access to food, just as a dog can be trained to associate the sound of a cupboard opening with getting a biscuit. Thanks to the genetically engineered mice, the scientists observed how various levels of hunger and the presence of the food cues affected the AgRP neurons.

As they expected, they observed that fasting activated AgRP neurons, and food cues in the environment -- via a network of neurons elsewhere in the brain -- work to inhibit AgRP activity. But remarkably, when the team blocked off this network, it caused the mice to have great difficulty learning a task in which sensory cues related to food were used to guide acquisition of food.

From this, the researchers suggest that fasting or deprivation -- known to activate the AgRP neurons and the feeling of hunger -- causes an unpleasant, or aversive, feeling. When food cues in the environment inhibit AgRP activity, it also tamps down the aversive feeling, which in turn serves as a reward powerful enough to enhance learning.

"It's as if these rewarding, sensory cue-linked drops in unpleasant AgRP neuron activity push the mouse towards environmental cues and tasks associated with obtaining food," said Lowell, who noted that thirst likely works the same way, although through a different specialized set of neurons. "An obvious implication of this idea is that it explains why dieting is so difficult -- dieters are perpetually stuck with this aversive feeling. So, in short, it appears that we eat and drink because we've learned that this reduces the activity of these deprivation neurons, and hence the linked bad feelings."

Highlights

The physician-scientist workforce doing kidney research in the United States is increasingly made up of women and international medical graduates.

However, this workforce is older, declining in relative number, and is less overwhelmingly focused on basic rather than clinical science.

Washington, DC (July 14, 2021) -- U.S. physician-scientists make enormous contributions to biomedical research. New research published in CJASN demonstrates increasing representation of women and international graduates within the physician-scientist workforce doing kidney research; however, this workforce is declining in relative number, is getting older, and is less overwhelmingly focused on basic science research.

The research relied on public data obtained from the internet. A team led by Susan M. Wall, MD (Emory University School of Medicine) mined records from the National Institutes of Health (NIH) to explore demographic changes of early career and established, physician and non-physician principal investigators doing kidney-focused NIH-funded research between 1990 and 2020.

The researchers found that kidney-focused principal investigators are aging, particularly among physicians. Moreover, the relative representation of physicians among both early career and established principal investigators is falling, particularly among those doing basic science research. In contrast, the number and relative representation of non-physician scientists is increasing. There is also greater representation of women and international graduates among physician and non-physician kidney-focused investigators; however, women physician-scientists are increasingly more likely to do clinical rather than basic science research.

"Physician-scientists are in a unique position to formulate testable hypotheses that are clinically relevant. Research training also provides a perspective that is useful when evaluating human disease in the clinic," said Dr. Wall.

What The Study Did: In this randomized clinical trial, a physician messaging campaign was effective in increasing COVID-19 knowledge, information-seeking and self-reported protective behaviors among diverse groups.

Authors: Esther Duflo, Ph.D., of the Massachusetts Institute of Technology in Cambridge, 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.2021.17115)

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, conflict of interest and financial disclosures, and funding and support.

#  #  #
Media advisory: The full study and commentary are linked to this news release.

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2021.17115?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=071421

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

What The Study Did: About half the women experiencing homelessness and unstable housing who were surveyed experienced symptoms of depression or anxiety or both during the pandemic and, in addition to unmet subsistence needs and social isolation, these symptoms were associated with increased challenges accessing non-COVID-19 care and managing symptoms for chronic medical conditions.

Authors: Elise D. Riley, Ph.D., M.P.H., of the University of California, San Francisco, 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.2021.17035)

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, conflict of interest and financial disclosures, and funding and support.

#  #  #
Media advisory: The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2021.17035?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=071421

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

What The Study Did: This study found an unequal pattern of COVID-19 outcomes that was associated with the socioeconomic circumstances in regions of Japan, suggesting that these disparities in COVID-19 outcomes aren't unique to the United States and Europe.

Authors: Yuki Yoshikawa, M.D., M.P.H., 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.2021.17060)

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

#  #  #
Media advisory: The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2021.17060?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=071421

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

A new study on the effects of Airbnb listings on Boston neighborhoods suggests that the prevalence of listings may hamper local social dynamics that prevent crime. However, tourists themselves do not appear to generate or attract higher levels of crime. Babak Heydari, Daniel T. O'Brien, and Laiyang Ke of Northeastern University in Boston, MA, USA present these findings in the open-access journal PLOS ONE on July 14, 2021.

Widespread sentiment holds that Airbnb listings cause increased crime in residential neighborhoods. However, there has been limited research to explore and clarify this link.

To better understand the relationship between Airbnb listings and crime, Heydari and colleagues conducted a statistical analysis of listings and data on different types of crime (using categories of 911 calls) in Boston, MA. Covering a period from 2011 to 2017, they focused on two mechanisms by which the presence of short-term rentals might boost crime. First, tourists themselves may generate or attract crime. Second, the presence of Airbnb listings may disrupt local social dynamics that would normally mitigate or prevent crime.

The researchers found that the prevalence of Airbnb listings in a given neighborhood was linked to higher rates of violence, but not to public social disorder or private conflict. In addition, this link did not appear immediately after the listings became available to tourists, but rather arose and grew over several years.

These findings, especially the lag in increased violence, suggest that Airbnb tourists themselves do not cause or attract greater amounts of crime. Instead, an increased proportion of a neighborhood's housing units being converted to short-term rentals may gradually erode local social dynamics, leading to increased violence.

These findings could help urban planners and policy makers make better-informed decisions related to the impact of Airbnb listings on neighborhoods. These findings could also be useful for platform companies to create more effective platform governance and self-regulating mechanisms. Future research could explore whether similar results are seen in other cities, including those of difference sizes or demographics. Additional studies could also investigate other facets of the presence of Airbnb listings in neighborhoods.

Heydari says: "We show that it's not the number of Airbnb tourists who stay in a neighborhood that causes increase in criminal activities, but it's the creation of transient properties spread throughout a neighborhood that undermines social organization and social capital and over time and can cause disorder and criminal activities as a result.

Heydari adds, "This paper is one of the first papers that measures the causal social impact of sharing platforms at neighborhood level for short-term rental platforms [and] quantifies the causal effect of short-term rentals on criminal activities and disorders in neighborhoods. More importantly, [this paper] identifies the mechanism behind such effects. Identifying causal mechanism is for more effective governance of these platforms, either through government regulations or via designing self-regulating mechanism by platforms themselves."

A team of international researchers, led by the University of Bologna, has discovered the fossilised remains of methane-cycling microbes that lived in a hydrothermal system beneath the seafloor 3.42 billion years ago.

The microfossils are the oldest evidence for this type of life and expand the frontiers of potentially habitable environments on the early Earth, as well as other planets such as Mars.

The study, published in the journal Science Advances, analysed microfossil specimens in two thin layers within a rock collected from the Barberton Greenstone Belt in South Africa. This region, near the border with Eswatini and Mozambique, contains some of the oldest and best-preserved sedimentary rocks found on our planet.

The microfossils have a carbon-rich outer sheath and a chemically and structurally distinct core, consistent with a cell wall or membrane around intracellular or cytoplasmic matter.

Prof Barbara Cavalazzi, the lead author of the study, said: "We found exceptionally well-preserved evidence of fossilised microbes that appear to have flourished along the walls of cavities created by warm water from hydrothermal systems a few meters below the seafloor. Sub-surface habitats, heated by volcanic activity, are likely to have hosted some of Earth's earliest microbial ecosystems and this is the oldest example that we have found to date."

The interaction of cooler sea-water with warmer subsurface hydrothermal fluids would have created a rich chemical soup, with variations in conditions leading to multiple potential micro-habitats. The clusters of filaments were found at the tips of pointed hollows in the walls of the cavity, whereas the individual filaments were spread across the cavity floor.

Chemical analysis shows that the filaments include most of the major elements needed for life. The concentrations of nickel in organic compounds provide further evidence of primordial metabolisms and are consistent with nickel-content found in modern microbes, known as Archaea prokaryotes, that live in the absence of oxygen and use methane for their metabolism.

"Although we know that Archaea prokaryotes can be fossilised, we have extremely limited direct examples. Our findings could extend the record of Archaea fossils for the first time into the era when life first emerged on Earth," said Prof Cavalazzi.

She added: "As we also find similar environments on Mars, the study also has implications for astrobiology and the chances of finding life beyond Earth."

Pioneering 'printed metal' procedure to create bespoke treatment for early knee osteoarthritis set to be trialled in the UK following MHRA approval.

World's first 3D printed high tibial osteotomy (HTO) device and procedure developed at University of Bath given approval for UK trials

Bespoke titanium alloy HTO implants that fit perfectly are designed to reduce discomfort for knee osteoarthritis patients

Sophisticated 3D scanning aims to make surgery quicker and safer

New TOKA process could make earlier intervention possible - saving patients decades of pain before surgery becomes viable

Intro

A groundbreaking new treatment that uses 3D printed implants and that could bring relief to tens of thousands of knee osteoarthritis sufferers has received approval to be trialled in UK patients, following a virtual "in-silico" trial that demonstrated its safety.

The personalised early knee osteoarthritis treatment, developed by engineers at the University of Bath’s Centre for Therapeutic Innovation (CTI) working with 3D Metal Printing Ltd, uses state of the art 3D metal printing technology to make personalised medical-grade titanium-alloy plates that perfectly fit every patient.

The TOKA (Tailored Osteotomy for Knee Alignment) treatment improves the operative procedure and fit of high-tibial osteotomy (HTO) plates used to realign a patient's knee, making them more stable, comfortable and better able to bear weight than existing generic plates. The technique also simplifies HTO surgery, making operations quicker and therefore safer.

The HTO plates have already been safety tested virtually, in a computer-based trial using CT scan data from 28 patients. The in-silico clinical trial, the first in the world to demonstrate the safety of an orthopaedic device, modelled the stresses that would be exerted on the bespoke plates and showed that they would be comparable in safety to the standard treatment.

Professor Richie Gill, from the Centre for Therapeutic Innovation, says: "Knee osteoarthritis is a major health, social and economic issue and does not receive as much attention as it should. A quarter of women over 45 have it, and about 15 percent of men, so it's a significant burden that many live with.

"Knee replacement is only useful for end-stage osteoarthritis, so you can be in pain and have to live with a disability for a long time, potentially decades, before it's possible. We hope that the new TOKA process we've developed will change that."

Knee osteoarthritis patients undergoing TOKA will undergo a 3D CT scan of their knee, before a personalised 3D printed surgical guide and plate, both shaped to their tibia (shin) bone is created. The surgical guide simplifies the surgery, and is designed to improve surgical accuracy.

The process also sees the first implementation of 3D printed screw threads into the HTO plates, meaning they can be optimally positioned to help secure them against the bone.

Trials to begin once clinical centres reopen for elective surgery

When clinical centres return to carrying out elective surgery, expected later this year, the trials will begin. Hospitals in Bath, Bristol, Exeter and Cardiff will take part in a randomised control trial to compare patient outcomes with an existing generic HTO procedure.

Tests of the TOKA technique have already begun in Italy, where so far 25 patients received new personalised HTO plates as part of a trial at the Rizzoli Institute in Bologna.

High Tibial Osteotomy (HTO) surgery realigns the knee joint by making a cut to the tibia (shin bone) and opening a small gap, which needs to be stabilised by a metal plate. This realignment moves the loading to a less 'worn' part of the knee. Patient outcomes depend on how accurately the cut is made and the gap opened.

Prof Gill adds: "The HTO surgery has a long clinical history and it has very good results if done accurately. The difficulty surgeons have is achieving high accuracy, which is why we have created the TOKA method, which starts with a CT scan and digital plan.

"3D printing the custom knee implant and doing the scanning before operating means surgeons will know exactly what they'll see before operating and where the implant will go."

"In addition to a surgeon being able to precisely plan an operation, a surgical guide (or jig) and a plate implant, each personalised to the patient, can be 3D printed automatically based on the scanning data.

"Importantly this type of treatment relieves the symptoms of knee osteoarthritis while preserving the natural joint."

The pre-planning element greatly simplifies surgery and could cut the time on the operating table from two hours to around 30 minutes.

The work to date and UK trial is supported and funded by Versus Arthritis. The in silico trial has been published in Communications Medicine.

Jacksonville, Fla. - A recent qualitative research study conducted by the University of North Florida, in partnership with Indianan University-Purdue Indianapolis and UF Health Jacksonville, shows that black teenage girls want inclusive body types to be featured in advertising to combat teen obesity rates. Insights provided in the study are ideal for pediatricians and healthcare educators developing advertising and patient care plans to combat obesity among African American teens.

The study investigated social and cultural consequences of food consumption among African American teenage girls between the ages of 14-18 in Jacksonville, Fla., and explored best practices for anti-obesity communication in advertising. The teenagers in the study led active lifestyles and disagreed with traditional advertising that centered on a one-size-fits-all recommendation for weight management among teens like them.

Results from the study indicate preference for an inclusive body type approach that showcases advertising featuring diverse girls of different body types, races, etc., and that messaging should promote healthy lifestyles instead of a specific body-mass index measure. Utilization of social media platforms was recommended as the best communication method for message dissemination.

"Promoting one-size-fits-all messaging is counterproductive and excludes important cultural factors that influence food choice, options and normative beliefs regarding food culture and body genetics," said Dr. Natalie A. Mitchell, UNF marketing professor and principal investigator of the study. "These teenage girls respond best to messages that portray them as curvy and healthy."

Research participants reported struggling to balance their cultural food preference of soul food, often high in fat and sugar, with healthier food options. Results also revealed that the teenage girls preferred "slim thick," curvier body types, which include slim waistlines with shapely bottoms regardless of their petite, thin frames and is considered cultural capital, according to the research team.

"A driving force behind the desire for the Coca-Cola bottle frame commonly seen within the African American community is due to celebrity culture that celebrates such body types," said Mitchell.

Through in-depth interviews and photo elicitation, the girls identified celebrity body types whom they greatly admired and desired. Tiffany Haddish and Tyra Banks were the celebrities most frequently selected. Decisions were based on celebrity curvy frames and their likability.

A team of scientists has uncovered how heavy, motorized objects climb steep slopes--a newly discovered mechanism that also mimics how rock climbers navigate inclines.

The findings, which appear in the journal Soft Matter, stem from a series of experiments in which motorized objects were placed in liquid and then moved up tilted surfaces.

"These 'micro-swimmers' are about 20 times heavier than the fluid they swim in, but they were able to climb steep slopes that are almost vertical," explains Jun Zhang, one of the paper's authors and a professor of physics and mathematics at New York University's Courant Institute of Mathematical Sciences and NYU Shanghai.

The work enhances our understanding of "gravitaxis"--directional movement in response to gravity. The phenomenon is a vital consideration in not only engineering, but also in medicine and pharmaceutical development. It explains, in part, how bacteria move through the body and provides insights into ways to create more effective drug-delivery mechanisms.

In the Soft Matter research, the scientists created swimmers, or nanorods, whose length is roughly 1/40th the width of a strand of human hair. These motorized swimmers were tasked with moving up an inclined surface while immersed in a liquid solution within a walled container. The swimmers were composed of two types of metal--gold and rhodium as well as gold and platinum--a makeup that gave them unbalanced densities given the varying weights of these metals.

The swimmers' composition, liquid environment, and juxtaposition of surfaces enabled them to move upward, despite their significant weight.

"These motors reorient themselves upward against gravity thanks to their density imbalance--much like a seesaw reorients itself in response to the movement and weight of its riders," adds Michael Shelley, a professor at the Courant Institute and director of the Flatiron Institute's Center for Computational Biology. "A hydrodynamic effect amplifies this movement--swimming next to a wall yields a bigger torque in repositioning the motors' bodies upwards. This is important because the microscopic world is noisy--for the motor it's always two steps up and one step down--and the bigger torque improves their ability to move vertically."

In previous work, published in Physical Review Letters, Zhang, Shelley, and their colleagues created "nano-motors" in uncovering an effective means of movement against currents. The new research expands on these findings by revealing how heavy objects can move up steeply inclined surfaces, offering the promise of even more sophisticated maneuvers.

"Now that these micro-swimmers are able to climb very steep slopes against gravity, we can look toward developing even more difficult assignments," observes Zhang. "Future, advanced motors will be designed to reach targeted locations and to perform designated functions."

The physical interactions between coral and algal cells as they combine to form a symbiotic relationship have been observed for the first time. Within minutes of being introduced, coral cells had started to engulf the algae, where they were either digested or moved to a protective 'bubble' within the cell. This new study, published in Frontiers in Marine Science, will form the basis of further research to understand what drives their symbiosis at a cellular and molecular level, including the eviction of algae, which is the cause of coral bleaching.

"We watched coral cells develop pseudopodia - temporary arm-like structures - that were used to engulf the algae as early as 5 minutes after the two cells were mixed," explains Professor Nori Satoh, co-lead author of the study and head of the Marine Genomics Unit at the Okinawa Institute of Science and Technology Graduate University, Japan. "Once inside the coral cell, some algae were moved to a vacuole, a protective membrane-bound bubble, while others were broken up and digested."

Eviction notice

Coral and algae have had a cooperative relationship for over 200 million years. Coral cells provide algae with shelter and the building blocks for photosynthesis. In return, the algae provide the coral with nutrients. When corals are stressed, the algae can be evicted, which turns the coral white. Linked to climate change and pollution, this coral bleaching can be devastating, with negative impacts on wildlife, tourism, fisheries, and coastal flood protection.

Experiments to understand the detailed mechanisms of algal symbiosis with stony reef-building corals have proved difficult in the past, but Satoh and Kawamura recently succeeded in growing stable cell cultures of Acropora tenuis, a coral species widespread across Asia. The researchers introduced dinoflagellate algae to these laboratory-cultured coral cells to understand what happens in the initial stages of coral and algal symbiosis.

"Our study was designed to understand at the single cell level what occurs in the process of symbiosis and what may cause this symbiosis to cease," says co-lead author Prof Kaz Kawamura from Kochi University, Japan.

Swallowed up

Several minutes after they were introduced, the corals cells started to move faster and actively incorporate the dinoflagellate algae within their cells.

"We were able to directly observe the interactions and symbiosis with video and confirmed what we saw by preserving the cells in plastic resin and taking semi-thin sections to show the engulfment of dinoflagellates inside the coral cells," explains Kamamura. "We also noted that the coral cells that had incorporated algae gradually became round and less mobile and that their symbiosis lasted for at least a month."

Future research will build on this study to help us understand how corals recognize, take up and maintain their algal endosymbionts.

"Our laboratory-based system of coral cells and algae may ultimately provide methods that we can use for the preservation and conservation of coral reefs," says Satoh.

Satoh adds, "We have already prepared comprehensive gene information of both the coral Acropora tenuis and dinoflagellate algae. This will be especially useful for future studies of cellular and molecular mechanisms involved in their symbiosis."

Depression is the most frequently diagnosed psychiatric disorder among older adults, with 8% to 16% of older patients presenting with clinically significant depressive symptoms. Researchers in Spain conducted a randomized clinical trial of 347 older adults with mild to moderate depression, comparing the effectiveness of physical exercise and antidepressants as treatment methods. Study participants were assigned to either a group engaged in supervised physical exercise or a group that received antidepressant treatment by their general practitioners. Depressive symptoms were not significantly different after one month between the two groups. However, after three and six months, the number of people who showed improvement was significantly higher in the antidepressant group. The authors note that the number of participants who withdrew from the study was higher in the physical activity group, while more adverse side-effects were reported in the group treated with antidepressants. Authors felt the advanced age of participants and the health problems and/or functional limitations common to older adults may have negatively influenced adherence to a six-month physical activity program.