Culture

AURORA, Colo. (Dec. 11, 2019) - A major study conducted by the National Heart, Lung and Blood Institute's Prevention and Early Treatment of Acute Lung Injury (PETAL) Network into whether high doses of vitamin D can improve health outcomes for critically ill patients has concluded that such supplements do not reduce mortality or improve other non-fatal outcomes.

The results of the Vitamin D to Improve Outcomes by Leveraging Early Treatment (VIOLET) study, which included contributions from over 200 researchers at 44 academic medical centers, are published in the online issue of the New England Journal of Medicine. The lead author of the article is Adit Ginde, MD, MPH, professor and vice chair of the Department of Emergency Medicine at the University of Colorado School of Medicine.

For this study, Ginde and Daniel Talmor, MD, MPH, chair of the Department of Anesthesia, Critical Care & Pain Medicine at Beth Israel Deaconess Medical Center in Boston, served as co-chairs of the protocol committee for the National Heart, Lung and Blood Institute (NHLBI) PETAL Network.

"The VIOLET study did not show benefit from vitamin D supplementation in this population of critically ill patients" said Ginde. "However, the study gives us a model to intervene in the earliest stage of critical illness, which will yield improved care and better health for our patients in the future."

In this case, the researchers sought to determine whether vitamin D supplementation could reduce morbidity and mortality in critically ill patients. A deficiency of vitamin D is a common risk factor for worse outcomes in critically ill patients. While vitamin D is most known for strong bone formation, it also helps to fight infections, is a potent anti-inflammatory agent, and is essential for lung development and function.

"We wanted to study whether rapidly correcting vitamin D deficiency could improve outcomes for patients with critical illness," Talmor said. "Previous studies suggested that this treatment might reduce mortality, so we wanted to definitively show whether high doses of vitamin D could reduce all-cause, all-location 90-day mortality in those critically ill patients."

In this study, the NHLBI PETAL Network conducted a controlled study of patients who needed admission into intensive care units. Among those cases, patients had pneumonia, sepsis, shock, respiratory failure, and other critical conditions.

"This is the kind of important question that the PETAL network was designed to answer efficiently," said James Kiley, PhD, director of the Division of Lung Diseases at the NHLBI. "This trial could not have been performed without the successful collaboration between emergency medicine and critical care that the PETAL network facilitated."

From April 2017 through July 2018, 2,624 patients at 44 hospitals consented to participate in the study. Of those, 1,360 screened as vitamin D deficient and ultimately 1,078 were included in the final analysis. About half received vitamin D and half received a placebo, and the vitamin D group achieved rapid correction of vitamin D deficiency in the blood. Patients were followed for 90 days, and researchers found no difference in mortality rates, hospital length of stay, or time on mechanical ventilation between the two groups.

"While we hoped that vitamin D supplementation might prove beneficial to critically ill patients, our large study does not support early testing for or treatment of vitamin D deficiency in those patients," Ginde said.

The study simulated Chernobyl-levels of radiation exposure in a laboratory to investigate the impacts it may be having on insects inhabiting the exclusion zone. Although it has been previously found that bumblebees are sensitive to radiation, few studies have investigated the effects on their fitness. The dose rates of radiation in which negative effects occur are also uncertain.

Jessica Burrows, who will be presenting the research at the conference, said: "An increase in nectar consumption for an individual bee could have important ecological consequences, as bees may need to spend more time foraging to collect nectar for their individual needs. As a result, the growth of bumblebee colonies may be impaired if fewer resources are available for the developing brood; this might reduce the number of bees in the ecosystem."

A reduction in bees in the environment would then impair pollinator ecosystem services, causing wider impacts on the environment. Jessica Burrows added: "Further work is needed within the Chernobyl Exclusion Zone to understand the impacts of chronic low-dose exposure on the wider ecosystem. There has been little work conducted on the effects of radiation on flowering plant species."

Although the Chernobyl exclusion zone is often thought of as a barren wasteland, in the years since the 1986 nuclear accident it has become a biodiverse habitat, home to dozens of charismatic species such as wolves and brown bears. Previous work at Stirling University has also revealed that pollinators are quite abundant in the area. It's thought this increase in biodiversity has been driven by the absence of humans.

However, the landscape still delivers low-dose rates of radiation to organisms that inhabit the area and the ecological consequences of this remain unclear. Jessica Burrows describes the modern day exclusion zone as a "living laboratory in which to study the impacts of radiation as an environmental stressor". She explains that "Whilst we know about how radiation affects some organisms at Chernobyl, one big challenge is to work out how multispecies ecosystems respond to this type of chronic radiation stress and whether evolutionary responses have occurred in the species that live there."

To test the effects of sub-lethal doses of radiation on bumblebees, the researchers used a caesium source that exposed the bees to radiation levels comparable to those found in the Chernobyl Exclusion Zone. They were able measure the amount of nectar consumed by weighing feeding tubes, and the bees' metabolic rates by measuring the rate they produced carbon dioxide.

On further research, Jessica said: "We would like to develop the work conducted here to understand if the effects recorded for metabolic rate and appetite in bumblebees could be found in other species. This will allow us to understand if this is a general effect of low dose radiation exposure, or if it is a unique effect on just bumblebees."

Using a laboratory setting as a proxy for the Chernobyl exclusion zone meant that the authors could safely replicate the levels of radiation found there. However, not all conditions could be replicated perfectly. Jessica explained that: "In the controlled environment bees were supplied with everything they could require for survival, including plentiful nectar so they didn't have to forage as they would naturally.

"In nature bumblebees would have to fly long distances to forage for pollen and nectar from flowers. We suspect that the effects of radiation exposure might be stronger under these natural conditions in the Chernobyl Exclusion Zone."

Jessica Burrows will present the research on Thirsday 12 December 2019 at the British Ecological Society annual meeting. The conference will bring together 1,200 ecologists from more than 40 countries to discuss the latest research.

WASHINGTON - A U.S. Naval Research Laboratory-built camera mounted on the NASA Parker Solar Probe revealed an asteroid dust trail that has eluded astronomers for decades.

Karl Battams, a computational scientist in NRL's Space Science Division, discussed the results from the camera called Wide-Field Imager for Solar Probe (WISPR) on Dec. 11 during a NASA press conference.

WISPR enabled researchers to identify the dust cloud trailing the orbit of the asteroid 3200 Phaethon.

"This is why NRL's heliospheric imagers are so ground-breaking," Battams said. "They allow you to see near-Sun outflows massively fainter than the Sun itself, which would otherwise blind our cameras. And in this case, you can also see solar system objects extremely close to the Sun, which most telescopes cannot do."

He said the trail is best seen near the Sun where 3200 Phaethon's dust is more densely packed, making WISPR a vital tool for scientists.

The data captured by WISPR determined the asteroid dust trail weighs an estimated billion tons, and measures more than 14 million miles long. The findings raise questions about the trail's origin.

"Something catastrophic happened to Phaethon a couple of thousand years ago and created the Geminid Meteor shower," Battams said. "There's no way the asteroid is anywhere near active enough when it is near the Sun to produce the mass of dust we are seeing, so we are confident that WISPR is seeing part of the Geminid meteor stream."

WISPR, designed, developed and led by NRL, records visible-light images of the solar corona and solar outflow in two overlapping cameras, which together cover more than 100-degrees angular width from the Sun.

Understanding how the solar environment behaves is important to the Navy and Marine Corps because when the solar winds reach Earth, they can affect GPS, spacecraft operations, and ground-based power grids.

WISPR and the Parker Solar Probe will continue to orbit the Sun for the next five years.

BINGHAMTON, N.Y. -- A gradual approach to increasing the stakes of group coordination projects can improve overall team performance, according to a new research paper featuring faculty at Binghamton University, State University of New York. 

"What drives successful group coordination is important because team coordination is ubiquitous in many work settings, such as in medical professions, in law enforcement, or in finance," said Plamen Nikolov, assistant professor of economics at Binghamton University. "Therefore, uncovering the key determinants of successful group coordination is paramount."

At the root of this success are efficient coordination mechanisms. Gradualism, defined as increasing the stakes of a fixed group coordination project step-by-step, is one such mechanism. This technique is frequently used within and between organizations in team building and training efforts, and collaborative endeavors, respectively. 

Examples of gradualism at work are abundant in the world of microfinance. "Group lending can result in better loan repayment rates when lenders first approve small loan sizes and then progressively approve a higher loan amount once a group proves to be a reliable borrower with smaller loan amounts," said Nikolov.

To study the effectiveness of gradualism as a group coordination mechanism, Nikolov and his team conducted an experiment in which groups were met with varying levels of stakes for hypothetical projects. One group had a gradual increase in stakes; the second group had consistently high stakes; and a third group had low stakes for the first half of the experiment and high stakes for the second half.

Nikolov and his team found that the gradualism treatment group significantly outperformed the alternative treatment groups. The gradualism group coordinated successfully nearly two-thirds of all sessions. Additionally, the occurrence of successful group coordination in the gradualism treatment was two to four times greater than the successful coordination seen in the alternative groups. 

"Our findings have broad lessons and implications for how managers can structure team practices where the decision regarding the order of tasks a team tackles is a variable that they have control over," said Nikolov. "If successful group coordination is a manager's objective, our central finding points to a stylized feature of how managers can structure group assignments optimally: teams need to start small and then progressively and slowly move to high-stake tasks."

According to Nikolov, future research will focus specifically on how individual beliefs toward other group members in a team affect gradualism and successful group coordination. 

Imagine the impact on first-year college student-athletes in highly competitive programs if you could teach them resilience - if they learned skills to cope with high expectations, challenging academic courses, rigorous training and physical injuries, homesickness and even the stressors of life beyond college.

In newly published research, a unique and expanding program at the University of Massachusetts Amherst has been shown to improve decision-making and emotional awareness, lower perceived stress and build resilience among diverse and sometimes at-risk college athletes, according to survey data reported by the student participants, compared to a control group of student-athletes. Part of the research was supported by funding in 2017 from the National Collegiate Athletic Association's (NCAA) Innovations in Research and Practice Grant Program, which is designed to improve the psychosocial well-being and mental health of the student-athlete.

"Participants gained skills key to victory on and off the field, including a sense of belonging, persistence, leadership and the ability to negotiate for the resources they need," says lead author Genevieve Chandler, a mental health nurse and UMass Amherst nursing professor who developed the innovative program from studying the effects of resilience for two decades.

The new study, published in the Journal of the American Psychiatric Nurses Association, focused on 47 first-year football players and 15 women's basketball players in Division 1 programs at UMass Amherst between 2016-2018. The participants were 18 or 19 years old; 66% were African American, and the rest were non-Hispanic white, with the exception of one Hispanic participant. The control group consisted of student-athletes who did not receive the training because they arrived later on campus.

Resilience - the ability to persist through challenges and recover from adversity - is no longer considered a character trait by researchers but a "practiced interaction between person and environment," the study points out.

"Negative thoughts stick to us like Velcro," Chandler explains. "We have to train our brain to hang on to the positive things. We are experts in stress, so we need to practice building up the calm side of the brain, the focused side."

Chandler developed the resilience-building workshop as a one-credit academic course called Changing Minds, Changing Lives to address the predictable stresses students face as they adjust to college life - especially those with a history of adverse childhood experiences (ACEs). ACEs emerging from a child's social experience within the family and community "have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity," according to the Centers for Disease Control and Prevention.

Initially offered to nursing students, Chandler's class caught the interest of psychiatric social worker Jim Helling, a UMass Center for Counseling and Psychological Health senior clinician who was then working in the Athletic Counseling Office. Helling thought that in a predominantly white university, black student-athletes in particular could benefit from a new kind of support system better suited to helping them cope with chronic stress exposure. "We needed a new approach, a psychological wellness program that would be culturally resonant for students of color," Helling says. "Ginny's work focuses on strengths, celebrates resilience and empowers black athletes to express themselves in their own voice. This model has been a game changer for our students."

Together, they began teaching the course to first-year football student-athletes, who in turn used their newly developed leadership skills to mentor high school football players in nearby Springfield.

In 2018, Chandler and Helling added basketball players, and interest has now spread across campus to target student groups facing particular stress, such as female and minority engineering students in a program traditionally dominated by white males. They have been featured at conferences and conducted resilience course trainings across the country so other educators can teach the curriculum.

Chandler points out that the 50% of study participants who reported ACEs showed greater increments of positive change in emotional awareness scales than participants without ACEs, illustrating the distinctive importance and benefits of resilience training for an at-risk group. An estimated 60% of the U.S. population has at least one ACE.

"I'd hope that it's a class that everyone could take, honestly," says Caeleb Washington, a UMass Amherst defensive lineman from Melbourne, Fla., who took the resilience course and later served as a teaching assistant.

The course is interactive and experiential. The content focuses on what Chandler calls the ABCS: active coping, such as exercise or meditation; building strength by focusing on and advancing one's aptitudes rather than weaknesses; cognitive awareness, which involves being aware of automatic thinking; and garnering social support. To gain the neuroplastic benefits of repetitive practice, each class follows the same format. It begins with each individual describing a "positive practice exercise" they did as homework. Breathing exercises and yoga poses follow. Relevant research is presented and then students, as well as teachers, complete a five-minute, deeply personal writing reflection related to the research. The writing is read aloud, after which class members share feedback about what they found strong in the writing. Class ends with each participant sharing an affirmation, appreciation or appraisal about that day's class.

"This class has taught me how to breathe. It taught me about leadership and it taught me how to just stay calm," says UMass Amherst senior Vashnie Perry, a health administration major from the Atlanta area and co-captain of the women's basketball team. "It's the best advice I've had since I've been in college."

Aside from car crashes, suicide is now the second-leading cause of death among young people in the United States, according to the Centers for Disease Control. In Ohio alone, suicide is the leading cause of death for 10- to 14-year-olds, according to new data from the state's health department.

Experts agree that among the most effective ways to prevent suicide among youth is getting adults to pay attention to the warning signs.

Toward that goal, new research from Case Western Reserve University examined the impact of virtual training on the mental-health and suicide-prevention skills of more than 33,000 middle-school educators. The researchers found, overwhelmingly, that those who completed the training had "higher levels of preparedness" in identifying suicide warning signs than participants at the pre-test evaluation.

"Middle-school educators can play a big role in suicide prevention," said Jane Timmons-Mitchell, a senior research associate at the Begun Center for Violence Prevention Research and Education at the university's Jack, Joseph and Morton Mandel School of Applied Social Sciences. "These educators are the gatekeepers. It's not just teachers--this is everyone in the educational system, from lunch ladies to bus drivers."

The idea behind the research was to get more educators trained--and to bring more awareness to the importance of the training--in suicide prevention.

"Bus drivers, for example have a great baseline for what a student is usually like, and they're on the frontlines and are able to watch out for behavior that's out of the ordinary," Timmons-Mitchell said.

The virtual training, Kognito At-Risk simulation, is essentially an online role-playing video game that replicates interactions with at-risk youth. The program also covers topics such as bullying, she said.

Timmons-Mitchell, lead evaluator on the research, said that of the 33,703 educators nationally who participated, more than 90% had never received any kind of mental-health training.

"The training by itself, while helpful, is just a part of the system," she said. "The training helps teach them about the next steps, which includes getting the information to trained professionals such as guidance counselors."

More than half the states nationally--and a few other countries--already require this type of training, Timmons-Mitchell said.

"There's a consensus that more people than teachers need to be prepared," she said. "This is a very straightforward concept. It's commonly discussed in academia, but there is a real result here in the classrooms, lunchrooms and school buses around the country."

Arlington, Va. - New research funded by the Frozen Food Foundation developed a modeling tool to assist the frozen food industry with understanding and managing listeriosis risks. The findings are published in the December 2019 issue of Journal of Food Protection.

The study developed a decision-making tool - Frozen Food Listeria Lot Risk Assessment (The FFLLoRA) - that incorporates several factors including individual facility attributes, Listeria monocytogenes (Lm) prevalence and consumer handling to estimate listeriosis risks.

"While Lm-related foodborne illness is rarely associated with frozen foods, the frozen food industry is focused on better understanding Listeria to prevent a listeriosis event from occurring," said Frozen Food Foundation Executive Vice President Dr. Donna Garren. "That's why we invest in scientific research from the frozen food facility to fork."

While researchers demonstrated that low-levels of Lm in frozen vegetables did not typically cause illness, the study also revealed the significance of production practices and finished-product testing, along with the role of consumers to follow validated cooking instructions.

"The goal of the research was to develop a tool for companies to assess individual production lot risks based on various scenarios," said Cornell lead researchers Dr. Renata Ivanek and Dr. Martin Wiedmann. "FFLLoRA helps interpret and evaluate finished-product testing results and may support food safety decisions to prevent recalls."

Lead author of the study Dr. Claire Zoellner added, "Importantly, the study also identified key data gaps that will be prioritized in future research, including quantifying the need for consumers to follow validated cooking instructions."

Cornell's research on Lm will continue throughout 2020 to provide a better understanding of Lm prevalence in frozen food facilities and related risk assessment. Additional frozen food industry Lm-related publications are available here.

"Through the work of the Frozen Food Foundation, the frozen food industry continuously builds upon its high food safety standards," added Dr. Garren. "This published research complements the tools and resources available on The Food Safety Zone to help prevent and control Lm."

WESTMINSTER, Colorado - DECEMBER 11, 2019 - Buffelgrass is a drought-tolerant, invasive weed that threatens the biodiversity of native ecosystems in the drylands of the Americas and Australia. Unfortunately, though, land managers trying to control the weed often experience mixed results.

To shed new light on buffelgrass and the best techniques to use for its control, researchers from the University of Arizona conducted a literature review that is featured in vol. 12 issue 4 of the journal Invasive Plant Science and Management. The authors synthesized the results from 229 studies conducted on several continents and in a variety of ecosystems. Among their findings:

The most effective buffelgrass control is achieved when multiple techniques are used in tandem and when follow-up treatments are applied. For example, fire might be used to destroy adult plants, followed by herbicide applications or the manual removal of new seedlings.

Buffelgrass takes advantage of environmental conditions to compete against native species. For example, it can access water deeper in the soil profile for longer into the dry season and can take advantage of nutrients and space made available after wildfires or other disturbances. As a result, land managers may want to focus on restoration of drought-tolerant native species that can compete effectively under the same conditions.

The long-term impact of buffelgrass treatments on native plants and ecosystems is poorly understood. The authors suggest the need for additional research to explore the issue.

"Our review highlights the value of integrated weed management programs," says Hannah Farrell, PhD student and lead author. "Herbicides or other treatments used in isolation are uniformly less effective in controlling buffelgrass than those used in tandem with other approaches."

NEW YORK, NY--December 10, 2019--From 2007 to 2018, claim lines with diagnoses of Lyme disease increased nationally 117 percent, according to a new white paper from FAIR Health, a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information. Comparing Lyme disease to other tick-borne diseases, the study draws on data from FAIR Health's comprehensive repository of over 29 billion private healthcare claim records--the largest in the country.

A bacterial infection transmitted through the bite of blacklegged ticks, Lyme disease historically has been associated more with rural than urban areas. But the new study shows that the growth in claim lines from 2007 to 2018 was more pronounced in urban locations. In urban areas, the increase was 121 percent, compared to 105 percent in rural areas--a difference perhaps attributable in part to people seeking care for the disease in or around their urban homes or work environments notwithstanding having contracted Lyme in a rural setting.

The white paper originated as an invited presentation to the Tick-Borne Disease Working Group's Subcommittee on Training, Education, Access to Care and Reimbursement. Congress established the Tick-Borne Disease Working Group as part of the 21st Century Cures Act of 2016.

Among the white paper's other findings:

Predominance. Claim lines for Lyme disease accounted for 94 percent of claim lines for tick-borne diseases in 2018.

Geographic spread. In 2007, the five states with the highest number of claim lines with Lyme disease diagnoses as a percentage of all medical claim lines by state were all in the Northeast, but in 2018, one (North Carolina) was in the South.

Gender. In both rural and urban areas in 2018, more claim lines with Lyme disease diagnoses were submitted for females than males.

Other diagnoses. In 2018, the 10 most common "other diagnoses" found in patients who had been diagnosed with Lyme disease were, in order from most to least common, general signs and symptoms, dorsopathies (disorders of the spine), soft tissue disorders, other joint disorders, disorders of the thyroid gland, anxiety and other nonpsychotic mental disorders, osteoarthritis, skin and subcutaneous tissue symptoms, dermatitis and eczema, and mood (affective) disorders. All were more common in patients with Lyme disease than in all patients.

Age. In both rural and urban areas in 2018, individuals aged 51 to 60 held the largest share of the age distribution of claim lines with Lyme disease diagnoses. The age group 41-50 held the second largest share in both rural and urban areas.

Monthly distribution. In 2018, July was the month with the highest share of the distribution of claim lines for Lyme disease. The month with the lowest share was December.

FAIR Health President Robin Gelburd commented: "FAIR Health is pleased to use our unequaled data repository to help fill the gaps in knowledge about Lyme disease. Our study provides a foundation to advance the work of other researchers."

New findings from a clinical trial show that treatment with the immunotherapy drug blinatumomab is superior to standard chemotherapy for children and young adults with high- or intermediate-risk B-cell acute lymphoblastic leukemia (B-ALL) that has relapsed. Those treated with blinatumomab had longer survival, experienced fewer severe side effects, had a higher rate of undetectable residual disease, and were more likely to proceed to a stem cell transplant.

"Our study demonstrates that immunotherapy with blinatumomab is more effective and less toxic than chemotherapy as a bridge to curative bone marrow transplant for children and young adults with very aggressive relapse of B-ALL," said Patrick Brown, M.D., who chaired the trial and is director of the Pediatric Leukemia Program at the Johns Hopkins Kimmel Cancer Center, Baltimore. "We are thrilled that these patients, whose survival has not substantially improved for decades, now have a new and better standard of care."

The findings were presented as a late-breaking abstract at the American Society of Hematology (ASH) annual meeting on Dec. 10, 2019. The trial was led by the Children's Oncology Group (COG), part of the National Cancer Institute (NCI)-sponsored National Clinical Trials Network. NCI is part of the National Institutes of Health. Amgen reviewed the trial protocol and amendments and provided the study drug under a Cooperative Research and Development Agreement with NCI.

"These findings will likely have immediate impact on the treatment of this group of children and young adults with relapsed B-ALL," said Malcolm Smith, M.D., Ph.D., associate branch chief for pediatric oncology in NCI's Cancer Therapy Evaluation Program, which sponsored the trial. "These results also reinforce the important role that federally funded clinical trials play in developing more effective treatments for children with cancer."

When children have B-ALL that relapses after their initial treatment, they are typically given chemotherapy. The first four to six weeks of chemotherapy, the reinduction phase, is commonly followed by additional intensive chemotherapy, or consolidation treatment, to further reduce disease levels. Following this, hematopoietic stem cell transplant is considered the best treatment for approximately half of patients, based on factors such as whether relapse occurred during initial treatment or shortly after it was completed.

However, chemotherapy can produce severe side effects in some patients and is sometimes ineffective in reducing leukemia levels to the low levels needed prior to transplant. As a result, patients may not be able to proceed to transplant or transplant may be delayed, which increases the risk that the leukemia will return.

The COG study investigated blinatumomab as an alternative type of consolidation treatment to follow the reinduction phase. Blinatumomab is a type of immunotherapy that works by binding to two different molecules: CD19, a protein, or antigen, expressed on the surface of B-ALL cells, and CD3, an antigen expressed on T cells. By bringing T cells close to leukemia cells, the immunotherapy helps the T cells recognize and kill the cancer cells.

Blinatumomab has been approved by the U.S. Food and Drug Administration (FDA) for adults and children with B-ALL that has returned or has not responded to treatment. FDA has also granted accelerated approval to the drug--meaning confirmatory trials must show it has clinical benefit--for some adults and children undergoing treatment for B-ALL who achieve complete remission but still have small amounts of leukemia detectable using very sensitive methods.
Investigators in this study wanted to see if blinatumomab could increase rates of survival free from leukemia and be less toxic than intensive chemotherapy in children and young adults undergoing consolidation treatment.

The trial report was based on 208 children and young adults aged 1-30 with relapsed B-ALL who had received reinduction chemotherapy and were considered to have high- or intermediate-risk disease. They were randomly assigned to receive either two rounds of intensive chemotherapy or two 4-week rounds of treatment with blinatumomab before proceeding to a transplant. (A separate part of the study addressed children with low-risk disease.)

After a median follow-up time of 1.4 years, those in the blinatumomab group had higher rates of 2-year disease-free survival, the primary outcome of the study, than those who received intensive chemotherapy (59.3 ± 5.4% vs. 41 ± 6.2%). Those treated with blinatumomab also had higher rates of overall survival (79.4 ± 4.5% vs. 59.2 ± 6%), fewer severe side effects, a higher rate of undetectable residual disease (79% vs. 21%), and a higher rate of proceeding to stem cell transplant (73% vs. 45%).

At a planned interim analysis, an independent data safety monitoring committee concluded that the outcome for children treated with blinatumomab was superior to that of children treated with chemotherapy only and recommended that enrollment to the high- and intermediate-risk part of the trial be stopped.

Future clinical trials will study whether blinatumomab's effects in relapsed B-ALL can be enhanced by combining it with other immunotherapy and will test whether adding the drug to standard chemotherapy for children and young adults with newly diagnosed B-ALL is beneficial.

DES PLAINES, IL -- Video discharge instructions in the emergency department are associated with less perceived acute otitis media (AOM) symptomatology compared to a paper handout. That is the finding of a study published in the December 2019 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The lead author of the study is Sheena Belisle MD, a faculty member in the Department of Pediatrics, Division of Paediatric Emergency Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario.

Children of parents with acute otitis media who watched a five?minute video in the emergency department (ED) detailing the identification and management of pain and fever experienced a clinically important and statistically significant decrease in symptomatology compared to a paper handout.

Both interventions were associated with high parental knowledge and satisfaction and were associated with clinically important reductions in symptoms within three days, however AOM symptomatology appeared to be significantly better among the video group.

The findings suggest that video discharge instructions are beneficial for ED use among parents of children with acute otitis media. Given the logistic advantages of using a video to provide discharge instructions in a busy ED, the authors recommend that this approach should be strongly considered, particularly when time and space constraints hamper efforts to engage in a dialogue.

Commenting on the study is Emily MacNeill, MD, associate program director and associate professor of emergency medicine at Atrium Health, Charlotte, North Carolina, where she is also the associate fellowship director for the Pediatric Emergency Medicine program and the assistant residency director for the emergency medicine residency program:

"This is an interesting study as it shows that giving parents video discharge instructions for care of children with otitis media leads to similar outcomes as paper. Interestingly, this paper shows a decrease in reported pain for the video group despite using the same or even less analgesia. This may have been selection bias or maybe even greater comfort with symptoms in the video group. Regardless, showing that video instructions yield similar outcomes as paper further emphasizes that we can consider novel methods for educating patients. The patient sample in this study had a high degree of educated parents. Perhaps more significant improvements in understanding would be found in video education for parents with low health literacy."

Low-productivity agricultural land could be transformed into millions of hectares of conservation reserve across the world, according to University of Queensland-led research.

The research team proposed a new way of understanding the conservation value of "uncontested lands" - areas where agricultural productivity is low.

Dr Zunyi Xie, from UQ's School of Earth and Environmental Sciences, said uncontested lands could be low-hanging fruit for expanding the world's conservation areas.

"These spaces could offer great opportunities, and it's time we recognise what that could mean and where it might be," Dr Xie said.

"Global agricultural area has actually declined over the past two decades due to socio-political trends, market changes and environmental degradation.

"Restoring degraded lands that are no longer contested for agricultural use, due to low productivity or inappropriate farming practices, may present a major conservation opportunity if balanced with local community and indigenous groups' needs."

UQ's Associate Professor Eve McDonald-Madden said this approach could be cheaper and quicker than others.

"Quite rightly, most conservation endeavours focus on protecting the best places for biodiversity," she said.

"Yet these areas are often in high demand for other uses, such as agricultural production or resource extraction.

"The contested nature of these places makes land acquisition for protecting species expensive and a lengthy process.

"While those battles for high-value biodiversity areas continue, as they should, let's take advantage of the vast areas of underutilised agricultural land across the globe.

"Those areas that don't play a key role in food security or economic well-being and once revived can bring conservation gains."

The team has been working on mapping and quantifying opportunities for protecting these lands, believing they could help nations reach their United Nations Sustainable Development Goals (SDGs) commitments.

"This research will support effective prioritisation of conservation restoration to support biodiversity and in an attempt to tackle climate change," Dr Xie said.

"It also provides a critical evidence base, helping broaden the options available to those making decisions about what land to preserve by highlighting areas that may otherwise be overlooked.

Every organ in the body is capable, to some extent, of repairing itself after an injury. As part of this process, scar tissue forms and then recedes to make room for normal tissue when healing is complete.

However, when healing is disrupted -- whether by chronic injury or disease -- the cells that make up scar tissue can go rogue, continuously dividing and spreading until the scar eventually strangles the organ it was intended to help heal, which can lead to organ failure.

That progressive, out-of-control scarring is called fibrosis, and it can occur in any organ in the body. Fibrosis plays a major role in many diseases and conditions, including chronic kidney disease, liver cirrhosis, idiopathic pulmonary fibrosis, scleroderma and heart failure.

"Millions of people living with fibrosis have very limited treatment options," said Dr. Brigitte Gomperts, a member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA . "Once scarring gets out of control, we don't have any treatments that can stop it, except for whole-organ transplant."

For decades, researchers have been seeking a therapy that can halt or reverse fibrosis, but one major roadblock has been the difficulty of replicating the complex, progressive nature of the disease in the lab, where possible treatments could be tested.

Now, a team led by Gomperts has developed a "scar in a dish" model that uses multiple types of cells derived from human stem cells to closely mimic the progressive scarring that occurs in human organs. The researchers used this model to identify a drug candidate that stopped the progression of and even reversed fibrosis in animal models.

Their study is published today in Cell Reports.

The model was created using induced pluripotent stem cells, or iPS cells, which are generated by reprogramming adult skin or blood cells back to a stem-like state from which they can generate any cell type.

Traditionally, when iPS cells are used to model scarring and other disorders, they are first coaxed to produce one specific cell type through a process called directed differentiation. To generate their model, Gomperts and her colleagues took a different approach: They let their iPS cells do what stem cells would normally do in the human body, which is to produce a range of cell types.

"Fibrosis likely occurs as the result of interactions between multiple different cell types, so we didn't think it made sense to use just one cell type to generate a scarring model," said Preethi Vijayaraj, the study's first author and an assistant adjunct professor of pediatric hematology/oncology at the David Geffen School of Medicine at UCLA and a member of the UCLA Jonsson Comprehensive Cancer Center.

The resulting mixture contained many types of cells that are thought to play a role in fibrosis, including mesenchymal cells, epithelial cells and immune cells. All of the cells in the mixture retained a degree of plasticity, meaning they had the capacity to change cell types, from an epithelial cell to a mesenchymal cell, for example.

Gomperts' model is the first to recreate that plasticity, a hallmark of progressive fibrosis.

With all of the key cell types involved in fibrosis in place, the team just needed to bring about the scarring process. To do that, they placed the cell mixture on a rigid hydrogel that recreated the approximate stiffness of a scarred organ. The cells responded in the same way that they respond to injury in the body, by producing signals of injury or damage and activating a molecule called transforming growth factor beta, or TGF beta, which serves as the spark that sets off the roaring fire of fibrosis.

In the past, when researchers have created models in the lab for fibrosis, they have used one type of cell -- usually mesenchymal cells -- to which they added TGF beta to provoke scarring. Because TGF beta was added by scientists (and not produced by the cells themselves in response to an injury), those experiments produced models that tended to heal on their own, which made it difficult to discern whether possible treatments were working or the model was simply "healing" itself.

By using the hydrogel to simulate injury and provoke TGF beta production, Gomperts' team ensured their model was not able to heal itself; as long as the cells remained on the hydrogel, they perceived an "injury" and continued to progressively scar. That gave the researchers the rare opportunity to test drug candidates on a scar that wasn't actively engaged in healing itself.

After confirming that the new model accurately recreated fibrosis in human organs, the team set out to identify drugs that could halt or reverse the process. They tested more than 17,000 small molecules -- organic compounds that are often used to create pharmaceutical drugs.

The team identified a small molecule that stopped progressive scarring and even healed the damage it had caused. The researchers suspect the molecule works by activating the cells' inherent wound healing processes.

"This drug candidate seems to be able to stop and reverse progressive scarring in a dish by actually breaking down the scar tissue," said Gomperts, who also is a professor of pediatrics and pulmonary medicine at the Geffen School of Medicine and a member of the Jonsson Cancer Center. "We tested it in animal models of fibrosis of the lungs and eyes, and found that it has promise to treat both of those diseases."

Moving forward, the team plans to pin down how that drug candidate reverses scarring and screen additional small molecules to gain a better understanding of the disease and identify more drug candidates.

The study was funded by the National Institutes of Health, the UCLA Children's Discovery and Innovation Institute and the UCLA Broad Stem Cell Research Center, including support from the Steffy Family Foundation.

The experimental therapy tested by the researchers was used in preclinical tests only and has not been tested in humans or approved by the Food and Drug Administration as safe and effective for use in humans. The newly identified therapeutic strategy is covered by a patent application filed by the UCLA Technology Development Group on behalf of the Regents of the University of California, with Gomperts and Vijayaraj as co-inventors. Gomperts is a co-founder and stock owner of InSpira LLC, a company founded to develop this therapeutic strategy for fibrosis.

AMES, Iowa - A new study that examines the genetics behind the bitter taste of some sorghum plants and one of Africa's most reviled bird species illustrates how human genetics, crops and the environment influence one another in the process of plant domestication.

The study untangles these factors to create a more complete look at crop domestication than is possible in other major crops, said Xianran Li, an adjunct associate professor in the Iowa State University Department of Agronomy and corresponding author of the paper. The study, published recently in the scientific journal Nature Plants, looked at how human genetics, and the presence of bird species with a taste for sorghum seeds might have influenced the traits farmers in Africa selected in their crops over thousands of years. The unique geographic distribution in Africa of sorghum plants that contain condensed tannins, or biomolecules that often induce a bitter taste, provided one side of a "domestication triangle" that helped the researchers piece together the domestication puzzle, Li said.

"It's a systematic view that gives us a full picture of domestication," he said. "Looking at just one component only tells us part of the story."

Sorghum is a cereal crop first domesticated in Africa that remains a staple food throughout the continent. The researchers noted that sorghum varieties with high levels of tannins commonly grow in eastern and southern Africa, while western African farmers tend to prefer varieties with low tannin content. In contrast, domestication processes in other continents removed condensed tannins from most other cereal crops, such as wheat, rice and corn, due to the bitter taste they produce.

But farmers in south and east Africa grow many cultivars that retained tannin, which would seem to be a puzzling decision considering the taste and unfavorable nutritional values. Li said the condensed tannins were likely retained as a defense mechanism from the red-billed quelea, a bird species sometimes referred to as a "feathered locust" that can cause up to $50 million in economic losses in Africa every year from eating crops. Li and his co-authors found the distribution of sorghum cultivars with tannin correspond to areas with red-billed quelea populations.

They also consulted publicly accessible genotype information on human populations in Africa and found an associated distribution of the taste receptor TAS2R among Africans in regions that commonly grow sorghum with tannin. Taste receptors are molecules that facilitate the sensation of certain tastes, and the patterns in the distribution of TAS2R could make people living in those regions of Africa less susceptible to the bitter taste caused by tannin.

Li called this unique interaction among sorghum tannin, human taste receptors and herbivorous birds a unique triangle that offers unique insight into crop domestication. And, because condensed tannins were bred out of other cereal crops, this kind of research is possible only with sorghum, he said.

"Our investigation uncovered coevolution among humans, plants and environments linked by condensed tannins, the first example of domestication triangle," Li said. "The concept of a domestication triangle has been proposed previously and generally accepted. Discovering a concrete case, particularly with some molecular evidence, is very exciting. We think this study could help uncover future cases."

To arrive at their conclusions, the research team grew sorghum varieties with and without tannin and analyzed publicly available datasets on human genetics and wild bird populations in Africa to untangle how these factors interact with one another to influence the domestication of sorghum in Africa. The experiments involving sorghum grown in Iowa found sparrows would feed on the seeds of plants without tannin but left alone the cultivars that contained tannin, reinforcing the concept that herbivore threats to sorghum crops prefer non-tannin varieties.

"The whole discovery was driven by curiosity, after we observed the unexpected sparrow damage in our sorghum field," said Jianming Yu, professor of agronomy and Pioneer Distinguished Chair in Maize Breeding. "We really had no clue that our gene cloning project to find the pair of interacting genes underlying sorghum tannins would lead to this discovery."

Ultra-stable laser light that was stored in optical resonators of up to 4km length enabled the first observations of gravitational waves from inspirals of binary black holes and neutron stars. Due to the rather low bandwidth of the optical resonator system, however, the scientifically highly interesting post-merger signals at frequencies above a few hundred hertz could not be resolved. Such information would give access to the physics of neutron stars, allowing to study the ultra-dense quantum matter and possibly to find the missing link between gravity and quantum physics.

Recently, scientists MSc. Mikhail Korobko and Prof. Roman Schnabel from the University of Hamburg and Dr. Yiqiu Ma and Prof. Yanbei Chen from the California Institute of Technology proposed a novel all-optical approach to expanding the detection bandwidth of gravitational-wave observatories towards kilohertz frequencies.

What they call 'quantum expander' takes advantage of squeezing the quantum uncertainty of the laser light inside the optical resonator system. While squeezing the quantum uncertainty of the laser light before injection into the resonator system is already routinely used in all gravitational-wave observatories since April 2019, the new add-on will specifically improve the signal-to-noise-ratio at kilohertz frequencies, in fact, without deteriorating today's high performance at lower frequencies.

The scientists propose placing a nonlinear crystal inside the so-called signal-recycling cavity, which is a subsystem in every gravitational-wave observatory today and pump this crystal with green laser light having half the wavelength of the main laser light used in the observatory. The interaction between the pump and the main light leads to a squeezed uncertainty in the quantum fluctuations of the main laser. When the signal-recycling cavity length is controlled to remain a non-integer multiple of the laser wavelength, especially the high frequency quantum fluctuations of the laser light are squeezed in addition to any squeezing injected from the outside.

The newly invented 'quantum expander' is fully compatible with previously invented quantum-noise-suppression techniques. It is intrinsically stable and doesn't require significant modifications to the general topology of the observatories. What it does require is a further improved quality of optical components for further reduction in loss of photons. The 'quantum expander' may find applications beyond gravitational-wave detection in the areas of quantum metrology and quantum optomechanics.