Culture

Whether they're dealing with impatient diners at a restaurant, handling returns at a clothing store or appeasing angry consumers at a call centre, anyone working in the service industry will tell you: it's a tough gig.

In fact, studies have shown that dealing with problematic customers can lead to emotional exhaustion, negative moods, poorer physical health, reduced performance and lower job satisfaction.

But does it also lead to higher employee turnover?

According to a new study led by the UBC Sauder School of Business in collaboration with the UBC-Okanagan Faculty of Management, the University of Illinois, and the University of Queensland in Australia, customer conflict plays a big role when it comes to workers saying "I quit" -- and how supervisors manage that conflict helps decide whether employees stay or go.

The study, entitled Unpacking the Relationship Between Customer (In)Justice and Employee Turnover Outcomes: Can Fair Supervisor Treatment Reduce Employees' Emotional Turmoil?, involved 420 retail workers and 363 restaurant employees in the Philippines, as well as 940 call centre employees in Canada. The researchers measured the workers' experience of customer mistreatment and its emotional effects, as well as their quit rates.

Even when controlling for other factors that would lead a worker to throw in the towel -- factors including low pay, long hours and poor working conditions -- the researchers found a significant link between customer mistreatment and employee quit rates.

"We were able to predict who was going to quit based on their experience of customer mistreatment and emotional exhaustion. You can see it coming," says UBC Sauder School of Business professor Danielle van Jaarsveld, lead author of the study.

"It starts accumulating, and eventually you hit the wall and say, 'I've got to look for another job.' Because if you don't find a way to replenish those emotional resources, they deplete and you've got nothing left," says study co-author and UBC Sauder School of Business professor Daniel Skarlicki.

But it turns out that how supervisors respond to front-line customer service staff can make a big difference when it comes to employee retention. When the surveyed workers felt their supervisors treated them with dignity and respect, listened to their concerns, and supported them when dealing with demanding customers, they were far more likely to stick around.

"Whether you quit isn't just about the customer; it's what's called an interaction effect -- that is, the customer mistreatment is buffered when the manager treats you fairly," explains Skarlicki. "So if you get berated by a customer and your boss says 'that's disrespectful, I'm going to support you,' it reduces the effect of that customer mistreatment."

This study is one of the first to examine the effect customer injustice has on workers' decisions about whether or not to stay in the job, and adds to the extensive existing research on how employees' interactions with their coworkers and supervisors affect churn rates.

The findings are important because, especially in the age of social media, online reviews and razor-thin margins, customer service quality can make or break a business -- and in the service industry, turnover rates can range from 26 to 200 percent.

They can also come with a high financial cost. According to Skarlicki, in one company, turnover attributed to bad management can cost a company more than $300,000 in a single year -- and that's not taking into account the customer dissatisfaction that invariably comes with a constantly shifting workforce, and the effect of the customer dissatisfaction on the company's reputation.

"Even though companies know these difficult encounters happen, the effect of customer mistreatment on turnover is huge -- and these are really significant effects," he says. "People think employees quit primarily because of factors like salary and workload, but it's also about how they're treated by customers and supervisors."

Skarlicki says companies that rely on customer service can reduce turnover by ensuring supervisors treat the employees with dignity and respect, having regular conversations with their employees, and training employees on how to deal with abusive customers.

"We know that employees don't leave companies; they leave managers. Our findings support this mantra," emphasizes Skarlicki, who says too many customer service managers focus solely on employee productivity. "Companies should make sure managers are going from employee to employee checking in on how they are dealing with the potential stress that can come from difficult customers. Although this may seem like common sense, common sense doesn't equal common practice."

What makes the female breast attractive? The answer is subjective, of course. But studies using eye-tracking technology are providing a more objective basis for determining which breast areas are most attractive - which may help to improve the outcomes of surgery, reports the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The lower breast - especially the nipple and surrounding area - gets the most attention from both men and women, according to the study by Piotr Pietruski, MD, PhD, Department of Plastic and Reconstructive Surgery, Prof. W. Orlowski Memorial Hospital, Warsaw. They write, "Thanks to objective analysis of observer's gaze pattern, eye-tracking technology may provide a better insight into the visual perception of breast esthetics and symmetry."

In the study, 50 male and 50 female observers were asked to assess the aesthetics and symmetry of eight types of female breasts. The images varied in terms of breast size and degree of ptosis (sagging). The researchers used eye-tracking technology to collect data on what parts of the breast image the observers were looking at, and how long they looked at each area.

Although there were some differences based on the sex of the observer and the type of breast, "the key characteristics of gaze patterns in women and men were essentially the same," Dr. Pietruski and colleagues write. The main area of interest was the lower portion of the breast - especially the nipple and surrounding area (nipple-areola complex, or NAC).

In both men and women, about three-fourths of gaze time was on the NAC and lower breasts. The NAC was also "the most common point of initial fixation." Surprisingly, the upper regions of the breast generally didn't attract the observers' attention - although men paid more attention to the upper breast than women did.

The question of what makes breasts attractive is obviously important for plastic surgeons and patients, for both cosmetic and reconstructive breast procedures. But for the breasts as for other areas of the body, surgeons and patients may have differing perceptions about attractiveness. Eye-tracking technology provides a tool for more objective assessment of factors affecting visual attention and attractiveness.

The findings - especially the data on "attention-capturing time" - may identify factors affecting breast attractiveness. "These data may be helpful for understanding and subsequent standardization of subjective breast assessment procedures, and perhaps might even facilitate surgeon-patient communication regarding priorities of the surgery," Dr. Pietruski and coauthors write.

They add, "It needs to be stressed that we still do not know how the visual pattern parameters translate on a subjective assessment of breast attractiveness."

The study adds to previous plastic surgery research using eye-tracking technology to identify factors affecting breast attractiveness. In a previous paper in Plastic and Reconstructive Surgery, researchers at Stanford University found that restoring the NAC played an important role in restoring normal viewing patterns of reconstructed breasts after mastectomy.

"We were able to understand what specifically patients were looking at, and also understand where we can improve our results," commented Gordon Lee, MD, one of the study authors. "By understanding the gaze pattern of patients preoperatively and postoperatively, we can target our surgical procedures to achieve the optimal symmetry."

"By looking at where a participant's gaze is directed, we can see what their attention is being drawn to--whether it be a scar, a shadow, a fold or a crease," said Rahim Nazerali, MD, co-author of the Stanford University study. "This technology allows us to enhance certain features or disguise parts of the procedure area to provide the patient with the best possible outcome."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Humans are now closer to seeing through the eyes of animals, thanks to an innovative software framework developed by researchers from the University of Queensland and the University of Exeter.

PhD candidate Cedric van den Berg from UQ's School of Biological Sciences said that, until now, it has been difficult to understand how animals really saw the world.

"Most animals have completely different visual systems to humans, so - for many species - it is unclear how they see complex visual information or colour patterns in nature, and how this drives their behaviour," he said.

"The Quantitative Colour Pattern Analysis (QCPA) framework is a collection of innovative digital image processing techniques and analytical tools designed to solve this problem.

"Collectively, these tools greatly improve our ability to analyse complex visual information through the eyes of animals."

Dr Jolyon Troscianko the study's co-leader from the University of Exeter said colour patterns have been key to understanding many fundamental evolutionary problems, such as how animals signal to each other or hide from predators.

"We have known for many years that understanding animal vision and signalling depends on combining colour and pattern information, but the available techniques were near impossible to implement without some key advances we developed for this framework."

The framework's use of digital photos means it can be used in almost any habitat - even underwater - using anything from off-the-shelf cameras to sophsiticated full-spectrum imaging systems.

"You can even access most of its capabilities by using a cheap (~ $110 AUD, £60 GBP, $80 USD) smartphone to capture photos," Dr Troscianko said.

It took four years to develop and test the technology, which included the development of an extensive interactive online platform to provide researchers, teachers and students with user-guides, tutorials and worked examples of how to use the tools.

UQ's Dr Karen Cheney said the framework can be applied to a wide range of environmental conditions and visual systems.

"The flexibility of the framework allows researchers to investigate the colour patterns and natural surroundings of a wide range of organisms, such as insects, birds, fish and flowering plants," she said.

"For example, we can now truly understand the impacts of coral bleaching for camouflaged reef creatures in a new and informative way."

"We're helping people - wherever they are - to cross the boundaries between human and animal visual perception."

"It's really a platform that anyone can build on, so we're keen to see what future breakthroughs are ahead."

Recent years have witnessed a rapid evolution of advanced fluorescence imaging techniques, such as single-molecule localization microscopy (SMLM) that allows for unprecedented resolution beyond the Abbe diffraction limit of the optical microscope.

However, insufficient brightness of fluorophores has posed a major bottleneck for the further advancement of this field and caused significant constraints to in vivo cellular dynamics studies.

Owing to the widespread applications of rhodamines in many super-resolution imaging studies, significant efforts have been taken to further enhance their performances.

Researchers from Dalian University of Technology (DUT) and the Singapore University of Technology and Design (SUTD) have developed a novel strategy for chemists to achieve brighter fluorescence and clearer resolution with the use of a new class of rhodamines (see image).

This means that chemists and scientists can benefit directly from a wider colour palette that they can use during biological imaging. This will help them to distinguish various intricate cellular structures for more precise analysis that was not possible before. Their research paper has been published in ACS publications.

The researchers also successfully demonstrated that this strategy was compatible with other families of fluorophores, resulting in substantially increased fluorescence brightness and "photon budget". The increased "photon budget" is critical to improve the resolution and clarity of super-resolution microscopes.

The key to this strategy was the combination of the mechanistic understanding of the photophysical process in these fluorophores (namely, twisted intramolecular charge transfer), and the tailed molecular design strategy to inhibit this detrimental process via an electronic inductive effect.

"With the close integration of computational and experimental studies to understand the structure-property relationships of fluorophores, the dye chemistry is currently transforming from trial-and-error to design-based molecular engineering. We expect more high-performance dyes will be created soon and thus greatly aiding the development of super-resolution microscopy," said Assistant Professor Liu Xiaogang from SUTD.

"In addition to brightness, other characteristics such as photostability and photo-activation properties need to be optimized to meet the stringent requirements of SMLM. We look forward to working closely with computational chemists to further advance the rational design of dyes for super-resolution imaging," added Professor Xiao Yi from DUT.

Poor sanitation leads to untreated wastewater entering river systems in many countries where industrialisation and urbanisation is not supported by appropriate infrastructure. The lack of regulation and enforcement means toxic chemicals can damage the ecology of the natural environment and pose a risk to human health.

Responsible producers of active pharmaceutical ingredients (APIs) are growing increasingly concerned that current environmental risk assessment methods do not adequately reflect the sources and pathways of APIs to the rivers of developing countries.

Now, new research led by the University of Plymouth suggests that failure to ensure the environmental sustainability of growing patient access to medicines in developing economies could increase the risk of adverse environmental impacts.

Scientists took a series of samples from the Nairobi/Athi river basin in Kenya to assess the source, occurrence, magnitude and risk associated with a range of APIs and other chemicals.

They found elevated levels of drugs including paracetamol, caffeine, sulfamethoxazole and trimethoprim, up to 75km downstream from the urban centre of the city of Nairobi.

The primary sources were the direct discharge of untreated domestic wastewater from informal settlements, the industrial area of Nairobi where drug formulation is known to occur, a major landfill site and veterinary medicines from upstream agricultural use.

Scientists say the chemicals could pose a number of risks, the most prominent being the potential threat of anti-microbial resistance (AMR) with the river being used by communities as a source of drinking water and for the irrigation of crops.

And, while this research focused on the Nairobi area, they say its findings could be applied to anywhere in the world where the development of an urban area has outpaced the development of basic sanitation and the environmental infrastructure required to support its population.

The study, published in Science of The Total Environment, was led Dr Simone Bagnis (as part of his PhD studies) and Dr Sean Comber from the University of Plymouth.

Samples were collected in 27 locations along the river catchment and were analysed by collaborators at the University of York for the occurrence of 55 APIs, with 45 compounds under scrutiny being detected in at least one sampling location. The APIs with the highest frequency of detection were caffeine (stimulant), carbamazepine (antiepileptic), trimethoprim, sulfamethoxazole ciprofloxacin (antibiotics), fluconazole (antifungal) and amitriptyline (antidepressant).

Dr Comber, Associate Professor (Reader) in Environmental Chemistry and the paper's corresponding author, said: "Nairobi is a massive sprawling city with large areas of unconstrained development, industrial areas, informal settlements and open landfill sites all polluting its river system. Its sewage treatment works were designed to cope with a population of around one million, but the city has quickly grown to at least four times that in recent decades. Extensive use of pit latrines within informal settlements means that untreated sewage either enters the environment directly, or leaches through groundwater. Sewage "exhauster" lorries often pump faeces out of the latrines and dump it directly into the river.

"Where that occurs, you would expect pharmaceuticals to be present, but the highest concentrations were over a thousand times greater than typically reported in, for example, UK rivers - with the antibiotics being of particular concern, given elevated levels extend so far downstream from the urban centre. As well as the environmental risk, this does pose the threat that bacteria develop a resistance to certain types of medication. And in locations where disease can spread at an alarming rate, that is obviously a major cause for concern."

The study was conducted through a PhD studentship funded by AstraZeneca Global Sustainability, and also involved researchers from the University of York and Jomo Kenyatta University of Agriculture and Technology in Nairobi.

Professor Snape, Environmental Director within Global Sustainability at AstraZeneca and co-author of the paper, said: "As a sustainable organisation, our commitment to society, people and the planet lies at the heart of all that we do. Access to healthcare and environmental protection are two of our sustainability priorities and this research is part of a wider programme of work that we are partnering with, to help ensure that access to medicines does not compromise environmental protection.

"We have a specific focus on emerging economies where environmental infrastructure is minimal, water use and re-use patterns are different, and environmental regulations either do not exist or need to be revised to reflect the latest scientific consensus. We are committed to providing scientific leadership to help proactively manage the risks posed by pharmaceuticals in the environment. In addition to funding basic research to understand the issue, we are working with stakeholders across the industry, regulatory agencies, governments and inter-governmental organisations, to help mitigate the environmental risks posed with increasing access to healthcare."

Challenges and perspectives for Russia's nuclear industry on its way to assuming a key role in the fight against the climate crisis on a global level, while also ensuring future growth and building on 65 years of prodigious legacy, dating back to the launch of the world's first nuclear power plant in Obninsk in 1954, are brought together in a paper recently published in the open-access journal Nuclear Energy and Technology.

The authors are three prominent nuclear physicists and key figures at Russia's National Research Nuclear University MEPhI: Prof. Mikhail N. Strikhanov (Rector of MEPhI), Dr. Alexandr V. Putilov (Dean of the Faculty of Business Informatics and Integrated Systems Management), and Dr. Georgy V. Tikhomirov (Deputy Director of the Institute of Nuclear Physics and Engineering MEPhI). MEPhI is also the basic university of the Rosatom State Atomic Energy Corporation (ROSATOM) and alone provides education to 25,000 students from over fifty countries.

In their article, the team pays special attention to the urgent need for a new "educational paradigm" to secure the smooth transfer of Russia's nuclear industry and knowledge to a global digital economy where industries blend together in new and even unexpected alliances with the ultimate promise of joining knowledge and skills for the common good of humanity. The approach is described as "front-line education" that encompasses training personnel for the specificity of the novel digital economy along the entire "front": from youth yet to enter university to production personnel.

To do so, the Consortium, supported by 18 specialised universities and led by ROSATOM, is to not only provide first-class educational formats, material and technical resources in addition to the high professionalism of the teaching staff to on-site domestic students, but also export nuclear education on a large scale, in order to pave the way for a subsequent international technological expansion by preparing "personnel of a new type, using a kind of symbiosis of engineering, information and economic training". According to the scientists behind the paper, students should persist throughout their whole education in their mission "to master new opportunities arising from end-to-end digital technologies, search for and create new technological solutions or production schemes, and develop fundamentally new product lines and business models for implementing new manufacturing technologies."

An excellent exemplary training format of the new age is the Multy-D system: a 3D digital model of the future nuclear power plants and additional dimensions in the format of terms, resources, etc. Developed over the last few years by MEPhI and Atomstroyexport, it allows for foreign specialists to acquire Russian-born competence. However, latest technological advances, including the transition to a closed nuclear fuel cycle with fast neutron reactors, requires changes in modelling systems.

All of these efforts and transitions are of top priority, given the urgent global need for affordable, environmentally friendly electricity on the background of depleting fossil resources and worrying levels of greenhouse gas emissions, point out the scientists. Meanwhile, the nuclear power industry has claimed its own ecological niche by providing the necessary amount of energy without leaving behind any carbon footprint.

"The improvement of existing and the development of new innovative technologies is a prerequisite for the development of a nuclear energy system that meets the principles of safety and sustainable development," conclude the authors. "All solutions to these problems are in the hands of the young people who are being trained throughout the country."

While a lab test might be ordered STAT to help save a life, a new study suggests that the STAT test order should rest in peace, and instead the time standard for most clinical lab tests, like the commonly requested complete blood count, or CBC, should be more efficient.

Ninety minutes is widely considered the standard time for STAT lab results, and four hours is considered a good turnaround for non-STAT tests.

But strategies like automation and other manufacturing practices used successfully by top automobile makers, can essentially cut usual STAT time in half for the majority of tests, says Dr. Gurmukh Singh, vice chair of pathology at the Medical College of Georgia at Augusta University.

Ninety percent of both categories of tests are now being done in 45 minutes or less at AU Health System, corresponding author Singh and his colleagues report in the journal Laboratory Medicine.

Time savings were accomplished with fewer work stations and fewer personnel, all aspects that were stressed by the clinical lab team during the conception of the fully automated core lab that became operational early this year and set the stage for improvements.

A pneumatic tube system, through which many test samples arrive but which also transports other items like drugs and documents, also had software and hardware updates and was lengthened to reach the new lab. Quick huddles at each shift change now provide the opportunity to talk about missed timeframes and equipment malfunctions and a quality monitor board is on permanent display.

Increased point of care testing, in areas like the Emergency Department, ICUs and Family Medicine Clinic, have helped speed things up as well, Singh says.

The other reality is that many tests ordered STAT are not really needed STAT in terms of an urgent health need, the investigators say, and too many STAT requests can be lethal to the system itself.

When STAT test volume passes about 30% of the total volume of tests -- a 37% median was reported in 52 U.S. laboratories six years ago -- it's considered the tipping point where STAT loses its meaning because the STAT volume exceeds many labs' staffing and equipment capacity and turnaround time gets too long, Singh says.

At one point, AU Health System had about 75% of lab tests ordered STAT, high even for a complex care facility that serves as a Level 1 trauma center, says Kellie A. Foss, administrative director of pathology at AU Health.

One approach to reducing suffocating demand is to place restrictions on what can be requested STAT, but another -- and they suggest better approach -- is to reduce STAT demand by improving the turnaround time for all tests, the investigators write.

"That is why this is the requiem for the STAT test. There is no need," says Dr. Brandy Gunsolus, utilization manager for clinical pathology at MCG and AU Health. "Everything for the emergency room, operating rooms and ICUs is considered STAT, but we do everything fast enough that we meet the criteria for STAT even for all our outpatient and more routine testing."

"There is no need for anybody to order STAT," adds Singh. "Even if you are coming to see your doctor in the outpatient clinic, if we get the blood fast enough, we can get results back to your doctor even as he or she is talking with you."

Test results in the hospital and outpatient setting are typically ordered routine or STAT, and bona fide reasons for ordering STAT include scenarios like measuring levels of the heart protein troponin, released when the heart is injured, when a patient arrives in the emergency department with chest pain.

But a reality is that many tests ordered STAT are really requested for the convenience of the patient and/or physician rather than a rapid need-to-know for medical purposes, they say. Another reality is a society that now expects instant answers, Gunsolus says.

AU Health's core lab, where the majority of clinical lab tests are done, was redesigned, relocated and automated, and Singh notes that the time improvements they have made in testing would have been essentially impossible if each step was still manual, with a number of requests for the same test coming in, being batched, hand-carried to a centrifuge for spinning then hand-carried to the place where the test was to be done.

"Now we put it on the conveyor belt, it sends it to the right centrifuge, it spins them, takes them out, removes the caps automatically and sends it to the right analyzer. That analyzer takes the sample it needs then sends it off to the next analyzer that may need a sample," Singh says of the 24-7 movement. "It's real time, continuous flow," adds Foss.

While even 45 minutes may not sound STAT to some, the reality is just getting a sample to the lab from remote sites throughout a hospital or its clinics may take that long. And test times definitely vary, from about 45 minutes for the thyroid hormone test to under five minutes for a hemoglobin test.

Singh notes there will always be exceptions to their new 45-minute standard, like the time-consuming thyroid test, and that many facilities do not yet have automation available.

A major reason for automation at the academic health system based in Augusta was staffing, says Gunsolus, with the availability of frontline clinical laboratory scientists dwindling along with the programs that train them.

"Right now we are not making replacement laboratorians to replace the ones that are retiring," she says, a reality that makes efficiency a STAT problem for clinical labs as populations of higher end users of health care like those 65 and older explode.

Even though automation has reduced need, there are currently 20 vacancies in the core lab for these individuals whose responsibilities include overseeing increasingly complex lab testing. "We are now doing more tests with fewer people," says Foss.

Common problems outside the lab that slow down sample deliveries include things like improper labeling and too little blood or urine being provided for testing. Delays can deteriorate the quality of the samples, for example, as blood cells, which are still living, continue to consume glucose, which could impact accurate measures of the patient's blood glucose levels and a reason why blood is sometimes put on ice.

SAN DIEGO, December 3, 2019 -- Killer whale pods each have their own set of calls they use to communicate, sometimes referred to as the pod's "dialect." By characterizing an individual pod's calls, researchers can track the pod's seasonal movements, gaining a better understanding of the whales' lives.

Jessica Sportelli, at the Scripps Institution of Oceanography at the University of California, San Diego, studies a pod of relatively unknown killer whales in Pond Inlet, Nunavut, Canada. Because little is currently known about this pod's ecology, Sportelli will describe their repertoire of calls at the 178th Meeting of the Acoustical Society of America, which will take place Dec. 2-6, at the Hotel del Coronado in San Diego.

The talk, "Call discrimination for an unknown pod of killer whales (Orcinus orca) in the Eastern Canadian Arctic," will be presented at 10:05 a.m. Pacific (U.S.) on Tuesday, Dec. 3 as part of a session on low-frequency sound production and passive acoustic monitoring.

Having a unique dialect allows the members of a pod to maintain cohesion and avoid inbreeding by being able to identify other members. Because call repertoires are unique to a pod, understanding them can help scientists observe the pod over time and map their migration behavior.

"Once we know more about where they come from and more about their migration abilities, we can start asking questions like, Why are they leaving their place of origin? What is changing about their place of origin, or what is now lacking in their place of origin that they needed to move in the summer?" said Sportelli.

A predominantly Inuit community, Pond Inlet has seen an increase in killer whales, which may affect the prosperity of indigenous subsistence hunters. Sportelli hopes to obtain acoustic readings of other whale populations around the North Atlantic to compare with the calls at Pond Inlet and build a timeline of the whales' movement.

"It is one piece of the puzzle to understanding the life history of these animals," Sportelli said. "We don't know a lot about North Atlantic killer whales, so any information on them that gives us a fuller picture on how they live their lives is important."

Sportelli's presentation 2aAB8, " Call discrimination for an unknown pod of killer whales (Orcinus orca) in the Eastern Canadian Arctic," will be at 10:05 a.m. PT, Tuesday, Dec. 3, in the Edison room of the Hotel del Coronado in San Diego.

A bacterial pathogen that causes strep throat and other illnesses cloaks itself in fragments of red blood cells to evade detection by the host immune system, according to a study publishing December 3 in the journal Cell Reports. The researchers found that Group A Streptococcus (GAS) produces a previously uncharacterized protein, named S protein, which binds to the red blood cell membrane to avoid being engulfed and destroyed by phagocytic immune cells. By arming GAS with this form of immune camouflage, S protein enhances bacterial virulence and decreases survival in infected mice.

"Our study describes a completely novel mechanism for immune evasion," says corresponding author David Gonzalez of the University of California, San Diego. "We believe the discovery of this previously overlooked virulence factor, S protein, has broad implications for development of countermeasures against GAS."

GAS is a human-specific pathogen that can cause many different infections, from minor illnesses to very serious and deadly diseases. Some of these conditions include strep throat, scarlet fever, a skin infection called impetigo, toxic shock syndrome, and flesh-eating disease. An estimated 700 million infections occur worldwide each year, resulting in more than half a million deaths. Despite active research, a protective vaccine remains elusive.

To date, penicillin remains a primary drug of choice for combatting GAS infections. But the rate of treatment failures with penicillin has increased to nearly 40% in certain regions of the world. "Due to the high prevalence of GAS infection and the decreasing efficacy of the available set of countermeasures, it is critical to investigate alternative approaches against GAS infection," Gonzalez says.

One alternative approach is to develop novel anti-virulence therapeutics. To avoid immune clearance, GAS expresses a wide variety of molecules called virulence factors to facilitate survival during infection. But the function of many of these proteins remains unknown, hindering the development of alternative pharmacological interventions to combat widespread antibiotic resistance.

To address this gap in knowledge, Gonzalez and co-first authors Igor Wierzbicki and Anaamika Campeau of the University of California, San Diego, used a nanotechnology-based technique called biomimetic virulomics to identify proteins that are secreted by GAS and bind to red blood cells. This approach revealed a previously uncharacterized protein, which the researchers named S protein, because this type of protein is limited to members of the Streptococcus genus.

The researchers found that a mutant bacterial strain lacking S protein was less able to grow in human blood, and less able to bind to red blood cells, compared to the non-mutated strain. The mutant strain was also more readily captured and killed by phagocytic immune cells called macrophages and neutrophils. In addition, the absence of S protein vastly reshaped the bacterial protein landscape, decreasing the abundance of many known virulence factors.

Moreover, mice infected with GAS cells coated with red blood cells showed a 90% mortality rate, compared to 40% of mice infected with uncoated GAS cells. Infection with coated GAS cells also caused a more rapid decrease in body weight. "These findings suggest that S protein co-opts red blood cell membranes for molecular mimicry, or imitation of host molecules, to evade the immune response," Gonzalez says.

Additional experiments showed that infection with GAS caused a progressive decline in the body weight of mice and a 90% mortality rate. By contrast, all mice infected with mutant GAS lacking S protein survived infection, and their body weight stabilized and remained constant after a slight initial decline. Infection with mutant GAS also resulted in a lower concentration of bacteria in the bloodstream and organs, and promoted a robust immune response and immunological memory.

"Taken together, the results suggest that inactivation of S protein function makes GAS vulnerable to host immunity," Gonzalez says. "S protein influences virulence by capturing lysed red blood cell membranes to cloak the bacterial cell surface, which allows bacteria to circumvent host immunity. This novel evasion mechanism can be targeted for anti-streptococcal therapies."

Currently, Gonzalez and his team are examining the mechanism by which S protein binds to red blood cells. They are also studying the role that S protein plays in other important human pathogens, including Streptococcus pneumoniae, which causes pneumonia and other illnesses, as well as Group B Streptococcus or S. agalactiae--a bacterium that is a common cause of severe infections in newborns during the first week of life.

"Ultimately, the findings could lead to the development of a novel vaccine candidate," Gonzalez says. "Because of its pivotal roles in pathogenesis and immune evasion, and its conserved nature in Streptococci, S protein shows promising clinical potential as a target for the development of anti-virulence pharmacological interventions."

Prescribing for self, family, friends and colleagues is widespread among young Irish doctors, suggest the results of a survey, published online in the Journal of Medical Ethics.

And some doctors are prescribing addictive and controlled substances, such as sedatives and opiates, despite clear guidance issued by the UK's professional regulator, the General Medical Council (GMC).

Quite apart from the potential legal pitfalls, self-prescribing has been linked to increased suicide risk among doctors, say the researchers, who point to the high prevalence of serious mental health issues in the profession.

Previous studies on doctors' personal prescribing habits have been few, and limited by the small number of participants and fears of repercussions following disclosure. To try and get round these issues, the researchers posted an anonymised online survey on a closed Facebook group for young doctors during the spring of 2017.

At the time, 4445 young doctors of all specialties and grades working in Ireland belonged to it, representing around a fifth of all those registered to work in the country.

The 16-item questionnaire aimed to assess what had been prescribed, and to whom; obtain basic personal background information; find out whether respondents were trainees; and if they were registered with, and/or had seen, a family doctor (GP) since qualifying.

Some 729 doctors responded, representing 16% of those in the Facebook group. Nearly two thirds (470) were women and two thirds (487) were younger than 31. Only a few were qualified GPs (42) or consultants (18).

The respondents represented a range of specialties, including hospital medicine, general practice, surgery, paediatrics, psychiatry, anaesthetics, emergency medicine, and obstetrics and gynaecology.

Two thirds of the respondents (466) were registered with a GP, and most (379, 81%) had visited their family doctor since qualifying. But registration with a GP wasn't a factor in whether they prescribed for themselves or others they knew, were close to, or worked with.

Two thirds (67%) had prescribed for themselves. Nearly three quarters had done so for family (72%) and over half had prescribed for friends (58.5%) and colleagues (59%).
Nearly all (93%) had been approached by friends, family, or colleagues to prescribe drugs, suggesting that doctors may feel under pressure to prescribe to those they know personally, say the researchers.

The over 30s were twice as likely to self-medicate as their younger peers, and older doctors were more likely to prescribe psychotropic drugs for mental health issues.
Between 3% and 7% of respondents had self medicated with a benzodiazepine (sedative), an opiate, or other psychotropic drug.

Men were more likely than women to self medicate with opioids. They were also more than 3 times as likely to prescribe these drugs to friends, and more than 7 times as likely to do so for colleagues.

Nearly half of the women who responded (43%) had prescribed the Pill for themselves.

Those not on training schemes were more likely to prescribe drugs for themselves and family members, including opiates. And they were more likely to prescribe benzodiazepines to colleagues.

Patterns of prescribing behaviour varied by specialty, with GPs, paediatricians, and those in hospital medicine more likely to prescribe to a family member, while surgeons were more likely to prescribe to a friend, and psychiatrists less likely to do so.

Anaesthetists were more likely to self medicate with opiates and benzodiazepines and to prescribe opiates to family and friends. Surgeons were also more likely to prescribe opiates for themselves and their friends, while psychiatrists were more likely to prescribe benzodiazepines to family members and colleagues.

"Prescribing outside a professional relationship can place the doctor in a compromised position and is unlikely to be covered by conventional malpractice insurance, exposing the doctor to legal or professional recourse in the event of an adverse reaction or prescribing error," warn the researchers.

But there are many ethical and potential patient safety implications as well, including for the prescribing doctor, they point out.

This is an observational study, and the survey wasn't designed to collect complex data, nor were comparative data available, the researchers acknowledge.

Nevertheless the study was large, and shows that "self prescribing and prescribing to personal contacts remains widespread among young Irish doctors, despite recent GMC guidelines," they write.

"Further education is needed to protect doctors from the risks posed by this practice, namely, risks on physical health or of addiction and suicide," they urge. And they call for this to be included in undergraduate medical degrees and postgraduate training, particularly for 'high risk' specialties, such as anaesthetics and surgery, as well as continuing professional development.

Artificial neurons on silicon chips that behave just like the real thing have been invented by scientists - a first-of-its-kind achievement with enormous scope for medical devices to cure chronic diseases, such as heart failure, Alzheimer's, and other diseases of neuronal degeneration.

Critically the artificial neurons not only behave just like biological neurons but only need one billionth the power of a microprocessor, making them ideally suited for use in medical implants and other bio-electronic devices.

The research team, led by the University of Bath and including researchers from the Universities of Bristol, Zurich and Auckland, describe the artificial neurons in a study published in Nature Communications.

Designing artificial neurons that respond to electrical signals from the nervous system like real neurons has been a major goal in medicine for decades, as it opens up the possibility of curing conditions where neurons are not working properly, have had their processes severed as in spinal cord injury, or have died. Artificial neurons could repair diseased bio-circuits by replicating their healthy function and responding adequately to biological feedback to restore bodily function.

In heart failure for example, neurons in the base of the brain do not respond properly to nervous system feedback, they in turn do not send the right signals to the heart, which then does not pump as hard as it should.

However developing artificial neurons has been an immense challenge because of the challenges of complex biology and hard-to-predict neuronal responses.

The researchers successfully modelled and derived equations to explain how neurons respond to electrical stimuli from other nerves. This is incredibly complicated as responses are 'non-linear' - in other words if a signal becomes twice as strong it shouldn't necessarily elicit twice as big a reaction - it might be thrice bigger or something else.

They then designed silicon chips that accurately modelled biological ion channels, before proving that their silicon neurons precisely mimicked real, living neurons responding to a range of stimulations.

The researchers accurately replicated the complete dynamics of hippocampal neurons and respiratory neurons from rats, under a wide range of stimuli.

Professor Alain Nogaret, from the University of Bath Department of Physics led the project. He said: "Until now neurons have been like black boxes, but we have managed to open the black box and peer inside. Our work is paradigm changing because it provides a robust method to reproduce the electrical properties of real neurons in minute detail.

"But it's wider than that, because our neurons only need 140 nanoWatts of power. That's a billionth the power requirement of a microprocessor, which other attempts to make synthetic neurons have used. This makes the neurons well suited for bio-electronic implants to treat chronic diseases.

"For example we're developing smart pacemakers that won't just stimulate the heart to pump at a steady rate but use these neurons to respond in real time to demands placed on the heart - which is what happens naturally in a healthy heart. Other possible applications could be in the treatment of conditions like Alzheimer's and neuronal degenerative diseases more generally.

"Our approach combines several breakthroughs. We can very accurately estimate the precise parameters that control any neurons behaviour with high certainty. We have created physical models of the hardware and demonstrated its ability to successfully mimic the behaviour of real living neurons. Our third breakthrough is the versatility of our model which allows for the inclusion of different types and functions of a range of complex mammalian neurons."

Professor Giacomo Indiveri, a co-author on the study, from the University of Zurich and ETF Zurich, added: "This work opens new horizons for neuromorphic chip design thanks to its unique approach to identifying crucial analog circuit parameters."

Another co-author, Professor Julian Paton, a physiologist at the University of Auckland and the University of Bristol, said: "Replicating the response of respiratory neurons in bioelectronics that can be miniaturised and implanted is very exciting and opens up enormous opportunities for smarter medical devices that drive towards personalised medicine approaches to a range of diseases and disabilities"."

Key points:

Amplifying genes and carrying these on satellite DNA circles can give yeast an edge by allowing faster adaptive evolution in challenging environments.

Findings indicate that gene duplication and the formation of DNA circles can be actively driven in response to the environment, rather than being purely accidental and random.

Analysing the sharing of DNA circles between mother and daughter cells suggests a cellular insurance policy, whereby older cells may gain an advantage by holding on to more circles than they pass on.

Understanding the mechanism of gene duplication and DNA circle formation has relevance to the biology of ageing and the development of drug resistance in cancers cells.

Genome amplification, whereby organisms bump up the number of copies of beneficial genes in response to environmental stresses, is implicated in diseases such as cancer and also in ageing. Researchers in the Babraham Institute's Epigenetics research programme have used yeast to learn more about how satellite (extrachromosomal) DNA circles are formed to carry amplified genes, how the gene duplication is specific to the environmental pressure and the effects of age. Their research is published today in the journal PLOS Biology.

Yeast cells are an excellent system to study gene amplification, environmental response and ageing due to their reproductive method whereby a daughter cell is formed by a mother cell dividing asymmetrically. Older mother and younger daughter cells coexist in the population and their responses to environmental stresses can be compared.

In this study the Houseley group analysed the process of gene duplication in yeast under the pressure of high concentrations of copper. The group had previously shown that yeast specifically increase copies of a gene, called CUP1, which allows the cells to survive in high concentrations of copper that would otherwise be toxic. As well as incorporating these gene amplifications into chromosomes, extra copies of the gene can exist in cells as satellite DNA circles called extrachromosomal circular DNA (eccDNA), which can be rapidly gained and lost from the cell, allowing genome flexibility in response to the environment. The latest study focused on how these structures are formed and whether there was an age-related aspect to their formation.

Dr Ryan Hull, a researcher in Dr Jon Houseley's group within the Institute's Epigenetics programme and first author on the paper said: "This work is a continuation of our focus on understanding how cells achieve adaptability in order to be successful in challenging environments. Analysing the creation of the eccDNA supports our finding that gene duplication can be actively driven and controlled in response to the environment, rather than random, in order to confer increased resilience to future environmental change."

Within a cell population, the amount of gene amplification can vary, leading to a large amount of variation in gene copy numbers across the population. However, the researchers found that the distribution of the eccDNA was not random during cell division - they were held onto by mother cells during asymmetrical division.

Dr Jon Houseley, a group leader within the Institute's Epigenetics programme, concluded: "It's an intriguing phenomenon. We can liken it to a selfish insurance policy implemented by the older cells, whereby they're hoarding these bits of DNA in the hope that they might confer an evolutionary advantage even at the cost of some inconvenience in having them around, including interference with essential cellular pathways and a likely contribution to ageing."

In cancer, such satellite DNA circles can contain drug resistance genes - amplified to confer a selective advantage to the cancer cells - and the cancer-driving oncogenes. Understanding this phenomenon may improve knowledge of how the same mechanism occurring in cancer cells can lead to large differences in how effective a drug treatment is.

LA JOLLA--(December 3, 2019) Metformin is the most commonly prescribed type 2 diabetes drug, yet scientists still do not fully know how it works to control blood sugar levels. In a collaborative effort, researchers from the Salk Institute, The Scripps Research Institute and Weill Cornell Medical College have used a novel technology to investigate why it functions so well. The findings, which identified a surprising number of biochemical "switches" for various cellular processes, could also explain why metformin has been shown to extend health span and life span in recent studies. The work was published in Cell Reports on December 3, 2019.

"These results provide us with new avenues to explore in order to understand how metformin works as a diabetes drug, along with its health-span-extending effects," says Professor Reuben Shaw, co-corresponding author of the paper and the director of Salk's NCI-designated Cancer Center. "These are pathways that neither we, nor anyone else, would have imagined."

Previously, the only biochemical pathway that was known to be activated by metformin was the AMPK pathway, which Shaw discovered stalls cell growth and changes metabolism when nutrients are scarce, as can occur in cancer. But the scientists believed more pathways than AMPK might be involved.

The scientists developed a novel screening platform to examine kinases, the proteins that transfer phosphate groups, which are critical on/off switches in cells and can be rapidly flipped by metformin. Using this technology, the researchers were able to decode hundreds of regulatory "switch-flipping" events that could affect healthy aging.

"Being mentored by John Yates, one of the top mass spectrometry investigators in the world, and Reuben Shaw, an expert in the field of metabolism, enabled me to both develop and apply a novel technology to a critical biological question: What pathways are regulated by metformin in the liver?" says Ben Stein, first author and postdoctoral associate at Weill Cornell Medical College.

The results revealed that metformin turns on unexpected kinases and pathways, many independent of AMPK. Two of the activated kinases are called Protein Kinase D and MAPKAPK2. These kinases are poorly understood, but are known to have some relation to cellular stress, which could connect them to the health-span- and life-span-extending effects observed in other studies. In fact, metformin is currently being tested in multiple large-scale clinical trials as a health-span- and life-span-extending drug, but the mechanism for how metformin could affect health and aging has not been clear. The current study indicates that Protein Kinase D and MAPKAPK2 may be two players in providing these therapeutic effects, and identifies new targets and cellular processes regulated by AMPK that may also be critical to metformin's beneficial effects.

"We never imagined these two kinases would have anything to do with metformin," says Shaw, holder of the William R. Brody Chair. "The results broaden our understanding of how metformin induces a mild stress that triggers sensors to restore metabolic balance, explaining some of the benefits previously reported such as extended healthy aging in model organisms taking metformin. The big questions now are what targets of metformin can benefit the health of all individuals, not just type 2 diabetics."

Next, the researchers plan to examine the new signaling pathways they discovered in more detail to better understand the beneficial effects of metformin.

The technical skills of the Roman agrimensores - the technicians in charge of the centuriations (division of the lands) and of other surveys such as planning towns and aqueducts - are simply legendary. For instance, extremely accurate projects of centuriations are still visible today in Italy and in other Mediterranean countries. Their work had also religious and symbolic connections being related with the foundation of towns and the Etruscan's tradition.

These technicians were called Gromatics due to their chief working instrument, called Groma. It was based on a cross made of four perpendicular arms each bringing cords with identical weights, acting as plumb-lines. The surveyor could align with extreme precision two opposite, very thin plumb-lines with reference poles held at various distances by assistants or fixed in the terrain, in the same manner as palines (red and white posts) are used in modern theodolite surveying.

Up to now, the unique known example of a Groma was coming from Pompeii excavations, while images illustrating the work of the Gromatics were passed on only by medieval codex's, dating to many centuries after the art of the agrimensores was not practiced any more. It now looks like that again Pompeii is the place where new information about these ancient architects can come out. As part of the Great Pompeii Project indeed, inaugurated in 2014 and co-financed by the European Community, new archaeological investigations unearthed a house with a solemn, ancient facade. Inside, almost intact floors have been found containing two beautiful mosaics probably representing Orion, and a series of enigmatic images.

The interpretation of the images has been recently given in a joint paper by Massimo Osanna, Director of the Pompeii archaeological site, and Luisa Ferro and Giulio Magli, of the School of Architecture at the Politecnico of Milan. Among the images there is, for instance, a square inscribed in a circle. The circle is cut by two perpendicular lines, one of which coincides with the longitudinal axis of the atrium of the house and appears as a sort of rose of the winds that identifies a regular division of the circle in eight equally spaced sectors. The image is strikingly similar to one used in the medieval codex's to illustrate the way in which the Gromatics divided the space. Another, complex image shows a circle with an orthogonal cross inscribed in it, connected by five dots disposed as a sort of small circle to a straight line with a base. The whole appears as the depiction of a Groma.

Was the house used for meetings and/or the owner himself belonged to the gromatic's guild? We do not know it for sure. In any case however, and once again, Pompeii reveals itself as an invaluable source in understanding key aspects of the Roman life and civilization.

Saussurea controversa is a perennial herbaceous plant that has been traditionally used by the people of the Far East, Siberia, Tibet, and Mongolia to treat liver, kidney, digestive tract, and locomotive diseases. Its dried leaves are sold in pharmacies because their decoction is widely used as a medicine against cold and bronchitis. To understand what substances this plant owes its medicinal properties to, a team of scientists from Siberian State Medical University and Tomsk Polytechnic University extracted individual components from the plant and determined their composition. To do so, they passed the substances in gas form through a special station. As the substances were of different size, it took them different time to pass through it. The useful components of the decoction included flavonoids and polysaccharides. These groups of substances are known for their antimicrobial properties and the ability to speed up bone tissue regeneration. Flavonoids are small aromatic molecules, while polysaccharides are high molecular weight hydrocarbons. However, both have a positive effect on bone tissue regeneration.

Infectious locomotive diseases are considered one of the most difficult to treat. The microorganisms that attack bone tissue are often resistant to antibiotics. The restoration of the bone also plays an important role in the healing process. Medics from BFU suggested using Saussurea extract to treat bone tissue infections and tested its ability to affect stem cells. To do so, the extract of Saussurea leaves was added to the substrate with such cells. The growth of the cell culture slowed down under the influence of plant polysaccharides. It turned out that Saussurea did not stimulate the division of stem cells, but made them turn into bone tissue. This was confirmed by specific colouring.

To test the antibacterial properties of Saussurea, the team from BFU added the extract of its leaves into substrate with Staphylococcus aureus. These bacteria cause such deadly diseases as osteomyelitis, endocarditis, pneumonia, and sepsis. Moreover, they are highly resistant to a wide range of antibiotics making the therapy long and complicated. The experiment showed the decrease of S. aureus growth in the substrate with Saussurea compared to a control group.

"The isolated components have antimicrobial and regenerative properties. Our plan is to participate in the development of a medicinal drug for comprehensive treatment of bone diseases and injuries associated with the risk of infectious complications. Plant materials are less toxic. They can be administered as regular pills making the treatment much easier," concluded Larisa Litvinova, MD, a head of the Basic Laboratory for Immunology and Cell Biotechnologies, Professor of the Department of Fundamental Medicine, Institute of Medicine, Kant Baltic Federal University.