Culture

Close to one in two cases of dementia could be preventable in low- to middle-income countries, finds a new UCL study.

The findings, published in The Lancet Global Health, found how improving childhood education and other health outcomes throughout life could reduce the risk of dementia.
"After our previous research finding that one in three cases of dementia could be preventable, we realised that the evidence was skewed towards higher-income countries," said the study's lead author, Dr Naaheed Mukadam (UCL Psychiatry).

"We have now found that in low- to middle-income countries in Asia and Latin America, dementia may be even more preventable than it is in more wealthy countries. If life-course risk factors such as low levels of education in early life and hearing loss, obesity and low physical activity in mid-life to old age are addressed, these countries could see large improvements in their dementia rates."

While the number of people with dementia is increasing globally, particularly in low- to middle-income countries, there have been modest reductions in age-specific dementia rates in many high-income countries over the last two decades. The researchers say this could be due to improvements in health outcomes throughout life that affect dementia risk.

The research team built on their previous work for the Lancet Commission on dementia prevention, intervention, and care, published in 2017, which found that 35% of dementia is attributable to nine risk factors: low levels of childhood education, hearing loss, smoking, hypertension, obesity, physical inactivity, social isolation, depression, and diabetes.

To understand whether the commission's findings would apply equally to global regions that were underrepresented in the report, a team of UCL researchers sought out data from China, India and Latin America. They drew from the research collective 10/66 Dementia Research Group's data, which used similar methodology to gauge prevalence of the nine risk factors in those countries, with sample sizes of 1,000 to 3,000 in each country.

The researchers found even more potential for preventing dementia across the globe, as the proportion of dementia linked to the nine modifiable risk factors was 40% in China, 41% in India and 56% in Latin America.

A major factor in that difference is the lower levels of educational attainment in low- to middle-income countries, which the researchers say signals hope for the future, as education levels rise.

"People growing up in Asia and Latin America today are more likely to have completed schooling than their parents and grandparents were, meaning they should be less at risk of dementia later in life than people who are already over 65. Continuing to improve access to education could reap great benefits for dementia rates in years to come," Dr Mukadam said.

On the other hand, social isolation is a major risk factor of dementia in higher income countries, but much less so in China and Latin America. The researchers say that public health officials in countries such as the UK could learn from China and Latin America in efforts to build more connected communities to buffer against the dementia risk tied to social isolation.

Obesity and hearing loss in mid-life, and physical activity in later life, were also strongly linked to dementia risk in the study area, as well as mid-life hypertension in China and Latin America and smoking in later-life in India.

"Reducing the prevalence of all of these risk factors clearly has numerous health benefits, so here we've identified an added incentive to support public health interventions that could also reduce dementia rates. The growing global health burden of dementia is an urgent priority, so anything that could reduce dementia risk could have immense social and economic benefit," Dr Mukadam said.

Senior author Professor Gill Livingston (UCL Psychiatry) added: "A lot of the findings of health and medical research derive primarily from higher income countries such as in Western Europe and North America, so ensuring that research is inclusive is vital to the development of global public health strategies."

"While we don't expect these risk factors to be eliminated entirely, even modest improvements could have immense impact on dementia rates. Delaying the onset of dementia by just five years would halve its prevalence*," she said.

Economists from the University of Sydney and the University of Technology Sydney (UTS) have co-authored a new study that challenges conventional thinking about auctions and is applicable to real-life bidding situations including property auctions.

The study suggested that the more bidders there are in an auction, the lower each individual bidder perceives their probability of winning, which has demotivating effect on their desire to win the auction.

"This is a counterintuitive finding because usually auctioneers would assume that the more bidders there are in an auction, the more money they will make - the logic being that that the more bidders there are, the more likely it is that there is a bidder with a high willingness to pay for the good," said co-author Associate Professor Agnieszka Tymula from the University of Sydney's School of Economics.

"However, it turns out that there is also a downside to having more bidders - most people bid less."

The researchers' conclusions were drawn from an experiment where they asked nearly 100 adults to bid on items of varying value - including clothing, movie tickets, Bluetooth speakers, and more.

On average, the participants bid less in auctions as the number of other bidders increased.

More than half of the participants changed their bids in response to an increase in the number of rivals.

"For most of the items, when the number of bidders increased from three to 12, the average bid declined by around 7%," said co-author Dr Antonio Rosato from UTS Business School.

"Our findings are consistent with 'loss aversion' - the idea that people dislike losses more than they like equal-size gains. When the number of bidders increase, participants experience this lower chance of winning as a loss and this reduces their willingness to pay."

Associate Professor Tymula said their findings could be applicable to many real-life auction situations, including property market auctions.

"In real-life, the auctions that attract many bidders are usually those auctions for better properties - and they will therefore generate higher bids just because the property is of higher quality," she said.

"Many real estate agents infer from this that more people at an auction, the higher the final bid is going to be, so they try to get as many people as possible to their auction. However, our results suggest that this actually plays against them because seeing many competitors at an auction makes bidders submit lower bids on average."

A multi-disciplinary team of scientists has issued a series of findings and recommendations on the safety of using dispersal agents in oil spill clean-up efforts in a report published this month by the National Academies of Science, Engineering, and Medicine.

By measuring the level of a leading dispersal agent, dioctyl sodium sulfosuccinate, in sea life following the 2010 Deepwater Horizon spill in the Gulf of Mexico, the team was able to establish how long the chemical lingers and what health effects it has on various organisms. The scientists found the risks associated with using DOSS were minimal, the team found that in areas where oil concentrations in water were more than 100 milligrams per liter did increase the toxicity, though they noted oil concentrations are typically much lower than that in most spills.

Terry Hazen, the University of Tennessee-Oak Ridge National Laboratory Governor's Chair for Environmental Biotechnology, who is known for his work on the Deepwater Horizon oil spill recovery efforts, co-authored the report.

"One of the biggest concerns in cleanup efforts is the effect the spill has on people's health and livelihood," Terry Hazen, University of Tennessee faculty a University of Tennessee said. "It's not just that oil itself is harmful and potentially even flammable, but you have to be careful what kind of chemicals you expose crews to while trying to clean or contain the oil."

The researchers also discovered that the testing methodology used after spills is typically so varied that it is hard to draw broad conclusions when comparing different spills.

To combat this, the team recommends the creation of some form of standardized testing that would enable data to be correlated from one spill to the next.

Indicators of despair--depression, suicidal ideation, drug use and alcohol abuse--are rising among Americans in their late 30s and early 40s across most demographic groups, according to new research led by Lauren Gaydosh, assistant professor of Medicine, Health and Society and Public Policy Studies at Vanderbilt University. These findings suggest that the increase in "deaths of despair" observed among low-educated middle-aged white Baby Boomers (born 1946-1964) in recent studies may begin to impact the youngest members of Generation X (born 1974-1983) more broadly in the years to come.

The study, The Depths of Despair Among U.S. Adults Entering Midlife, appears in the American Journal of Public Health. Gaydosh's co-authors are Kathleen Mullan Harris, Robert A. Hummer, Taylor W. Hargrove, Carolyn T. Halpern, Jon M. Hussey, Eric A. Whitsel, and Nancy Dole, all at the University of North Carolina at Chapel Hill.

In 2016, U.S. life expectancy began to decline for the first time in nearly a quarter-century, and researchers theorized that this was driven by a marked increase in deaths due to drug overdose, alcoholic cirrhosis and suicide among middle-aged whites with low education or in rural areas. At the time, this was explained by a unique triple-punch of worsening employment prospects accompanied by a declining perception of socioeconomic status and an erosion of social supports for this group. But studies to better understand those mortality trends did not definitively show that low-income rural whites were actually experiencing more despair than other groups.

"What we wanted to do in this paper was to examine whether the factors that may be predictive of those causes of death--substance use, suicidal ideation and depression--are isolated to that particular population subgroup, or whether it's a more generalized phenomenon," Gaydosh said.

To do so, they turned to the National Longitudinal Study of Adolescent to Adult Health, or Add Health, directed by Harris at the University of North Carolina, which tracked the physical and mental health of thousands of Americans born between 1974-1983 from adolescence through their late 30s and early 40s in 2016-18.

"We found that despair has increased in this cohort, but that increases are not restricted to non-Hispanic whites with low education," Gaydosh said. "Instead, the increase in despair that occurs across the 30s is generalized to the entire cohort, regardless of race, ethnicity, education, and geography."

While patterns of drinking, drug use and mental health symptoms varied across races and education levels--whites were more likely to binge-drink in adolescence, while Hispanics and African Americans of all ages were more likely to report depressive symptoms, for example--the trends were broadly the same. Adolescence was, perhaps unsurprisingly, a rocky time for everyone, followed by a period of improvement in their twenties. By the time the teens were in their late 30s, however, indicators of despair were trending back up across the board, and in some cases were higher for minority populations than they were for low-educated whites or rural adults.

Gaydosh and her colleagues say these findings should be cause for concern, as they suggest midlife mortality may begin to increase across a wide range of demographic groups. "Public health efforts to reduce these indicators of despair should not be targeted toward just rural whites, for example," she said, "because we're finding that these patterns are generalized across the population."

Less than one hour of brain training with neurofeedback leads to a strengthening of neural connections and communication among brain areas. This is the main finding of a new study conducted at D'Or Institute for Research and Education (IDOR), published today in Neuroimage. According to the authors, the study may pave the way for the optimization and development of therapeutic approaches against stroke and Parkinson's, for example.

"We knew that the brain has an amazing ability to adapt itself, but we were not sure that we could observe these changes so quickly. Understanding of how we can impact on brain wiring and functioning is the key to treat neurological disorders", says Theo Marins, a biomedical scientist from IDOR and the Ph.D. responsible for the study.

Neurofeedback has been considered a promising way to regulate dysfunctional brain areas associated with disorders, such as chronic pain and depression, for example. With this technique, the magnetic resonance equipment helps individuals to have access to their own brain activity in real time and quickly gain control over it.

Thirty-six healthy subjects participated in the study in which the goal was to increase the activity of brain regions involved in hand movements. However, instead of actually move their hand, participants were asked to only imagine the movement, in total rest. Nineteen of them received the real brain training and the remaining seventeen were trained with placebo neurofeedback, for comparisons purposes. Immediately before and after the brain training, which lasted around 30 minutes, their neural networks were scanned in order to investigate the impact of the neurofeedback (or placebo) on brain wiring and communication, also known as structural and functional connectivity, respectively.

The results show that the corpus callosum - the major cerebral bridge that connects the right and left hemispheres - exhibited increased integrity, and the neural network controlling the movements of the body became strengthened. It seems that the whole system became more robust. Likewise, the training also had a positive impact on the default mode network, a brain network which is impaired after stroke, Parkinson's and depression, for example. These changes were not observed in the control group.

"We showed that the neurofeedback can be considered a powerful tool to induce brain changes at record speed. Now, our goal is to develop new studies to test whether patients with neurological disorders can also benefit from it", concludes Fernanda Tovar Moll, president of IDOR and leader of the study.

The study was conducted in collaboration with Federal University of Rio de Janeiro (UFRJ) and Augusto Motta University (Unisuam) and was part of the Ph.D. thesis of Theo Marins.

New research presented at this week's 29th European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13 - 16 April 2019), identifies a novel association between antibiotic resistance and climate change. The study was conducted at the Institute of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Germany, in collaboration with the Hannover Medical School (MHH), Germany. The lead author is Professor Simone Scheithauer of UMG.

Antimicrobial resistance (AMR) is a threat across Europe with burdens mainly peaking around the Mediterranean Basin [1]. Recently, the association of AMR with climate gained increased attention, since resistance increased with increasing local temperatures in the USA [2].

This new research investigated whether the explanatory strength of climate variables holds true in a region with diverse healthcare systems and societies and whether a climate change dimension can be identified, using Europe as a case region.

The researchers conducted a 30-country observational study across Europe (see below for list of countries). The six-year prevalence of carbapenem resistant Pseudomonas aeruginosa (CRPA), Klebsiella pneumoniae (CRKP), multiresistant Escherichia coli (MREC), and Methicillin resistant Staphylococcus aureus (MRSA) was determined based on data published by the European Centre for Disease Prevention and Control (ECDC) [3].

Statistical analysis and computer modelling were performed to identify associations between AMR and seasonal temperature [4], including potential socioeconomic and health system related confounders. The team found significant associations of CRKP, MREC and MRSA with the warm-season mean temperature, which had a higher contribution to MRSA variance than outpatient antimicrobial drug use.

Furthermore, CRPA was significantly associated with the warm-season change in temperature. The authors also used their models to estimate AMR in four other countries, not included in the database used (Belarus, Serbia, Switzerland and Turkey). The results displayed varying degrees of accuracy compared to empirical data [5], with comparatively good matches for CRPA in all countries except Belarus.

The authors conclude: "Our study identified a novel association between AMR and climatic factors in Europe. These results reveal two aspects: climatic factors significantly contribute to the prediction of AMR in different types of healthcare systems and societies, while climate change might increase AMR transmission, in particular carbapenem resistance."

They add: "While these results remain hypothetical as it is unknown if any causal association exists, future analysis of AMR and climatic developments is necessary to determine whether potential climate change effects on AMR become stronger."

New research presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April) shows that the geographical range of vector-borne diseases such as chikungunya, dengue fever, leishmaniasis, and tick-borne encephalitis (TBE) is expanding rapidly.

Spurred on by climate change and international travel and trade, vector-borne disease outbreaks are set to increase across much of Europe over the next few decades--and not just in the temperate countries around the Mediterranean.
Even previously unaffected areas in higher latitudes and altitudes, including some parts of northern Europe, could see an increase in outbreaks unless action is taken to improve surveillance and data sharing, and to monitor environmental and climatic precursors to outbreaks, alongside other preventive measures.

"Climate change is not the only or even the main factor driving the increase in vector-borne diseases across Europe, but it is one of many factors alongside globalisation, socioeconomic development, urbanisation, and widespread land-use change which need to be addressed to limit the importation and spread of these diseases", says Professor Jan Semenza from the European Centre for Disease Prevention and Control, Stockholm, Sweden.

"The stark reality is that longer hot seasons will enlarge the seasonal window for the potential spread of vector-borne diseases and favour larger outbreaks", says Dr Giovanni Rezza, Director of the Department of Infectious Diseases at the Istituto Superiore di Sanitá in Rome, Italy. "We must be prepared to deal with these tropical infections. Lessons from recent outbreaks of West Nile virus in North America and chikungunya in the Caribbean and Italy highlight the importance of assessing future vector-borne disease risks and preparing contingencies for future outbreaks."

However, the authors caution, that given the complicated interplay between multiple drivers (eg, warming temperatures and international travel), weather sensitive pathogens, and climate-change adaption, projecting the future burden of disease is difficult.

Global warming has allowed mosquitoes, ticks and other disease-carrying insects to proliferate, adapt to different seasons, and invade new territories across Europe over the past decade--with accompanying outbreaks of dengue in France and Croatia, malaria in Greece, West Nile Fever in Southeast Europe, and chikungunya virus in Italy and France.

Worryingly, the authors say, this might only be the tip of the iceberg. "Mediterranean Europe is now a part-time tropical region, where competent vectors like the Tiger mosquito are already established", says Dr Rezza.

Hotter and wetter weather could provide ideal conditions for the Asian tiger mosquito (Aedes albopictus), which spreads the viruses that cause dengue and chikungunya, to breed and expand across large parts of Europe including the south and east of the UK and central Europe.

Previously dengue transmission was largely confined to tropical and subtropical regions because freezing temperatures kill the mosquito's larvae and eggs, but longer hot seasons could enable A albopictus to survive and spread across much of Europe within decades, researchers say.

The European climate is already suitable for the transmission of Lyme borreliosis and tick-borne encephalitis which are spread by ticks (primarily Ixodes ricinus)--with an estimated 65,000 cases of Lyme borreliosis a year in the European Union, and a 400% rise in reported cases of TBE in European endemic areas over the past 30 years (partly due to enhanced surveillance and diagnosis).

In the future, warmer winter temperatures, longer growing seasons, and earlier hotter summers could make conditions more favourable for ticks and increase the range of deer host populations, say the authors. Climate change models indicate that by 2040-2060, there could be a 3.8% growth in the habitat of Ixodes ricinus in Europe, with Scandinavia anticipated to be most at risk.

Moreover, improved climate conditions for sandflies--the main carrier of Leishmaniasis--could extend their geographical spread to southern parts of the UK, France, and Germany by the end of the 2060s.

"Given the ongoing spread of invasive mosquitoes and other vectors across Europe, we must anticipate outbreaks and move to intervene early", says Professor Semenza. "Public health agencies need to improve surveillance, for example through early warning systems, increase awareness of the potential risks among healthcare workers and the general public, as well as adopt innovative control strategies such as community interventions."

Researchers at the University of São Paulo (USP) in Brazil have discovered that growth hormone (GH), which stimulates skeletal maturation and linear bone growth, as well as helping maintain tissue and organs throughout life, also acts directly on the brain to conserve energy when the body loses weight.

A paper on the discovery has just been published in the journal Nature Communications. "Growth hormone has been known for decades, but our discovery shows it does a lot more than was thought," said José Donato Junior (https://bv.fapesp.br/en/pesquisador/64998/jose-donato-junior), a professor at the University of São Paulo's Biomedical Science Institute (ICB-USP) and one of the authors of the paper.

"GH receptors are found in large quantities in muscle and tissue, in the liver, and in organs directly involved in growth metabolism, but we found that the brain is also full of GH receptors. This is entirely new," Donato said.

"We also found that brain GH is not only involved in growth metabolism but above all influences the metabolic responses that conserve energy when we're hungry or on a diet. This discovery, which is also new to science, has important implications in terms of understanding why it's so hard to lose weight."

The study was part of the Thematic Project "The role of growth hormone in the brain: relevance for neural functions and in disease", supported by São Paulo Research Foundation - FAPESP. In addition to researchers affiliated with ICB-USP, the group also included scientists at the University of São Paulo's Ribeirão Preto Medical School (FMRP-USP), Argentina's La Plata National University (UNLP), and Ohio University in the United States.

"For decades, scientists have been trying to understand why it's so difficult to maintain the weight achieved after the sacrifices of a successful diet and why it's so easy to regain the lost weight. Leptin has hitherto been considered the main hormone that acts to conserve energy when we're hungry," Donato said.

Bloodstream leptin levels are known to fall in response to weight loss, he explains, but this knowledge has never resulted in the creation of a successful diet or therapy with leptin that could enable subjects to lose weight and not regain it soon afterwards.

"The weight loss process evidently involves several metabolic processes and several hormones besides leptin. This is where GH comes in. We found that in response to weight loss, GH acts on the brain in a similar way to leptin. However, while leptin levels fall, the opposite happens to GH. Weight loss triggers a rise in bloodstream levels of GH," Donato said.

"In the recently published article, we show that central growth hormone signaling also promotes neuroendocrine adaptations during food deprivation."

GH receptors in the brain are located in the hypothalamus, the highest center of the autonomic nervous system. Impulses from the hypothalamus influence the cells of the neurovegetative system and regulate smooth muscle tissue in the gut and blood vessels, cardiac muscle, all glands, and the kidneys, among other organs.

The researchers found that GH receptors in the hypothalamus specifically activate a small population of neurons called AgRP, which is short for agouti-related protein. AgRP neurons in turn increase the production of AgRP, which increases appetite and diminishes energy metabolism and expenditure.

"AgRP is one of the most powerful appetite stimulants. It's curious to see how a small number of AgRP neurons, only a few thousand out of the billions of neurons in the hypothalamus, can play such an important role," Donato said.

Energy conservation

To conduct a detailed study of the influence of GH signaling on AgRP neurons, the scientists at USP and colleagues bred genetically modified mice with AgRP-specific GH receptor ablation (called AgRP GHR knockout mice). Their experiments also used a control group comprising wild-type mice that were not genetically modified.

In various experiments, the researchers measured whole-body energy expenditure in the two groups of mice when subjected to a diet with 60% food restriction. Their aim was to determine whether a lack of adaptive response to the resulting energy deficit would have a significant impact on energy balance.

They found that the control mice decreased energy expenditure during food restriction, which is consistent with the adaptive responses that conserve energy in this situation.

Energy expenditure by the AgRP GHR KO mice during food restriction decreased significantly less, suggesting that they did not save energy as efficiently as the control mice.

As a result, the AgRP GHR KO mice displayed a higher rate of weight loss, owing primarily to decreased fat mass (energy reserves) but also to loss of lean mass (vital organs, bone, muscle, ligaments, tendons, and body fluids).

"In other words, we discovered that weight loss triggers an increase in hypothalamus GH levels, which activates the AgRP neurons, making weight loss harder and intensifying the sense of hunger. That's precisely the same function leptin performs," Donato said.

Energy conservation is so important to the organism, he added, that evolution has endowed humans with two energy conservation mechanisms, one activated by leptin and the other by GH.

"One functions as a backup for the other. This is why weight loss treatments based solely on leptin don't work. The GH mechanism has to be dealt with at the same time," Donato said.

Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. "A particularly promising application is the solution of quantum many-body problems utilizing the concept of digital quantum simulation", says Markus Heyl from Max Planck Institute for the Physics of Complex in Dresden, Germany. "Such simulations could have a major impact on quantum chemistry, materials science and fundamental physics." Within digital quantum simulation the time evolution of the targeted quantum many-body system is realized by a sequence of elementary quantum gates by discretizing time evolution, called Trotterization. "A fundamental challenge, however, is the control of an intrinsic error source, which appears due to this discretization", says Markus Heyl. Together with Peter Zoller from the Department of Experimental Physics at the University of Innsbruck and the Institute of Quantum Optics and Quantum Communication at the Austrian Academy of Sciences and Philipp Hauke from the Kirchhoff Institute for Physics and the Institute for Theoretical Physics at the University of Heidelberg they show in a recent paper in Science Advances that quantum localization-by constraining the time evolution through quantum interference-strongly bounds these errors for local observables.

More robust than expected

"Digital quantum simulation is thus intrinsically much more robust than what one might expect from known error bounds on the global many-body wave function", Heyl summarizes. This robustness is characterized by a sharp threshold as a function of the utilized time granularity measured by the so-called Trotter step size. The threshold separates a regular region with controllable Trotter errors, where the system exhibits localization in the space of eigenstates of the time-evolution operator, from a quantum chaotic regime where errors accumulate quickly rendering the outcome of the quantum simulation unusable. "Our findings show that digital quantum simulation with comparatively large Trotter steps can retain controlled Trotter errors for local observables", says Markus Heyl. "It is thus possible to reduce the number of quantum gate operations required to represent the desired time evolution faithfully, thereby mitigating the effects of imperfect individual gate operations." This brings digital quantum simulation for classically challenging quantum many-body problems within reach for current day quantum devices.

New research presented at this week's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April) shows that a formulation containing zinc oxide is effective at reducing armpit odour through killing the responsible bacteria, and assists in wound healing. The study was carried out by Professor Magnus S. Ågren, Copenhagen Wound Healing Center, Bispebjerg Hospital, Copenhagen, Denmark (where the study took place) and Khaled Saoud Ali Ghathian, Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark and colleagues.

Bothersome odour from the axilla (under the armpit) is in most cases caused by Corynebacterium spp. and Staphylococcus spp. The antimicrobial effects of zinc oxide (ZnO) have been extensively documented. In experimental studies, ZnO prevented bacterial generation of short-chain fatty acids with a bad smell. Furthermore, topical ZnO reduced the occurrence of corynebacteria and bad odour from open surgical wounds, which gave the idea to the researchers to test the compound on body odour directly.

The axilla is warm, moist and nutrient rich, all of which are conditions that increase pH. Because the solubility of ZnO is pH-dependent, the efficacy may vary due to the skin surface pH. Moreover, there is no consensus on the effect of gender on axillary pH level.

The primary aim of this double-blind, placebo-controlled trial (ZINC-ON) was to study if repeated application of ZnO formulated in an oil-in-water emulsion reduced underarm odour in healthy volunteers. The association with the overall bacterial growth and specifically of Corynebacterium spp. and S. hominis was also studied. Skin surface pH was monitored in parallel. Secondly, the anti-inflammatory and wound-healing effects of topical ZnO were studied by assessing the extent of skin erythema and keratin evolution in two standardised wound models: one inflicted by a contact-activated lancet producing small bleeding wounds and the other was induced by ablative CO2 laser producing dry erosions in the skin.

The trial included 30 healthy volunteers (15 female/15 male) of mean age of 25.6 years. Participants' left and right axilla were randomised to ZnO application or placebo and treated for 13 consecutive days with 5 visits to the hospital. The participants were enrolled, swabbed and started treatment on day minus 8; on day 0 bacterial swabs were obtained again and wounds were inflicted, and then the participants were seen on days 3, 4 and 5. At the last visit day 5, the participants were asked (1) whether they had observed a difference in the odour from the left and right axillae and, if so, (2) to state which axilla they judged superior with respect to odour.

Treatment with ZnO reduced self-perceived bad odour compared with placebo. The overall bacterial growth and specifically the odour-generating Corynebacterium spp. and S. hominis were reduced with ZnO treatment despite increasing skin surface pH (all results were statistically significant). Topical ZnO reduced peri-wound erythema (redness) around the lancet-induced wounds and promoted the formation of keratin.

The authors conclude: "Daily application of ZnO reduced malodour from the axilla and causative bacteria, increased skin surface pH and attenuated wound inflammation."

Professor Ågren says: "The most frequent response we had from participants was: 'where can I buy this fantastic product?'. Even though it contained no fragrance like conventional deodorants, the participants could identify that it had neutralised any bad odour under the arm where it was applied. The product has since been progressed to commercialisation by Colgate-Palmolive, who produced the product and sponsored this trial."

A new study led by Western University and Lawson Health Research Institute has found that most patients entering hospital intensive care units (ICU) for non-brain-related injuries or ailments also suffer from some level of related cognitive dysfunction that currently goes undetected in most cases.

The findings were published today in the influential scientific journal, PLOS ONE.

Many patients spend time in the ICU for reasons that have nothing to do with a known brain injury, and most health care providers and caregivers don't have any evidence to believe there is an issue with the brain. For example, a patient may have had a traumatic injury that does not involve the brain, yet still requires breathing support to enable surgeons to fix damaged organs, they may have issues with their heart or lungs, they may contract a serious infection, or they may simply be recovering from a surgical procedure like an organ transplant that has nothing directly to do with their brain.

For the study, Western investigators from the Schulich School of Medicine & Dentistry and the Brain and Mind Institute and researchers from Lawson assessed 20 such patients as they left the ICU and every single patient had detectable cognitive deficits in two or more cognitive areas of investigation, including memory, attention, decision-making and reasoning. Again, this is in spite of the fact that, on the face of it, they had no clear brain injury.

The discovery was made using online tests, developed by renowned Western neuroscientist Adrian Owen and his teams at the Brain and Mind Institute and BrainsCAN, which were originally designed to examine cognitive ability in patients following brain injuries but for this purpose, are being used to detect cognitive deficits in people who have spent time in an intensive care unit without a diagnosed brain injury.

"Many people spend time in an intensive care unit following a brain injury and, of course, they often experience deficits in memory, attention, decision-making and other cognitive functions as a result," explains Owen, a professor at Schulich Medicine & Dentistry. "In this study, we were interested to see how patients without a specific brain injury fair after leaving the ICU. The results were astonishing."

Why cognitive ability declines even in non-brain related visits to the ICU likely varies from patient to patient, but Dr. Kimia Honarmand from Schulich Medicine & Dentistry says the lesson to be learned is that many conditions affect brain function, even though they might not directly involve the brain.

"If you are having trouble breathing, your brain may be starved of oxygen. If you have a serious infection, the inflammation that occurs as a result of infection may affect brain function. If you are undergoing major surgery, you might be given drugs and have procedures that may affect your breathing, which in turn may affect the flow of oxygen to the brain," explains Dr. Honarmand. "What we have shown here is that all or any of these events can lead to deficits in brain function that manifest as impairments in cognition. And healthy cognition is a vital determinant of functional recovery."

Dr. Marat Slessarev, Lawson Scientist, says these findings can shift how the medical community treats incoming patients and more importantly, outpatients following ICU visits.

"Historically, the clinical focus has been on just survival. But now we can begin to focus on good survival," says Dr. Slessarev, also an associate member at the Brain and Mind Institute and an assistant professor at Schulich Medicine & Dentistry. "These sensitive tests will enable doctors to both detect cognitive impairment and track cognitive performance over time, which is the first step in developing processes for optimizing brain recovery."

New research presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April) shows that the early microbiome (population of gut bacteria) in newborn babies is able to predict the risk of the child subsequently becoming overweight. These gut bacteria can also be affected by maternal antibiotic use during pregnancy.

The study by Dr Katja Korpela of the PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland, and colleagues aimed to determine the association between the early intestinal microbiome and the subsequent growth and weight gain of children up to the age of three.

The early microbiome is important for the maturation of the gut and subsequent metabolic programming; a process of early adaptations to nutritional stresses or stimuli, which permanently change the physiology and metabolism of the child. An association between the administration of antibiotics during infancy, and the likelihood of a child later being overweight had been observed in previous epidemiological studies, suggesting that changes to the early microbiome could have long-lasting effects.

The team conducted a population-based cohort study comprising 212 consecutive newborn babies and collected the first-pass meconium (the first stool produced by an infant, comprising material ingested while in the uterus) as well as a follow-up stool sample at one year. Children had their weight and length/height measured at regular visits and records were taken of any antibiotic use after birth.

Genetic sequencing was then used to determine the species and relative abundance of bacteria in the stool samples.

Infants who received a course of antibiotics in their first year had a lower abundance of Actinobacteria at age one than infants who had prenatal antibiotic exposure or were given the drug shortly after birth. They also had a smaller Actinobacteria population than children who had not been exposed to any antimicrobial substances, demonstrating the long-lasting impact of antibiotics on a child's microbiome.

Newborns who later became overweight by the age of three had a much higher (29% vs 15%) relative abundance of Bacteroidetes phylum (a large group of bacteria found in a wide range of environments, as well as in the gut and on the skin of many animals) in their microbiome. These overweight children also had a lower relative abundance of Proteobacteria (19% vs 35%). The abundance of Staphylococcus in meconium was discovered to be inversely associated with body length at one year, and height at two years of age.

A further analysis of the results using computer algorithms found that, while the population of gut bacteria at one year of age was not useful in trying to predict the likelihood of a child becoming overweight, the microbiome of the first stool, formed in utero during the fetal period, was linked to the risk of excess weight gain by the age of three.

The authors conclude: "The microbiome of the first stool, formed in utero during fetal period, was associated with subsequent overweight at the age of three years."

DURHAM, N.C. (PRWEB) April 09, 2019 -- Stem cells collected from the patient's own bone marrow holds great interest as a potential therapy for osteoarthritis of the knee (KOA) because of their ability to regenerate the damaged cartilage. The results were released today in STEM CELLS Translational Medicine (SCTM).

KOA is a common, debilitating disease of the aging population in which the cartilage wears away, resulting in bone wearing upon bone and subsequently causing great pain. In its end stages, joint replacement is currently the recommended treatment. In the first clinical trial of its kind to take place in Canada, researchers used mesenchymal stromal cells (MSCs), collected from the patient's own bone marrow under local anesthesia, to treat KOA.

The study was conducted by a research team from the Arthritis Program at the Krembil Research Institute, University Health Network, Toronto, led by Sowmya Viswanathan, Ph.D., and Jaskarndip Chahal, M.D. "Our goal was to test for safety as well as to gain a better understanding of MSC dosing, mechanisms of action and donor selection," Dr. Viswanathan said.

It involved 12 patients, aged 45 to 65, with moderate to severe KOA. They were divided into three groups, with each group receiving a different dose of MSCs. (Each patient was injected with his or her own cells.) The researchers then followed the patients for the next 12 months, using analytical methods that included imaging, biomarkers, molecular fingerprinting and the patient's own assessment of how he or she felt.

At the end of the 12-month period, the team noted significant improvements in the patients' pain levels and quality of life. The study also showed that the MSCs were safe at all the doses tested and that the higher the dose, the more effective the outcome.

Dr. Viswanathan said, "We also obtained novel insights into a potential anti-inflammatory mechanism of action of these cells in osteoarthritic knee joints. We noted that donor heterogeneity is an important factor, and our assembled panel of genes helps us identify cells which are potent in osteoarthritis. These are important findings which we hope to translate into a larger, powered clinical trial as part of our next steps."

"Furthermore," added Dr. Chahal, "we have been able to show that through an anti-inflammatory mechanism of action, such patients have an improvement in pain, function and quality of life. This sets the stage for the future of cell-based therapy and trials in Canada."

"This clinical pilot study advances the field of stem cell research for patients with arthritis, showing safety, and giving insights into potential therapy efficacy guidelines", said Anthony Atala, M.D., Editor-in-Chief of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. "We look forward to larger scale trial results."

A leading public health expert says the UK should learn lessons from systematic violence reduction work in Cali, Columbia to tackle rising rates of knife crime on British streets. The work in Columbia resulted in significant reductions in homicides between 1995 and 2018.

Writing in the Journal of the Royal Society of Medicine, Professor John Ashton describes how, faced with a horrendous toll of over 1,000 drug related homicides each year, the Mayor of Cali, public health professor Rodrigo Guerrero and his colleague Dr Alberto Concha-Eastman, adopted a classical public health model to tackle the problem.

The model is based on an understanding and detailed mapping of time, place and person with appropriate interventions to match. Interventions in Cali included restriction of alcohol sales in the affected neighbourhoods and access to weapons, police surveillance and enforcement using 24 hour courts, tackling organised crime, together with a holistic approach to poverty reduction, increased educational and employment opportunity and the mobilisation of communities, including especially the mothers of young men, fearful that their son would be next in the mortuary.

In 1995 the homicide rate in Cali per 100,000 inhabitants was 100. This reduced to 47.3 per 100,000 inhabitants in 2018.

Professor Ashton says: "The current popular refrain for a public health response to violence is being linked to recent efforts in Glasgow which seem to be having some impact. However, the roots of this approach can be traced to systematic work in Cali over the past 30 years.

"The UK is now at a stage which requires stronger community organisation and participation linked to whole systems action, if knife crime and street violence is to be reduced. We have much to learn from our colleagues in Cali."

People can automatically assume that someone who gives less money to charity is less generous, according to new research. The assumption was made in the study when people had no knowledge of how much someone had donated as a percentage of their overall income.

The online study was carried out by researchers at the University of Exeter Business School, Yale University, MIT and Harvard Business School. Participants were able to choose to 'penalise' different groups of people based on their contributions to society. The researchers found that participants tended to 'penalise' those who had given smaller cash amounts to charity in real terms, without realising that those people had actually given more as a proportion of their income than their wealthier counterparts.

However, the participants' behaviour changed completely when they were made aware of others' incomes. Participants then 'penalised' the rich for giving a lower percentage, even when the cash amount was actually more in real terms.

"This lack of awareness of inequality can have substantial consequences for society - how we treat each other and what we expect others to contribute to society," said Dr Oliver Hauser, Senior Lecturer in Economics at the University of Exeter and lead author of the report.

In one experiment, participants were given actual figures from a list of five U.S. school districts and told the annual donation given to each of their Parents' Teachers' Associations (PTA). They then had to choose which school district should pay an additional tax bill, which would benefit all five districts collectively. Those participants who didn't know the average income of parents in each area chose to levy the tax on the poorest school district, which had given the least amount of money to the PTA in real terms. Those who were made aware of the average incomes chose to give the tax bill to a school district with richer parents, who had given less as a proportion of their income.

"If people don't realise how little the poor actually have, they may be less sympathetic to the lower contributions made by that group," said Professor Michael Norton from Harvard Business School, who is a co-author of the report.

"Conversely, they are less likely to view the rich negatively for not contributing their 'fair share.' This can have real implications for the on-going gap between the rich and poor in society, particularly when it comes to making decisions on how to distribute public resources fairly."

The income distribution used in the four studies of the research article used recent figures from actual U.S. income distribution, which ranks among the most unequal in the Western world.

The research was carried out by Dr Hauser, Professor Norton and co-authors Dr Gordon Kraft-Todd from Yale University, Associate Professor David G. Rand from Massachusetts Institute of Technology and Professor Martin Nowak from Harvard University.

The research is published in the peer-reviewed academic journal Behavioural Public Policy. Funding was provided by the Harvard Foundations of Human Behavior Initiative and Harvard Business School.