Culture

ANN ARBOR, Mich. -- They're in the country illegally. Or maybe they had protected status before, but lost it due to policy changes by the current presidential administration.

Or they're waiting for word from Congress or the courts on whether they'll get to stay.

Whatever their situation under the law, the 11.3 million undocumented immigrants currently in the United States still need, and sometimes get, health care.

Even if they don't have health insurance, federal law requires hospitals to care for them in emergencies. They can turn to safety-net clinics for basic needs.

Now, a new analysis highlights an ironic development in the intertwined issues of immigration and health care - two areas where the current and previous administrations differ greatly.

Undocumented people in certain states may get more medical help while they are here, it finds, thanks to the current administration's effort to give states more flexibility with their health care spending. And in a reversal of the previous administration's stance, states may find it easier to get that permission.

In a new article in the New England Journal of Medicine, two members of the University of Michigan Institute for Healthcare Policy and Innovation unpack recent events, political philosophies and medical evidence about caring for the undocumented.

They conclude that more states may want to apply for permission to use state and federal dollars to pay safety-net hospitals that care for everyone - whether or not they are here legally.

Waivers already in action

Such permission, which requires the government to approve an application called a waiver, has already gone into effect in Florida and Texas.

As two of the states with the highest numbers of undocumented immigrants living in their borders, they've seen the amount of money they can award to safety-net hospitals rise by 50 percent to 70 percent.

"Ironically, the same administration that is targeting undocumented immigrants with one set of policies may be helping them get care by preserving hospitals' abilities to serve them with other policies," says A. Taylor Kelley, M.D., M.P.H., who led the analysis.

Kelley says their example may bode well for other states that, like Florida and Texas, didn't choose to expand Medicaid under the ACA.

"The United States has one of the highest rates of uninsured people in the world among developed countries, and the Affordable Care Act was designed to increase health insurance options for men, women and children across the country. But undocumented immigrants were excluded," so they can't enroll in Medicare or Medicaid, or buy a plan on the ACA marketplace, explains Kelley, who is a clinical lecturer in general internal medicine at the U-M Medical School and a National Clinician Scholar at IHPI.

"Undocumented immigrants rely on safety-net institutions that deliver care for people, with insurance or without insurance," he explains. "Safety net hospitals are also major employers and economic drivers in their communities. And so to keep their doors open, states can seek federal permission to increase the funding they get. And generally, the current administration has been very receptive."

States didn't get a warm welcome from the Obama administration for such waivers, because that administration's priority was encouraging states to expand Medicaid coverage to all low-income adults - or at least those who had legal status. In fact, the previous administration said it would take away existing funding for safety-net hospitals in states that didn't expand Medicaid.

Florida actually decided to redirect some of its own funds to help its hospitals, rather than expand Medicaid, when its waiver was ended by the Obama administration.

A door closes, a door opens

But with the change in administrations, Kelley and co-author Renuka Tipirneni, M.D., M.Sc., write, the states that didn't expand Medicaid and have high numbers of undocumented residents may find it easier.

States along the Mexican border, for instance, may want to seek a waiver - or apply to take part in a program that incentivizes new care delivery models for poor patients.

As for the states that did expand Medicaid, only time will tell if the government will also approve waivers to further ease the financial burden on safety net hospitals and clinics there.

A recent IHPI report about Michigan's Medicaid expansion finds that while hospitals saw their uncompensated care drop by an average of 50 percent in the first year after expansion, the level has stayed flat since that time.

So hospitals are still absorbing the cost of caring for many people who can't pay their medical bills, whether it's because they have no insurance or they can't afford the part of their bill that their insurance expects them to pay. Around half of the undocumented immigrants in the U.S. lack insurance of any kind, according to estimates.

"The major question when talking about state flexibility is, where are the limits? And how much are we going to honor states' rights?" says Kelley. "Both Medicaid expansion and support for the safety net are programs where states are now being given the autonomy to act as they feel best for the people within their borders. Will these approaches be honored by the administration as a state right?"

Spending up front, or later

At the same time, Kelley notes, the inpatient hospitals that have historically received the waiver funds are more and more likely to be part of new network-based models of care, such as accountable care organizations, which makes it easier for them to offer integrated care for those who come through the doors of their emergency rooms.

That may mean it's easier to care for undocumented immigrants in a preventive or early-stage way, rather than waiting for an emergency.

In addition, Congress recently extended funding for federally qualified health centers that provide care to underserved patients outside of the hospital.

Such care can actually save money, according to research cited in the new piece. For instance, one study showed that states can save money by covering dialysis care for undocumented immigrants whose kidneys are failing, rather than waiting to provide the legally required emergency dialysis when they are in crisis. Illinois has even gone so far as to cover kidney transplants for undocumented people, because of the potential long-term cost savings.

Other research shows that expansion of individual insurance coverage provides better outcomes and use of resources than insurance for some and no insurance for others who must turn to safety net care, says Kelley. But the political philosophies and policy stances of current leadership don't make expanded coverage likely right now.

"We've come out of eight years of one way of thinking, now we're in a new way of thinking," says Kelley. "And it's a new shift for states if they're going to cover the people they need to cover and help institutions out, then they have to shift their focus and their thinking."

"Some might ask, what does care for the undocumented have to do with me as an American citizen. And the reality is that, because we provide care to anyone who stands in need of a health emergency, we all pay for everyone's healthcare sooner or later," he says. "When we provide access to care for undocumented immigrants, it's not necessarily going to be a cost burden every time. In some ways, it may be beneficial to us in both indirect ways and even in direct ways."

PLAYING with an imaginary companion (IC) helps children learn essential social skills such as empathy with other people. It is often believed that autistic youngsters are incapable of creating pretend play pals - a further hindrance to their development of emotional understanding.

But now a project headed by a University of Huddersfield researcher confirms that children diagnosed with autism are able to create and play with ICs. Further research is to be conducted and could eventually help to develop new therapies.

The current findings - based on data collected in the USA and the UK - are reported in a new article for which the lead author is Dr Paige Davis, who lectures in psychology at the University of Huddersfield. Imaginary companions are one of her key specialities.

The research described in the Journal of Autism and Developmental Disorders by Dr Davis and her three co-authors is based on evidence gathered from 215 questionnaires completed by approximately equal numbers of parents of children with typical development (TD) and of children diagnosed with autistic spectrum disorder (ASD).

The findings do indicate that fewer children with ASD create an imaginary companion - 16.2 per cent as opposed to 42 per cent of TD youngsters. Also children with autism began playing with their ICs at a significantly later age and were proportionately more likely to play with a "personified object" such as a stuffed toy or doll.

But the argument of the new article from Dr Davis is that while there is a quantitative difference between the developments of ICs between the two categories of children, there is no difference in the quality of the play.

The article includes examples of some of the imaginary companions created by children with autism whose parents took part in the project. They include Ghosty Bubble, an invisible bubble person who slept on a bubble bed next to the child; Mikey, an invisible Ninja who lived in a sewer; and Pretend Ada, an invisible version of a real school pal who played with the child when she needed a friend.

"The finding that children diagnosed with ASD even spontaneously create such imaginary companions refutes existing beliefs that they are not imagining in the same way as typically developing children," said Dr Davis.

"Imaginary companions are special because they are social in nature and children with autism have issues with social development and communication. So if you are actually creating a mind for an imaginary person you are involving yourself in a range of social activities that the autism diagnosis itself would say you couldn't do."

Dr Davis argues that if children with ASD are showing the same positive social developments as TD youngsters from the creation of ICs, then that could have implications for future intervention and lead to new therapies based on the imagination.

Her collaborators on the research and co-authors of the article were Elizabeth Meins of the University of York, Haley Simon of Drexel University in Philadelphia, USA, and Diana Robins of the AJ Drexel Autism Institute in Philadelphia. The article - titled Imaginary Companions in Children with Autism Spectrum Disorder - describes the research methodology and the findings in detail.

Now there are plans for further research into the benefits of imaginary companions to typically developing children and whether the same applies to autistic youngsters.

The research could eventually help to develop new therapies

PORTLAND, Oregon/BOSTON, Massachusetts - An algorithm that uses artificial intelligence can automatically and more accurately diagnose a potentially devastating cause of childhood blindness than most expert physicians, a paper published in JAMA Ophthalmology suggests.

The finding could help prevent blindness in more babies with the disease, called retinopathy of prematurity, or ROP. Musician Stevie Wonder went blind due to this condition.

The algorithm accurately diagnosed the condition in images of infant eyes 91 percent of the time. On the other hand, a team of eight physicians with ROP expertise who examined the same images had an average accuracy rate of 82 percent.

"There's a huge shortage of ophthalmologists who are trained and willing to diagnose ROP. This creates enormous gaps in care, even in the United States, and sadly leads too many children around the world to go undiagnosed," said the study's co-lead researcher, Michael Chiang, M.D., a professor of ophthalmology and medical informatics & clinical epidemiology in the OHSU School of Medicine and a pediatric ophthalmologist at the Elks Children's Eye Clinic in the OHSU Casey Eye Institute.

"This algorithm distills the knowledge of ophthalmologists who are skilled at identifying ROP and puts it into a mathematical model so clinicians who may not have that same wealth of experience can still help babies receive a timely, accurate diagnosis," said the other lead researcher, Jayashree Kalpathy-Cramer, Ph.D., of the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital, who is also an associate professor of radiology at Harvard Medical School.

Leading cause of childhood blindness

Retinopathy of prematurity is caused by abnormal blood vessel growth near the retina, the light-sensitive portion in the back of an eye. The condition is common in premature babies and is the leading cause of childhood blindness globally.

The National Eye Institute of the National Institutes of Health reports that up to 16,000 U.S. babies experience retinopathy of prematurity to some degree, but only up to 600 become legally blind each year as a result. The condition is becoming more common as medical care for premature babies improves.

The disease is diagnosed by visually inspecting a baby's eye. Physicians typically use a magnifying device that shines light into a baby's dilated eye, but that approach can lead to variable and subjective diagnoses.

Computational smarts

Artificial intelligence, also called AI, enables machines to think like humans and is a growing field in health care. Last month, the FDA approved an AI device that detects diabetes-related eye disease. Others have tried developing computerized systems to diagnose retinopathy of prematurity, but none have been able to match the accuracy of visual diagnosis by physicians.

This algorithm specifically uses deep learning, a form of AI that mimics how humans perceive the world through vision, including identifying objects. The MGH researchers combined two existing AI models to create the algorithm, while the OHSU researchers developed extensive reference standards to train it.

They first trained the algorithm to identify retinal vessels in more than 5,000 pictures taken during infant visits to an ophthalmologist. Next, they trained it to differentiate between healthy and diseased vessels. Afterward, they compared the algorithm's accuracy with that of trained experts who viewed the same images and discovered it performed better than most of the expert physicians.

The full research team is now working with a collaborator in India to see if the algorithm can diagnose ROP in Indian babies as well as it did for the group of primarily Caucasian babies involved in this study. They are also exploring whether the algorithm can diagnose the condition in images of other parts of the retina besides vessels. The ultimate goal is to enable physicians to incorporate the technology into their clinical practices.

French Bulldogs, predicted soon to become the most popular dog breed in the UK, are vulnerable to a number of health conditions, according to a new study published in the open access journal Canine Genetics and Epidemiology.

Researchers at The Royal Veterinary College (RVC), UK found that the most common issues in French Bulldogs over a one year period were ear infections, diarrhea and conjunctivitis (inflammation of the eye surface).

Dr. Dan O'Neill, RVC Senior Lecturer and the main author, said: "French Bulldogs are a relatively new arrival to the list of common UK breeds so there is very little current research on them in the UK. Our study - the first on this breed in the UK - is based on anonymised records gathered from hundreds of UK vet clinics. It provides owners with information on the issues that they could expect and should look out for in French Bulldogs. It may also help potential new owners to decide if a French Bulldog really is for them."

Dr. O'Neill adds: "One of the interesting finding from our research is that male French Bulldogs appear to be less healthy than females. Males were more likely to get 8 of the 26 most common health problems while there were no issues that females were more likely to get than males."

The authors suggest that the distinctive appearance of the French Bulldog, with their short muzzles and wide, prominent eyes, may be a key factor influencing their popularity. However, these characteristics may also increase the risk for some of the health problems seen in French Bulldogs. For example breathing issues, seen in 12.7% of the dogs in this study, are a known problem in breeds with short noses and flat faces. Skin problems overall were the most common group of health issues and the authors suggest that this may be due to the skin folds that are characteristic of the breed.

Dr. O'Neill said: "This study also documents the dramatic rise in popularity of the French Bulldog, from 0.02% of puppies born in 2003 to 1.46% of puppies born in 2013. This level of population growth in a single dog breed is unprecedented. There is a worry that increased demand for the French Bulldog is damaging to these dogs' welfare because of the health risks associated with their extreme physical features."

The authors analyzed data on 2,228 French Bulldogs under veterinary care during 2013 from 304 UK clinics, collected in the VetCompass™ database. The French Bulldogs had a median age of 1.3 years old compared to a median age of 4.5 years for the other dog breeds in the VetCompass™ database. This reflects the growth in popularity of French Bulldogs.

The authors caution that the study may even under-estimate the true number of dogs with health problems as the data may include more severely affected animals that require veterinary management. Additionally, as French Bulldogs have only recently become popular the data was mostly collected from young dogs and it is well recognized that health problems generally become more common with age.

Emollient bath additives provide no meaningful benefit when used in addition to standard eczema care in children, finds a trial published by The BMJ today.

Bath additives are widely prescribed at a cost of more than £23m ($33m; €26m) annually to the NHS in England. The researchers say their findings may help guide decisions around effective prescribing in this area.

Eczema (also known as atopic eczema or atopic dermatitis) is the most common inflammatory skin condition in childhood and can have a substantial impact on patients' and families' quality of life and NHS resources.

Emollients are the mainstay of treatment, providing a barrier over the skin, reducing moisture loss, and protecting against skin irritants. There are three methods of application of emollients; leave-on emollients, soap substitutes and emollient bath additives.

Although evidence supports the use of leave-on emollients and there is clinical consensus around soap substitutes, little good evidence exists on the benefits of emollient bath additives.

So a team of UK researchers, led by Miriam Santer at the University of Southampton, set out to determine both the clinical and cost effectiveness of including emollient bath additives in the management of eczema in children.

The trial included 482 children (244 girls / 238 boys) aged 1-11 years diagnosed with eczema from 96 general practices in England and Wales. Most participants had moderate eczema.

Children were randomly assigned to two groups. For one year, children in the intervention group were prescribed one of three bath additives, while the control group was asked to use no bath additives.

All participants received written instructions to use leave-on emollients as soap substitutes. They were advised to continue all other eczema care as usual, including regular use of leave-on emollients and corticosteroid creams as required.

Eczema control was measured weekly for 16 weeks using the patient oriented eczema measure (POEM, scores 0-7 mild, 8-16 moderate, 17-28 severe).

The researchers found no statistically significant difference in weekly POEM scores between the two groups over the 16 week period (mean POEM score of 7.5 in the bath additives group and 8.4 in the no bath additives group).

After taking account of eczema severity and other factors that could have affected the results, the POEM score in the no bath additives group was 0.41 points higher than in the bath additives group over 16 weeks, which is substantially lower than the minimal clinically important difference for POEM of 3 points.

There were also no significant differences between the two groups for additional measures, including eczema severity over one year, number of eczema flare-ups, quality of life, cost effectiveness, and adverse effects.

While the researchers cannot exclude the possibility of a small benefit among children bathing more than five times a week or among children aged less than 5 years, they say differences are sufficiently small to be unlikely to be clinically useful.

As such, they say this trial "found no evidence of clinical benefit from including emollient bath additives in the standard management of eczema in children."

In a linked editorial, Carsten Flohr, Consultant Dermatologist from St John's Institute of Dermatology at Guy's & St Thomas' NHS Foundation Trust in London says: "Important remaining evidence gaps are optimal regimen for leave-on treatments, soap substitutes, and frequency of bathing in children with eczema."

So there is still some room for further work, "but it is heartening to see that an important evidence gap has been closed," he concludes. Both the NHS and families of children with eczema can now better invest in more effective treatments for this common and distressing condition.

Robots that can build homes, marathoners' running shoes and NASA's upcoming spacecraft all have one thing in common: 3-D printed parts. But as enthusiasm for 3-D printing continues to grow and expand across markets, the objects printed by the process can have weaknesses. Now, one group reports in ACS Applied Materials & Interfaces that using a simple modification to the manufacture of the starting materials improves the toughness of these printable plastics.

As the 3-D printing market not only expands but also becomes more affordable, it is finding applications in many different areas. But this versatility is limited by the strength and durability of the printed parts. Most of these objects are printed in layers, which inherently results in weak spots where the layers meet. Thus, 3-D printed objects are not as strong as those made with current methods in which plastics are injected into molds. To create stronger 3-D printed parts, Miko Cakmak, Bryan D. Vogt and colleagues wanted to explore whether the starting materials could be changed to self-reinforce the printed parts.

The researchers made a structured, core-shell polymer filament in which a polycarbonate core acts as a stiff skeleton to support and reinforce the 3-D printed shape. An olefin ionomer shell around the polycarbonate core improves and strengthens the connection between the printed layers. During testing, printed parts with the filaments could withstand impacts without cracking, unlike parts made without them. The new filaments bring 3-D printed parts closer to the strength of parts manufactured by current methods. 

Emerging evidence suggests that microbes in the digestive system have a big influence on human health and may play a role in the onset of disease throughout the body. Now, in a study appearing in ACS Chemical Biology, scientists report that they have potentially found a way to use chemical compounds to target and inhibit the growth of specific microbes in the gut associated with diseases without causing harm to other beneficial organisms.

The digestive system is crammed with trillions of bacteria, fungi, and other microbes that help process food. Recent studies suggest that the changes in these gut flora, or microbiome, may play a role in the onset of a host of diseases and conditions including obesity, diabetes, cancer, allergies, asthma, autism and multiple sclerosis. Antibiotics can help regulate the microbiome, but bacterial resistance is on the rise. In addition, antibiotics can wipe out some of the organisms that contribute to a healthy microbiome, and the microbes that take their place can sometimes cause more harm than good. Researchers have also investigated using probiotics and fecal transplants to resolve some of these problems. But to date, few have really looked at using non-microbicidal small molecules to alter the microbiome in a targeted way to improve health. To help fill this gap, Daniel Whitehead, Kristi Whitehead and colleagues sought to use a chemical compound to precisely target and disrupt the metabolic processes of members of the Bacteroides genus, a group of bacteria commonly found in the gut that appear to be associated with the onset of type I diabetes in genetically susceptible individuals.

In laboratory studies, the researchers found that small concentrations of acarbose, a drug used to treat diabetes, significantly disrupted the activity of a group of proteins involved in the Starch Utilization System (Sus). The model bacteria called Bacteroides thetaiotaomicron (Bt), as well as other Bacteroides members, have this system. With Sus inhibited, Bt couldn't metabolize a pair of complex carbohydrates that are not digested by humans once they reach the colon, but that are vital to the survival of the microbes. As a result, the bacteria cannot grow. The team found that acarbose was specific, having similar effects on another Bacteroides bacteria, but little or no effect on other types of gut microbes. The researchers conclude that with further study it may be possible to develop drugs that target gut bacteria with pinpoint accuracy to permanently alter the composition of the microbiome and, in turn, prevent or treat disease.

DURHAM, N.C. -- More than 2 million people worldwide live with inherited and untreatable retinal conditions, including retinitis pigmentosa, which slowly erodes vision.

Developing treatments is challenging for scientists, as these conditions are caused by more than 4,000 different gene mutations. But many of these mutations have something in common -- a propensity for creating misfolded proteins that cells in the eye can't process. These proteins build up inside cells, killing them from the inside out.

Now Duke University scientists have shown that boosting the cells' ability to process misfolded proteins could keep them from aggregating inside the cell. The researchers devised and tested the strategy in mice, significantly delaying the onset of blindness. Their findings are outlined in the journal Nature Communications.

Their approach potentially could be used to prevent cell death in other neurodegenerative diseases, such as Huntington's, Parkinson's and Alzheimer's, said Vadim Arshavsky, Ph.D., senior author of the paper and Helena Rubenstein Foundation Professor of Ophthalmology at the Duke University School of Medicine.

"You can offer almost nothing in terms of treatment to a patient with retinitis pigmentosa or other inherited blindness today," Arshavsky said. "This investigation provides evidence that enhancing the capacity of the cell to process misfolded proteins is worth pursuing. Another important piece is that inherited blindness is just a subset of a larger category of neurodegenerative diseases, so this concept could be tested in other conditions, as well."

The Duke team collaborated with colleagues from the California Institute of Technology. They focused on the proteasome: machinery inside all cells that eliminates misfolded proteins. Arshavsky compares the barrel-shaped structure to a paper shredder, with the cutting elements hidden inside.

Misfolded proteins must pass through a "lid" on the shredder to be processed, but cells in diseased mice do not have enough lids, enabling the buildup of the damaged proteins.

Instead of trying to alter the shredders, Arshavsky and his team genetically increased the quantities of lids for the shredders, allowing cells to process more misfolded proteins.

In trials, mice with added proteasome lids retained four times the number of functional retinal cells by adulthood than mice with the same form of retinitis pigmentosa, which went blind as adults.

The lids were introduced genetically in the line of lab mice. In humans, lids could potentially be added through gene therapy or drug compounds.

"If you can retain four times the number of the functional cells in the eye, that would mean decades more vision in a human patient," Arshavsky said. "It's not a complete cure, but it's a tremendous delay. This type of treatment has the potential to defer the onset of blindness beyond the human lifespan."

High dose vitamin D supplements improve weight gain and the development of language and motor skills in malnourished children, according to a study led by University of the Punjab, Pakistan, and Queen Mary University of London.

Vitamin D - the 'sunshine vitamin' - is well known for its beneficial effects on bone and muscle health, and a study by Queen Mary researchers last year found that it could also protect against colds and flu. Now new research from the team is revealing further benefits.

Lead author Dr Javeria Saleem from University of the Punjab and Queen Mary University of London said: "High-dose vitamin D significantly boosted weight gain in malnourished children. This could be a game-changer in the management of severe acute malnutrition, which affects 20 million children worldwide."

Senior author Professor Adrian Martineau from Queen Mary University of London added: "This is the first clinical trial in humans to show that vitamin D can affect brain development, lending weight to the idea that vitamin D has important effects on the central nervous system.

"Further trials in other settings are now needed to see whether our findings can be reproduced elsewhere. We are also planning a larger trial in Pakistan to investigate whether high-dose vitamin D could reduce mortality in children with severe malnutrition."

The study, published in The American Journal of Clinical Nutrition, took place in Pakistan, where an estimated 1.4 million children live with severe acute malnutrition and are at increased risk of long-term effects on their physical and mental health.

High energy food sachets are the standard treatment for the condition, but they contain relatively modest amounts of vitamin D.

In the study, 185 severely malnourished children aged 6-58 months were treated with an eight-week course of high energy food sachets, and were also randomised to either receive additional high-dose vitamin D (two doses of 200,000 international units / 5 milligrams, given by mouth) or placebo.

After eight weeks, vitamin D supplementation led to clinically significant improvements in weight (on average gaining an extra 0.26 kg compared to the control group).

Vitamin D supplementation also resulted in substantial reductions in the proportion of children with delayed motor development, delayed language development and delayed global development (reaching certain milestones such as learning to walk or talk).

Senior author Dr Rubeena Zakar from University of the Punjab added: "Our findings could be a great help to the Health Ministry of Pakistan in dealing with the issue of malnutrition."

The study was funded by the Higher Education Commission of Pakistan.

The researchers say their study has some limitations including that it did not look at varying the dose of vitamin D to see if a lower dose would have been sufficient to boost weight gain and brain development. While they saw no overt adverse reactions, the possibility of side effects arising with clinical use of this high dose of vitamin D cannot be excluded.

Plants--Surviving the heat

A study by Oak Ridge National Laboratory detailed the response and recovery of certain tree species after short-term, extreme weather events such as heat waves. Scientists exposed sets of four different saplings to dramatic temperature swings that peaked above 120 F, or around 50 C, in a climate-controlled test chamber. Sensors attached to each tree and located throughout the chamber tracked telltale signs of heat and drought stress such as fluxes in carbon uptake and shifts in water demand. "By monitoring specific trait behavior, we characterized each tree's reaction to being kicked into survival mode for brief periods of time," said ORNL's Anirban Guha. "We found that during simulated heat waves, the entire plant mechanism was impacted, which affects its year-long survival." The ORNL-led team's findings, which were published in Environmental Research Letters, will improve predictive Earth system models. [Contact: Sara Shoemaker, (865) 576-9219; shoemakerms@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/ORNL_heat_wave_chamber2.jpg

Caption: ORNL's Jeffrey Warren (left) and Anirban Guha used a climate-controlled test chamber to simulate heat waves that peaked above 120 F and analyzed the impact on certain tree species. Credit: Genevieve Martin/Oak Ridge National Laboratory, U.S. Dept. of Energy.

Video: https://youtu.be/5j-jEEJwLCU

Caption: ORNL scientists exposed sets of four different saplings to dramatic temperature swings that peaked above 120 F, or around 50 C, in a climate-controlled test chamber. Credit: Jenny Woodbery/Oak Ridge National Laboratory, U.S. Dept. of Energy.

Sensors--Vehicle fingerprinting

Algorithms designed to parse data gathered by roadside sensors could make it easier to identify vehicles sought in AMBER Alerts and to assist researchers studying traffic patterns. Oak Ridge National Laboratory scientists built a sensor platform to collect detailed images of cars, as well as electrical pulses and audio signals from engines, to uniquely identify vehicles. "Two cars with an identical make, model and color would be difficult to differentiate on the road," said ORNL's Ryan Kerekes. "With data pulled from sensors, we can use machine learning to extract important features to create a vehicle 'fingerprint.'" The algorithms could be deployed with specialized sensor arrays or modified to apply to existing traffic cameras. The ORNL team presented their work at an IEEE Vehicle Technology Conference. Research is ongoing to upgrade sensors to capture larger vehicles and to improve matching algorithms. [Contact: Stephanie Seay, (865) 576-9894; seaysg@ornl.gov]

Image #1: https://www.ornl.gov/sites/default/files/VehicleIDSensorinCone2.jpg

Caption: ORNL researchers test a sensor array inside a traffic cone as they developed a method to more accurately identify vehicles. Credit: Jason Richards/Oak Ridge National Laboratory, U.S. Dept. of Energy.

Image #2: https://www.ornl.gov/sites/default/files/VehicleIDSensorKerekesTokola.jpg

Caption: ORNL scientists Ryan Kerekes (left) and Ryan Tokola codeveloped a prototype of the sensor platform for vehicle fingerprinting. Credit: Jason Richards/Oak Ridge National Laboratory, U.S. Dept. of Energy.

Computing--Filling the gaps

Researchers from the Max Planck Institute, renowned for advances in nonmetallic catalysis, leveraged computational modeling support from Oak Ridge National Laboratory to overcome a major limiting factor in the breakdown of simple organic compounds called olefins. Olefins are among nature's most abundant chemical compounds and are commonly obtained from crude oil. But current industrial processes to catalyze olefins into useful products are energy-intensive and costly. ORNL's Dmytro Bykov ran a series of calculations on experimental data provided by Max Planck to fill in the gaps. "The team had theorized the most promising catalysis candidates, but they needed details on the reaction mechanisms that are difficult to determine in a lab setting," Bykov said. The resulting three-dimensional models helped the team better predict the most plausible ways to catalyze olefins. Their discovery was published in the journal Science. [Contact: Sara Shoemaker, (865) 576-9219; shoemakerms@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/ORNL_catalysis_of_olefins_0.png

Caption: Computational modeling helped researchers visualize possible reactions when olefins are exposed to various catalysts. Credit: Dmytro Bykov/Oak Ridge National Laboratory, U.S. Dept. of Energy.

Materials--Taking the heat

A shield assembly that protects an instrument measuring ion and electron fluxes for a NASA mission to touch the Sun was tested in extreme experimental environments at Oak Ridge National Laboratory--and passed with flying colors. Components aboard Parker Solar Probe, which will endure the heat near the Sun, will get closer to the Sun than prior missions. The ORNL team exposed the shield assembly to a searing 3,227 F for up to 72 hours and simulated solar intensity of 65 watts per square centimeter using ORNL's Radioisotope Power Systems Program and Plasma-Arc Lamp facilities, respectively. This exceeded the worst conditions that the mission is predicted to experience in the corona. Andrew Driesman, project manager of the Johns Hopkins University Applied Physics Laboratory, which designed, built and will operate the spacecraft for NASA, said, "ORNL's support was crucial in completing our testing on time by helping to solve difficult materials and technical challenges." [Contact: Dawn Levy, (865) 576-6448; levyd@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/NASA_Parker_Solar_Probe_rendering.jpg

Caption: NASA's Parker Solar Probe, shown in this artist's concept, is scheduled to launch on July 31 to contribute data that may improve the agency's ability to forecast space weather, which can disrupt communications satellites and power grids, and may demystify why the Sun's corona is hotter than its surface. Credit: Steve Gribben/NASA, Johns Hopkins APL.

Neutrons--On the down-low

An Oak Ridge National Laboratory-led team has observed how a prolific class of antibiotics may be losing its effectiveness as certain bacteria develop drug resistance by acquiring enzymes known as aminoglycoside modifying enzymes. Aminoglycosides are commonly used in antibiotics to treat tuberculosis, meningitis and listeriosis. Using X-rays and neutron diffraction, researchers found a known but previously undetected biological architecture called a catalytic triad within this enzyme group. The team identified a low-barrier hydrogen bond, involving a single hydrogen atom formed in this catalytic triad, which is crucial for the enzyme's ability to disrupt the drugs' molecular structure and render them ineffective to combat pathogenic bacteria. Detailed in Science Advances, this information provides new insights that could help improve future drug design. [Contact: Sara Shoemaker, (865) 576-9219; shoemakerms@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/ORNL_neutrons_low-barrierH.png

Caption: The ORNL-led team identified a low-barrier hydrogen bond, involving a single hydrogen atom formed in this catalytic triad, which is crucial for the enzyme's ability to disrupt the drugs' molecular structure and render them ineffective to combat pathogenic bacteria. Credit: Oak Ridge National Laboratory, U.S. Dept. of Energy.

BOSTON - Twenty-five million Americans suffer from asthma, a chronic lung disease that has been on the rise since the 1980s. While physicians have long known that smog and pollution can bring on an asthma attack among children and adults suffering from asthma, researchers remained uncertain about what role long-term exposure to certain pollutants might play in the development of the disease in children.

New research led by scientists at Beth Israel Deaconess Medical Center (BIDMC) and the Harvard T.H. Chan School of Public Health suggest that long-term exposure to traffic-related pollution significantly increases the risk of pediatric asthma, especially in early childhood. Their findings were published today in a Letter to the Editor in the Journal of Allergy and Clinical Immunology.

"Our previous research demonstrated that living close to a major roadway and lifetime exposure to air pollutants were associated with lower lung function in seven- to ten- year-old children," said corresponding author Mary B. Rice, MD, MPH, a pulmonary and critical care physician at BIDMC. "We suspected that these exposures would also be associated with pediatric asthma."

To find out, Rice and colleagues analyzed data from 1,522 Boston-area children born between 1999 and 2002 whose mothers had enrolled in a long-term study called Project Viva, which was established to examine how behavioral and environmental factors - such as sleep and eating habits or exposure to pollution - impact children's health. As part of Project Viva, mothers provided comprehensive medical, socio-economic and demographic information, including residential address histories.

Rice and colleagues used mapping technologies to determine the distance between each child's home address and the nearest major roadway. The researchers also linked home addresses to census data and satellite-derived atmospheric data to calculate each participant's daily exposure to fine particulate matter (PM) - tiny particles suspended in the air that when inhaled deposit in the terminal sacs of the lung. Fine PM originates from fuel combustion, including traffic, power plants, and other pollution sources.

The research team also examined children's daily exposure to soot, a component of fine PM also known as black carbon. Incompletely burned fossil fuels expelled from engines (especially diesel) and power plants produce black carbon, which is a known carcinogen and potent contributor to climate change. In the Boston area, the presence of black carbon is linked to traffic-related pollution - as opposed to other regions where soot may come from a mix of sources.

Further analysis of the geographic data and Project Viva questionnaires revealed clear patterns. Most strikingly, living close to a major road was linked to childhood asthma at all ages examined.

"Children living less than 100 meters from a major road had nearly three times the odds of current asthma - children who either experience asthma symptoms or use asthma medications daily - by ages seven to 10, compared with children living more than 400 meters away from a major road," said Rice, who is also an assistant professor of medicine at Harvard Medical School. "Even in the Boston area, where pollution levels are relatively low and within Environmental Protection Agency standards, traffic-related pollutants appear to increase the risk of asthma in childhood."

"Lifetime exposure to black carbon and fine PM were also linked to the asthma in early childhood (ages three to five years), but in mid-childhood (ages seven to 10 years), these pollutants were associated with asthma only among girls. "Younger children spend a larger proportion of their time at home than school-aged children, and their airways are smaller and may be more likely to wheeze in response to pollution," says Rice. "This may explain why pollution exposure was most consistently linked to asthma in young children.

The stronger link between lifetime pollution and asthma among school-age girls was somewhat surprising. According to Rice, "Future work will need to investigate whether girls are more susceptible to pollution than boys."

With the 2018 World Cup just around the corner, soccer players and coaches are preparing to perform at their best. A recent article proposes that soccer coaches should be empowered to make reliable assessments of player psychological characteristics, based on their behavior during matches and training. Published in Frontiers in Psychology, the article suggests that coaches, with their extensive experience, could provide unique insights into the psychological characteristics required for player success. Using coach assessments could help teams to foster talented players and enhance their performance and well-being.

Previous research has identified that psychological skills and traits are important in sporting success. Researchers are increasingly investigating the psychological characteristics that make for a successful mindset on the pitch, such as commitment, discipline and resilience.

Recognizing and measuring these characteristics allows teams to identify and foster talented players. Currently, some soccer teams ask their coaches to assess their players' psychological characteristics. However, these assessments involve scouting sheets that haven't necessarily been approved by sports psychologists and which may not cover the most relevant psychological characteristics.

So far, studies on player psychology have been mostly based on standardized questionnaires filled out by the players themselves. While this is undoubtedly valuable, players may be tempted to overrate their own performance or downplay psychological issues. So far, these studies have not yet resulted in guidelines that teams can easily put into practice to identify and assist talented players.

In the new article, researchers based at the German Sport University Cologne propose that soccer coaches could provide a unique perspective on player psychology. So far, sports psychology researchers have largely overlooked coaches as a source of information on player psychology.

"We see coaches as experts who have an intuition about the relevant psychological characteristics a talented soccer player should have or develop," says Lisa Musculus, a sports psychologist who wrote the article along with Dr. Babett Lobinger.

Through working with a variety of players with different temperaments and skill levels, coaches have unique insight into the characteristics of successful players. While players may overestimate their performance, previous studies have shown that coaches do not. In addition, coaches can more easily compare players to each other. The authors propose that coach assessments could complement standard questionnaires completed by the players themselves.

However, if coaches are to contribute in assessing player psychology, it is important that they make sound judgements about players' psychological characteristics.

"We see great potential in getting coaches involved in assessing psychological characteristics that are relevant for sports performance," says Musculus. "However, it is important that we provide them with support, so that their assessments can be objective, reliable and valid."

By including many practical suggestions in their article, the authors aim to facilitate researchers and coaches in making robust and accurate assessments. These include providing coaches with clear definitions and explanations of each psychological characteristic when they complete an assessment.

The authors also advise that researchers should consult coaches on the most appropriate questions and criteria to include when developing these tests and that sports psychologists should also be involved in the process.

"Sports psychology should be included in youth coach education programs, so that coaches get a better understanding of these issues," says Musculus.

The authors conclude their article by stressing that the benefits of assessing and fostering player psychology may extend beyond enhanced performances on the pitch, to increased player well-being and positive relationships among the squad.

New research, led by biologists from the University of Bristol, has uncovered fresh findings about the most mobile eyes in the animal kingdom - the eyes of the mantis shrimp.

Mantis shrimp vision is extraordinary, both in terms of their colour vision and their ability to see the polarisation of light.

Not only this, but they have extremely mobile eyes that never seem to stop moving. While most animals keep eye movements to a minimum to avoid blur, mantis shrimp apparently go out of their way to move their eyes as much as possible.

Each eye is capable of independent rotation in all three degrees of rotational freedom; pitch (up-down), yaw (side-to-side) and roll (twisting about the eye-stalk).

The Bristol-led team of researchers based at the University's Ecology of Vision Laboratory, wanted to test the limits of this incredible mobility to discover at what point mantis shrimp have to steady their gaze. Their findings are published today in the journal Proceedings of the Royal Society B.

Like other animals, mantis shrimp do make stabilising side-to-side movements that help keep their vision steady as they move through the world, but the team found that even while stabilising in the horizontal direction, they can't resist rolling their eyes.

This is completely counter-intuitive; the whole point in stabilising gaze is to keep the appearance of the world around them steady, but by rolling their eyes 'up' suddenly becomes 'sideways' and the world gets very complicated.

Amazingly, this has no effect on the mantis shrimp - no matter what position they've rolled their eyes to, or how quickly they're rolling, mantis shrimp can still reliably and accurately follow the motion of a pattern that is moving sideways.

Ilse Daly from Bristol's School of Biological Sciences and lead author of the study, said: "It would be like you tipping your head on its side, then back to normal and all angles in between all while trying to follow the motion of a target.

"Just to make things even more confusing, the left and right eyes can move completely independently of one another, such that one eye could be oriented horizontally, while the other could be twisted completely through 90 degrees to be on its side."

Following this unexpected discovery, the team tested to see how mantis shrimp would respond if the world started to roll around them.

In humans, such a stimulus would induce severe vertigo, as visitors to certain theme parks may have experienced with rides which challenge people to walk through a tunnel along a solid, fixed gangway while the walls of the tunnel rotate around them - which is nearly impossible to do without falling over.

Ilse Daly added: "We expected that, in response to the world around them apparently rolling, mantis shrimp should roll their eyes to follow their surroundings. They did not.

"The mantis shrimp visual system seems entirely immune from any negative effects of rolling their eyes. Indeed, it appears as though rolling has absolutely no effect on their perception of space at all: up is still up, even when their eyes have rolled completely sideways. This is unprecedented in the animal kingdom."

The next step is to confirm the existence of such a unique motion detection system and fully explore how it provides mantis shrimps with a clear view of the world regardless of how much or how quickly they're rolling their eyes.

However, a more fundamental question is why mantis shrimp need to roll their eyes in the first place, and this is what the team will seek to answer next

Researchers have found evidence that acupuncture could help people who experience dental anxiety.

Dental anxiety affects up to an estimated 30% of the adult population in countries world-wide. Patients can experience nausea, difficulty breathing and dizziness at the thought of going to the dentist, during an examination, and following treatment.

Reasons behind dental anxiety can be various, such as fear of pain, needles or anaesthetic side effects, as well as embarrassment or feeling a loss of control.

In a review of six trials with 800 patients, researchers used a points scale to measure anxiety and studies show that anxiety reduced by eight points when dental patients were given acupuncture as a treatment. This level of reduction is considered to be clinically relevant, which means that acupuncture could be a possibility for tackling dental anxiety.

Previous clinical trials have involved acupuncture for treatment on a range of conditions, including lower back pain, depression, and irritable bowel syndrome. There is, however, limited research detailing its impact on specific cases of anxiety.

More than 120 trials across England, China, Spain, Portugal and Germany were identified as having investigated the effects of acupuncture on patients with dental anxiety, and six trials were eligible for review, with two demonstrating high quality methods.

Professor of Acupuncture, Hugh MacPherson, at the University of York's Department of Health Sciences, said: "There is increasing scientific interest in the effectiveness of acupuncture either as a standalone treatment or as an accompanying treatment to more traditional medications.

"We have recently shown, for example, that acupuncture treatment can boost the effectiveness of standard medical care in chronic pain and depression.

"Chronic pain is often a symptom of a long-term condition, so to further our understanding of the various uses of acupuncture we wanted to see what it could achieve for conditions that occur suddenly, rapidly and as a reaction to particular experiences."

Studies that compared anxiety levels between patients that received acupuncture and those that did not, showed a significant difference in anxiety scores during dental treatment. A clinically relevant reduction in anxiety was found when acupuncture was compared with not receiving acupuncture.

No conclusions could be drawn, however, between patients that received acupuncture as an intervention and those that received placebo treatment, suggesting that larger scale controlled trials are needed to increase the robustness of the findings.

Professor MacPherson said: "These are interesting findings, but we need more trials that measure the impact of acupuncture on anxiety before going to the dentist, during treatment and after treatment.

"If acupuncture is to be integrated into dental practices, or for use in other cases of extreme anxiety, then there needs to be more high quality research that demonstrates that it can have a lasting impact on the patient. Early indications look positive, but there is still more work to be done."

The research is published in the European Journal of Integrative Medicine.

Among predictions of a second fracking boom in the US, the first evidence that chemicals found in ground water near fracking sites can impair the immune system will be published in Toxicological Sciences on May 1. The study, performed in mice, suggests that exposure to fracking chemicals during pregnancy may diminish female offspring's ability to fend off diseases, like multiple sclerosis.

Fracking, also called hydraulic fracturing or unconventional oil and gas extraction, involves pumping millions of gallons of chemical-laden water deep underground to fracture rock and release oil and gas. About 200 chemicals have been measured in waste water and surface or ground water in fracking-dense regions and several studies have reported higher rates of diseases, like acute lymphocytic leukemia and asthma attacks, among residents in these areas.

"Our study reveals that there are links between early life exposure to fracking-associated chemicals and damage to the immune system in mice," said Paige Lawrence, Ph.D., chair of Environmental Medicine at the University of Rochester Medical Center, who led the study. "This discovery opens up new avenues of research to identify, and someday prevent, possible adverse health effects in people living near fracking sites."

Of the 200 fracking chemicals found in ground water, 23 were recently linked to reproductive and developmental defects in mice. Susan Nagel, Ph.D., associate professor of Reproductive and Perinatal Research at the University of Missouri School of Medicine and a co-author of this study, classified the chemicals as endocrine disrupters, meaning they can interfere with hormones and derail hormone-controlled systems.

Because the immune system is greatly influenced by hormones, Lawrence tested the immune impact of those 23 fracking chemicals on mice. Lawrence's team added the chemicals to the drinking water of pregnant mice at levels similar to those found in ground water near fracking sites.

"Our goal is to figure out if these chemicals in our water impact human health," said Lawrence, "but we first need to know what specific aspects of health to look at, so this was a good place to start."

In Lawrence's study, mouse pups - particularly females - who were exposed to a mixture of 23 fracking chemicals in the womb had abnormal immune responses to several types of diseases later on, including an allergic disease and a type of flu. What was most striking: these mice were especially susceptible to a disease that mimics multiple sclerosis, developing symptoms significantly earlier than mice that were not exposed to the chemicals.

At the heart of these abnormal immune responses lies an intricate mosaic of immune cells, each playing specific and important roles defending against infections, or preventing allergies or damage caused by uncontrolled immune responses. Some of these cells jump into action to fight off invaders, while others tamp down an immune response once an infection is under control.

Proper immune function requires a delicate balance of all of these players - which fracking chemicals appear to disrupt. Lawrence and her colleagues believe the chemicals derail cellular pathways that control which immune cells are spurred to action.

The group will continue to investigate how fracking chemicals interact with the developing immune system in hopes of understanding what this could mean for human health. Their new discoveries will inform biomedical scientists, health care professionals, policy makers, and the public.