Culture

Leonardo da Vinci's world-renowned "Mona Lisa" painting of Lisa Gherardini has captivated millions since it was created in the early 1500s, including experts in the medical community. For years, scientists and physicians have studied the discoloration of Gherardini's skin, the thickness of her neck, and her enigmatic smile to hypothesize about her health during the Renaissance time period.

The most recent published theory suggests she suffered from severe hypothyroidism, or underactive thyroid. The cardiologist cites her yellow skin, the enlarged appearance of her thyroid gland, and lack of eyebrows as symptoms to support his theory. He also writes that her mysterious smile may represent a hint of resulting psychomotor retardation and muscle weakness.

Not so fast, said Michael Yafi, MD, a pediatric endocrinologist at The University of Texas Health Science Center at Houston (UTHealth).

"I felt a personal responsibility to defend the "Mona Lisa" and the fascinating lady the painting portrays," said Yafi, the director of the Division of Pediatric Endocrinology at McGovern Medical School and a specialist with UT Physicians, the clinical practice of UTHealth. "She has inspired thousands of people over the past few centuries. I couldn't have the public thinking she had hypothyroidism, when it seems to me she was euthyroid, meaning her thyroid was normal. So, I decided to give her a fresh 21st-century medical opinion."

Yafi's opinion was recently published in Hormones-International Journal of Endocrinology and Metabolism. In it, he explains that the documentation of thyroid disease is well known in art history, and this painting doesn't match the countless other depictions of goiters, or enlargements of the thyroid gland.

"Artists often depicted what they saw in society. Sculptures from the ancient Andean and Egyptian civilizations recorded endemic goiters in areas of environmental iodine deficiency, like the Tuscany region where Gherardini lived. Ancient Greek art represents this symptom as well, as do several poetic works and even Shakespearean literature. If Gherardini had a goiter from iodine deficiency, it would have been severe and more clearly demarcated in the painting like the other historical representations; a talented painter like da Vinci would have had no problem expressing it," Yafi said.

Yafi also points out that many of da Vinci's paintings depict women without eyebrows, so it's not conclusive to attribute that feature to underactive thyroid.

Additionally, he says the yellowing of the skin only develops after a long duration of the disease. Typically, having long-term hypothyroidism would have severely affected fertility, but Gherardini is known to have given birth to five children, including one only months before sitting for the painting.

"The discoloration could simply be attributed to the age of the artwork, as well as the varnish applied by the artist. Furthermore, the painting was stolen and then hidden away for almost three years, and someone also once vandalized it with acid in an act of sabotage," Yafi said.

And as for the mysterious smile and the proposal that it's caused by muscle weakness:

"Making a diagnosis of hypothyroidism on the basis of subtle and vague features in an old painting is, needless to say, risky," Yafi said. "Hypothyroid myopathy, or muscle tissue disease, manifests in muscles that are closer to the body's midline. It is usually severe, which means that it would have prevented Gherardini from posing with a straight back. Moreover, there are plenty of people who have an asymmetric smile, but this does not necessarily mean that they are hypothyroid."

Yafi, an avid art lover and active member of Houston's art community, enjoys studying the intersection between art and medicine. His second medical diagnosis of a famous piece of art, this time focused on Edward Munch's "The Scream," was just published in Hektoen International, A Journal of Medical Humanities.

"Artists and art interpreters throughout history were able to detect many diagnoses and conditions, even before doctors. However, they weren't always correct," he said. "The artwork or person in the artwork may need a second opinion, or even third or fourth, based on current medical or scientific discoveries. It's always best to keep an open mind."

Star Trek's Spock would not be surprised: People are "illogical." New research exploring American liberals and conservatives shows that regardless of political affiliation, tribal instincts kick in and people's ability to think logically suffers when it comes to arguments related to their political belief systems. When confronted with the unsound reasoning of opposing groups, people become better able to identify flawed logic.

The research was recently published in Social Psychological and Personality Science.

In their first study, the researchers studied ideological belief bias - the tendency to judge logical arguments based on the believability of their conclusions rather than whether or not the arguments' premises support the conclusions - effects among 924 liberals and conservatives from YourMorals.org. Visitors to the site evaluated the logical soundness of classically structured logical syllogisms supporting liberal or conservative beliefs. Of 16 syllogisms, half were structured as sound arguments, and half unsound.

On average, participants correctly judged 73% of the syllogisms. But their ability to judge correctly depended on their political views.

"Liberals were better at identifying flawed arguments supporting conservative beliefs and conservatives were better at identifying flawed arguments supporting liberal beliefs," says Anup Gampa (University of Virginia), a lead coauthor of the paper.

In a second study, they observed ideological belief bias effects among 1,489 participants from ProjectImplicit.org. The participants in this study were trained in logical reasoning before evaluating political syllogisms using language similar to what they might encounter in popular media.

Even with the training, the ability to analyze arguments fell into the same patterns. The authors found similar patterns of bias in a nationally representative sample containing 1,109 liberals and conservatives.

In the era of fake news, these logical fallacies can be even more potent.

"When two sides don't share a common view of even seemingly objective facts, these differences become embedded in our collective reasoning ability," says Sean Wojcik (University of California, Irvine), a lead coauthor of the paper. "Our biases drive us apart not only in our disagreements about political and ideological worldviews, but also in our understanding of logic itself."

Both Gampa and Wojcik agree that in our political world, "we might not be as vigilant as we think" about the logical grounding of our own beliefs and "we might be unreasonably harsh about the logical grounding of the belief of those we disagree with."

Despite this, being able to hear the other side can open us to our own flawed arguments, suggest the researchers.

Philadelphia, April 17, 2019 - To improve the treatment of children with irritable bowel syndrome (IBS), investigators have developed a sophisticated way to analyze the microbial and metabolic contents of the gut. A report in The Journal of Molecular Diagnostics, published by Elsevier, describes how a new battery of tests enables researchers to distinguish patients with IBS from healthy children and identifies correlations between certain microbes and metabolites with abdominal pain. With this information, doctors envision tailoring nutritional and targeted therapies that address a child's specific gastrointestinal problems.

"This research highlights the importance of the microbiome-gut-brain axis and our understanding of chronic abdominal pain. Development of new disease classifiers based on microbiome data enables precision diagnostics to be developed for IBS and similar disorders. Although other studies have found differences in the gut microbiomes of patients with IBS, this study is the first to combine deep microbiome analysis with development of new diagnostic strategies," explained James Versalovic, MD, PhD, of the Department of Pathology & Immunology at Baylor College of Medicine and the Department of Pathology at Texas Children's Hospital, Houston, TX, USA. The term microbiome refers to the genetic material of all the microbes--bacteria, fungi, protozoa, and viruses--that live on and inside the human body.

Samples for this study were obtained from 23 preadolescent children with IBS (age 7 to 12 years) and 22 healthy controls. Participants were asked to maintain daily pain and stool diaries for two weeks and to provide stool (fecal) samples.

Investigators found that there are differences in bacterial composition, bacterial genes, and fecal metabolites in children with IBS compared to healthy controls. In addition to identifying correlations of these factors with abdominal pain, they generated a highly accurate classifier using metagenomic and metabolic markers that distinguishes children with IBS from healthy controls with 80 percent or greater accuracy. This classifier assesses specific metabolites, types of bacteria, functional pathways, and other factors. "This disease classifier represents a significant advance in the diagnosis of IBS and could be clinically impactful," commented Dr. Versalovic.

This microbiome-based classifier can potentially help identify subpopulations of children with IBS that are more likely to benefit from microbiome-related therapies including diet modification, while guiding others to alternative appropriate treatment plans. The investigators also provide insights into how specific microbiome-related findings may be related to abdominal pain, thus opening up potential novel treatment approaches.

A chronic disease that is evaluated clinically can be stratified in the future based on differences in the composition and function of the intestinal microbiome. Dr. Versalovic envisions that these findings will begin to usher in an era of metagenomics-based, data-driven precision diagnostics for IBS and other functional gastrointestinal disorders. "Microbiome-based diagnosis and disease stratification of patients with IBS means that we create hope for tailored nutrition and targeted therapies in the future, leading to better outcomes for patients with chronic disease," noted Dr. Versalovic.

IBS is a disruptive gastrointestinal condition characterized by bloating, changes in bowel habits, and pain that affects up to 20 percent of the world's population (children and adults). Increasing evidence indicates that the onset and symptoms of IBS are related to the gut microbiome. Deficiencies or excesses of specific gut microbes or metabolites may contribute to the disease process of IBS.

LA JOLLA, CALIF. - April 17, 2019 - Lying within our muscles are stem cells, invisible engines that drive the tissue's growth and repair. Understanding the signal(s) that direct muscle stem cells to spring into action could uncover new ways to promote muscle growth. However, these mechanisms are poorly understood.

Now, scientists from Sanford Burnham Prebys have uncovered a molecular signaling pathway involving Stat3 and Fam3a proteins that regulates how muscle stem cells decide whether to self-renew or differentiate--an insight that could lead to muscle-boosting therapeutics for muscular dystrophies or age-related muscle decline. The study was published in Nature Communications.

"Muscle stem cells can 'burn out' trying to regenerate tissue during the natural aging process or due to chronic muscle disease," says Alessandra Sacco, Ph.D., senior author of the paper and associate professor in the Development, Aging and Regeneration Program at Sanford Burnham Prebys. "We believe we have found promising drug targets that direct muscle stem cells to 'make the right decision' and stimulate muscle repair, potentially helping muscle tissue regeneration and maintaining tissue function in chronic conditions such as muscular dystrophy and aging."

Muscle wasting occurs as part of the natural aging process, called sarcopenia, or due to genetic diseases such as muscular dystrophy. Sarcopenia affects nearly 10 percent of adults over the age of 50 and nearly half of individuals in their 80s. The condition leads to loss of independence and contributes to falls, a leading cause of accidental death in people age 65 or older. Muscular dystrophies are a group of more than 30 genetic diseases characterized by progressive muscle weakness and degeneration. A cure does not exist.

Muscle stem cells select between two fates over a person's lifetime: Either differentiate to become adult muscle cells or self-renew to replenish the stem cell population. Accumulating evidence shows that mitochondrial respiration (cellular breathing) is a key switch that drives muscle stem cells to differentiate, an energy-intensive process, instead of self-renew.

In the study, the scientists used mouse models to demonstrate that Stat3 promotes mitochondrial respiration. Because Stat3 regulates many cellular processes, the scientists combed through genes expressed during muscle growth to find additional proteins regulated by Stat3 that might serve as more specific targets.

These efforts uncovered the protein Fam3a. Further work conducted, including generating a mouse model and cell lines that lack Fam3a, demonstrated that the protein is required for muscle stem cell differentiation and muscle growth. The researchers also showed that Fam3a is secreted by muscle cells during muscle repair, and treatment with the protein restored mitochondrial respiration and stem cell differentiation in muscle stem cells that lacked Stat3--all demonstrating the integral role of Fam3a in determining muscle stem cells' fate.

"As the number of people over the age of 65 rises due to the aging of the baby-boomer generation, it is important to not only extend life span but also health span--the years we can remain healthy and active," says David Sala, Ph.D., the first author of the paper and a postdoctoral researcher in the Sacco laboratory. "The ability to boost and maintain muscle tissue function can help more people live an active and independent life. The results of our research can also find applications for muscle wasting disorders such as muscular dystrophy."

The scientists are already conducting preclinical studies to validate Fam3a as a therapeutic target. They also hope their findings could apply to stem cells that differentiate to create other tissues, which could help treat other degenerative tissue diseases.

A large, multi-ethnic genome-wide association study (GWAS) of asthma identified novel associations with potential relevance for asthma susceptibility in older adults of diverse racial backgrounds. The study, "Large-scale, multi-ethnic genome wide association study identifies novel loci contributing to asthma susceptibility in adults," appears in the April issue of the Journal of Allergy and Clinical Immunology.

Asthma affects over 300 million persons globally and susceptibility to asthma is influenced by environmental and genetic risk factors. "Identifying the genetic variants associated with asthma through GWAS is crucial for determining the genetic basis of asthma" said co-first author Joanne Sordillo, ScD, MS, Research Scientist at the Harvard Pilgrim Health Care Institute. "It's also necessary to understand how genetic heterogeneity underlying asthma risk may be influenced by ethnic background, using large, multi-racial patient populations."

Researchers conducted an asthma GWAS in the Kaiser Permanente Northern California Genetic Epidemiology Research in Adult Health and Aging (GERA) cohort, using a total of 68,623 asthma cases and non-asthmatic controls. Study results found a novel potential mechanism for asthma susceptibility by the gene, IL1RL1. Study investigators believe this could be associated with asthma susceptibility through introduction of a new binding site for micro RNA, a small non-coding RNA molecule, that regulates expression of this locus. The study also replicated 16 novel associations with asthma susceptibility in the non-Hispanic white populations, all of which were annotated to either HLA-DQA1, a major histocompatibility complex gene, or IL18R1/IL1RL1. Study results showed no overlap in genome-wide asthma associations across the four ethnic groups, suggesting that unique biological pathways may contribute to asthma susceptibility within older adults of different ethnicities.

"This study contributes novel and unique associations with asthma within four major human ethnic groups and represents one of the largest GWAS of asthma conducted to date" said senior author Ann Chen Wu, MD, MPH, Associate Professor of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School.

CHAMPAIGN, Ill. -- A team that studies how biological structures such as cactus spines and mantis shrimp appendages puncture living tissue has turned its attention to viper fangs. Specifically, the scientists wanted to know, what physical characteristics contribute to fangs' sharpness and ability to puncture?

They report their findings in the Royal Society journal Biology Letters.

Like most venomous snakes, vipers have fangs that function primarily as hypodermic needles, said University of Illinois postdoctoral researcher Stephanie Crofts, who conducted the analysis of viper fangs with U. of I. animal biology professor Philip Anderson. But vipers - a group that includes rattlesnakes, asps and puff adders - tend to have hinged jaws that fold the fangs up into their mouths for storage.

Viper fangs are smooth and efficient, Anderson said.

"They typically don't have to hold on very long," he said. "They sink their fangs in and out, and they're done."

The researchers wanted to know which characteristics of the fangs made them good at puncturing.

"The question was: How do we measure sharpness?" Crofts said. "Intuitively, we think we know what is sharp and what isn't, but in biology, we have to measure specific morphological traits."

The Field Museum in Chicago lent the researchers fangs from a variety of species. The team used 28 viper fangs for its tests.

For each fang, the researchers measured the angle of the tip (was it wide or narrow?), how rounded the tip is, and its surface area. They mounted each fang to a machine that can apply and measure the force required to puncture something - in this case, cubes of ballistics gel of uniform size and density.

Mechanical engineers on the team also manufactured a series of metal punches with varying tip angles, degrees of bluntness and surface areas, and the team also tested those using the same methods.

"With the punches, we could very tightly control the different parameters," Crofts said. "It was a way of isolating those different metrics."

The tests revealed that the angle of a fang's tip contributed the most to sharpness. Even a narrow fang with a rounded tip tended to perform better than a wider fang that was intact - not rounded or dulled - at its end.

"The narrowness of the tip angle is what's really important," Crofts said. "I found that a little surprising, because most measures of sharpness focus on the roundedness of the tip. That does come into play, but it's secondary to that overall angle."

"This study tells us what aspect of shape to measure when we want to measure sharpness," Anderson said. "Whether we're looking at biological systems or other systems, the tip angle appears to be the primary factor driving sharpness."

A novel type of body awareness training helps women recover from drug addiction, according to new research from the University of Washington. People in the study made marked improvement, and many improvements lasted for a year.

It's the first time the mindfulness approach has been studied in a large randomized trial as an adjunct treatment. The training helps people better understand the physical and emotional signals in their body and how they can respond to these to help them better regulate and engage in self-care.

"We could teach this intervention successfully in eight weeks to a very distressed population, and participants not only really learned these skills, they maintained increases in body awareness and regulation over the yearlong study period," said Cynthia J. Price, a research associate professor in the UW School of Nursing and lead author of the study. "The majority of participants also reported consistent use of MABT skills, on a weekly basis, over the duration of the study."

And likely due to using the skills learned in the intervention, the women showed less relapse to drug and alcohol use compared to those who didn't receive the intervention, Price said. The findings were published in March in the journal Drug and Alcohol Dependence.

The training included one-on-one coaching in an outpatient setting, in addition to the substance use disorder treatment the women were already receiving. The intervention is called Mindful Awareness in Body-oriented Therapy (MABT) and combines manual, mindfulness and psycho-educational approaches to teach interoceptive awareness and related self-care skills. Interoceptive awareness is the ability to access and process sensory information from the body.

Researchers studied 187 women at three Seattle-area locations. The cohort, all women in treatment for substance use disorder (SUD), was split into three relatively equal groups. Every group continued with their regular SUD treatment. One group received SUD treatment only, another group was taught the mindfulness technique in addition to treatment, and the third group received a women's education curriculum in addition to treatment in order to test whether the additional time and attention explained any positive study outcomes.

Women were tested at the beginning, and at three, six and 12 months on a number of factors including substance use, distress craving, emotion regulation (self-report and psychophysiology), mindfulness skills and interoceptive awareness. There were lasting improvements in these areas for those who received the MABT intervention, but not for the other two study groups.

"Those who received MABT relapsed less," Price said. "By learning to attend to their bodies, they learned important skills for better self-care."

UBC researchers have determined the majority of men struggle when it comes to understanding the diagnosis and treatment of prostate cancer.

Professors Joan Bottorff and John Oliffe are scientists with UBC's Men's Health Research Program. Together, while studying men's knowledge or literacy of prostate cancer, they realized many are in the dark when it comes to what they know about the disease. And, more importantly, what direction to take after diagnosis.

"In terms of health literacy, there is a long history of people saying men are not up to speed," says Oliffe. "This includes their knowledge when it comes to understanding prescription drugs and dosages, whether they know the stages of a disease and how they apply the knowledge they have."

Health literacy is the ability to access, understand and use health-related information to make informed decisions and manage personal health. However, when it comes to prostate cancer, the information is overwhelming for many men, adds research coordinator and study lead author Cherisse Seaton.

"Our research looks at how men apply the knowledge they have," she says. "Quite often there is so much information out there and it's complex in terms of choice."

Prostate cancer is the most common cancer among Canadian men and it has a high survival rate. However, says Seaton, low health literacy is considered a risk factor for poor health and poor decision-making.

"Men have some big decisions to make after diagnosis," says Seaton. "Not all prostate cancers are aggressive and it can be challenging to predict if a patient has slow-growing cancer or one that is aggressive. The patients have to decide what type of treatment course to follow. To do that they need to be well informed and understand of all the options."

A common treatment option--active surveillance --calls for no surgery or active treatments. The goal is to wait out the disease while consulting regularly with a doctor. While active surveillance can be an option, the study shows more than 91 per cent of men surveyed opted for treatment.

"There are some men who just really want to get rid of the cancer regardless of what they are told," says Bottorff, who teaches in UBC Okanagan School of Nursing. "They go forward with the surgery or a more aggressive treatment than they might need, quite often from fear or lack of knowledge. These active treatment options have considerable side effects and we believe the better the men's health literacy, the better they will do when it comes to making informed choices and avoiding decisional regret."

Although research shows men rate their understanding of health information highly, many feel they do not have enough information to manage their personal health.

To help with men's health literacy for prostate cancer, the Men's Health Research team created an interactive website titled If I Were Tom. The site, Oliffe explains, is useful for men right after diagnosis. A number of videos follow fictional patient named Tom through the prostate test, diagnosis and a treatment decision. Site visitors can make decisions with Tom, and learn of the many options available. The interactive website also shares messages from survivors, health care providers and family members.

"Our research showed that even though men had a lot of interaction with health care providers, and there are tools out there, they still felt they needed more information," says Bottorff. "Clearly, we need to find other ways to connect men with the information they are looking for. This website is an effort to address those information needs in a way that is accessible to men."

The narratives we tell about the past often feature a cast of familiar main characters: kings and rulers, warriors and diplomats -- men who made laws and fought wars, who held power over others in their own lands and beyond. When women enter our stories, we rarely afford them much agency. But across the globe in a variety of societies, royal women found ways to advance the issues they cared about and advocate for the people important to them.

In a recent paper published in the Journal of Archaeological Research, anthropologist Paula Sabloff analyzes the archeological and written records of eight premodern states separated by both time and space, detailing ways that queen rulers and main wives took political action. Her comparative analysis reveals similar patterns in the societies despite the fact that they were isolated from one another.

Sabloff's analysis includes three types of regions: independent states or city-states (including the Mari Kingdom of Old Babylonia, 2000-1600 BC, and Protohistoric Hawai'i, AD 1570-1788); empires (Old Kingdom Egypt, 2686-2181 BC, Late Shang China, 1250-1046 BC, the Aztec Empire, AD 1440-1520, and the Inca Empire, AD 1460-1532); and states in regions that contained both states and empires (Late Classic Maya, AD 600-800, and Postclassic Zapotec, AD 1050-1500).

As Sabloff described in another recent paper, women were often used as bargaining chips, used to form strategic alliances between states through marriage. "Here are examples of, even when women were pawns in marriage, they still ended up with a lot of power," she says. She found remarkable similarities in the types of power that royal women used.

"Queen rulers held nearly the same political power as kings," she explains. "Main wives were active players in determining succession, governing the polity, building inter- and intrapolity alliances, and expanding or defending territory." These women also exerted influence by obligating courtiers and tradesmen through patron-client relationships, interceded on behalf of their relatives, and sometimes spied on or conspired against their royal husbands.

"Political agency wasn't just about waging war," says Sabloff. "It was about being able to influence policy, to influence who is on the throne. There were levels of agency, but hers was right behind his."

BOSTON (April 15, 2019, 5:00 a.m. ET)--The Food and Drug Administration's (FDA) mandatory added sugar labeling policy for packaged foods and beverages, set to take effect between 2020 and 2021, could be a cost-effective way to generate important health gains and cost-savings for both the healthcare system and society in the U.S., according to a new modeling study led by researchers from the Friedman School of Nutrition Science and Policy at Tufts University and the University of Liverpool. The analysis is the first to estimate the potential health and economic impacts of the new label.

In 2016, the FDA announced several mandatory changes to the Nutrition Facts label in order to provide consumers with enhanced nutritional information. Among the changes was adding the grams and percent Daily Value of added sugar content, which would help consumers limit calories from added sugar in accordance with the recommendations of the 2015-2020 Dietary Guidelines for Americans.

The study, published today in Circulation, estimates that the FDA's added sugar label could prevent or postpone nearly 1 million cases of cardiometabolic disease, including heart disease, stroke and type 2 diabetes, over a 20-year period. When combined with possible industry reformulations to reduce added sugar content in packaged foods and beverages, the label could prevent or postpone nearly 3 million cases of cardiovascular disease and diabetes over the same time period. Cost-effectiveness of each scenario was evaluated from a healthcare perspective (accounting for policy costs and medical costs) and from a societal perspective (further accounting for informal care costs and lost productivity costs). Both scenarios were estimated to be cost-effective within five years and cost-saving within seven years.

Specifically, the analysis estimates that the added sugar label could:

Prevent or postpone 354,400 cases of cardiovascular disease and 599,300 cases of diabetes;

Gain 727,000 quality-adjusted life-years (QALYs); and

Save $31 billion in net healthcare costs and $61.9 billion in societal costs. Policy costs were estimated to be $1.7 billion.

Taking into consideration possible reformulation by the food industry, the analysis yielded greater corresponding gains, estimating that the new label could:

Prevent or postpone 708,800 cases of cardiovascular disease and 1.2 million cases of diabetes;

Gain 1.3 million QALYs; and

Save $57.6 billion in net healthcare costs and $113.2 billion in societal costs. Policy costs, including industry reformulation costs, were estimated to be $4.3 billion.

"The added sugar label is an important policy step toward reducing consumption of foods and beverages with high added sugar contents, improving health, and lowering healthcare spending," said Renata Micha, R.D., Ph.D., the study's co-senior and corresponding author and research associate professor at the Friedman School of Nutrition Science and Policy at Tufts University. "These findings have important implications for individuals, policy makers and the food industry alike. Modest industry reformulation would be a powerful way to maximize potential benefits, highlighting industry's critical role in being part of the solution."

While some companies have begun listing added sugar content, the 2018 deadline for compliance has been extended to 2020 for large manufacturers and 2021 for small manufacturers.

"Informing consumers about what is in their sugary drinks, cakes, and sweets will help them decide what they want to eat for their health now and later," said Martin O'Flaherty, M.D., Ph.D., co-senior author and professor in epidemiology at the University of Liverpool. "Full implementation of the label before 2021 could help maximize health and economic gains."

The researchers note that Americans consume more than 15 percent of their total calories from added sugars and overconsumption of added sugars is linked to an increased risk of cardiometabolic diseases. These diseases pose large health and economic burdens for the society and the healthcare system. Food labeling could be an effective strategy to support informed consumer choice and reduce added sugar intake, while further stimulating industry reformulation, as supported by recent experience with trans fat labeling in the U.S.

The researchers used a validated microsimulation model (IMPACT) to estimate the potential health impact, costs, and cost-effectiveness of the FDA's added sugar label based on the two scenarios, which were compared with a "no intervention" baseline scenario over a 20-year timeframe (2018-2037). The model generated a sample representative of the U.S. adult population and utilized data from the two most recent National Health and Nutrition Examination Survey cycles (2011-2014), CDC Wonder, meta-analyses, and other validated sources.

The model evaluated health benefits and cost-savings from cardiometabolic health outcomes; increased healthcare costs from competing diseases could reduce cost-effectiveness, while other health benefits would further contribute to health gains and cost-savings.

DALLAS, April 15, 2019 -- A label showing added sugars content on all packaged foods and sugary drinks could have substantial health and cost-saving benefits in the United States over the next 20 years, according to a new study published in the American Heart Association's journal Circulation. Using a validated model, researchers were able to estimate a significant reduction in cardiovascular disease and type 2 diabetes cases from 2018 to 2037, if such a mandated addition to the Nutrition Label was implemented.

Poor diet, especially with overconsumption of sugar, is a known, preventable cause of cardiovascular disease and diabetes. The Food and Drug Administration (FDA) announced an added sugars-labeling requirement on the Nutrition Facts label in 2016.

"The purpose of our study was to estimate the impact of the FDA's added sugars label on reducing sugar intake and preventing diabetes and cardiovascular disease," says Renata Micha, R.D., Ph.D., of the Friedman School of Nutrition Science and Policy at Tufts University in Boston. "Our results indicate that timely implementation of the added sugars label could reduce consumption of foods and beverages with added sugars, which could then lead to an improvement in health and a reduction in healthcare spending."

The study was conducted as part of a National Institutes of Health-funded initiative, Food-PRICE, at Tufts University to identify nutrition strategies that can have the greatest impact on improving diet and health in the U.S.

The researchers predict that between 2018 and 2037, the added sugars label would prevent more than 354,000 cardiovascular disease cases and lead to almost 600,000 fewer cases of type 2 diabetes. The estimated reduction in net healthcare costs would be more than $31 billion, after policy costs have been factored in, and not including societal costs, such as lost productivity.

"We and others have shown that food labeling can be an effective strategy to support informed consumer choice and effectively change consumer behavior," said Micha.

The study authors believe that the added sugars label would likely encourage food and beverage-makers to reformulate their products. As a result, they calculate the impact to be twice as great as having the added sugars label alone, at more than 700,000 fewer cases of cardiovascular disease and 1.2 million fewer diabetes cases, with net healthcare cost savings of more than $57 billion.

In explaining the potential effect that a mandated added sugars label would have on sugar content, Micha points to recent experience with food manufacturers who reduced or removed trans fats from their products following trans-fat labeling on products in the U.S. "That suggests that mandated labeling of added sugars content would stimulate the food industry to reduce sugar in their products," she said.

"Clear, easy-to-understand nutrition labels help guide everyone on the path to healthy eating," says Linda Van Horn, PHD, RDN., American Heart Association volunteer expert and Professor and Chief of Nutrition in the Department of Preventive Medicine at the Feinberg School of Medicine, Northwestern University, in Chicago. "Consumers are better empowered to make more informed food choices that will help reduce their risk for heart disease and stroke and live longer, healthier lives."

Although there have been recent declines in sugar consumption, mainly from sugary drinks, Americans still consume more than 300 calories per day from added sugar. The largest single source is sugary drinks, followed by cookies, cakes and pastries, candies and ice cream.

"Our findings may be conservative and underestimate the full health and economic impacts. The model only evaluated health benefits and cost-savings from diabetes and cardiovascular disease outcomes," said Micha, who added that impact on other health concerns could further contribute to health benefits and reduced costs.

ANN ARBOR, Mich. -- As teens prepare to leave home for college or live on their own in a new city, many may also be using ride sharing services for the first time - and that raises safety concerns for many parents - a new national poll suggests.

One in three parents say their 18-year-old has used a ride sharing service, either alone or with another teen, according to the C.S. Mott Children's Hospital National Poll on Children's Health at the University of Michigan. Parents' top concerns involved driving safety and risk of sexual assault by a driver.

And despite rules prohibiting unaccompanied minors from getting a lift through such services, one in eight parents (13 percent) reported their teen aged 14-17 had used one.

"Ride sharing services are increasingly used as a convenient way to get around for adults and may potentially also be an attractive option for teens with busy schedules and social lives," says poll co-director and Mott pediatrician Gary Freed, M.D., MPH.

"Company policies prohibit minors from riding without an adult, but these rules can be difficult to enforce and it may be challenging to verify a rider's age."

"Sometimes parents and teens may find themselves in a bind for transportation and look for ways around the rules," Freed adds.

Parents' top concern was that the driver would not be driving safely, with three in four parents polled worried about issues such as speeding or a driver being distracted by a phone. Over half of parents were also worried about the ride share driver being impaired from alcohol or drugs while half were concerned that their teen would not wear a seat belt.

Two thirds of parents also shared concerns that a ride share driver might sexually assault their teen. This concern was more common among parents for their daughters than for their sons (79 percent versus 55 percent) and for teens aged 14-17 compared with 18-year-olds (69 percent versus 58 percent.)

Ride sharing safety was recently in the news after a tragic case involving a South Carolina college student who was killed after mistakenly getting into what she believed was her Uber ride. A bill has since been introduced in the South Carolina Legislature to require Uber and Lyft drivers to use illuminated signs marking their vehicles.

In a limited number of communities, "kid-friendly" ride sharing services have also been launched, usually involving a specific pool of drivers from which parents can choose to interview and select for future rides.

"If teens do use a ride share service, families should discuss practical and important strategies to stay safe," Freed says.

Parents should go over safety rules with teens preparing to use any kind of ride sharing or ride hailing service that involves getting into a car with a stranger, Freed says. Parents should instruct teens to always match the driver's description, car and license plate to what was provided, in addition to traveling with a friend and not alone, being alert and aware of surroundings and paying attention to whether the driver is being safe and going to the right place.

Teens should know that if they feel they are in any danger, they should ask the driver to stop the car or call 911.

Parents may also consider using technology to track the route of their teen to make sure the ride goes as planned, Freed notes.

"Before teens use any ride sharing service, parents should discuss the potential dangers and develop a strategy with their teen," Freed says.

"Teens may feel awkward or inhibited to speak up if they notice a driver is not driving safely or if something does 'not feel right' about the car or the driver. Parents should empower their teens to feel comfortable to speak out or refuse a ride. They should be reminded that they are getting into a vehicle with someone they do not know and that it is essential for them be especially attentive to anything that may risk their safety."

The negative effects of social media and a hectic news cycle on our attention span has been an on-going discussion in recent years--but there's been a lack of empirical data supporting claims of a 'social acceleration'. A new study in Nature Communications finds that our collective attention span is indeed narrowing, and that this effect occurs - not only on social media - but also across diverse domains including books, web searches, movie popularity, and more.

Our public discussion can appear to be increasingly fragmented and accelerated. Sociologists, psychologists, and teachers have warned of an emerging crisis stemming from a 'fear of missing out', keeping up to date on social media, and breaking news coming at us 24/7. So far, the evidence to support these claims has only been hinted at or has been largely anecdotal. There has been an obvious lack of a strong empirical foundation.

In a new study, conducted by a team of European scientists from Technische Universität Berlin, Max Planck Institute for Human Development, University College Cork, and DTU, this empirical evidence has been presented regarding one dimension of social acceleration, namely the increasing rates of change within collective attention.

"It seems that the allocated attention in our collective minds has a certain size, but that the cultural items competing for that attention have become more densely packed. This would support the claim that it has indeed become more difficult to keep up to date on the news cycle, for example." says Professor Sune Lehmann from DTU Compute.

The scientists have studied Twitter data from 2013 to 2016, books from Google Books going back 100 years, movie ticket sales going back 40 years, and citations of scientific publications from the last 25 years. In addition, they have gathered data from Google Trends (2010-2018), Reddit (2010-2015), and Wikipedia (2012-2017).

Rapid exhaustion of attention ressources

On this background, they find empirical evidence of ever-steeper gradients and shorter bursts of collective attention given to each cultural item. The paper uses a model for this attention economy to suggest that the accelerating vicissitudes of popular content are driven by increasing production and consumption of content, and therefore are not intrinsic to social media. This results in a more rapid exhaustion of limited attention resources.

When looking into the global daily top 50 hashtags on Twitter, the scientists found that peaks became increasingly steep and frequent: In 2013 a hashtag stayed in the top 50 for an average of 17.5 hours. This gradually decreases to 11.9 hours in 2016.

This trend is mirrored when looking at other domains, online and offline--and covering different periods. Looking, for instance, at the occurrence of the same five-word phrases (n-grams) in Google Books for the past 100 years, and the success of top box office movies. The same goes for Google searches and the number of Reddit comments on individual submissions. When looking into Wikipedia and scientific publications, however, this trend was not mirrored. Though the exact reason is unclear, the authors suggest that it could be because of their being knowledge communication systems.

"We wanted to understand which mechanisms could drive this behavior. Picturing topics as species that feed on human attention, we designed a mathematical model with three basic ingredients: 'hotness', aging and the thirst for something new." says Dr. Philipp Hövel, lecturer for applied mathematics, University College Cork.

This model offers an interpretation of their observations. When more content is produced in less time, it exhausts the collective attention earlier. The shortened peak of public interest for one topic is directly followed by the next topic, because of the fierce competition for novelty.

"The one parameter in the model that was key in replicating the empirical findings was the input rate - the abundance of information. The world has become increasingly well connected in the past decades. This means that content is increasing in volume, which exhausts our attention and our urge for 'newness' causes us to collectively switch between topics more rapidly." says postdoc Philipp Lorenz-Spreen, Max Planck Institute for Human Development.

Since the available amount of attention remains more or less the same, the result is that people are more rapidly made aware of something happening and lose interest more quickly. However, the study does not address attention span on the level of the individual person, says Sune Lehmann:

"Our data only supports the claim that our collective attention span is narrowing. Therefore, as a next step, it would be interesting to look into how this affects individuals, since the observed developments may have negative implications for an individual's ability to evaluate the information they consume. Acceleration increases, for example, the pressure on journalists' ability to keep up with an ever-changing news landscape. We hope that more research in this direction will inform the way we design new communication systems, such that information quality does not suffer even when new topics appear at increasing rates."

A gene that enables bacteria to be highly resistant to linezolid, an antibiotic that is used as a last resort for treating infections in humans, has been found in bacterial samples [1] from cats and a dog at a small-animal hospital in the UK for the first time. The new research is being presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April).

Linezolid is licensed for the treatment of certain bacterial infections in humans including streptococci and methicillin-resistant staphylococci (MRSA), but it is not used in animals in the UK. However, samples from companion animals in a small-animal hospital in the UK indicated that pets could carry bacteria which are resistant to linezolid.

The new research suggests that there is potential for the gene (optrA) that plays a key role in bacterial resistance to linezolid to spread between different bacterial populations in animals and humans.

"We believe this is the first report of optrA-positive enterococci isolated from companion animals in the UK", says Dr Katie Hopkins from Public Health England who led the research. "This is concerning as transmission of this organism to owners carries the potential for spread to other bacteria, including Staphylococcus aureus. This may lead to difficult-to-treat infections. In order to minimise transmission of resistant bacteria between companion animals and people veterinary surgeries need to ensure adequate cleaning takes place and pet owners should wash their hands after handling pets."

"Whilst linezolid is not licensed for veterinary use in the UK, optrA also is involved in resistance to florfenicol, which is used in animals. However, standard protocols for the management of colonised or infected animals should prevent transmission to veterinary staff, and therapeutic options (eg, ampicillin or glycopeptides) are available should an infection occur."

Linezolid resistance is still rare in enterococci (

During routine testing for antibiotic resistance, an Enterococcus faecalis isolate from a cat wound swab was referred by the veterinary diagnostic laboratory to Public Health England's Antimicrobial Resistance and Healthcare Associated Infections Reference Unit. Subsequently, three further E. faecalis isolates from other two cats and one dog from the same small-animal hospital (but different households) were analysed.

Four isolates from three wound swabs (two cats, one dog), and a third cat rectal swab were confirmed to be resistant to linezolid and gentamicin, but susceptible to the antibiotics teicoplanin, vancomycin, and daptomycin.

Concerningly, all four isolates were positive for optrA and there was evidence that there was transmission between animals.

"Our findings further the 'One-Health' view that antibiotic-resistant bacteria can be shared by animals and humans, although the direction of transfer is often difficult to prove. We currently do not know the prevalence of linezolid-resistant enterococci in companion animals and therefore a joint approach to monitoring emergence and dissemination of resistance mechanisms of public health importance is needed", says Dr Hopkins. "In this instance, further transmission was stopped by cleaning and decontamination and we have no evidence that any people acquired an infection from these animals."