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Cosmic dawn, when stars formed for the first time, occurred 250 million to 350 million years after the beginning of the universe, according to a new study led by researchers at University College London (UCL) and the University of Cambridge.

The study, published in the Monthly Notices of the Royal Astronomical Society, suggests that the NASA James Webb Space Telescope (JWST), scheduled to launch in November, will be sensitive enough to observe the birth of galaxies directly.

The UK-led research team examined six of the most distant galaxies currently known, whose light has taken most of the universe's lifetime to reach us. They found that the distance of these galaxies away from Earth corresponded to a "look back" time of more than 13 billion years ago, when the universe was only 550 million years old.

Analysing images from the Hubble and Spitzer Space Telescopes, the researchers calculated the age of these galaxies as ranging from 200 to 300 million years, allowing an estimate of when their stars first formed.

Lead author Dr Nicolas Laporte (University of Cambridge), who started the project while at UCL, said: "Theorists speculate that the universe was a dark place for the first few hundred million years, before the first stars and galaxies formed.

"Witnessing the moment when the universe was first bathed in starlight is a major quest in astronomy.

"Our observations indicate that cosmic dawn occurred between 250 and 350 million years after the beginning of the universe, and, at the time of their formation, galaxies such as the ones we studied would have been sufficiently luminous to be seen with the James Webb Space Telescope."

The researchers analysed starlight from the galaxies as recorded by the Hubble and Spitzer Space Telescopes, examining a marker in their energy distribution indicative of the presence of atomic hydrogen* in their stellar atmospheres. This provides an estimate of the age of the stars they contain.

This hydrogen signature increases in strength as the stellar population ages but diminishes when the galaxy is older than a billion years. The age-dependence arises because the more massive stars that contribute to this signal burn their nuclear fuel more rapidly and therefore die first.

Co-author Dr Romain Meyer (UCL Physics & Astronomy and the Max Planck Institute for Astronomy in Heidelberg, Germany) said: "This age indicator is used to date stars in our own neighbourhood in the Milky Way but it can also be used to date extremely remote galaxies, seen at a very early period of the universe.

"Using this indicator we can infer that, even at these early times, our galaxies are between 200 and 300 million years old."

In analysing the data from Hubble and Spitzer, the researchers needed to estimate the "redshift" of each galaxy which indicates their cosmological distance and hence the look-back time at which they are being observed. To achieve this, they undertook spectroscopic measurements using the full armoury of powerful ground-based telescopes - the Chilean Atacama Large Millimetre Array (ALMA), the European Very Large Telescope, the twin Keck telescopes in Hawaii, and Gemini-South telescope.

These measurements enabled the team to confirm that looking at these galaxies corresponded to looking back to a time when the universe was 550 million years old.

Co-author Professor Richard Ellis (UCL Physics & Astronomy), who has tracked ever more distant galaxies over his career, said: "Over the last decade, astronomers have pushed back the frontiers of what we can observe to a time when the universe was only 4% of its present age. However, due to the limited transparency of Earth's atmosphere and the capabilities of the Hubble and Spitzer Space Telescopes, we have reached our limit.

"We now eagerly await the launch of the James Webb Space Telescope, which we believe has the capability to directly witness cosmic dawn.

"The quest to see this important moment in the universe's history has been a holy grail in astronomy for decades. Since we are made of material processed in stars, this is in some sense the search for our own origins."**

The new study involved astronomers at the University of California-Santa Cruz, the University of California, and the University of Texas.

The researchers received support from the Kavli Foundation, the European Research Council, the National Aeronautics and Space Administration (NASA), and the National Science Foundation (NSF) in the United States.

The NASA-led James Webb Space Telescope, the successor to the Hubble observatory, is scheduled to be launched into space in November. It will be the premier observatory over the next decade, serving thousands of astronomers worldwide. It consists of an infrared observatory, an immense mirror 6.5 metres wide, and a diamond-shaped sunshield. UCL scientists at the Mullard Space Science Laboratory have built and tested key hardware components for the NIRSpec (Near-Infrared Spectrograph), one of the telescope's four instruments.

*Atomic hydrogen is hydrogen that has not been split into protons and electrons.

**All the heavier elements in the universe - everything except for hydrogen, helium and lithium - are synthesised in stars and then seeded across the universe when the stars explode at the end of their lives. This includes the elements that make up humans - the calcium in our bones, the iron in our blood.

This worm that lives in the White Sea is able to restore lost body segments. However, it turned out that suppression of FGF protein activity disturbs this ability. Similar proteins are found in humans. This discovery may lead to developing methods of fast wound healing. The research findings are published in the journal Genes as part of the project supported by the Russian Science Foundation.

Fibroblast growth factors (FGF) are proteins that play an important role in wound healing and tissue growth. When the need for regeneration of damaged body parts occur, FGFs are produced by epidermis, nervous tissue, macrophages and fibroblasts, which are the main cells of connective tissue. As a result, the process of active cell division and the production of tropocollagen (the structural unit of a collagen fibre) is triggered; the intercellular matrix and the main substance of the connective tissue are synthesised; and the growth of nerves and blood vessels begins.

'Proteins of the FGF group are currently used in experimental methods of cell culture. They are added to the cocktail of nutritious medium in order to grow various cell cultures of animal origin. However, we can go beyond cell culture, for example, we can use them in fast wound treatment medicine', explains Vitaly Kozin, Head of the project, Assistant Professor at St Petersburg University.

Embryologists of St Petersburg University studied FGF of Alitta virens. This annelids live in the White Sea. They are the largest annelids (up to half a metre long) and thanks to their unusual colour they are look very impressive. They are extremely fecund, live long (three to seven years) and are able to grow lost body parts. Also, one can catch them with a scoop net: during spawning that happens at the end of June - beginning of July, when the animals swarm near the water surface. This is how the researchers gathered them. After that they fertilised them artificially in a laboratory and grew new individuals in controlled environment that were suitable for research.

First, the embryologists studied bioinformatics data base where they found the genes they were interested in. Then they described the structure and origins of the genes in order to compare them with the part of DNA which play the similar role in humans. Alitta virens has only two ligands (molecules that bind to cell surface thereby transmitting the signal) and two FGF receptors, which is much less than in humans. Then the scientists extracted these genes products from Alitta virens that were regenerating after damage, and cloned their fragments. They synthesised detectable probes that made it possible to see where exactly these genes work in worms. The method is called hybridisation in situ, which means RNA sticking inside the body.

When the time and the place of gene activity was identified, the scientists artificially blocked receptors and intermediates of FGF signalling pathway by adding inhibitors SU5402 and U0126 into sea water where the worms lived. The process was monitored using antibodies with a special colour, fluorescent dyes and impulse laballing of DNA precursors. It turned out that blocking of FGF affected not only the process of cell division in the damaged part of the body, but also the regeneration process in general. The control animals (those that did not receive inhibitors) started cell division in four hours after amputation and regeneration of muscles and nerves was observed for six days, whereas, inhibitors stopped regeneration completely.

'We managed to study the mechanism of regeneration of the tissues in Alitta virens. This knowledge can be used for therapeutic approaches in regenerative medicine. The study showed that the principal role of FGF in vertebrates and invertebrates does not differ. The analysis showed that participation of FGF in regenerating processes must have existed in a common ancestor of animals with bilateral symmetry that lived 500 million years ago. We are still to find out what was the reason for slowing of regeneration in humans. This summer we will test synthesised fibroblast growth factor on Alitta virens. Perhaps, its increased level in comparison with a natural one will lead to speeding up regeneration. Also, we need to find out how damaging of tissues activates FGF and what other parts of genome comply with its signals', said Vitaly Kozin.

Berlin and Bath, 24th June 2021 - Precision-fermentation company Formo and the University of Bath co-published the first large-scale study of consumer acceptance for animal-free dairy products.

Researchers surveyed 5,054 individuals from Brazil, Germany, India, the UK, and the USA to understand what consumers think of animal-free dairy products.

Precision fermentation is a process that allows specific proteins to be produced via microorganisms. By inserting a copied stretch of cow DNA, microorganisms produce milk proteins. The process is more efficient than using animals to make proteins and avoids the negative side effects of industrial animal agriculture, which is responsible for 18% of all greenhouse gas emissions.

The findings of the study, published in the journal Frontiers in Sustainable Food Systems, show that consumers around the world are ready for cheese made from real milk proteins produced by microorganisms.

Across countries and age groups, 79% of consumers are willing to try precision-fermentation-derived dairy cheese, with 71% willing to pay for such products. Across dietary preferences, flexitarians showed the highest levels of enthusiasm for these products.

"Just as we have seen plant-based milk taking an increasing share of the milk market in recent years, we now see that consumers are ready for a new kind of animal-free dairy cheese product." Christopher Bryant, PhD, of the University of Bath, said.

"Seeing the growing consumer groups of flexitarians and young people driving adoption of animal-free cheese is a big indicator that these products will appeal to consumers far beyond the niche markets of current vegan cheese."

Findings highlighted that consumers understood the big taste improvements over current vegan cheese products, while also showing that consumers across countries recognised the environmental and ethical advantages of animal-free dairy, which causes 85-97% less greenhouse gas emissions than conventional dairy.

"Most cheese lovers think current vegan cheeses are nowhere near the flavour or functionality level that meets their cheese needs." said Oscar Zollman Thomas, Formo's lead researcher on the project.

"Precision fermentation is allowing us to fundamentally change that and make real cheese without animals involved."

This was reflected in another major finding of the research, that those who currently eat the most cheese were the most likely to want to buy animal-free dairy cheese.

"That finding was explosive because that's always how we've understood the mission: Initiating change not through consumer sacrifice, but rather through delicious, satisfying products" said Oscar Zollman Thomas.

INDIANAPOLIS -- A first-of-its-kind large-scale study of vegetation growth in the Northern Hemisphere over the past 30 years has found that vegetation is becoming increasingly water-limited as global temperatures increase.

The results are significant since vegetation is one of the biggest factors when it comes to controlling water and carbon cycling across Earth, which influences global temperatures. The work by IUPUI and Indiana University Bloomington researchers Wenzhe Jiao, , Qing Chang and Honglang Wang was published in the journal Nature Communications on June 18.

"Without water, living things struggle to survive, including plants," said Lixin Wang, senior author of the study and an associate professor of earth sciences at the School of Science at IUPUI. His ecohydrology group led the study. "Changes in vegetation response to water availability can result in significant shifts of climate-carbon interaction."

Honglang Wang is an assistant professor of statistics at the School of Science at IUPUI. Wenzhe Jiao, the first author, and Qing Chang are Ph.D. students at IUPUI and IU Bloomington, respectively.

This multidisciplinary research between the School of Science at IUPUI, the O'Neill School of Public and Environmental Affairs at IU Bloomington and two other universities began three years ago to determine vegetation constraints on a global scale. Until now, it was largely unknown, despite the growing interest in predicting global and regional trends in vegetation growth in response to climate change.

"Global temperature and the concentration of atmospheric CO2, or carbon dioxide, have been increasing," Lixin Wang said. These changes are expected to cause increased atmospheric water demand, more frequent extreme hot days, and drought events. All these factors indicate that vegetation growth may have suffered more and more water stress under a warming climate.

"However, quantifying the changes in vegetation constraints at large spatial and temporal scales is challenging," he said.

To overcome this obstacle, the researchers used satellite remote sensing data and meteorology data covering large spatial scales from 1982 to 2015.

"We developed our own metrics to indicate water constraints and then examined the changes in the metrics," Jiao said. "The study is quite computationally extensive since we examined the relationship between vegetation growth and water deficit at each grid cell over the whole extratropical Northern Hemisphere -- 604,800 data points each year -- over more than 30 years."

The data analysis provided strong evidence of a widespread, significant increase in water vegetation constraint in the Northern Hemisphere over the studied period. Some regions, like the Great Plains in the United States, were comparatively worse than others.

Until recently, elevated carbon in the atmosphere increased plant growth, which has the benefit of removing more carbon from the atmosphere. However, this study reveals a cause for concern.

"Increasing water constraints on vegetation productivity may drive a shift from a period of increasing land carbon sink strength to a period in which climate change is reducing land carbon sink strength," Lixin Wang said.

In other words, the warming climate is increasing water constraints, reversing the earlier trend of stronger vegetation carbon uptake.

"Our research shows that increasing water constraints will likely limit continuous vegetation growth, thus slowing down the removal of CO2 from the atmosphere by plants," Jiao said.

"The results emphasize the need for actions that could slow down CO2 emissions," Lixin Wang said. "Without that, water constraints impacting plant growth -- and the weakening of vegetation's ability to removal of CO2 from the atmosphere -- are unlikely to slow."

Burnout is a widespread reality in today's NHS

Current NHS workforce plans are "a smart looking car minus the engine"

An editorial published by The BMJ today raises important concerns about the health
and wellbeing of the NHS workforce after a parliamentary report found "burnout is a widespread reality in today's NHS."

Commenting on the report, Suzie Bailey of the King's Fund says: "Excessive workloads need to be dealt with at every level of the health and care system."

She suggests that ineffective workforce planning is partly to blame, citing evidence given to the House of Commons Health and Social Care Committee by Professor Michael West of The King's Fund, who characterised current NHS workforce plans as "a smart looking car minus the engine."

Bailey points to the 2020 NHS staff survey showing that 44% of staff reported feeling unwell owing to work related stress - the highest level since 2016 - and reported high levels of bullying, harassment, and discrimination experienced by ethnic minority staff.

"Improving staff health and wellbeing is therefore far from being a "nice to have," it is a moral, social, and economic priority," she writes. "The focus must be on tackling the root causes of stress, not on interventions that seek only to manage or mitigate it."

It is encouraging that the committee's recommendations emphasised the importance of compassionate leadership in improving workplace culture, she says, and has called for Health Education England to publish independent annual workforce projections.

But she questions plans to place new workforce responsibilities on integrated care systems (local partnerships designed to help join up health and care services).

Will the health and social care committee's report improve outcomes, she asks?

In part, it will depend on whether multiple leaders across the health and care system can maintain the current momentum behind workforce and workplace transformation, she explains.

She notes that progress is already being made, but says effective workforce planning and purposeful culture change "will require sustained political leadership as well as long term investment at a level commensurate with the urgent need for improvement."

Parents of children with the most complex medical conditions are more likely to report poor or fair mental health and struggle to find community help, according to a study completed by researchers at University of Rochester Medical Center (URMC) and Golisano Children's Hospital. The study was published in Pediatrics, the journal of the American Academy of Pediatrics (AAP).

The study, "A National Mental Health Profile of Parents of Children with Medical Complexity," examined parent-reported data from the National Survey of Children's Health, and compared three groups: households of children with medical complexity (CMC), households of noncomplex children with special health care needs, and households of children without special health care needs.

CMC are defined as the 1 percent of children with the most complex medical conditions. They tend to have multiple chronic health conditions and disabilities, and frequently utilize health care services. Examples of CMC include those with cerebral palsy, serious congenital heart defects, or genetic disorders. Given these children's significant needs, their caregivers are challenged to balance treating their child with completing other family responsibilities.

The study found the following:

-About 20 percent of parents of CMC reported poor or fair mental health, more than 5 times the proportion of parents of children who did not have medical problems.

-In addition, 36 percent of parents of CMC reported not knowing where to go for help in their community when they encounter difficulties, which was more than 2 times the proportion of parents of children who did not have medical problems.

These findings indicate that health care systems should be proactive in trying to serve parents of CMC and provide support resources, and that mental health should be prioritized, according to Nathaniel Bayer, M.D., assistant professor and pediatric hospitalist at Golisano Children's Hospital in the URMC Department of Pediatrics and lead author of the study.

"As we partner with these families, we need to make sure we're taking care of the parents as well as the children," said Bayer, "It is our job as pediatricians and health care teams to recognize the parents' needs and connect them to services."

Only 15 percent of parents of CMC reported access to peer support groups, which are critical for families to be able to exchange ideas and support each other, according to Bayer. To help address these gaps, hospitals should offer peer-to-peer support groups and grow family advisory councils to support the health and emotional wellness of caregivers of CMC.

"Having a child with this level of needs affects families in so many different ways. With the right support, these families thrive and fulfill their goals," said Bayer. "Without enough support, these families often struggle with the emotional and physical demands of constant caregiving, financial stressors, and employment issues. They may also be unable to find assistance from community services and home nurses, which are under-funded and under-reimbursed."

Research on families and parents of CMC is an emerging field, because kids with complex conditions are living longer as healthcare interventions have improved in the 21st century. "In the last decade, there's a heightened interest in discussing and focusing on these children and their families because we are increasingly recognizing that they need more support to successfully navigate the complicated health, education, and community systems."

The study also found that families of lower socio-economic status (SES) reported feeling significantly more isolated and unaware of how to seek support. "Families of lower SES often do not have the resources to easily access services. They may lack the transportation to travel to the clinic or struggle to find community resources in their area. If your family is also struggling to put food on the table or keep the lights on, it's harder to manage your child's medical needs and take care of yourself," said Bayer.

In addition to health care systems providing more peer-to-peer services, more federal and state support of CMC parents - including greater reimbursement for home-health services and caregivers, expanded services and access for kids with disabilities, and improved early intervention support - can all help parents of CMC, according to Bayer. Behavioral health and wellness services - both for children and parents - should also be expanded.

"Mental health is a part of health," said Bayer, "Parent and caregiver mental health is a major issue that has a significant impact on children's health. We need to talk more about parent mental health, screen for it more, and proactively support it."

Bayer and his research team plans to continue studying the mental health of CMC parents, the resilience of their families, and their abilities to adapt to challenges. The team is currently surveying and interviewing local families of CMC in the Rochester region to examine these topics. After studying how resilience and emotional wellness develop in families of children with complex medical conditions, he is planning to build family support programs and study their impact on child and caregiver health.

Ozone levels in the earth's troposphere (the lowest level of our atmosphere) can now be forecasted with accuracy up to two weeks in advance, a remarkable improvement over current systems that can accurately predict ozone levels only three days ahead. The new artificial intelligence system developed in the University of Houston's Air Quality Forecasting and Modeling Lab could lead to improved ways to control high ozone problems and even contribute to solutions for climate change issues.

"This was very challenging. Nobody had done this previously. I believe we are the first to try to forecast surface ozone levels two weeks in advance," said Yunsoo Choi, professor of atmospheric chemistry and AI deep learning at UH's College of Natural Sciences and Mathematics. The findings are published online in the scientific journal, Scientific Reports-Nature.

Ozone, a colorless gas, is helpful in the right place and amount. As a part of the earth's stratosphere ("the ozone layer"), it protects by filtering out UV radiation from the sun. But when there are high concentrations of ozone near earth's surface, it is toxic to lungs and hearts.

"Ozone is a secondary pollutant, and it can affect humans in a bad way," explained doctoral student Alqamah Sayeed, a researcher in Choi's lab and the first author of the research paper. Exposure can lead to throat irritation, trouble breathing, asthma, even respiratory damage. Some people are especially susceptible, including the very young, the elderly and the chronically ill.

Ozone levels have become a frequent part of daily weather reports. But unlike weather forecasts, which can be reasonably accurate up to 14 days ahead, ozone levels have been predicted only two or three days in advance - until this breakthrough.

The vast improvement in forecasting is only one part of the story of this new research. The other is how the team made it happen. Conventional forecasting uses a numerical model, which means the research is based on equations for the movement of gasses and fluids in the atmosphere.

The limitations were obvious to Choi and his team. The numerical process is slow, making results expensive to obtain, and accuracy is limited. "Accuracy with the numerical model starts to drop after the first three days," Choi said.

The research team used a unique loss function in developing the machine learning algorithm. A loss function helps in optimization of the AI model by mapping decision to their associated costs. In this project, researchers used index of agreement, known as IOA, as the loss function for the AI model over conventional loss functions. IOA is a mathematical comparison of gaps between what is expected and how things actually turn out.

In other words, team members added historical ozone data to the trials as they gradually refined the program's reactions. The combination of the numerical model and the IOA as the loss function eventually enabled the AI algorithm to accurately predict outcomes of real-life ozone conditions by recognizing what happened before in similar situations. It is much like how human memory is built.

"Think about a young boy who sees a cup of hot tea on a table and tries to touch it out of curiosity. The moment the child touches the cup, he realizes it is hot and shouldn't be touched directly. Through that experience, the child has trained his mind," Sayeed said. "In a very basic sense, it is the same with AI. You provide input, the computer gives you output. Over many repetitions and corrections, the process is refined over time, and the AI program comes to 'know' how to react to conditions that have been presented before. On a basic level, artificial intelligence develops in the same way that the child learned not to be in such a hurry to grab the next cup of hot tea."

In the lab, the team used four to five years of ozone data in what Sayeed described as "an evolving process" of teaching the AI system to recognize ozone conditions and estimate the forecasts, getting better over time.

"Applying deep learning to air quality and weather forecasting is like searching for the holy grail, just like in the movies," said Choi, who is a big fan of action plots. "In the lab, we went through some difficult times for a few years. There is a process. Finally, we've grasped the holy grail. This system works. The AI model 'understands' how to forecast. Despite the years of work, it somehow still feels like a surprise to me, even today."

Before success in the laboratory can lead to real-world service, many commercial steps are ahead in before the world can benefit from the discovery.

"If you know the future - air quality in this case - you can do a lot of things for the community. This can be very critical for this planet. Who knows? Perhaps we can figure out how to resolve the climate change issue. The future may go beyond weather forecasting and ozone forecasting. This could help make the planet secure," said Choi.

Sounds like a happy ending for any good action story.

HOUSTON - (June 24, 2021) - Hold on there, graphene. Seriously, your grip could help make better catalysts.

Rice University engineers have assembled what they say may transform chemical catalysis by greatly increasing the number of transition-metal single atoms that can be placed into a carbon carrier.

The technique uses graphene quantum dots (GQD), 3-5-nanometer particles of the super-strong 2D carbon material, as anchoring supports. These facilitate high-density transition-metal single atoms with enough space between the atoms to avoid clumping.

An international team led by chemical and biomolecular engineer Haotian Wang of Rice's Brown School of Engineering and Yongfeng Hu of Canadian Light Source at the University of Saskatchewan, Canada, detailed the work in Nature Chemistry.

They proved the value of their general synthesis of high-metal-loading, single-atom catalysts by making a GQD-enhanced nickel catalyst that, in a reaction test, showed a significant improvement in the electrochemical reduction of carbon dioxide as compared to a lower nickel loading catalyst.

Wang said expensive noble metals like platinum and iridium are widely studied by the single-atom catalyst community with the goal of reducing the mass needed for catalytic reactions. But the metals are hard to handle and typically make up a small portion, 5 to 10% by weight or less, of the overall catalyst, including supporting materials.

By contrast, the Wang lab achieved transition-metal loads in an iridium single atom catalyst of up to 40% by weight, or 3 to 4 spaced-out single metal atoms per every hundred carbon substrate atoms. (That's because iridium is much heavier than carbon.)

"This work is focused on a fundamental but very interesting question we always ask ourselves: How many more single atoms can we load onto a carbon support and not end up with aggregation?" said Wang, whose lab focuses on energy-efficient catalysis of valuable chemicals.

"When you shrink the size of bulk materials to nanomaterials, the surface area increases and the catalytic activity improves," he said. "In recent years, people have started to work on shrinking catalysts to single atoms to present better activity and better selectivity. The higher loading you reach, the better performance you could achieve."

"Single atoms present the maximum surface area for catalysis, and their physical and electronic properties are very different compared to bulk or nanoscale systems," he said. "In this study, we wanted to push the limit of how many atoms we can load onto a carbon substrate."

He noted that the synthesis of single-atom catalysts has to now been a "top-down" or "bottom-up" process. The first requires making vacancies in carbon sheets or nanotubes for metal atoms, but because the vacancies are often too large or not uniform, the metals can still aggregate. The second involves annealing metal and other organic precursors to "carbonize" them, but the metals still tend to cluster.

The new process takes a middle approach by synthesizing GQDs functionalized with amine linkers and then pyrolyzing them with the metal atoms. The amines crosslink with the metal ions and keep them spread out, maximizing their availability to catalyze reactions.

"The maximum appears to be about 3-4 atomic percent using this approach," Wang said. "Future challenges include how to further increase the density of single atoms, ensure high stability for real applications and scale up their synthesis processes."

Researchers are calling for changes to working culture and conditions for junior doctors in the UK after their new research has highlighted a lack of access to clinical and emotional support.

The call comes as a University of Birmingham-led team of researchers, including experts from Keele University, University College London, Oxford University Hospitals NHS Foundation Trust, the London School of Hygiene and Tropical Medicine, and the Universities of Leeds and Manchester, carried out a qualitative study using in-depth interviews with 21 NHS junior doctors.

All participants, 16 of whom were women and five were men, self-identified as having chronic stress and/or mental health problems, including anxiety and depression.

The National Institute for Health Research-funded study, detailed in two papers published today (June 24) in BMJ Open, examined the psychological, cultural and occupational contexts associated with reduced psychological wellbeing in junior doctors, and protective factors which may mitigate against this.

The findings showed four key themes relating to work-related stress - workload and working conditions; toxic work cultures including abuse and bullying, sexism and racism, and a culture of blaming and shaming; lack of support; stigma and a perceived need to appear invulnerable.

Analysis from the interviews also pin-pointed themes that protect junior doctors and facilitate support, with these including emotional and practical support from work colleagues to help manage workloads; supportive leadership strategies including those that challenge stigma; and access to professional support such as counselling, cognitive behavioural therapy and medication.

First author and Chief Investigator of the research Dr Ruth Riley, of the University of Birmingham, said: "Normalising vulnerability through disclosure and creating emotionally open cultures where vulnerability is accepted and understood, allows junior staff greater confidence to be open about factors affecting their own wellbeing and to seek and receive support when needed.

"Supporting doctors who request time out or time off and facilitating access to support could reduce the potential for isolation in the workplace and reduce stigma-related barriers to seeking help.

"Examples of effective interventions and solutions to minimise distress and support staff are evidenced in existing leadership and collegial support, but need to be more consistently practiced across the NHS."

Co-author, Carolyn Chew-Graham Professor of General Practice Research at Keele University, said: "Participants reported stress and distress attributable to working conditions, such as unrealistic workloads and long hours, toxic work cultures including bullying, sexism and discrimination, a 'blame and shame' culture, and fear of whistleblowing.

"We call for a cultural shift within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination."

The research is the first study to qualitatively examine how junior doctors view their working conditions, work cultures, and the factors which may protect them from psychological distress or offer them support.

There are currently 115,376 doctors working in the NHS, almost half of whom (56,404) are termed 'junior doctors', which includes doctors in specialist training or at pre-Consultant grade, and Foundation Year doctors.

Early in the pandemic, it was expected that satellite imagery around the world would show cleaner air as a result of COVID-19 lockdowns. But not all pollutants were taken out of circulation. For tiny airborne-particle pollution, known as PM 2.5, researchers using NASA data found that variability from meteorology obscured the lockdown signals when observed from space.

"Intuitively you would think if there is a major lockdown situation, that we would see dramatic changes, but we didn't," said Melanie Hammer, a visiting research associate at Washington University in St. Louis who led the study. "It was kind of a surprise that the effects on PM 2.5 were modest."

PM 2.5 describes the mass of nose-level particles, often produced anthropogenically, that are smaller than 2.5 micrometers, or roughly 30 times smaller than the width of a human hair. PM 2.5 is small enough to linger in the atmosphere, and, when inhaled, is associated with increased risk of heart attack, cancer and a host of other implications for human health.

By combining NASA spacecraft data with ground-based monitoring and an innovative computer modeling system, the scientists mapped PM 2.5 levels across China, Europe and North America during the early months of the pandemic. The researchers found seasonal differences in PM 2.5 between recent years were driven primarily by the natural variability of the meteorology, not by pandemic lockdowns.

Published June 23 in the journal Science Advances, the new research integrates data from NASA's Terra and Aqua satellites, as well as meteorological modeling input from the NASA Global Modeling and Assimilation Office.

The meteorological effects analyzed in the study include changes in the sources of mineral dust, the way pollutants react to sunlight in the atmosphere, mixing and heat transfer, as well as the removal of pollutants from the atmosphere by precipitation.

PM 2.5 is among the most complicated pollutants to study because its particle size, composition and toxicity vary greatly depending on its source and environmental conditions.

A gas pollutant known as nitrogen dioxide, or NO2, did see dramatic declines during the lockdowns. A major byproduct of fuel burning by trucks, cars and other vehicles, the decline of nitrogen dioxide was visible from space and from the ground. Images of clear, blue skies where heavy smog had been the norm flooded popular news and social media, suggesting COVID-19 has drastically decreased all pollution in general.

When nitrogen dioxide is emitted, it can also interact with other chemicals in the atmosphere and form PM 2.5. However, the two pollutants do not have a linear relationship. Half as much nitrogen dioxide in the atmosphere does not necessarily lead to half as much PM 2.5 produced by nitrogen dioxide.

Because PM 2.5 often comes from the same sources as NO2, the researchers also began to question whether the lockdowns resulted in a decline of PM 2.5.

Early pandemic studies of PM 2.5 changes analyzed data from ground monitoring sites, which test the surrounding air. But because those ground sites are few and far between, their data alone are unable to piece together the bigger picture of PM 2.5 concentrations in the air, Hammer said.

"We were most interested in looking at changes in PM 2.5 because PM 2.5 is the leading environmental risk factor for premature mortality globally," Hammer said. "We decided to look again, using a more complete picture from satellite images."

The study was co-led by Randall Martin at Washington University in St. Louis, who pioneered research integrating modeling and remote sensing to study atmospheric pollutants such as PM 2.5.

"Many countries in the world have no operational PM 2.5 monitoring at all," Martin said. "These tools enable insight into ground level PM 2.5 at the global or regional scale."

To ensure a comprehensive analysis, the team focused on regions with extensive ground monitoring systems in place and compared monthly estimates of PM 2.5 from January to April in 2018, 2019 and 2020.

When the researchers compared PM 2.5 levels over the three years during the months that coincided with each region's lockdown phases, there weren't many clear signals over North America or Europe. The most significant lockdown-related differences were detected in China.

"We found the most clearly detectable signal was a significant reduction over the North China Plain, where the strictest lockdowns were concentrated," Hammer said.

To figure out whether the lockdown was responsible for that signal, and several smaller ones dotted around the areas surveyed, the team ran different "sensitivity simulations" using GEOS-Chem, a chemical transport model to which Martin's team helps lead.

They simulated a scenario where anthropogenic emissions of nitrogen dioxide were held constant and meteorological variability was solely responsible for year over year differences in PM 2.5 during the key lockdown months. They also ran simulations in which they reduced transportation-related emissions and other anthropogenic sources of nitrogen dioxide, mirroring lockdown, when fewer people were driving and fewer industrial sites were operational.

They found the simulation where both meteorology and transportation effects were included most closely mirrored the real-world situation.

"Tackling PM 2.5 is a very complex issue, and you have to take into account its multiple sources, not just the fact that fewer people are on the road," Hammer said. "Just decreasing transportation emissions would not be enough to account for the complexity of the problem."

Most satellites sample the atmosphere through vertical columns spanning the ground to the edge of space. Identifying the concentrations of airborne particles near the surface, where they affect air quality, cannot be determined from these satellites alone.

The satellite data used in this study, referred to as aerosol optical depth, were related to surface PM 2.5 concentrations using GEOS-Chem, which simulates the composition of the atmosphere, the reactions and relationships among its different components, and the way they move horizontally as well as vertically through the air.

The model is a sophisticated tool that helps paint a more complete picture of air quality, said Ralph A. Kahn, senior research scientist at NASA's Goddard Space Flight Center in Greenbelt, Maryland and adjunct professor at University of Maryland in College Park.

"The bigger story is actually the global characterization of air quality, especially in places where there aren't surface monitors," said Kahn, who was part of the study. "The satellites provide an important piece of it, the models provide an important piece of it, and the ground-based measurements make an important contribution as well."

Hammer suspects the change in PM 2.5 levels over the North China Plain was more apparent because of the region's higher pollution levels during "normal" times.

The new insights also highlight a relevant point that may not at first be intuitive: Average PM 2.5 levels have been dropping steadily in North America and Europe. Pollution concentrations that are already low are more difficult to change, Hammer said.

Tooth loss is often accepted as a natural part of aging, but what if there was a way to better identify those most susceptible without the need for a dental exam?

New research led by investigators at Harvard School of Dental Medicine suggests that machine learning tools can help identify those at greatest risk for tooth loss and refer them for further dental assessment in an effort to ensure early interventions to avert or delay the condition.

The study, published June 18 in PLOS ONE, compared five algorithms using a different combination of variables to screen for risk. The results showed those that factored medical characteristics and socioeconomic variables, such as race, education, arthritis, and diabetes, outperformed algorithms that relied on dental clinical indicators alone.

"Our analysis showed that while all machine-learning models can be useful predictors of risk, those that incorporate socioeconomic variables can be especially powerful screening tools to identify those at heightened risk for tooth loss," said study lead investigator Hawazin Elani, assistant professor of oral health policy and epidemiology at HSDM.

The approach could be used to screen people globally and in a variety of health care settings even by non-dental professionals, she added.

Tooth loss can be physically and psychologically debilitating. It can affect quality of life, well-being, nutrition, and social interactions. The process can be delayed, even prevented, if the earliest signs of dental disease are identified, and the condition treated promptly. Yet, many people with dental disease may not see a dentist until the process has advanced far beyond the point of saving a tooth. This is precisely where screening tools could help identify those at highest risk and refer them for further assessment, the team said.

In the study, the researchers used data comprising nearly 12,000 adults from the National Health and Nutrition Examination Survey to design and test five machine-learning algorithms and assess how well they predicted both complete and incremental tooth loss among adults based on socioeconomic, health, and medical characteristics.

Notably, the algorithms were designed to assess risk without a dental exam. Anyone deemed at high risk for tooth loss, however, would still have to undergo an actual exam, the researchers added.

The results of the analysis point to the importance of socioeconomic factors that shape risk beyond traditional clinical indicators.

"Our findings suggest that the machine-learning algorithm models incorporating socioeconomic characteristics were better at predicting tooth loss than those relying on routine clinical dental indicators alone," Elani said. "This work highlights the importance of social determinants of health. Knowing the patient's education level, employment status, and income is just as relevant for predicting tooth loss as assessing their clinical dental status."

Indeed, it has long been known that low-income and marginalized populations experience a disproportionate share of the burden of tooth loss, likely due to lack of regular access to dental care, among other reasons, the team said.

"As oral health professionals, we know how critical early identification and prompt care are in preventing tooth loss, and these new findings point to an important new tool in achieving that," said Jane Barrow, associate dean for global and community health and executive director of the Initiative to Integrate Oral Health and Medicine at HSDM. "Dr. Elani and her research team shed new light on how we can most effectively target our prevention efforts and improve quality of life for our patients."

The research was done in collaboration with researchers at the Harvard T.H. Chan School of Public Health, the University of São Paolo in Brazil, and the University of Otago Faculty of Dentistry in New Zealand.

Co-investigators included André F. M. Batista, W. Murray Thomson, Ichiro Kawachi, and Alexandre D. P. Chiavegatto Filho.

This work was supported by the National Institute on Minority Health And Health Disparities (grant K99MD012253) and CNPq (grant 308731/2018-2).

Wastewater treatment facilities clean the water that goes down our sinks and flushes our toilets, but they do not remove everything. A recent study by Portland State researchers detected low levels of pharmaceuticals and personal care product chemicals in oysters the team deployed at various distances from wastewater effluent pipes along the Oregon and Washington coast. Elise Granek, professor of environmental science and management at Portland State University, and Amy Ehrhart, a recent graduate of PSU's Earth, Environment, and Society doctoral program, conducted the study.

To explore how aquatic pollution varies based on proximity to wastewater facilities, Ehrhart and Granek placed one-week-old Pacific oysters at wastewater sites (not approved by state agencies as oyster growing sites) and near oyster aquaculture sites (approved for growing oysters) along the Oregon and Washington coastline. Nine and twelve months later, they collected the oysters, measured their health and size, and tested their tissues for pharmaceuticals and chemicals called alkylphenols, which are used in a variety of personal care and industrial products. Alkylphenols are endocrine disruptors that can alter the growth and reproduction of aquatic organisms.

Out of the 63 compounds tested, Granek and Ehrhart found only six in the oysters. The two pharmaceuticals detected in the oysters were miconazole, an over-the-counter drug for fungal infections like Athlete's foot, and virginiamycin, a veterinary antibiotic used in livestock. As expected, the concentrations of pharmaceuticals were higher near the wastewater sites. The condition of the oysters was also poorer at wastewater sites compared to the sites near oyster farms.

Four types of alkylphenols were found in oysters from all the sites.

"This makes sense because they are really ubiquitous," said Ehrhart. "They're found in all sorts of common household and industrial products."

Everyday products like detergents, cosmetics, soaps, and cleaners often contain alkylphenols as do forestry pesticide application mixtures. While detectable, the chemical levels were much lower than reported in other estuarine studies near more populated areas.

"The levels that we found were very low," Ehrhart said. She noted that the levels detected are significantly lower than the Environmental Protection Agency's no effect level for nonylphenol exposure in humans and the Food and Drug Administration's allowable limits for antibiotics in meat. "It's unlikely to pose a risk to human consumers of shellfish," she said. Additionally, the Oregon Department of Agriculture and Washington Department of Health continually monitor and approve areas for shellfish growing to ensure they meet strict water quality standards for food safety.

That said, the very presence of these chemicals in oysters relatively far from wastewater sites and in sparsely populated coastal areas suggests that current wastewater treatment technology, stormwater mitigation strategies, and industrial use guidelines for alkylphenol use may not be sufficient. This could be bad news for aquatic animals, including shellfish.

"It's not an aquaculture-driven problem. It's coming from upstream, but it's making its way to aquaculture and it may be negatively affecting oysters, given other studies on how alkylphenols can affect animals," says Granek. "So it really points to a need to address the sources of these alkylphenols."

Granek suggested that possible solutions for this kind of aquatic pollution include upgrading wastewater treatment plants and creating regulations that target the use of industrial products containing alkylphenols.

Individuals can also do their part by not flushing medications down sinks or toilets and instead using drop boxes available at many pharmacies.

"For the pharmaceuticals it's better disposal, for the alkylphenols it's buying products that don't have them," said Ehrhart.

It can be difficult to determine which products contain alkylphenols just from reading ingredient lists, so Ehrhart suggests looking for the EPA's Safer Choice label. "If you see that on cleaning products and detergents, that means that those products don't have alkylphenols, so they are better for the environment."

The study was published in Marine Pollution Bulletin on June 20.

CHAPEL HILL, NC--Researchers at the University of North Carolina at Chapel Hill and the UNC Lineberger Comprehensive Cancer Center have uncovered a new mechanism that activates specific genes, leading to the development of cancers.

They showed that a mutation that fuses two unrelated genes can promote a process similar to that observed when oil and water are mixed but do not blend together. The process, called liquid-liquid phase separation, occurs inside a cell's nucleus and enables the formation of compartments with various physical properties that can promote cancers such as acute leukemias. Their findings will be published online June 23, 2021, in Nature.

"Phase separation and its role in cancer has been a missing puzzle piece in understanding this disease," said UNC Lineberger's Greg Wang, PhD, associate professor of Biochemistry and Biophysics and Pharmacology at the UNC School of Medicine and co-lead author of this article. "This finding is among the first to link phase separation to cancer formation."

The discovery brings new insights to a complex, multistep process that bridges biology and physics. To help unravel this process, the investigators performed laboratory experiments in cancer cells that carried a common gene fusion called NUP98-HOXA9. This aberrant fusion is found solely in blood cells of patients that develop leukemia.

"Because similar gene fusions have been observed in other malignancies, the mechanism we elucidated could explain other types of cancer as well," said UNC Lineberger's Douglas H. Phanstiel, PhD, assistant professor of Cell Biology and Physiology at the UNC School of Medicine and co-lead author of this article. "We believe that our research could open up new and innovative avenues to attack cancer cells."

Within the proteins produced by NUP98-HOXA9 are unstructured stretches, known as intrinsically disordered regions, or IDRs. The role of IDRs has been a mystery, but the researchers showed that IDRs promote liquid-liquid phase separation of NUP98-HOXA9 proteins when they reach critical concentrations in the nucleus, causing NUP98-HOXA9 to become phased, or compartmentalized.

"The way that liquid-liquid phase separation alters the behavior of NUP98-HOXA9 proteins is that it makes them bind to target genes much more strongly," said Jeong Hyun Ahn, PhD, a postdoctoral fellow at UNC and first author of this article. "DNA binding of NUP98-HOXA9 proteins, when they are phase-separated, generates a unique pattern called a 'super-enhancer.' Stronger, super enhancer-like binding by NUP98-HOXA9 proteins to DNA leads to more potent activity of this factor, which underlies the formation of aggressive blood cancers."

"Theoretically, a drug that specifically disrupts or dissolves the phase-separated liquid droplets formed by NUP98-HOXA9 could be a therapeutic agent," Wang said. "We hope to look into possible therapeutic agents that target phase separation as we know that this process can also impact neurodegenerative diseases such as Alzheimer's where plaques that build up in the brain may be due, in part, to liquid-liquid phase separation."

The researchers also discovered that phase separation can influence the three-dimensional structure of the genome by creating chromatin loops, which organize the genome and help control which regions are active and which are not. But alterations in this structure can cause human disease when they are aberrantly formed.

"Our discovery is the first clear evidence of chromatin loops formed by phase separation," Phanstiel said. "This new class of loops appears to be driving cancer development by connecting regulatory regions of chromatin to cancer genes, thereby increasing cancer gene expression and lethality."

Taken together, the complex interplay of biology, physics and genetics inside a cell is now better understood due to this latest research finding. Having performed most of their experiments in the lab, the scientists hope to be able to study certain aspects of the process in living organisms and other diseases in the near future.

This release has been removed upon request of the submitting institution.

For more information, email news@illinois.edu.

Journal

American Antiquity

DOI

10.1017/aaq.2021.34

When a pregnant person declines a recommended treatment such as prenatal testing or an epidural, tension and strife may ensue between the patient and provider, according to a new analysis by researchers at NYU Rory Meyers College of Nursing and the University of British Columbia.

"People should feel safe, respected, and engaged in their maternity care, but our findings suggest that when providers do not listen to patients, it can foster mistrust and avoidance," said P. Mimi Niles, PhD, MPH, CNM, assistant professor at NYU Rory Meyers College of Nursing and the lead author of the study, which is published in the journal PLOS ONE. "These situations deprioritize a person's autonomy and preferences."

In recent years, the World Health Organization and the Lancet have published frameworks about quality of care during pregnancy, birth, and the period after birth. Notably, they emphasize not just physical outcomes, but also a person's psychosocial experiences. These experiences are greatly influenced by interactions with healthcare providers--including physicians, midwives, and nurses--and factors such as respect, trust, agency, and autonomy have emerged as critical aspects of maternity care.

"Providing care is an act of respect and regard, and how we provide care is just as important as what care we provide," said Niles, a practicing midwife.

But many times, healthcare interactions fall short--or worse--and patients report dismissive, disrespectful behavior by providers. Participants in the study described not having choice in their treatment and experiencing a lack of respect when asserting their autonomy, which can hurt their self-efficacy, mental health, and willingness to engage with healthcare in the future.

These interactions are particularly fraught when a pregnant person declines or refuses care that is offered or recommended by healthcare providers. In maternity care, this may include foregoing certain prenatal testing (e.g. gestational diabetes or genetic testing), medications (e.g. epidural or other pain relief), or childbirth interventions (e.g. inducing labor), as University of British Columbia researchers and Niles demonstrated in a recent study in Reproductive Health.

To better understand the experience of childbearing women, Niles and her colleagues conducted a qualitative content analysis of 1,540 written accounts from more than 1,000 women in the Canadian province British Columbia. The accounts were part of the Changing Childbirth in British Columbia study, conducted in 2014 using an online survey with open-ended questions, including those about the experience of declining care.

Four themes emerged:

Contentious interactions: In interactions fraught with tension, participants described "fighting" for the kind of care they wanted and the right to refuse a procedure or intervention.

Knowledge as control and power: Knowledge was viewed as a source of power both for providers, considered keepers of medical knowledge, and for patients, who found strength in knowing about the procedures or interventions they were declining.

Morbid threats: Providers made extreme threats--for instance, "Do you want your baby to die?"--when pregnant people declined interventions. These were particularly powerful during labor and were often experienced as coercion or manipulation to accept the procedures being offered.

Compliance as valued: Many recounted the sense that obedience to clinical recommendations--being a "good client"--was valued in their healthcare experience, but it could also suppress their questions or desire to decline care.

"Our findings demonstrate the complex experiences that patients have when declining care in a traditional, gendered healthcare system," said Niles. "As providers, learning how to support our patients' autonomy and decision-making process means that we must understand how to interact and continue to provide care when what we suggest is not in alignment with what the patient wants."

The researchers write that supporting patient autonomy requires bringing their values into care planning--not as an event, but as an ongoing process reflected in the idea of person-centered care.

While the study focused on childbearing people in British Columbia, the researchers note that their findings are part of a global phenomenon and likely translate to other populations.

"In the U.S., one in six people report being mistreated during childbirth, which includes feeling threatened or coerced in their care. Among women of color, this increases to one in three," added Niles, citing the Giving Voice to Mothers study. "Healthcare exists in relationships, not just as a service. We're not auto mechanics. The same things we value in our relationships--trust, autonomy, respect--are what should be valued and supported by providers and the healthcare system."