Tech

Researchers at the National University of Singapore (NUS) and Tohoku University have demonstrated that an array of electrically connected spintronic devices can harvest a 2.4 GHz wireless signal, which can be used to power and charge small electronic devices and sensors.

The researchers from NUS and Tohoku University have successfully synchronized the four electrically connected magnetic tunnel junction (MTJ), for the signal transmission at 2.4 GHz. Furthermore, the eight MTJs array was integrated with the conventional battery-free electronics to harvest a wireless signal of 2.4 GHz to a DC signal, which is used to power light emitting diodes (LED).

"This breakthrough has proven the potential of an on-chip array of the MTJs towards high-frequency applications such as wireless transmission and energy harvesting," said Professor Hyunsoo Yang of NUS, who spearheaded the project.

With the increase of Wi-Fi sources everywhere in smart cities, the radio-frequency signal primarily at 2.4 GHz becomes an abundant source of energy harvesting. The radio-frequency energy harvester captures electromagnetic waves from the wireless sources and converts them into a usable DC signal, which can be utilized for wireless charging and self-sustained smart wireless sensors.

MTJs, a representative functional device of spintronics exploiting the spin degree of freedom of electrons, has already had an enormous impact on magnetic sensors and computing memories. The MTJ is expected to find application in wireless communication systems in the form of radio-frequency generation and high-frequency rectification. However, the commercial viability of high-frequency MTJs is hindered due to a typically low output power (nW) and broad linewidth (MHz). Mutual synchronization of multiple MTJs is one way to overcome this problem. However, an effective pathway to synchronize the MTJs at the Wi-Fi bandwidth has not been clear until now.

The researchers overcame this challenge by developing MTJs with canted anisotropy that can be electrically synchronized at a GHz-range using a single DC source. The MTJs were fabricated by Shunsuke Fukami's team at Tohoku University and the integration and measurement were performed by Hyunsoo Yang's team at the NUS. They found an efficient scheme to convert rf signal to DC at zero bias and zero magnetic field. Using this advantage, the rectified response of eight connected STOs in series is integrated with the conventional battery-free electronics to light up a 1.6 V LED.

This work opens a new avenue to realize wireless and battery-free sensors and processors. Enhancing the MTJ performance and increasing the number of MTJs are expected to make this technology useful in the new paradigm of IoT societies, where many more "things" can communicate via the Internet.

In a world hungry for cheaper, more efficient renewable energy, Australian researchers have served up a treat.

Work led by the ARC Centre of Excellence in Exciton Science has shown that the two-dimensional (2D) thin films used in some perovskite solar cells closely resemble a sandwich. Perovskite is an exciting material at the forefront of solar energy research and design.

Previously, scientists thought these 2D perovskite films had a 'gradient' structure, in which certain components were found deep in the material, with other complementary elements only located nearer to the surface, like topping on a cracker.

However, in a paper published in Journal of Materials Chemistry C, members of Exciton Science based at the University of Melbourne, together with collaborators at Australia's national science agency CSIRO and Shandong University, have provided evidence for a sandwich-like structure, in which two layers of the same type (the bread) surround one central, contrasting layer (the filling).

This layout encourages excitons - quasiparticles important for converting sunlight to electricity - to move from the central layer to both surfaces of the film, while free carriers transport charge for collection by electrodes, helping to result in more efficient solar energy generation when incorporated into devices.

"A real problem has been understanding what the structure of these 2D perovskite solar cells really is," corresponding author Professor Ken Ghiggino said.

"There's been quite a lot of controversy in the literature. The advance that we've achieved is to find out what the real structure of these films is and how they work in a solar cell."

2D perovskite devices are of particular interest due to their superior stability and durability relative to '3D' perovskite cells. Prototype 2D devices, developed by the researchers using infrastructure and expertise at CSIRO, have demonstrated 13% efficiency.

With greater fundamental understanding of the structure, the researchers will now attempt to increase device efficiency by changing the thickness of the layers within the perovskite 'sandwich'.

In addition to solar cells, improved 2D perovskite films have important applications in light-emitting diodes (LEDs) and photodetectors, such as video imaging, optical communications, biomedical imaging, security, night-vision, gas sensing, and motion detection.

Lead author Dr Fei Zheng said: "This is the first time a sandwich structure has been proposed versus the conventional gradient distribution model. We think this discovery will help design and device optimisation for higher performance of the 2D cells and LEDs."

Nearly a quarter of pregnant women say they've been around secondhand smoke - in their homes, at work, around a friend or relative - which, according to new research, is linked to epigenetic changes - meaning changes to how genes are regulated rather than changes to the genetic code itself - in babies that could raise the risk of developmental disorders and cancer.

The study, published today in Environmental Health Perspectives by researchers at Virginia Commonwealth University Massey Cancer Center, is the first to connect secondhand smoke during pregnancy with epigenetic modifications to disease-related genes, measured at birth, which supports the idea that many adult diseases have their origins in environmental exposures - such as stress, poor nutrition, pollution or tobacco smoke - during early development.

"What we recommend to mothers in general is that no level of smoke exposure is safe," said study lead author Bernard Fuemmeler, Ph.D., M.P.H., associate director for population science and interim co-leader of the Cancer Prevention and Control program at VCU Massey Cancer Center. "Even low levels of smoke from secondhand exposure affect epigenetic marks in disease-related pathways. That doesn't mean everyone who is exposed will have a child with some disease outcome, but it contributes to a heightened risk."

Fuemmeler and colleagues analyzed data from 79 pregnant women enrolled in the Newborn Epigenetics Study (NEST) between 2005 and 2011. During the first trimester, all had a concentration of cotinine - a nicotine byproduct - in their blood consistent with low levels of smoke exposure, ranging from essentially none to levels consistent with secondhand smoke.

After these women gave birth, the researchers sampled the umbilical cord blood, which is the same blood that circulates through the fetus in utero, and performed what's referred to as an epigenome-wide association study (EWAS) to search for correlations between blood cotinine levels of the mothers during pregnancy and epigenetic patterns in the babies at birth.

When cotinine levels were higher, the newborns were more likely to have epigenetic "marks" on genes that control the development of brain function, as well as genes related to diabetes and cancer.

These marks could mean either unusually many or unusually few molecules bound to the DNA strand, which affects how accessible a particular gene is. If a gene is bound up tightly by lots of marks, then it's harder for molecular machinery to access and less likely to be expressed. On the other hand, if a gene is relatively unencumbered, then it might be expressed at higher levels than normal. Tipping the scale in either direction could lead to disease.

To solidify their results, the team repeated the analysis in a separate sample of 115 women and found changes to two of the same disease-related epigenetic regions - one that regulates genes involved in inflammation and diabetes and another that regulates cardiovascular and nervous system functions - are correlated with cotinine levels in mothers.

In all cases, the analyses controlled for race, ethnicity, age, prior number of children and maternal education.

"It highlights the importance of clean air," said Fuemmeler, who is also a professor of health behavior and policy in the VCU School of Medicine and holds the Gordon D. Ginder, M.D., Chair in Cancer Research at Massey. "It's important not only for our homes, but also in the environment. Clean air policies limit smoke in public, and for pregnant women that may have long-term effects on offspring."

Among the large cast of microbiome players, bacteria have long been hogging the spotlight. But the single-celled organisms known as protists are finally getting the starring role they deserve.

A group of scientists who study the interactions between plants and microbes have released a new study detailing the dynamic relationships between soil-dwelling protists and developing plants, demonstrating that soil protists respond to plant signals much like bacteria do.

An enormous variety and diversity of microbes live in soil, and studying how these organisms interact with each other and with plant roots is a hot topic in biology, as it has applications for agriculture, land stewardship, and climate change resilience technologies.

"Protists represent a new frontier in the study of soil microbial ecology," said lead author Javier A. Ceja Navarro, a research scientist at Lawrence Berkeley National Laboratory (Berkeley Lab). "Here we show that this group of organisms really must be included in microbial studies aiming to understand how microbes interact with plants."

Protists are not a distinct lineage of organisms, but rather a category assigned to any single-celled eukaryotic organism (an organism whose cells contain a nucleus) that is not a plant, fungi, or animal. This diverse group of 200,000+ species (new ones are being discovered continuously) includes amoebas, diatoms, dinoflagellates, slime molds, and even various parasites - such as the malaria-causing Plasmodium and the eponymous Giardia-causing genus of protozoans.

Protists are found across the planet in a variety of ecosystems. Some species, like certain marine plankton protists and human disease-causing protists have been studied closely. Yet for the majority of species, scientists are just beginning to scratch the surface of what the organism does and how they respond to the environment. Such is the case for soil protists.

According to Navarro, protists are known to control soil microbial dynamics and nutrient cycling by feeding on other microbes. Although there is a good body of knowledge about their interactions with other members of the soil microbiome, little is known about how protists respond to changes in their environment.

"Even though protists are important and their relevance has been known for decades, our study is the first one showing an association of protists with plants in a large-scale field experiment," noted project leader Mary Firestone, a faculty scientist in Berkeley Lab's Earth and Environmental Sciences Area and a professor at UC Berkeley. The project was a collaboration among scientists from Berkeley Lab, UC Berkeley, Lawrence Livermore National Laboratory (LLNL), the Noble Research Institute, and the University of Oklahoma.

The team grew switchgrass - a crop proposed for large-scale biofuel production - from seedlings at two large-scale field sites, and took samples of the soil surrounding the roots of plants at different stages of growth. They used next-generation genome sequencing to identify the types of protists present in each sample and the abundance of each species.

"As plants grow, the cells in their roots release metabolites that send signals out to the surrounding soil environment," added Jennifer Pett-Ridge, a senior staff scientist from LLNL. "We saw that protists communities shift and change in response to the plant's effects - in a manner that is similar to what we've observed for bacterial communities."

"Future studies focusing on understanding the mechanisms of plant establishment in soil will need to consider protists as a key part of the plant microbiome," added Navarro, who is part of Berkeley Lab's Biosciences Area. "Ignoring protists in terrestrial ecological studies will result in a big knowledge gap that will make our understanding of the environmental microbiome incomplete."

Invasions by alien insect and animal species have much in common with outbreaks of infectious diseases and could tell us a great deal about how pandemics spread, according to a research paper published today.

Biological invasions, where animals, insects, plants and microorganisms are transported around the globe by humans, are becoming more common and have a global annual cost of at least £118billion.

An investigation by an international team of scientists, including the University of Leeds' School of Biology, says the emergence of human diseases share many of the same challenges as species invasions and that studying them together could provide solutions.

Co-author of the report, Dr Alison M. Dunn, a Professor of Ecology in the School of Biology, said: "Integrated approaches that take into account the health of humans and that of animals, plants and the environment are urgently needed to prevent future pandemics and the spread of invasive species across the globe.

"Cross-fertilization between the two disciplines could improve prediction, prevention, treatment, and mitigation of invasive species and infectious disease outbreaks, including pandemics, such as COVID-19."

The paper, which is published today in the journal, BioScience, says the prevention of species invasion requires analysis of how it will arrive into a new region (primary spread) and how it spreads to the surrounding region (secondary spread).

But this dual pathway classification has seldom been used to look at emerging infectious organisms in humans - even though it is well known that factors such as behaviour, income, tourism and trade can influence transmission.

Invasive insects are the most frequent transmitters of organisms causing human diseases. The tiger mosquito has spread to all inhabited continents through trade and has been responsible for the spread of dengue fever, yellow fever, West Nile virus, and chikungunya.

Pathogens that cause these diseases go through the same stages as invasive species but can spread much more quickly, leading to pandemics, say the researchers.

Even the patterns of spread of re-emerging "native" diseases, such as Ebola in West Africa, share similarities to those of invasive species.

The paper concludes that biosecurity is key to preventing the spread of invasive species and of infectious diseases in humans and calls for medical scientists and ecologists to work together to learn more about both.

Professor Montserrat Vilà, researcher at the Estación Biológica de Doñana and lead author of the study, said: "Pandemics such as COVID-19 and biological invasions have much in common. They are often linked by the same global change drivers, and they are showing similar features. This paper gives a detailed review of the parallels between scientific approaches to invasions and human epidemics.

"Given increasing rates of emerging infectious pathogens and biological invasions worldwide and the ongoing global health crisis caused by coronavirus, the need for integrative and interdisciplinary approaches to biosecurity has never been greater."

The cover for issue 7 of Oncotarget features Figure 5, "SUM149-MA cells surviving a 6-MP treatment are sensitive to chemotherapeutic drugs," published in "Inhibition of resistant triple-negative breast cancer cells with low-dose 6-mercaptopurine and 5-azacitidine" by Singh, et al. which reported that the authors have reported that a lengthy treatment with low-dose 6-mercaptopurine, a clinically useful anti-inflammatory drug, inhibits such resistant cells.

They found that a lengthy treatment with 1 μM 5-azacitidine, without a significant effect on cell proliferation, sensitized cancer cells to the inhibitory effects of low-dose 6-mercaptopurine.

Importantly, treatment for several weeks with low doses of 6-mercaptopurine and/or 5-azacitidine did not render cancer cells resistant to chemotherapeutic drugs doxorubicin or paclitaxel.

In fact, the cells became more sensitive to chemotherapeutic drugs upon treatment with 6-mercaptopurine and/or 5-azacitidine.

The Oncotarget author's analyses of protein markers of epithelial-to-mesenchymal transition indicated that treatments with 6-mercaptopurine and/or 5-azacitidine do not significantly reverse this process in their model. Their results showed that safe drugs such as low-dose 6-mercaptopurine singly or combined with 5-azacitidine, which are suitable for use prior to disease relapse, have a potential of inhibiting highly resistant triple-negative breast cancer cells.

The Oncotarget author's analyses of protein markers of epithelial-to-mesenchymal transition indicated that treatments with 6-mercaptopurine and/or 5-azacitidine do not significantly reverse this process in their model.

Dr. Anthony Lucci and Dr. Balraj Singh both from The University of Texas MD Anderson Cancer Center said, "Breast cancer patients who have minimal residual disease (MRD) after surgery or systemic therapies are at a higher risk of relapse."

The model involves choosing cancer cell lines established from therapy-resistant breast cancers, such as inflammatory breast cancer, and subjecting them to prolonged glutamine deficiency to select progenitor-like cancer cells that are highly resistant and can metastasize to multiple organs in nude mice.

To explain this experimental strategy for therapeutic evaluation against resistant cancer cells, although their selection protocol for resistant cells is very robust, a majority of the progeny cells would gradually revert back to non-resistant cells in non-selective in vitro conditions.

Since a majority of relatively sensitive cells are preferentially eliminated first by most therapies, lengthy therapeutic evaluations in cell culture provide more useful information about the resistant subpopulation of cancer cells than rapid cell proliferation assays.

6-MP treatment affects cells via mis-incorporation of 6-thioguanine triphosphate into RNA and deoxy-6-thioguanine triphosphate into DNA along with other effects on nucleoside pools and cell signaling. The authors chose low-dose 6-MP for evaluation in our model of adaptable cancer cells because of 6-MP's ability to induce and maintain remission in inflammatory bowel disease and childhood acute lymphoblastic leukemia.

It has also been shown to stabilize quiescence in cancer cells and to sensitize resistant cancer cells to cell death with an apoptosis-inducing agent in a preclinical model of multiple myeloma.

The Lucci/Balraj Research Team concluded in their Oncotarget Research Output that finally, because immune checkpoint blockade therapy is likely to become common in both neoadjuvant and adjuvant settings in a heterogeneous cancer such as TNBC, the industry must consider any new therapy in this new context.

A common hurdle with the immune checkpoint therapy is severe autoimmune reaction toxicities.

When such therapies are given in the setting of metastasis, they may be combined with other therapies such as cytotoxic agents, which may also adversely affect immunity.

Although therapies like TNF antibodies are useful in managing the acute phase of IBD, 6-MP has been a mainstay for several decades for keeping the disease in remission.

Applying the lessons from IBD treatment to the setting cancer treatment, low-dose 6-MP followed by immune checkpoint blockade could be a good way of limiting severe autoimmune toxicities, thereby increasing the chances of success with these promising therapies.

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DOI - https://doi.org/10.18632/oncotarget.27922

Full text - https://www.oncotarget.com/article/27922/text/

Correspondence to - Anthony Lucci - alucci@mdanderson.org and Balraj Singh - bsingh@mdanderson.org

Keywords -
esistant TNBC,
minimal residual disease,
intratumor heterogeneity,
breast cancer relapse,
metastasis prevention

About Oncotarget

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Journal

Oncotarget

DOI

10.18632/oncotarget.27922

Rice farmers in Nepal are chronically falling short of their potential productivity. Poor rice yields are persistent across the Terai--a lowland region lying south of the outer foothills of the Himalayas that extends through southern Nepal into northern India--and existing decision support systems are failing to provide the precision required.

To date, farmers in the area have lacked the knowledge and support they need to properly plan nutrient applications for their crops. Current nutrient recommendation systems only provide "blanket" prescriptions that fail to consider the large variability that occurs across their rice-growing landscapes. Nepal's rice yield gaps--the difference between actual and attainable yields--are widening as soil fertility declines, which represents a major threat to the sustainability of these smallholder farms.

A team of researchers, headed by Dr. Lal Prasad Amgain, Far Western University, Nepal, along with Dr. Jagdish Timsina, Global Evergreening Alliance, Melbourne, Australia, looked at reversing this trend through the implementation of a flexible nutrient recommendation system that can adapt to the unique conditions faced by individual smallholder farmers.

Published in the Journal of Plant Nutrition, the article describes the impact of a 4-year study conducted across the Terai and the central mid-hill regions of Nepal. The basis for study is a broadly field-tested digital tool called Nutrient Expert® (NE).

This software-based system leads individual farmers, or farm advisors, through a step-by-step decision-making process that describes how best to apply nutrients to their rice fields. Prior to its introduction into Nepal, NE Rice has been successfully implemented in India, Bangladesh, Sri Lanka, as well as in China. The tool has been proven effective in a variety of smallholder cropping systems.

"Soil nutrient supply often varies greatly between neighboring fields," explains Dr. Sudarshan Dutta, co-author of the study and Scientist at the African Plant Nutrition Institute (APNI). "This study adds innovation to the process of fertilizer application through the use of a tailored, scientifically robust approach."

During the study, NE-based recommendations increased yields by over 2 t/ha compared to the status quo of farmers applying fertilizer based on either informal knowledge or generalized recommendations.

Given that the size of the yield gap for rice in Nepal is estimated at 3 t/ha, the NE approach shows great potential for contributing to the country's nutrient security goals if adopted on a wider scale. The economics of the approach also proved attractive as NE was capable of doubling rice crop profitability if compared to the generalized recommendations.

"Nutrient Expert gives farmer's the confidence that they are using nutrients in the right way," explains Dr. Kaushik Majumdar, APNI Director General, and co-author of the study. "The tool also provides farmers with a clear plan on how to best match the timing of their applications with the periods of peak nutrient demand, which is a critical step to ensuring fertilizers are used most effectively."

With these positive results in hand, researchers are looking to expand the effort through additional research on rice and other cereals.

"On-farm demonstrations provide the evidence that farmers, farm advisors, and other stakeholders need to pave the way for expanded adoption of the NE-based nutrient recommendations across Nepal," concluded Dr. Dutta.

While some international students come to Canada knowing whether they intend to stay or return home after completing their degrees, the majority decide after they have had a chance to live here for a few years, a new study has found.

"Nearly a quarter of our participants made the decision prior to arriving in Canada," said Elena Neiterman, a lecturer in the School of Public Health and Health Systems at the University of Waterloo. "However, the majority were not certain what their plans for the future were until they had a chance to live here and explore life in Canada."

The students identified several factors shaping their decision to stay or go, including family ties in Canada or abroad, employment opportunities here compared to their home country, the perceived complexity of the immigration system and feelings of isolation or experiences of racism.

The researchers also found that the way students conceived of the word "staying" varied considerably. While two-thirds of the study participants said they hoped to stay, 17 per cent of them saw it as permanently settling in Canada. More than 33 per cent planned to stay for a few years, then move back home. The others were not sure what the future will hold.

For more than half the participants, staying in Canada included a plan to apply for permanent residency following graduation. Students said that permanent residency would allow them the flexibility to keep more options open and give them access to increased job opportunities.

The researchers interviewed 60 international students from two universities, aiming for diversity in graduate versus undergraduate status, male versus female or non-binary, with 20 students each studying in three fields: social sciences and humanities, health sciences, and STEM (science, technology, engineering and math).

"Only 10 students had a strong initial desire to stay in Canada that remained unchanged while they studied, and for them, an international education was a means to immigration," Neiterman said. "For the others, the decision-making process regarding migration was complex and changed over time."

Participants were all in their last year of study and represented 23 different countries, with 30 per cent coming from China.

International students comprised 16.5 per cent of the total number of students enrolled in Canadian schools in 2018. In 2017, they contributed $15 billion to the Canadian economy, according to Global Affairs Canada.

Imagine an entire twenty storey concrete building which can store energy like a giant battery. Thanks to unique research from Chalmers University of Technology, Sweden, such a vision could someday be a reality. Researchers from the Department of Architecture and Civil Engineering recently published an article outlining a new concept for rechargeable batteries - made of cement.

The ever-growing need for sustainable building materials poses great challenges for researchers. Doctor Emma Zhang, formerly of Chalmers University of Technology, Sweden, joined Professor Luping Tang's research group several years ago to search for the building materials of the future. Together they have now succeeded in developing a world-first concept for a rechargeable cement-based battery.

The concept involves first a cement-based mixture, with small amounts of short carbon fibres added to increase the conductivity and flexural toughness. Then, embedded within the mixture is a metal-coated carbon fibre mesh - iron for the anode, and nickel for the cathode. After much experimentation, this is the prototype which the researchers now present.

"Results from earlier studies investigating concrete battery technology showed very low performance, so we realised we had to think out of the box, to come up with another way to produce the electrode. This particular idea that we have developed - which is also rechargeable - has never been explored before. Now we have proof of concept at lab scale," Emma Zhang explains.

Luping Tang and Emma Zhang's research has produced a rechargeable cement-based battery with an average energy density of 7 Watthours per square metre (or 0.8 Watthours per litre). Energy density is used to express the capacity of the battery, and a modest estimate is that the performance of the new Chalmers battery could be more than ten times that of earlier attempts at concrete batteries. The energy density is still low in comparison to commercial batteries, but this limitation could be overcome thanks to the huge volume at which the battery could be constructed when used in buildings.

A potential key to solving energy storage issues

The fact that the battery is rechargeable is its most important quality, and the possibilities for utilisation if the concept is further developed and commercialised are almost staggering.Energy storage is an obvious possiblity, monitoring is another. The researchers see applications that could range from powering LEDs, providing 4G connections in remote areas, or cathodic protection against corrosion in concrete infrastructure.

"It could also be coupled with solar cell panels for example, to provide electricity and become the energy source for monitoring systems in highways or bridges, where sensors operated by a concrete battery could detect cracking or corrosion," suggests Emma Zhang.

The concept of using structures and buildings in this way could be revolutionary, because it would offer an alternative solution to the energy crisis, by providing a large volume of energy storage.

Concrete, which is formed by mixing cement with other ingredients, is the world's most commonly used building material. From a sustainability perspective, it is far from ideal, but the potential to add functionality to it could offer a new dimension. Emma Zhang comments:

"We have a vision that in the future this technology could allow for whole sections of multi-storey buildings made of functional concrete. Considering that any concrete surface could have a layer of this electrode embedded, we are talking about enormous volumes of functional concrete".

Challenges remain with service-life aspects

The idea is still at a very early stage. The technical questions remaining to be solved before commercialisation of the technique can be a reality include extending the service life of the battery, and the development of recycling techniques.
"Since concrete infrastructure is usually built to last fifty or even a hundred years, the batteries would need to be refined to match this, or to be easier to exchange and recycle when their service life is over. For now, this offers a major challenge from a technical point of view," says Emma Zhang.

But the researchers are hopeful that their innovation has a lot to offer.
"We are convinced this concept makes for a great contribution to allowing future building materials to have additional functions such as renewable energy sources," concludes Luping Tang.

SALT LAKE CITY - A new study published in the Journal of Clinical Oncology reports findings on Huntsman at Home™, a cancer hospital-at-home model operated by Huntsman Cancer Institute (HCI) at the University of Utah (U of U). The study analyzed aspects of Huntsman at Home acute care--meaning a level of care that is generally provided in an inpatient hospital setting.

In the 30 days after study entry, Huntsman at Home participants had 55% fewer hospitalizations, 45% fewer emergency department visits, and shorter hospital stays by one day. They also had 47% lower health care costs during the same 30-day period as compared with patients who did not participate in Huntsman at Home.

Kathleen Mooney, PhD, RN, Huntsman at Home research director and distinguished professor of nursing at the U of U, led the study, along with a team of nine other investigators. Their evaluation adds to the existing evidence of a reduction in costs and unplanned health care visits among Huntsman at Home participants.

Launched in 2018, Huntsman at Home was one of the first programs in the United States to provide acute cancer care at home. The service combines HCI research and clinical expertise for in-person care, remote patient and caregiver support, and acute-level clinical care provided by nurse practitioners. Huntsman at Home has a variety of home-based services that range from symptom management to acute medical, post-surgical, palliative, and end-of-life care. The publication examines factors related to acute care admissions to Huntsman at Home on health care utilization and costs.

"Acute cancer care in the home had not previously been evaluated," says Mooney. "We sought to create a model that extended the compassionate care of HCI to provide services in a patient's home that otherwise might require urgent or emergency care or a longer hospitalization to resolve. Yet we also knew it had to be sustainable and would require new insurance reimbursement models. Therefore, we evaluated our Huntsman at Home program on health care utilization and costs to determine the value added by the acute care model."

The Huntsman at Home team is led by HCI nurse practitioners working in conjunction with HCI oncologists and is operated in partnership with Community Nursing Services, a home health and hospice agency that provides the program with registered nurses, social workers, and physical therapists. Huntsman at Home was initially offered to patients who lived within a 20-mile radius of HCI's flagship cancer hospital in Salt Lake City.

"We found that emergency department visits and hospitalizations were approximately cut in half for patients who participated in Huntsman at Home," Mooney says.

Mooney and her team plan further studies to evaluate other aspects of Huntsman at Home. They are currently examining patient and family caregiver satisfaction, and potential reductions in symptom severity and caregiving burden.

In alignment with HCI's focus on meeting the needs of rural residents in its catchment area--a geographic region that spans 17% of the continental United States and includes all of Utah, Idaho, Montana, Nevada, and Wyoming--the team also plans to determine whether the model can improve care for patients who live far from a major medical center.

"Huntsman at Home is expanding to three rural counties in southeastern Utah, areas that require a two- to four-hour drive for patients to come to HCI," Mooney says. This will be the first expansion of the Huntsman at Home service area. The HCI cancer care team will partner with local providers and community organizations to provide care through a combination of in-person, remote monitoring, and telehealth approaches. "This important expansion exemplifies HCI's commitment to serve cancer patients where they live," says Mooney.

Americans who get their news from traditional sources (e.g.: TV, newspapers) are more likely to accept the COVID-19 vaccine than those who rely on social media.

New research published in Anaesthesia (a journal of the Association of Anaesthetists) shows the huge pressure that anaesthesia and critical care staff in the UK have been under throughout the winter wave of COVID-19, as the number of newly admitted infected patients surged and most planned surgeries, including a substantial number of critical cancer operations, were cancelled.

"These findings have important implications for understanding what has happened during the COVID-19 pandemic, planning recovery and building a system that will better respond to future waves or new epidemics," explains co-author Professor Tim Cook, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK, and Honorary Professor, School of Medicine, University of Bristol, UK.

Between October 2020 and January 2021, the authors conducted three national surveys to track anaesthetic, surgical and critical care activity during the second COVID-19 pandemic wave in the UK - the first round as the November 2020 lockdown was being implemented, the second in December 2020 as restrictions were lifted, and the final survey in February 2021 just after the peak of the new year surge caused by the new Kent (UK) variant of SARS-CoV-2.

They surveyed all NHS hospitals where surgery is undertaken. Response rates, by round, were 64%, 56% and 51%. The surveys showed increasing systemic pressure on anaesthetic and peri-operative services due to the need to support critical care pandemic demands.

There was evidence of significant stress in the system in October and this increased in December 2020 including redeployment of one in six doctors from anaesthesia to critical care, and by December approximately half of critical care units were expanded so much that planned surgery could not be safely undertaken. During this period, almost one in five operating theatres were closed but many hospitals were able to displace surgery to other locations. Overall surgery rates fell by around one quarter compared with similar periods in previous years.

The situation then deteriorated dramatically during the peak of the second surge (January 2021), with responses showing that the system was close to breaking point. Almost half of all operating theatres were closed and those that were open were often running at close to half normal activity. Hospitals were less able to relocate activity to other locations, due to lack of staff.

"The impact on surgery was in part due to a lack of space in which to operate as operating theatres were used as expanded ICUs. But the most important factor was lack of anaesthetists to deliver care as they were redeployed to critical care. In the January peak, almost one in three anaesthetic doctors were unavailable for anaesthetic work as redeployments more than doubled the critical care workforce," explains Prof Cook. "All but a quarter of critical care units were expanded to the extent that planned surgery could not be safely undertaken. As a result, surgical activity fell massively, with all types of surgery affected. There was important regional variation and in hard-pressed regions, paediatric and non-cancer surgery fell to 12-20% of normal activity and even cancer surgery, usually considered an urgent priority, fell to below half of normal activity."

As long as the UK's exit from lockdown restrictions continues and vaccination rates keep COVID-19 infections low, a rapid decompression is likely to occur whereby critical care units quickly decrease their capacity and the rest of the health system resumes elective and other surgical care. However, tackling the surgical backlog requires working at well above normal capacity for several years and even returning to normality is likely to be challenging. Co-author Dr Emira Kursumovic says: "Our data illustrate very clearly that anaesthetists - and in all probability other healthcare providers working in operating theatres - have been central in the critical care response to the pandemic, and that they will have been similarly impacted. These staff have had an increased workload and intensity, decreased leave, and psychological burdens including moral injury. The physical and psychological needs of the workforce must be considered in planning recovery of non-COVID healthcare services."

The authors add: "The surveys illustrate the pressure points in the current system. These include space and, most particularly, staff. The fact that critical care expansion requires redeployment of substantial numbers of anaesthetists is likely to have important implications for at least the next year, as critical care services work flexibly to address fluctuations in demand and expand as necessary. This in turn will have important implications for addressing surgical waiting lists. Expansion of both space and the anaesthetic workforce are likely to be inevitable requirements."

Dr Mike Nathanson, President of the Association of Anaesthetists, said: "These important surveys demonstrate the pressure anaesthetists and anaesthetic departments were under during the pandemic surges. The impact on the mental and physical wellbeing of our colleagues is still being felt. The impact on the health of the nation, in terms of the expanding waiting lists for investigations and surgery, is a huge concern. Workforce shortages and the inability for many of our trainee anaesthetists to progress their careers due to the lack of suitable jobs will accentuate this backlog, even without any further surges."

Professor Ravi Mahajan, President of the Royal College of Anaesthetists, which funded the surveys, said: "These findings confirm the central role anaesthetists played during the pandemic, treating critically ill patients with and without COVID. It is clear that the success of any recovery will hinge on having the right staff, in the right place, at the right time."

He adds: "In the rush to reduce the backlog, however, we must not forget the enormous physical and psychological toll that working in the pandemic has had on anaesthetists. Any attempt to go too fast risks staff cutting back on hours or leaving the profession altogether, jeopardising the sustainability of the NHS. It is vital that we take onboard the lessons from the past year, so we are able to identify areas for improvement, plan a sustainable NHS recovery and respond more effectively to future pandemics."

Simon Fraser University researchers are playing a key role in guiding conservation efforts to protect a declining butterfly population. The eastern monarch butterfly, an important pollinating species known for its distinct yellow-orange and black colour, is diminishing due to the loss of the milkweed plant--its primary food source.

Researchers analyzed current conservation strategies and recommended changes to how and where declining milkweed can be restored, based on assessments of climate and butterfly migration. Their study is published today in Frontiers in Environmental Science.

SFU PhD student Rodrigo Solis-Sosa and professor Sean Cox, from the School of Resource and Environmental Management, led the study with biological sciences professor Arne Mooers. The trio collaborated with Christina Semeniuk, Great Lakes Institute for Environmental Research (GLIER) and study co-writer Maxim Larrivée, director of the Insectarium de Montréal, one of the five Montréal's Space for Life museums.

Solis-Sosa says researchers hope to prevent the eastern monarch butterfly from the same fate as the western population, which typically migrated from the Okanagan to California each winter. This year's measurements of western monarch butterfly colonies found "zero overwintering populations, putting them at an all-time low and closer to extinction," he explains.

Eastern monarch butterflies overwinter in Mexico from November to March then migrate and reproduce across the U.S. before reaching eastern Canada in late August.

Milkweed has declined across the U.S. due to clearing land for agricultural use, GMO crops, herbicides and climate change. While identifying the U.S. midwest as the best place to focus on restoration efforts, given optimal weather and milkweed availability when the monarch butterfly arrives, the team also found that the southern U.S. has a paramount yet somewhat neglected role.

"While increasing the number of milkweed stems in the South wasn't as effective as in the Midwest, decreasing their number in the South was catastrophic," says Solis-Sosa. "While the South may not play a huge role in increasing the eastern monarch butterfly population, it acts as a safety net."

Researchers also found that recommended estimates of between 1.2 and 1.6 billion milkweed stems falls short of supporting butterfly populations-- by 50 to 90 percent. Existing conservation models don't factor in the effects of drought, changes in temperature and the stem's effective usability by the monarch butterflies.

"Monarchs may need at least three billion stems to reach a safe minimum threshold population of six overwintering hectares," says Solis-Sosa. The population once covered the equivalent of 18 hectares over its wintering territory nearly 25 years ago, but that hasn't risen above six over the past decade. The latest measure has dwindled to just 2.3 overwintering hectares.

Communities in Mexico also depend on monarch butterfly ecotourism as an essential part of their livelihoods. "Monarch butterflies also hold a special significance in traditional Mexican culture," says Solis-Sosa. "They arrive in Mexico by November 2--the Day of the Dead--and symbolize the dead souls of loved ones arriving to comfort them through the dark and cold winter season. Losing the monarch butterfly would represent a cultural loss to the Mexican people."

Solis-Sosa says their research will help policymakers across North America update conservation strategies and has already led to discussions with the Commission for Environmental Cooperation (CEC). The CEC supports cooperation between North American Free Trade Agreement (NAFTA) partners to address environmental issues of continental concern.

As the global energy demand continues to grow along with atmospheric levels of carbon dioxide (CO2), there has been a major push to adopt more sustainable and more carbon-neutral energy sources. Solar/wind power and CO2 capture - the process of capturing waste CO2 so it is not introduced into the atmosphere - are two promising pathways for decarbonization, but both have significant drawbacks.

Solar and wind power is intermittent and cannot be deployed everywhere; CO2 capture processes are incredibly energy-intensive. Both of these pathways have benefits, but each on their own does not present a viable strategy at the moment. However, a research team led by Dr. Faruque Hasan, Kim Tompkins McDivitt '88 and Phillip McDivitt '87 Faculty Fellow and associate professor in the Artie McFerrin Department of Chemical Engineering at Texas A&M University, has uncovered a way to combine both of these processes together to increase the efficiency of both.

Much of Hasan's research deals with synergy and synergistic effects in complex systems. Synergy is the combined effect of cooperative interactions between two or more organizations, substances or other agents that is greater than the sum of their separate effects. To this end, Hasan examined the synergistic integration of renewables and flexible carbon capture with individual fossil power plants.

"We are addressing three things that each have pros and cons: fossil fuels are cheap, but they release a lot of CO2; CO2 capture is very beneficial for the environment, but it is prohibitively expensive; renewable energy sources such as wind or solar power are good for the environment, but the energy output is intermittent and variable," Hasan said.

While each area presents significant challenges individually, Hasan and his research team have found a significant benefit when all the components are used in tandem. In a research paper published in Energy & Environmental Science, Hasan and his doctoral students Manali Zantye and Akhil Arora examined the use of synergistic integration of renewables and flexible carbon capture and found a significant benefit to efficiency and cost reduction.

"Despite the growing interest in sustainable renewable energy sources, their intermittent availability would make it difficult to completely replace the dispatchable fossil-based energy generators in the near future," said Zantye, who is the first author of the paper.

CO2 capture is an energy-intensive process. Normally, this process runs alongside standard energy generation at power plants. As energy is generally priced on a demand basis, the use of CO2 capture processes during peak energy demand can quickly drive up operational costs to an unsustainable level. In this research, Hasan also found that utilizing a flexible CO2 capture system can greatly offset operational costs.

Normally, CO2 is captured into a large solvent tank and then removed in an energy-intensive process. In a flexible system, rather than removing the CO2 as it is introduced to the solvent, it can be stored for short periods of time and removed at non-peak times when the cost of power is lower. Further, by incorporating a renewable energy source, the cost of CO2 capture is offset even more.

According to Hasan, the synergistic framework presented in the research can dramatically improve the system beyond the component parts. "We have developed a computational framework to utilize dynamic operational schedules to manage all these very complex decisions," he said. "Developing carbon capture technology is very important, but equally important is how you integrate them. The operational aspect of integration is very important. Our study shows that this can be done in such a way that renewables, fossil fuels and carbon capture are all working together."

According to Zantye, the proposed framework provides an effective decarbonization mechanism for the current fossil-dominated energy landscape as we transition to a more fully sustainable future.

PROVIDENCE, R.I. [Brown University] -- Mindfulness-based meditation programs have emerged as a promising treatment for conditions ranging from stress to sleeplessness to depression. In some cases, they're even offered to people -- schoolkids or employees, for example -- who aren't actively seeking help or who haven't been screened for suitability. Yet most research and discourse about these programs focuses only on their benefits, with little investigation of the risks or the potential for adverse effects.

A recent review of nearly 7,000 studies of meditation practices found that less than 1% of them measured adverse effects. Willoughby Britton, an associate professor of psychiatry and human behavior at Brown University, said that this is largely because assessing adverse effects (a process known as "harms monitoring") in non-pharmacological treatments like mindfulness-based meditation programs is difficult to do well.

To address that gap, Britton conducted a new study on adverse effects in mindfulness-based programs that identified common obstacles to harms monitoring and, importantly, showed how to address them. The study also found that the rates of adverse effects from mindfulness were similar to those found in other psychological treatments.

The study was published on May 18 in Clinical Psychological Science.

"Our ultimate goal is to maximize the efficacy of mindfulness-based meditation while minimizing harms," said Britton, who directs the Clinical and Affective Neuroscience Laboratory at Brown. "In order to address risks and modify treatment accordingly, you need thorough and detailed knowledge about potential harms. Our study, the most comprehensive of its kind, provides a blueprint for how to accurately assess the risks of mindfulness-based meditation programs."

~Why no one wants to talk about meditation's adverse effects~

The adverse effects of mindfulness-based meditation programs are often an unpleasant topic for providers and participants alike, Britton said. For the study, she and her colleagues reviewed the most current harms monitoring best practices from regulatory agencies like the World Health Organization, the National Institutes of Health and the U.S. Food and Drug Administration. In the paper, they outlined the key considerations around assessing adverse effects, including hesitancy of participants to report negative reactions to treatment because of feelings of shame or a desire to please the researcher or instructor.

Researchers and mindfulness teachers (Britton is both) are understandably more focused on the help they can provide than any harm they could cause. As a result, a lack of negative feedback from participants is often interpreted as evidence of absence of harm. "It's very easy for our enthusiasm and desire to help to become a kind of blindness," Britton explained.

Another complicating factor, she said, is the lack of knowledge of proper harms assessment.

"Often the mindfulness teacher will ask the class, 'Did anyone have any challenges with your meditation practice this week?'" Britton said. "But participants, in general, tend to avoid answering open-ended questions asked by the teacher in a public setting. Research has shown that having someone other than the teacher ask specific questions in a private setting will increase the likelihood of honest reporting."

Finally, she highlighted the fact that term "adverse" is a highly subjective judgment that can vary across people and even across the same person in different contexts.

"The re-living of a previous trauma may be healing for some and destabilizing for others, in the same way that the drowsiness caused by cold medicine -- or meditation -- may be undesirable or 'adverse' in the morning but highly desirable before bed," she said. What's more, Britton added, the literature shows that mental health treatment providers (like therapists or doctors) may dismiss patient complaints or reframe them as a sign that the therapy is working.

~Designing a model assessment~

Britton's research team followed 24 current harms monitoring guidelines to assess the nature and frequency of meditation-related adverse effects in mindfulness-based programs. The study participants were representative of typical meditators in the U.S.: predominantly middle-age women seeking methods to self-manage mild to severe levels of anxiety, depression and stress. After completing one of three versions of an eight-week mindfulness meditation program, participants were interviewed by a researcher unaffiliated with the treatment about their experiences, with 44 questions based on previous research of meditation-related challenges.

To more accurately and thoroughly capture patient perspectives, this study allowed each participant to evaluate the emotional tone or "valence" of each of 44 meditation-related experiences as well as the impact it had on their life and functioning. By asking participants specific questions about duration and impact, researchers were able to differentiate temporary distress, negative-impact side effects and "lasting bad effects." In this way, the researchers sought to clarify which effects were experienced as "adverse" on a case-by-case basis.

To accommodate the varying definitions of harm, results were reported in tiers of severity ranging from "transient distress during meditation" (i.e., temporary) to "enduring impairment in functioning" -- or "lasting bad effects."

~The "what" is as important as the "how"~

The significance of the study, Britton said, has as much to do with what it found as how it found it.

"The fact that meditation can cause altered states, for example, isn't news: It's something that people have been talking about for centuries," Britton said. "What we haven't been very good about is measuring the impact and significance of these states on individual participants."

Of the 96 participants, 58% reported at least one meditation-related adverse effect, which ranged from perpetual hypersensitivity to nightmares to traumatic re-experiencing. Meditation-related adverse effects with negative impacts on functioning occurred in 37% of the sample. Six percent of the sample had "lasting bad effects," or impairments in functioning lasting more than one month. Notably, the researchers say, this rate is similar to those of other psychological treatments.

In the study, meditation-related effects with negative impacts tended to be associated with signs of what's called dysregulated arousal -- for example, the participants reported feeling anxious, hyper-stimulated or emotionally flat or disconnected after meditating.

This is important for instructors and participants to note, Britton said, because unlike the experiences of anxiety or insomnia, a feeling of being dissociated or emotionally checked-out is not always experienced as unpleasant and can provide some relief, especially for a person suffering from intense anxiety. Yet in the study, this feeling of dissociation tended to predict more significant and lasting impairment in functioning.

"This is where the differentiation between valence and impact becomes important, because the valence, or emotional tone, of an experience might be not particularly distressing at the time," Britton said. "Meditators are often taught to reappraise their experience as not being problematic, and to accept it for what it is. Our results are basically saying that when it comes to dissociation, this approach isn't going to work."

Britton and colleagues also found that the open-ended question "Have you had any unexpected, unpleasant, adverse or challenging experiences as a result of mindfulness meditation practice during or following the program?" underestimated the true rate by 70%, confirming the inadequacy of open-ended questions compared to specific ones.

The study concludes that the active ingredient of these therapeutic programs, which is mindfulness meditation practice, can be associated with both transient distress and enduring negative impacts on life and functioning. Britton said that it is important to note that adverse effects and benefits are not mutually exclusive: many of the same participants who reported adverse effects also reported improvements in depression.

Britton noted that the intent of the study, as well as of her broader research, is not to discourage mindfulness-based meditation programs -- rather, it is to generate findings on both the positive and negative effects so that providers and meditators can make informed decisions.

She compared mindfulness to aspirin, as an example. This medicine-cabinet staple can cause nausea, heartburn and stomach cramps -- and taking a daily aspirin can cause gastrointestinal bleeding in some people. But these potential adverse effects do not take away from aspirin's many benefits. Instead, detailed knowledge about the benefits and risks allows practitioners to make educated, effective and safe recommendations to specific patients.

"That's where we need to get with mindfulness, too," Britton said. "Our study is an attempt to bring harms monitoring up to the standards of other treatments so that providers can identify events that require monitoring and intervention in order to maximize the safety and efficacy of mindfulness-based meditation."