Tech

Novel data describes use of instrument that encourages vets to report on their health using a brief survey

PROMIS self-reported outcomes matched physician diagnoses documented in medical records

This tool may serve as a motivator for some veterans who are hesitant to seek medical care

Findings provide fuller picture of national health, allow health professionals to see how everyone, including veterans, is doing

CHICAGO --- For the first time, a large national population of United States veterans used the same standardized tool that the general population uses for tracking health.

More than 3,000 veterans from across the country used the tool to self-report their health in the study led by a researcher from Northwestern Medicine and the U.S. Department of Veterans Affairs. Findings showed that veterans scored worse in several areas, including feeling more anxiety, depression, fatigue, sleep disturbance and pain compared to people in the general population.

These self-reported outcomes were valid because they matched physician diagnoses documented in medical records, the study found.

The study's scientists believe patient self-reporting will be a successful way to track the health of veterans, who may be hesitant to seek medical care.

The self-reporting tool - a survey called PROMIS-29 - is commonly used in the general population but not widely or systematically offered to veterans. The scientists mailed the survey to veterans for this study, which is the first to report PROMIS-29's use in a large national cohort of veterans.

"These are our nation's veterans. They served our country, and they deserve access to things made available to everyone," said lead author Sherri LaVela, a research associate professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine and a department of veterans affairs scientist. "The PROMIS instrument is being used more and more for health care, and we hope to see it integrated into veteran care as well."

The instrument used in the study may be a useful tool for health care providers to assess veteran patient's physical and mental health, as indicated by the positive associations between scores and clinical documentation which suggests clinical validity for targeted measures, LaVela said.

The study was published last week in the Journal of General Internal Medicine.

The VA serves more than 8.3 million veterans in the U.S. annually.

"Seeing how veterans fare relative to population norms is important because it gives us a fuller picture of their health and allows us a cursory glance at how they are doing in general," LaVela said. "Estimates like this are important because they provide normal ranges for health measures across cohorts.

"Veterans have enhanced options of seeking care outside the VA, which makes it crucial to have an accurate measurement of health status and symptoms among population-based samples. Being able to simply, yet effectively, collect these data will identify unmet needs in which to intervene."

Patients using PROMIS-29 answered a short series of questions about their health and quality of life. The survey is scored to indicate if they are experiencing disturbed sleep, anxiety, depression or pain, for instance. Given the responses, the patient and their health care team can follow up and schedule a doctor's appointment.

"If a veteran has poor scores, we want to get them in and take a look," LaVela said.

Veterans in the study also scored lower for physical function than civilians and lower for satisfaction with social role, such as being satisfied with their ability to work, do regular personal and household responsibilities, and perform daily routines.

Patient-reported data can be used to inform health care providers about symptoms, perceived state of health and are especially important to understand patient experiences among people with chronic diseases.

The ability to quickly and easily identify health disparities in veterans is important because it can prompt health care providers to intervene. For example, the study found that relative to general population norms, veterans reported worse scores for pain interference. The VA has been integrating innovative, patient-centric approaches ways into treatment options. Using pain as an example, the VA has a stepped-care pain management approach that can be used for intervention, and recently the VA implemented mindfulness types of interventions to help veterans with pain, post-traumatic stress disorder, and other conditions that may afflict veterans, LaVela said.

Former Marine Dustin Lange said seeing how a veteran's health stacks up against the general population can serve as much-needed motivation for a veteran to go see the doctor.

"A lot of times, veterans might be hesitant to go to the hospital or not get proper checkups," said Lange, a U.S. Veteran who spent eight years in the Marines and is now the associate director of the Chez Center for Wounded Veterans in Higher Education at University of Illinois, Urbana-Champaign.

Lange has taken the PROMIS-29 survey, though not for this study. His score indicated some disturbances in his sleep, which prompted him to schedule a doctor's appointment. His clinical checkup validated his PROMIS-29 results. Lange said he hopes PROMIS-29 becomes more widely available for veterans, because he thinks it could motivate veterans to see a doctor.

"As a vet, you're able to see, 'Am I having similar problems to the general population? Do I have higher sleep or pain problems?" Lange said. "Seeing that difference from the general population could prompt a vet to visit the VA and get help."

A team of researchers at Texas A&M University has developed an innovative way to print therapeutics in 3D for regenerative medicine.

3D bioprinting is emerging as a promising method for rapidly fabricating cell-containing constructs for designing new, healthy, functional tissues. However, one of the major challenges in 3D bioprinting is lack of control over cellular functions. Growth factors, which are a special class of proteins, can direct cellular fate and functions. However, these growth factors cannot be easily incorporated within a 3D-printed structure for a prolonged duration.

In a recent study conducted at Texas A&M, researchers in Dr. Akhilesh K Gaharwar's lab in the Department of Biomedical Engineering formulated a bioink consisting of 2D mineral nanoparticles to sequester and 3D print therapeutics at precise locations. Their findings were published in Advanced Healthcare Materials.

The team has designed a new class of hydrogel bioinks -- 3D structures that can absorb and retain considerable amounts of water -- loaded with therapeutic proteins. This bioink is made from an inert polymer, polyethylene glycol (PEG), and is advantageous for tissue engineering because it does not provoke the immune system. However, due to low viscosity of the PEG polymer solution, it is difficult to 3D print this type of polymer. To overcome this limitation, the team has found that combining PEG polymers with nanoparticles leads to an interesting class of bioink hydrogels that can support cell growth and may have enhanced printability compared to polymer hydrogels by themselves.

This new technology, based on a nanoclay platform developed by Gaharwar, assistant professor, can be used for precise deposition of protein therapeutics. This bioink formulation has unique shear-thinning properties that allow the material to be injected, quickly stop flowing and then cure to stay in place, which is highly desirable for 3D bioprinting applications.

"This formulation using nanoclay sequesters the therapeutic of interest for increased cell activity and proliferation," said Dr. Charles W. Peak, senior author on the study. "In addition, the prolonged delivery of the bioactive therapeutic could improve cell migration within 3D printed scaffolds and can help in rapid vascularization of scaffolds."

Gaharwar said the prolonged delivery of the therapeutic could also reduce overall costs by decreasing the therapeutic concentration as well as minimizing the negative side effects associated with supraphysiological doses.

"Overall, this study provides proof of principle to print protein therapeutics in 3D that can be used to control and direct cell functions," he said.

Iron-doping of the topological insulator Sb2Te3 results in useful electronic and magnetic properties, quantified in a recent FLEET study at the University of Wollongong.

The researchers studied the magneto-transport properties of an iron-doped topological insulator (Fe-Sb2Te3).

After the material is doped via the addition of iron, its electronic structure changes significantly:

multiple response frequencies emerge, in contrast to the single frequency detected for Sb2Te3 in its pure form

carrier density and mobility is reduced.

"This improved understanding of the effects of doping on the topological insulator Sb2Te3 are critical to inform future possible use in low-energy electronics," explains project leader Xiaolin Wang.

BACKGROUND

Topological insulators (TIs) are novel materials that are neither electrical conductors, nor electrical insulators. Instead, a topological insulator is an insulator in its interior, but conducts along its edges (likened to a chocolate block wrapped in aluminium foil).

Topological insulators' unique 'Dirac' surface states are attractive for electronic applications and potentially host a range of fascinating and useful phenomena.

In three-dimensional (3D) topological insulators such as Sb2Te3, the surface electronic structure is entangled with the internal (bulk) electronic structure and, consequently, both aspects need to be understood at the fundamental level.

Unresolved questions concerning the effect of metal doping of Sb2Te3 is related to one of the most fascinating transport properties in topological insulators: the quantum anomalous Hall effect (QAHE).

QAHE describes an effect that was once 'unexpected' (ie, 'anomalous'): quantisation of the transverse 'Hall' resistance, accompanied by a considerable drop in longitudinal resistance.

It's an area of great interest for technologists," explains Xiaolin Wang. "They are interested in using this significant reduction in resistance to significantly reduce the power consumption in electronic devices."

The study of magnetic-doped topological insulators seeks to find the optimal set of dopants, magnetic order, and transport properties in order to:

Achieve a higher (near ambient) QAHE onset temperature

Eliminate unwanted features in the electronic structure introduced by the transition-metal dopant that are detrimental to performance.

THE STUDY

The study Quantum oscillations in iron-doped single crystals of the topological insulator Sb2Te3 was published in Physical Review B in April this year.

This project was led by Prof Xiaolin Wang, who is the theme Leader of ARC Fleet Enabling technology A and the Director of ISEM at the University of Wollongong.

As well as funding by the Australian Research Council, the research benefited from resources of Australia's National Computational Infrastructure (NCI).

NOVEL MATERIALS AT FLEET

The properties of novel materials such as the topological insulator Sb2Te3 are studied at FLEET, an Australian Research Council Centre of Excellence, within the Centre's Enabling technology A.

The Centre for Future Low-Energy Electronics Technologies (FLEET) is a collaboration of over a hundred researchers, seeking to develop ultra-low energy electronics to face the challenge of energy use in computation, which already consumes 8% of global electricity, and is doubling each decade.

Hyperspectral data comprises the full light spectrum; this dataset of continuous spectral information has many applications from understanding the health of the Great Barrier Reef to picking out more productive crop cultivars. To help researchers better predict high-yielding crop traits, a team from the University of Illinois have stacked together six high-powered, machine learning algorithms that are used to interpret hyperspectral data--and they demonstrated that this technique improved the predictive power of a recent study by up to 15 percent, compared to using just one algorithm.

"We are empowering scientists from many fields, who are not necessarily experts in computational analysis, to translate their enormous datasets into beneficial results," said first author Peng Fu, a postdoctoral researcher at Illinois, who led this work for a research project called Realizing Increased Photosynthetic Efficiency (RIPE). "Now scientists do not need to scratch their heads to figure out which machine learning algorithms to use; they can apply six or more algorithms--for the price of one--to make more accurate predictions."

RIPE, which is led by Illinois, is engineering crops to be more productive by improving photosynthesis, the natural process all plants use to convert sunlight into energy and yields. RIPE is supported by the Bill & Melinda Gates Foundation, the U.S. Foundation for Food and Agriculture Research (FFAR), and the U.K. Government's Department for International Development (DFID).

In a recent study, published in Remote Sensing of Environment, the team introduced spectral analysis as a means to quickly identify photosynthetic improvements that could increase yields. In this new study, published in Frontiers in Plant Science, the team improved their previous predictions of photosynthetic capacity by as much as 15 percent using machine learning, where computers automatically applied these six algorithms to their dataset without human help.

"I've loved seeing what's possible when you can use computational power to exploit the data for all its worth," said co-author Katherine Meacham-Hensold, a RIPE postdoctoral researcher at Illinois, who led the previous study in Remote Sensing of Environment. "It's exciting to see what a data analyst like Peng can do with my data. Now other non-data-analyst scientists can test several powerful algorithms to figure out which one will help them leverage their data to the fullest extent."

However, more studies are needed to prove the relevance of this stacked algorithm technique to the plant science community and other fields of study.

"By applying the expertise of data analysts to address the needs of plant physiologists like myself, we ended up refining a technique that is relevant to other hyperspectral datasets," said co-author Carl Bernacchi, a RIPE research leader and scientist with the U.S. Department of Agriculture, Agricultural Research Service, who is based at Illinois' Carl R. Woese Institute for Genomic Biology. "The next step is to test more stacked machine learning algorithms on datasets from many more crop species and explore the utility of this technique to estimate other parameters, such as abiotic stresses from drought or disease."

"As scientists, we should try to use our domain knowledge to explain advanced performance from machine learning methods," said co-author Kaiyu Guan, an assistant professor in Illinois' College of Agriculture, Consumer, and Environmental Sciences (ACES). "Combining computational methods and domain disciplines allows us to possibly unravel what causes the measurable differences in hyperspectral datasets--which is an unsolved mystery in our work and worth future exploration."

SMU Office of Research & Tech Transfer - At the movies, scientific discoveries are often portrayed as a Eureka moment in the laboratory. Reality, however, couldn't be more different - early-stage academic inventions often require long cycles of testing, validation and regulatory approvals before they can be turned into something useful, such as a new vaccine.

In a new study published in Research Policy, Associate Professor Reddi Kotha from the Lee Kong Chian School of Business at Singapore Management University and colleagues Phil Kim, Sebastian Fourne, and Kristof Coussement investigated how one type of early-stage opportunity - university-based academic inventions - are selected to receive support from their technology transfer offices (TTOs).

"If you want to study uncertainty, there is no better place to study it than very, very early stage scientific inventions. You have to imagine its potential to many different industries, and you also have to imagine all the development that is required to turn it into products and services. There is very little information to make the decision, making it quite a 'leap of faith'," Professor Kotha said.

Using a quantitative, top-down, textual analytical technique, the researchers studied nearly 700 invention evaluation reports from the oldest university TTO in the world, over a seven-year period from 1998 to 2005. These are three- to four-page reports on the commercial potential of the invention, written by a member of the TTO with domain knowledge.

"There are two dimensions that our evaluators think about - feasibility and desirability. Feasibility is whether the outcome can be achieved, and desirability is how useful the invention is, whether it can change people's lives," Professor Kotha said.

In terms of feasibility, their study showed that text that indicated doubt and lack of maturity was associated with a 10% decline and 15% decline in budgetary support, respectively. In terms of desirability, background familiarity and scientific complexity was associated with a 13% and 10% improvement in budgetary support, respectively.

According to Professor Kotha, the work has broader implications to management situations in which early-stage opportunities are evaluated for resource commitments. These could include proposals written by business unit directors, venture capital investors, individuals seeking crowdfunding, non-profit organisations and even Hollywood film studios. Considering that the majority of bets seldom yield positive returns, seeking out the most promising proposals could make a significant difference to an organisation's success.

"Conventional thinking is that we have to take a bet on the individual for early ideas. But we also need to develop some expertise in thinking about how to evaluate novel ideas beyond relying heavily on the signal of past reputation," Professor Kotha said. "Valuable ideas can come from anybody, and young scientists and young entrepreneurs may have truly transformative inventions and ideas, respectively. We in management theory would like to develop models and tools to access, evaluate and carry forward good ideas, from whoever they may come from."

This recent study is part of series of studies published in the Academy of Management Journal (2013), Harvard Business Review (November 2014) and Research Policy (2018), where Professor Kotha and collaborators studied how science is turned into products and services.

Nuclear--Tiny test fuels

For the first time, Oak Ridge National Laboratory has completed testing of nuclear fuels using MiniFuel, an irradiation vehicle that allows for rapid experimentation. The compact experiment, which was irradiated at ORNL's High Flux Isotope Reactor and then examined to see how the fuel responded, comprises a miniature target that holds pinhead-size fuel kernels. Conventional fuel tests use pellets with volumes more than 1,000 times that size. MiniFuel's small size helps researchers better control variables and accelerate burnup conditions during irradiation. "Fuel performance testing is extremely complex, and it is difficult to interpret the data because so much is happening across the fuel pellet," said ORNL's Chris Petrie, who developed the concept. "With MiniFuel, we can isolate conditions, test specific fuel phenomena and acquire performance data much faster." The first tests are focused on uranium nitride fuel for light water reactors--a fuel type lacking performance data. [Contact: Jason Ellis, (865) 241-5819; ellisjk@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/2019-05/MiniFuel_2019-P03618.jpg

Caption: The ORNL-designed MiniFuel significantly decreases the size of fuel specimens and capsules that are irradiated in ORNL's High Flux Isotope Reactor. The smaller experiments allow researchers to better control various conditions during irradiation and improve interpretation of data during post-irradiation examination. Credit: Carlos Jones/Oak Ridge National Laboratory, U.S. Dept. of Energy

Computing--Routing out the bugs

A study led by Oak Ridge National Laboratory explored the interface between the Department of Veterans Affairs' healthcare data system and the data itself to detect the likelihood of errors and designed an auto-surveillance tool to help improve overall quality and safety. The team's computing method can scan data for more than one million patients and push system error alerts for the VA to review and address. "Similar surveillance tools can detect human errors, but our major focus is routing out machine-generated errors that could lead to unintended consequences in health IT," said ORNL's Olufemi (Femi) Omitaomu, co-author of the published study. Feedback from the VA's review informs improvements to the surveillance tool. The next phase will involve machine learning techniques for smarter, faster error detection. Over time, the VA's platform will run more smoothly, accurately and efficiently in real-time, enabling a quicker response to potentially unsafe conditions in or functionality of health IT. [Contact: Sara Shoemaker, (865) 576-9219; shoemakerms@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/2019-05/CADES2019-P00182.jpg

Caption: An ORNL-developed computing method can scan data for more than one million patients and push system error alerts for the Department of Veterans Affairs to review and address. Part of ORNL's computing team includes, from left, Ozgur Ozmen, Mohammed M. Olama, Mark Martin, Hilda B. Klasky and Olufemi A. Omitaomu. Credit: Carlos Jones/Oak Ridge National Laboratory, U.S. Dept. of Energy

Materials--Engineering heat transport

Scientists have discovered a way to alter heat transport in thermoelectric materials, a finding that may ultimately improve energy efficiency as the materials convert heat flow into electricity. Caltech theorists simulating the thermoelectric material lead selenide saw something surprising--a thermal wave that did not propagate. They determined the trick to potentially increasing energy efficiency in this material was to stop heat-carrying vibrational waves without thwarting electricity-bearing electrons. To verify the discovery, they called on experimentalists to probe a real crystal. "Vibrational waves stop propagating in a perfect crystal because of nonlinear interactions between phonons," said Michael Manley of Oak Ridge National Laboratory. The experiment used neutron scattering at ORNL's Spallation Neutron Source and the National Institute of Standards and Technology's Center for Neutron Research and X-ray scattering at Argonne National Laboratory's Advanced Photon Source. The discovery improves understanding of thermoelectric performance and may enable unconventional heat transport in future materials. [Contact: Dawn Levy, (865) 576-6448; levyd@ornl.gov]

Image: https://www.ornl.gov/sites/default/files/2019-05/Materials-Engineering_heat_transport_0.png

Caption: In a perfect thermoelectric crystal, vibrational waves decompose and localize. A diagram of simulated phonon energy versus momentum reveals exactly where heat transport stops because of vibrations interfering nonlinearly--the flat band between the curved top and V-shaped bottom bands. Credit: Michael Manley/Oak Ridge National Laboratory, U.S. Dept. of Energy

Drinking coffee might keep us up at night, but new research has given us a reason to sleep easy knowing that the popular drink isn't as bad for our arteries as some previous studies would suggest.

The research from Queen Mary University of London has shown that drinking coffee, including in people who drink up to 25 cups a day, is not associated with having stiffer arteries.

The research, led by Professor Steffen Petersen, was presented today at the British Cardiovascular Society (BCS) Conference in Manchester and part-funded by the British Heart Foundation (BHF).

Arteries carry blood containing oxygen and nutrients from your heart to the rest of your body. If they become stiff, it can increase the workload on the heart and increase a person's chance of having a heart attack or stroke.

The study of over 8,000 people in the UK debunks previous studies that claimed drinking coffee increases arterial stiffness. Previous suggestions that drinking coffee leads to stiffer arteries are inconsistent and could be limited by lower participant numbers, according to the team behind this new research.

Coffee consumption was categorised into three groups for the study. Those who drink less than one cup a day, those who drink between one and three cups a day and those who drink more than three. People who consumed more than 25 cups of coffee a day were excluded, but no increased stiffening of arteries was associated with those who drank up to this high limit when compared with those who drank less than one cup a day.

The associations between drinking coffee and artery stiffness measures were corrected for contributing factors like age, gender, ethnicity, smoking status, height, weight, how much alcohol someone drank, what they ate and high blood pressure.

Of the 8,412 participants who underwent MRI heart scans and infrared pulse wave tests, the research showed that moderate and heavy coffee drinkers were most likely to be male, smoke, and consume alcohol regularly.

Dr Kenneth Fung, who led the data analysis for the research at Queen Mary University of London, said:

"Despite the huge popularity of coffee worldwide, different reports could put people off from enjoying it. Whilst we can't prove a causal link in this study, our research indicates coffee isn't as bad for the arteries as previous studies would suggest.

"Although our study included individuals who drink up to 25 cups a day, the average intake amongst the highest coffee consumption group was 5 cups a day. We would like to study these people more closely in our future work so that we can help to advise safe limits."

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said:

"Understanding the impact that coffee has on our heart and circulatory system is something that researchers and the media have had brewing for some time.

"There are several conflicting studies saying different things about coffee, and it can be difficult to filter what we should believe and what we shouldn't. This research will hopefully put some of the media reports in perspective, as it rules out one of the potential detrimental effects of coffee on our arteries."

Ask just about any parent whether napping has benefits and you'll likely hear a resounding "yes," particularly for the child's mood, energy levels, and school performance. New research from the University of Pennsylvania and the University of California, Irvine, published in the journal SLEEP backs up that parental insight.

A study of nearly 3,000 fourth, fifth, and sixth graders ages 10-12 revealed a connection between midday napping and greater happiness, self-control, and grit; fewer behavioral problems; and higher IQ, the latter particularly for the sixth graders. The most robust findings were associated with academic achievement, says Penn neurocriminologist Adrian Raine, a co-author on the paper.

"Children who napped three or more times per week benefit from a 7.6% increase in academic performance in Grade 6," he says. "How many kids at school would not want their scores to go up by 7.6 points out of 100?"

Sleep deficiency and daytime drowsiness are surprisingly widespread, with drowsiness affecting up to 20% of all children, says lead author on the study Jianghong Liu, a Penn associate professor of nursing and public health. What's more, the negative cognitive, emotional, and physical effects of poor sleep habits are well-established, and yet most previous research has focused on preschool age and younger.

That's partially because in places like the United States, napping stops altogether as children get older. In China, however, the practice is embedded into daily life, continuing through elementary and middle school, even into adulthood. So, Liu and Raine, with Penn biostatistician Rui Feng, UC Irvine sleep researcher Sara Mednick and others, turned to the China Jintan Cohort Study, established in 2004 to follow participants from toddlerhood through adolescence.

From each of 2,928 children, the researchers collected data about napping frequency and duration once the children hit Grades 4 through 6, as well as outcome data when they reached Grade 6, including psychological measures like grit and happiness and physical measures such as body mass index and glucose levels. They also asked teachers to provide behavioral and academic information about each student. They then analyzed associations between each outcome and napping, adjusting for sex, grade, school location, parental education, and nightly time in bed.

It was the first comprehensive study of its kind, Mednick says. "Many lab studies across all ages have demonstrated that naps can show the same magnitude of improvement as a full night of sleep on discrete cognitive tasks. Here, we had the chance to ask real-world, adolescent schoolchildren questions across a wide range of behavioral, academic, social, and physiological measures."

Predictably, she adds, "the more students sleep during the day, the greater the benefit of naps on many of these measures."

Though the findings are correlational, the researchers say they may offer an alternative to the outcry from pediatricians and public health officials for later school start times. "The midday nap is easily implemented, and it costs nothing," says Liu, particularly if accompanied by a slightly later end to the day, to avoid cutting into educational time. "Not only will this help the kids, but it also takes away time for screen use, which is related to a lot of mixed outcomes."

Future directions could look at why, for example, children with better-educated parents nap more than children with less educated parents, or whether, by investigating the influence of culture and personality, nap interventions could be advanced on a global scale. Ideally, a randomized control trial would get at causation questions like whether napping leads to better academic achievement or whether they're linked in some other way. However, none of this is yet in the works.

For now, the researchers say they hope the results of this current study can inform future interventional work that targets adolescent sleepiness.

ANN ARBOR, Michigan - A technique that illuminates blood flow during surgery predicted which head and neck cancer patients were likely to have issues with wound healing. It could enable surgeons to make adjustments during surgery or recovery to improve outcomes.

A team of surgeons at the University of Michigan Rogel Cancer Center found the approach so successful in a clinical trial that they closed the study early.

Most people with larynx cancer will have radiation and chemotherapy. But about one-third of the time, the cancer will return or will prove resistant, leaving surgery as the next option.

At this point, tissue damage from the radiation adds challenges to the operation. When the surgeon closes the wound, damaged tissue can interfere. For about 40% of patients, this will lead to a pharyngocutaneous fistula, a hole in the neck where saliva can leak out. It can cause bleeding or infections, keeping patients in the hospital longer, and in 10% of cases sending them back to the operating room to fix it.

"Radiation damage is something you can't always see. There have been very few examples in the literature that would explain or predict who's going to have a complication," says Matthew E. Spector, M.D., assistant professor of otolaryngology-head and neck surgery at Michigan Medicine. Spector is the senior author on a paper made available online in February ahead of final print publication in May in Annals of Surgical Oncology.

Researchers enrolled 41 patients who were undergoing laryngectomy after radiation. After removing the tumor but before closing the throat, anesthesiologists gave the patients an intravenous injection of a type of medical dye, indocyanine green. The dye circulates within about 40 seconds. Surgeons then use laser angiography, which illuminates the dye, allowing them to observe blood flow.

The results were clear-cut: patients with lower blood flow had a significantly higher risk of developing a fistula, whereas patients with high blood flow had a very low risk of wound complications.

Knowing this, Spector suggests a few possible interventions. One could be cutting out a wider margin of tissue to get a cleaner, healthier edge. Another possibility is to keep high-risk patients in the hospital longer, while sending the low-risk patients home more quickly.

The laser angiography approach would be straightforward to implement in many setting. It's already used by other surgeons, including in breast reconstruction, so many hospitals already own the equipment. The technique has little impact on patients because it can be administered so quickly while they are still under anesthesia. Reactions to the indocyanine are minimal.

Researchers are developing a randomized clinical trial to assess whether cutting back more tissue leads to fewer fistulas in the high-risk group.

"We need to find an intervention that can lower this risk," Spector says.

HUNTINGTON, W.Va. -- New research from a team at the Marshall University Joan C. Edwards School of Medicine establishes a role of adipocyte Na/K-ATPase signaling in worsening obesity and its companion diseases, including neurodegeneration and non-alcoholic steatohepatitis (NASH), that was enhanced by specific targeting of NaKtide, an antagonist of Na/K-ATPase signaling, to the adipocyte.

The findings are published in the May 28, 2019, edition of Scientific Reports, an online journal from the publishers of Nature.

"I am very excited about the work in the current Scientific Reports article and the clinical relevance it presents for the role of adipocytes in obesity and other disease states," said Komal Sodhi, M.D., senior author, and associate professor of surgery and biomedical sciences at the Joan C. Edwards School of Medicine.

The results from this study at Marshall University demonstrate that the Na/K-ATPase oxidant amplification loop in adipocytes, or cells specialized for fat storage, when impaired, could cause adipocyte dysfunction, worsening obesity and potentially increasing the severity of related diseases. The basis of the research examined more closely the role of the adipocyte in obesity, including how it impacts oxidative stress, inflammation, neurodegeneration and NASH. The researchers were able to successfully demonstrate through decreased adiposity and an improved metabolic profile the therapeutic potential of targeting NaKtide to the adipocytes.

"Our data clearly suggests that obesity and the Na/K-ATPase oxidant amplification loop plays a role in neurodegeneration," said first author Rebecca Pratt, a Ph.D. candidate in the department of biomedical research at Marshall University. "Even targeting NaKtide to adipocytes alone still showed a whole-body effect, which highlights the much larger role that adipocytes play in obesity and whole body homeostasis."

This work builds on the body of work initiated by Marshall Institute for Interdisciplinary Research (MIIR) Director Zijian Xie, Ph.D., on the previously unappreciated signaling function of the NaK-ATPase. To read the article its entirety, please visit https://www.nature.com/articles/s41598-019-44350-9.

The use of satellite telemetry in conservation is entering a "golden age," and is now being used to track the movements of individual animals at unprecedented scales.

To determine the success or failure of satellite tracking devices across species and habitats, authors analyzed data from over 3,000 devices deployed on 62 terrestrial species in 167 projects worldwide

While the analysis showed that 48 percent of the unit deployments ended prematurely - half of them due to technical failure - the study showed that the performance of satellite telemetry applications has shown improvements over time, and based on the findings, recommendations are provided for both users and manufacturers.

DURHAM, N.C. - Recent studies have suggested that people who experience the impacts of hurricanes, catastrophic flooding or other severe weather events are more likely to believe in, and be concerned about, climate change in the wake of the disaster.

But a new study by researchers at Duke University and the University of Colorado Denver (UCD) finds that not all severe weather impacts have the same effect.

"How our community or neighborhood fares -- the damages it suffers -- may have a stronger and more lasting effect on our climate beliefs than individual impacts do," said Elizabeth A. Albright, assistant professor of the practice of environmental science and policy methods at Duke's Nicholas School of the Environment.

"We found that damage at the zip-code level as measured by FEMA was positively associated with stronger climate change beliefs even three or four years after the extreme flooding event our study examined," Albright said.

People who perceived that damage had occurred at such a broad scale were more likely to believe that climate change is a problem and is causing harm, she explained. They were also more likely to perceive a greater risk of future flooding in their community.

In contrast, individual losses such as damage to one's own house appeared to have a negligible long-term impact on climate change beliefs and perceptions of future risks.

"These findings speak to the power of collective experiences and suggest that how the impacts from extreme weather are conceptualized, measured and shared matters greatly in terms of influencing individual beliefs," said Deserai Crow, associate professor of public affairs at UCD.

Albright and Crow published their peer-reviewed paper May 31 in the journal Climatic Change.

To conduct their study, in 2016 and 2017 they surveyed residents of six Colorado communities -- Boulder, Longmont, Lyons, Estes Park, Loveland and Evans -- that had suffered devastating flooding after days of intense rainfall dropped nearly a year's worth of precipitation in mountains upstream from them in September 2013.

The surveys queried residents about their climate change beliefs, their perception of the extent of damage caused by the 2013 flooding, and their perception of future flood risks in their neighborhood. It also asked for personal information, such as political affiliation.

In each community, 150 surveys were sent to randomly selected homes in areas that had been inundated by the flood and 350 surveys were sent to randomly selected homes in neighborhoods that had been spared. A total of 903 surveys were completed and returned, for an overall response rate of about 17%.

"As expected, we found that political affiliation was related to the extent to which flood experience affected a person's climate beliefs," said Crow, who is also an affiliate with the Center for Science & Technology Policy Research at the University of Colorado Boulder.

This partisan divide did not extend to perceptions of future floods risks, she noted. Republicans and Democrats perceived similar levels of risk, regardless of whether or not they attributed it to human-caused climate change.

"It's important that we understand these differences and commonalities if we want to build back better and more resiliently after a severe weather disaster," Albright said. "As climate change plays out and we see more frequent extreme weather and floods, how communities respond to those events may predict how resilient they become and how they will recover."

MONTREAL, QC (30 May 2019)

Treatment guidelines for managing anaphylaxis in children should be reassessed, according to a new Canadian study published in the Journal of Allergy and Clinical Immunology: In Practice.

Involving nearly 3,500 patients, it is the largest study to assess the clinical outcomes of pre-hospital treatment of anaphylaxis, including the use of epinephrine autoinjector, antihistamines (such as diphenhydramine known most commonly as its brand name Benadryl) and corticosteroids. Of the patients examined, 80 percent were children aged 1 to 17 years.

"We found that steroids, which are part of the treatment plan for managing anaphylaxis, can have a negative effect on patient outcomes," says AllerGen researcher Dr. Moshe Ben-Shoshan, a pediatric allergist and immunologist at the Research Institute of the McGill University Health Centre (RI-MUHC) and at the Montreal Children's Hospital of the MUHC.

The researchers found that admission to the intensive care unit or the hospital ward was nearly three times more likely in cases where anaphylaxis was treated with steroids in the pre-hospital setting (e.g.: at home, at school, or with the paramedics).

"Although we could not comment on the use of steroids in the emergency department (ED) specifically, our results suggest that their role in anaphylaxis management guidelines should be reassessed," adds Dr. Ben-Shoshan, who is also an assistant professor of Pediatrics at McGill University.

The researchers analyzed data from nine EDs in five provinces across the country between 2011 and 2017, as part of AllerGen's nationwide Cross-Canada Anaphylaxis REgistry (C-CARE) project. C-CARE is led by Dr. Ben-Shoshan and is the first prospective study on anaphylaxis to assess the rate, triggers and management of anaphylaxis in different provinces and settings.

Anaphylaxis, a sudden and potentially life-threatening allergic reaction, was defined in the study as a reaction affecting at least two organ systems (e.g.: problems breathing, hives on the skin, and/or a sudden drop in blood pressure).

The study also highlighted the benefit of using an epinephrine autoinjector to manage anaphylaxis.

"Our study shows, for the first time, that the use of an epinephrine autoinjector in the prehospital setting has a significant positive impact on the clinical management of anaphylaxis," says first author Sofianne Gabrielli, an AllerGen trainee and a research associate at the RI-MUHC. "We looked at the use of both epinephrine and antihistamines and found that when an epinephrine autoinjector was used before arriving at the hospital, patients were nearly five times less likely to require multiple doses of epinephrine in the ED to control anaphylaxis. This protective effect was much more significant than the protection achieved with antihistamines."

According to the researchers, these results suggest that current anaphylaxis management practices should be modified, at least as applies to the pre-hospital setting, to exclude steroids and to call for the administration of antihistamines only in conjunction with epinephrine in all cases of anaphylaxis.

"It is concerning that less than one-third of reactions were treated with an epinephrine autoinjector prior to arriving at the hospital," comments Jennifer Gerdts, a study co-author and Executive Director of Food Allergy Canada, a non-profit charitable organization that educates, supports and advocates for Canadians with food allergies and those who care for them.

"The findings from this study reinforce the need to equip individuals with the knowledge and confidence to assess the signs and symptoms of anaphylaxis, and to treat it swiftly with an epinephrine autoinjector when it occurs. Our current Give and Go campaign is one educational initiative intended to achieve this, but much more is required to understand and address this significant gap."

Among the study's other findings:

Less than one-third (31 percent) of anaphylactic reactions were treated with epinephrine before arriving at the hospital. Antihistamines were used in 46 percent of cases and steroids in 2 percent of cases in the pre-hospital setting.

The majority of the anaphylactic reactions were caused by food (79 percent), while 5 percent were caused by drugs and 2 percent by venom.

The most common food triggers causing anaphylaxis were peanut (21 percent), tree nut (15 percent), egg (7 percent), and milk (7 percent).

The majority of anaphylactic reactions were of moderate severity (74 percent) and the most common settings in which reactions occurred was at home (55 percent).

Researchers from Japan have demonstrated that a long-elusive kind of laser diode based on organic semiconductors is indeed possible, paving the way for the further expansion of lasers in applications such as biosensing, displays, healthcare, and optical communications.

Long considered a holy grail in the area of light-emitting devices, organic laser diodes use carbon-based organic materials to emit light instead of the inorganic semiconductors, such as gallium arsenide and gallium nitride, used in traditional devices.

The lasers are in many ways similar to organic light-emitting diodes (OLEDs), in which a thin layer of organic molecules emits light when electricity is applied. OLEDs have become a popular choice for smartphone displays because of their high efficiency and vibrant colors, which can easily be changed by designing new organic molecules.

Organic laser diodes produce a much purer light enabling additional applications, but they require currents that are magnitudes higher than those used in OLEDs to achieve the lasing process. These extreme conditions caused previously studied devices to break down well before lasing could be observed.

Further complicating progress, previous claims of electrically generated lasing from organic materials turned out to be false on several occasions, with other phenomena being mistaken for lasing because of insufficient characterization.

But now, scientists from the Center for Organic Photonics and Electronics Research (OPERA) at Kyushu University report in the journal Applied Physics Express that they have enough data to convincingly show that organic semiconductor laser diodes have finally been realized.

"I think that many people in the community were doubting whether we would actually one day see the realization of an organic laser diode," says Atula S. D. Sandanayaka, lead author on the paper, "but by slowing chipping away at the various performance limitations with improved materials and new device structures, we finally did it."

A critical step in lasing is the injection of a large amount of electrical current into the organic layers to achieve a condition called population inversion. However, the high resistance to electricity of many organic materials makes it difficult to get enough electrical charges in the materials before they heat up and burn out.

On top of that, a variety of loss processes inherent to most organic materials and devices operating under high currents lowers efficiency, pushing the necessary current up even higher.

To overcome these obstacles, the research group led by Prof. Chihaya Adachi used a highly efficient organic light-emitting material (BSBCz) with a relatively low resistance to electricity and a low amount of losses--even when injected with large amounts of electricity. But having the right material alone was not enough.

They also designed a device structure with a grid of insulating material on top of one of the electrodes used to inject electricity into the organic thin films. Such grids--called distributed feedback structures--are known to produce the optical effects required for lasing, but the researchers took it one step further.

"By optimizing these grids, we could not only obtain the desired optical properties but also control the flow of electricity in the devices and minimize the amount of electricity required to observe lasing from the organic thin film," says Adachi.

The researchers are so confident in the promise of these new devices that they founded the startup company KOALA Tech Inc.--short for Kyushu Organic Laser Technology Inc.--on March 22, 2019, to accelerate research and overcome the final obstacles remaining for using the organic laser diodes in commercial applications.

The founding members of KOALA Tech Inc., Prof. Chihaya Adachi, Dr. Jean-Charles Ribierre, Dr. Fatima Bencheikh, and Dr. Takashi Fujihara, are now hard at work improving the performance of their organic laser diodes to bring this most advanced organic light-emitting technology to the world.

When you peer into the night sky, much of what you see is plasma, a soupy amalgam of ultra-hot atomic particles. Studying plasma in the stars and various forms in outer space requires a telescope, but scientists can recreate it in the laboratory to examine it more closely.

Now, a team of scientists led by physicists Lan Gao of the U.S. Department of Energy's (DOE) Princeton Plasma Physics Laboratory (PPPL) and Edison Liang of Rice University, has for the first time created a particular form of coherent and magnetized plasma jet that could deepen the understanding of the workings of much larger jets that stream from newborn stars and possibly black holes -- stellar objects so massive that they trap light and warp both space and time.

"We are now creating stable, supersonic, and strongly magnetized plasma jets in a laboratory that might allow us to study astrophysical objects light years away," said astrophysicist Liang, co-author of the paper reporting the results in the Astrophysical Journal Letters.

The team created the jets using the OMEGA Laser Facility at the University of Rochester's Laboratory for Laser Energetics (LLE). The researchers aimed 20 of OMEGA's individual laser beams into a ring-shaped area on a plastic target. Each laser created a tiny puff of plasma; as the puffs expanded, they put pressure on the inner region of the ring. That pressure then squeezed out a plasma jet reaching over four millimeters in length and created a magnetic field that had a strength of over 100 tesla.

"This is the first step in studying plasma jets in a laboratory," said Gao, who was the primary author of the paper. "I'm excited because we not only created a jet. We also successfully used advanced diagnostics on OMEGA to confirm the jet's formation and characterize its properties."

The diagnostic tools, developed with teams from LLE and the Massachusetts Institute of Technology (MIT), measured the jet's density, temperature, length, how well it stayed together as it grew through space, and the shape of the magnetic field around it. The measurements help scientists determine how the laboratory phenomena compare to jets in outer space. They also provide a baseline that scientists can tinker with to observe how the plasma behaves under different conditions.

"This is groundbreaking research because no other team has successfully launched a supersonic, narrowly beamed jet that carries such a strong magnetic field, extending to significant distances," said Liang. "This is the first time that scientists have demonstrated that the magnetic field does not just wrap around the jet, but also extends parallel to the jet's axis," he said.

The researchers hope to expand their research with larger laser facilities and investigate other types of phenomena. "The next step involves seeing whether an external magnetic field could make the jet longer and more collimated," Gao said.

"We would also like to replicate the experiment using the National Ignition Facility at Lawrence Livermore National Laboratory, which has 192 laser beams, half of which could be used to create our plasma ring. It would have a larger radius and thus produce a longer jet than that produced using OMEGA. This process would help us figure out under which conditions the plasma jet is strongest."