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Frequent home hemodialysis linked to lower mortality risk vs. traditional hemodialysis

San Diego, CA (October 26, 2018) -- A new study has uncovered a survival advantage associated with more frequent home hemodialysis compared with traditional hemodialysis. The findings will be presented at ASN Kidney Week 2018 October 23-October 28 at the San Diego Convention Center.

Home hemodialysis (HHD) is an alternative to traditional in-center hemodialysis (IHD) performed at a dialysis facility. To compare survival rates among patients who choose these different types of dialysis when they are first beginning treatment, Eric Weinhandl, PhD, MS (NxStage Medical, Inc. and University of Minnesota, Minneapolis) and his colleagues analyzed data from the United States Renal Data System on 1,773 HHD patients and 555,366 IHD patients.

Survival after one year of follow-up was 91.7% and 81.4% in HHD and IHD patients, respectively. After adjustments, HHD patients were 23% less likely to die during follow-up than IHD patients. Dr. Weinhandl noted that this likely reflects the combined effects of better care coordination and education before dialysis initiation and better volume and pressure management due to increased hemodialysis frequency.

Within age strata, the risk of death associated with HHD was 46% lower for 20-44 years, 26% lower for 45-64 years, and 11% lower for ?65 years. Within kidney function strata, the risk of death associated with HHD was 32% lower for estimated GFR

"The survival difference favoring more frequent home hemodialysis was largest in patients aged 20 to 44 years and attenuated with increasing age; however, the survival difference favoring home hemodialysis did not significantly differ across the range of estimated GFR at dialysis initiation," said Dr. Weinhandl. "Unfortunately, less than 1% of new dialysis patients were prescribed home hemodialysis."

Dr. Weinhandl added that there is growing interest in transitional care units, in which new dialysis patients may be treated with more frequent hemodialysis and are also educated about different types of dialysis, with the aim of encouraging more patients to select home dialysis. "These data support the concept of transitional care units and targeting greater utilization of home hemodialysis among new dialysis patients," he said.

Credit: 
American Society of Nephrology

'Navigator' neurons play critical role in sense of smell

image: This image shows individual olfactory sensory axons (thin fibers) labeled with adenoviruses traversing through the olfactory bulb and terminating in their target glomerulus. Cell nuclei in the brain are stained in blue.

Image: 
Yu Lab, Stowers Institute for Medical Research

KANSAS CITY, MO - Researchers at the Stowers Institute for Medical Research have identified "navigator" neurons that are key to setting up connections in the system responsible for the sense of smell. The new study builds on a breakthrough 2014 report from the laboratory of Stowers Investigator Ron Yu, Ph.D., which showed a critical period in olfactory wiring using mice as a model system.

The olfactory system depends on a complex web of neural connections to detect odors. Olfactory sensory neurons in the nose pass information through their axons to the brain's olfactory bulb for further processing. Neurons with the same receptor reach out, or project their axons, and connect to the same spot in the brain, called a glomerulus. This convergence forms an olfactory map, and it acts as a kind of code book for the scents we encounter. Glitches in the map's wiring affect how scents are perceived.

Previously, researchers thought that since olfactory neurons regenerate and replace themselves throughout the life of an animal, they kept the ability to re-establish correct connections. Yu and his team found that wasn't the case. They used a number of transgenic mouse lines to demonstrate that the first week after birth is a critical window of time to fix problems. If mis-targeting is not corrected during this period, cells still regenerate, but many get locked onto the wrong tracks.

In their follow-up report published online October 25, 2018, in Neuron, the researchers detail the unexpected discovery of a group of olfactory sensory neurons, or navigator neurons, that play an essential role in establishing the olfactory map and correcting faulty connections.

"The results indicate that the map of neural connectivity is set early in life by a group of neurons that only exist during the critical period. Neurons generated at an adult stage do not have this capacity," says first author Yunming Wu, Ph.D. At the time the research was conducted, Wu was a predoctoral researcher with Open University.

The discovery of navigator neurons is the culmination of five years of research conducted in the Yu lab, aimed at distinguishing early-born neurons from later-born neurons. Because navigator neurons look identical and function the same as neurons born later, it took a variety of creative approaches to finally pinpoint them.

The researchers used a combination of approaches and technologies to identify the neurons. Chronogenetic tracking, a method developed in the lab, allowed them to trace a neuron's lifespan using genetic labeling across a mouse's entire life. They constructed an adenovirus to carry genes into the neurons so they could clearly label individual axons emanating from the neurons. By combining virus labeling and CLARITY, a technique that makes samples of mouse brain tissue transparent, they obtained entire trajectories of axon projection into the olfactory bulb. They also used single-cell transcriptome analysis to characterize the molecular identity of the cells and changes of gene expression during development. Used together, these methods demonstrated that navigator neurons are distinct from other olfactory sensory neurons.

The researchers found that the neurons undergo a phase of exuberant axon growth and have a shortened lifespan, as well as distinct molecular signatures. By extending the lifespan of navigator neurons, they prolonged their period of exuberant growth and stopped the axons from converging. They also found that while all of the olfactory sensory nerves were able to regenerate, only the navigators had the ability to establish a convergent map. Navigator neurons also have very different trajectories when they're projecting during early development - roaming around instead of going straight to the glomeruli. This behavior may help them correct improper connections, because they are able to find new connections by sampling a much larger area.

Learning more about the mechanisms driving navigator neurons, and their role in establishing olfactory map wiring, could hold promise for regenerating and repairing olfactory neurons and neurons in other types of neural systems, such as those involved in spinal cord injury. Finding out how to make later-born neurons that have lost their ability to regenerate and connect correctly behave like navigator neurons might be the key.

"We know that when there's trauma-related anosmia, the sense of smell is lost because of the severing of connection from sensory neurons to the olfactory bulb. When the axons get cut, even when they regenerate, if they cannot re-form the connections properly, you would still lose the sense of smell or have an altered perception of smell," Yu says. "If we can understand this process involved in early development - if we can reopen the critical period- we may be able to let regenerating axons find the right target when they are projecting back. This study is a step towards that goal."

In addition to Yu and Wu, other study contributors from the Stowers Institute include Limei Ma, Ph.D., Kyle Duyck, Carter Long, Andrea Moran, Hayley Scheerer, Jillian Blanck, Allison Peak, and Andrew Box. This research was assisted by Stowers scientific support teams including Computational Biology, Cytometry, Laboratory Animal Services, Microscopy, and Molecular Biology.

The study was funded by the Stowers Institute for Medical Research and the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health (award R01DC016696). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Lay Summary of Findings

A newly discovered group of "navigator neurons" may hold the key to understanding the neural circuitry behind our sense of smell. The study builds on a breakthrough 2014 report from the laboratory of Stowers Investigator Ron Yu, Ph.D., that showed a critical period in olfactory wiring. Glitches in the wiring affect how scents are perceived. Yu and his colleagues found that in mice, there's a brief window to fix problems - about a week after mice are born.

In their follow-up report published online October 25, 2018, in Neuron, the researchers detail the surprise discovery of a group of olfactory sensory neurons, or "navigator" neurons, that play an essential role in establishing the olfactory map, a kind of code book for the scents we encounter. The navigator neurons also correct faulty wiring that can impair the sense of smell. Because navigator neurons look identical and function the same as other neurons, the Stowers researchers creatively employed a variety of approaches and technologies, some they developed themselves, to finally pinpoint them. Learning more about navigator neurons could hold promise for regenerating and repairing olfactory neurons and neurons in other types of neural systems, such as those involved in spinal cord injury.

Credit: 
Stowers Institute for Medical Research

Cigarette pictorial warning labels most effective when including body parts, testimonials

At least 120 countries around the world require pictorial warning labels on cigarette packages--for example, gangrene feet or a dead body--but the United States is notably missing from the list. Despite a 2009 Congressional act instructing the Food and Drug Administration (FDA) to implement pictorial warning labels, American cigarette packs still contain text-only warnings. A new court order issued in September 2018 says the FDA must speed up its timeline for the implementation of pictorial warning labels.

A new study from the Annenberg School for Communication at the University of Pennsylvania aims to contribute valuable research toward this end. Researchers analyzed more than 300 pictorial warning labels to determine which features most effectively get smokers to quit. They found that testimonial frameworks and images of diseased body parts were the most effective individual features.

"Humans act in response to our emotions," says Doctoral Candidate Jazmyne Sutton, lead study author. "When we feel a negative emotion--fear, disgust, etc.--we want to avoid the source of that emotion."

It makes sense, then, that images of diseased body parts and smoking horror stories told by real people would be most influential in getting smokers to stop smoking. No one wants to end up as the testimonial on a cigarette pack.

To analyze the various features used in pictorial warning labels, the researchers collected more than 300 warning labels from various sources. They used pictorial warning messages on cigarette packs in Australia, Canada, New Zealand, and the United Kingdom; pictorial warning messages proposed by the FDA that have not been implemented; a set of anti-smoking messages produced by tobacco companies; testimonial pictorial warning messages developed for an experimental study; and pictorial ads used in various local and national campaigns.

The researchers identified 48 objective features that could be present in the ads, including factors like image color, photo type, presence of male or female characters, presence of medical equipment, and argument type. They then recruited nearly 1,400 current smokers to view the ads and answer questions about how the ads affected them.

"A wide variety of studies from different countries show that pictorial warning labels are effective in curtailing smoking behavior," says senior author Joseph N. Cappella. "Our work seeks to isolate some of the specific elements that enhance and retard effectiveness to help guide future message designs."

The researchers say they hope that this study can offer generalizable guidelines for label designers to create more effective pictorial warning messages, which will eventually impact smoking-related attitudes and promote behavior change. In upcoming studies, they will focus on the relationship between text that appears on the labels and the pictorial elements.

The study, "Perceived Effectiveness of Objective Features of Pictorial Warning Messages," was published in Tobacco Control. Authors include: Doctoral Candidate Jazmyne Sutton, Doctoral Candidate Sijia Yang, and Professor Joseph N. Cappella.

Credit: 
University of Pennsylvania

Study: 4.6 percent of Massachusetts residents have opioid use disorder

Boston - A recent study estimates that more than 275,000 people - or 4.6 percent of people over the age of 11 in Massachusetts- have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. Led by researchers at Boston Medical Center, the study involved an analysis of several linked public health data sets, allowing for a more accurate picture of the impact of opioids in the state. Published online in the American Journal of Public Health, the results indicate that better surveillance systems need to be deployed locally and nationally to make more accurate opioid use disorder prevalence data available to better address the epidemic.

Traditional methods to estimate prevalence only count those who have interacted with the health care system, which are included in both state and national records. However, for those who don't encounter the system and perhaps overdose, they would not be included in any estimates. Individuals with substance use disorders are less likely to seek medical care or be insured. Additionally, when people are asked about sensitive topics, like drug use, by their provider or in a health survey, they typically don't self-report for many reasons, including stigma.

"There are many people with opioid use disorder who do not encounter the health care system, which we know is a barrier to understanding the true impact of the opioid epidemic," said Joshua Barocas, MD, an infectious disease physician at BMC who led the study. For this study, the researchers examined the Massachusetts Public Health Data Warehouse, a novel database that links data from 16 state agencies for a comprehensive analysis of health care system utilization and fatal and non-fatal opioid overdoses rates. Through a capture-recapture analysis, the researchers were able to identify those known to have an opioid use disorder based on their encounters with the health care system as well as estimate those who have the disorder but aren't included in the data.

According to the results, in 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Surprisingly, those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of "known" persons increased throughout the study period - from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015.

The data was also sorted by county, and counties with rural populations had some of the highest prevalence estimates, including: Barnstable (5.03 percent); Berkshire (6.06 percent); Bristol (5.81 percent); Hampden (5.34 percent); and Worcester (4.38 percent). For Suffolk County, which encompasses Boston, the prevalence in 2015 was 3.36 percent.

"Our methodology coupled with the data available from the Department of Public Health provides an innovative approach to more accurately assess opioid use disorder in Massachusetts, which indicates that the issue is more widespread than previous available data was showing," added Barocas, assistant professor of medicine at Boston University School of Medicine. "The information from linked databases can and should be implemented by other states trying to better understand and change the course of the opioid epidemic, which includes deploying resources in areas with the greatest need."

The researchers note that while fentanyl is likely a cause in the surge of overdoses in Massachusetts, the increased prevalence of opioid use disorder is likely also contributing to the continuing increase in overdose deaths. They also highlight that, given the clinical complexity of opioid use disorder, better surveillance can help increase the accuracy of diagnosing and treating the disease. Unlike diseases such as HIV or hepatitis C virus, where a blood test can diagnose a patient, opioid use disorder is based on a clinical diagnosis.

Credit: 
Boston Medical Center

Hallucinations associated with brain hyperactivity in people with macular degeneration

video: New research from The University of Queensland has shown for the first time that visual hallucinations in people with macular degeneration are associated with abnormally heightened activity in the visual cortex of the brain.

The findings, published in the journal Current Biology, could improve diagnosis of such hallucinations.

Researchers stimulated the peripheral visual fields of volunteers using screens showing letters and checkerboards, finding that individuals who experienced hallucinations show significantly heightened activity in particular parts of their visual system.

Image: 
The University of Queensland

New research from the University of Queensland has shown for the first time that visual hallucinations in people with macular degeneration are associated with abnormally heightened activity in the visual cortex of the brain.

The findings, published in the journal Current Biology, could improve diagnosis of such hallucinations.

Macular degeneration is a retinal eye disease that causes progressive deterioration of the central region of the retina, leading to visual loss in the centre of the field of vision, while peripheral vision usually remains unaffected. In Australia, MD is the leading cause of legal blindness in people over the age of 40.

Curiously, many people who develop MD go on to develop a condition known as Charles Bonnet Syndrome, in which they experience hallucinations as the brain adjusts to significant vision loss. The hallucinations can be simple geometric patterns, or much more complex scenes involving animals, people and places.

Why some people with MD experience hallucinations while others do not has remained unclear, but there have been suggestions that the activity levels - or 'excitability' - of certain visual regions of the brain could play a role.

To address this, Professor Jason Mattingley and his team from The University's Queensland Brain Institute and School of Psychology stimulated the peripheral visual fields of study participants and found that individuals with hallucinations do indeed show significantly heightened activity in particular parts of their visual system.

"We used electroencephalography (EEG) to measure brain electrical activity in three groups: a group with macular degeneration and Charles Bonnet hallucinations, a group with macular degeneration and no hallucinations, and a control group of visually-healthy elderly people," Dr David Painter - the paper's first author - said.

"Their task was to look at letters appearing on the screen in their periphery, and we flashed checkerboards at unique frequencies on the screen.

"We found that these checkerboards produced unique oscillations in visual areas of the brain that we can measure using mathematical techniques.

"The main finding is that when we drive activity in the visual system of people with macular degeneration who report experiencing hallucinations, there is a huge visual response compared with participants who have the same visual loss but don't have the hallucinations."

Dr Painter noted that while people with macular degeneration who experience hallucinations demonstrated visual hyperexcitability, the translation of this hyperexcitability into hallucinations was not automatic and is dependent on external triggers which are still not known.

"During the testing, none of our participants experienced hallucinations, so it's not that heightened excitability of the brain produces hallucinations - it's some other factor," Dr Painter said.

"Sometimes people have these hallucinations when they're in periods of low sensory stimulation, such as in low-light or periods of inactivity, but for others it can be triggered by things such as car rides or television - it varies for the individual."

"What our results say is that the brains of those reporting hallucinations are more excitable, but it still remains unclear how that excitability is then translated into hallucinations - that's a question for future research."

The findings could help reduce misdiagnosis of hallucinations in people with MD.

"When people get older and they start having these unusual experiences, they are often worried that something is wrong with them, such as dementia or something similar, so they tend to not report the hallucinations for fear they may be treated differently," Dr Painter said.

"Doctors sometimes don't recognise the disease either, and therefore can give people inappropriate medication; but our method potentially allows us to detect people who might have Charles Bonnet Syndrome by looking at their brain excitability in response to flickering stimuli."

"Once people realise it's not a brain disorder as such, they tend to have a neutral or even positive experience of their hallucinations. Unlike the hallucinations in people with schizophrenia, for example, individuals with Charles Bonnet Syndrome are aware their hallucinations aren't real."

Credit: 
University of Queensland

The ghost of Cassiopeia

image: IC 63 -- nicknamed the Ghost Nebula -- is about 550 light-years from Earth. The nebula is classified as both a reflection nebula -- as it is reflecting the light of a nearby star -- and as an emission nebula -- as it releases hydrogen-alpha radiation. Both effects are caused by the gigantic star Gamma Cassiopeiae. The radiation of this star is also slowly causing the nebula to dissipate.

Image: 
ESA/Hubble, NASA

About 550 light-years away in the constellation of Cassiopeia lies IC 63, a stunning and slightly eerie nebula. Also known as the ghost of Cassiopeia, IC 63 is being shaped by radiation from a nearby unpredictably variable star, Gamma Cassiopeiae, which is slowly eroding away the ghostly cloud of dust and gas. This celestial ghost makes the perfect backdrop for the upcoming feast of All Hallow's Eve -- better known as Halloween.

The constellation of Cassiopeia (constellation)], named after a vain queen in Greek mythology, forms the easily recognisable "W" shape in the night sky. The central point of the W is marked by a dramatic star named Gamma Cassiopeiae.

The remarkable Gamma Cassiopeiae is a blue-white subgiant that is surrounded by a gaseous disc. This star is 19 times more massive and 65 000 times brighter than our Sun. It also rotates at the incredible speed of 1.6 million kilometres per hour -- more than 200 times faster than our parent star. This frenzied rotation gives it a squashed appearance. The fast rotation causes eruptions of mass from the star into a surrounding disk. This mass loss is related to the observed brightness variations.

The radiation of Gamma Cassiopeiae is so powerful that it even affects IC 63, sometimes nicknamed the Ghost Nebula, that lies several light years away from the star. IC 63 is visible in this image taken by the NASA/ESA Hubble Space Telescope.

The colours in the eerie nebula showcase how the nebula is affected by the powerful radiation from the distant star. The hydrogen within IC 63 is being bombarded with ultraviolet radiation from Gamma Cassiopeiae, causing its electrons to gain energy which they later release as hydrogen-alpha radiation -- visible in red in this image.

This hydrogen-alpha radiation makes IC 63 an emission nebula, but we also see blue light in this image. This is light from Gamma Cassiopeiae that has been reflected by dust particles in the nebula, meaning that IC 63 is also a reflection nebula.

This colourful and ghostly nebula is slowly dissipating under the influence of ultraviolet radiation from Gamma Cassiopeiae. However, IC 63 is not the only object under the influence of the mighty star. It is part of a much larger nebulous region surrounding Gamma Cassiopeiae that measures approximately two degrees on the sky -- roughly four times as wide as the full Moon.

This region is best seen from the Northern Hemisphere during autumn and winter. Though it is high in the sky and visible all year round from Europe, it is very dim, so observing it requires a fairly large telescope and dark skies.

From above Earth's atmosphere, Hubble gives us a view that we cannot hope to see with our eyes. This photo is possibly the most detailed image that has ever been taken of IC 63, and it beautifully showcases Hubble's capabilities.

Credit: 
ESA/Hubble Information Centre

Study questions certain treatments for diabetic patients at high risk for heart disease

image: Visual Abstract

Image: 
Mottl

Highlights

In patients with type 2 diabetes at high risk for cardiovascular disease, targeting blood sugar to normal levels (HbA1cTargeting low blood pressures (

Washington, DC (October 25, 2018) -- New research suggests that attempts to normalize blood pressure, and cholesterol may have negative long-term effects on kidney health in adults with type 2 diabetes who are at high risk for cardiovascular disease. The results appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) and will be presented at ASN Kidney Week 2018.

Type 2 diabetes greatly increases the risk for both cardiovascular disease and chronic kidney disease. Therefore, it is especially important to protect the heart and kidney health of patients with type 2 diabetes. In these patients, aggressive control of blood sugar, blood pressure, and cholesterol has resulted in conflicting short-term effects on kidney health. To determine the long-term kidney effects of these interventions, Amy K. Mottl, MD (University of North Carolina Kidney Center), Timothy E. Craven, MSPH (Wake Forest School of Medicine), and their colleagues examined information on more than 10,000 participants in ACCORDION, which is an extension phase of the ACCORD trial, a multifactorial intervention study in people with type 2 diabetes at high risk for cardiovascular disease.

The team found that intensive blood sugar control aiming for normal average blood sugar (hemoglobin A1c target

"These results, along with those from the primary study which showed no benefit of the interventions on heart attacks and strokes, provide evidence against aggressive targets for glucose, blood pressure, and use of fenfibrate in adults with type 2 diabetes at high risk of cardiovascular events," said Dr. Mottl.

An accompanying editorial takes issue with some of the conclusions. "In our view, the findings observed for doubling of serum creatinine do not suggest harm to the kidneys, but rather are more likely to reflect the limitations of the small number of creatinine measurements available," the authors wrote. "We believe that the data actually suggest possible benefit for ESKD [end-stage kidney disease] with intensive glucose control, and remain inconclusive for intensive blood pressure control and fibrate use given the wide confidence intervals for the more reliable ESKD outcomes."

Credit: 
American Society of Nephrology

Method for determining donor kidneys' suitability for transplantation may be flawed

image: Visual Abstract

Image: 
Mohan/Husain

Highlight

Results from biopsies taken when kidneys were procured from donors were not reliable for determining whether the organs were suitable for transplantation.

Washington, DC (October 25, 2018) -- New research indicates that many kidneys obtained for transplantation from deceased donors are not being used because of biopsy findings despite their unreliability and reproducibility. The findings, which appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) and will be published at ASN Kidney Week 2018, may suggest an urgent need to re-examine the role of such biopsies in the allocation of kidneys.

Kidneys obtained from deceased donors for transplantation are a scarce and valuable resource, yet 20% of kidneys are discarded--most commonly due to findings noted on biopsies taken when the kidney is procured from the donor. Such procurement biopsies are often read by pathologists with limited training or experience in pathology of the kidney.

To study the predictive value and reproducibility of procurement biopsies for deciding which kidneys should be transplanted and which should be discarded, a team led by Sumit Mohan, MD, MPH and S. Ali Husain, MD, MPH (Columbia University Vagelos College of Physicians and Surgeons and the Mailman School of Public Health) examined information on nearly 300 deceased-donor kidneys that were transplanted at their institution from 2006-2009. The organs had undergone both a procurement biopsy and a reperfusion biopsy, the gold standard as it is done as a core needle biopsy read by an experienced pathologist using paraffin embedded tissue and multiple stains.

The investigators found that the agreement between the procurement biopsies and the reperfusion biopsies was poor. Also, the procurement biopsies were not as accurate as reperfusion biopsies for predicting transplant success after organs were transplanted into patients. The researchers also studied a subset of 116 kidneys that underwent more than one procurement biopsy during the allocation process, and they found significant disagreement between sequential procurement biopsies on the same kidney, underscoring the poor reproducibility of the procurement biopsy.

"Limited reliance on procurement biopsy histology will likely result in an improvement in organ utilization by reducing the discard of kidneys attributable to these findings," said Dr. Mohan. "This has the potentially to improve organ allocation efficiency and dramatically increase the number of kidney transplants being performed in the United States."

The investigators noted that efforts to improve the predictive value of biopsies could include requiring biopsy review by experienced kidney pathologists, standardizing biopsy techniques and biopsy reporting, and better integrating biopsy data with other clinical information. "We believe that prospective and randomized studies are needed to definitively understand the role of procurement biopsies, if any, in efficient and appropriate organ allocation and utilization," said Dr. Husain.

Credit: 
American Society of Nephrology

'Cellular dust' provides new hope for regenerative medicine

While stem cells have the most therapeutic potential, the benefits of regenerative medicine may best be mobilised using extracellular vesicles (EVs), also known in the past as "cellular dust". A team of researchers from CNRS, AP-HP, INSERM and Paris Descartes and Paris Diderot Universities have tested these vesicles for the first time in a porcine model for the treatment of post-operative digestive fistulas. Their results, which yielded a 100% success rate and appear in the 23 October 2018 edition of ACS Nano, open the door to testing in humans and broader possibilities for applications.

Extracellular vesicles are matter that is released by cells. Seen for many years as not having any value, this 'cellular dust' has been studied and presents therapeutic properties similar to their mother cells, without their disadvantages: These vesicles do not divide, limiting the risk of cancer, and do not differentiate either, thus preventing the development of poor function. Furthermore, it appears that they can be produced by a single donor for several patients, and have already demonstrated their therapeutic potential in animals in repairing heart, liver and kidney lesions.

In the case of digestive fistula, in which there is abnormal communication between organs in the digestive tract or with the skin, regenerative medicine is an important therapeutic avenue to explore. Fistulas of this kind respond poorly to current treatments; they can develop following post-operative complications or an auto-immune disorders such as Crohn's disease, which causes digestive tract dysfunction.

For the first time, scientists at the Matières et systèmes complexes Lab (CNRS/Université Paris Diderot), the Gastroenterology and Endoscopy Department at the Hôpital Européen Georges Pompidou (HEGP) AP-HP and the Laboratoire Imagerie de l'angiogénèse, plateforme d'imagerie du petit animal (INSERM/Université Paris Descartes/HEGP)*, used extracellular vesicles from stem cells to treat digestive fistula in a swine model. The study reveals that local injections into the fistula of a gel containing these vesicles results in the complete closure of post-operative digestive fistula.

Researchers intend to test the new approach in a perineal fistula model found in Crohn's disease, with the hope of replacing the stem cell injections. The vesicle gel could be administered locally and easily and become a simpler, safer and more effective treatment.

Credit: 
CNRS

Normal function of ALS and dementia linked gene determined for the first time

The normal function of a gene associated with the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) has been determined for the first time by University of Bath scientists.

Both ALS, the most common form of motor neurone disease, and FTD progressively develop in adults and have been shown to be closely linked, with overlapping genetic origins and similar effects on some nervous system cells. There is no cure for either disease.

One gene, called C9orf72, is strongly suspected to be the cause of inherited ALS and FTD when a short sequence of DNA repeats hundreds or even thousands of times within the gene, causing problems in its transcription and expression. However, until now scientists were uncertain as to what normal role or roles the C9orf72 gene played in cells.

A University of Bath team from the Department of Biology and Biochemistry have now biochemically characterised the protein produced by the C9orf72 gene and have shown that it is a guanine nucleotide exchange factor (GEF).

GEFs are a type of protein which regulate molecules called RABs which control key processes inside cells. They respond to signals received by a cell in normal as well as diseased states. Recent evidence suggests that some GEF proteins may be potential therapeutic targets for developing drugs to treat various diseases, including cancer.

The study is published in PeerJ -- Life and Environment Journal.

Dr Vasanta Subramanian, who led the study alongside Professor K. Ravi Acharya, said: "It is vital that we know as much as we can about the causes and triggers for ALS and FTD, so we have a better chance of developing treatments, and even one day a cure for these devastating diseases.

"Understanding the function of C9orf72, which is linked to both diseases, is a crucial step in that process."

Dr Brian Dickie, Director of Research at the Motor Neurone Disease Association, said: "These findings are very timely, as new gene therapy approaches are being developed to specifically target the C9orf72 gene. Understanding what the healthy gene is doing within cells will be important in ensuring that the toxic and not the beneficial effects of the gene are targeted.

Credit: 
University of Bath

Stress can impair memory, reduce brain size in middle age, study finds

SAN ANTONIO--Adults in their 40s and 50s with higher levels of cortisol--a hormone linked to stress--performed worse on memory and other cognitive tasks than peers of the same age with average cortisol levels, research found. Higher cortisol in the blood also was associated with smaller brain volumes, according to the study, published Oct. 24 in Neurology, the medical journal of the American Academy of Neurology.

"In our quest to understand cognitive aging, one of the factors attracting significant interest and concern is the increasing stress of modern life," said study senior author Sudha Seshadri, M.D., professor of neurology at UT Health San Antonio and founding director of the university's Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases. "One of the things we know in animals is that stress can lead to cognitive decline. In this study, higher morning cortisol levels in a large sample of people were associated with worse brain structure and cognition."

The cognitive data are from 2,231 participants in the Framingham Heart Study, for which Dr. Seshadri is a senior investigator; 2,018 participants also underwent magnetic resonance imaging (MRI) to measure brain volume. The team included Framingham collaborators at Harvard Medical School; the National Heart, Lung, and Blood Institute; Boston University School of Medicine; the University of California, Davis, at Sacramento; and UT Health San Antonio.

Blood serum cortisol, which varies in level throughout the day, was measured in early morning (between 7:30 and 9 a.m.) in each fasting participant. The study featured a relatively young sample of male and female participants (mean age 48.5).

"Cortisol affects many different functions, so it is important to fully investigate how high levels of the hormone may affect the brain," said study lead author Justin B. Echouffo-Tcheugui, M.D., Ph.D., of Harvard Medical School. "While other studies have examined cortisol and memory, we believe our large, community-based study is the first to explore, in middle-aged people, fasting blood cortisol levels and brain volume, as well as memory and thinking skills."

Memory loss and brain shrinkage were found in the study's middle-age participants before the onset of any symptoms, Dr. Echouffo-Tcheugui noted. He said it is important for physicians to counsel people with higher cortisol levels on ways to reduce stress, such as getting enough sleep and engaging in moderate exercise.

"The faster pace of life today probably means more stress, and when we are stressed, cortisol levels increase because that is our fight-or-flight response," Dr. Seshadri said. "When we are afraid, when we are threatened in any way, our cortisol levels go up. This study adds to the prevailing wisdom that it's never too early to be mindful of reducing stress."

Findings were adjusted for factors including age, sex, smoking and body mass index. The team asked whether having APOE4, a genetic risk factor for cardiovascular disease and Alzheimer's disease, might be associated with higher cortisol level. This did not prove to be the case.

Credit: 
University of Texas Health Science Center at San Antonio

More goals in quantum soccer

image: The four lenses surround the resonator and are used to focus the laser beams that hold the atom in the resonator and to observe the atom.

Image: 
© Miguel Martinez-Dorantes / University of Bonn

Let's suppose you were allowed to blindfold German soccer star Timo Werner and turn him on his own axis several times. Then you'd ask him to take a shot blind. It would be extremely unlikely that this would hit the goal.

With a trick, Bonn physicists nevertheless managed to achieve a 90-percent score rate in a similar situation. However, their player was almost 10 billion times smaller than the German star striker - and much less predictable.

It was a rubidium atom that the researchers had irradiated with laser light. The atom had absorbed radiation energy and had entered an excited state. This has a defined lifespan. The atom subsequently releases the absorbed energy by emitting a particle of light: a photon.

The direction in which this photon flies is purely coincidental. However, this changes when the rubidium is placed between two parallel mirrors, because then the atom prefers to shoot at one of the mirrors. In the example with Timo Werner, it would be as if the goal magically attracted the ball.

This phenomenon is called the Purcell effect. The existence of it was already proven several decades ago. "We have now used the Purcell effect for the targeted emission of photons by a neutral atom," explains Dr. Wolfgang Alt from the Institute of Applied Physics at the University of Bonn.

There is great interest in the Purcell effect, partly because it makes the construction of so-called quantum repeaters possible. These are needed to transmit quantum information over long distances. Because, whilst it is possible to put a photon into a certain quantum state and send it through a light guide, this can only be done over limited distances; for greater distances, the signal has to be buffered.

Repeaters pass on quantum information

In the quantum repeater, the photon is for instance guided to an atom which swallows it and thereby changes into another state. In response to a reading pulse with a laser beam, the atom spits out the light particle again. The stored quantum information is retained.

The emitted photon must now be collected and fed back into a light guide. But that is difficult when the photon is released in a random direction. "We have succeeded in forcing the photons onto the path between the two mirrors using the Purcell effect," explains Alt. "We have now made one of the mirrors partially transmissive and connected a glass fiber to it. This allowed us to introduce the photon relatively efficiently into this fiber."

The Purcell effect also has another advantage: It shortens the time it takes the rubidium atom to store and release the quantum information. This gain in speed is extremely important: Only if the repeater works fast enough can it communicate with the transmitter of the information, a so-called quantum dot. Today, quantum dots are regarded as the best source for single photons for the transmission of quantum information, which is completely safe from being intercepted. "Our experiments are taking this important future technology one step further," says Alt.

Credit: 
University of Bonn

The good book: Bible helps researchers perfect translation algorithms

image: Texts from 34 versions of the English-language Bible were used to help improve computer-based style transfer systems. The result can create different versions of written passages to suit specific audiences.

Image: 
Bible photo © Chris Downer. Composite illustration courtesy of Keith Carlson.

HANOVER, N.H. - October 24, 2018 - In search of inspiration for improving computer-based text translators, researchers at Dartmouth College turned to the Bible for guidance. The result is an algorithm trained on various versions of the sacred texts that can convert written works into different styles for different audiences.

Internet tools to translate text between languages like English and Spanish are widely available. Creating style translators--tools that keep text in the same language but transform the style--have been much slower to emerge. In part, efforts to develop the translators have been stymied by the difficulty of acquiring the enormous amount of data required. This is where the research team turned to the Bible.

In addition to being a source of spiritual guidance for many people around the globe, the Dartmouth-led team saw in the Bible "a large, previously untapped dataset of aligned parallel text." Beyond providing infinite inspiration, each version of the Bible contains more than 31,000 verses that the researchers used to produce over 1.5 million unique pairings of source and target verses for machine-learning training sets.

According to the research published in the journal Royal Society Open Science, this is not the first parallel dataset created for style translation. But it is the first that uses the Bible. Other texts that have been used in the past, ranging from Shakespeare to Wikipedia entries, provide data sets that are either much smaller or not as well suited for the task of learning style translation.

"The English-language Bible comes in many different written styles, making it the perfect source text to work with for style translation," said Keith Carlson, a PhD student at Dartmouth and lead author of the research paper about the study.

As an added benefit for the research team, the Bible is already thoroughly indexed by the consistent use of book, chapter and verse numbers. The predictable organization of the text across versions eliminates the risk of alignment errors that could be caused by automatic methods of matching different versions of the same text.

"The Bible is a 'divine' data set to work with to study this task," said Daniel Rockmore, a professor of computer science at Dartmouth and contributing author on the study. "Humans have been performing the task of organizing Bible texts for centuries, so we didn't have to put our faith into less reliable alignment algorithms."

To define "style" for the study, the researchers reference sentence length, the use of passive or active voices, and word choice that could result in texts with varying degrees of simplicity or formality. According to the study: "Different wording may convey different levels of politeness or familiarity with the reader, display different cultural information about the writer, be easier to understand for certain populations."

The team used 34 stylistically distinct Bible versions ranging in linguistic complexity from the "King James Version" to the "Bible in Basic English." The texts were fed into two algorithms - a statistical machine translation system called "Moses" and a neural network framework commonly used in machine translation, "Seq2Seq."

While different versions of the Bible were used to train the computer code, systems could ultimately be developed that translate the style of any written text for different audiences. As example, a style translator could take an English-language selection from "Moby Dick" and translate it into different versions suitable for young readers, non-native English speakers, or any one of a variety of audiences.

"Text simplification is only one specific type of style transfer. More broadly, our systems aim to produce text with the same meaning as the original, but do so with different words," said Carlson.

Dartmouth College has a long history of innovation in computer science. The term "artificial intelligence" was coined at Dartmouth during a 1956 conference that created the AI research discipline. Other advancements include the design of BASIC--the first general-purpose and accessible programing language--and the Dartmouth Time-Sharing System that contributed to the modern day operating system.

Credit: 
Dartmouth College

Birds startled by moving sticks

image: The objects used in this research

Image: 
University of Exeter

Do animals - like humans - divide the world into things that move and things that don't? Are they surprised if an apparently inanimate object jumps to life?

Yes - according to scientists at the universities of Exeter and Cambridge.

The researchers tested how jackdaws responded to moving birds, moving snakes and moving sticks - and found they were most cautious of the moving sticks.

The study, using remote-controlled objects placed in jackdaws' nests, will help scientists understand how birds perceive potential threats.

"Although as humans we see the divide between animate an inanimate objects as an intuitive one, we've had very little evidence that wild animals also see the world this way," said lead author Dr Alison Greggor, formerly of the University of Cambridge and now at the San Diego Zoo Institute for Conservation Research.

"Laboratory studies have shown that human infants and a few other species discriminate between animate and inanimate objects.

"This ability is assumed to have evolved to support social interactions, but its role for wild animals has never been examined.

"Our work extends the potential function of this ability beyond the social realm. It might therefore be a more common ability than previously thought."

By placing remote-controlled objects in jackdaws' nests, the researchers tested how the birds assessed possible threats to their offspring.

Jackdaws were startled by any movement, producing alarm calls, but they delayed longest in entering their nest box after encountering an "inanimate" object that moved (ie the remote controlled stick).

This suggests they recognised the movement as unexpected and delayed entering the nest in order to gather more information about the situation.

Dr Alex Thornton, of the Centre for Ecology and Conversation on the University of Exeter's Penryn Campus in Cornwall, added: "There is still a great deal we do not understand about some of our common bird species.

"Dedicated field experiments, such as ours, can yield insights into their minds, revealing more about how they understand the world."

Credit: 
University of Exeter

Deformation of nanotubes to control conductivity

image: Picture 1 - different types of nanotubes: 1) zigzag, 2) chiral and 3) armchair (or dentated).

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© NUST MISIS

Scientists from the NUST MISIS Laboratory of Inorganic Nanomaterials together with their international colleagues have proved it possible to change the structural and conductive properties of nanotubes by stretching them. This can potentially expand nanotubes' application into electronics and high-precision sensors such as microprocessors and high-precision detectors. The research article has been published in Ultramicroscopy.

Carbon nanotubes can be represented as a sheet of graphene rolled in a special way. There are different ways of &laquofolding» it, which leads to the graphene edges interconnecting at different angles, forming either armchair, zigzag or chiral nanotubes (Pic.1).

Nanotubes are considered to be promising materials for use in electronics and sensors because they have high electrical conductivity, which would work well in things like microprocessors and high-precision detectors. However, when producing carbon nanotubes it is hard to control their conductivity. Nanotubes with metallic and semiconducting properties can grow into a single array while microprocessor-based electronics require semiconducting nanotubes that have the same characteristics.

Scientists from the NUST MISIS Laboratory of Inorganic Nanomaterials jointly with a research team from Japan, China and Australia, led by Professor Dmitri Golberg, have proposed a method that allows for the modification of the structure of ready-made nanotubes and thus changes their conductive properties.

&laquoThe basis of the nanotube - a folded layer of graphene - is a grid of regular hexagons, the vertices of which are carbon atoms. If one of the carbon bonds in the nanotube is rotated by 90° degrees, a pentagon and a heptagon are formed at this [junction] instead of a hexagon, and a so-called Stone-Wales defect is obtained in this case. Such a defect can occur in the structure under certain conditions. Back in the late 90s, it was predicted that the migration of this defect along the walls of a highly heated nanotube with the application of mechanical stress could lead to a change in its structure - a sequential change in the chirality of the nanotube, which leads to a change in its electronic properties. No experimental evidence for this hypothesis has previously been obtained, but our research paper has presented convincing proof of it», said Associate Professor Pavel Sorokin, Doctor of Physical & Mathematical Sciences and head of the &laquoTheoretical Materials Science of Nanostructures» infrastructure project at the NUST MISIS Laboratory of Inorganic Nanomaterials.

Scientists from the NUST MISIS Laboratory of Inorganic Nanomaterials have conducted simulations of the experiment at the atomic level. At first, the nanotubes were lengthened to form the first structural defect consisting of two pentagons and two heptagons (a Stone-Wales defect, pic.2a), where the prolonged lengthening of the tube began to &laquospread» to the sides, rearranging other carbon bonds (pic.2b). It was at this stage that the structure of the nanotubes changed. With further stretching, more and more Stone-Wales defects began to form, eventually leading to a change in the nanotubes' conductivity (Pic. 2).

&laquoWe were responsible for the theoretical modeling of the process on a supercomputer in the NUST MISIS Laboratory for Modeling and Development of New Materials for the experimental part of the work. We are glad that the simulation results [support] the experimental data», added Dmitry Kvashnin, co-author of the research work, Candidate of Physical & Mathematical Sciences and a researcher at the NUST MISIS Laboratory of Inorganic Nanomaterials.

The proposed technology is capable of helping in the transformation of &laquometallic» nanotubes' structure for their further application in semiconductor electronics and sensors such as microprocessors and ultrasensitive detectors.

Credit: 
National University of Science and Technology MISIS