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TORONTO, ON - Anxiety disorders are the most common type of psychiatric illness, yet researchers know very little about factors associated with recovery. A new University of Toronto study investigated three levels of recovery in a large, representative sample of more than 2,000 Canadians with a history of generalized anxiety disorder (GAD).

The study reports that 72% of Canadians with a history of GAD have been free of the mental health condition for at least one year. Overall, 40% were in a state of excellent mental health, and almost 60% had no other mental illness or addiction issues, such as suicidal thoughts, substance dependence, a major depressive disorder or a bipolar disorder, in the past year,

The definition of excellent mental health sets a very high bar. To be defined in excellent mental health, respondents had to achieve three things: 1) almost daily happiness or life satisfaction in the past month, 2) high levels of social and psychological well-being in the past month, and 3) freedom from generalized anxiety disorder and depressive disorders, suicidal thoughts and substance dependence for at least the preceding full year.

"We were so encouraged to learn that even among those whose anxiety disorders had lasted a decade or longer, half had been in remission from GAD for the past year and one-quarter had achieved excellent mental health and well-being," says Esme Fuller-Thomson, lead author of the study. Fuller-Thomson is Director of the University of Toronto's Institute for Life Course and Aging and Professor at the Factor-Inwentash Faculty of Social Work and the Department of Family & Community Medicine.

"This research provides a very hopeful message for individuals struggling with anxiety, their families and health professionals. Our findings suggest that full recovery is possible, even among those who have suffered for many years with the disorder," she says.

Individuals who had at least one person in their lives who provided them with a sense of emotional security and wellbeing were three times more likely to be in excellent mental health than those without a confidant.

"For those with anxiety disorders, the social support that extends from a confidant can foster a sense of belonging and self-worth which may promote recovery" says co-author Kandace Ryckman, a recent graduate of University of Toronto's Masters of Public Health.

In addition, those who turned to their religious or spiritual beliefs to cope with everyday difficulties had 36% higher odds of excellent mental health than those who did not use spiritual coping. "Other researchers have also found a strong link between recovery from mental illness and belief in a higher power," reports Fuller-Thomson.

The researchers found that poor physical health, functional limitations, insomnia and a history of depression were impediments to excellent mental health in the sample.

"Health professionals who are treating individuals with anxiety disorders need to consider their patients' physical health problems and social isolation in their treatment plans" says Ryckman.

The researchers examined a nationally representative sample of 2,128 Canadian community-dwelling adults who had a generalized anxiety disorder at some point in their lives. The data were drawn from Statistics Canada's Canadian Community Health Survey-Mental Health. This research was published online ahead of press this week in the Journal of Affective Disorders.

New Rochelle, NY, January 7, 2020--Leading experts representing The Academy of Breastfeeding Medicine (ABM) have released new evidence-based recommendations regarding the benefits and risks of bedsharing for mother-infant pairs who have initiated breastfeeding and are in home settings. The new protocol is published in Breastfeeding Medicine, the official journal of the Academy of Breastfeeding Medicine published by Mary Ann Liebert, Inc., publishers. Click here to read the protocol free on the Breastfeeding Medicine website.

In "Bedsharing and Breastfeeding," Peter Blair and colleagues cite published evidence to support the overall conclusion that close nighttime proximity facilitates breastfeeding duration and exclusivity. Safe bedsharing is possible and the existing evidence does not support the conclusion that bedsharing among breastfeeding infants causes sudden infant death syndrome (SIDS) in the absence of known hazards. Hazardous circumstances include sleeping with an adult on a sofa or armchair; sleeping next to an adult impaired by alcohol, medications, or illicit drugs; tobacco exposure; preterm birth; and never having initiated breastfeeding.

The protocol emphasizes that all parents should be educated on safe bedsharing, with the understanding that bedsharing is very common, and when bedsharing is unplanned, it carries a higher risk than planned bedsharing.

Arthur I. Eidelman, MD, Editor-in-Chief of Breastfeeding Medicine, states: "This is a most welcome balanced statement that emphasizes the positive value of safe bedsharing while properly delineating the clinical and environmental hazards that should be avoided."

"Having conversations about safe bedsharing is important for removing stigma around the topic and for facilitating open and honest dialogue between parents and providers," said Alison Stuebe, MD, president of the Academy of Breastfeeding Medicine.

LA JOLLA, CALIF. - JANUARY 7, 2020 - Scientists at Sanford Burnham Prebys Medical Discovery Institute have identified a new way to boost the immune system's ability to fight cancer. The study, which was performed in collaboration with NYU Langone's Perlmutter Cancer Center, used a mouse model to identify the importance of the Siah2 protein in the control of immune cells called T regulatory cells (Tregs), which limit the effectiveness of currently used immunotherapies. The research, which offers a new avenue to pursue immunotherapy in cases where the treatment fails, was published today in Nature Communications.

"While Siah2 is involved in control of activities that govern cancer development, this study offers the first direct evidence for its role in the immune system, namely in anti-tumor immunity," says Ze'ev Ronai, Ph.D., professor in Sanford Burnham Prebys' Tumor Initiation and Maintenance Program and senior author of the study. "Our study shows that a PD-1 inhibitor can be used to treat tumors that currently do not respond to this therapy, when administered in mice lacking the Siah2 gene, thereby offering a means to expand the effectiveness of immunotherapy. The findings also provide further justification for our efforts to find a drug that blocks Siah2."

The development of cancer immunotherapies, which harness the power of an individual's immune system to destroy tumors, has revolutionized the treatment of certain cancers. For some people with advanced melanoma, a deadly skin cancer, the treatment has extended survival to years instead of months. However, the treatment only works for about 40% of people with advanced melanoma. The study from the Ronai lab offers a new means to make this treatment effective in individuals who at present do not respond to anti-PD-1 therapy.

Ronai explains, "In our study, mice lacking the Siah2 gene were able to mount an immune attack against melanoma. Moreover, the effectiveness of Siah2 in immunotherapy was demonstrated for 'cold' tumors--those that do not respond to immunotherapy--which were effectively eliminated by a PD-1 blockade in Siah2-mutant mice."

“Understanding the basic mechanisms of tumor immunity will ultimately help us improve the effectiveness of immunotherapy,” says Michael Rape, Ph.D., Howard Hughes Investigator and professor of Cell and Developmental Biology at University of California, Berkeley. “This study uncovers an important layer in the regulation of key immune cell components that impact the effectiveness of cancer immunotherapy, highlighting the need to develop inhibitors for Tregs, in which a Siah2 inhibitor holds promise.”

Scientists have known for many years that Siah2 is involved in cellular responses to hypoxia (low oxygen) and the unfolded protein response--two processes that are exploited by tumors to keep growing. Ronai has studied the protein for nearly a decade in hopes of finding better cancer treatments: His team is currently working to develop a small molecule drug that blocks the protein. Now, Ronai's study shows that the protein also plays an important role in regulating the immune system's response to a tumor.

In the study, the scientists used genetically engineered mice that did not produce the Siah2 protein and then introduced BRAF-mutant melanoma--a mutation that occurs in about half of human melanomas. This approach allowed the researchers to study the role of Siah2 in the tumor's microenvironment, of which the immune system is a major component. In the absence of the Siah2 gene, the melanoma tumors receded--a stark contrast to mice with the Siah2 gene, in which the tumor continued to grow. Giving these mice anti-PD-1 therapy effectively eliminated melanoma that otherwise resisted this therapy, demonstrating a new path to enhance the effectiveness of current immunotherapies.

Digging deeper into their findings, the scientists discovered that in the Siah2 mutant mice, the tumors were infiltrated by killer but not Treg immune cells--indicating the immune system was more active in clearing the tumors. The lack of the Treg cells was attributed to reduced proliferation and recruitment into the tumor due to the role of Siah2 and its control of cell cycle regulatory proteins.

"Our discovery only fuels our sense of urgency to find a drug that inhibits Siah2," says Ronai. "Using an arsenal of novel approaches should enable us to advance the targeting of Siah2 in both the tumors and their microenvironment."

Online services that allow users to upload their genetic information, research genealogy and find lost relatives may be vulnerable to a sort of genetic hacking, according to two geneticists at the University of California, Davis. A paper describing the work is published Jan. 7 in the journal eLife.

With the growth of home DNA testing, online services such as GEDMatch, MyHeritage and FamilyTreeDNA have become popular places for people to upload their genetic information and research their genealogy. They have also been used by law enforcement to find criminal suspects through a DNA match with relatives.

But according to Professor Graham Coop and postdoctoral researcher Michael 'Doc' Edge at the UC Davis Department of Evolution and Ecology, someone with a bit of expertise in genetics and computing could design and upload DNA sequences that extract far more from these databases than some lost cousins. It may be possible for an attacker to pull out the genetic information of most people in a database or to identify people with specific genetic traits such as Alzheimer's Disease.

Coop and Edge notified the database companies of the problem in July, 2019 to allow them time to put countermeasures in place before publishing a preprint in October.

"People are giving up more information than they think they are," when they upload to these publicly accessible sites, Coop said. And unlike credit card information, you can't just cancel your old genome and get a new one.

The problems do not affect for-profit DNA sequencing companies such as 23andMe, Coop said. You have to submit your DNA as a saliva sample to get access to their genetic data. The public databases, however, allow anyone to upload DNA sequences and search for other users with matching sequences.

Identical by state and descent

These sites work by using software to compare DNA sequences uploaded by users with sequences already in their database. Your genome is a mosaic of pieces inherited from your ancestors. Bigger pieces, or tiles in the mosaic, come from recent ancestors. As generations pass, matching sequences get chopped into smaller pieces. So if you share large chunks of DNA sequence with someone else, it's likely you share a recent ancestor.

Coop and Edge found three approaches to attacking these databases. They call these methods IBS (identical by sequence) tiling, IBS probing and IBS baiting.

Their tests primarily used a public collection of human DNA sequences available for research. They also carried out a proof of concept test in the GEDMatch database but without interacting with other users' DNA data.

In IBS tiling, an attacker uploads several genomes found in public research databases and keeps track of which ones match with other genomes in the database, and where. If they can find enough matching tiles, they can put together most of someone's genome.

IBS probing can be used to hunt for people who carry a specific genetic variant - for example, a gene tied to Alzheimer's disease. To do this, the attacker creates a fake genome with a DNA sequence that isn't likely to match anyone, except for one small section that will match the gene of interest. Matches from the database are likely to be people with this genetic variant.

Finally, IBS baiting relies on tricking one class of algorithms used to identify relatives. (Not all databases use this type of algorithm, though). Coop and Edge calculate that with as few as 100 uploaded DNA sequences, an attacker could use this method to obtain most of the genomic information in a database.

Coop and Edge carried out a proof-of-concept test with the GEDMatch database in December 2019. Working with only with DNA sequences they had uploaded and using GEDMatch's 'research mode' so as not to interact with other users' data, they showed that IBS baiting could be used to identify specific genetic variants (single nucleotide polymorphisms, or SNPs) in the database.

All three attacks could be carried out by someone with knowledge of genetics and computing, such as a graduate student or serious hobbyist, but "the good news is that it's quite preventable," Edge said.

Coop and Edge's paper sets out a series of steps direct-to-consumer genetics services could take to block these attacks. While they have already shared the information with the leading services, they have had a 'varied' response, Coop said.

Using these services necessarily involves giving up personal information, and millions of people seem willing to do that in exchange for researching family history or other personal uses. But users should be more aware of exactly how much information they might be giving up when they access these services.

"We would like (the services) to clarify their vulnerabilities and how they're addressing them," Coop said.

The website Nursing Home Compare, sponsored by the Centers for Medicare & Medicaid Services, is a go-to resource for many families researching nursing home options for their loved ones. The number of falls that lead to injury are a critical category of concern for nursing home residents, however, a University of Chicago researcher has found that the data used by Nursing Home Compare to report patient safety related to falls may be highly inaccurate.

Prachi Sanghavi, PhD, an assistant professor in public health sciences at UChicago, uncovered significant discrepancies between the falls calculations used for Nursing Home Compare's ratings and actual Medicare claims for falls by nursing home residents from 2011-2015. She found that only 57.5% of falls were accounted for in the Nursing Home Compare's Minimum Data Set (MDS), which is self-reported by nursing homes. Reporting rates were higher for white residents (59%) than non-white residents (46%) and for long-term stays (62.9%) than short-term stays (47.1%). The findings were published December 29, 2019 in the journal Health Services Research.

"This is a substantial amount of underreporting and is deeply concerning because without good measurement, we cannot identify nursing homes that may be less safe and in need of improvement," Sanghavi said.

A significant, yet preventable, risk

Falls are a leading cause of death among the over-65 population, and they can lead to other serious injuries. Patients become fearful of walking again for fear of reinjury, yet falls are considered widely preventable. They are a discrete event that is easy to identify and record, compared to other clinical conditions on Nursing Home Compare such as pressure ulcers or infections, so there should be a wealth of reliable data.

"That's why falls are a patient safety measure on Nursing Home Compare," Sanghavi said. "They reflect how well a nursing home does at preventing these injuries."

Sanghavi started her research with a data set of nearly 88.7 million Medicare admissions claims from 2011 to 2015. She narrowed the sample set in stages, zeroing in on nursing home residents who met several criteria. First, their fall occurred during their time in the nursing home. Second, they were discharged from the nursing home to go to a hospital. Third, the patient's Medicare claim was filed under the code for a major injury fall. Finally, they returned to the same nursing home after treatment for the fall.

"We wanted to be as conservative as possible in our calculations so there would be little argument about whether a fall should have been reported," Sanghavi said. "Our primary outcome measure was based on whether a fall with the appropriate code was reported or not."

Using these criteria, Sanghavi identified 150,828 major injury falls in Medicare claims filed by nursing home residents. The data used by Nursing Home Compare accounted for only 57.5% of these falls, with far fewer falls being reported for black, Asian, and Hispanic patients relative to whites.

Accounting for discrepancies

Nursing Home Compare has faced prior scrutiny for using self-reported data. Sanghavi's own research was sparked by a 2014 New York Times investigation into serious deficiencies found in nursing homes rated five stars by Nursing Home Compare.

"I found it odd that Nursing Home Compare would use self-reported data," she said. "Having worked with Medicare claims data, I thought I could use it to study MDS reporting. The Medicare claims we used are hospital bills. They want to get paid and should not have an interest in nursing home public reporting. That's why they are a more objective source than the self-reported data from nursing homes."

Sanghavi has two theories on why the reporting rate is nearly 15 points higher for long-term stays than short-term stays. "It could be that the nursing homes are more familiar with long-stay patients," she said. "Plus, the falls measure on Nursing Home Compare is specifically for long stays. It could be that nursing homes are taking that measure more seriously."

Sanghavi was especially surprised by the 13-point difference in falls reporting between white and non-white residents. "I didn't expect it to be that different by race," she said, "but it is consistent with other modes of racial disparities in long-term care."

Based on her results, Sanghavi suggests that the Centers for Medicare & Medicaid Services change their evaluation criteria for falls on Nursing Home Compare.

"They should use an objective source, like claims data," she said. "It should be relatively easy for them to do, since they already have the data. There are other claims-based measures already used on Nursing Home Compare."

Restoration of lost motor function after stroke is typically accomplished after strenuous rehabilitation therapy lasting for over months. However, new research published by a group led by Yukio Nishimura, the project leader of the Neural Prosthesis Project, Tokyo Metropolitan Institute of Medical Science showed that an artificial neural connection (ANC)*1 successfully allowed a new cortical site, previously unassociated with hand movements, to regain control of a paralyzed hand in a matter of minutes.

In this research, experimental animals regained voluntary control of a paralyzed hand about ten minutes after establishment of an ANC. Animals engaged in learning with a functional ANC showed variable levels of input signals provided by the cerebral cortex*2 as hand movement improved. Specifically, the activated area of the cortex became more focused as control of hand movements improved.

Through this training of various areas of the cerebral cortex, the research team successfully imparted a new ability to control paralyzed hands via an ANC, even if those areas were not involved in hand control prior to the stroke. Examples of such regions include areas of the cortex that controls the movement of other body parts such as the face or shoulder, and even the somatosensory cortex, which is responsible for tactile and proprioception processing and is normally not associated with motor control. This finding suggests that an ANC can impart new motor control functions to any cortical region.

This research will contribute to the development of innovative therapies that will help stroke patients regain lost motor function by imparting this function to regions of the cerebral cortex previously not associated with hand movement. It is expected that these therapies will have practical clinical applications beyond restoring motor function and lead to the development of novel techniques to further integrate human brains with computers.
The researchers will continue to investigate whether extended use of an ANC will enhance the activity of spared neural networks and facilitate functional recovery so that patients will be able to regain voluntary control of paralyzed body parts even if they discontinue using the ANC.

Working as a collaborative research team, Tatsuo Kaneyasu (SAGA Light Source/Institute for Molecular Science), Yasumasa Hikosaka (University of Toyama), Masahiro Katoh (Hiroshima University/Institute for Molecular Science) and co-workers have invented a way to manipulate the shape of an electron cloud in an atom using the coherent control technique with synchrotron radiation. The work, which has been published in Physical Review Letters, paves the way towards the ultrafast control of electronic systems using synchrotron radiation.

Controlling and probing the electronic motion in atoms and molecules on their natural time scale of attoseconds is one of the frontiers in atomic physics and attosecond physics. Thanks to advances in laser technology, a number of attosecond experiments have been performed with ultrashort laser pulses. In contrast, this research team have presented a new route to the attosecond coherent control of electronic systems using synchrotron radiation. The potential use of undulator radiation as longitudinally coherent wave packets was demonstrated by achieving population control in the photoexcitation of helium atoms [Y. Hikosaka et al., Nature Commun. 10, 4988 (2019)]. The next challenge was the application of the polarization properties of the synchrotron radiation to coherent control.

The team's latest paper, recently published in Physical Review Letters, reports a successful observation of the control of the electron cloud in a helium atom. Pairs of left- and right-circularly polarized radiation wave packets were generated using two helical undulators. The duration of each wave packet pair was a few femtoseconds, and the extreme ultraviolet radiation was used to irradiate helium atoms. With this technique they succeeded in controlling the shape and orientation of the electron cloud, formed as a coherent superposition state, by tuning the time delay between the two wave packets on the attosecond level.

In contrast to standard laser technology, there is no technical restriction on the extension of this method to shorter and shorter wavelengths. This new capability of synchrotron radiation not only helps scientists to study ultrafast phenomena in atomic and molecular processes, but may also open up new applications in the development of functional materials and electronic devices in the future.

Osaka, Japan - A team of researchers at Osaka University has investigated a new method for generating nuclear fusion power, showing that the relativistic effect of ultra-intense laser light improves upon current "fast ignition" methods in laser-fusion research to heat the fuel long enough to generate electrical power. These findings could provide a spark for laser fusion, ushering in a new era of carbonless energy production.

Current nuclear power uses the fission of heavy isotopes, such as uranium, into lighter elements to produce power. Yet, this fission power has major concerns, such as spent fuel disposal and the risk of meltdowns. A promising alternative to fission is nuclear fusion. Like all stars, our sun is powered by the fusion of light isotopes, notably hydrogen, into heavier elements. Fusion has many advantages over fission, including the lack of hazardous waste or risk of uncontrolled nuclear reactions.

However, getting more energy out of a fusion reaction than was put into it has remained an elusive goal. This is because hydrogen nuclei strongly repel each other, and fusion requires extreme heat and pressure conditions - like those found in the interior of the sun, for instance - to squeeze them together. One method, called "inertial confinement" uses extremely high-energy laser pulses to heat and compress a fuel pellet before it gets the chance to be blown apart. Unfortunately, this technique requires extremely precise control of the laser's energy so that the compression shock waves all arrive at the center simultaneously.

Now, a team led by Osaka University has developed a modified method for inertial confinement that can be performed more consistently using a second laser shot. In "super-penetration" fast ignition, the directly irradiated second laser produces fast-moving electrons in dense plasma that heat the core during compression to trigger fusion. "By utilizing the relativistic behavior of the high-intensity laser, the energy can be reliably delivered to fuel in the imploded plasma aiming the ignition," first author Tao Gong says.

The fuel for this method, which is usually a mix of the hydrogen isotopes deuterium and tritium, is easier to obtain than uranium, and becomes harmless helium after fusion. "This result is an important step towards the realization of laser fusion energy, as well as for other applications of high-energy density physics, including medical treatment," explains senior author Kazuo Tanaka.

After a detailed topographic analysis, Eurac Research´s ecologists identified 15 stretches of streams throughout South Tyrol that flow into four distinct categories of land cover: rocky terrain (slightly over 2000m), pastures at high altitudes (around 2000m), conifer woodlands (around 1500/1600m) and valley floor pastures (between 1000/1200m).

Sample sites were selected to be as similar as possible in order to avoid factors that could cause interference. "We only selected and sampled streams born from springs and tracts with an upstream area of almost half a square kilometre of uniform land cover type, they also had to be devoid of human activities such as houses or stables," explains ecologist Alberto Scotti. "Our goal was to assess whether and how the life of invertebrates living in the riverbed is influenced by the characteristics of the surrounding land cover". To verify this, Scotti collected various samples. In total 70 different genera or species of invertebrates were classified.

The analysis of their distribution and functional traits astonished the researcher. Contrary to expectations, their presence was not in fact influenced exclusively by the elevation: there were more organisms and different species in the streams that flowed through the pastures, whether at 2000m or at the bottom of the valley. Moreover, in these watercourses aquatic macroinvertebrates perform several and more diversified tasks, for example there are organisms that feed on fragmented plants, others that filter particles dispersed in water and so on. In every sense, the diversity of these populations is greater than those that live in woodland and rocky areas.

"We already knew that the biodiversity of the terrestrial flora is more abundant where grazing or mowing takes place. We were surprised to discover that this relationship also applies to aquatic ecosystems. Biodiversity is greater both in terms of the number of species and the number of functions that aquatic invertebrates carry out in the streams that cross pastures, "says Scotti. "Regardless of the quality of the water - which is generally very high - the abandonment of extensive pastures at high altitudes risks depleting the streams from an ecological point of view". The study was published in Freshwater Biology.

A new method to fit together layers of semiconductors as thin as a few nanometres has resulted in not only a scientific discovery but also a new type of transistor for high-power electronic devices. The result, published in Applied Physics Letters, has aroused huge interest.

The achievement is the result of a close collaboration between scientists at Linköping University and SweGaN, a spin-off company from materials science research at LiU. The company manufactures tailored electronic components from gallium nitride.

Gallium nitride, GaN, is a semiconductor used for efficient light-emitting diodes. It may, however, also be useful in other applications, such as transistors, since it can withstand higher temperatures and current strengths than many other semiconductors. These are important properties for future electronic components, not least for those used in electric vehicles.

Gallium nitride vapour is allowed to condense onto a wafer of silicon carbide, forming a thin coating. The method in which one crystalline material is grown on a substrate of another is known as "epitaxy". The method is often used in the semiconductor industry since it provides great freedom in determining both the crystal structure and the chemical composition of the nanometre film formed.

The combination of gallium nitride, GaN, and silicon carbide, SiC (both of which can withstand strong electric fields), ensures that the circuits are suitable for applications in which high powers are needed.

The fit at the surface between the two crystalline materials, gallium nitride and silicon carbide, is, however, poor. The atoms end up mismatched with each other, which leads to failure of the transistor. This has been addressed by research, which subsequently led to a commercial solution, in which an even thinner layer of aluminium nitride was placed between the two layers.

The engineers at SweGaN noticed by chance that their transistors could cope with significantly higher field strengths than they had expected, and they could not initially understand why. The answer can be found at the atomic level - in a couple of critical intermediate surfaces inside the components.

Researchers at LiU and SweGaN, led by LiU's Lars Hultman and Jun Lu, present in Applied Physics Letters an explanation of the phenomenon, and describe a method to manufacture transistors with an even greater ability to withstand high voltages.

The scientists have discovered a previously unknown epitaxial growth mechanism that they have named "transmorphic epitaxial growth". It causes the strain between the different layers to be gradually absorbed across a couple of layers of atoms. This means that they can grow the two layers, gallium nitride and aluminium nitride, on silicon carbide in manner so as to control at the atomic level how the layers are related to each other in the material. In the laboratory they have shown that the material withstands high voltages, up to 1800 V. If such a voltage were placed across a classic silicon-based component, sparks would start flying and the transistor would be destroyed.

"We congratulate SweGaN as they start to market the invention. It shows efficient collaboration and the utilisation of research results in society. Due to the close contact we have with our previous colleagues who are now working for the company, our research rapidly has an impact also outside of the academic world", says Lars Hultman.

(Boston)-- Among low-income adults enrolled in Medicaid, disruptions in coverage, or churning, decreased following the Affordable Care Act (ACA).

"This study provides the first nationwide evidence that Medicaid expansion has led to decreased rates of coverage disruptions. We estimate that half a million fewer adults experienced an episode of churning annually," explained corresponding author Anna Goldman, MD, assistant professor of medicine at Boston University School of Medicine (BUSM).

People who experience coverage disruptions are more likely to delay care, receive less preventive care, refill prescriptions less often and increase the number of emergency department visits. Income fluctuation that leads to changes in Medicaid eligibility from month to month is a common cause of coverage disruption however, even disruptions due to plan switching can result in impeded access to care.

The researchers analyzed data from the Medical Expenditure Panel Survey- Household Component, which captured monthly insurance status from 2011-16, three years before and three years after the ACA's Medicaid expansion went into effect in 2014. They found that the number of low-income adults who experienced disruptions in and loss of Medicaid coverage decreased significantly (4.3 percent) in states that expanded Medicaid under the ACA, compared to states that did not.

They also found improved coverage continuity among nonwhites, men and people without chronic conditions. "Our results suggest that Medicaid expansion helped healthier people--who tend to have less regular contact with the health care system--retain more stable coverage," added Goldman, who also is a physician at Boston Medical Center.

The researchers caution that waiver features approved in recent years by the Centers for Medicare and Medicaid Services, including work requirements and premiums in Medicaid, may partially erode some of these improvements in continuity of coverage.

The findings appear online in the journal Health Affairs.

A new method of producing carbon nanotubes - tiny molecules with incredible physical properties used in touchscreen displays, 5G networks and flexible electronics - has been given the green light by researchers, meaning work in this crucial field can continue.

Single-walled carbon nanotubes are among the most attractive nanomaterials for a wide range of applications ranging from nanoelectronics to medical sensors. They can be imagined as the result of rolling a single graphene sheet into a tube.

Their properties vary widely with their diameter, what chemists call chirality - how symmetrical they are - and by how the graphene sheet is rolled.

The problem faced by researchers is that it is no longer possible to make high quality research samples of single-walled carbon nanotubes using the standard method. This was associated with the Carbon Center at Rice University, which used the high-pressure carbon monoxide (HiPco) gas-phase process developed by Nobel Laureate, the late Rick Smalley.

The demise of the Carbon Center in the mid-2010s, the divesting of the remaining HiPco samples to a third-party entity with no definite plans of further production, and the expiration of the core patents for the HiPco process, meant that this existing source of nanotubes was no longer an option.

Now however, a collaboration between scientists at Swansea University (Wales, UK), Rice University (USA), Lamar University (USA), and NoPo Nanotechnologies (India) has demonstrated that the latter's process and material design is a suitable replacement for the the Rice method.

Analysis of the Rice "standard" and new commercial-scale samples show that back-to-back comparisons are possible between prior research and future applications, with the newer HiPco nanotubes from NoPo Nanotechnologies comparing very favourably to the older ones from Rice.

These findings will go some way to reassure researchers who might have been concerned that their work could not continue as high-quality nanotubes would no longer be readily available.

Professor Andrew Barron of Swansea University's Energy Safety Research Institute, the project lead, said:

"Variability in carbon nanotube sources is known to be a significant issue when trying to compare research results from various groups. What is worse is that being able to correlate high quality literature results with scaled processes is still difficult".

Erstwhile members of the Smalley group at Rice University, which developed the original HiPco process, helped start NoPo Nanotechnologies with the aim of updating the HiPco process, and produce what they call NoPo HiPCO® SWCNTs.

Lead author Dr. Varun Shenoy Gangoli stated:

"It is in the interest of all researchers to understand how the presently available product compares to historically available Rice materials that have been the subject of a great range of academic studies, and also to those searching for a commercial replacement to continue research and development in this field."

The new study appears in the open-access MDPI journal C.

PITTSBURGH (Jan. 6, 2020) ... As a healthy heart ages, it becomes more susceptible to cardiovascular diseases. Though researchers have discovered that relaxin, an insulin-like hormone, suppresses atrial fibrillation (AF), inflammation, and fibrosis in aged rats, the underlying mechanisms of these benefits are still unknown. In a recent Scientific Reports paper, University of Pittsburgh graduate student Brian Martin discusses how relaxin interacts with the body's signaling processes to produce a fundamental mechanism that may have great therapeutic potential.

The study, "Relaxin reverses maladaptive remodeling of the aged heart through Wnt-signaling" (DOI: 10.1038/s41598-019-53867-y) was led by Guy Salama, professor of medicine at Pitt, and Brian Martin, a graduate student researcher from the Swanson School of Engineering's Department of Bioengineering.

"Relaxin is a reproductive hormone discovered in the early 20th century that has been shown to suppress cardiovascular disease symptoms," said Martin. "In this paper, we show that relaxin treatment reverses electrical remodeling in animal models by activating canonical Wnt signaling - a discovery that reveals a fundamental underlying mechanism behind relaxin's benefits."

A better understanding of how relaxin interacts with the body may improve its efficacy as a therapy to treat cardiovascular disease in humans. As the U.S. population ages, the rates of these age-associated diseases are expected to rise, requiring better treatment for this leading cause of death. According to a report from the American Heart Association, the total direct medical costs of cardiovascular disease are projected to increase to $749 billion in 2035.

"A common problem in age-associated cardiovascular disease is altered electrical signaling required for proper heart contraction," Martin explained. "When ions in the heart and their associated channels to enter or exit the heart are disrupted, complications occur."

"Natural, healthy aging has been shown to be accompanied by changes in structure and function," Salama added. "For example, aged cardiomyocytes start to express embryonic contractile proteins and fewer voltage-gated Na+ channels by unknown mechanisms. The reversal of some aspects of the aging process by relaxin is mediated by the reactivation of Wnt canonical signaling which may partly explain mechanisms of the aging process."

The group's study found that relaxin upregulated the prominent sodium channel, Nav1.5, in cells of heart tissue via a mechanism inhibited by the Wnt pathway inhibitor Dickkopf-1.

"Wnt signaling is thought to be active primarily in the developing heart and inactive later in life," Martin said. "However, we show that relaxin can reactivate Wnt signaling in a beneficial way to increase Nav1.5."

Increased Nav1.5 is associated with better electrical signaling in the heart may reduce susceptibility to cardiac rhythm disorders.

"Further, we show that relaxin can also reverse the age-associated reduction in cell adhesion molecules and cell-cell communication proteins," he continued. "In summary, relaxin appears to reverse problematic reductions or pathological reorganization of vital cardiac signaling proteins."

While these data provide new insight into relaxin's mechanisms of action, further work is needed to understand the precise steps required for relaxin to alter Wnt signaling and if steps can be taken to directly alter Wnt signaling to provide its beneficial effects.

Researchers of the Faculty of Psychology of the University of Malaga (UMA) have demonstrated how computerized training -through a specific software- can improve the attentional capacity of athletes, particularly, soccer players.

Based on a study carried out in 9 weeks, through 27 training sessions, the UMA research team has verified the efficiency of this type of computerized training in the development of the selective attention of soccer players.

"Athletes, especially of open skill sports like soccer, which are very variable, learn game patterns that they activate almost automatically in response to a stimulus. However, many times during the game, unexpected events occur to these learnt patterns that require them to make creative decisions", explains Professor of Social Psychology of the UMA Antonio Hernández Mendo, main author of this study published in the scientific journal Frontiers in Psychology.

This expert asserts that it is precisely when facing these unforeseen events that the perceptive and attentional capacity is essential to process information rapidly and effectively. "The development of selective attention enables them to focus on specific and unexpected stimuli and ignore others at any time of the game", adds Hernández Mendo.

The results of this study, which is part of a wider line of research that started 3 years ago, prove that soccer players with a better cognitive functioning show greater performance on the pitch.

This way, these researchers of the group "Psychosocial Assessment in Natural Contexts: Sports and Consumption" have designed a computerized tool to train the attention, and their future steps include the evaluation of the most appropriate training based on the type of sport and the position of the player on the pitch.

Air pollution affects physical health, and research results now conclude that it also affects our psychological health. The study, which combines genetic data from iPSYCH with air pollution data from the Department of Environmental Science, shows that children who are exposed to a high level of air pollution while growing up, have an increased risk of developing schizophrenia.

"The study shows that the higher the level of air pollution, the higher the risk of schizophrenia. For each 10 μg/m3 (concentration of air pollution per cubic metre) increase in the daily average, the risk of schizophrenia increases by approximately twenty per cent. Children who are exposed to an average daily level above 25 μg/m3 have an approx. sixty per cent greater risk of developing schizophrenia compared to those who are exposed to less than 10 μg/m3," explains Senior Researcher Henriette Thisted Horsdal, who is behind the study.

To put these figures into perspective, the lifetime risk of developing schizophrenia is approximately two per cent, which equates to two out of a hundred people developing schizophrenia during their life. For people exposed to the lowest level of air pollution, the lifetime risk is just under two per cent, while the lifetime risk for those exposed to the highest level of air pollution is approx. three per cent.

Unknown cause

The results of the study have just been published in the scientific journal JAMA Network Open.

"The risk of developing schizophrenia is also higher if you have a higher genetic liability for the disease. Our data shows that these associations are independent of each other. The association between air pollution and schizophrenia cannot be explained by a higher genetic liability in people who grow up in areas with high levels of air pollution," says Henriette Thisted Horsdal about the study, which is the first of its kind to combine air pollution and genetics in relation to the risk of developing schizophrenia.

The study included 23,355 people in total, and of these, 3,531 developed schizophrenia. Though the results demonstrate an increased risk of schizophrenia when the level of air pollution during childhood increases, the researchers cannot comment on the cause. Instead they emphasise that further studies are needed before they can identify the cause of this association.