It could be a few hundred years before another dangerous, explosive Vesuvius eruption occurs, according to a new study.

Located near Naples, Italy, Vesuvius last had a violent eruption in 1944, towards the end of the Second World War.

More than three million people live in the volcano’s immediate vicinity, and in historical and prehistoric times, there were explosive eruptions that destroyed entire settlements and towns in the area.

For a new study in Science Advances, researchers took a close look at the four largest eruptions of Vesuvius over the last 10,000 years to better assess whether a dangerous event might be expected in the foreseeable future.

The four eruptions studied include the Avellino eruption of 3,950 years ago, which is considered a possible “worst case scenario” for future eruptions, and the eruption of CE 79 that buried the Roman cities of Pompeii and Herculaneum.

The Roman writer Pliny the Younger documented the latter, and so all eruptions of this type are referred to as “Plinian” eruptions. Further, the volcanologists studied eruptions of 472 CE and 8890 y BP (years before present). The sub-Plinian eruption of CE 472 is the smallest of the investigated eruptions but still similar in size compared to the recent Tonga eruption.

Garnets in volcanic deposits

In the study, researchers determined the age of garnet crystals present in the volcanic deposits. This mineral grows from the magma as it is stored in the magma chamber in the upper crust beneath Vesuvius. Knowing the age of these minerals makes it possible to infer how long magma resided in this chamber before the volcano spewed it out.

Garnet is an unusual choice for determining the age of volcanic ejecta. Researchers typically use zircons, which are tiny accessory minerals found in many igneous rocks. Magma from Vesuvius, however, is too alkaline to crystallize zircons, but it is rich in garnet.

To determine the age of the garnets, the researchers used the radioactive elements uranium and thorium. The crystal structure of garnet incorporates both in small but measurable quantities, with a preference for uranium. Using the ratio of the isotopes uranium-238 to thorium-230, the researchers can calculate the crystallization age of the minerals.

The garnets for this study all came from material that researchers at ETH Zurich collected on site with the help of colleagues from the University of Milan and the University of Bari. For this purpose, they searched for corresponding sites where the volcanic deposits from the four eruptions mentioned above are exposed at the surface and are accessible for sampling.

Vesuvius has ‘complicated’ plumbing’

By using the crystallization ages of garnets, the researchers can now show that the most explosive magma type at Vesuvius (so called “phonolitic” magma) is stored in a reservoir in the upper crust for several thousand years before the influx of more primitive, and hotter, magma from the lower crust triggers an eruption.

For the two prehistoric events, the researchers determined that the phonolitic magma resided in the chamber for about 5,000 years. Before the eruptions in the historical period, it was stored in this reservoir for only about 1,000 years.

For all the eruptions, the residence time of the phonolitic magma in the upper crustal chamber coincides with Vesuvius’ quiescent periods.

“We think it’s likely that a large body of phonolitic magma in the upper crust blocked the upwelling of more primitive, hotter magma from deeper reservoirs,” says Olivier Bachmann, professor at ETH Zurich. “Vesuvius has quite a complicated plumbing system,” he adds with a grin.

Below the volcano are several magma chambers connected by a system of pipes. The top chamber, which is critical for the eruptions, fills with magma from one of the lower chambers in a fairly short time. In this colder environment, the magma cools and crystallizes, leading to chemical changes of the residual melt (a process called “magmatic differentiation”).

Experts call the “differentiated” magma of Vesuvius phonolite. At some point (probably at relatively regular intervals), more primitive, or “mafic” magma flows into the upper chamber from greater depths. This recharge leads to a pressure rise within the chamber, which can force the phonolitic magma upwards, potentially all the way to the surface, starting an eruption.

A reservoir of phonolitic magma appears to have almost always existed beneath Vesuvius for the last 10,000 years. However, the question is whether one today that could feed a dangerous eruption like the one of 3,950 years ago or the one of CE 79.

Naptime for Vesuvius?

Seismic surveys indicate that there is indeed a reservoir at a depth of about six to eight kilometers (about 3 to 5 miles) underneath Vesuvius. However, the composition of the magma it contains—i.e., whether it is phonolitic, or more mafic—cannot be determined using seismic technology. But since Vesuvius has been producing mostly mafic magma since 1631, researchers believe it is unlikely that differentiated phonolite is currently accumulating.

“The last major eruption in 1944 is now nearly 80 years ago, which may well be the beginning of a prolonged quiescent period during which differentiated magma can accumulate. Still, a dangerous eruption comparable to the one in AD 79 probably needs the quiescent period to last much longer,” says lead author Jörn-Frederik Wotzlaw of ETH Zurich.

If predominantly mafic magma is ejected in the coming decades, this could indicate that the magma body detected by seismic surveys is not composed of differentiated magma and that none is currently present beneath Vesuvius.

“That’s why we think it’s more likely that a large, explosive eruption of Vesuvius would occur only after a quiescent period lasting for centuries,” Bachmann says.

Wotzlaw adds: “However, smaller but still very dangerous eruptions like the one in 1944 or even the one in 1631 can occur after shorter periods of quiescence. Accurate forecasting of size and style of volcanic eruptions is so far not possible. However, the reawakening of the magma reservoirs beneath volcanoes are now recognizable by monitoring.”

To avoid any nasty surprises, Vesuvius and its activity, together with its big brother to the west, the Phlegraean Fields, are monitored around the clock. For example, Italy’s National Institute of Geophysics and Volcanology measures every earthquake around the volcanoes, analyzes gases emitted from fumaroles, and observes ground deformation, which are indicators of underground activity. There is also an emergency plan outlining how to evacuate the greater Naples area should surveillance conclude that an eruption is imminent.

Source: ETH Zurich

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The American Rescue Plan Act could do more to tackle racial wealth inequality, argues professor Goldburn P. Maynard Jr.

While the American Rescue Plan Act provided a major infusion of economic aid to low-income and middle-class Americans, more should be done to address racial wealth inequality and the structural issues in the tax code that allow those at the top of the income distribution to benefit disproportionately from tax subsidies, writes Maynard, assistant professor of business law and ethics at the Indiana University Kelley School of Business.

“Where these policies fall short is their lack of focus on historic systemic discrimination.”

Maynard analyzed the American Rescue Plan Act’s major provisions to determine their potential impact on racial equity, presenting his findings in Yale Law Journal.

The article is part of a forum series that examines the novel tax implications of the American Rescue Plan Act through the lens of fiscal impoverishment, race, unemployment insurance, and state and local responses to economic crises.

“While analysis reveals that the Biden Administration made some progress on (racial equity) through ARPA, in the months since its passage, federal courts have undermined some of this progress by halting race-conscious equity programs in ARPA,” writes Maynard, who worked as an estate tax attorney for the Internal Revenue Service before entering academia. His essay argues that “race consciousness is central to achieving” racial equity and “requires more than traditional policies that target financial need.”

The bulk of the stimulus measure focused on redistribution through the tax system, which does not incorporate racism and other dimensions of social inequity into its notions of fairness, Maynard writes. To this day, the IRS does not collect racial data on taxpayers.

He also notes that several policies targeted people or groups based on need. For example, the Department of Housing and Urban Development in November provided $14 million in American Rescue Plan funds to support fair housing organizations. But few new policies under the plan have addressed systemic discrimination, and most were designed to be temporary, such as the child tax credit.

“Where these policies fall short is their lack of focus on historic systemic discrimination,” Maynard writes. “ARPA does not tackle the central issues that lead to racial inequity in the first place. Because RE requires the consideration social hierarchy and historical injustices, these provisions of ARPA are not as impactful as others.”

Several core policies in the American Rescue Plan Act target individuals or groups based on need, particularly racial minorities, he said. But several courts with conservative judges have treated race-based policies designed to counteract racial inequities as discriminatory in their interpretations of the Constitution.

“Today, many courts equate efforts to promote RE with efforts to promote racial segregation. The odds of having all three branches in perfect alignment are slim,” Maynard writes. “ARPA also illustrates weaknesses in our current understanding of the Constitution as limiting the government’s ability to redress historic wrongs. The status quo limitations are so strong that it is hard to imagine any large pro-equality advancements in the foreseeable future.

“At our current pace, achieving RE will be a centuries-long project. This is discouraging, but highlights the importance of continuing the fight for wealth taxation and other levies on capital. It also underscores the smallness of the tax system when tackling a problem as embedded as RE. There are many decisions, regulations, and laws that have embedded racism structurally and systematically.

“The tax system serves as an efficient compensator of harm, but this is not always what the victims of harm want. Instead of after-the-fact compensation for discrimination, victims of inequities often prefer to have the discrimination eliminated. That is the purpose of RE. The tax system can play an important role in promoting RE, even if it is not the leading one.”

Source: Indiana University

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Researchers have discovered a possible reason why L-dopa, the front-line drug for treating Parkinson’s disease, loses efficacy as treatment progresses.

The drug causes dyskinesia, involuntary, erratic muscle movements of the patient’s face, arms, legs, and torso.

“Paradoxically, the exact therapy that improved the quality of life for tens of thousands of Parkinson’s patients is the one that contributes to the rapid decline in quality of life over time,” says Amal Alachkar, associate professor of teaching in the University of California, Irvine’s pharmaceutical sciences department and co-corresponding author of the study. “L-dopa has been shown to accelerate disease progression through neural mechanisms that are not very well understood.”

L-dopa and other pharmacological treatments for Parkinson’s are designed to replace the lost dopamine caused by the degeneration of nerve cells in the brain. Although dopamine can’t cross the blood-brain barrier, which lets substances such as water and oxygen pass into the brain, L-dopa can, and it’s used to treat the disease’s motor symptoms.

However, 99% of L-dopa is metabolized outside the brain, so it’s administered in combination with an enzyme inhibitor to increase the amount of the dose that reaches the brain to 5 to 10% and to prevent side effects such as nausea and heart problems.

The team studied the molecular binding characteristics of L-dopa and related compounds using an optical technology called surface plasmon resonance to measure interactions between the drug and target proteins.

The findings of the study, which appear in ACS Chemical Neuroscience, demonstrate that L-dopa and the protein siderocalin combine in the presence of iron to create a complex that may cause a cellular iron overload, leading to an imbalance between free radicals and antioxidants, as well as neuroinflammation in the brain, triggering dyskinesia, fluctuations in mobility, and freezing episodes.

As Parkinson’s progresses, lower doses of L-dopa induce these negative side effects, while the dose required to alleviate disease symptoms increases, resulting in a narrow therapeutic window.

“This small L-dopa molecule is certainly mysterious,” Alachkar says. “We’re interested in unlocking L-dopa mysteries and, in particular, understanding how it acts as such a magic therapeutic agent and, at the same time, contributes to disease progression. The formation of the L-dopa-siderocalin complex may play a role in decreasing efficacy by reducing the amount of free L-dopa available for dopamine synthesis in the brain.”

Ongoing studies focus on testing whether continuous L-dopa administration in animal models of Parkinson’s disease is associated with increased iron accumulation in the brain’s dopaminergic neurons and if this accumulation depends on L-dopa binding to siderocalin.

Researchers also want to determine whether the complex can be detected in the blood of Parkinson’s patients, serving as a biomarker showing the correlation with their physical deterioration and as a target for new treatments for the disease.

The National Institutes of Health supported the work.

Source: UC Irvine

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Older adults who are socially isolated are more likely to have missing teeth, and to lose their teeth more quickly over time, than those with more social interaction, according to a study of older adults in China.

“Our study suggests that maintaining and improving social connections may benefit the oral health of older adults,” says Xiang Qi, a PhD student at New York University Rory Meyers College of Nursing and first author of the study in Community Dentistry and Oral Epidemiology.

“The findings align with previous studies demonstrating that structural indicators of social disconnection can have powerful effects on indicators of health and well-being.”

Social isolation and loneliness in older adults are major public health concerns around the world and are risk factors for heart disease, mental health disorders, cognitive decline, and premature death.

In some countries, including the United States and China, up to one in three older adults are lonely, according to the World Health Organization. The COVID-19 pandemic has exacerbated these issues among older adults, as many in-person interactions have been interrupted to protect older adults from infection.

Social isolation and loneliness are related but different. Social isolation is an objective measure defined as having few social relationships or infrequent social contact with others, while loneliness is the feeling created by a lack of social connection.

“While social isolation and loneliness often go hand in hand, it’s possible to live alone and be socially isolated but to not feel lonely, or to be surrounded by people but still feel lonely,” says Bei Wu, a professor in global health and the study’s senior author.

Older adults are also at risk for another health concern: losing teeth. In China, older adults aged 65 to 74 have fewer than 23 teeth on average (adults typically have 32 teeth, or 28 if wisdom teeth have been removed) and 4.5% of this age group has lost all of their teeth.

Gum disease, smoking, lack of access to dental care, and chronic illnesses like diabetes and heart disease increase the risks of tooth loss. Missing teeth can have a significant effect on quality of life, affecting nutrition, speech, and self-esteem.

To understand the relationship between social isolation, loneliness, and tooth loss in older adults in China, the researchers used the Chinese Longitudinal Healthy Longevity Survey to analyze data from 4,268 adults aged 65 and up. The participants completed surveys at three different timepoints (2011-12, 2014, and 2018), which captured measures of social isolation and loneliness, how many teeth people had and lost over the 7-year study, and other factors. More than a quarter (27.5%) of the study participants were socially isolated, and 26.5% reported feeling lonely.

The researchers found that higher levels of social isolation were associated with having fewer teeth and losing teeth more quickly over time, even when controlling for other factors such as oral hygiene, health status, smoking and drinking, and loneliness. Older adults who were socially isolated had, on average, 2.1 fewer natural teeth and 1.4 times the rate of losing their teeth than those with stronger social ties.

“Socially isolated older adults tend to be less engaged in social and health-promoting behaviors like physical activity, which could have a negative impact on their overall functioning and oral hygiene, as well as increase their risk for systemic inflammation,” says Wu. “This functional impairment seems to be a major pathway linking social isolation to tooth loss.”

Surprisingly, loneliness was not associated with the number of remaining teeth, nor with the rate of tooth loss.

“While social isolation can result in a lack of support that can affect health behaviors, for older adults who feel lonely, it’s possible that their social networks are still in place and can help them to keep up healthy behaviors,” says Qi.

The findings—which are relevant to countries beyond China, given that social isolation and tooth loss are global issues—highlight the importance of developing interventions to reduce social isolation. Programs could aim to foster intergenerational support within families and improve older adults’ peer and social connections within their local communities.

Additional coauthors are from Duke University and Fudan University in China. The National Institute on Aging and the National Institute of Dental and Craniofacial Research funded the work.

Source: NYU

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Acceptance of a combination influenza-COVID-19 vaccine among minority individuals is higher than for the COVID-19 vaccine alone, according to new research.

The findings suggest that bundling COVID-19 vaccines or boosters with influenza vaccines may be a convenient option to increase future uptake of both vaccines among minorities.

“Millions of people in the United States remain unvaccinated to COVID-19 due to persistent vaccine hesitancy,” says Robert Lennon, associate professor of family and community medicine in the College of Medicine at Penn State.

“As new variants continue to emerge, hospitalizations and deaths will continue to have a disproportionate impact on minority individuals given historic disparities in health care access and quality. It is critical to improve access to and education about vaccines for these individuals.”

According to Lennon, some vaccine manufacturers have announced that they are pursuing the development of a combined COVID-19-influenza vaccine.

“This is important,” he says, “because our research suggests that a combination vaccine may entice more minority individuals to get vaccinated than either the COVID-19 or influenza vaccine alone.”

In the study, published in the journal Vaccine, Lennon and colleagues, including Ray Block, professor in the McCourtney Institute and associate professor of political science and African American studies, collaborated with the African American Research Collaborative (AARC), an organization dedicated to bringing an accurate understanding of African American civic engagement to the public discourse.

Together, the team developed a survey and conducted a national telephone and online poll of more than 12,887 US minority adults—including Latino/a/X, Black/African American, Asian American or Pacific Islander, Native American/American Indian, and white—from May 7 to June 7, 2021.

“Our goal was to determine the acceptability of a combination influenza-COVID-19 vaccine compared to influenza or COVID-19 vaccines alone in a nationally representative sample of US adults,” says Lennon. “This is the largest COVID-19 vaccine intention study that we know of; certainly, it’s the largest for underserved minorities.”

To assess acceptance of the seasonal flu vaccine alone, the team asked participants, “Do you plan to get the flu vaccine this year? (a) yes, (b) no, or (c) don’t know/unsure.”

The team assessed acceptance of an annual COVID-19 vaccine by asking participants, “Some medical professionals think COVID-19 vaccines may need to be taken annually, similar to the seasonal flu vaccine. Would you say (a) I would definitely take an updated COVID-19 vaccine once per year, (b) I might take an updated COVID-19 vaccine each year, or (c) I would not take an updated COVID-19 vaccine each year.”

Acceptance of a combination COVID-19-flu vaccine was measured by asking participants, “Would you be willing to take a combination COVID-19-flu vaccine as one shot every year to protect yourself from both COVID-19 and influenza? (a) yes, (b) no, or (c) don’t know/unsure.”

The team found that 45% of respondents said that they have, will certainly, or will most likely get a COVID-19 vaccine, while 58% said they would get an influenza vaccine. For a combination influenza-COVID-19 vaccine, overall acceptance was 50%.

“It is interesting that acceptance was higher for the combination vaccine than for the COVID-19 vaccine,” says Block. “This may be due to the convenience of getting two vaccines in one visit or even concern over increased exposure during two visits compared to one. I think we could get some people who are hesitant to consider getting vaccinated if they know they can do them both at the same time.”

Block notes that another explanation for the finding that more people would be willing to get a combination vaccine than a COVID-19 vaccine alone could be that the long history of influenza vaccine safety helped to reduce some participants’ concerns over the newness of the COVID-19 booster.

“The fact that approximately half of the population we surveyed says they were willing to accept a combination vaccine suggests that bundling COVID-19 boosters with the highly accepted influenza vaccines may be a convenient option to increase uptake of vaccines among minorities,” says Lennon.

“An optimal approach may be to offer a combination vaccine first, and if refused, offer individual influenza or COVID-19 boosters to accommodate those who will accept only one.”

Additional coauthors are from the Commonwealth Fund and the African American Research Collaborative 2021 COVID Group. The Commonwealth Fund, the Robert Wood Johnson Foundation, and the WK Kellogg Foundation funded the work.

Source: Penn State

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The first genome-wide, ancient human DNA data from Sudan reveals new insights into the ancestry and social organization of people who lived more than 1,000 years ago.

In Nature Communications, researchers report their analyses of the DNA of 66 individuals from a site in ancient Nubia known as Kulubnarti, located on the Nile River in Sudan, just south of the Egyptian border, an important genetic and cultural crossroads.

“…dividing people up socially on the basis of their genetic ancestry is a recent phenomenon…”

“Before this work, there were only three ancient genome-wide samples available, from Egypt, for the entire Nile Valley,” says first author Kendra Sirak, who began the project as a PhD student at Emory University. “And yet the region was, and still is, an incredibly important part of the world in terms of the movement, meeting, and mixing of people.”

Sirak was the last graduate student of the late George Armelagos, former professor of anthropology at Emory and a pioneer in bridging the disciplines of archeology and biology. While still a graduate student in the 1960s, Armelagos was part of a team that excavated ancient skeletons from Sudanese Nubia, so the bones would not be lost forever when the Nile was dammed.

“Nubia was a place of human habitation for tens of thousands of years,” says Sirak, who is now a staff scientist at Harvard University. “This ancient genetic data helps fill in some major gaps in our understanding of who these people were.”

Two cemeteries

The 66 individuals date back from 1,080 to 1,320 years ago, during the Christian Period of Sudanese Nubia, prior to the genetic and cultural changes that occurred along with the introduction of Islam. The analyses showed how the Kulubnarti gene pool formed over the course of a least a millennium through multiple waves of admixture, some local and some from distant places. They had ancestry seen today in some populations of Sudan, as well as ancestry that was ultimately West Eurasian in origin and likely introduced into Nubia through Egypt.

“A key finding is that social status did not have a strong relationship to biological relatedness or to ancestry in this ancient population, who lived during a period of cultural and social change,” says Jessica Thompson, a co-senior author of the paper. Thompson, a former PhD supervisor of Sirak in Emory’s anthropology department, is now at Yale University.

The remains of the individuals came from two cemeteries with Christian-style burials that previous evidence indicated were socially stratified. In one cemetery, located on an island in the Nile, the skeletal remains bore more markers of stress, disease, and malnutrition and the average age of those buried was just over 10 years old. By contrast, the average age at death in the other cemetery, located on the mainland, was 18 years.

Ancient DNA

One hypothesis that grew out of this skeletal evidence was that the island cemetery was for a Kulubnarti “underclass,” possibly laborers for members of landowning families buried in the mainland cemetery. It was a mystery whether the social stratification may have developed because one population came from a different origin.

A genome-wide analysis suggests that was not the case—the people buried in the separate cemeteries came from a single genetic population.

“It seems that people in this area did not use biological ancestry as a basis for social differentiation,” Thompson says. “This reinforces the point that dividing people up socially on the basis of their genetic ancestry is a recent phenomenon, with no basis in universal human tendencies.”

Another key finding of the genetic analyses shows that some people as close as second-degree relatives were buried across the cemetery divide. Examples of second-degree relationships include grandparents to grandchildren, aunts and uncles to nieces and nephews, and half siblings.

“That indicates that there was some fluidity among the two groups of people,” Sirak says. “There wasn’t an intergenerational caste system that meant someone was prescribed to being in the same social group as all of their relatives.”

Eurasian-derived ancestry

A further interesting twist is that much of the Eurasian-derived ancestry within the population came from women. “Often when you think of ancestry and how genes move, you think of males who are trading or conquering or spreading religion,” Sirak says. “But the genetic data here reveals that female mobility was really crucial to shaping the gene pool in Kulubnarti.”

One possible explanation is that Kulubnarti was a patrilocal system, meaning that males tended to stay where they were born and females moved away from their homelands.

“The Christian Period Nubians from Kulubnarti are fascinating,” Sirak says. “They survived in a barren, isolated, desolate region where life was never easy. I like to think that the ancient DNA research is giving a new life to these people from 1,000 years ago by providing a more nuanced view of them. Anytime you’re studying someone’s remains, their physical being, you owe it to them to tell the most accurate, respectful, and meaningful story that you can.”

Funded by National Geographic Explorer grants, Sirak is now working with Sudanese colleagues to gather and analyze ancient DNA samples from other geographic locations in the Nile Valley, going even deeper into its past, to add more details to the story of how people moved, mixed, and thrived in the region across millennia.

Coauthors of the paper include researchers from Harvard Medical School, Yale University, the University of Colorado Boulder, the University of Vienna, the University of Coimbra in Portugal, the Howard Hughes Medical Institute, the University of Pompeu Fabra in Barcelona, the University of Georgia, the University of California, Santa Cruz, and the University of Michigan.

Source: Emory University

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Decisions feel right to us if we have compared the options as attentively as possible—and if we are conscious of having done so, according to a new study.

This requires a capacity for introspection, researchers report.

Buying a second-hand car at a good price feels good. But choosing a delicious-looking doughnut in the supermarket leaves us riddled with doubt. After all, we resolved to eat a healthier diet this year—so wouldn’t it be better to buy an apple?

We’ve all experienced this feeling at one time or another: some decisions intuitively feel right, while others leave us feeling doubtful and may even cause us to revise our initial choice. But where does this feeling come from?

For the first time, researchers have investigated this question systematically. They used experimental data to develop a computer model that can predict how an individual will choose between different options and why they might subsequently feel confident or doubtful about the decision they made.

“Using our model, we’ve successfully shown that decisions are most likely to feel right if we have invested significant attentional effort in weighing up the different options and, what’s more, are conscious of having done so,” says Rafael Polanía, a professor who heads up the Decision Neuroscience Lab at ETH Zurich.

Consequently, the ability to question and revise poor decisions depends on how well we are able to judge for ourselves whether we thoroughly weighed up the options or allowed ourselves to be distracted during the decision-making process. This self-awareness, which experts typically refer to as introspection, is an essential prerequisite for self-control.

The confidence we have in our own decisions is based on subjective value estimations that we typically make automatically and unquestioningly as part of our day-to-day lives. To enable a systematic analysis of how this process works, Polanía and his team studied how test subjects evaluate and select everyday foods.

The researchers asked 35 study participants to evaluate 64 products from two Swiss supermarket chains. The researchers presented them with a picture of each product on screen and asked how much they would like to eat it at the end of the experiment. In the second part of the experiment, the test subjects viewed a series of pictures that showed two products at the same time. In each case, the researchers asked them to choose one of the two options—doughnut or apple, pizza or pear—and then rate how much confidence they had in their decision.

To make the experiment as realistic as possible, the participants had to eat the products after the experiment. The researchers used an eye scanner during both the evaluation and decision-making phases to determine whether the participants spent longer looking at one of the two products, how often their gaze shifted from left to right, and how quickly they made their decision.

Using this data and a similar dataset from a different research group, Polanía together with his PhD student Jeroen Brus developed a computer model that can predict under which conditions people will have confidence—or a lack thereof—in their decisions.

“We discovered that people are particularly likely to have a bad feeling about a decision if they introspect that they didn’t pay enough attention to comparing the different options,” Polanía says.

The model uses the patterns of participants’ eye movements to determine how much effort they actually put into evaluating and comparing the different products. Someone who takes their time and always keeps both options in their sights is considered to have invested high attentional effort, while those who tend to fixate on just one option and neglect the other are regarded as having been less attentive.

The best way to illustrate these findings is by considering an example from everyday life: if we unthinkingly add a doughnut to our shopping basket, even after expressing an intention to eat more healthily, and subsequently realize that we didn’t even think about healthier alternatives, we ought to have low confidence in our decision and revise it. If, on the other hand, we are conscious of having carefully considered a series of healthier products but then decided against them because we simply wanted the doughnut more than an apple or pear, we should have confidence in our decision.

According to the study’s authors, the ability to question poor decisions and have confidence in good ones depends to a large extent on how conscious an individual is of their subjective value judgements and comparisons after making a decision. This is something neuroscientists refer to as introspection.

“Once we’ve made a decision, we can feel doubtful as to its value and revise it only if we’re actually conscious of the fact that we failed to pay enough attention to comparing the options,” Polanía says. This capacity for introspection is also a crucial part of our ability to exercise self-control. Without it, Polanía says, we would be far more likely to act on our preferences for, say, unhealthy foods without questioning them. The good news is that we can train this ability through mindfulness exercises and meditation.

Polanía says this model could eventually be incorporated into smart glasses that track eye movements. “The glasses could use the model to determine how attentive we’re being and let us know when we should question a decision,” he says.

Polanía also believes the model could be useful for self-driving cars. The algorithms used in autonomous vehicles are constantly making decisions based on a continuous stream of data from the vehicle’s sensors. “Our model could help the vehicle evaluate its decisions and revise them where necessary,” Polanía says.

The research appears in Nature Communications.

Source: ETH Zurich

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To detect wound complications as soon as they happen, researchers have invented a battery-free “smart suture” that can wirelessly sense and transmit information about wounds from deep surgical sites.

Monitoring surgical wounds after an operation is an important step to prevent infection, wound separation, and other complications.

However, when the surgical site is deep in the body, monitoring is normally limited to clinical observations or costly radiological investigations that often fail to detect complications before they become life-threatening. Hard bioelectronic sensors can be implanted in the body for continuous monitoring, but may not integrate well with sensitive wound tissue.

The new smart sutures incorporate a small electronic sensor that can monitor wound integrity, gastric leakage, and tissue micromotions, while providing healing outcomes which are equivalent to medical-grade sutures.

How do the smart sutures work?

The invention has three key components: a medical-grade silk suture coated with a conductive polymer to allow it to respond to wireless signals, a battery-free electronic sensor, and a wireless reader used to operate the suture from outside the body.

One advantage of these smart sutures is that their use involves minimal modification of the standard surgical procedure. During the stitching of the wound, the insulating section of the suture is threaded through the electronic module and secured by applying medical silicone to the electrical contacts.

The entire surgical stitch then functions as a radio-frequency identification (RFID) tag and can be read by an external reader, which sends a signal to the smart suture and detects the reflected signal. A change in the frequency of the reflected signal indicates a possible surgical complication at the wound site.

The smart sutures can be read up to a depth of 50 mm (about 2 inches), depending on the length of stitches involved, and increasing the conductivity of the suture or the sensitivity of the wireless reader could potentially further extend the depth.

Similar to existing sutures, clips, and staples, the smart sutures may be post-operatively removed by a minimally invasive surgical or endoscopic procedure when the risk of complications has passed.

Early alert

To detect different types of complications—such as gastric leakage and infection—the research team coated the sensor with different types of polymer gel.

The smart sutures are also able to detect if they have broken or unraveled, for example, during dehiscence (wound separation). If the suture is broken, the external reader picks up a reduced signal due to a reduction in the length of the antenna formed by the smart suture, alerting the attending doctor to take action.

In experiments, the team showed that wounds closed by the smart sutures and unmodified, medical-grade silk sutures both healed naturally without significant differences, with the former providing the added benefit of wireless sensing.

The team also tested the polymer-coated sutures and found its strength and biotoxicity to the body was indistinguishable from normal sutures, and also ensured that the power levels needed to operate the system were safe for the human body.

“Currently, post-operative complications are often not detected until the patient experiences systemic symptoms like pain, fever, or a high heart rate,” says John Ho, assistant professor from National University of Singapore Electrical and Computer Engineering and the NUS Institute for Health Innovation & Technology.

“These smart sutures can be used as an early alert tool to enable doctors to intervene before the complication becomes life-threatening, which can lead to lower rates of re-operation, faster recovery, and improved patient outcomes.”

In the future, the team is looking to develop a portable wireless reader to replace the setup currently used to wirelessly read out the smart sutures, enabling surveillance of complications even outside of clinical settings. This could enable patients to be discharged earlier from the hospital after surgery.

The team is now working with surgeons and medical device manufacturers to adapt the sutures for detecting wound bleeding and leakage after gastrointestinal surgery. They are also looking to increase the operating depth of the sutures, which will enable deeper organs and tissues to be monitored.

The study is published in Nature Biomedical Engineering .

Source: NUS

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New findings challenge the common advice for women with obesity to lose weight before trying to have a baby.

The study found that women with obesity and unexplained infertility who lost weight prior to starting infertility treatments did not have a greater chance of having a healthy baby than those who did not lose weight prior to starting therapy.

Of United States women between the ages of 20 and 40, 40% are estimated to have obesity, which has been associated with trouble getting pregnant, pregnancy complications, and loss. As a result, it is common for those women to receive guidance to lose weight prior to conception to increase their chances of having a healthy baby.

Richard Legro, professor and chair of the department of obstetrics and gynecology at Penn State Health Milton S. Hershey Medical Center, led the multi-center study of more than 300 women with obesity and unexplained infertility.

No significant differences

Participants had to have a body mass index greater than or equal to 30 kg/m² with regular ovulation and at least one year of unexplained infertility. Women with anovulation, where an egg doesn’t release from the ovary during the menstrual cycle, and polycystic ovary syndrome, where women often experience infrequent or abnormal menstrual cycles as a result of hormone imbalance in the ovaries, were not eligible to participate in the study.

The researchers divided participants into two groups. One group followed a protocol of increased physical activity and targeted weight loss through meal replacements and medication, while members of the other group increased their physical activity without guided weight loss. The women completed these programs for a period of 16 weeks before beginning three cycles of infertility therapy that consisted of ovarian stimulation and intrauterine insemination.

At the end of the study period, the researchers noticed no significant differences in the amount of pregnancies and healthy births between the two groups. Members of the guided weight loss group lost an average of 7% of their body weight, while the other participants experienced no significant weight loss. The results appear in PLOS Medicine.

Time to change advice?

According to Legro, the results add to a growing body of evidence that healthy births are not more likely to occur in women with obesity who lose weight prior to starting infertility treatment than those who have not lost weight prior to conception.

“Although it differs from current clinical standards of care, there’s just not enough evidence to recommend preconception weight loss in women with obesity and unexplained infertility,” Legro says.

While it may not increase a woman with obesity’s chances of delivering a healthy baby, the researchers note there may be other health benefits for these women if they lose weight. Some of the women in the weight loss group had decreased blood pressure and a reduction in waist circumference.

Additional coauthors contributed to the study from the University of Oklahoma Health Sciences Center; Augusta University; the University of North Carolina, Chapel Hill; the University of Pennsylvania; the University of California, San Francisco; the University of Rochester; Atrium Health; the University of Utah; the University of Virginia Center for Research in Reproduction; SUNY Upstate University Hospital; Wayne State University; Penn State College of Health and Human Development; Temple University; the University of Colorado School of Medicine; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; and Yale University. Competing interests from authors can be viewed in the manuscript.

The Eunice Kennedy Shriver National Institute of Child Health and Human Development supported the work, as did the Penn State Clinical and Translational Science Institute and the Yale Center for Clinical Investigation through the National Center for Advancing Translational Sciences of the National Institutes of Health. Nutrisystem and Fitbit also provided discounts for study materials.

Source: Penn State

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Many countries have much room for improvement in end-of-life care, including some high-income countries, researchers report.

They ranked 81 countries on how well their health systems provide for the physical and mental well-being of patients at the end of life. Only six countries earned A grades while 36 earned Ds or Fs.

“We spend billions trying to get people to live longer, but very little in comparison helping people die better.”

Among the most troubling scenes from the COVID-19 era are the images of patients dying in isolation, unable to be with loved ones during their final moments. The new survey shows, however, that even before the pandemic, harrowing deaths were all too common in most parts of the world.

“Society should also be judged on how well people die,” says Eric Finkelstein, a professor and palliative care expert with Duke-NUS and the Duke Global Health Institute who led the study. “Many individuals in both the developed and developing world die very badly—not at their place of choice, without dignity, or compassion, with a limited understanding about their illness, after spending down much of their savings, and often with regret about their course of treatment. These experiences are very common, yet avoidable.”

To compile the rankings, Finkelstein and colleagues surveyed more than 1,200 caregivers from several countries to identify what is most important to patients at the end of life. They then asked 181 palliative care experts across the globe to grade their countries’ health systems on 13 weighted factors that people most often listed, including proper management of pain and comfort, having a clean and safe space, being treated kindly, and treatments that address quality of life, rather than merely extending life.

The United Kingdom earned the highest ranking in the study, followed by Ireland, Taiwan, Australia, South Korea, and Costa Rica, which all earned A grades. Singapore received a B, ranking 23rd among the countries surveyed, while the United States earned a C, ranking 43rd.

At the bottom of the rankings were 20 countries earning failing grades, many of which are low- or middle-income countries with fewer health resources than the top-rated countries.

“Perhaps the main conclusion from this important exercise is that most people in the world die badly—many through no treatment at all and many through excessive often futile treatment that increases suffering,” says Richard Smith, a former editor of the British Medical Journal, who is serving with Finkelstein on The Lancet Commission on the Value of Death, a global panel of palliative care experts who are expected to issue recommendations for improving end-of-life care later this year.

“It’s no coincidence that most of the survey’s top scorers are wealthy countries with well-funded health systems, while low- and middle-income countries fared worse,” says coauthor Stephen Connor, executive director of the Worldwide Hospice Palliative Care Alliance. “The overwhelming need for palliative care is in low- and middle-income countries, where less than a third of services exist.”

But Connor and Finkelstein both point to the US’ middling ranking as proof that money doesn’t always guarantee attention on end-of-life care. In the US, resources are often invested in last-ditch efforts to extend life, rather than measures to ensure comfort and quality of life in a patient’s final days.

“We spend billions trying to get people to live longer, but very little in comparison helping people die better,” says Finkelstein, who is also the director of the Lien Centre for Palliative Care.

The harrowing stories of COVID-19 deaths, when nurses or healthcare workers were often the only people allowed to comfort the dying, should bring renewed focus on end-of-life care, Connor notes.

“Generally, people don’t talk about death. COVID has made it less taboo. We have an opportunity to continue this discussion and not just help COVID patients, but to help everyone have a better end-of-life experience.”

Finkelstein and colleagues hope the country rankings spur action from policymakers to improve conditions for dying patients, such as loosening restrictions on pain medications given to comfort those at the end of life.

But people don’t need to wait for policy change to take steps to ensure a better end-of-life experience. He advises that people develop an advanced care plan or at least express their wishes to friends and family.

“Don’t wait,” Finkelstein urges. “By the time you fall ill, it may be too late and others may not know what you want.”

The research is outlined in three papers (paper 1, paper 2, paper 3) published in the Journal of Pain and Symptom Management. The Lien Foundation, a Singapore-based nonprofit focused on improving quality of life, funded the work.

Source: Duke-NUS

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New research explains how hairs called cilia move fluids and small particles in the body.

Sperm can’t claim all the credit for their strong swimming. Carpets of tiny hairs called cilia lining the inside of the fallopian tubes give them an extra boost, propelling them upwards.

John Toner, a theoretical physicist at the University of Oregon, has created a mathematical model that explains how the cilia align to move particles in a consistent direction. The fluid flowing above the cilia help the hairs to wave in the same direction and push the particles along.

Toner and his colleagues describe the equations in two new papers, published in Physical Review E and Physical Review Letters.

Toner has studied the physics of flocking for years. He previously developed equations that explain how hundreds of birds synchronously swoop across the sky or how schools of fish swim in unison.

But considering the question of cilia requires a slightly different approach.

“In biological systems, much of the important action is happening at a surface where a solid meets a fluid,” Toner says. “What I realized is, that’s a very different kind of flocking than what I’d been thinking about.”

Cilia drive not just sperm, but many other kinds of crucial movements inside the body, including removing mucus from the lungs. They’re an interesting challenge from a physics perspective because the hairs are fixed in place on one end, Toner says.

Aligning is easier when movement is involved. For instance, Toner envisions a large group of people standing in a foggy field. They can see the people near them, but not everyone in the crowd. If asked to all point the same way, they’ll fail to do so. But ask the group to all walk in the same direction, and they’ll succeed.

The liquid moving over the cilia has an important effect, it turns out. It supplies the motion that helps the cilia align in one direction, creating a feedback loop that in turns propels the fluid in a consistent direction. That is, the system stabilizes and self-corrects.

“Individual hairs make small mistakes, but the overall fluid drags it back,” Toner says, like getting pulled into the current of a river.

In the future, Toner wants to improve his model to more closely replicate what’s seen in biological systems. “We treated the fluid above the cilia carpet as if it was infinitely deep,” he says.

But fluid in the body usually moves through small channels. Limiting the depth of the fluid in the model will change the projected interactions between the cilia. How this changes the overall behavior of the whole system remains an open question, Toner says.

Source: Laurel Hamers for University of Oregon

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Over time, being in an on-again-off-again relationship can have a lasting negative influence on mental health, research shows.

The negative effects sometimes linger on for more than a year, says researcher Kale Monk, assistant professor at the University of Missouri.

“We’re seeing several consequences associated with remaining in these relationships, such as less relationship satisfaction, poorer communication, less commitment, more intimate partner violence, and in this particular study, finding that it’s associated with depression and anxiety symptoms over time,” Monk says.

Monk and his colleagues surveyed 545 individuals who were in relationships. Approximately 34% of partners reported relationship cycling, which means they had experienced at least one cycle of breakup and reconciliation in their relationship. He used established measures of depression and anxiety symptoms to analyze the mental health of the individuals in the relationship.

Relationship cycling

In an earlier study, Monk found that on-again, off-again relationship cycling was associated with psychological distress and that those who cycled more frequently—in and out of the same relationship—also reported more distress symptoms. However, in this most recent study, he found that these same debilitating effects can last much longer.

“We followed these people over time, and we found that our prior findings ring true over a year out,” Monk says. “Breaking up and getting back together previously in your relationship was associated with more symptoms of psychological distress over a 15-month period.”

While it can be distressing to be in an on-again, off-again relationship, getting out of one could have well-being benefits. In fact, in a related study, Monk surveyed divorcing individuals—in other words, people who were in the “off” phase of their relationships—and found that, for women who had experienced cycling in their prior relationship, they reported fewer distress symptoms than those who did not experience cycling previously. Monk and his team speculate that these women might have experienced a sense of relief derived from exiting the unstable relationship.

Return to a past love?

Monk says these findings put popular media portrayals of relationship cycling in context. As romantic comedies became increasingly popular, so did the trend of narratives display these relationships in an idealized way.

“There can be a lot of popular narratives that make us think that returning to a former partner is a good idea,” Monk says. “We see it quite often in movies and TV shows, where the main characters break up and get back together. It can lead us to believe that it’s an ideal situation that people should want.”

Although this trend may be problematic for many, returning to a relationship that previously ended is not always doomed to fail.

“In some of our other studies, we certainly do hear from partners who report that time apart made them realize how much they valued each other and they were rededicated to making it work,” Monk says.

Monk adds that it depends on the situation and whether or not cycling becomes a repeated pattern.

“If somebody is considering getting back together with a former partner, it’s really important to consider what caused the breakup and work to make improvements so the pattern does not continue,” Monk says. “It’s also important for the couple to have conversations about what is going to change. How is this relationship going to be different moving forward?”

The latest findings appear in Family Relations: Interdisciplinary Journal of Applied Family Sciences.

Source: University of Missouri

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Emotional exhaustion, isolation, and “nonsensical” visitor and other hospital policies contributed to parents of babies in neonatal intensive care units feeling less satisfied with care during the early days of COVID-19, researchers report.

For a new study, researchers examined the effects on family and financial well-being of 178 parents whose infants were hospitalized in neonatal intensive care units between February 1 and July 31, 2020, during the early period of COVID-19.

Parents reported significant family impact and greater financial difficulty. Extremely premature infants, lower household income, parental mental health, and lower parental confidence were predictive of greater impacts on family life, says first author Ashlee Vance, who was a postdoctoral researcher at the University of Michigan during the study. Vance is now an assistant scientist at Henry Ford Health System at the Center for Health Policy and Health Services Research.

The scores were from a sample of parents in hospitals across the United States.

Anxiety, worry, and hopelessness

Overall, parents reported that the experience of NICU hospitalization during the early months of the pandemic was one of emotional exhaustion and isolation. Parents reported they felt changes in visitor policies due to COVID “split” the family unit, were “nonsensical,” and not family-centered.

Parents also reported that they wanted to be valued as essential caregivers, and wanted acknowledgment and empathy from health care providers about the challenges of having an infant in the NICU during a pandemic.

Vance was surprised at how low the neonatal satisfaction scores were.

“This, to me, signals that families in general had concerns about the care of their infant, yet it’s still unclear as to what contributed to this. Was it COVID specifically? Or overall care that was provided in certain NICUs? This is an area I want to continue to explore,” she says.

Another interesting finding is that mothers in the study didn’t report greater depression during this period. Vance says that one explanation may be that because the questions were designed to capture mood within the last two weeks, it may not have been long enough for more depressive or anxious symptoms to take hold.

However, even though the scores were in the mild range, more than 40% still reported feeling nervous or anxious nearly every day, 32% had difficulty stopping or controlling how much they worried, and 38% said they felt down, depressed, or hopeless several days in the previous two weeks. So, even though overall scores were mild, many were struggling with anxiety, worry, and hopelessness.

Let parents stay in NICU

COVID-19 isn’t going away anytime soon, and Vance believes things can be done to improve parents’ and families’ NICU experiences.

“I think reestablishing a commitment to unlimited family presence can help mitigate the risks associated with a NICU stay,” Vance says. “I think for families a real attention to connection and providing supportive services needs to be a priority for providers. Their workdays are busy but families notice when someone is connecting with them, values their presence, and is empathic.

“It doesn’t cost anything to welcome families into the health care space and new studies are showing that transmission risk in the hospital setting, with mitigation strategies in place, is low.

“If health care workers can continue to work with or without a vaccine and wear a mask and we do not know what practices they abide by when they are not at work, then I think it is unreasonable to limit parents who also live in the same household.”

The study appears in the American Journal of Perinatology. Additional coauthors are from Marquette University, the University of Nebraska Medical Center, and the University of Michigan School of Nursing.

Source: University of Michigan

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As many as a third of people with “wet” age-related macular degeneration, a blinding retinal disease, may someday be able to safely stop eye injection therapy without further vision loss, a preliminary study shows.

The findings fall short of setting a timeline for ending treatment or predicting precisely which patients can stop injections, the researchers say, but add to growing evidence that many people with the disease may not need the lifelong monthly medication currently recommended.

The findings, the researchers say, also point to specific proteins produced at different levels in the eyes of those who stopped therapy, which may lead to the development of a test to accurately identify who may be weaned off medication.

“Such a test could let us tell patients early on how well they would do and when they might be able to stop,” says Akrit Sodhi, professor of ophthalmology and associate professor of ophthalmology at Johns Hopkins University School of Medicine and Wilmer Eye Institute.

Age-related macular degeneration (AMD) is the most common cause of vision loss among people age 50 and older. The majority of those who lose vision from the condition have the “wet” form, characterized by the abnormal growth of blood vessels that leak damaging fluids into the light-sensitive tissues of the eye.

Treatment of wet AMD requires monthly or bimonthly injections of drugs called anti-VEGF—or anti-vascular endothelial growth factor—into the eye. Anti-VEGF agents can slow or stop the growth of the leaky blood vessels and, in most cases, effectively stave off further vision loss.

However, the need to return to a physician’s office or clinic each month for injections is a common barrier to care among patients, leading to missed treatments and potentially worsening vision.

Macular degeneration fluid accumulation

For the study in the Journal of Clinical Investigation, Sodhi and his team analyzed the treatment outcomes of 106 people with wet age-related macular degeneration whom he treated at the Johns Hopkins Wilmer Eye Institute between 2013 and 2020.

Each patient had undergone a customized anti-VEGF injection schedule in which Sodhi monitored response to therapy and determined whether patients needed another injection at each visit or if they could enter a treatment pause in which the injection was held unless there was evidence of new disease activity at the next visit.

Eyes without treatment that showed no signs of fluid accumulation or advancing vision loss after at least 30 weeks of monitoring were considered safely weaned off anti-VEGF therapy.

At the end of a year, up to a third of the patients had stopped anti-VEGF treatments in at least one eye. That amounted to 38 of 122 (31%) of treated eyes. A smaller percentage of eyes still required monthly injections, amounting to treatments for 21 of 122 (17%) patients’ eyes. The other half of patients required treatment every 6–12 weeks; a handful of these patients were also ultimately weaned from treatment at the end of year two.

Patients who stopped anti-VEGF treatments in at least one eye showed the best outcome, with less fluid and improved vision compared with those who required continued injections to maintain their vision.

“Across the board, the patients who could enter a treatment pause did the best even though they were receiving no anti-VEGF drugs. They had better visual acuity, better gain of vision, and less fluid in their retina,” Sodhi says.

Protective protein

The researchers next sought biomarkers that could show what distinguished these patients from those who required monthly injections to maintain their vision.

Before beginning treatment with anti-VEGF therapy using their treatment plan, Sodhi’s team collected small amounts of fluid from the eyes of some of the patients, and continued collecting samples at subsequent clinic visits from many of the patients.

In the fluids, the researchers found differences in the amounts of 172 proteins between patients who were able to stop treatments compared with those who required monthly treatment.

In a proof-of concept experiment, the researchers chose one of the 172 proteins to investigate further—apolipoprotein B100—that other studies had demonstrated is an important part of drusen, the material that accumulates under the retina in all patients with AMD and was thought to promote early changes in dry AMD.

The researchers found that apolipoprotein B100 was present at much higher levels in the eyes of patients who had been weaned off anti-VEGF treatment. They further observed that the levels of this protein were higher in patients who did not develop wet AMD compared with patients who did. The researchers hypothesized this protein may help protect patients from developing wet AMD.

The researchers then conducted tests in mice by inciting in the mouse retina abnormal blood vessel growth similar to that seen in humans with macular degeneration. Mice genetically engineered with elevated apolipoprotein B100 levels had less abnormal blood vessel growth in the retina than mice with lower levels of this protein, suggesting the protein indeed has a protective effect against the retinal disorder.

Sodhi says there are potentially other proteins among the 172 that could be used as biomarkers to predict the response to anti-VEGF therapies. He notes that some of these proteins could be used for developing new macular degeneration treatments.

Randomized clinical trials in a large group of patients with wet macular degeneration must happen before broader recommendations on pausing anti-VEGF therapies can be developed, Sodhi adds.

Additional coauthors are from the University of Maryland and Johns Hopkins University School of Medicine.

The National Eye Institute, Research to Prevent Blindness, Inc., the Alcon Young Investigator Award from the Alcon Research Institute, the Robert Bond Welch Professorship, and the Branna and Irving Sisenwein Professorship in Ophthalmology funded the work.

Source: Johns Hopkins University

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A new technique uses small wearable sensors to gather data on how people who have experienced a traumatic hand amputation use a prosthesis versus a transplant in everyday life.

So far, the data shows people with a transplanted hand demonstrate a more balanced use of their hands than those who use a prosthesis.

“Most activities performed by a typical adult involve a fairly evenly balanced reliance on both hands,” says Scott Frey, chair in cognitive neuroscience in the psychological sciences department at the University of Missouri. Frey also has a joint appointment in the physical medicine and rehabilitation department.

“Over the course of a normal day, roughly 55% of people’s activities involve the dominant hand and 45% involve the non-dominant hand. Now we have evidence that shows experienced prosthesis users rely on their prosthetic hand during about 20% of daily activities and use their uninjured limb for the remaining 80%.

“Hand transplant recipients exhibit a more balanced pattern of limb use that is closer to what we see in healthy adults, although not quite at the 55%/45% split.”

Nevertheless, Frey also notes that a hand transplant comes with significant risks, such as developing certain infections and cancers from the lifetime use of immunosuppressants needed to help keep the body from rejecting the new hand.

The findings from the new study in the journal Neurorehabilitation and Neural Repair could help physicians and other medical professionals personalize treatment options to meet a patient’s individual needs based on their daily routine.

“We can bring people into a clinic or laboratory setting, and measure how they are doing with a prosthetic or hand transplant, but these observations are typically made under optimal and artificial conditions, and therefore might not accurately show us how people are truly functioning during their everyday lives,” Frey says.

“These sensors, which continuously record movements over multiple days while people go about their lives, have the ability to revolutionize treatments by providing real world data that will help us develop personalized approaches to treat traumatic hand loss.”

While military personnel can experience a traumatic hand loss in both combat and non-combat situations, Frey says these injuries can also occur in civilian populations with work-related or recreational accidents, such as with farming equipment or fireworks.

Researchers collected data continuously over three days as participants went about their normal lives. They wore four different sensors—two on the wrists of the prosthetic or transplanted hand as well as on the uninjured limb, and one on each the upper arms.

The technique could also lead to new ways for medical professionals to evaluate the effectiveness of treatments and personalized care for a variety of neurological diseases that affect hand use, including multiple sclerosis and stroke, Frey says.

Frey’s own mother had multiple sclerosis, and watching her condition deteriorate continues to motivate his work into furthering knowledge of the neural mechanisms and cognitive processes that are responsible for complex behaviors.

In addition to possible applications in other areas of medicine, including neurology, Frey’s approach is currently being used to investigate patterns of recovery in individuals with severe upper limb injuries who are at increased risk of developing chronic one-handedness through learned disuse of the injured limb.

Additional coauthors are from the University of Louisville, the Hanger Clinic in Salt Lake City, Utah, and the University of Missouri.

The Department of Defense funded the work.

Source: University of Missouri

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“Doomscrolling,” a term used to describe the concept of binging on negative news, is a new and unique behavior, and not just another trendy, clickbaity phrase, a new study finds.

The study in Technology, Mind, and Behavior also developed a technique to measure doomscrolling, paving the way for researchers to further investigate the concept and make sense of people’s obsessive focus on negative news.

The researchers set out to determine if doomscrolling was just a new name for an existing issue. The term is thought to have originated in 2018 on Twitter, gaining popularity in 2020 during the height of the COVID-19 pandemic.

It starts when users of social media want to stay up-to-date with the latest news—specifically negative news. Over time, however, it turns into compulsive online scrolling for negative information, according to the study’s findings.

A key purpose of the research was to design and assess a survey scale that could measure doomscrolling. Results showed that the measure had good accuracy and that a doomscroller is more than just someone who is interested in remaining informed.

“It’s this obsession with trying to make sense of the crisis or all of our crises,” says Benjamin K. Johnson of the University of Florida. “It’s the combination of living through a crisis and having a smartphone with a newsfeed that never ends. It just keeps going. So, we keep scrolling.”

The study also found that there are no ideological differences between doomscrollers; they are both left- and right-leaning. But men and young people were more likely to engage in the behavior than women and older adults.

“It was a surprising finding,” says Bhakti Sharma, also of the University of Florida. “I didn’t even think gender would be a factor.”

It’s unclear what triggers the behavior. Johnson says it’s specific to the moment users are currently experiencing; between the pandemic, political issues in the world, and mass shootings, people can get sucked into seeking bad news. The study found doomscrolling can be associated with a fear of missing out and constantly being connected online through smartphones.

It remains unclear if doomscrolling causes anxiety or if anxiety leads to it. Although the study’s authors believe that they feed off each other, establishing the cause and effect will require further research.

News organizations should take note of the behavior of doomscrollers, Johnson says. Although doomscrolling does lead to the consumption of more news, it’s a particular type of news. And once doomscrollers become aware of what they’re doing, they may take proactive measures to address it, the study suggests.

“People do recognize their behavior; that maybe they are consuming too much negative news, and they put in measures to opt out of that,” Johnson says. “They become self-aware that ‘this is making me feel bad,’ and they can work to form new media habits.”

That could be detrimental to news organizations, which often rely on stories shared through social media to drive traffic to their websites. Also, the study found people may become wary of social media accounts that post disproportionate amounts of negative content.

Johnson suggests news organizations balance their share of bad news with positive ones on social media. And ideally, as the awareness of doomscrolling grows, social media platforms will allow users a more in-depth customization of their news feeds, he says.

Source: University of Florida

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Marketing researchers have identified the combination of characteristics that make people “like” images on Instagram.

Previous work found there are two aspects of an image that people respond to: feature complexity and design complexity. Essentially, feature complexity refers to fundamental characteristics such as color and brightness. Design complexity refers to the actual things found in an image and how they are arranged.

Image complexity and Instagram ‘likes’

To begin their analysis of how people respond to image complexity, the researchers identified six measures that can be used to assess various aspects of image complexity:

• Distribution of color in the image;
• Distribution of luminance in the image;
• Number of edges within the image;
• Number of objects in the image;
• Regularity of objects, which is determined by whether objects share an orientation and the extent to which they overlap; and
• How symmetrical the arrangement of objects is.

The researchers wrote a computer program to scan images and automatically generate scores for each of the six measures. The researchers also ran a validation experiment to ensure that the image assessment program was consistent with how humans perceive complexity in images.

The researchers then created a model to determine which combination of measures was most closely associated with generating “likes” on Instagram. The model accounted for confounding variables, such as the number of followers a given Instagram feed has.

These two qualities count the most

For the study, the researchers fed 147,963 Instagram images and related data into the model.

“We found that all six measures are important, but there were particular patterns in which images generated the most positive feedback,” says William Rand, coauthor of a paper on the work and an associate professor of marketing at North Carolina State University.

When it comes to feature complexity, the researchers found that there is a sweet spot right in the middle. Consumers preferred images with some diversity of light and color, but not too much and not too little. The opposite is true for design complexity. People preferred images that were either very simple or very complex.

“In practical terms, we found that you could improve the number of likes of any given image by about 3% if you applied the appropriate filter to address issues related to feature complexity,” says Rand.

“That’s nothing to sneeze at, particularly since applying a filter only takes a few seconds. What’s more, our model suggests that optimizing both feature and design complexity could improve consumer engagement by about 19%—after accounting for variables such as an account’s total number of followers.

“We are increasingly able to determine whether images included in social media messages are likely to garner interest from consumers,” says Rand. “But a lot of the variables that we know affect public interest have very little to do with the images themselves.

“For example, a brand’s strength, and the number of followers it has on Instagram, is the strongest predictor of whether consumers will engage with an image,” Rand says. “The text accompanying an image is also important.

“We’re putting this out there with the idea that it can be used to inform decisions made by design professionals in the marketing sector. But we’ve made the raw code for the model available. It’s not in a user-friendly format right now, but I’m sure the right tech-savvy people could use it to create a valuable tool for the industry.”

The paper appears in the International Journal of Research in Marketing. Coauthors are from the Rochester Institute of Technology, the University of Amsterdam, and the Ferdowsi University of Mashhad.

Source: NC State

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Sex education lacks representation of Black and Brown people, research finds.

In recent years, attention to diversity of images in visual media—TV, movies, stock photos, children’s books, and more—has increased.

The new paper investigates skin color and skin tone diversity in anatomical diagrams within contemporary human sexuality textbooks. Their findings appear in the Journal of Sex & Marital Therapy.

The research team found that only 1.1% of diagrams represented dark skin tones, while 83.5% represented light skin tones. Their findings are based on analysis of skin tone and skin color diversity in 182 anatomical diagrams and images from eight contemporary, college-level human sexuality textbooks.

“Our findings demonstrate a pattern of staggeringly uneven representation of darker skin tones in comparison to lighter skin tones,” says Deana Williams, a doctoral student in the Center for Sexual Health Promotion at the Indiana University School of Public Health-Bloomington.

“And in some images where skin colors commonly associated with Black and Brown people were presented, the hues were noticeably washed out or lightened with white shading.”

“Sex research and education materials—including human sexuality textbooks—rarely reflect racial or skin tone diversity and inclusion in their anatomical imagery,” says Yael R. Rosenstock Gonzalez, also a doctoral student at the Center for Sexual Health Promotion.

The most frequent skin color coded was white with pink undertones, which comprised 42.3% of the anatomical images. The second most prevalent color was pinkish brown, at 29.1%.

While skin color and skin tone alone are not necessarily definitive indicators of race, they are what we use to quickly categorize individuals, the researchers say. Depicting light skin tones as normative perpetuates not only racism but also colorism, which privileges light skin over dark skin.

“Racism and colorism perpetuate body ideals that have implications for self-esteem, disordered eating, and mental health and well-being, as well as sexual and reproductive health,” says Debby Herbenick, the center’s director and a professor. “Our findings demonstrate the perpetuation of colorism within sexuality education, and how colorism becomes part of institutional structures and systems of formal education.”

The researchers note that such skin color bias has a negative impact on the health outcomes of people with dark skin tones, who may avoid or delay sexuality education opportunities or clinical care if they do not see themselves represented in recommended resources, thereby endangering their sexual and reproductive health.

“Sexuality authors and educators as well as sexuality textbook editors and publishers need to recognize the ways that white supremacy culture affects sexuality education materials and reevaluate how we can create richer, more holistic representations,” Rosenstock Gonzalez says.

The university’s Racial Justice Research Fund supported the work.

Source: Indiana University

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Researchers suspect that the Earth’s heat may dissipate sooner than previously thought.

The researchers have come to this conclusion after showing in the lab how well a mineral common at the boundary between the Earth’s core and mantle conducts heat.

The evolution of our Earth is the story of its cooling: 4.5 billion years ago, extreme temperatures prevailed on the surface of the young Earth, and it was covered by a deep ocean of magma. Over millions of years, the planet’s surface cooled to form a brittle crust. However, the enormous thermal energy emanating from the Earth’s interior set dynamic processes in motion, such as mantle convection, plate tectonics, and volcanism.

Still unanswered, though, are the questions of how fast the Earth cooled and how long it might take for this ongoing cooling to bring the aforementioned heat-driven processes to a halt.

One possible answer may lie in the thermal conductivity of the minerals that form the boundary between the Earth’s core and mantle.

This boundary layer is relevant because it is here that the viscous rock of the Earth’s mantle is in direct contact with the hot iron-nickel melt of the planet’s outer core. The temperature gradient between the two layers is very steep, so there is potentially a lot of heat flowing here. The boundary layer is formed mainly of the mineral bridgmanite. However, researchers have a hard time estimating how much heat this mineral conducts from the Earth’s core to the mantle because experimental verification is very difficult.

Now, researchers have developed a sophisticated measuring system that enables them to measure the thermal conductivity of bridgmanite in the laboratory, under the pressure and temperature conditions that prevail inside the Earth. For the measurements, they used a recently developed optical absorption measurement system in a diamond unit heated with a pulsed laser.

“This measurement system let us show that the thermal conductivity of bridgmanite is about 1.5 times higher than assumed,” says Motohiko Murakami, a professor at ETH Zurich. This suggests that the heat flow from the core into the mantle is also higher than previously thought. Greater heat flow, in turn, increases mantle convection and accelerates the cooling of the Earth. This may cause plate tectonics, which is kept going by the convective motions of the mantle, to decelerate faster than researchers were expecting based on previous heat conduction values.

The researchers have also shown that rapid cooling of the mantle will change the stable mineral phases at the core-mantle boundary. When it cools, bridgmanite turns into the mineral post-perovskite. But as soon as post-perovskite appears at the core-mantle boundary and begins to dominate, the cooling of the mantle might indeed accelerate even further, the researchers estimate, since this mineral conducts heat even more efficiently than bridgmanite.

“Our results could give us a new perspective on the evolution of the Earth’s dynamics. They suggest that Earth, like the other rocky planets Mercury and Mars, is cooling and becoming inactive much faster than expected,” Murakami explains.

However, he cannot say how long it will take, for example, for convection currents in the mantle to stop. “We still don’t know enough about these kinds of events to pin down their timing.”

To do that calls first for a better understanding of how mantle convection works in spatial and temporal terms. Moreover, scientists need to clarify how the decay of radioactive elements in the Earth’s interior—one of the main sources of heat—affects the dynamics of the mantle.

The research appears in Earth and Planetary Science Letters. Additional researchers from Carnegie Institution for Science contributed to the work.

Source: ETH Zurich

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Boosting levels of the neurotransmitter norepinephrine with atomoxetine, a repurposed ADHD medication, may be able to stall neurodegeneration in people with early signs of Alzheimer’s disease, according to a new study.

The results appear in the journal Brain.

This is one of the first published clinical studies to show a significant effect on the protein tau, which forms neurofibrillary tangles in the brain in Alzheimer’s. In 39 people with mild cognitive impairment (MCI), six months of treatment with atomoxetine reduced levels of tau in study participants’ cerebrospinal fluid (CSF), and normalized other markers of neuro-inflammation.

The study points toward an alternative drug strategy against Alzheimer’s that does not rely on antibodies against tau or another Alzheimer’s-related protein, beta-amyloid. A recent FDA-approved drug, adacanumab, targets beta-amyloid but its benefits are controversial among experts in the field.

Larger and longer studies of atomoxetine in MCI and Alzheimer’s are warranted, the researchers conclude. The drug did not have a significant effect on cognition or other clinical outcomes, which was expected given the relatively short study duration.

“One of the major advantages of atomoxetine is that it is already FDA-approved and known to be safe,” says senior author David Weinshenker, professor of human genetics at Emory University School of Medicine. “The beneficial effects of atomoxetine on both brain network activity and CSF markers of inflammation warrant optimism.”

“We are encouraged by the results of the trial,” says lead author Allan Levey, professor of neurology at Emory University School of Medicine and director of the Goizueta Institute @Emory Brain Health. “The treatment was safe, well tolerated in individuals with mild cognitive impairment, and modulated the brain neurotransmitter norepinephrine just as we hypothesized. Moreover, our exploratory studies show promising results on imaging and spinal fluid biomarkers which need to be followed up in larger studies with longer period of treatment.”

The researchers picked atomoxetine, which is commercially available as Strattera, with the goal of boosting brain levels of norepinephrine, which they thought could stabilize a vulnerable region of the brain against Alzheimer’s-related neurodegeneration.

Norepinephrine is produced mainly by the locus coeruleus, a region of the brainstem that appears to be the first to show Alzheimer’s-related pathology—even in healthy, middle-aged people. Norepinephrine is thought to reduce inflammation and to encourage trash-removing cells called microglia to clear out aggregates of proteins such as beta-amyloid and tau. Increasing norepinephrine levels has positive effects on cognition and pathology in mouse and rat models of Alzheimer’s.

“Something that might seem obvious, but was absolutely essential, was our finding that atomoxetine profoundly increased CSF norepinephrine levels in these patients,” Weinshenker says. “For many drugs and trials, it is very difficult to prove target engagement. We were able to directly assess target engagement.”

Weinshenker also emphasizes that the trial grew out of pre-clinical research conducted in animal models, which demonstrated the potential for norepinephrine.

The researchers conducted the study between 2012 and 2018 with a cross-over design, such that half the group received atomoxetine for the first six months and the other half received placebo—then individuals switched. It is possible that participants who received atomoxetine for the first six months experienced carryover effects after treatment stopped, so their second six month period wasn’t necessarily a pure placebo.

Study participants were all diagnosed with mild cognitive impairment and had markers of potential progression to Alzheimer’s in their CSF, based on measuring tau and beta-amyloid. More information about inclusion criteria is available at clinicaltrials.gov.

The researchers measured levels of dozens of proteins in participants’ CSF; the reduction of tau from atomoxetine treatment was small—about 5% over six months—but if sustained, it could have a larger effect on Alzheimer’s pathology. No significant effect on beta-amyloid was seen.

In addition, in participants taking atomoxetine, researchers were able to detect an increase in metabolism in the medial temporal lobe, critical for memory, via PET (positron emission tomography) brain imaging.

Study participants started with a low dose of atomoxetine and ramped up to a higher dose, up to 100mg per day. Participants did experience weight loss (4 pounds, on average) and an increase in heart rate (about 5 beats per minute) while on atomoxetine, but they did not display a significant increase in blood pressure. Some people reported side effects such as gastrointestinal symptoms, dry mouth, or dizziness.

The FDA approved atomoxetine in 2002 for ADHD (attention deficit hyperactivity disorder) in children and adults, and the drug has been shown to be safe in older adults. It is considered to have low abuse potential, compared with conventional stimulants that are commonly prescribed for ADHD.

Looking ahead, it is now possible to visualize the integrity of the locus coeruleus in living people using MRI techniques, so that could be an important part of a larger follow-up study, Weinshenker says. Atomoxetine’s effects were recently studied in people with Parkinson’s disease—the benefits appear to be greater in those who have reduced integrity of the locus coeruleus.

Funding for the study was provided by the Cox and Kenan Family foundations and the Alzheimer’s Drug Discovery Foundation.

Source: Emory University

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