The mutual dependencies of many plant species and their pollinators mean that the negative effects of climate change are exacerbated. As UZH researchers show, the total number of species threatened with extinction is therefore considerably higher than predicted in previous models.

The mutual dependencies of many plant species and their pollinators mean that the negative effects of climate change are exacerbated. As UZH researchers show, the total number of species threatened with extinction is therefore considerably higher than predicted in previous models.

Global climate change is threatening biodiversity. To predict the fate of species, ecologists use climatic models that consider individual species in isolation. This type of model, however, overlooks the fact that species are part of a giant network of mutual dependencies: For example, plants need insects to disperse their pollen and, in turn, insects depend on plants for food.

Seven pollination networks in Europe investigated

These types of mutually beneficial interactions have been very important in generating the diversity of life on Earth. But the interaction also has a negative knock-on effect when the extinction of one species causes other species that are dependent on it to also die out, an effect that is called co-extinction. Evolutionary biologists at the University of Zurich, together with ecologists from Spain, Great Britain and Chile, have now quantified how much more of an impact climate change has on biodiversity when these mutual dependencies between the species are taken into account. To this end, the researcher team analyzed the networks between flowering plants and their insect pollinators in seven different regions of Europe.


Extinction of the rock rose means the myrtle is also under threat

First author Jordi Bascompte gives a specific example to illustrate the results of the study: "In one of the networks situated in southern Spain, the sage-leaved rock rose has a 52 percent predicted probability of extinction caused by climate change in 2080. Should this happen, one of its pollinators, the small carpenter bee, would face a risk of co-extinction as a consequence of losing one of the resources it depends upon. Because the small carpenter bee also pollinates the myrtle, the latter is also under threat of extinction." Thus while the predicted extinction risk of the myrtle considered in isolation is 38 percent, the risk rises to around 62 percent when taking into account the network of interactions.

"If the interactions of individual species are also considered, the total number of species threatened with extinction rises," summarizes Bascompte. "Some species with a very low likelihood of climate-related extinction according to the traditional model are at high risk of extinction due to their dependencies."

Optical illusions reveal that regular waves of brain activity enable visual feature integration

Optical illusions reveal that regular waves of brain activity enable visual feature integration

Rhythmic waves of brain activity cause people to see or not see complex images that flash before our eyes. An image can become practically invisible if it flashes before our eyes at the same time as a low point of those brain waves. We can reset that brain wave rhythm with a simple voluntary action, like choosing to push a button.

The new results come from experts who use optical illusions to understand human vision. Human sight involves activity both in the eyes and in the brain. Optical illusions are formed by playing tricks on any part of our complex visual system.

"This is the first record of rhythmic brain activity used to achieve integrated visual perception," said Associate Professor Isamu Motoyoshi from the University of Tokyo and co-author of the recent research article.

NIH and radiology societies map path for translational research on AI in medical imaging Clinical emphasis rounds out foundational research focus of earlier report.

NIH and radiology societies map path for translational research on AI in medical imagingClinical emphasis rounds out foundational research focus of earlier report.

A new report, with contributions from the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health, provides a roadmap for translational research on artificial intelligence (AI) in medical imaging. The report, published in the May 28, 2019, Journal of the American College of Radiology, identifies research priorities that leverage big data, the cloud, and machine learning for augmenting clinicians’ image planning and use to make diagnoses or assess patients’ responses to therapy.

This report and a companion report published last month summarize conclusions from an August 2018 workshop co-organized by NIH, the Radiologic American College of Radiology (ACR), the Radiological Society of North America (RSNA), and The Academy for Radiology and Biomedical Imaging Research. The first report published April 16, 2019, maps a path forward for foundational research in AI and this second report focuses on translational research necessary to deliver AI to clinical practice.

“Radiology has transformed the practice of medicine in the past century, and AI has the potential to radically impact radiology in positive ways,” said Krishna Kandarpa, M.D., Ph.D., co-author of the report and director of research sciences and strategic directions at NIBIB. “This roadmap is a timely survey and analysis by experts at federal agencies and among our industry and professional societies that will help us take the best advantage of AI technologies as they impact the medical imaging field.”

The companion reports — co-authored by government, industry, academia and radiology specialty society leaders — have identified and prioritized initiatives to accelerate foundational and translational research in AI for medical imaging.

“This new roadmap paper gives guidance for the clinical translation of AI innovation,” said Curtis P. Langlotz, M.D., Ph.D., report co-author and RSNA Board Liaison for Information Technology and Annual Meeting. “Together, these two connected roadmaps show us how AI not only will transform the work of radiologists and other medical imagers, but also will enhance the delivery of care throughout the clinical environment.”

The authors suggest that the application of AI can impact the entire radiology process, from the clinical decision to perform diagnostic imaging, to preparation of patients for procedures, to conducting the scan, to interpretation of imaging results, and finally to the management of workflow in radiology departments. While most attention is drawn to the power of computers to aid in interpreting images, there is ongoing research on AI applications that address every aspect of the imaging process, according to the report. AI tools considered by this roadmap are algorithms for disease detection and classification, image optimization, radiation reduction, and workflow enhancement. The authors suggest that radiologists should take the lead in identifying the most important areas for AI development.

The authors identified key priorities:

• Structured AI use cases. In software development, use cases define who will use a system and for what specific goal. AI use cases should define and highlight clinical challenges potentially solvable by AI.
• Data sharing. Researchers should establish methods to encourage data sharing for training and testing AI algorithms to promote generalizability to widespread clinical practice and minimize unintended bias.
• Tools for validation and performance monitoring of AI algorithms to facilitate regulatory approval.
• Standards and common data elements for seamless integration of AI tools into existing clinical workflows.

“Although advances in foundational research are occurring rapidly, translation to routine clinical practice has been slower because we must ensure AI in medical imaging is useful, safe, effective, and easily integrated into existing radiology workflows before they can be used in routine patient care,” said Bibb Allen, M.D., report co-author and chief medical officer of the ACR Data Science Institute.

The report establishes that an important goal of the resulting roadmap is to grow an ecosystem—facilitated by professional societies, industry, and government agencies—that will allow robust collaborations between practicing clinicians and AI researchers to advance foundational and translational research relevant to medical imaging.

“This NIBIB sponsored workshop was an important step in coordinating private and government efforts related to AI implementation in medical imaging,” said Mitchell Schnall, M.D. Ph.D., Eugene P. Pendergrass Professor & Chair of Radiology, University of Pennsylvania, Philadelphia; vice president & DxCP Task Force Chair, Academy of Radiology & Biomedical Imaging Research. “It will take a true public-private partnership to realize the tremendous potential contribution of AI to transform medical imaging, and this roadmap is the first step in that direction.”

About the National Institute of Biomedical Imaging and Bioengineering:  NIBIB’s mission is to improve health by leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the physical and engineering sciences with the life sciences to advance basic research and medical care. NIBIB supports emerging technology research and development within its internal laboratories and through grants, collaborations, and training. More information is available at the NIBIB website: https://www.nibib.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Researchers at the University of Southampton have forecast a worldwide move towards smaller birds and mammals over the next 100 years.

Researchers at the University of Southampton have forecast a worldwide move towards smaller birds and mammals over the next 100 years.

In the future, small, fast-lived, highly-fertile, insect-eating animals, which can thrive in a wide-variety of habitats, will predominate. These 'winners' include rodents, such as dwarf gerbil -- and songbirds, such as the white-browed sparrow-weaver. Less adaptable, slow-lived species, requiring specialist environmental conditions, will likely fall victim of extinction. These 'losers' include the tawny eagle and black rhinoceros.

The researchers predict the average (median) body mass of mammals specifically will collectively reduce by 25 per cent over the next century. This decline represents a large, accelerated change when compared with the 14 per cent body size reduction observed in species from 130,000 years ago (the last interglacial period) until today.

Findings are published in detail in the journal Nature Communications.

Rob Cooke is lead author on this work and a postgraduate researcher at the University of Southampton. He comments: "By far the biggest threat to birds and mammals is humankind -- with habitats being destroyed due to our impact on the planet, such as deforestation, hunting, intensive farming, urbanisation and the effects of global warming.

'Breakthrough' diabetes drug cut kidney and heart disease deaths by a third, trial shows

'Breakthrough' diabetes drug cut kidney and heart disease deaths by a third, trial shows

A breakthrough treatment could help protect hundreds of millions of people from the “21st century epidemic” of deadly diabetic kidney disease, a major trial has found.

Research from Australia and the UK has shown that a once-a-day blood sugar lowering drug, canagliflozin, reduced cases of kidney failure and death by a third in diabetic patients.

There are nearly five million UK diabetics and diabetic kidney disease costs the NHS as much as £927m a year according to researchers . However there have been no new treatments for nearly two decades.

“There are more than 400 million people with diabetes worldwide, around 40 per cent of these people will get kidney disease,” said the study’s lead author Professor Vlado Perkovic, executive director of the George Institute for Global Health.

“Once they’ve got kidney disease, they’re at very high risk of kidney failure, heart attack, stroke, and of death.”

Epidural Positioning During Labor May Affect Outcomes

Epidural Positioning During Labor May Affect Outcomes

New York—A new study examining a potential effect of patient positioning on epidural pressure during labor is raising the question of whether higher epidural pressure is a clinical concern in this context. The study’s authors say anesthesiologists should administer an epidural in a lateral decubitus position during labor because there is less epidural pressure and better uteroplacental perfusion, making it safest for mother and infant.

In contrast, other experts say there is no reason to be concerned with positioning and there is no evidence that epidural pressure affects labor or fetal outcomes.

“Maintaining adequate uteroplacental perfusion in a lateral position, as reflected by lower epidural pressures during an epidural block, can protect against maternal hypotension and minimize the potential for maternal and neonatal morbidity, and our study shows that a lateral decubitus position is safe for both the mother and fetus,” said lead researcher Shaul Cohen, MD, the director of obstetric anesthesia at Rutgers-Robert Wood Johnson Medical School, in New Brunswick, N.J.

Dr. Cohen reached this conclusion after he and his colleagues retrospectively reviewed medical records from 100 women who gave birth at their institution and received epidural analgesia in the sitting position, compared with 80 women who were administered epidural analgesia in the lateral position.

The investigators analyzed fetal distress and maternal hypotension to determine if there was a relationship between epidural pressure, positioning and those two outcomes.

Dr. Cohen’s gravity-based technique involves connecting a syringe with IV extension tubing filled with 20 mL of 0.1% ropivacaine, 1 mcg/mL of sufentanil and 2 mcg/ml of epinephrine attached to the epidural needle, which is positioned in the epidural space. “We assumed that the epidural pressure correlated to the length of the fluid column just before it started to flow into the epidural space, while fluid levels fluctuated along with maternal heart rates and respirations.” Dr. Cohen explained that a higher column of fluid in the IV tubing indicated greater epidural pressure.

In a presentation at the 72nd Annual Postgraduate Assembly in Anesthesiology (abstract P-9074), Dr. Cohen’s team reported that average epidural pressure was higher in women administered anesthetic in the sitting position than the lateral decubitus position. For patients giving birth for the first time, for example, the height of the fluid column in the sitting position was 38.81 (±1.67) cm H2O, compared with 18.9 (±0.88) cm H2O in the lateral position (P<0.0001). Epidural pressures were similarly higher in women who had given birth previously and were administered an epidural in the sitting position

Higher epidural pressures in the sitting position indicate the uterus may be partially occluding the vena cava, thus potentially reducing uteroplacental perfusion and compromising fetal well-being as well as increasing the risk for hypotension, Dr. Cohen noted. Although there were no signs of either outcome during the first hour of the epidural block in either group, he believed this was a reflection of the healthy population of patients and fetuses in the study, and that outcomes could have differed if patients with higher-risk pregnancies were included.

“Healthy mothers and healthy babies can tolerate this reduction in uteroplacental perfusion, but women with diabetes, severe preeclampsia, and those who have early separation of the placenta—which can be silent and not immediately diagnosed—already have preexisting compromised uteroplacental perfusion, so further reducing uteroplacental perfusion places them and their fetuses at greater risk of poor outcomes,” he said.

As evidence that positioning matters, Dr. Cohen cited an earlier publication that reported a 20% rate of vasovagal reflexes in women administered an epidural in the sitting position during labor (Int J Obstet Anesth 2008;17[2]:146-149).

However, not everyone was convinced. Neither that study nor Dr. Cohen’s research convinced Stephen Halpern, MD, an obstetric anesthesiologist and a professor of anesthesia at the University of Toronto Faculty of Medicine, that epidural anesthetic is safer to administer in the lateral position. According to Dr. Halpern, a major weakness of Dr. Cohen’s study is that his team did not objectively measure fetal harm to support their assertion that fetal well-being can be affected by epidural pressure. In view of that gap and what he said was a lack of data indicating that epidural pressure is related to negative birth outcomes, Dr. Halpern said he won’t be changing his practice.

“During labor and during life, pregnant women assume all sorts of positions for various periods of time,” said Dr. Halpern. “I would continue to use the body position that is most efficient and comfortable for the patient.”

—David Wild

How to eat healthily

How to eat healthily

Healthy eating is a pattern. It's about how you eat over days, weeks and even months. The simple steps in this guide show you how to eat a diet that's naturally low in salt, sugar and saturated and trans fats.

Healthy eating patterns don't focus on one type of food or one type of nutrient to promote heart health. Heart-healthy eating relies on a combination of foods, chosen regularly, over time.

This style of eating is naturally low in saturated and trans fats, salt and added sugar. And it's rich in wholegrains, fibre, antioxidants and unsaturated fats.

Fruit, vegetables and wholegrains

These foods are high in fibre, vitamins and minerals. Eating plenty of vegetables, fruits and wholegrains is consistently linked to people having healthier hearts. And research shows there is a link between eating them and having a lower risk of heart disease.

Study Shows Intrathecal Bupivacaine Effective for Long-Term Cancer Pain Treatment

Study Shows Intrathecal Bupivacaine Effective for Long-Term Cancer Pain Treatment

Boston-Patients suffering from cancer pain refractory to systemic opioids may find relief in an unlikely source, according to a pilot study by Swedish researchers: intrathecal bupivacaine. They concluded that the therapy can be effectively used for long-term pain management in these individuals with little increase in dose and few of the side effects that often accompany opioid-related treatment.

“Treating cancer pain with morphine is often effective, but it’s not without its problems,” said Anders Wincent, MD, a senior consultant at the Karolinska University Hospital in Stockholm. “Previously we found there was no analgesic benefit to adding morphine to intrathecal bupivacaine in severe cancer-related pain [Int J Clin Pharmacol Ther 2017;55(6):525-532]. So in this study we wanted to see if we could address this pain only with intrathecal bupivacaine.”

Putting It to the Test

To help answer this question, Dr. Wincent and his co-investigator Karl-Fredrik Sjolund, MD, PhD, enrolled 30 adult patients (17 women; median age, 55 years) with cancer-related pain, who presented to the institution between November 2013 and June 2017, into the longitudinal case series; each was receiving systemic opioid therapy. All patients were started on an intrathecal bupivacaine infusion of 2 mg/mL; flow rates and subsequent bolus doses were titrated as necessary. The catheter tip was positioned cranially to the individual’s most painful dermatome; catheter tip position was verified with fluoroscopy. After subcutaneous tunneling, the catheter was attached to a subcutaneous port and connected to an external pump.

Before intrathecal bupivacaine therapy, the participants completed a pain-related questionnaire. Follow-up was performed by nurses via a structured telephone interview with the patients, their families or staff at a palliative care facility or hospital. Pain intensity at rest and during activity was measured using the numerical rating scale (NRS); other tools included the short form of the Brief Pain Inventory, the revised Edmonton Symptom Assessment Scale and ECOG Performance Status.

Motor function was graded with the modified Bromage scale (0-3); daily systemic opioid data were extracted from electronic health records. Patient data were collected on the day before and day of catheter insertion; one day after catheter insertion; on days 3, 7, 14, 21 and 28; and once monthly thereafter.

                                                                                  

Structure of Sesquisabinene Synthase 1, a Terpenoid Cyclase That Generates a Strained [3.1.0] Bridged-Bicyclic Product

The natural product sesquisabinene is a key component of the fragrant essential oil of the sandalwood tree, currently valued at $5,000/L. Sesquisabinene contains a highly strained [3.1.0] bicyclic ring system and is generated from farnesyl diphosphate in a reaction catalyzed by a class I terpenoid cyclase. To understand how the enzyme directs the formation of a strained hydrocarbon ring system, we now report the X-ray crystal structure of sesquisabinene synthase 1 (SQS1) from the Indian sandalwood tree (Santalum album). Specifically, we report the structure of unliganded SQS1 at 1.90 Å resolution and the structure of its complex with three Mg2+ ions and the inhibitor ibandronate at 2.10 Å resolution. The bisphosphonate group of ibandronate coordinates to all three metal ions and makes hydrogen bond interactions with basic residues at the mouth of the active site. These interactions are similarly required for activation of the substrate diphosphate group to initiate catalysis, although partial occupancy binding of the Mg2+B ion suggests that this structure represents the penultimate metal coordination complex just prior to substrate activation. The structure of the liganded enzyme enables a precise definition of the enclosed active site contour that serves as a template for the cyclization reaction. This contour is very product-like in shape and readily fits an extended conformation of sesquisabinene and its precursor, the homobisabolyl cation. Structural comparisons of SQS1 with epi-isozizaene synthase mutants that also generate sesquisabinene suggest that [3.1.0] ring formation is not dependent on the isoprenoid tail conformation of the homobisabolyl cation.

Get Help with Your Nurse Corps Scholarship Application Today!

Get Help with Your Nurse Corps Scholarship Application Today!

The 2019 Nurse Corps Scholarship Program application cycle will close Tuesday, May 21 at 7:30 p.m. ET. Nurse Corps Scholarship Program staff will be available to address any questions regarding the program components, requirements, and obligations, as well as to support you as you complete the application process. Don’t miss this unique opportunity!

Nurse Corps Scholarship Application Technical Assistance Call Thursday, May 16 3:00 - 4:30 p.m. ET Dial-in: 1-888-455-2923 | Passcode: 2458846

Prior to participating, we encourage you to review the 2019 Nurse Corps Scholarship Application and Program Guidance and the Nurse Corps Scholarship Application Webinar Recording, which review the eligibility requirements, application process, and more!

Cell Division in Tumor Cells

What Is Cancer?

Cancer also called malignancy is an abnormal growth of cells. There are more than 200 different types of cancer, including breast cancer, skin cancer, lung cancer, colon cancer, prostate cancer and lymphoma. Symptoms vary depending on the type. Cancer causes cells to divide uncontrollably. This can result in tumors, damage to the immune system and other impairment that can be fatal. Some cancers can spread to other parts of the body.

Cancer starts when cells change abnormally: cancer start

Cancer starts with changes in one cell or a small group of cells. Cells produce signals to control how much and how often the cells divide. If any of these signals are faulty or missing, cells may start to grow and multiply too much and form a lump called a tumour.

Cancer grows as cells multiply over and over: cancer growth

Benign tumours are made up of cells that are quite similar to normal cells. The cancer cells grow and divide to create more cells and will eventually form a tumour. A tumour may contain millions of cancer cells. All body tissues have a layer (a membrane) that keeps the cells of that tissue inside. This is the basement membrane. Cancer cells can break through this membrane. If this happens, the cancer is called invasive. As the tumour gets bigger, its centre gets further and further away from the blood vessels in the area where it is growing. So the centre of the tumour gets less and less oxygen and nutrients. Like healthy cells, cancer cells cannot live without oxygen and nutrients. So they send out signals, called angiogenic factors, that encourage new blood vessels to grow into the tumour. This is called angiogenesis. Without a blood supply, a tumour can't grow much bigger than a pin head.

Once a cancer can stimulate blood vessel growth, it can grow bigger and rapidly. It stimulates the growth of hundreds of new small blood vessels (capillaries) to bring in nutrients and oxygen. As the tumour grows and takes up more space, it begins to press on the normal body tissue nearby. The tumour growth will force itself through the normal tissue, as in the diagram below. it will squeeze and block small blood vessels in the area. Due to low blood and oxygen levels, some of the normal tissue will begin to die off. This makes it easier for the cancer to continue to push its way through.

Journal of Heart Failure and Cardiology Research

Linezolid Resistant Coagulase Negative Staphylococci Isolated from Clinical Specimens in A Tertiary Care Cardiac Hospital, Pakistan

Arif Maqsood Ali*1, Gul e Raana Waseem2, Shazia Arif 3

Abstract

Background: The objective of this study was to determine the emergence of Linezolid resistance among Coagulase Negative Staphylococcus in patients of tertiary healthcare facility at Rawalpindi Institute of Cardiology (RIC), Pakistan. 

Method: A retrospective study was carried out to find Linezolid Resistance Coagulase Negative Staphylococcus (LZRC) from clinical specimens in microbiology department of Rawalpindi institute of cardiology from year January 2016 to October 2018. The clinical specimens included blood, wound swab, pus swab, bronchial secretions, urine, catheter tip, suction tip, central venous (CVP) tip, Temporary Pace Maker (TPM) tip and valvular vegetation. These specimens were collected from indoor & outdoor patients and cultured in microbiology laboratory. Culture media used to isolate Coagulase Negative Staphylococci (CoNS) included Blood Agar and MacConkey Agar. The organisms were identified by standard microbiological methods. Antibiotic susceptibility was performed by modified disc diffusion & Vitek 2 methods and confirmed on Microbroth Dilution (MBD) according to CLSI Guidelines. 

Results: A total of 104 specimens yielded CoNS. Four of them were LZRC (3.84%) isolated in blood, pus, bronchial secretions and urine specimens. Three were isolated in specimens from male patients and one sample from a female patient. Out of these four positive LZRC isolates two were Staphylococcus haemolyticus. 

Conclusions: The findings of LZRC isolated at RIC is comparatively higher than other studies worldwide. Judicious use of this antibiotic along with infection control measures is crucial to control antibiotic resistance so that the availability of linezolid in life threatening infections is not compromised. 

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World journal of Neurosurgery, Neurobiology and Stroke

Diabetes increases risk for dementia and mild cognitive impairment (MCI)

Hiroshi BANDO*

Abstract:

Summary There have been large lifestyle and demographic changes across the world, and the diabetes and dementia become large challenges to healthcare system in each countries and districts. People with dementia seem to exist about 50 million, in which common types are Alzheimer’s disease (AD) and Vascular Dementia (VasD) [1]. The number of people with dementia is expected to increase to 66 million by 2030, and 131 million by 2050 driven by rising numbers of older adults [2].

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