Adolescents born preterm have similar self-esteem/wellbeing levels to those born full-term

New research led by the universities of Kent and Warwick has found that, contrary to previous beliefs, adolescents born preterm have the same levels of self-esteem and overall wellbeing as those born full-term

UNIVERSITY OF KENT

Research News

 

New research led by the universities of Kent and Warwick has found that, contrary to previous beliefs, adolescents born preterm have the same levels of self-esteem and overall wellbeing as those born full-term.

Preterm birth, defined as birth before 37 weeks of gestation, has been previously found to be associated with an increased risk for lower academic achievement, higher mental health problems and increased difficulties in social relationships compared to those born full-term. This new study, co-led by Dr Ayten Bilgin (Kent) alongside colleagues from Warwick, demonstrates that in contrast, preterm birth does not affect the development of subjective wellbeing and self-esteem, which are personal evaluations and thus different from school grades or psychiatric diagnoses.

The research paper, published by the Journal of Developmental & Behavioral Pediatrics, reveals how adolescents born very preterm (28 to 32 weeks) or moderate-to-late preterm (32 to 37 weeks) are no different from those born full-term regarding general subjective wellbeing, and family, school and physical appearance related wellbeing, and global self-esteem.

However, the study found that adolescents born very preterm perceive their peer relationships as poorer than those born full-term. This would indicate that interventions to enhance wellbeing in very preterm adolescents may be focused around improving peer relationships in childhood and adolescence.

Dr Bilgin said: 'It is very encouraging to find that preterm born adolescents show the same levels of self-esteem and wellbeing as full-term born adolescents, despite the association between preterm birth and increased mental health problems. We hope our findings will impact the focus of future studies.'

Dieter Wolke, Professor of Developmental Psychology and Individual Differences at the University of Warwick's Department of Psychology, added: 'It is concerning that those born preterm perceive themselves to have poorer peer relationships. Together with our previous evidence that preterm children may be more often the subject of bullying, supporting friendships and peer relations in school and leisure activities should be a priority.'

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For their study, the team utilised data from: The Avon Longitudinal Study of Parents and Children (ALSPAC; United Kingdom); the Millennium Cohort Study (MCS; United Kingdom); the Basel Study of Preterm Children (BSPC; Switzerland); and the Bavarian Longitudinal Study (BLS; Germany). Using questionnaires, a total of 986 moderate-to-late preterm, 412 very preterm and 12,719 full-term born adolescents reported on wellbeing and 927 moderate-to-late preterm, 175 very preterm and 13,312 full-term born adolescents reported on self-esteem. The age of the participants ranged from 12-17 years.

'Subjective Well-Being and Self-Esteem in Preterm Born Adolescents: An Individual Participant Data Meta-Analysis' is published by the Journal of Developmental & Behavioral Pediatrics. (Dr Ayten Bilgin, Kent; Dr Asteria Brylka, Warwick; Professor Dieter Wolke, Warwick; Dr Hayley Trower; Warwick; Nicole Baumann, Warwick; Professor Sakari Lemola, University of Bielefeld). DOI: 10.1097/DBP.0000000000000947

 

Maternal stress in conception linked to higher chance of female foetus

Women who experience more stress around the time of conception are twice as likely to give birth to a girl

UNIVERSITY OF GRANADA

Research News

 

IMAGE: THE UGR RESEARCH TEAM THAT CONDUCTED THIS STUDY view more 

CREDIT: UNIVERSITY OF GRANADA

A total of 108 women participated in the research from the first weeks of pregnancy to delivery, having recorded their stress levels before, during, and after conception (via the concentration of cortisol in hair) and performed different psychological tests

A study carried out by scientists from the University of Granada (UGR) has revealed that women who experience stress both before becoming pregnant and during conception are almost twice as likely to have a girl as a boy.

Researchers from the Mind, Brain and Behaviour Research Centre (CIMCYC), the Department of Pharmacology (Faculty of Pharmacy), and the Faculty of Psychology have analysed the levels of cortisol (a steroid hormone that is released in response to stress) in the hair of pregnant women in the period spanning from before conception to week 9 of pregnancy, to determine whether there was any link with the sex of the baby.

A total of 108 women were monitored from the first weeks of pregnancy through to delivery, to record their stress levels before, during, and after conception via the concentration of cortisol in their hair and various psychological tests. The measurement of cortisol in hair samples taken approximately in week 8-10 of pregnancy showed the concentration of cortisol in the pregnant woman for the previous three months (one month per centimetre of hair growth), meaning that it covered the period preceding and after conception. Subsequently, the UGR scientists recorded different variables relating to the birth and the sex of the baby.

María Isabel Peralta Ramírez, the main author of this work and researcher at the UGR's Department of Personality, Evaluation and Psychological Treatment explains: "The results we found were surprising, as they showed that the women who had given birth to girls presented higher concentrations of hair cortisol in the weeks before, during, and after the point of conception than those who had boys." In fact, these cortisol concentrations in the hair of mothers who subsequently had girls were almost double those who had boys.

Consequences of stress

There is ample scientific evidence demonstrating the impact of stress on the mother in the processes of pregnancy, birth, and even infant neurodevelopment. "Specifically, our research group has shown in numerous publications how psychological stress in the mother generates a greater number of psychopathological symptoms during pregnancy, postpartum depression, a greater likelihood of assisted delivery, an increase in the time taken for lactation to commence (lactogenesis), or inferior neurodevelopment of the baby six months after birth," says Peralta.

All of the existing research tells us about the effect of stress when pregnancy has already occurred. However, few studies have shown the link between stress and the mother-to-be before or during the conception of the baby, the present study being a rare exception. Its findings were recently published in the prestigious Journal of Developmental Origins of Health and Disease.

One possible explanation for the results would be that the activation of the "stress system"--the hypothalamus-pituitary-adrenal gland system--which involves an increase in cortisol secretion, modifies the concentrations of sex hormones at the time of conception. However, the mechanisms underlying this modification are not clear, because, on the one hand, there is evidence that testosterone could influence the determination of the baby's sex, since the higher the levels of prenatal stress, the higher the levels of female testosterone.

On the other hand, there is scientific evidence that sperm carrying the X chromosome (which determines that the baby will be female) perform better at passing through the cervical mucus in circumstances of adversity. Therefore, due to the hormonal changes associated with stress in the mother, these sperm are more likely to be successful in reaching the egg than sperm carrying the Y chromosome (which determines that the baby will be male).

"There are other possible hypotheses that attempt to explain this phenomenon. Among the strongest theories is the idea that there are more terminations of male foetuses on medical grounds during the first weeks of gestation in situations of severe maternal stress. That said, in light of the design of these studies, it is recommended that the results are corroborated in greater depth," observes Peralta.

The effect of stress on the foetus

What does appear to be clear-- and this has been shown in several studies--is that foetuses are vulnerable to the effect of stress, since it plays a key role in their development. An example of this is the proven fact that male (XY) foetuses mature more slowly than female (XX) foetuses; they tend to be associated with more complications in pregnancy and premature delivery; and, at birth, they are more likely to have shorter telomeres. This renders XY foetuses more vulnerable to adverse prenatal environments, suggesting that women who experience high levels of stress around the time of conception may be less likely to give birth to a boy.

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This study was conducted by members of the research group Neuropsychology and Psychoneuroimmunology Applied to Children, Adults and the Elderly. It operates under the auspices of the Framework for R&D Projects granted by the Spanish Ministry of Science, Innovation and Universities (ABORSTRESS AND CHILDSTRESS).

 

Tiny brains grown in 3D-printed bioreactor

Small device contains wells to let small bits of tissue grow, develop, and be studied in real time

AMERICAN INSTITUTE OF PHYSICS

Research News

 

IMAGE: A 3D-PRINTED MICROFLUIDIC BIOREACTOR FOR ORGAN-ON-CHIP CELL CULTURE view more 

CREDIT: IKRAM KHAN

WASHINGTON, April 6, 2021 -- Scientists from MIT and the Indian Institute of Technology Madras have grown small amounts of self-organizing brain tissue, known as organoids, in a tiny 3D-printed system that allows observation while they grow and develop. The work is reported in Biomicrofluidics, by AIP Publishing.

Current technology for real-time observation of growing organoids involves the use of commercial culture dishes with many wells in a glass-bottomed plate placed under a microscope. The plates are costly and only compatible with specific microscopes. They do not allow for the flow or replenishment of a nutrient medium to the growing tissue.

Recent advances have used a technique known as microfluidics, where a nutrient medium is delivered through small tubes connected to a tiny platform or chip. These microfluidic devices are, however, expensive and challenging to manufacture.

The current advance uses 3D printing to create a reusable and easily adjustable platform that costs only about $5 per unit to fabricate. The design includes imaging wells for the growing organoids and microfluidic channels to provide a nutrient medium and preheating that supports tissue growth.

A biocompatible type of resin used in dental surgery was used for the 3D-printed device. The printed chip was cured by exposing it to UV light, then sterilized before live cells were placed in the wells. After sealing the top of the wells with a glass slide, the nutrient medium and drugs for use in the study were added through small inlet ports.

"Our design costs are significantly lower than traditional petri dish- or spin-bioreactor-based organoid culture products," said author Ikram Khan. "In addition, the chip can be washed with distilled water, dried, and autoclaved and is, therefore, reusable."

The investigators tested their device with organoids derived from human cells. They observed the growing brain organoids with a microscope and were able to successfully follow their growth and development for seven days. The small bit of brain tissue developed a cavity or ventricle surrounded by a self-organizing structure that resembles a developing neocortex.

The percentage of cells in the core of the organoid that died during this one-week period was smaller in the 3D-printed device than in regular culture conditions. The investigators believe that their cell design protects the tiny growing brain.

Khan said, "One advantage offered by our microfluidic device is that it allows constant perfusion of the culture chamber, which more closely mimics a physiological tissue perfusion than conventional culture, and thus reduces cell death at the organoid core."

The investigators hope to increase the capacity of their device by scaling up the number of available wells. Other improvements will allow for additional instruments to be integrated into the design.

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The article "A low-cost 3D printed microfluidic bioreactor and imaging chamber for live-organoid imaging" is authored by Ikram Khan, Anil Prabhakar, Chloe Delepine, Hayley Tsang, Vincent Pham, and Mriganka Sur. The article will appear in Biomicrofluidics on April 6, 2021 (DOI: 10.1063/5.0041027). After that date, it can be accessed at https://aip.scitation.org/doi/10.1063/5.0041027.

ABOUT THE JOURNAL

Biomicrofluidics rapidly disseminates research in fundamental physicochemical mechanisms associated with microfluidic and nanofluidic phenomena. The journal also publishes research in unique microfluidic and nanofluidic techniques for diagnostic, medical, biological, pharmaceutical, environmental, and chemical applications. See https://aip.scitation.org/journal/bmf.

 

Brain cells decide on their own when to release pleasure hormone

NYU LANGONE HEALTH / NYU SCHOOL OF MEDICINE

Research News

 

In addition to smoothing out wrinkles, researchers have found that the drug Botox can reveal the inner workings of the brain. A new study used it to show that feedback from individual nerve cells controls the release of dopamine, a chemical messenger involved in motivation, memory, and movement.

Such "self-regulation," the researchers say, stands in contrast to the widely held view that the release of dopamine -- known as the "feel good" hormone -- by any cell relied on messages from nearby cells to recognize that it is releasing too much of the hormone.

Led by researchers at NYU Grossman School of Medicine, the new study showed that dopamine-releasing brain cells respond to their own signals to regulate the hormone's output. Because the death of dopamine-releasing brain cells is a key factor in Parkinson's disease, the new findings provide insight into why these cells die in the movement disorder, the researchers say.

"Our findings provide the first evidence that dopamine neurons regulate themselves in the brain," says study lead author Takuya Hikima, PhD. "Now that we better understand how these cells behave when they are healthy, we can start to unravel why they break down in neurodegenerative disorders like Parkinson's disease," adds Hikima, an instructor in the Department of Neurosurgery at NYU Langone Health.

Hikima says their study was prompted by what the research team saw as flaws in the older way of thinking about how dopamine works. First, for one cell to control its neighbor with dopamine, a large number of synapses, or junctions where two cells meet and exchange messages, would be required. Yet researchers say there were not enough synapses to account for this. Second, many types of hormone-producing cells in the body use a streamlined system that self-regulates further release, so it seemed odd that dopamine neurons would use a more roundabout process.

For the study, publishing April 6 in the journal Cell Reports, the research team collected dopamine neurons from dozens of mice. They injected some of the brain cells with Botox, a toxin that blocks nerve cells from sending chemical messages to neurons and other cells. The chemical's nerve-blocking action accounts for its ability to relax muscles in migraine and wrinkle treatments.

By injecting Botox into single neurons, says Hikima, the researchers hoped to show whether any signal to continue or stop dopamine release could only come from outside the "paralyzed" cell. If the neurons were in fact controlled by neighboring dopamine cells, then dopamine release would remain unaffected because the treated cells would still receive dopamine signals from the untreated cells nearby.

Instead, the findings revealed a 75 percent drop in dopamine outflow, suggesting that dopamine neurons largely rely on their own discharge to determine release rate of the hormone, according to the investigators.

"Since our Botox technique helped us solve the problem of how dopamine neurons regulate their communication, it should also enable us to uncover how other nerve cells interact with each other in the mammalian brain," says study senior author Margaret Rice, PhD.

The research team next plans to explore other areas of dopamine neuron activity that remain poorly understood, such as the dependence of dopamine release on calcium from outside the brain cells, says Rice, a professor in the Departments of Neurosurgery and Neuroscience and Physiology at NYU Langone. The investigators also intend to examine how self-regulation of dopamine might contribute to cell death in Parkinson's disease.

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Funding for the study was provided by National Institute of Health grants R01 DA038616 and R01AI093504 and by the Marlene and Paolo Fresco Institute for Parkinson's Disease and Movement Disorders.

In addition to Hikima and Rice, other NYU Langone researchers include Christian Lee, PhD; Paul Witkovsky, PhD; Julia Chesler, PhD; and Konstantin Ichtchenko, PhD.

 

Gut microbiome plays role in autism

AMERICAN SOCIETY FOR MICROBIOLOGY

Research News

 

Washington, D.C. - April 6, 2021 - A new study has demonstrated that autism spectrum disorder is related to changes in the gut microbiome. The findings are published this week in mSystems, an open-access journal of the American Society for Microbiology.

"Longitudinally, we were able to see that within an individual, changes in the microbiome were associated with changes in behavior," said principal study investigator Catherine Lozupone, PhD, a microbiologist in the Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado. "If we are going to understand the link between the gut microbiome and autism, we need more collaborative efforts across different regions and centers to get really thorough generalizable information about this relationship."

In the new study, researchers compared the gut microbiome composition between individuals with autism spectrum disorder and neurotypical controls in Arizona and Colorado using standardized DNA extraction and sequencing methods. The researchers found that the gut microbiome composition differed between individuals in Arizona and those in Colorado and gastrointestinal symptoms were significantly higher in those with autism compared with those without autism in Arizona but not Colorado. Gut microbiome composition was significantly associated with autism while controlling for study-site location but not when controlling for gastrointestinal symptoms.

The researchers also longitudinally evaluated the gut microbiome's relationship to autism behavioral severity, diet, and gastrointestinal symptoms in the individuals from Colorado. "We reached out to study participants every three months or so and had them fill out a number of checklists, one being the aberrant behavior checklist which looks at behaviors that are associated like inappropriate speech and repetitive motions," said Dr. Lozupone. "A food frequency questionnaire asked participants what they were eating in the past week. We also asked what types of GI symptoms participants were experiencing. We obtained fecal samples to look at the microbiome. We collected all this data to see how it related to each other."

In the longitudinal analysis, the researchers found that difference in levels of lethargy/social withdrawal measured in individuals at different time points correlated with the degree of change in gut microbiome composition and that a worsening of inappropriate speech between time points was associated with decreased gut microbiome diversity.

"We need more research, but our work shows that the gut microbiome is playing a role in the provocation of symptoms in kids with autism spectrum disorder," said Dr. Lozupone.

"This further supports the fact that the gut microbiome could be a valuable therapeutic target for children with autism spectrum disorders. I know that some labs have been exploring things like fecal microbiome transplant in these children and having some promising results."

Further work to tease out the mechanisms at play could lead to new therapies for children with autism.

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The American Society for Microbiology is one of the largest professional societies dedicated to the life sciences and is composed of 30,000 scientists and health practitioners. ASM's mission is to promote and advance the microbial sciences.

ASM advances the microbial sciences through conferences, publications, certifications, educational opportunities and advocacy efforts. It enhances laboratory capacity around the globe through training and resources. It provides a network for scientists in academia, industry and clinical settings. Additionally, ASM promotes a deeper understanding of the microbial sciences to diverse audiences

 

The sea urchin microbiome

Researchers begin to decipher the composition and function of sea urchin microbiomes

UNIVERSITY OF CALIFORNIA - SANTA BARBARA

Research News

 

Sea urchins receive a lot of attention in California. Red urchins support a thriving fishery, while their purple cousins are often blamed for mowing down kelp forests to create urchin barrens. Yet for all the notice we pay them, we know surprisingly little about the microbiomes that support these spiny species.

Researchers at UC Santa Barbara led by geneticist Paige Miller sought to uncover the diversity within the guts of these important kelp forest inhabitants. Their results reveal significant differences between the microbiota of the two species, as well as between individuals living in different habitats. The study, which appears in Limnology and Oceanography Letters, represents the first step in understanding the function of urchins' microbial communities, including the possibility that urchins may be able to 'farm' microbes in their guts to create their own food sources.

California hosts two common species of sea urchin: red and purple. They generally consume algae, but are actually fairly opportunistic omnivores that will eat decaying plant and animal matter, microbial mats and even other urchins if need be. The microbiome in their guts might help urchins handle such a varied diet, but it hasn't been examined until now.

"It's very important to understand what animals eat and why," Miller said, "and we think the microbiome could play an important role in why species thrive despite all the variation in food availability that's out there in the ocean." However, scientists are only beginning to investigate the microbiota of ocean animals, let alone the function these microorganisms serve in their hosts.

To begin their investigation, Miller and her team collected red and purple urchins from three habitats in the Santa Barbara Channel. Some came from lush kelp forests; others from urchin barrens; and a few came from one of the channel's many hydrocarbon seeps, where they scratch a living feeding on mats of microbes that thrive off of petroleum compounds.

Key to this study's success was the researchers' stringent protocol. They used meticulous techniques to remove each specimen's stomach and guts in order to avoid contamination from microbes in the lab, elsewhere on the animal, and even in the sea water.

The researchers were then able to sequence a particular region of the genetic code that scientists commonly use to identify microbes. This enabled them to compare what they found with several comprehensive taxonomic databases that scientists use for genetic identification of microbial life.

The team found significant differences between the bacterial communities living within the two urchin species. However, they saw just as much variation between the microbiomes of individuals from the same species living in different habitats.

Purple sea urchin closeup

Comparing the microbiome of purple (pictured) and red sea urchins points toward differences between the similar species.

Photo Credit: KATIE DAVIS

"Our study is the first to examine the microbiome in these extremely common, and really ecologically important, species," said coauthor Robert (Bob) Miller, a researcher at the university's Marine Science Institute. "We're just scratching the surface here, but our study shows how complex these communities are."

One group of bacteria that was prevalent in both species is the same group that helps break down wood in the guts of termites, and could help the urchins digest algae. Previous research indicates that these microbes could potentially be autotrophic. "Some members of this group can create their own food, like photosynthetic plants, for example," explained Paige Miller, "only they don't use sunlight for energy, they use hydrogen."

Although the authors caution against jumping to conclusions, ascertaining whether urchins can produce their own food would be a huge revelation. "We know that the urchins can survive a long time without food," Bob Miller said. "And they can survive almost indefinitely in these barren areas that have very low food supplies. So, this could really help them out, if they have their own little farmed food supply in their gut."

The findings also stress the oversight of conflating these similar species. People often treat species like the red and purple sea urchins as equivalent when making decisions about resource use and management, Paige Miller explained. Even ecologists can fall into this line of reasoning. "But it's very important to look at how these things actually function," she noted. "And as we saw, the red and purple sea urchins are not necessarily functioning the same way, or eating the same things, if their microbiome is an indicator."

Understanding the makeup and function of microbiota could help researchers recognize the subtle differences between superficially similar species. "More recently, people have begun considering the microbiome as another trait that these species have," Bob Miller said. "We wanted to find out whether this is a hidden source of variation that's separating these two species."

This study provides a launch point for additional research. In the future, the Millers and their coauthors plan to further investigate the function of the different microbes in urchin guts. For now, there's still more work to do simply identifying what species reside in the prickly critters.

"This is a new subfield of ecology," said Paige Miller, "trying to understand what these microbiomes do and the role they play in the living organism out in the wild."

Thinking with your stomach? The brain may have evolved to regulate digestion

Researchers from the University of Tsukuba find that sea urchin larvae use light to control digestion

UNIVERSITY OF TSUKUBA

Research News

 

IMAGE: PHOTOIRRADIATION DRIVES THE PYLORIC OPENING. IMAGES OF FIVE SECONDS (SEC) AND 1 MIN 30 SEC view more 

CREDIT: UNIVERSITY OF TSUKUBA

Tsukuba, Japan - Many life forms use light as an important biological signal, including animals with visual and non-visual systems. But now, researchers from Japan have found that neuronal cells may have initially evolved to regulate digestion according to light information.

In a study published this month in BMC Biology, researchers from the University of Tsukuba have revealed that sea urchins use light to regulate the opening and closing of the pylorus, which is an important component of the digestive tract.

Light-dependent systems often rely on the activity of proteins in the Opsin family, and these are found across the animal kingdom, including in organisms with visual and non-visual systems. Understanding the function of Opsins in animals from different taxonomic groups may provide important clues regarding how visual/non-visual systems evolved in different creatures to use light as an external signal. The function of Opsins in the Ambulacraria groups of animals, which include sea urchins, has not been characterized, something the researchers aimed to address.

"The functions of eyes and visual systems have been well-characterized," says senior author of the study Professor Shunsuke Yaguchi. "However, the way in which light dependent systems were acquired and diversified throughout evolution is unclear especially in deuterostomes because of the lack of data regarding the signaling pathway in the Ambulacraria group."

To address this, the researchers tested whether light exposure caused changes in digestive tract activity in sea urchins. They then conducted micro-surgical and genetic knockdown experiments to test whether Opsin cells in the sea urchin digestive system mediated the effect of light.

"The results provided new information about the role of Opsins in sea urchins," explains Professor Yaguchi. "Specifically, we found that stimulation of sea urchin larvae via light caused changes in digestive system function, even in the absence of food stimuli."

Furthermore, the researchers identified brain serotonergic neurons near the Opsin-expressing cells that were essential for mediating the light-stimulated release of nitric oxide, which acts as a neurotransmitter.

"Our results have important implications for understanding the process of evolution, specifically, that of light-dependent systems controlled via neurotransmitters," says Professor Yaguchi.

The data indicate that an early function of brain neurons may have been the regulation of the digestive tract in our evolutionary ancestors. Because food consumption and nutrient absorption are critical to survival, the development of a sophisticated brain-gut regulatory system may have been a major step in animal evolution.

The article, "Sea urchin larvae utilize light for regulating the pyloric opening" was published in BMC Biology at DOI:10.1186/s12915-021-00999-1

CAPTION

A schematic diagram the light ? pylorus signaling pathway in sea urchin larvae.

CREDIT

University of Tsukuba

 

Simple fetal heartbeat monitoring still best to reduce unnecessary cesarean sections

CANADIAN MEDICAL ASSOCIATION JOURNAL

Research News

 

Newer is not always better; a study in CMAJ (Canadian Medical Association Journal) led by researchers at the University of Warwick shows that simple fetal heartbeat monitoring is still the best method for determining whether a baby is in distress during delivery and whether cesarean delivery is needed http://www.cmaj.ca/lookup/doi/10.1503/cmaj.202538.

Cesarean delivery is the most common surgical procedure worldwide, performed to expedite birth and avoid neonatal complications.

Listening to the fetal heart rate using a stethoscope -- intermittent auscultation -- has been used for years to assess the fetal state and whether the baby is experiencing distress that might require a cesarean delivery. Other monitoring techniques have become common in recent years, including echocardiograms and blood tests.

"Despite extensive investment in clinical research, the overall effectiveness of such methods in improving maternal and neonatal outcomes remains debatable as stillbirth rates have plateaued worldwide, while cesarean delivery rates continue to rise," writes Dr. Bassel Al Wattar, Warwick Medical School, University of Warwick, Coventry, United Kingdom, with coauthors.

Researchers from the United Kingdom and Spain reviewed 33 studies that included more than 118,000 women, mainly from high-income countries as well as India and Tanzania, to evaluate the effectiveness of different monitoring methods in improving outcomes for mothers and babies and reducing the number of cesarean deliveries.

They found that all methods had similar outcomes for babies, but only intermittent auscultation reduced the risk of cesarean deliveries without increased risk to babies' health. The researchers estimate that intermittent auscultation led to an average 30% reduction in emergency cesareans compared to other methods.

"Our analysis suggests that all additional methods introduced to improve the accuracy of electronic fetal heart monitoring have failed to reduce the risk of adverse neonatal or maternal outcomes beyond what intermittent auscultation achieved 50 years ago, and this may have contributed to the increased incidence of unnecessary emergency cesarean deliveries," write the authors.

The authors urge investment in developing novel techniques to monitor fetuses to make delivery safer for mothers and their babies.

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"Effectiveness of intrapartum fetal surveillance to improve maternal and neonatal outcomes: a systematic review and network meta-analysis" is published April 6, 2021.

Cannabis legalization and link to increase in fatal collisions

CANADIAN MEDICAL ASSOCIATION JOURNAL

Research News

 

Legalization of recreational cannabis may be associated with an increase in fatal motor vehicle collisions based on data from the United States, and authors discuss the implications for Canada in an analysis in CMAJ (Canadian Medical Association Journal).

"Analyses of data suggest that legalization of recreational cannabis in United States jurisdictions may be associated with a small but significant increase in fatal motor vehicle collisions and fatalities, which, if extrapolated to the Canadian context, could result in as many as 308 additional driving fatalities annually," says Ms. Sarah Windle, Lady Davis Institute/McGill University, Montreal, Quebec, with coauthors.

In Canada, the number of people reporting cannabis consumption increased from 14% in 2018 (before legalization) to 17% in 2019 (after legalization). Among cannabis users with a driver's licence, 13% reported driving within 2 hours of cannabis consumption, with the number of individuals who reported driving after recent cannabis use increasing from 573,000 to 622,000. An analysis of 2012 data estimated the cost of cannabis-related collisions in Canada to be $1.1 billion annually in societal and economic costs, with drivers aged 34 years and younger responsible for the bulk of the costs.

Health care providers can play a role in educating patients, and the authors suggest resources to help.

"Health care professionals have an opportunity to educate patients about the safer use of cannabis products, including advising against cannabis use and driving (especially in combination with alcohol), with a suggested wait time of at least 6 hours before driving," the authors say.

Government regulation and public awareness could also help reduce the risk of injuries and deaths from driving after cannabis use.

"Implementation of impaired driving regulations and educational campaigns, including federal THC driving limits and public awareness of these limits, may contribute to the prevention of potential increases in cannabis-impaired driving in Canada," the authors conclude.

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"Impaired driving and legalization of recreational cannabis" is published April 6, 

 

Canada-wide ban on menthol cigarettes leads to significant increases in quitting among smokers

UNIVERSITY OF WATERLOO

Research News

 

Bans on menthol cigarettes across Canada from 2016 to 2017 led to a significant increase in the number of smokers who attempted to quit, smokers who quit successfully, and lower rates of relapse among former smokers, according to a new research study from the International Tobacco Control Policy Evaluation Project (the ITC Project) at the University of Waterloo.

Menthol is the most common flavoring for cigarettes in many countries. Menthol creates a cooling sensation, which reduces the harshness of cigarette smoke. Because of this, menthol leads to increased experimentation and progression to regular smoking among new smokers, especially among youth.

"Our study demonstrates the substantial benefits of banning menthol cigarettes," said Geoffrey T. Fong, Professor of Psychology and Public Health and Health Systems at Waterloo, and principal investigator of the ITC Project. "The enormous success of the Canadian menthol ban makes it even clearer now that the U.S. should finally ban menthol, which the tobacco industry has used for decades to attract new smokers and to keep many of them as customers, especially among the African-American community.

"The positive effects of the Canada menthol ban suggest that a U.S. menthol ban would lead to greater benefits since menthol cigarettes are much more popular in the U.S. From our findings, we estimate that banning menthol cigarettes in the U.S. would lead an additional 923,000 smokers to quit, including 230,000 African-American smokers."

The study conducted by Fong and his team examined the impact of menthol bans across seven Canadian provinces, covering 83 per cent of the Canadian population, which saw menthol cigarettes banned between August 2016 and October 2017. Canada was the one of the first countries to implement a ban on menthol cigarettes, and the first country where a menthol ban has been evaluated.

"The Canadian menthol ban did not lead to a high level of illicit menthol cigarette purchasing, which has been a concern by regulators considering a menthol ban," said Fong. "Fewer than 10 per cent of menthol smokers reported still smoking a menthol brand after the ban."

Scientific reviews conducted by the Tobacco Products Scientific Advisory Committee to the U.S. Food and Drug Administration (FDA), the FDA itself, and the World Health Organization have also concluded that banning menthol would have significant public health benefits. 

The harms of menthol cigarettes in the U.S. have been much greater among African-Americans. Menthol cigarettes are smoked by 85 per cent of African-American smokers, over 2.8 times the percentage of menthols among white smokers.

A national sample of 1098 non-menthol and 138 menthol smokers participating in the ITC Canada Smoking and Vaping Survey were surveyed both before the menthol ban (in 2016) and after the menthol ban (in 2018).

The survey demonstrated three benefits of the Canadian menthol ban. Menthol smokers were significantly more likely than non-menthol smokers to attempt to quit after the menthol ban (58.7 per cent vs. 49 per cent). 

Daily menthol smokers were almost twice as likely than daily non-menthol smokers to quit after the menthol ban (21 per cent vs. 11.6 per cent). 

Finally, those menthol smokers who had quit smoking before the menthol ban were significantly less likely than non-menthol smokers who had quit smoking to have relapsed back to smoking.

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The study, Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016-2018 ITC Four Country Smoking and Vaping Surveys, was published today in the journal Tobacco Con