It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Tuesday, December 13, 2022
Alcohol-involved injuries linked to increased risk of death in the next year: Study
IMAGE: AMBULANCE RESPONDING TO AN EMERGENCYview more
CREDIT: JOURNAL OF STUDIES ON ALCOHOL AND DRUGS
By Kimberly Flynn
PISCATAWAY, NJ — When people are injured severely enough to require treatment at the hospital and they are either intoxicated or have an alcohol use disorder, they have a fivefold increased risk of dying in the next year, according to a new study in the Journal of Studies on Alcohol and Drugs.
“Injuries are one of the most immediate hazards of problematic drinking behavior,” says lead researcher Sidra Goldman-Mellor, Ph.D., from the Department of Public Health at the University of California, Merced. “In addition to getting injured from things like car accidents and falls, some people may get injured in fights or even engage in self-harm after they’ve been drinking. However, we actually know very little about what happens to people with an alcohol use disorder after they’ve had a serious injury. So we wanted to investigate the most important outcome of all: how likely they were to die.”
To study this, Goldman-Mellor and colleagues examined data on all 10 million emergency department visits by California residents age 10 and older from 2009 to 2012. Of these patients, 262,222 had a nonfatal injury and either had a diagnosis of an alcohol use disorder or were intoxicated at the time of the injury.
Most (76.9%) of these injuries were coded as unintentional, with an additional 13.2% due to assault, 7.9% to self-harm and 2.1% due to undetermined intent.
Within 12 months of their hospital visit, 13,175 of these patients had died -- more than 5% -- with a total mortality rate of nearly 5,205 per 100,000. The researchers determined this is more than five times the rate for the rest of the California population, matched for age, gender, race and ethnicity, all strong determinants of mortality risk.
Goldman-Mellor says she and her colleagues were prompted to study this topic because of evidence that alcohol use -- including problematic alcohol use -- has increased over the last several years, especially during the pandemic. She says they were surprised by their findings.
“Injuries associated with alcohol use disorders are a public health problem in their own right, but now we know that they’re also associated with a substantially increased risk of death,” says Goldman-Mellor. “Most people who struggle with alcohol misuse don’t get the help they need.”
The research team was not able to examine what happened to the patients after discharge but suspects that many were already quite sick when they initially came to the hospital, with patients’ health declining after that.
Goldman-Mellor points to emergency departments themselves as one place in which people with alcohol problems might be able to get additional help. She notes that some emergency departments can connect patients to resources such as outpatient programs integrating substance use treatment with regular primary care for chronic conditions such as heart disease, diabetes and liver disease.
“Hopefully studies like ours can be used to increase resources for getting all such patients connected with comprehensive care, both for their substance use and general health,” she says.
----- Goldman-Mellor, S., Kaplan M. S., & Qin P. (2022). Mortality risk following nonfatal injuries with alcohol use disorder involvement: A one-year follow-up of emergency department patients using linked administrative data. Journal of Studies on Alcohol and Drugs, 83, 879–887. doi:10.15288/jsad.21-00444 ----- To arrange an interview with Sidra Goldman-Mellor, Ph.D., please contact Juan Flores at jflores331@ucmerced.edu or (562) 201-7317. ----- The Journal of Studies on Alcohol and Drugs (jsad.com) is published by the Center of Alcohol & Substance Use Studies (alcoholstudies.rutgers.edu) at Rutgers, The State University of New Jersey. It is the oldest substance-related journal published in the United States. ----- The Journal of Studies on Alcohol and Drugs considers this press release to be in the public domain. Editors may publish this press release in print or electronic form without legal restriction. Please include a byline and citation. ----- To view the public domain, stock-photo database of alcohol, tobacco and other drug-related images compiled by the Journal of Studies on Alcohol and Drugs, please visit www.jsad.com/photos.
Mortality risk following nonfatal injuries with alcohol use disorder involvement: A one-year follow-up of emergency department patients using linked administrative data
According to data from the Centers for Disease Control and Prevention (CDC), alcohol kills on average 2,760 people per year. The leading causes include 641 poisoning deaths, 350 deaths from alcoholic liver disease, 294 deaths from cancers attributable to alcohol use, and 211 liver cirrhosis deaths.
Alcohol’s toll in terms of death and disability rose by 13.8% from 2009 to 2019—faster than lung cancer, diabetes, hypertension, dietary risks or tobacco use. During the pandemic, nearly two in five (38%) of Massachusetts adults reported they increased their drinking, while nationwide, deaths involving alcohol increased by 25.5% from 2019 to 2020.
Meanwhile, the state’s alcohol taxes have lost 72% of their value in real dollars since they were last raised, and now amount to less than a nickel per drink. The CDC estimated that alcohol problems cost the state $5.6 billion in 2010, the last year for which an estimate is available. Of that, $2.26 billion (or $345 per person and $.77 per drink consumed) was paid directly by governments.
“Alcohol is clearly not paying its way in the Bay State,” said Rep. Kay Khan (D-11th Middlesex District), in response to the report. Rep. Khan has repeatedly introduced bills in the legislature to increase the state’s alcohol tax. “Our taxes on alcohol are far out of date, while alcohol problems have continued to increase.”
Massachusetts has a reputation for strict alcohol policies and high taxes, but according to the report, this is inaccurate. While Bay State drinkers consume and binge drink more than the national average, the state’s alcohol policies rank 17th in restrictiveness among the 50 states, and they have fallen behind other states in moving in more restrictive directions.
Massachusetts has five times as many licenses for bars and restaurants as are permitted in New Jersey and Pennsylvania. Of 16 states that set quotas on retail alcohol outlets, just three—Montana, South Dakota and Washington State—are more generous with these licenses than the Bay State.
And the state’s taxes on beer and wine are the lowest of the New England states, while its tax on distilled spirits is lower than all its neighbors except New Hampshire, which sells spirits at a discount in its state-run stores.
“In Massachusetts, alcohol policies are mostly discussed from a business point of view,” said David Jernigan, lead author of the report and a professor of health law, policy and management at BUSPH. “Health and safety data tell a different alcohol story, and need to be part of the policy debate.”
Binge drinking—consuming four or more drinks for females or five or more for males within two hours—is the most common and costly pattern of excessive alcohol use in the U.S., according to the CDC. In Massachusetts, binge drinking is common among both in the general population and among underage drinkers: 44% of current (past-30 day) drinkers age 12 and above, and 63% of current underage drinkers (ages 12-20) binged in the past month.
“The fact that Massachusetts has such a high rate of youth binge drinking is very concerning,” said Senator Jason Lewis, Senate Chair of the Joint Committee on Education and previously Senate Chair of the Joint Committee on Public Health. “This is no doubt linked to the easy and widespread availability of cheap alcohol, and is a public health issue that I hope we will tackle in the new legislative session.”
The report was coauthored by Xixi Zhou, a Master of Public Health candidate at BUSPH, and it was funded by a grant from BUSPH’s idea hub.
**
About Boston University School of Public Health Founded in 1976, Boston University School of Public Health is one of the top five ranked private schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.
METHOD OF RESEARCH
Literature review
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Alcohol, Health and Safety In Massachusetts
ARTICLE PUBLICATION DATE
13-Dec-2022
Share of patients with heat exhaustion increased 53 percent when comparing June 2016 to June 2021
More males than females diagnosed with heat-related illnesses, according to new FAIR Health study
NEW YORK, NY—December 13, 2022—Among privately insured individuals receiving medical services, the percentage of patients diagnosed with heat exhaustion increased 52.5 percent when comparing June 2016 to June 2021. This was part of a general trend in which, from May to September, the percentage of patients who were diagnosed with heat stress, heat exhaustion or heatstroke was higher in each month in 2021 than in the corresponding month of 2016. These and other findings are reported in a FAIR Health brief released today, Heat-Related Illness: A Window into Recent Trends.
In the context of other researchers’ projections that rising summer temperatures will be a source of adverse health impacts from climate change, FAIR Health drew on its repository of more than 39 billion private healthcare claim records—the nation’s largest such repository—to analyze recent trends and patterns in heat-related illnesses in the United States. Three types of heat-related illness—in order of increasing severity, heat stress, heat exhaustion and heatstroke—were examined in the period from May through September for the years 2016-2021. Changes in percent of patients diagnosed, as well as their age and gender, were studied for each type of illness. Among the key findings:
In the months from May through September, the greatest increase in percent of patients diagnosed for heatstroke was 40.1 percent when comparing September 2016 to September 2021. The greatest increase for heat stress was 37.8 percent when comparing May 2016 to May 2021.
The percentage of patients with heat stress, heat exhaustion or heatstroke diagnoses increased with age, with the greatest percentage found in the age group 65 years and older. Of patients who received medical services nationally in the 65-and-older population, 2.61 percent had a diagnosis of heat exhaustion, 1.93 percent had a diagnosis of heat stress and 0.70 percent had a diagnosis of heatstroke.
More males than females were diagnosed with the three heat-related illnesses studied. Though the distribution was close for heat stress (males 52 percent, females 48 percent), there was greater gender disparity for heat exhaustion and heatstroke. For each of these diagnoses, males constituted 64 percent and females constituted 36 percent.
Age was a factor in whether males or females were more likely to be diagnosed with heat stress. In individuals 36 years and older, males were more likely than females to be diagnosed; in individuals 35 years and younger, females were more likely than males to be diagnosed with heat stress. For heat exhaustion and heatstroke, males were more likely than females to be diagnosed in every age group.
For all three heat-related illnesses studied, the largest disparity between males and females in percentage of diagnoses was in the age group 55 to 64.
FAIR Health President Robin Gelburd stated: “The findings in this report have implications for all healthcare stakeholders concerned with heat-related illnesses, including patients, providers, payors and policy makers. FAIR Health hopes that these findings will also be starting points for further research on heat-related illnesses.”
About 1 in 100 heart disease deaths linked to extreme hot and cold weather days
International analysis suggests extreme temperatures increase risk of heart failure deaths, pointing to need for mitigating strategies in era of climate change
IMAGE: THIS GRAPH SHOWS TEMPERATURE PERCENTILES AND RELATIVE RISK OF DYING FROM HEART DISEASE IN 567 COUNTRIES. DASHED LINE REPRESENTS TEMPERATURES ASSOCIATED WITH LOWEST RISK OF DEATH. DOTTED LINES REPRESENT 1ST PERCENTILE (EXTREME COLD) AND 99TH PERCENTILE (EXTREME HEAT).view more
CREDIT: CIRCULATION
Exposure to extremely hot or cold temperatures increases a heart disease patient’s risk of dying, according to a new study published today in the American Heart Association’s journal Circulation. The global analysis of more than 32 million cardiovascular deaths over 40 years measured more deaths on days when temperatures were at their highest or lowest compared to more moderate climate days.
“It underscores the urgent need to develop measures that will help our society mitigate the impact of climate change on cardiovascular disease,” said study co-author Haitham Khraishah, MD, a cardiovascular disease fellow at the University of Maryland School of Medicine (UMSOM) and University of Maryland Medical Center (UMMC).
Among the types of cardiovascular disease, people with heart failure were most likely to be negatively impacted by very cold and very hot days, experiencing a 12 percent greater risk of dying on extreme heat days compared to optimal temperature days in a specific city. Extreme cold increased the risk of heart failure deaths by 37 percent.
Findings were based on an analysis of health data from more than 32 million cardiovascular deaths that occurred in 567 cities in 27 countries on 5 continents between 1979 and 2019. The definition of extreme weather differed from city to city. It was defined as the top 1 percent or bottom 1 percent of the “minimum mortality temperature,” which is the temperature at which the lowest death rate is achieved.
For every 1,000 cardiovascular deaths, the researchers found that:
Extreme hot days (above 86° F in Baltimore) accounted for 2.2 additional deaths.
Extreme cold days (below 20° F in Baltimore) accounted for 9.1 additional deaths.
Of the types of heart diseases, the greatest number of additional deaths was found for people with heart failure (2.6 additional deaths on extreme hot days and 12.8 on extreme cold days).
“While we do not know the reason why temperature effects were more pronounced with heart failure patients it could be due to the progressive nature of heart failure as a disease,” said Dr. Khraishah. “One out of four people with heart failure are readmitted to the hospital within 30 days of discharge, and only 20 percent of patients with heart failure survive 10 years after diagnosis.”
Climate change has been found to cause weather extremes on both ends of the spectrum with hotter summers and colder winters. A 2021 study published in the journal Science found that Arctic warming caused a change of events leading to a disruption of the polar vortex causing periods of extreme cold in the Northern hemisphere.
Barrak Alahmad, MD, PhD, research fellow at the Harvard T.H. Chan School of Public Health at Harvard University in Boston and a faculty member at the College of Public Health at Kuwait University in Kuwait City was the corresponding author of the study. Dr. Khraishah and Dr. Alahmad led an effort over the past four years to build the heart disease mortality database for this study with their colleagues from more than 35 institutions worldwide.
The team developed and expanded the heart disease mortality database as part of the Multi-Country Multi-City (MCC) Collaborative Research Network. This is a consortium of epidemiologists, biostatisticians and climate scientists studying the health impacts of climate and related environmental stressors on death rates.
“This study provides an indisputable link between extreme temperatures and heart disease mortality from one of the largest multinational datasets ever assembled,” said Mark T. Gladwin, MD, Dean, UMSOM, Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor. “The data can be more deeply mined to learn more about the role of health disparities and genetic predispositions that make some populations more vulnerable to climate change.”
Such questions will be addressed in future research, according to Dr. Khraishah.
Some limitations of the study include an underrepresentation of data from South Asia, the Middle East and Africa. It could be that extreme heat had more of an impact than initially measured due to this lack of data.
The researchers took into account humidity and air pollutants, which could have accounted for excess deaths in places of temperature extremes. They also controlled for the delayed effect of temperature on human health (lag effect) and climate zone.
“This landmark paper is a call to view climate change as a growing public health concern and highlights the need to investigate it as a potential cause of health disparities,” said Stephen N. Davis, MBBS, Chair of the Department of Medicine at UMSOM and Physician-in-Chief at UMMC.
This analysis was funded by the Kuwait Foundation for the Advancement of Science.
About the University of Maryland School of Medicine
Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu
JOURNAL
Circulation
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality
ARTICLE PUBLICATION DATE
12-Dec-2022
Extremely hot and cold days linked to cardiovascular deaths
More heart failure deaths were linked with extreme temperatures than other heart conditions, from an international study in the journal Circulation
According to a multinational analysis of more than 32 million cardiovascular deaths over four decades, there were more deaths on days when temperatures were at their highest or lowest.
Among the types of cardiovascular disease, people with heart failure experienced the most additional deaths when temperatures were at extremes.
With climate change, more research is needed to examine and develop strategies to potentially mitigate the impact of extreme temperatures on cardiovascular disease, researchers said.
DALLAS, Dec. 12, 2022 — Extremely hot and cold temperatures both increased the risk of death among people with cardiovascular diseases, such as ischemic heart disease (heart problems caused by narrowed heart arteries), stroke, heart failure and arrhythmia, according to new research published today in the American Heart Association’s flagship journal Circulation.
Among the cardiovascular diseases examined in this study, heart failure was linked to the highest excess deaths from extreme hot and cold temperatures.
“The decline in cardiovascular death rates since the 1960s is a huge public health success story as cardiologists identified and addressed individual risk factors such as tobacco, physical inactivity, Type 2 diabetes, high blood pressure and others. The current challenge now is the environment and what climate change might hold for us,” said Barrak Alahmad, M.D., M.P.H., Ph.D., research fellow at the Harvard T.H. Chan School of Public Health at Harvard University in Boston and a faculty member at the College of Public Health at Kuwait University in Kuwait City.
Researchers explored how extreme temperatures may affect heart diseases – the leading cause of death globally. They analyzed health data for more than 32 million cardiovascular deaths that occurred in 567 cities in 27 countries on 5 continents between 1979 and 2019. The global data came from the Multi-Country Multi-City (MCC) Collaborative Research Network, a consortium of epidemiologists, biostatisticians and climate scientists studying the health impacts of climate and related environmental stressors on death rates.
Climate change is associated with substantial swings in extreme hot and cold temperatures, so the researchers examined both in the current study. For this analysis, researchers compared cardiovascular deaths on the hottest and the coldest 2.5% of days for each city with cardiovascular deaths on the days that had optimal temperature (the temperature associated with the least rates of deaths) in the same city.
For every 1,000 cardiovascular deaths, the researchers found that:
Extreme hot days accounted for 2.2 additional deaths.
Extreme cold days accounted for 9.1 additional deaths.
Of the types of heart diseases, the greatest number of additional deaths was found for people with heart failure (2.6 additional deaths on extreme hot days and 12.8 on extreme cold days).
“One in every 100 cardiovascular deaths may be attributed to extreme temperature days, and temperature effects were more pronounced when looking at heart failure deaths,” said Haitham Khraishah, M.D., co-author of the study and a cardiovascular disease fellow at the University of Maryland School of Medicine and the University of Maryland Medical Center in Baltimore. “While we do not know the reason, this may be explained by the progressive nature of heart failure as a disease, rendering patients susceptible to temperature effects. This is an important finding since one out of four people with heart failure are readmitted to the hospital within 30 days of discharge, and only 20% of patients with heart failure survive 10 years after diagnosis.”
Researchers suggest targeted warning systems and advice for vulnerable people may be needed to prevent cardiovascular deaths during temperature extremes.
“We need to be on top of emerging environmental exposures. I call upon the professional cardiology organizations to commission guidelines and scientific statements on the intersection of extreme temperatures and cardiovascular health. In such statements, we may provide more direction to health care professionals, as well as identify clinical data gaps and future priorities for research,” Alahmad said.
The underrepresentation of data from South Asia, the Middle East and Africa limits the ability to apply these findings to make global estimates about the impact of extreme temperatures on cardiovascular deaths.
“This study contributes important information to the ongoing societal discussions regarding the relationship between climate and human health. More work is needed to better define these relationships in a world facing climate changes across the globe in the years ahead, especially as to how those environmental changes might impact the world’s leading cause of death and disability, heart disease,” said AHA Past President Robert A. Harrington, M.D., FAHA, who is the Arthur L. Bloomfield Professor of Medicine and chair of the department of medicine at Stanford University.
Other co-authors of the study are Dominic Royé, Ph.D.; Ana Maria Vicedo-Cabrera, Ph.D.; Yuming Guo, Ph.D.; Stefania I. Papatheodorou, M.D.; Souzana Achilleos, Sc.D.; Fiorella Aquaotta, Ph.D.; Ben Armstrong, Ph.D.; Michelle L. Bell, Ph.D.; Shih-Chun Pan, Ph.D.; Micheline Sousa Zanotti Stagliorio Coelho, Ph.D.; Valentina Colistro, Ph.D.; Tran Ngoc Dang, Ph.D.; Do Van Dung, Ph.D.; Francesca K. De’ Donato, Ph.D.; Alireza Entezari, Ph.D.; Yue-Liang Leon Guo, Ph.D.; Masahiro Hashizume, Ph.D.; Yasushi Honda, Ph.D.; Ene Indermitte, Ph.D.; Carmen Íñiguez, Ph.D.; Jouni J.K. Jaakkola, Ph.D.; Ho Kim, Ph.D.; Eric Lavigne, Ph.D.; Whanhee Lee, Ph.D.; Shanshan Li, Ph.D.; Joana Madureira, Ph.D.; Fatemeh Mayvaneh, Ph.D.; Hans Orru, Ph.D.; Ala Overcenco, Ph.D.; Martina S. Ragettli, Ph.D.; Niilo R. I. Ryti, Ph.D.; Paulo Hilario Nascimento Saldiva, Ph.D.; Noah Scovronick, Ph.D.; Xerxes Seposo, Ph.D.; Francesco Sera, Ph.D.; Susana Pereira Silva, M.Sc.; Massimo Stafoggia, Ph.D.; Aurelio Tobias, Ph.D.; Eric Garshick, M.D.; Aaron S. Bernstein, M.D.; Antonella Zanobetti, Ph.D.; Joel Schwartz, Ph.D.; Antonio Gasparrini, Ph.D.; and Petros Koutrakis, Ph.D. Authors’ disclosures are listed in the manuscript.
This analysis was funded by the Kuwait Foundation for the Advancement of Science (KFAS).
Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.
Follow news from the AHA’s flagship journal Circulation@CircAHA
About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.
An international research team has provided valuable new information about what drives the global spread of genes responsible for antimicrobial resistance (AMR) in bacteria.
The collaborative study, led by researchers at the Quadram Institute and the University of East Anglia, brought together experts from France, Canada, Germany and the UK and will provide new information to combat the global challenge of AMR.
By examining the whole genome sequences of around two thousand resistant bacteria, predominantly Escherichia coli collected between 2008 and 2016, the team found that different types of AMR genes varied in their temporal dynamics. For example, some were initially found in North America and spread to Europe, while for others the spread was from Europe to North America.
Not only did the study look at bacteria from different geographic regions but also from diverse hosts including humans, animals, food (meat) and the environment (wastewater), to define how these separate but interconnected factors influenced the development and spread of AMR. Understanding this interconnectivity embodies the One Health approach and is vital for understanding transmission dynamics and the mechanisms by which resistance genes are transmitted.
The study, published in the journal Nature Communications, was supported by the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), a global collaboration spanning 29 countries and the European Commission that is tasked with turning the tide on AMR. Without concerted efforts on a global scale, AMR will undoubtedly make millions more people vulnerable to infections from bacteria and other microorganisms that can currently be tackled with antimicrobials.
The team focussed on resistance to one particularly important group of antimicrobials, the Extended-Spectrum Cephalosporins (ESCs). These antimicrobials have been classed as critically important by the World Health Organization because they are a ‘last resort’ treatment for multidrug resistant bacteria; despite this, since their introduction, efficacy has declined as bacteria have developed resistance.
Bacteria that are resistant to ESCs achieve this through the production of specific enzymes, called beta-lactamases, that are able to inactivate ESCs.
The instructions for making these enzymes are encoded in genes, particularly two key types of genes: extended-spectrum beta-lactamases (ESBLs), and AmpC beta-lactamases (AmpCs).
These genes may be found on the chromosomes of bacteria where they are passed to progeny during clonal multiplication, or in plasmids, which are small DNA molecules separate to the bacterium’s main chromosome. Plasmids are mobile and can move directly between individual bacteria representing an alternative way of exchanging genetic material.
This study identified how some resistance genes proliferated through clonal expansion of particularly successful bacterial subtypes while others were transferred directly on epidemic plasmids across different hosts and countries.
Understanding the flow of genetic information within and between bacterial populations is key to understanding AMR transmission and the global spread of resistance. This knowledge will contribute to the design of vitally needed interventions that can halt AMR in the real world where bacteria from diverse hosts and environmental niches interact, and where international travel and trade mean that these interactions are not limited by geography.
Professor Alison Mather, group leader at the Quadram Institute and the University of East Anglia, said: “By assembling such a large and diverse collection of genomes, we were able to identify the key genes conferring resistance to these critically important drugs. We were also able to show that the majority of resistance to extended spectrum cephalosporins is spread by only a limited number of predominant plasmids and bacterial lineages; understanding the mechanisms of transmission is key to the design of interventions to reduce the spread of AMR”.
Lead author Dr Roxana Zamudio said “Antimicrobial resistance is a global problem, and it is only by working collaboratively with partners in multiple countries that we can get a holistic understanding of where and how AMR is spreading”.
n; the gut and the microbiome; food innovation and population health.
Multiple Sclerosis (MS) is almost always accompanied by fatigue, a massive tiredness that is described by the vast majority of patients as the most distressing symptom. In a recent scientific study, a research group led by Stefan Seidel from the Department of Neurology at MedUni Vienna and AKH Vienna identified light therapy as a promising non-drug treatment option: patients included in the study showed a measurable improvement after just 14 days of use. The study results were recently published in the Multiple Sclerosis Journal – Experimental, Translational and Clinical.
For the first time, Stefan Seidel's research team relied not only on surveys but also on objective measurements when selecting the test persons. For example, sleep-wake disorders were ruled out in the 26 participating MS patients, particularly with the assistance of various sleep medicine examinations. "In this manner, for example, we ensured that MS patients with fatigue do not suffer from sleep apnea or periodic leg movements during sleep. Both are sleep disorders that can lead to fatigue in everyday life," elaborated study leader Stefan Seidel.
Performance improvement The test persons - all patients of the Neurology Department at MedUni Vienna and AKH Vienna - were equipped with commercially available light sources for self-testing at home: Half of the participants received a daylight lamp with a brightness of 10,000 lux, while the other half received an identical lamp that emitted a red light with an intensity of <300 lux due to a filter. While the red light used by the control group showed no effect, the researchers were able to observe measurable successes in the other group after only 14 days: The participants who used their 10,000 lux daylight lamp for half an hour every day showed improved physical and mental performance after only a short period of time. In addition, the group of participants who had consumed bright light displayed less daytime sleepiness in comparison with the other group.
Up to 99 percent of patients Fatigue is a severe form of tiredness and fatigability that occurs in 75 to 99 percent of people with MS and is described as particularly distressing. Nerve damage triggered by MS is being discussed as the cause. In addition to behavioural measures, such as regular rest breaks, various medications are currently available to alleviate fatigue, but some of these are associated with severe side effects. "The findings from our study represent a promising non-drug therapeutic approach," Stefan Seidel affirms. However, the results still need to be confirmed in a subsequent larger-scale study. The exact background of the invigorating effect of light therapy on MS patients will also be the subject of further scientific research.
JOURNAL
Multiple Sclerosis Journal - Experimental Translational and Clinical
IMAGE: PHD RESEARCHER YEMIMA EHRNST HOLDING THE ACOUSTIC DEVICE THE RESEARCH TEAM USED TO BOOST THE HYDROGEN PRODUCTION, THROUGH ELECTROLYSIS TO SPLIT WATER.view more
CREDIT: RMIT UNIVERSITY
Engineers in Melbourne have used sound waves to boost production of green hydrogen by 14 times, through electrolysis to split water.
They say their invention offers a promising way to tap into a plentiful supply of cheap hydrogen fuel for transportation and other sectors, which could radically reduce carbon emissions and help fight climate change.
By using high-frequency vibrations to “divide and conquer” individual water molecules during electrolysis, the team managed to split the water molecules to release 14 times more hydrogen compared with standard electrolysis techniques.
Electrolysis involves electricity running through water with two electrodes to split water molecules into oxygen and hydrogen gases, which appear as bubbles. This process produces green hydrogen, which represents just a small fraction of hydrogen production globally due to the high energy required.
Most hydrogen is produced from splitting natural gas, known as blue hydrogen, which emits greenhouse gases into the atmosphere.
Associate Professor Amgad Rezk from RMIT University, who led the work, said the team’s innovation tackles big challenges for green hydrogen production.
“One of the main challenges of electrolysis is the high cost of electrode materials used, such as platinum or iridium,” said Rezk from RMIT’s School of Engineering.
“With sound waves making it much easier to extract hydrogen from water, it eliminates the need to use corrosive electrolytes and expensive electrodes such as platinum or iridium.
“As water is not a corrosive electrolyte, we can use much cheaper electrode materials such as silver.”
The ability to use low-cost electrode materials and avoiding the use of highly corrosive electrolytes were gamechangers for lowering the costs of producing green hydrogen, Rezk said.
The research is published in Advanced Energy Materials. An Australian provisional patent application has been filed to protect the new technology.
First author Yemima Ehrnst said the sound waves also prevented the build-up of hydrogen and oxygen bubbles on the electrodes, which greatly improved its conductivity and stability.
“Electrode materials used in electrolysis suffer from hydrogen and oxygen gas build-up, forming a gas layer that minimises the electrodes’ activity and significantly reduces its performance,” said Ehrnst, a PhD researcher at RMIT’s School of Engineering.
As part of their experiments the team measured the amount of hydrogen produced through electrolysis with and without sound waves from the electrical output.
“The electrical output of the electrolysis with sound waves was about 14 times greater than electrolysis without them, for a given input voltage. This was equivalent to the amount of hydrogen produced,” Ehrnst said.
The potential applications of the team’s work
Distinguished Professor Leslie Yeo, one of the lead senior researchers, said the team’s breakthrough opened the door to using this new acoustic platform for other applications, especially where bubble build-up on the electrodes was a challenge.
“Our ability to suppress bubble build-up on the electrodes and rapidly remove them through high-frequency vibrations represents a major advance for electrode conductivity and stability,” said Yeo from RMIT’s School of Engineering.
“With our method, we can potentially improve the conversion efficiency leading to a net-positive energy saving of 27%.”
Next steps
While the innovation is promising, the team needs to overcome challenges with integrating the sound-wave innovation with existing electrolysers to scale up the work.
"We are keen to collaborate with industry partners to boost and complement their existing electrolyser technology and integrate into existing processes and systems," Yeo said.
Suggested caption: PhD researcher Yemima Ehrnst holding the acoustic device the research team used to boost the hydrogen production, through electrolysis to split water. Credit: RMIT University
Acoustically-Induced Water Frustration for Enhanced Hydrogen Evolution Reaction in Neutral Electrolytes
ARTICLE PUBLICATION DATE
4-Dec-2022
New approaches to the mystery of why ice is slippery
• An international team led by the Complutense University of Madrid has conducted a computer simulation of how a solid slides over ice at the atomic scale, confirming the presence of a self-lubricating layer on the surface
The surface of the ice melts in contact with a solid, forming a lubricant layer which is self-perpetuating, as greater weight and slippage are applied to it. This cooperative phenomenon makes the ice more slippery and more likely to cause skating or car accidents, according to international research led by the Complutense University of Madrid (UCM).
In this study, published in Proceedings of the National Academy of Science, the researchers conducted a computer simulation of how a solid slides over the surface of the ice at the atomic scale.
"Our analysis of how the ice molecules are collectively organised to give them their peculiar lubricant power offers us a privileged insight into the process that could not be achieved through conventional experiments, given the huge difficulty in conducting an experimental observation of a lubricating layer of a thickness of a billionth of a metre", stresses Luis González MacDowell, a researcher at the UCM Physical Chemistry Department.
The slippery properties of ice have in some cases been exploited for leisure purposes (such as in ice-skating), and in others as a means of transport.
"It is important to understand the origin of this widely known property of ice, both in order to improve the performance of Olympic athletes, and to ensure vehicle safety during the winter," the expert indicates.
Aside from the UCM, the study also involves the Autonomous University of Madrid (UAM) and Marie Curie-Skłodowska University (MCSU) of Lublin, Poland.
Compatible hypotheses which pave the way for energy savings
Scientists have spent two centuries wondering why ice is slippery, and what causes the liquid layer which forms on top of it. Over the decades, figures including Michael Faraday, James Thomson, Osborne Reynolds and Philip Browden have come up with divergent hypotheses.
However, this study has served to demonstrate that they are in truth compatible, and operate simultaneously. "What we in fact find is that the key principles of the slippery nature of ice are the surface melting phenomenon proposed by Faraday; the gradual melting caused by pressure, reminiscent of Thomson's hypothesis, and the melting caused by friction, as proposed by Bowden", the UCM chemist points out.
This combination of factors gives the surface of the ice an exceptional self-repairing lubrication layer. "The problem with lubrication is that as the pressure increases, the lubricant is expelled from between the opposing faces, which leaves them in direct contact. In the case of ice, Le Chatelier's principle operates, and as the lubricating layer is driven away by the pressure, the ice itself melts and repairs the loss," indicates Lukasz Baran, the MCSU researcher who worked on the simulation technique during a six-month placement at the UCM.
Aside from preventing sporting and traffic accidents, the results of this study could be applied in designing better lubricants in other systems.
"It is important to remember that more than half the energy generated worldwide is lost through friction. Improved lubrication processes would mean a huge saving in fuel, money and environmental impact," concludes Pablo Llombart, researcher at the UAM's Nicolás Cabrera Institute.
