Drinkable, carbon monoxide-infused foam enhances effectiveness of experimental cancer therapy

Peer-Reviewed Publication

UNIVERSITY OF IOWA HEALTH CARE

 

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GAS-ENTRAPPING FOAM INFUSED WITH CARBON MONOXIDE ENHANCES ANTI-CANCER ACTIVITY OF AUTOPHAGY INHIBITORS, WHICH MAY HELP IMPROVE THERAPIES FOR MANY DIFFERENT CANCERS.

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CREDIT: UNIVERSITY OF IOWA HEALTH CARE

Did smokers do better than non-smokers in a clinical trial for an experimental cancer treatment? That was the intriguing question that led University of Iowa researchers and their colleagues to develop a drinkable, carbon monoxide-infused foam that boosted the effectiveness of the therapy, known as autophagy inhibition, in mice and human cells. The findings were recently published in the journal Advanced Science. 

Looking for ways to exploit biological differences between cancer cells and healthy cells is a standard approach for devising new cancer treatments. But it is a painstaking process that requires a deep understanding of complex cancer biology and often a dose of unexpected insight. 

The potential of autophagy inhibitors 

Researchers have known for several decades that autophagy, which is the cell’s natural recycling system, is increased in cancer cells relative to healthy cells, suggesting that inhibiting autophagy might be a way to target cancer cells. However, results from almost 20 clinical trials testing autophagy inhibitors have been inconclusive. 

"Within those clinical trials they found mixed results; there was some benefit, but for many patients there was no benefit, which really pushed researchers back to the drawing board,” says James Byrne, MD, PhD, UI assistant professor of radiation oncology and biomedical engineering and senior author on the new study.  

Searching for insight into why autophagy inhibition only seems to work some of the time, the researchers made the surprising discovery that smokers in two of the previous trials of autophagy inhibitors seemed to do better than non-smokers.  

“When we looked at how the smokers did in those trials, we saw an increase in overall response in smokers that received the autophagy inhibitors, compared to (non-smoker) patients, and we also saw a pretty robust decrease in the target lesion size,” Byrne says. 

This was an exciting finding for Byrne and his team because smoking is also associated with increased levels of carbon monoxide, a gas molecule that can increase autophagy in cells in a way that researchers think might enhance the anti-cancer effect of autophagy inhibitors. 

“We know also that smokers have higher carbon monoxide levels and while we definitely don’t recommend smoking, this suggested that elevated carbon monoxide might improve the effectiveness of autophagy inhibitors. We want to be able to harness that benefit and take it into a therapeutic platform,” says Byrne, who also is a member of University of Iowa Holden Comprehensive Cancer Center. 

Carbon monoxide boosts anti-cancer activity of autophagy inhibition 

The team already had just such a “platform” to test their ideas. Byrne specializes in crafting gas-entrapping materials (GEMs)—foams, gels, and solids made from safe, edible substances that can be infused with different gas molecules. For this study, the researchers created a drinkable foam infused with carbon monoxide.  

When mice with pancreatic and prostate cancers were fed the carbon monoxide foam and simultaneously treated with an autophagy inhibitor, tumor growth and progression was significantly reduced in the animals. The team also showed that combining carbon monoxide with autophagy inhibitors had a significant anti-cancer effect in human prostate, lung, and pancreatic cancer cells in petri dishes. 

Ultimately, Byrne hopes to test this approach in human clinical trials. 

“The results from this study support the idea that safe, therapeutic levels of CO, which we can deliver using GEMs, can increase the anti-cancer activity of autophagy inhibitors, opening a promising new approach that might improve therapies for many different cancers,” he says. 

In addition to Byrne, the research team included UI researchers Jianling Bi, Emily Witt, Megan McGovern, Arielle Cafi, Lauren Rosenstock, Lucas Absler, Srija Machkanti, Kellie Bodeker, Scott Shaw, Vitor Lira, and Michael Henry. 

The research team also included scientists from MIT, Harvard Medical School, University of Pennsylvania, Rutgers Cancer Institute of New Jersey, University of North Carolina Wilmington, and Oregon Health and Science University. 

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JOURNAL

Advanced Science

DOI

10.1002/advs.202308346 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Oral Carbon Monoxide Enhances Autophagy Modulation in Prostate, Pancreatic, and Lung Cancers

ARTICLE PUBLICATION DATE

12-Dec-2023

COI STATEMENT

HB, DG, LEO, GT, and JDB are co-inventors on a patent application (WO2022055991A1) submitted by Brigham and Women's Hospital, MIT, and BIDMC that covers therapeutic carbon monoxide formulations. Complete details of all relationships for profit and non for profit for GT can be found at www.dropbox.com/sh/szi7vnr4a2ajb56/AABs5N5i0qAfT1IqIJAE-T5a?dl=0. The authors declare that they have no other competing interests.

News media trigger conflict for romantic couples with differing political views

 NEWS RELEASE 12-JAN-2024

UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN, NEWS BUREAU

 

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COUPLES WITH DIFFERING POLITICAL VIEWS AND IDENTITIES FACE UNIQUE CHALLENGES IN THEIR CONSUMPTION OF NEWS, WHICH CAN CREATE SIGNIFICANT STRESS ON THEIR RELATIONSHIP, UNIVERSITY OF ILLINOIS URBANA-CHAMPAIGN COMMUNICATION PROFESSOR EMILY VAN DUYN FOUND IN A RECENT STUDY.

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CREDIT: L. BRIAN STAUFFER

CHAMPAIGN, Ill. — By one estimate, as many as 30% of people in the U.S. are in romantic relationships with partners who do not share their political views. In today’s hyperpartisan climate, where Democrats and Republicans have difficulty talking to each other and their views are polarized about media outlets’ credibility, how do couples with differing political perspectives decide which media to follow? And how do these decisions affect their discussions on political issues and their relationship in general?

To explore these questions, University of Illinois Urbana-Champaign communication professor Emily Van Duyn conducted in-depth interviews with 67 people whose partners’ political views differed from their own. For these couples, seemingly mundane decisions about media consumption became “especially difficult,” Van Duyn said.

“Their cross-cutting political views presented many challenges for these couples,” Van Duyn said. “Deciding which media to consume and whether to do so together or separately was difficult because it presented them with a choice about recognizing their political differences and finding a way to navigate them.

“They saw the news as inherently political, and their selection of a news outlet or the act of sharing an article or video meant they were intentionally pulling their partner into a recognition of their political differences.”

News coverage activated differences between the partners that otherwise would not have emerged, sparking conflict as well as discussion. Conflict emerged in various ways, including disagreement over news sources and content, but also when one person failed to respond as intensely as their partner when the latter shared news that they found disturbing or alarming, Van Duyn said.

Partners’ differing political beliefs and/or identities created a need to influence or negotiate their news consumption, a process that Van Duyn calls “negotiated exposure” and that played out across public-facing media such as television and those that are more private in nature like social media.

This process and the interpersonal conflict that resulted from it “often worked in tandem to reinforce one another and impact the relationship,” Van Duyn said. “Conflict resulting from news consumption often caused individuals to seek greater control of their news exposure, a reinforcing process that highlights the muddled order in how individuals simultaneously navigate news and relationships in contemporary democracy.”

 Van Duyn chose to interview only one partner from each couple so that participants would feel comfortable speaking freely without the concern of impacting their relationship or feeling constrained by their partners’ views. To protect the privacy of those interviewed, who were recruited through social media advertisements, pseudonyms were used in the study.

Of the participants, 39 were female, 27 were male and one identified as non-binary. Most were in opposite-sex relationships and had been in their current relationship more than two years. The majority (42) of the study participants where white, 11 were Black, three were Hispanic and 11 were Asian.

A 46-year-old Virginia woman identified as “Wendy” in the study was a Donald Trump-supporting Republican whose boyfriend of two years was a Democrat who voted for Hillary Clinton. Wendy said that she and her partner compromised on which news programs they viewed on television and when, with Wendy having control over programming during the morning hours and her boyfriend’s preferences taking precedence during the afternoon.

 Since the couple fervently disagreed about then-President Trump, co-viewing TV news together created friction, especially when Wendy felt there was too much negative coverage of Trump and wanted to avoid it. Moreover, negative news stories about Trump made Wendy susceptible not only to her boyfriend’s criticism of her favored candidate – but also of herself, personally.

Some couples sought a common media outlet they could agree on to co-view together, while others intentionally chose to consume news independently, whether in separate rooms or by scrolling their social media feeds on separate devices while in each other’s company. Other individuals sought ways of consuming news with their partner that superseded their differences and utilized other news media privately, according to the study.

Nancy, a 49-year-old Michigan woman who had switched from voting Republican to voting Democratic in 2016 and 2020, said her husband was a Trump supporter that held political beliefs she described as “diametrically opposed” to her own. News was a significant source of conflict between them as was Nancy’s ideological shift, which her husband attributed to her viewing CNN.

Nancy, who worked from home, responded by watching CNN secretly during the day when her spouse was away and kept her political activity – working as a text banker for the Democratic party during the 2020 election – secret as well.

“The point in their relationship when couples’ political differences emerged affected how partners negotiated news with one another,” Van Duyn said. “While some were aware of their ideological differences at the outset of the relationship, other individuals found their shared tradition of amicably co-viewing the news together disrupted when their partners’ views or party affiliation changed. Negotiations around news selection in cross-cutting relationships involved a negotiation of political identity as much as of news exposure.”

When the news began to take a negative toll on some participants and their relationship, these couples decided to avoid the news altogether and quit sharing articles or videos with each other because doing so triggered tensions that affected their emotional intimacy.

Van Duyn said that some of those who chose news avoidance cited heightened conflict within their relationship or mental health concerns such as anxiety.

The study, published in the journal Political Communication, was funded by the Institute for Humane Studies at George Mason University.

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JOURNAL

Political Communication

DOI

10.1080/10584609.2023.2270445 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

“Negotiating news: How cross-cutting romantic partners select, consume and discuss news together

2023: the warmest year on record globally

NEWS RELEASE 12-JAN-2024

UNIVERSITY OF EAST ANGLIA

Globally 2023 was the warmest year in a series stretching back to 1850, according to figures released today by the Met Office and the University of East Anglia. 

2023 is the tenth year in succession that has equalled or exceeded 1.0 °C above the pre-industrial period (1850-1900).  

The global average temperature for 2023 was 1.46 °C above the pre-industrial baseline; 0.17 °C warmer than the value for 2016, the previous warmest year on record in the HadCRUT5 global temperature dataset which runs from 1850. 

Dr Colin Morice is a Climate Monitoring and Research Scientist with the Met Office. He said: 

“2023 is now confirmed as the warmest year on average over the globe in 174-years of observation. 2023 also set a series of monthly records, monthly global average temperatures having remained at record levels since June. Ocean surface temperatures have remained at record levels since April. 

“Year-to-year variations sit on a background of around 1.25 °C warming in global average temperatures above pre-industrial levels. This warming is attributable to human-induced climate change through greenhouse gas emissions.” 

On top of the long-term warming, a transition into El Niño conditions contributed to further elevated temperatures for the latter part of the year. El Niño is part of a pattern of climate variability in the tropical Pacific that imparts warmth to the global atmosphere, temporarily adding up to 0.2 °C to the temperature of an individual year. This stands in contrast to the reverse pattern of climate variability, La Niña, which suppressed global average temperatures in 2021 and 2022. 

Outlook for 2024  

Professor Adam Scaife is a Principal Fellow and Head of Monthly to Decadal Prediction at the Met Office. He said: “It is striking that the temperature record for 2023 has broken the previous record set in 2016 by so much because the main effect of the current El Niño will come in 2024. Consistent with this, the Met Office’s 2024 temperature forecast shows this year has strong potential to be another record-breaking year.” 

The Met Office global temperature for 2024 is forecast to be between 1.34 °C and 1.58 °C (with a central estimate of 1.46 °C) above the average for the pre-industrial period (1850-1900): the 11th year in succession that temperatures will have reached at least 1.0 °C above pre-industrial levels. 

HadCRUT5 

The HadCRUT5 dataset is compiled by the Met Office and the University of East Anglia (UEA), with support from the National Centre for Atmospheric Science. It shows that when compared with the pre-industrial reference period, 2023 was 1.46 ± 0.1 °C above the 1850-1900 average. This aligns extremely well with figures published today by other international centres. 

Professor Tim Osborn, of the University of East Anglia’s Climatic Research Unit, said: “Twenty-five years ago, 1998 was a record-breaking year for global average temperature. But last year’s global temperature was 0.5 °C warmer than 1998, providing further evidence that our planet is warming on average by 0.2 °C per decade.  

“At the current rate of human-induced warming, 2023’s record-breaking values will in time be considered to be cool in comparison with what projections of our future climate suggest.” 

Other data sets 

The World Meteorological Organization uses six international data sets to provide an authoritative assessment of global temperature change. They report 2023 was around 1.45 ± 0.12°C warmer than the 1850-1900 baseline based on an average of the six data sets.   

The long-term warming is clear. Since the 1980s, each decade has been warmer than the previous one. 

Importance of global mean temperature  

Global average temperature is the key measure of climate change, providing a headline metric that is expanded upon by the changing patterns of rainfall, drought, ice, temperature and extreme weather that are associated with a warming climate. You can see the impact on other key climate indicators on the Met Office global climate dashboard. 

It is complex and challenging to track the average temperature of an entire planet, using around a billion temperature observations from the last 174 years. 

The UK’s contribution to measuring this key indicator of climate change is led by scientists at the Met Office, UEA and NCAS. This ongoing work is crucial as the world moves still closer to the limits set out in the Paris Agreement 

Prof Philip Jones, Professorial Fellow at UEA’s Climatic Research Unit, said: “I've been working with the global temperature series since the early 1980s. There has never been a year like 2023 where the warmest-ever June, warmest-ever July through to the warmest-ever December was recorded for seven months in a row, from June to December, 2023.” 

Defining global temperature change relevant to the Paris Agreement 

While the global average temperature in a particular year is well-known, this will not be suitable as an indicator of whether the “Paris 1.5” has been breached or not, because the Paris Agreement refers to long-term warming, not individual years. But no alternative has yet been formally agreed.  

In a recent paper published in Nature, Met Office scientist Prof Richard Betts and coauthors proposed an indicator combining the last ten years of global temperature observations with an estimate of the projection or forecast for the next ten years. If adopted by the international community this could mean a universally agreed measure of global warming that could trigger immediate action to avoid further rises. 

Using this suggested approach, the researchers found that the figure for the current global warming level, relevant to the Paris Agreement, is around 1.26 °C, with an uncertainty range of 1.13 °C to 1.43 °C.    

This graphic shows the annual global temperature anomaly for 2023 compared to a 1961-1990 averaging period. The global average temperature for 2023 was 1.46 °C above the pre-industrial baseline according to the HadCRUT5 data set. This map uses HadCRUT5 data, compiled by the Met Office and the University of East Anglia, with support from the National Centre for Atmospheric Science.  

[An animated monthly version of this graphic is available here] 

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METHOD OF RESEARCH

Data/statistical analysis

NASA analysis confirms 2023 as warmest year on record

Reports and Proceedings

NASA/GODDARD SPACE FLIGHT CENTER

Earth’s average surface temperature in 2023 was the warmest on record, according to an analysis by NASA. Global temperatures last year were around 2.1 degrees Fahrenheit (1.2 degrees Celsius) above the average for NASA’s baseline period (1951-1980), scientists from NASA’s Goddard Institute for Space Studies (GISS) in New York reported.

“NASA and NOAA’s global temperature report confirms what billions of people around the world experienced last year; we are facing a climate crisis,” said NASA Administrator Bill Nelson. “From extreme heat, to wildfires, to rising sea levels, we can see our Earth is changing. There’s still more work to be done, but President Biden and communities across America are taking more action than ever to reduce climate risks and help communities become more resilient – and NASA will continue to use our vantage point of space to bring critical climate data back down to Earth that is understandable and accessible for all people. NASA and the Biden-Harris Administration are working to protect our home planet and its people, for this generation – and the next.”

In 2023, hundreds of millions of people around the world experienced extreme heat, and each month from June through December set a global record for the respective month. July was the hottest month ever recorded. Overall, Earth was about 2.5 degrees Fahrenheit (or about 1.4 degrees Celsius) warmer in 2023 than the late 19th-century average, when modern record-keeping began.

“The exceptional warming that we’re experiencing is not something we’ve seen before in human history,” said Gavin Schmidt, director of GISS. “It’s driven primarily by our fossil fuel emissions, and we’re seeing the impacts in heat waves, intense rainfall, and coastal flooding.”

Though scientists have conclusive evidence that the planet’s long-term warming trend is driven by human activity, they still examine other phenomena that can affect yearly or multi-year changes in climate such as El Niño, aerosols and pollution, and volcanic eruptions.

Typically, the largest source of year-to-year variability is the El Niño – Southern Oscillation ocean climate pattern in the Pacific Ocean. The pattern has two phases – El Niño and La Niña – when sea surface temperatures along the equator switch between warmer, average, and cooler temperatures. From 2020-2022, the Pacific Ocean saw three consecutive La Niña events, which tend to cool global temperatures. In May 2023, the ocean transitioned from La Niña to El Niño, which often coincides with the hottest years on record.

However, the record temperatures in the second half of 2023 occurred before the peak of the current El Niño event. Scientists expect to see the biggest impacts of El Niño in February, March, and April.

Scientists have also investigated possible impacts from the January 2022 eruption of the Hunga Tonga-Hunga Ha’apai undersea volcano, which blasted water vapor and fine particles, or aerosols, into the stratosphere. A recent study found that the volcanic aerosols – by reflecting sunlight away from Earth’s surface – led to an overall slight cooling of less than 0.2 degrees Fahrenheit (or about 0.1 degrees Celsius) in the Southern Hemisphere following the eruption.

“Even with occasional cooling factors like volcanoes or aerosols, we will continue to break records as long as greenhouse gas emissions keep going up,” Schmidt said. “And, unfortunately, we just set a new record for greenhouse gas emissions again this past year.”

“The record-setting year of 2023 underscores the significance of urgent and continued actions to address climate change,” said NASA Deputy Administrator Pam Melroy. “Recent legislation has delivered the U.S. government’s largest-ever climate investment, including billions to strengthen America’s resilience to the increasing impacts of the climate crisis. As an agency focused on studying our changing climate, NASA’s fleet of Earth observing satellites will continue to provide critical data of our home planet at scale to help all people make informed decisions.”

Open Science in Action

NASA assembles its temperature record using surface air temperature data collected from tens of thousands of meteorological stations, as well as sea surface temperature data acquired by ship- and buoy-based instruments. This data is analyzed using methods that account for the varied spacing of temperature stations around the globe and for urban heating effects that could skew the calculations.

Independent analyses by NOAA and the Hadley Centre (part of the United Kingdom Met Office) concluded the global surface temperatures for 2023 were the highest since modern record-keeping began. These scientists use much of the same temperature data in their analyses but use different methodologies. Although rankings can differ slightly between the records, they are in broad agreement and show the same ongoing long-term warming in recent decades.

Building on a half century of research, observations, and models, the Biden-Harris Administration including NASA and several federal partners recently launched the U.S. Greenhouse Gas Center to make critical climate data readily available to decisionmakers and citizens. The center supports collaboration across U.S. government agencies and the non-profit and private sectors to make air-, ground-, and space-borne data and resources available online.

NASA’s full dataset of global surface temperatures through 2023, as well as details with code of how NASA scientists conducted the analysis, are publicly available from GISS. GISS is a NASA laboratory managed by the Earth Sciences Division of the agency’s Goddard Space Flight Center in Greenbelt, Maryland. The laboratory is affiliated with Columbia University’s Earth Institute and School of Engineering and Applied Science in New York.

 

Could an already approved drug cut down on opioid use after surgery?

A pilot study conducted by Medical University of South Carolina researchers has found that an FDA-approved drug called NAC could be useful for reducing the need for opioids after spinal surgery

Peer-Reviewed Publication

MEDICAL UNIVERSITY OF SOUTH CAROLINA

 

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AN ASTROCYTE, A TYPE OF NON-NEURONAL CELL, IN THE RODENT CORTEX. THE OUTER BOUNDARY OF THE CELL IS SHOWN IN YELLOW; THE CELL “SKELETON” IN TEAL.

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CREDIT: MEDICAL UNIVERSITY OF SOUTH CAROLINA. IMAGE COURTESY OF DR. MICHAEL D. SCOFIELD OR CONTACT DR. SCOFIELD FOR PERMISSION.

Researchers in the Department of Anesthesia and Perioperative Medicine at the Medical University of South Carolina (MUSC) have found that an FDA-approved drug may help to decrease pain after surgery. In the pilot study published in Pain Management, spinal surgery patients who received N-acetylcysteine (NAC) during surgery in addition to standard pain control treatments reported lower pain scores and requested fewer opioids after surgery than patients given a placebo.

Opioids are often given for a short time after surgery to treat pain. Although effective, their potency can wain and addictive potential can be dangerous without careful supervision by a health care provider. As such, physicians welcome the opportunity to limit opioid use in managing pain.

“Can we stop giving opiates completely? Likely not. Can we decrease the amount patients need? We should try,” said Sylvia Wilson, M.D., the Jerry G. Reves Endowed Chair in Anesthesia Research in the Department of Anesthesia and Perioperative Medicine and a principal investigator of the study.

Wilson has worked for years on efforts to improve pain management and limit opioid usage after surgical operations. As it turns out, a collaboration with a basic scientist within her own department could offer a solution.

A productive partnership

Wilson began to work closely with Michael Scofield, Ph.D., the Jerry G. Reves Endowed Chair in Basic Science Anesthesiology Research and a senior author of the published study. Scofield has conducted laboratory research on NAC, an anti-inflammatory drug that is used to treat acetaminophen poisoning, mushroom poisoning and liver damage. Researchers, such as Scofield, have also studied its effects on the nervous system, especially in the areas of addiction and pain perception. Wilson’s clinical goals and Scofield’s research on NAC made them ideal collaborators.

“This project is really an elegant synthesis of basic science and clinical research, using things we find have efficacy in the laboratory and taking them to the clinic,” said Scofield.

Wilson believes that partnerships between physicians and basic scientists can spur clinical advances. She credits the supportive environment within the department fostered by Chairman Scott Reeves, M.D., and former College of Medicine Dean Jerry G. Reves, M.D., for making such partnerships possible.

Promising trial insights

The research team chose spinal surgery patients for its pilot study because these patients often experience chronic pain before surgery and are more likely to be exposed to higher levels of opioids before, during and after surgery. During surgery, patients received a standard regimen of anesthesia in addition to a dose of NAC or a saline infusion. Information on patients’ pain and opioid consumption was then collected.

In the 48 hours after surgery, patients who were administered NAC via IV infusion (150 mg/kg) received 19% fewer opioid doses on average than patients who received saline. NAC patients also reported lower pain scores and took a longer time to request pain medication after their surgery than the saline patients. The researchers were especially encouraged to see that the beneficial effect seemed to last longer than the NAC was expected to remain in the body.

“We’ve seen the impact of giving this medication persisting, and I think that’s significant,” said Wilson. “We’re not seeing a rebound effect when that medication wears off.”

This extended effect on pain perception mirrored previous findings from Scofield’s laboratory research.

“For heroin addiction, we had seen in NAC preclinical studies that protection against relapse vulnerability is long lasting,” said Scofield. “Certainly, the hope is that it’s something that has a long duration.”

Looking to the future

Next, the research team wants to investigate whether the findings can be translated to other procedures. They are currently enrolling patients undergoing minimally invasive hysterectomies in a larger trial. As more patients are enrolled, the researchers will be able to conduct more in-depth statistical tests to improve their understanding of the effects of NAC on surgery-associated pain. This will help them to set the stage for future clinical trials of NAC during surgery.

“To change practice, you need many large clinical trials with different settings, different types of surgeries to show that you’re going to cause benefit, not harm,” said Wilson. “We want to show good clinical efficacy, but also safety in that situation.”

# # #

About MUSC

Founded in 1824 in Charleston, MUSC is the state’s only comprehensive academic health system, with a unique mission to preserve and optimize human life in South Carolina through education, research and patient care. Each year, MUSC educates more than 3,200 students in six colleges – Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy – and trains more than 900 residents and fellows in its health system. MUSC brought in more than $298 million in research funds in fiscal year 2022, leading the state overall in research funding. MUSC also leads the state in federal and National Institutes of Health funding, with more than $220 million. For information on academic programs, visit musc.edu.

As the health care system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest-quality and safest patient care while educating and training generations of outstanding health care providers and leaders to serve the people of South Carolina and beyond. Patient care is provided at 16 hospitals (includes owned and equity stake), with approximately 2,700 beds and four additional hospital locations in development; more than 350 telehealth sites and connectivity to patients’ homes; and nearly 750 care locations situated in all regions of South Carolina. In 2022, for the eighth consecutive year, U.S. News & World Report named MUSC Health University Medical Center in Charleston the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.

MUSC has a total enterprise annual operating budget of $5.1 billion. The nearly 26,000 MUSC family members include world-class faculty, physicians, specialty providers, scientists, students, affiliates and care team members who deliver groundbreaking education, research, and patient care.

  

Michael Scofield, Ph.D.  (left) is the Jerry G. Reves Endowed Chair in Basic Science Anesthesiology Research at the Medical University of South Carolina. Sylvia Wilson, M.D. (right) is the Jerry G. Reves Endowed Chair in Anesthesia Research at MUSC.

CREDIT

Medical University of South Carolina. Photograph by Sarah Pack

JOURNAL

Pain Management

DOI

10.2217/pmt-2023-0061 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The impact of intraoperative N-acetylcysteine on opioid consumption following spine surgery: a randomized pilot trial

 

Male gender expression in schools is associated with substance abuse later in life

Peer-Reviewed Publication

UNIVERSITY OF CHICAGO MEDICAL CENTER

A new study led by researchers at the University of Chicago found that changes in male gender expression from adolescence to young adulthood align closely with the gender norms present in individuals’ school environments, and that these trajectories are associated with subsequent patterns of substance abuse.

Amidst a growing consensus among social science researchers that separates gender from biological sex, gender has come to be defined as a constellation of expected behaviors, attributes, preferences and beliefs typically associated with a specific gender identity. Prior research shows that traditional models of male gender identity, constructed over time through sociocultural processes and interactions, can be a risk factor for unhealthy behaviors.

With that background, the UChicago researchers set out to explore how sociocultural pressures around male gender in particular might evolve in relation to environmental factors, and how that change could impact a person's long-term health in specific ways.

“There’s a real misconception that men aren’t particularly sensitive or emotional,” said Nathaniel Glasser, MD, a general internist and pediatrician at UChicago Medicine and lead author on the paper. “In reality, I think men’s emotions simply present differently because of the impact of sociocultural narratives telling them not to express emotions through tears or words that construe weakness. And they can face especially harsh social and psychological penalties if they fail to live up to the norms of their gender identity.”

“We set out to investigate how that often-overlooked sensitivity among cisgender men might manifest in a reluctance to engage in healthy behaviors, as well as an over-engagement in health risk behaviors in an effort to convey dominance and reduce vulnerability,” Glasser said.

Impact of gender dynamics within school environments

The UChicago researchers used data from a nationally representative longitudinal cohort study called Add Health. In the initial round of data collection in the 1990s, the study enrolled large numbers of participants who attended the same schools, which enabled granular social network mapping and analyses. Rather than being limited to analyzing data from individuals out of context, researchers could find out how each person compared to their peers in gender expression and who they identified as people close to them.

Using a previously validated technique, Glasser and his colleagues Jacob Jameson, Elizabeth Tung, Stacy Lindau and Harold Pollack measured male gender expression quantitatively by analyzing survey responses to survey items that were found to be answered most differently by male versus female respondents, such as frequency of crying and military service. Importantly, this empirically derived method helped them avoid projecting today’s gender norms onto adolescents in the 1990s.

The researchers found that the way adolescent boys at a school are enacting their gender has a significant impact on other males who attend that school, shaping the ways those same males respond to sociocultural pressures around male gender as young adults. That in turn predicts their likelihood of engaging in substance abuse.

Adolescent boys whose gender expression was further from their school’s norm showed the greatest change in their gender expression as young adults, shifting toward that local norm of their school. Those who displayed the greatest changes were also the most likely to abuse substances including alcohol, cigarettes, marijuana and recreational drugs as young adults.

“These results add quantitative evidence to a conclusion that others have already drawn qualitatively: local expectations shape people’s understanding of their identity and how they perform it to their peers,” said senior author Harold Pollack, PhD, the Helen Ross Distinguished Service Professor at the UChicago Crown Family School of Social Work, Policy and Practice.

Countering the narrative to promote health

Based on these results, Pollack suggested public health experts could play a role in countering detrimental cultural narratives, such as when advertisers use gender-based messaging to promote harmful products like tobacco, alcohol or gambling platforms.

“It’s important to understand what motivates people,” he said. “If someone has a male gender expression where they put a lot of weight on self-reliance and strength and being a source of strength for the people around them, we can help them see that one of the ways to do that is by attending to their health.”

This study is part of a larger body of research around the tangible health effects of social pressures, especially those related to gender identity and expression. The results have the potential to shape paradigms in public health research and in clinical practice.

“We need to start taking social pressures more seriously as health determinants,” Glasser said. “If someone thinks using a product or following a doctor’s recommendation will undermine their identity or status or cause some kind of embarrassment, it is worth considering that social barrier as seriously as affordability or transportation issues.”

The study, “Associations of Adolescent School Social Networks, Gender Norms, and Adolescent-to-Adult Changes in Male Gender Expression With Adult Substance Abuse,” was published in the Journal of Adolescent Health in January 2024. In addition to Pollack and Glasser, co-authors were Jacob Jameson of Harvard University and Elizabeth Tung and Stacy Lindau of University of Chicago.

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JOURNAL

Journal of Adolescent Health

DOI

10.1016/j.jadohealth.2023.11.018 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Associations of Adolescent School Social Networks, Gender Norms, and Adolescent-to-Young Adult Changes in Male Gender Expression With Young Adult Substance Use

ARTICLE PUBLICATION DATE

11-Jan-2024