MRI can cut overdiagnoses in prostate-cancer screening by half

KAROLINSKA INSTITUTET

Research News

IMAGE: MARTIN EKLUND, ASSOCIATE PROFESSOR AT THE DEPARTMENT OF MEDICAL EPIDEMIOLOGY AND BIOSTATISTICS AT KAROLINSKA INSTITUTET, AND TOBIAS NORDSTRÖM, ASSOCIATE PROFESSOR OF UROLOGY AT THE DEPARTMENT OF CLINICAL SCIENCES, DANDERYD HOSPITAL... view more 

CREDIT: STEFAN ZIMMERMAN

Most countries have not introduced nationwide prostate-cancer screening, as current methods result in overdiagnoses and excessive and unnecessary biopsies. A new study by researchers at Karolinska Institutet in Sweden, which is published in The New England Journal of Medicine, indicates that screening by magnetic resonance imaging (MRI) and targeted biopsies could potentially cut overdiagnoses by half. The results are presented today at the European Association of Urology Congress.

"Our results from a large, randomised study show that modern methods for prostate cancer screening maintain the benefits of screening, while decreasing the harms substantially. This addresses the greatest barrier to the introduction of nationwide screening," explains Tobias Nordström, associate professor of Urology at the Department of Clinical Sciences, Danderyd Hospital at Karolinska Institutet, who is in charge of the STHLM3MRI study.

Yearly, approximately 1,4 million men get a prostate cancer diagnosis and 375,000 men die from the disease. Previous studies have shown that organised screening can result in earlier detection and thereby reduce the risk of prostate-cancer deaths.

Current screening methods - PSA (prostate-specific antigen) tests combined with traditional biopsies - result in unnecessary biopsies, and the detection of numerous minor low-risk tumours. Consequently, no country except Lithuania has chosen to introduce a nationwide prostate-cancer screening programme, as the benefits do not exceed the disadvantages.

"Refined screening methods are required to reduce overdiagnosis and overtreatment of low-risk tumours, and prevent unnecessary biopsies and biopsy-related side-effects," explains Martin Eklund, associate professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, with joint responsibility for the STHLM3MRI study.

The results of the STHLM3MRI study indicate that overdiagnoses can be halved by substituting traditional prostate biopsies with magnetic resonance imaging (MRI) and targeted biopsies. The number of unnecessary biopsies and the identification of minor low-risk tumours is reduced, while the new method can detect just as many clinically significant tumours.

STHLM3MRI is a randomised study conducted between 2018 and 2021 with participants from Stockholm County, which included 12,750 men. The participants first provided a blood sample for PSA analysis, as well as analysis by the new Stockholm3 test, developed by researchers at Karolinska Institutet. Men whose tests showed elevated levels were then randomly selected for traditional biopsies or MRI. In the MRI group, biopsies were conducted strictly on suspected tumours identified by MRI.

The study proceeded thereafter by investigating how the Stockholm3 test could be combined with MRI to further improve the method for prostate-cancer screening.

"We will soon present the second of the two main reports from the STHLM3MRI trial where we assess the role of a novel blood test as adjunct to MRI in prostate cancer screening. The future of prostate cancer diagnostics probably includes both improved blood tests and MRI. Nationwide screening for breast and cervical cancer among women has been available in the Western world for some time. We are finally able to show that men can also reduce their risk of malignant cancer through nationwide prostate-cancer screening that utilises modern methods," Tobias Nordström concludes.

Professor Hendrik Van Poppel, Adjunct Secretary General of the European Association of Urology (EAU) said: "It is exciting to see breakthroughs such as this in the field of early detection of prostate cancer. An innovation such as STHLM3MRI makes an even more compelling case for the European Commission to ensure a risk stratified approach to early detection of prostate cancer is adopted across the whole of Europe. The EAU is working hard to ensure that early detection of prostate cancer is addressed in the implementation of Europe's Beating Cancer Plan in order to reduce mortality of Europe's most common male cancer while also dealing with the challenges of overdiagnosis and overtreatment. We are really looking forward to seeing how STHLM3MRI can continue to contribute to this aim".

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The research was financed by the Swedish Cancer Society, the Swedish Research Council, the Swedish Research Council for Health, Working Life and Welfare, Karolinska Institutet, Hagstrandska Minnesfonden, Region Stockholm, the Swedish Order of Druids, the Åke Wiberg Foundation, the Swedish e-Science Research Center (SeRC) and Prostatacancerförbundet (the Prostate Cancer Association). Henrik Grönberg, Martin Eklund and Tobias Nordström are partners of the company A3P Biomedical AB, which holds the development rights of the Stockholm3 test.

Publication: "MRI-targeted or standard biopsy in prostate cancer screening", M. Eklund, F. Jäderling, A. Discacciati, M. Bergman, M. Annerstedt, M. Aly, A. Glaessgen, S. Carlsson, H. Grönberg, T. Nordström, for the STHLM3 consortium. The New England Journal of Medicine (NEJM), online 9 July 2021, doi: 10.1056/NEJMoa2100852.

Karolinska Institutet is one of the world's leading medical universities. Our vision is to advance knowledge about life and strive towards better health for all. Karolinska Institutet accounts for the single largest share of all academic medical research conducted in Sweden and offers the country's broadest range of education in medicine and health sciences. The Nobel Assembly at Karolinska Institutet selects the Nobel laureates in Physiology or Medicine.

About EAU21:

Europe's biggest urology congress will take place from 8th-12th July 2021 in a virtual setting. With over 1,500 abstracts presented and moderated live, the Annual Congress of the European Association of Urology (EAU21) will be amongst Europe's biggest medical congresses in 2021.

Clinicians, scientists, and patients will meet to discuss topics such as:

• Prostate cancer: new developments to improve treatments of the most common male cancer
• Urinary incontinence: a growing concern for the elderly population
• Practice changing treatments for both bladder and kidney cancer
• Prevention and treatment of urinary stones; 1 in 10 people (55 million adults in Europe) will form a stone at some point
• Special track for representatives of patient advocacy group on Friday 9 July

...and many other conditions related to the male and female urinary tract system and male reproductive organs. Review the full scientific programme on https://eaucongress.uroweb.org/

 

Researchers overcome winking, napping pigs to prove brain test works

UNIVERSITY OF ILLINOIS COLLEGE OF AGRICULTURAL, CONSUMER AND ENVIRONMENTAL SCIENCES

Research News

IMAGE: ADAM JONES, RESEARCH COORDINATOR FOR THE PIGLET NUTRITION AND COGNITION LABORATORY AT THE UNIVERSITY OF ILLINOIS, SETTLES PIGLET INTO A CUSTOM-BUILT HAMMOCK BEFORE TESTING ITS EYEBLINK REFLEX, A SIMPLE ASSAY... view more 

CREDIT: COLLEGE OF ACES, UNIVERSITY OF ILLINOIS

URBANA, Ill. - If you've ever been to an eye doctor, there's a good chance you've felt the sudden puff of air to the eye that constitutes a traditional test for glaucoma. It's no one's favorite experience, but the puff is non-invasive and harmless.

Scientists use a similar method to test learning and memory in animals and humans. Like Pavlov's classic experiments linking a neutral stimulus with a physiological response, the eyeblink test pairs a light or sound with a quick puff of air to the eye. With repetition, the animal learns to close its eye, or blink, in response to the light or sound only. It's called associative learning, and the response is ruled by a brain region known as the cerebellum.

While the eyeblink test has been around since 1922, it had never been attempted in pigs until now. In a new study in Frontiers in Behavioral Neuroscience, researchers prove the eyeblink test works in 3-week-old pigs, a model species for nutritional neuroscience research in human infants.

"The idea is, if we can improve structural development in the brain through nutritional interventions, it should take pigs fewer trials to learn the rule. We're in the process of assessing the nutrition piece now, but we had to get the test to work first," says Ryan Dilger, professor in the Department of Animal Sciences at the University of Illinois and co-author on the study.

Dilger specializes in the effects of nutrition on the developing brain, with much of his work feeding directly into the infant formula industry. He uses neonatal pigs because, unlike rodents, their brain anatomy and structure, gut physiology, and nutritional requirements are strikingly similar to human infants.

Dilger's team typically studies pig brain response to new ingredients through magnetic resonance imaging, MRI, which focuses on the structure and size of various brain regions. They also rely on well-validated behavioral tasks, such as novel object recognition, that reflect activity in the hippocampus and striatum, some of the brain regions related to learning and memory.

But Dilger wanted a tool to specifically assess cognitive processing in the cerebellum. That's when he turned to Henk-Jan Boele and Sebastiaan Koekkoek, eyeblink specialists and neuroscientists at Erasmus Medical Center in the Netherlands.

Although humans and all sorts of animals have undergone the eyeblink test, the behavioral paradigm had never been validated for pigs.

"For human and mouse eyeblink conditioning, we use completely different systems," says Boele, a postdoctoral researcher with dual appointments at Erasmus and Princeton University. "Humans are easy to instruct, usually are very cooperative, and sit still during the experiment, which makes it easy to deliver the puff and measure the eyelid. Mice are mostly head-fixed during the experiment, which makes it easy to deliver the air puff and measure the eyelid. Pigs, instead, were a challenge because we did not want to fixate their head. It was really difficult to reliably deliver the air puff and measure the eyelid responses.

"We tried video cameras, diodes, and all kinds of things, to capture the blink. And we had to use a piece of equipment to deliver the air puff that was very close to the eye to avoid any delays. We need really sharp, short puffs that are not invasive for the animal but are still very precisely timed. So that was a challenge," he says.

The solution was taping a short piece of air tubing next to one eye, and pasting magnetic sensors on the forehead and eyelid to record the blink. The system measured the eyeblink down to the millisecond.

And yes, Boele puffed himself in the eye to test out the system. It worked. "Oh yes, I blinked," he laughs.

To ensure the pigs had free head movement but didn't get up and run around, the researchers placed them in a custom-built sound-dampening box fitted with a pig-sized hammock.

It was apparently very comfy.

Sangyun Joung, a doctoral student in the Neuroscience Program at Illinois and co-author on the study, says, "Each pig had five days of training to habituate them to the hammock and the testing environment. By day three, they were very relaxed, to the point where some of them were literally falling asleep. That was a little challenge for us during the analysis, because that definitely influenced their responses. But it also told us this whole behavior paradigm is not stressful for them. For us, it was interesting and frustrating at the same time."

Once the pigs were used to the setup, the real work began. The pigs did a series of eight tests in a row. The first was the air puff only, to measure the eyeblink reflex. The next six tests paired a small blue LED light with the air puff. The light came on for half a second, 500 milliseconds, and right at the end, with the light still on, the air puff was delivered. That last part, with both the light on and the air puffing, lasted a tiny 50 milliseconds. The final test was the light only - no puff.

The researchers repeated each set of eight tests five times on each of five consecutive days. The time between tests varied a bit to keep the pigs guessing.

"It wasn't just on and off, once per second. The system waits until the eye is in a stable place, and then repeats the test at random times so the pigs can't anticipate the puff," Dilger says.

But they did learn, over the course of the five-day experiment, to anticipate the puff. Pretty soon, pigs were closing their eyes at exactly the 500-millisecond mark during the eighth trial - the one with a light but no puff.

"The timing is perfect. If you look at the conditioned eyelid responses, you can see that the eyelid is closed exactly at the moment the puff would have been delivered," Boele says. "Just perfect motor timing, down to the millisecond. That's beautiful."

The research team learned something else about pigs they hadn't known before.

"We learned that pigs can just close one eye at a time; they can wink. We weren't sure about that, actually," Dilger says. "But because they are pigs, they will frustrate you all day long. Some pigs would just lay there with their one eye closed, which meant we couldn't use that that particular subject. They're smart creatures."

The eyeblink test specifically targets activity in the cerebellum, the part of the brain responsible for making quick, unconscious predictions. These predictions relate to motor responses, such as where to step while you're walking; and cognitive processes, such as predicting what someone is going to say next in a conversation.

"The cerebellum is making short-term predictions all the time, continuously. It's essential to interact with our environment. When we think about learning and memory, often we think about really complex cognitive things, but most of our daily life behavior is just smooth, automatic interactions with our environment," Boele says. "In eyeblink conditioning, your cerebellum basically solves the problem for you. You don't have to think about it. It's making this short-term prediction, and that's what we are studying."

Pigs are born with a more developed cerebellum than human babies. That's clear from eyeblink conditioning tests Boele has done with six-to-eight-month-old infants; they don't typically learn the task at that age.

Unlike humans, pigs need to be able to make motor and cognitive predictions right away, since they can get up and walk around minutes after birth. When Dilger studies the pig cerebellum using MRI, which focuses mostly on structure, he typically doesn't see much change due to nutritional interventions. That's because the cerebellum is more developed at birth in the pig, which makes them a precocial species. But nutritional changes might alter the functioning of the brain region. That is what the eyeblink test will tell him in future studies.

"Often, function follows structure, but not always. Having a nutritional deficiency may show a deficit in eyeblink conditioning, this associative learning task," he says. "We want to be able to use a nutritional intervention as a relatively non-invasive way of understanding cerebellar development here."

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The study, "Young domestic pigs (Sus scrofa) can perform Pavlovian eyeblink conditioning," is published in Frontiers in Behavioral Neuroscience [DOI: 10.3389/fnbeh.2021.690019]. Current and former University of Illinois authors include Sangyun Joung, Joanne Fil, Austin Mudd, Stephen Fleming, and Ryan Dilger. Co-authors Sebastiaan Koekkoek and Henk-Jan Boele are affiliated with Erasmus Medical Center.

The Department of Animal Sciences is in the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois.

 

Reporting of adverse effects in drug trials has only improved slightly in 17 years, new study shows

UNIVERSITY OF YORK

Research News

Researchers, including academics from the University of York, analysed systematic reviews of 1,200 Randomised Controlled Trials (RCTs) to assess whether reporting had improved over time.

However, the information the researchers needed to assess what adverse effects were reported (and how they were reported) was only included in less than half of the RCTs they analysed.

Co-author Dr Su Golder from the Department of Health Sciences, said: "Drug trials are conducted to give clinicians information on the benefits and adverse effects of treatments. Our study shows that, disappointingly, there's only been a slight improvement in reporting the adverse effects in trials over the last 17 years."

The study argues that many trials focus on the benefits, rather than the adverse effects of the drug being trialled.

"There is also a tendency to focus only on those harms that are either common, or defined as serious which cause hospitalisation, disability or death. Yet other seemingly minor harms which may be important to patients - everything from diarrhoea and insomnia to rashes, coughs and muscle aches - may be important to capture, especially since it may stop people taking medication," Dr Golder added.

Randomised Control Trials authors were also at times selective about which harms they reported, the study went on to say.

Dr Golder added: "We also need to know if a particular drug affected people differently, for example if it affected females more than males, or if a particular harm increased with age."

The study concluded that the lack of reporting or selective reporting of adverse effects in published clinical trials can promote a false impression of safety and misinform clinical and policy decisions and that the NHS, policy makers and patients all need reliable information about the benefits and adverse effects of treatments to make good, informed decisions.

In 2004, major new guidelines on reporting Randomised Controlled Trials (RCTs) were published, with the aim of improving the reporting of adverse effects in trials.

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'Time to improve the reporting of harms in randomized controlled trials' is published in the Journal of Clinical Epidemiology.

 WHAT DOES THAT MEAN

Women and lower-education users more likely to tweet personal information

PENN STATE

Research News

UNIVERSITY PARK, Pa. -- When it comes to what users share on Twitter, women and users who never attended college voluntarily disclose more personal information than users from other socioeconomic and demographic backgrounds -- potentially making these populations more susceptible to online privacy threats, according to a recent study led by the Penn State College of Information Sciences and Technology.

Additionally, the researchers unexpectedly found that neither socioeconomic status nor demographics is a significant predictor of the use of account security features such as two-factor login authentication, and that users from all backgrounds actually shared less personal information than they recalled.

"We didn't find a strong correlation between people's stated attitudes and their observed behaviors, which is pretty contradictory to what privacy literature has explained about people's digital inequality and privacy divide," said Jooyoung Lee, doctoral student of information sciences and technology and lead author on the research paper.

In the exploratory study, the researchers set out to understand whether socio-demographic factors impact the usage of login verification, a user's likeliness to share personal information online, and whether topics of self-disclosure vary across socio-demographic groups.

"There is a robust literature on self-disclosure, but purely data-driven approaches typically don't allow us access to users' gender, education, occupation, race and other sensitive information," said Sarah Rajtmajer, assistant professor of information sciences and technology. "At the same time, there is growing concern about the inequitable distribution of privacy risk amongst different socio-demographic groups with respect to online information sharing. The experimental approach taken in this work allowed us a first attempt to bridge the gap."

According to Shomir Wilson, assistant professor of information sciences and technology, the researchers were motivated to expand on past work that indicated that people in lower socio-economic brackets had more difficulty understanding online privacy controls.

"The original thing we were expecting to see based on the survey methods and prior work actually didn't bear out in that we got negative results on the socio-economic status," said Wilson. "But we got some other results that surprised us and are leading us into next steps."

The Penn State study is novel in that it explores the contents of personal information in self-disclosure along socio-demographic lines. In prior work, only gender and age variables have been primarily explored.

The researchers surveyed 110 active Twitter users and monitored their posting behaviors in more than 6,900 tweets over the course of a month. Then, using statistical analysis methods, they examined the tweets for mentions of topics in 12 categories of self-disclosure -- such as marital status, or location -- and labeled which of the categories, if any, the tweet fit.

Those categories were then measured against six socio-demographic factors -- income, gender, age, education level, race/ethnicity and occupation -- to analyze users' login verification settings, quantity of self-disclosure, and self-disclosure by topic. Finally, a post-study survey was sent to participants to collect their recollection of self-disclosure, which the researchers measured against their actual posts.

"A key distinction between our work and prior work was that prior work surveyed people for their attitudes and beliefs," said Wilson. "We took this a step further: we not only gave people surveys, but we followed them on Twitter to see how they were behaving and if their behaviors actually correlated with what they thought they were doing. And we found that people were sharing less than they thought they were sharing."

Added Lee, "People don't always remember what they share on social media, which could be a really big problem. Reminding people of their sharing behaviors could be a good solution to help them keep track of what kind of data they're sharing publicly."

Rajtmajer added that this is particularly true about the combined information of what they've shared over time, which led the researchers to ask survey participants whether they remembered sharing specific pieces of personal information.

"We know that, most often, the critical worries derive from inferences about an individual made possible by the aggregation of all the various, and often seemingly harmless, details they share," she said. "These inferences can be used to profile, monetize, manipulate and surveil. Already-vulnerable groups in many cases are most at risk."

According to Wilson, there are also scenarios where users don't realize that they are sharing posts containing personal information with an audience that includes their co-workers or the general public. Conversely, there are cases where people might not share enough, not realizing that there are certain pieces of information that their friends and followers might want to know.

"Aligning those two things helps people better understand their public persona and gives people a greater sense of security when they use online social networks," Wilson said. "And that in itself is valuable."

The study unveils that users often can't accurately construct a mental model of their sharing behaviors over a month-long period, which could potentially lead to design updates for social networks to implement features that help users keep track of their sharing behaviors.

"This provides context to how people use these tools, both for the users and for the people creating them," said Wilson.

Eesha Srivatsavaya, an undergraduate data sciences student at the College of IST, was also involved with the project. The team's paper appears in the July 2021 Proceedings on Privacy Enhancing Technologies. The work was supported in part by an Accelerator Award from the Center for Social Data Analytics at Penn State.

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Researchers study anxiety differences between females and males

INDIANA UNIVERSITY SCHOOL OF MEDICINE

Research News

 

Feeling anxious about health, family or money is normal for most people--especially during the COVID-19 pandemic. But for those with anxiety disorders, these everyday worries tend to heighten even when there is little or no reason to be concerned.

Researchers from Indiana University School of Medicine recently studied the behaviors associated with anxiety--published in Psychopharmacology--examining how biological factors impact anxiety disorders, specifically in females. They found that anxiety in females intensifies when there's a specific, life-relevant condition.

The team, led by Thatiane De Oliveira Sergio, PhD, postdoctoral fellow in the laboratory of Woody Hopf, PhD, professor of psychiatry and primary investigator at Stark Neurosciences Research Institute, studied male and female rodent models to better understand sex differences in biological responses related to anxiety.

Anxiety disorders occur in twice as often in women than men, and social and cultural factors likely play an important role in the development of anxiety in females, De Oliveira said.

The COVID-19 pandemic heavily influenced anxiety in people. According to the Centers for Disease Control and Prevention, in June 2020--a few months into the pandemic--13 percent of Americans started using or increasing substance use to cope with their emotions and stress due to the unknowns at that time about the pandemic.

Knowing that women have more incidence of anxiety than men, De Oliveira said the roles for many women have amplified during the pandemic--working remotely, teaching children in virtual school, everyday tasks, errands. She said these life-relevant conditions could have increased their anxiety.

"This work is giving us a foundation to start and explore anxiety behaviors that are very important and even more relevant now," De Oliveira said.

While anxiety in humans is complex, anxiety in animals is based solely on biology.

"Biological factors play an important role in these types of mood disorders, but it can be hard to untangle the mechanisms that drive anxiety in humans," De Oliveira said. "This rodent work is important to do to help develop more effective and personalized treatments."

Through studying both male and female rodent models, they found that females and males were very different in their response to the most life-relevant aspects related to anxiety, Hopf said.

In one of the behavioral tasks, rodents had to grab pellets of food which were in the brightly lit center of a big arena. Rats don't like the light, so this creates an anxious conflict. In this task, female rats took longer to touch the food and ate less food relative to males.

The researchers also gave the rodents diazepam--a drug used to treat anxiety--and it greatly reduced anxiety in females, but it had little effect in males when interacting with food. There were also other measures that showed similarities between males and females, Hopf said, including how many times a rat approached the lit center and how long it remained there. Thus, only the parts of the task that were most life-relevant--in this case food--showed sex differences.

Previous studies support the idea that anxiety in females is focused on the most life-relevant aspects of a situation, Hopf said, which aligned with their findings. For example, females--more than males in both studies--showed greater responses to the urine of a predator and had higher anxiety when in the presence of a second rat that was free to wander around.

"Knowing that anxiety can manifest from different concerns in males and females, with females particularly attuned to the most life-relevant conditions, is a valuable step towards seeking better treatments based on sex differences," De Oliveira said.

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This research was funded by the National Institute of Alcohol Abuse and Alcoholism, part of the National Institutes of Health.

Disclaimer: AAAS and EurekAlert! are not responsi

Protein supplements work for women and not men, during fasted carb-restricted training

THE PHYSIOLOGICAL SOCIETY

Research News

 

Consuming a protein supplement, specifically protein hydrolysate, during carbohydrate-restricted training was helpful for improving training intensity in women, but not in men.

That's according to new research which will be part of a presentation this week at The Physiological Society's Annual Conference Physiology 2021.

Most nutrition guidelines for athletes are based on research in men only. This study, by Tanja Oosthuyse and her colleagues, emphasizes that this shouldn't be the case, because nutritional research findings in men don't always apply to women.

While the protein supplement helped training intensity in women, it did not improve training intensity and instead resulted in modest negative effect in men. It made exercise feel harder for them because their bodies were working harder to break down the supplement, as compared to when they were drinking just plain water.

The conclusion from this research is that women should ingest protein supplements during fasted carbohydrate-restricted exercise, while men should be aware that it will increase their perception of effort.

Future studies need to determine whether ingesting protein hydrolysate supplements during carbohydrate-restricted training over a longer time frame of weeks or months will be beneficial.

In this study, the researchers did not consider menstrual phase. Follow up studies are needed to determine whether the improved training intensity when ingesting a protein hydrolysate compared with placebo-water is specific to menstrual phase.

Commenting on the study, first author Tanja Oosthuyse said,

"The application of the findings from our study are purely for the specialised training tactic of overnight fasted carbohydrate-restricted exercise that aims to enhance training.

Racing nutrition, however, is very different and at the moment guidelines are standard for both men and women. We need to specify potential differences so that both men and women can train and race at the highest possible calibre."

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Peer reviewed Experimental study People

Better pregnancy outcomes linked to reduction of armed conflict in Colombia

Study highlights adverse pregnancy outcomes in pregnant women living in areas with conflict violence

PLOS

Research News

 

A new study has linked a July 2015 ceasefire of conflict violence in Colombia with better pregnancy outcomes for women who conceived after the ceasefire began. Giancarlo Buitrago of Universidad Nacional de Colombia in Bogotá, Colombia, and Rodrigo Moreno-Serra of the University of York, U.K., present these findings in the open-access journal PLOS Medicine.

Previous research has suggested the possibility that women living in areas with armed violence experience adverse pregnancy outcomes. However, methodological problems or inappropriate data have hampered prior investigations into these associations.

To better understand these associations, Buitrago and Moreno-Serra examined pregnancy outcome data for women who conceived before and after a ceasefire of conflict violence was declared in Colombia on July 20, 2015. The ceasefire called for a halt in violence by the guerrilla group FARC (Fuerzas Armadas Revolucionarias de Colombia), which was later followed by a final peace agreement between the government and FARC.

The analysis included data for more than 3 million women living across Colombia who were pregnant between 2013 and 2017. It found that the women were indeed exposed to fewer conflict events, on average, after the ceasefire began, and this reduction was associated with lower risks of stillbirths and perinatal mortality--death of the child before or shortly after birth.

In areas with greater numbers of FARC-related conflict violence events, stillbirths decreased by up to 9.53 deaths per 1,000 pregnancies, and perinatal mortality decreased by up to 10.69 deaths per 1,000 pregnancies. No statistically significant associations were found between miscarriages and reduced exposure to conflict violence.

These findings are in line with other evidence for the benefits of reduced exposure to conflict violence in early pregnancy, and suggest that the peace process in Colombia is contributing to better population health. The authors note that their findings also highlight the need for countries with long-running armed conflict to make special efforts to protect pregnant women.

The authors add: "The results in our paper uncover some less researched consequences of armed conflicts for health. We find that, beyond the tragic loss of life amid armed conflicts, which in Colombia is estimated to have reached over 200,000 deaths, exposure to conflict violence is also linked to worse pregnancy outcomes. Pregnancies of women exposed to more intense conflict violence in Colombia were more likely to result in a stillbirth or perinatal death, particularly if mothers were exposed to violence during the early stages of pregnancy. This has often been an undocumented, "invisible" health penalty associated with protracted conflicts. While we still need further research to fully understand the most important biological pathways linking violence exposure to pregnancy outcomes, our study has important implications for policy. First, it suggests that the de-escalation in violence brought about by the ongoing Colombian peace process has been contributing to better health, and therefore that the peace process in the country should be protected and strengthened. Second, it indicates the high relevance of devising focused health policies that can protect pregnant women in contexts of protracted violence, as these women represent a particularly vulnerable group in those settings."

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In your coverage please use this URL to provide access to the freely available paper: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003684

Funding: RMS was supported by a research grant from the UK Medical Research Council (MR/R013667/1). GB was supported by the School of Medicine at Universidad Nacional de Colombia and University of York (CHE Research Fellowship). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Buitrago G, Moreno-Serra R (2021) Conflict violence reduction and pregnancy outcomes: A regression discontinuity design in Colombia. PLoS Med 18(7): e1003684. https://doi.org/10.1371/journal.pmed.1003684

Study: How a large cat deity helps people to share space with leopards in India

The story of the Warli and the Waghoba

WILDLIFE CONSERVATION SOCIETY

Research News

IMAGE: THE RESEARCHERS HAVE IDENTIFIED OVER 150 SHRINES DEDICATED TO WORSHIPPING WAGHOBA view more 

CREDIT: RAMYA NAIR

BENGALURU, India (July 8, 2021) - A new study led by WCS-India documents how a big cat deity worshipped by Indigenous Peoples facilitates coexistence between humans and leopards.

The study, published in a special issue of the journal Frontiers in Conservation Science: Human-Wildlife Dynamics called Understanding Coexistence with Wildlife documents how the Indigenous Warli people of Maharashtra, India, worship Waghoba, a leopard/tiger deity to gain protection from leopards, and how they have lived side-by-side with them for centuries (formerly tigers, too). The researchers have identified over 150 shrines dedicated to worshipping Waghoba. The researchers note that while there are still negative interactions with leopards such as livestock depredation, they are likely to be more accepted under the institution of Waghoba.

Warlis believe in a reciprocal relationship, where Waghoba will protect them from the negative impacts of sharing spaces with big cats if the people worship the deity and conduct the required rituals, especially at the annual festival of Waghbaras.

Researchers suggest that such relationships facilitate the sharing of spaces between humans and leopards that live in the landscape. In addition, the study addresses the ways in which the range of institutions and stakeholders in the landscape shape the institution of Waghoba and thereby contribute to the human-leopard relationship in the landscape.

Said the study's lead author Ramya Nair of WCS India: "The main aim of the study is to diversify the way we understand and approach human-wildlife interactions. It does so by shedding light on how local institutions that contribute to co-existence are not devoid of conflict, but have a role in negotiating the conflicts that arise."

Locally produced systems that address issues surrounding human-wildlife interactions may exist in several other cultures and landscapes. The authors note that while conservation interventions have shown a movement toward the inclusion and participation of local communities, we have to recognize that landscapes have a history before our own point of entry into them. This is relevant for present-day wildlife conservation because such traditional institutions are likely to act as tolerance-building mechanisms embedded within the local belief system. Further, it is vital that the dominant stakeholders outside of the Warli community (such as the Forest Department, conservation biologists, and other non-Warli residents who interact with leopards) are informed about and sensitive to these cultural representations because it is not just the biological animal that the Warlis predominantly deal with.

The study was conducted by researchers from WCS-India, NINA, Norway, Inland Norway University of Applied Sciences, Norway and supported by Wildlife Conservation Trust. Fieldwork was conducted across Mumbai Suburban, Palghar and Thane districts of Maharashtra in 2018-19. An ethnographic approach was taken to collect data wherein researchers conducted semi-structured interviews and conducted participant observation (particularly attending worship ceremonies) concurrent to documenting Waghoba shrines. Questions were asked to explore narratives on the role of Waghoba in the lives of the Warli, the history of Waghoba worship, associated festivals, rituals and traditions, and the ties between Waghoba and human-leopard interactions.

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WCS (Wildlife Conservation Society)

MISSION: WCS saves wildlife and wild places worldwide through science, conservation action, education, and inspiring people to value nature. To achieve our mission, WCS, based at the Bronx Zoo, harnesses the power of its Global Conservation Program in nearly 60 nations and in all the world's oceans and its five wildlife parks in New York City, visited by 4 million people annually. WCS combines its expertise in the field, zoos, and aquarium to achieve its conservation mission. Visit: newsroom.wcs.org Follow: @WCSNewsroom. For more information: 347-840-1242.

When resistance is futile, new paper advises RAD range of conservation options

ECOLOGICAL SOCIETY OF AMERICA

Research News

 

Major ecosystem changes like sea-level rise, desertification and lake warming are fueling uncertainty about the future. Many initiatives - such as those fighting to fully eradicate non-native species, or to combat wildfires - focus on actively resisting change to preserve a slice of the past.

However, resisting ecosystem transformation is not always a feasible approach. According to a new paper published today in the Ecological Society of America's journal Frontiers in Ecology and the Environment, accepting and directing ecosystem change are also viable responses, and should not necessarily be viewed as fallback options or as last resorts. The paper presents a set of guiding principles for applying a "RAD" strategy - a framework that involves either resisting, accepting or directing ecosystem changes.

"We are facing the harsh reality that, in some locations, ecosystems are transforming at such a pace that we won't be able to restore or rehabilitate them to what they once were," said Abigail Lynch, the paper's lead author and a research fish biologist at the United States Geological Survey (USGS) National Climate Adaptation Science Center. "The RAD framework provides a common language for starting productive conversations about what comes next - when we need to consider options to accept and direct change in addition to just trying to resist it."

The paper was a collaborative effort by 20 federal, state and academic researchers from across the United States. It zeroes in on three National Wildlife Refuges (NWRs) along the East Coast, where sea-level rise is increasing at three to four times the global average rate and transforming ecosystems and local communities. Managers of the three NWRs have applied all three of the responses outlined in the paper:

• John H Chafee NWR (Rhode Island): managers are resisting the effects of sea-level rise by depositing dredged sediment on waterlogged salt marshes and securing the sediment with bags of recycled oyster shells.
• Chincoteague NWR (Virginia): After years of resisting dune overwash, managers are now allowing storm-induced waves to fill in waterfowl impoundments, accepting the landward transport of sand and moving National Park Service visitor infrastructure.
• Blackwater NWR (Maryland): Managers are directing the effects of sea-level rise by facilitating marsh migration upwards. Assisted marsh migration is ten times cheaper than trying to restore marsh in situ.

According to Erik Beever, a research ecologist at the USGS Northern Rocky Mountain Science Center, research affiliate faculty at Montana State University and a coauthor of the paper, the importance of considering costs and benefits is paramount when selecting a course of action within the RAD framework.

"A 'resist' approach may involve less cost in the immediate term or may allow the persistence of a culturally treasured species, but it may involve substantially higher costs over the course of a period as short as 10-15 years," said Beever. "For example, if that treasured species' bioclimatic niche no longer occurs within the management area, facilitating its persistence will require more intensive and more costly efforts."

Accepting ecosystem change can involve a fundamental shift in the way of life for communities that rely on an ecosystem's goods and services. However, solutions that focus on resisting change are becoming increasingly impractical as ecological changes occur more frequently and more dramatically. The paper contends that three broad feasibility criteria - ecological, societal, and financial - must be considered when deciding which RAD strategy is most suitable.

Natural resource managers are using options from within the RAD framework to tackle a variety of problems across many different systems, including:

• Loss of corals in the Mexican state of Quintana Roo
• Spruce bark beetle epidemic and wildfires on Alaska's Kenai peninsula, where white spruce forests are transforming into grasslands
• Projected decline of cisco populations under warming conditions in Minnesota lakes

In the RAD framework, accepting change is not a passive approach; rather, it is a deliberate course of action geared toward a defined set of objectives. While the framework still needs to be tested and fine-tuned, the authors ultimately view it as a strategy of empowerment.

"It might be tempting to throw one's hands up in the air when faced with drastic and transformative environmental change, but there are options available," said Laura Thompson, a coauthor who is a research ecologist at the USGS National Climate Adaptation Science Center and adjunct faculty member at the University of Tennessee, Knoxville. "This RAD framework provides the full range of strategies."

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Journal article:
Lynch AJ, Thompson LM, Beever EA, et al. 2021. Managing for RADical ecosystem change: applying the Resist-Accept-Direct (RAD) framework. Frontiers in Ecology and the Environment. doi.org/10.1002/fee.2377

Authors:
Abigail J Lynch1, Laura M Thompson1,2, Erik A Beever3,4, David N Cole5, Augustin C Engman2,6, Cat Hawkins Hoffman7,

Stephen T Jackson8,9, Trevor J Krabbenhoft10, David J Lawrence7, Douglas Limpinsel11, Robert T Magill12, Tracy A Melvin13, John M Morton14, Robert A Newman15, Jay O Peterson16, Mark T Porath17, Frank J Rahel18, Gregor W Schuurman7, Suresh A Sethi19, and Jennifer L Wilkening20

1National Climate Adaptation Science Center, US Geological Survey (USGS), Reston, VA; 2Department of Forestry, Wildlife and Fisheries, University of Tennessee, Knoxville, TN; 3Northern Rocky Mountain Science Center, USGS, Bozeman, MT; 4Department of Ecology, Montana State University, Bozeman, MT; 5Retired, Aldo Leopold Wilderness Research Institute, Missoula, MT; 6North Carolina Cooperative Fish and Wildlife Research Unit, North Carolina State University, Raleigh, NC; 7Climate Change Response Program, National Park Service, Fort Collins, CO; 8Southwest and South Central Climate Adaptation Science Centers, USGS, Tucson, AZ; 9School of Natural Resources and Environment and Department of Geosciences, University of Arizona, Tucson, AZ; 10Department of Biological Sciences and RENEW Institute, University at Buffalo, Buffalo, NY; 11National Oceanic and Atmospheric Administration (NOAA) Fisheries, Alaska Region, Habitat Conservation Division, Anchorage, AK; 12Coconino County Parks and Recreation, Arizona Game and Fish Department, Flagstaff, AZ; 13Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI; 14Kenai National Wildlife Refuge, US Fish and Wildlife Service (FWS), Soldotna, AK; 15Department of Biology, University of North Dakota, Grand Forks, ND; 16NOAA Fisheries, Office of Science and Technology, Silver Spring, MD; 17Nebraska Game and Parks Commission, Lincoln, NE; 18Department of Zoology and Physiology, Program in Ecology, University of Wyoming, Laramie, WY; 19USGS, New York Cooperative Fish and Wildlife Research Unit, Cornell University, Ithaca, NY; 20Southern Nevada Fish and Wildlife Office, FWS, Las Vegas, NV

Author contact:
Abigail Lynch (ajlynch@usgs.gov">ajlynch@usgs.gov)

RAD resources:
https://usgs.gov/casc/rad

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Remotely-piloted sailboats monitor 'cold pools' in tropical environments

UNIVERSITY OF WASHINGTON

Research News

 

IMAGE: SAILDRONE UNCREWED SURFACE VEHICLES (USVS), LIKE THE ONE PICTURED HERE, MADE MEASUREMENTS OF ATMOSPHERIC COLD POOLS IN REMOTE REGIONS OF THE TROPICAL PACIFIC. view more 

CREDIT: SAILDRONE, INC.

Conditions in the tropical ocean affect weather patterns worldwide. The most well-known examples are El Niño or La Niña events, but scientists believe other key elements of the tropical climate remain undiscovered.

In a study recently published in Geophysical Research Letters, scientists from the University of Washington and NOAA's Pacific Marine Environmental Laboratory use remotely-piloted sailboats to gather data on cold air pools, or pockets of cooler air that form below tropical storm clouds.

"Atmospheric cold pools are cold air masses that flow outward beneath intense thunderstorms and alter the surrounding environment," said lead author Samantha Wills, a postdoctoral researcher at the Cooperative Institute for Climate, Ocean and Ecosystem Studies. "They are a key source of variability in surface temperature, wind and moisture over the ocean."

The paper is one of the first tropical Pacific studies to rely on data from Saildrones, wind-propelled sailing drones with a tall, hard wing and solar-powered scientific instruments. Co-authors on the NOAA-funded study are Dongxiao Zhang at CICOES and Meghan Cronin at NOAA.

Atmospheric cold pools produce dramatic changes in air temperature and wind speed near the surface of the tropical ocean. The pockets of cooler air form when rain evaporates below thunderstorm clouds. These relatively dense air masses, ranging between 6 to 125 miles (10 to 200 kilometers) across, lead to downdrafts that, upon hitting the ocean surface, produce temperature fronts and strong winds that affect their surroundings. How this affects the larger atmospheric circulation is unclear.

"Results from previous studies suggest that cold pools are important for triggering and organizing storm activity over tropical ocean regions," Wills said.

To understand the possible role of cold pools in larger tropical climate cycles, scientists need detailed measurements of these events, but it is hard to witness an event as it happens. The new study used uncrewed surface vehicles, or USVs, to observe the phenomena.

Over three multi-month missions between 2017 and 2019, 10 USVs covered over 85,000 miles (137,000 kilometers) and made measurements of more than 300 cold pool events, defined as temperature drops of at least 1.5 degrees Celsius in 10 minutes. In one case, a fleet of four vehicles separated by several miles captured the minute-by-minute evolution of an event and revealed how the cold pool propagated across the region.

"This technology is exciting as it allows us to collect observations over hard-to-reach, under-sampled ocean regions for extended periods of time," Wills said.

The paper includes observations of air temperature, wind speed, humidity, air pressure, sea surface temperature and ocean salinity during cold pool events. The authors use the data to better describe these phenomena, including how much and how quickly air temperatures drops, how long it takes the wind to reach peak speeds, and how sea surface temperature changes nearby. Results can be used to evaluate mathematical models of tropical convection and explore more questions, like how the gusts created by the temperature difference affect the transfer of heat between the air and ocean.

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For more information, contact Wills at smwills@uw.edu