New surgery may enable better control of prosthetic limbs

Reconnecting muscle pairs during amputation gives patients more sensory feedback from the limb

MASSACHUSETTS INSTITUTE OF TECHNOLOGY

Research News

 

IMAGE: MIT RESEARCHERS IN COLLABORATION WITH SURGEONS AT HARVARD MEDICAL SCHOOL HAVE DEVISED A NEW TYPE OF AMPUTATION SURGERY THAT CAN HELP AMPUTEES BETTER CONTROL THEIR RESIDUAL MUSCLES AND RECEIVE SENSORY... view more 

CREDIT: MIT

CAMBRIDGE, MA -- MIT researchers have invented a new type of amputation surgery that can help amputees to better control their residual muscles and sense where their "phantom limb" is in space. This restored sense of proprioception should translate to better control of prosthetic limbs, as well as a reduction of limb pain, the researchers say.

In most amputations, muscle pairs that control the affected joints, such as elbows or ankles, are severed. However, the MIT team has found that reconnecting these muscle pairs, allowing them to retain their normal push-pull relationship, offers people much better sensory feedback.

"Both our study and previous studies show that the better patients can dynamically move their muscles, the more control they're going to have. The better a person can actuate muscles that move their phantom ankle, for example, the better they're actually able to use their prostheses," says Shriya Srinivasan, an MIT postdoc and lead author of the study.

In a study that will appear this week in the Proceedings of the National Academy of Sciences, 15 patients who received this new type of surgery, known as agonist-antagonist myoneural interface (AMI), could control their muscles more precisely than patients with traditional amputations. The AMI patients also reported feeling more freedom of movement and less pain in their affected limb.

"Through surgical and regenerative techniques that restore natural agonist-antagonist muscle movements, our study shows that persons with an AMI amputation experience a greater phantom joint range of motion, a reduced level of pain, and an increased fidelity of prosthetic limb controllability," says Hugh Herr, a professor of media arts and sciences, head of the Biomechatronics group in the Media Lab, and the senior author of the paper.

Other authors of the paper include Samantha Gutierrez-Arango and Erica Israel, senior research support associates at the Media Lab; Ashley Chia-En Teng, an MIT undergraduate; Hyungeun Song, a graduate student in the Harvard-MIT Program in Health Sciences and Technology; Zachary Bailey, a former visiting researcher at the Media Lab; Matthew Carty, a visiting scientist at the Media Lab; and Lisa Freed, a Media Lab research scientist.

CAPTION

MIT researchers in collaboration with surgeons at Harvard Medical School have devised a new type of amputation surgery that can help amputees better control their residual muscles and receive sensory feedback.

CREDIT

MIT

Restoring sensation

Most muscles that control limb movement occur in pairs that alternately stretch and contract. One example of these agonist-antagonist pairs is the biceps and triceps. When you bend your elbow, the biceps muscle contracts, causing the triceps to stretch, and that stretch sends sensory information back to the brain.

During a conventional limb amputation, these muscle movements are restricted, cutting off this sensory feedback and making it much harder for amputees to feel where their prosthetic limbs are in space or to sense forces applied to those limbs.

"When one muscle contracts, the other one doesn't have its antagonist activity, so the brain gets confusing signals," says Srinivasan, a former member of the Biomechatronics group now working at MIT's Koch Institute for Integrative Cancer Research. "Even with state-of-the-art prostheses, people are constantly visually following the prosthesis to try to calibrate their brains to where the device is moving."

A few years ago, the MIT Biomechatronics group invented and scientifically developed in preclinical studies a new amputation technique that maintains the relationships between those muscle pairs. Instead of severing each muscle, they connect the two ends of the muscles so that they still dynamically communicate with each other within the residual limb. In a 2017 study of rats, they showed that when the animals contracted one muscle of the pair, the other muscle would stretch and send sensory information back to the brain.

Since these preclinical studies, about 25 people have undergone the AMI surgery at Brigham and Women's Hospital, performed by Carty, who is also a plastic surgeon at the Brigham and Women's hospital. In the new PNAS study, the researchers measured the precision of muscle movements in the ankle and subtalar joints of 15 patients who had AMI amputations performed below the knee. These patients had two sets of muscles reconnected during their amputation: the muscles that control the ankle, and those that control the subtalar joint, which allows the sole of the foot to tilt inward or outward. The study compared these patients to seven people who had traditional amputations below the knee.

Each patient was evaluated while lying down with their legs propped on a foam pillow, allowing their feet to extend into the air. Patients did not wear prosthetic limbs during the study. The researchers asked them to flex their ankle joints -- both the intact one and the "phantom" one -- by 25, 50, 75, or 100 percent of their full range of motion. Electrodes attached to each leg allowed the researchers to measure the activity of specific muscles as each movement was performed repeatedly.

The researchers compared the electrical signals coming from the muscles in the amputated limb with those from the intact limb and found that for AMI patients, they were very similar. They also found that patients with the AMI amputation were able to control the muscles of their amputated limb much more precisely than the patients with traditional amputations. Patients with traditional amputations were more likely to perform the same movement over and over in their amputated limb, regardless of how far they were asked to flex their ankle.

"The AMI patients' ability to control these muscles was a lot more intuitive than those with typical amputations, which largely had to do with the way their brain was processing how the phantom limb was moving," Srinivasan says.

In a paper that recently appeared in Science Translational Medicine, the researchers reported that brain scans of the AMI amputees showed that they were getting more sensory feedback from their residual muscles than patients with traditional amputations. In work that is now ongoing, the researchers are measuring whether this ability translates to better control of a prosthetic leg while walking.

Freedom of movement

The researchers also discovered an effect they did not anticipate: AMI patients reported much less pain and a greater sensation of freedom of movement in their amputated limbs.

"Our study wasn't specifically designed to achieve this, but it was a sentiment our subjects expressed over and over again. They had a much greater sensation of what their foot actually felt like and how it was moving in space," Srinivasan says. "It became increasingly apparent that restoring the muscles to their normal physiology had benefits not only for prosthetic control, but also for their day-to-day mental well-being."

The research team has also developed a modified version of the surgery that can be performed on people who have already had a traditional amputation. This process, which they call "regenerative AMI," involves grafting small muscle segments to serve as the agonist and antagonist muscles for an amputated joint. They are also working on developing the AMI procedure for other types of amputations, including above the knee and above and below the elbow.

"We're learning that this technique of rewiring the limb, and using spare parts to reconstruct that limb, is working, and it's applicable to various parts of the body," Herr says.

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The research was funded by the MIT Media Lab Consortia, the National Institute of Child Health and Human Development, the National Center for Medical Rehabilitation Research, and the Congressionally Directed Medical Research Programs of the U.S. Department of Defense.

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Teens may be more likely to use marijuana after legalization for adult recreational use

JOURNAL OF STUDIES ON ALCOHOL AND DRUGS

Research News

 

IMAGE: LEGAL MARIJUANA view more 

CREDIT: PHOTO BY ERIK MCLEAN FROM PEXELS

Teens may be more likely to use marijuana after legalization for adult recreational use

PISCATAWAY, NJ - Adolescents who live in California may be more likely to use marijuana since adult recreational marijuana use was legalized in 2016, according to a new report in the Journal of Studies on Alcohol and Drugs.

"The apparent increase in marijuana use among California adolescents after recreational marijuana legalization for adult use in 2016 is surprising given the steady downward trend in marijuana use during years before legalization," says lead researcher Mallie J. Paschall, Ph.D., senior research scientist at the Prevention Research Center of the Pacific Institute for Research and Evaluation in Berkeley, California.

Paschall and his colleagues analyzed data from over three million 7th, 9th, and 11th graders who participated in the California Healthy Kids Survey from 2010-2011 through 2018-2019 school years. The adolescents provided information on their grade, sex, ethnicity, race and lifetime and past-30-day marijuana use. The marijuana use question was updated in the 2017-2018 and 2018-2019 surveys to include the words "smoke, vape, eat, or drink," reflecting the wide variety of marijuana products now available.

The researchers observed significant increases in the prevalence of lifetime and past-30-day marijuana use among nearly all demographic groups from 2017-2018 to 2018-2019 school years, after legalization of adult recreational use: an 18% increase in the likelihood of lifetime use and a 23% increase in past-30-day use. These numbers may reflect greater use of vaping products, and the overall increase was even more likely among those in demographic groups with historically lower rates of marijuana use.

"I was somewhat surprised to see relatively greater increases in the prevalence of marijuana use among younger adolescents (7th graders) relative to 9th and 11th graders, among females versus males, among non-Hispanic versus Hispanic youth, and among Whites versus youth in other racial groups," says Paschall. "In other words, there were greater increases in marijuana use prevalence after recreational marijuana legalization among youth in 'low-risk' groups, which is concerning."

Paschall says he can only speculate as to the reason, but that the greater increases in these normally low-risk groups may be attributed to marijuana use becoming more normative due to legalization, along with relatively greater overall declines in marijuana use among youth in historically 'high-risk' groups during the study period.

The study also indicated greater increases in the frequency of past-30-day marijuana use among older adolescents, males, African American and Asian youth who were regular users. There were notable increases in marijuana use frequency among adolescents in 2018-19, which may reflect national increases in the use of vaping products.

"Recreational marijuana legalization may be contributing to an increase in marijuana use among adolescents in California, but we need to do further research to confirm this," says Paschall. "We also need to look more closely at what's happening at the local level, because there is a lot of variation in marijuana policies in communities across California and the United States. Also, we need to know more about how adolescents are getting marijuana and what forms of marijuana they are using, since there is such a great variety of cannabis products available."

The researchers suggest that recreational marijuana legalization may present increased opportunities for adolescents to obtain marijuana and that the increasing availability of non-smoking products such as edibles may prove appealing as well.

"I'm interested in whether recreational marijuana legalization for adult use may affect use among adolescents, possibly by changing norms regarding the acceptability of marijuana use, perceived harms of marijuana use, or availability or marijuana to youth," says Paschall.

Paschall and his colleagues also write that states and communities that have legalized adult recreational marijuana use and sales could benefit from implementing both stricter controls on the availability of marijuana to adolescents and evidence-based prevention programs.

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By Kimberly Flynn

Paschall, M. J., García-Ramírez, G., & Grube, J. W. (2021). Recreational marijuana legalization and use among California adolescents: Findings from a statewide survey. Journal of Studies on Alcohol and Drugs, 82, 103-111. doi:10.15288/jsad.2021.82.103

To set up an interview with Mallie J. Paschall, please contact him at 510-883-5753 or paschall@prev.org.

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.

To learn about education and training opportunities for addiction counselors and others at the Rutgers Center of Alcohol & Substance Use Studies, please visit https://education.alcoholstudies.rutgers.edu/education-training.

The Journal of Studies on Alcohol and Drugs considers this press release to be in the public domain. Editors and journalists may publish this press release in print or electronic form without legal restriction. Please include proper attribution.

Counterintuitive approach may improve eyewitness identification

UNIVERSITY OF CALIFORNIA - SAN DIEGO

Research News

Experts have devised a novel approach to selecting photos for police lineups that helps witnesses identify culprits more reliably.

In a paper published by the Proceedings of the National Academy of Sciences, researchers - from the University of California San Diego and Duke University in the United States and the University of Birmingham in the U.K. - show for the first time that selecting fillers who match a basic description of the suspect but whose faces are less similar, rather than more, leads to better outcomes than traditional approaches in the field.

The counterintuitive technique improves eyewitness performance by about 10 percent.

"In practice, police tend to err on the side of picking facially similar fillers for their lineups," said John Wixted, the paper's senior author and a professor in the UC San Diego Department of Psychology. "What our study shows is that it is, contrary to intuition, actually better to pick fillers who are facially dissimilar. Doing it this way continues to protect the innocent to the same degree while helping witnesses to correctly identify the guilty more frequently."

In a study of 19,732 participants, the researchers played a mock-crime video depicting a white male stealing an office laptop and then provided photographs of one suspect (either the perpetrator or an innocent suspect) plus five police lineup fillers. The fillers always matched the most basic description of the perpetrator but they varied in how much they facially resembled him. Facial similarity among photos was scored by an additional set of participants on a scale of 1 to 7, with 7 being most similar.

The researchers found that picking fillers who were facially dissimilar enhanced the ability of eyewitnesses to accurately pick out the perpetrator when he was in the lineup, without increasing the likelihood of wrongly identifying an innocent suspect when the real perpetrator was not in the lineup.

In a typical police lineup, one photo of the suspect is displayed, plus photos of five or more "fillers" who are known to be innocent. To create a fair lineup in which the suspect does not stand out, fillers are selected if they are similar in basic appearance to the suspect (height, weight, race, hair color and length, etc.), or if they have facial features included in a witness's description of the culprit. Often, a combined approach is used, in which fillers with similar facial features are selected from a pool of description-matched photos.

For decades, experts have disagreed on and puzzled over the question of what is most effective, while also being fair to the suspect. There are concerns that using fillers that are too facially similar to the suspect will confuse eyewitnesses and protect guilty suspects by making the identification task too difficult. Conversely, if the fillers are too facially dissimilar to the suspect, there are concerns that this would put an innocent suspect at risk of being falsely identified.

The new approach relied on insights from signal detection theory - which considers the memory strengths that are generated by each face in the lineup in the mind of the eyewitness - to deduce that selecting fillers who are not facially similar to the suspect from a pool of acceptable description-matched photos actually increases the ability of eyewitnesses to discriminate between innocent and guilty suspects.

Importantly, this approach did not have any effect on the number of "false alarms," in which an innocent suspect is incorrectly identified.

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Study co-author Melissa Colloff, of the University of Birmingham's School of Psychology, said: "Eyewitness misidentifications have contributed to many wrongful convictions, which are later overturned by DNA evidence. Eyewitnesses failing to identify a perpetrator when he is in the lineup can also result in guilty perpetrators being free to commit additional crimes. Although many useful reforms have been introduced to protect the innocent, sometimes these will also protect the guilty. Our approach demonstrates it is possible to create police lineups that are more effective for everyone involved - increasing the likelihood that a guilty perpetrator will be identified, without increasing the likelihood that an innocent suspect will be imperilled."

The study's other co-authors are Brent M. Wilson of UC San Diego and Travis M. Seale-Carlisle of Duke University. The study was supported by the College of Life and Environmental Sciences, University of Birmingham (Colloff) and the Laura and John Arnold Foundation (Wixted).

Large-scale study finds genetic testing technology falsely detects very rare variants

UNIVERSITY OF EXETER

Research News

 

A technology that is widely used by commercial genetic testing companies is "extremely unreliable" in detecting very rare variants, meaning results suggesting individuals carry rare disease-causing genetic variants are usually wrong, according to new research published in the BMJ.

After hearing of cases where women had surgery scheduled after wrongly being told they had very rare genetic variations in the gene BRCA1 that could significantly increase risk of breast cancer, a team at the University of Exeter conducted a large-scale analysis of the technology using data from nearly 50,000 people. They found that the technology wrongly identified the presence of very rare genetic variants in the majority of cases.

The team analysed SNP chips, which test genetic variation at hundreds-of-thousands of specific locations across the genome. While excellent at detecting common genetic variation that can increase the risk of diseases such as type 2 diabetes, geneticists have long known they are less reliable at detecting rarer variation. However, this problem is less well known outside the genetic research community, and SNP chips are widely used by commercial companies that offer genetic testing direct to consumers.

Caroline Wright, Professor in Genomic Medicine at the University of Exeter Medical School, senior author on the paper, said: "SNP chips are fantastic at detecting common genetic variants, yet we have to recognise that tests that perform well in one scenario are not necessarily applicable to others. We've confirmed that SNP chips are extremely poor at detecting very rare disease-causing genetic variants, often giving false positive results that can have profound clinical impact. These false results had been used to schedule invasive medical procedures that were both unnecessary and unwarranted."

The team compared data from SNP chips with data from the more reliable tool of next generation sequencing in 49,908 participants of UK Biobank, and an additional 21 people who shared results of their consumer genetic tests via the Personal Genome Project.

The study concluded that SNP chips performed extremely well in detecting common genetic variants. However, the rarer the variation was, the less reliable the results became. In very rare variants, present in fewer than 1 in 100,000 individuals, typical of those causing rare genetic disease, 84 per cent were false positives in UK Biobank. In the data from commercial customers, 20 of 21 individuals analysed had at least one false positive rare disease-causing variant that had been incorrectly genotyped.

Dr Leigh Jackson, Lecturer in Genomic Medicine at the University of Exeter and co-author of the paper, said: "The number of false positives on rare genetic variants produced by SNP chips was shockingly high. To be clear: a very rare, disease-causing variant detected using a SNP chip is more likely to be wrong than right. Although some consumer genomics companies perform sequencing to validate important results before releasing them to consumers, most consumers also download their "raw" SNP chip data for secondary analysis, and this raw data still contain these incorrect results. The implications of our findings are very simple: SNP chips perform poorly for detecting very rare genetic variants and the results should never be used to guide a patient's medical care, unless they have been validated."

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The paper published today in the BMJ is entitled 'Using SNP chips to detect very rare pathogenic variants: retrospective population-based diagnostic evaluation'.

Notes to editors: For further context, see the joint statement from the Royal College of General Practitioners and the British Society for Genetic Medicine on direct to consumer genomic testing, which references the pre-print version of the paper.

Once the embargo lifts, the paper will publish at: https://www.bmj.com/content/372/bmj.n214

*Labels applied according to the Academy of Medical Sciences press release labelling system.

About the University of Exeter Medical School

The University of Exeter Medical School is part of the University of Exeter's College of Medicine and Health. Our mission is to improve the health of the South West and beyond, through the development of high quality graduates and world-leading research that has international impact.

As part of a Russell Group university, we combine this world-class research with very high levels of student satisfaction. Exeter has over 19,000 students and is ranked 12th in The Times and Sunday Times Good University Guide 2020.

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Improved use of databases could save billions of euro in health care costs

Billions of euro in health care costs - arising from osteoporosis-related bone fractures - could be saved by improved use of existing databases

LERO

Research News

 

Years of suffering and billions of euro in global health care costs, arising from osteoporosis-related bone fractures, could be eliminated using big data to target vulnerable patients, according to researchers at Lero, the Science Foundation Ireland Research Centre for Software.

A study of 36,590 patients who underwent bone mineral density scans in the West of Ireland between January 2000 and November 2018, found that many fractures are potentially preventable by identifying those at greatest risk before they fracture, and initiating proven, safe, low-cost effective interventions.

The multi-disciplinary study, led by Lero's Prof. John J. Carey, Consultant Physician in Medicine and Rheumatology, Galway University Hospital, Mary Dempsey, Mechanical Engineering and Dr Attracta Brennan, Computer Science, NUI Galway has just been published in the British Medical Journal.

The Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) project on bone mineral density now plans to assess current diagnostic classification and risk prediction algorithms for osteoporosis and fractures, according to Prof. Carey.

"This will identify which predictors are most important for Irish people at risk for osteoporosis, and develop new, accurate and personalised risk prediction tools using the large, multicentre, longitudinal follow-up cohort.

"Furthermore, the dataset may be used to assess, and possibly support, the assessment and management of other chronic conditions such as cardiovascular disease, cancer and other illnesses due to the large number of variables collected in this project," he added.

Prof. Carey points out that while Ireland has one of the highest osteoporosis rates globally, currently there is no national public or government policy to address the healthcare requirements of osteoporotic fractures, with costs rising rapidly.

"In Ireland, public hospital bed days have increased by almost 50% in the past decade for osteoporotic fractures and outnumber heart attacks, cancer, diabetes and many other illnesses that receive much greater attention," he added.

"Preliminary estimates suggest the number of fragility fractures and deaths following fracture for Irish adults aged 50 years and older in 2020 was similar or greater to the numbers with COVID infection, but there is no daily report on the numbers tested, hospitalised or who die following a fracture. Use of these and other data could help close those gaps," he added.

Prof. Carey says there is a global osteoporosis health crisis, with predictions of American medical costs associated with osteoporotic-related fractures including productivity losses and caregiving expenditure to exceed $94 billion (€77.6bn) annually by 2040.

Prof. Carey said previous studies have shown, for example in 2010, approximately 43,000 European deaths were fracture-related while expenditure related to osteoporosis exceeded €37 billion.

"A modest 5% reduction in those costs would result in an annual saving of €1.85bn at 2010 prices," he added.

"We now have big datasets, similar to the one utilised in our study, available throughout the globe. Cost-effective, innovative forms of data interrogation such as AI (Artificial Intelligence) will enable the timely identification and treatment of patients vulnerable to osteoporosis fractures, providing them with better care and using precious resources efficiently. There will be many opportunities to provide better patient outcomes and save billions of euro," he added.

Prof. Carey believes this collaboration between clinicians, big data scientists, engineering and computer scientists in Ireland, Britain and China will help leverage innovation, critical thinking and international partnerships to accelerate their programme and opportunities.

Director of Lero, Professor Brian Fitzgerald, said the utilisation of AI, as envisaged by Prof Carey and his team, shows how software development initiatives can directly impact people's lives at a fundamental level. Lero is a world leader in research on connected health and human performance.

"When Lero's work can help alleviate suffering, improve patient outcomes and free up resources, then we are doing the job we were established to do, and that's very rewarding for all concerned," he added.

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Citation: E E, Wang T, Yang L, et al The Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project.

BMJ Open 2020;10:e040488. doi: 10.1136/bmjopen-2020-040488

Ethics approval: Before data collection, formal approval was sought and obtained for each clinical site from the local hospitals' Research Ethics Committee to process information from a retrospective cohort to explore DXA validity for Ireland.

How to improve gender equity in medicine

CANADIAN MEDICAL ASSOCIATION JOURNAL

Research News

 

Gender equity and racial diversity in medicine can promote creative solutions to complex health problems and improve the delivery of high-quality care, argue authors in an analysis in CMAJ (Canadian Medical Association Journal).

"[T]here is no excuse for not working to change the climate and environment of the medical profession so that it is welcoming of diversity," writes lead author Dr. Andrea Tricco, Knowledge Translation Program, Unity Health, and the University of Toronto, with coauthors. "The medical profession should be professional, be collegial, show mutual respect, and facilitate the full potential and contribution of all genders, races, ethnicities, religions and nationalities for the benefit of patient care."

The authors describe the root causes of gender inequity in society as well as medicine, and how to improve equity based on current evidence. Gender inequity in medicine is a long-standing problem and the time to act is now, they urge.

"The history of gender inequity in Canadian medical leadership is long, despite women outnumbering men in medical schools now for over a quarter of a century," says coauthor Dr. Ainsley Moore, a family physician and associate professor, Department of Family Medicine, McMaster University, Hamilton, Ontario. "Only 8 of the past 152 presidents of the Canadian Medical Association were women, and it took 117 years for a woman to be appointed dean of a medical faculty, and only 8 have been appointed since. The time is ripe for addressing this systemic problem."

For racialized women, the issue of equity is even more pronounced. "The effects of systemic and structural racism have resulted in racialized women experiencing a double-jeopardy of race and gender bias, thereby exaggerating their underrepresentation in leadership positions in academic medicine," says coauthor Dr. Nazia Peer, research program manager of the Knowledge Translation Program, Unity Health.

Addressing gender equity requires a multi-pronged approach targeting the medical system as well as individual behaviours.

Solutions include

• Ensuring core principles of equity, diversity, inclusion, mutual respect, collegiality and professionalism are embedded in all policies and all stages of medicine
• Communicating gender statistics
• Getting buy-in from professional organizations at the national, provincial and local levels
• Championing structural and behavioural change from the top
• Role modelling
• Diverse search committees for hiring
• Flexible schedules, non-gendered parental leave and family-friendly policies
• Career support and peer mentoring

"Equity will only be realized when everyone -- regardless of gender and other differences -- experiences equity in pay, promotions and other opportunities. There is no better time than now to implement policies to advocate for and support equity in medicine," they conclude.

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Listen to a podcast with Drs. Andrea Tricco and Ainsley Moore: https://www.cmaj.ca/lookup/doi/10.1503/cmaj.200951/tab-related-content.

"Advancing gender equity in medicine" is published February 16, 2021.

Ageism and sexism barring grandmothers from initiatives to save newborn lives in Global South

This is despite published research suggesting they have key roles in many cultures

BMJ

Research News

 

Ageism, sexism, and Western ideals of the nuclear family have excluded grandmothers from national and international policy initiatives to save newborn lives in the Global South, suggests an analysis published in the online journal BMJ Global Health.

This is despite published research indicating that they are a valuable and influential resource for children's health and survival in many cultures, the study author points out.

Around three out of 4 newborn deaths in the Global South occur in the first week of life--40% of them on the first day, and most of them at home.

But Initiatives to promote the survival of newborns across the Global South have primarily focused on strengthening health services and on young mothers within a nuclear family unit, to the exclusion of caregiver roles and practices within the wider family, says the author.

And extra funds invested in programmes to cut the newborn death rate have had relatively little impact.

To explore the role of the wider family in the care of newborns, and specifically that of grandmothers, the author reviewed relevant published studies of 70 different cultures in the three continents of Africa, Asia, and Latin America.

Cultures in the Global South tend to be collectivist rather than individualist, as in the West. They feature hierarchy based on age and experience, with elders as teachers of younger generations, and interdependency and shared decision-making valued over autonomy.

The studies revealed that grandmothers' knowledge is not always up to date and that some of their newborn practices may be harmful.

But where initiatives have recognised the value of grandmothers, such as in Nepal, Uttar Pradesh in India, Malawi, Burkina Faso and Senegal, these have been successful and prove that grandmothers may not be as resistant to change as is often assumed, notes the author.

The studies also revealed numerous examples of the significant role and influence of experienced older women, or grandmothers, on newborn care, both as authoritative advisors and direct caregivers within multi-generational family systems.

These roles extend from pregnancy onwards and include care of sick newborns, acting as breastfeeding coaches, and providing vital emotional and social support networks.

And across all three continents, the studies showed that grandmothers have similar core roles in newborn care, irrespective of variations in cultural practice.

"A growing body of evidence from across non-western, collectivist societies reveals the culturally designated role of these experienced, older women as newborn advisors and caregivers," writes the author.

"Unfortunately, at the global level, newborn research, policies and interventions continue to focus primarily on medical technologies and services, [and] to a lesser extent on mothers."

She adds: "While all research reviewed provides evidence of grandmothers' influence on newborn care, surprisingly, some does not explicitly recommend their inclusion in future programmes.

"Unfortunately, there is continued reluctance to explicitly involve grandmothers in interventions addressing newborn and other [mother and child health] issues.

"This appears to be related to: the often-repeated idea that grandmothers are barriers to change; a narrow perception of grandmothers focusing on their harmful traditional practices; and gender and ageist biases toward older women."

Future research should be grounded within a family systems framework that reflects collectivist cultures, argues the author.

And initiatives to save newborn lives should "aim not only to strengthen health services, but also influential family caregivers, particularly grandmothers and the indigenous social support networks of which they are a part," she concludes.

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Externally peer reviewed? Yes
Evidence type: Analysis
Subjects: Families

Managing crab and lobster catches could offer long-term benefits

UNIVERSITY OF PLYMOUTH

Research News

VIDEO: AN ANIMATION SHOWING HOW MANAGING CRAB AND LOBSTER CATCHES COULD OFFER LONG-TERM BENEFITS TO FISHERMEN AND THE ENVIRONMENT view more 

CREDIT: UNIVERSITY OF PLYMOUTH

The UK's commercial fishing industry is currently experiencing a number of serious challenges.

However, a study by the University of Plymouth has found that managing the density of crab and lobster pots at an optimum level increases the quality of catch, benefits the marine environment and makes the industry more sustainable in the long term.

Published today in Scientific Reports, a journal published by the Nature group, the findings are the result of an extensive and unprecedented four-year field study conducted in partnership with local fishermen off the coast of southern England.

Over a sustained period, researchers exposed sections of the seabed to differing densities of pot fishing and monitored any impacts using a combination of underwater videos and catch analysis.

They found that in areas of higher pot density, fishermen caught 19% less brown crab and 35% less European lobster, and their catches of brown crab were on average 35 grams per individual (7%) lighter.

The effect on marine species was also significant with two ecologically important reef species, Ross coral (Pentapora foliacea) and Neptune's Heart sea squirt (Phallusia mammillata), 83% and 74% less abundant respectively where pot density was higher.

Researchers say the study provides evidence of a pot fishing intensity 'threshold' and highlights that commercial pot fisheries are likely to be compatible with marine conservation when managed correctly at low, sustainable levels.

The study was carried out by academics from the University's School of Biological and Marine Sciences, with funding from Defra and the Blue Marine Foundation and working with the Lyme Bay Consultative Committee.

CAPTION

A stack of crab and lobster pots at the end of Lyme Regis harbour, ready for fishing

CREDIT

Adam Rees, University of Plymouth

It builds on an interim report published by Defra in 2019, and research published in October 2020 which used previously unseen footage to show the environmental impacts of pot fishing.

Dr Adam Rees, Post-Doctoral researcher and lead author on the current research, said: "The effects of bottom-towed fishing have been clearly shown as part of the University's long-term monitoring project in Lyme Bay. But before we started this research, very little was known about the precise impacts of pot fishing over a prolonged period. We have shown that - if left unchecked - it can pose threats but that changing ways of working can have benefits for species on the seabed and the quality and quantity of catches."

The study focussed on the Lyme Bay Reserve, a 206 km² area that has been protected from all bottom-towed fishing since 2008. It is part of the Lyme Bay and Torbay Special Area of Conservation, a 312 km² section of the English Channel that is predominantly fished by small boats operating out of towns and villages.

The University has been assessing the seabed recovery since 2008 and has previously demonstrated that several species have returned to the area since the MPA was introduced. Recommendations from this work have been included within the Government's 25-year Environment Plan, and a major UK government report into Highly Protected Marine Areas (HPMAs), led by former Defra Fisheries Minister Richard Benyon.

This latest study comes just days after the Marine Management Organisation (MMO) signalled its intent to ban bottom trawling at various offshore MPAs around the UK.

Dr Emma Sheehan, Associate Professor of Marine Ecology and one of the study's co-authors, said: "Over a decade ago, the fishing community in Lyme Bay realised that changing the way they fish was essential to the sustainability of their industry. We have worked closely with them ever since to take their concerns into account and attempt to provide them with solutions. This study is the latest part of our ongoing work to establish the best ways to both preserve their traditions and enhance the environment they work in."

Martin Attrill, Professor of Marine Ecology and senior author on the research, added: "The fishing industry is currently facing huge uncertainty. And we of course know that every fishing community is different. But with the drive to further enhance marine protection around the UK, some of the lessons we have learned in Lyme Bay could help other fleets make changes that can secure their long-term future."

CAPTION

A local fishermen involved in the project out hauling fishing gear within the Lyme Bay and Torbay Special Area of Conservation

CREDIT

Adam Rees, University of Plymouth

Tropical paper wasps babysit for neighbours

UNIVERSITY OF BRISTOL

Research News

 

IMAGE: POLISTES COLONIES OFFER WINDOWS INTO THE EVOLUTION OF COOPERATION view more 

CREDIT: P KENNEDY

[Images and video available: see notes to editors]

Wasps provide crucial support to their extended families by babysitting at neighbouring nests, according to new research by a team of biologists from the universities of Bristol, Exeter and UCL published today [15 February] in Nature Ecology and Evolution.

The findings suggest that animals should often seek to help more distant relatives if their closest kin are less in need.

Dr Patrick Kennedy, lead author and Marie Curie research fellow in the School of Biological Sciences at the University of Bristol, said: "These wasps can act like rich family members lending a hand to their second cousins. If there's not much more you can do to help your immediate family, you can turn your attention to the extended family."

By closely observing twenty thousand baby wasps and their carers on colonies around the Panama Canal, the research team could determine the usefulness of workers on colonies of different sizes. They showed that workers become less useful as the number of colony members rises, due to a surplus of help.

Andy Radford, Professor of Behavioural Ecology, also from Bristol and co-author, explained: "By helping more distant relatives who are more in need--those living next door with fewer carers--workers can pass on more copies of their genes overall. We believe that similar principles of diminishing returns might explain seemingly paradoxical acts of altruism in many other social animals."

Dr Kennedy added: "The fact that these paper wasps in Central and South America help at other colonies is really bizarre when you consider that most wasps, ants and bees are extremely hostile to outsiders. To solve this puzzling behaviour, we combined mathematical modelling with our detailed field observations."

Dr Kennedy continued: "We ended up being stung a lot. But it was worth it, because our results show that worker wasps can become redundant at home. A wasp on a colony with few larvae but lots of other workers becomes almost useless: the best thing to do is to babysit the larvae of other relatives."

Since Darwin, biologists have been trying to understand how 'altruism' evolves in animals. At first glance, acts of selflessness to help other individuals do not seem to allow individuals to pass on their genes.

Professor Radford said: "In 1964, the legendary biologist W. D. Hamilton figured out the cardinal rule of animal altruism. Lavish help on your family because they share many of your genes. Copies of your genes will triumph in the population."

But the tropical paper wasps studied by the team baffled Hamilton back in 1964. In Brazil, he was surprised to notice that Polistes wasps were leaving their close family on their home nests and flying off to help the neighbours, who are less closely related.

Previous work by co-author Seirian '@WaspWoman' Sumner, Professor of Behavioural Ecology at University College London, showed that over half the workers in a Panamanian population were helping on multiple nests. Wasps usually viciously attack outsiders, so this babysitting suggested something unusual was going on.

Professor Sumner explained: "Wasps offer amazing windows into the evolution of selflessness. There is so much going on in a wasp nest: power struggles, self-sacrifice, groups battling against the odds to survive... If we want to understand how societies evolve, we should look more deeply at wasps."

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This fieldwork was supported by the National Geographic Society and the Smithsonian Tropical Research Institute in Panama.

Paper

'Diminishing returns drive altruists to help extended family' by P. Kennedy, S. Sumner?, P. Botha, N. J. Welton, A. D. Higginson and A. N. Radford in Nature Ecology and Evolution

Capuchin monkey genome reveals clues to its long life and large brain

UNIVERSITY OF LIVERPOOL

Research News

 

An international team of scientists has sequenced the genome of a capuchin monkey for the first time, uncovering new genetic clues about the evolution of their long lifespan and large brains.

Published in PNAS, the work was led by the University of Calgary in Canada and involved researchers at the University of Liverpool.

"Capuchins have the largest relative brain size of any monkey and can live past the age of 50, despite their small size, but their genetic underpinnings had remained unexplored until now," explains Professor Joao Pedro De Magalhaes, who researches ageing at the University of Liverpool.

The researchers developed and annotated a reference assembly for white-faced capuchin monkeys (Cebus imitator) to explore the evolution of these traits.

Through a comparative genomics approach spanning a wide diversity of mammals, they identified genes under evolutionary selection associated with longevity and brain development.

"We found signatures of positive selection on genes underlying both traits, which helps us to better understand how such traits evolve. In addition, we found evidence of genetic adaptation to drought and seasonal environments by looking at populations of capuchins from a rainforest and a seasonal dry forest," said senior author and Canada Research Chair Amanda Melin who has studied capuchin monkey behaviour and genetics for almost 20 years.

The researchers identified genes associated with DNA damage response, metabolism, cell cycle, and insulin signalling. Damage to the DNA is thought to be a major contributor to ageing and previous studies by Professor de Magalhaes and others have shown that genes involved in DNA damage responses exhibit longevity-specific selection patterns in mammals.

"Of course, because aging-related genes often play multiple roles it is impossible to be sure whether selection in these genes is related to ageing or to other life-history traits, like growth rates and developmental times, that in turn correlate with longevity," said Professor De Magalhaes.

"Although we should be cautious about the biological significance of our findings, it is tempting to speculate that, like in other species, changes to specific aging-related genes or pathways, could contribute to the longevity of capuchins," he added.

The team's insights were made possible thanks to the development of a new technique to isolate DNA more efficiently from primate faeces.

FecalFACS utilises an existing technique that has been developed to separate cells types in body fluids - for example to separate different cell types in blood for cancer research - and applies it to primate faecal samples.

"This is a major breakthrough because the typical way to extract DNA from faeces results in about 95-99% of the DNA coming from gut microbes and food items. A lot of money has been spent sequencing genomes from different organisms than the mammals we're actually trying to study. Because of this, when wildlife biologists have required entire genomes, they have had to rely on more pure sources of DNA, like blood, saliva, or tissue - but as you can imagine, those are very hard to come by when studying endangered animals," explained the study's lead author, Dr Joseph Orkin, who completed work on this project as a postdoctoral scholar at the University of Calgary, and in his present location at Universitat Pompeu Fabra-CSIC in Barcelona.

"FecalFACS finally provides a way to sequence whole genomes from free-ranging mammals using readily available, non-invasive samples, which could really help future conservation efforts," he added.

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