Superconductors: Unraveling the stripe order mystery

One of the greatest mysteries in condensed matter physics is the exact relationship between charge order and superconductivity in cuprate superconductors. In superconductors, electrons move freely through the material — there is zero resistance when it’s cooled below its critical temperature. However, the cuprates simultaneously exhibit superconductivity and charge order in patterns of alternating stripes. This is paradoxical in that charge order describes areas of confined electrons. How can superconductivity and charge order coexist?

Now researchers at the University of Illinois at Urbana-Champaign, collaborating with scientists at the SLAC National Accelerator Laboratory, have shed new light on how these disparate states can exist adjacent to one another. Illinois Physics post-doctoral researcher Matteo Mitrano, Professor Peter Abbamonte, and their team applied a new x-ray scattering technique, time-resolved resonant soft x-ray scattering, taking advantage of the state-of-the-art equipment at SLAC. This method enabled the scientists to probe the striped charge order phase with an unprecedented energy resolution. This is the first time this has been done at an energy scale relevant to superconductivity.

The scientists measured the fluctuations of charge order in a prototypical copper-oxide superconductor, La2?xBaxCuO4 (LBCO) and found the fluctuations had an energy that matched the material’s superconducting critical temperature, implying that superconductivity in this material — and by extrapolation, in the cuprates — may be mediated by charge-order fluctuations.

The researchers further demonstrated that, if the charge order melts, the electrons in the system will reform the striped areas of charge order within tens of picoseconds. As it turns out, this process obeys a universal scaling law. To understand what they were seeing in their experiment, Mitrano and Abbamonte turned to Illinois Physics Professor Nigel Goldenfeld and his graduate student Minhui Zhu, who were able to apply theoretical methods borrowed from soft condensed matter physics to describe the formation of the striped patterns.

These findings were published on August 16, 2019, in the online journal Science Advances.

Cuprates have stripes

The significance of this mystery can be understood within the context of research in high-temperature superconductors (HTS), specifically the cuprates — layered materials that contain copper complexes. The cuprates, some of the first discovered HTS, have significantly higher critical temperatures than “ordinary” superconductors (e.g., aluminum and lead superconductors have a critical temperature below 10 K). In the 1980s, LBCO, a cuprate, was found to have a superconducting critical temperature of 35 K (-396°F), a discovery for which Bednorz and Müller won the Nobel Prize.

That discovery precipitated a flood of research into the cuprates. In time, scientists found experimental evidence of inhomogeneities in LBCO and similar materials: insulating and metallic phases that were coexisting. In 1998, Illinois Physics Professor Eduardo Fradkin, Stanford Professor Steven Kivelson, and others proposed that Mott insulators — materials that ought to conduct under conventional band theory but insulate due to repulsion between electrons — are able to host stripes of charge order and superconductivity. La2CuO4, the parent compound of LBCO, is an example of a Mott insulator. As Ba is added to that compound, replacing some La atoms, stripes form due to the spontaneous organization of holes — vacancies of electrons that act like positive charges.

Still, other questions regarding the behavior of the stripes remained. Are the areas of charge order immobile? Do they fluctuate?

“The conventional belief is that if you add these doped holes, they add a static phase which is bad for superconductivity — you freeze the holes, and the material cannot carry electricity,” Mitrano comments. “If they are dynamic — if they fluctuate — then there are ways in which the holes could aid high-temperature superconductivity.”

Probing the fluctuations in LBCO

To understand what exactly the stripes are doing, Mitrano and Abbamonte conceived of an experiment to melt the charge order and observe the process of its reformation in LBCO. Mitrano and Abbamonte reimagined a measurement technique called resonant inelastic x-ray scattering, adding a time-dependent protocol to observe how the charge order recovers over a duration of 40 picoseconds. The team shot a laser at the LBCO sample, imparting extra energy into the electrons to melt the charge order and introduce electronic homogeneity.

“We used a novel type of spectrometer developed for ultra-fast sources, because we are doing experiments in which our laser pulses are extremely short,” Mitrano explains. “We performed our measurements at the Linac Coherent Light Source at SLAC, a flagship in this field of investigation. Our measurements are two orders of magnitude more sensitive in energy than what can be done at any other conventional scattering facility.”

Abbamonte adds, “What is innovative here is using time-domain scattering to study collective excitations at the sub-meV energy scale. This technique was demonstrated previously for phonons. Here, we have shown the same approach can be applied to excitations in the valence band.”

Hints of a mechanism for superconductivity

The first significant result of this experiment is that the charge order does in fact fluctuate, moving with an energy that almost matches the energy established by the critical temperature of LBCO. This suggests that Josephson coupling may be crucial for superconductivity.

The idea behind the Josephson effect, discovered by Brian Josephson in 1962, is that two superconductors can be connected via a weak link, typically an insulator or a normal metal. In this type of system, superconducting electrons can leak from the two superconductors into the weak link, generating within it a current of superconducting electrons.

Josephson coupling provides a possible explanation for the coupling between superconductivity and striped regions of charge order, wherein the stripes fluctuate such that superconductivity leaks into the areas of charge order, the weak links.

Obeying universal scaling laws of pattern formation

After melting the charge order, Mitrano and Abbamonte measured the recovery of the stripes as they evolved in time. As the charge order approached its full recovery, it followed an unexpected time dependence. This result was nothing like what the researchers had encountered in the past. What could possibly explain this?

The answer is borrowed from the field of soft condensed matter physics, and more specifically from a scaling law theory Goldenfeld had developed two decades prior to describe pattern formation in liquids and polymers. Goldenfeld and Zhu demonstrated the stripes in LBCO recover according to a universal, dynamic, self-similar scaling law.

Goldenfeld explains, “By the mid-1990s, scientists had an understanding of how uniform systems approach equilibrium, but how about stripe systems? I worked on this question about 20 years ago, looking at the patterns that emerge when a fluid is heated from below, such as the hexagonal spots of circulating, upwelling white flecks in hot miso soup. Under some circumstances these systems form stripes of circulating fluid, not spots, analogous to the stripe patterns of electrons in the cuprate superconductors. And when the pattern is forming, it follows a universal scaling law. This is exactly what we see in LBCO as it reforms its stripes of charge order.”

Through their calculations, Goldenfeld and Zhu were able to elucidate the process of time-dependent pattern reformation in Mitrano and Abbamonte’s experiment. The stripes reform with a logarithmic time dependence — a very slow process. Adherence to the scaling law in LBCO further implies that it contains topological defects, or irregularities in its lattice structure. This is the second significant result from this experiment.

Zhu comments, “It was exciting to be a part of this collaborative research, working with solid-state physicists, but applying techniques from soft condensed matter to analyze a problem in a strongly correlated system, like high-temperature superconductivity. I not only contributed my calculations, but also picked up new knowledge from my colleagues with different backgrounds, and in this way gained new perspectives on physical problems, as well as new ways of scientific thinking.”

In future research, Mitrano, Abbamonte, and Goldenfeld plan to further probe the physics of charge order fluctuations with the goal of completely melting the charge order in LBCO to observe the physics of stripe formation. They also plan similar experiments with other cuprates, including yttrium barium copper oxide compounds, better known as YBCO.

Goldenfeld sees this and future experiments as ones that could catalyze new research in HTS: “What we learned in the 20 years since Eduardo Fradkin and Steven Kivelson’s work on the periodic modulation of charge is that we should think about the HTS as electronic liquid crystals,” he states. “We’re now starting to apply the soft condensed matter physics of liquid crystals to HTS to understand why the superconducting phase exists in these materials.”

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From the tiny testes of flies, new insight into how genes arise

In the battle of the sexes, males appear to have the innovative edge — from a genetic standpoint, at least. Scientists are finding that the testes are more than mere factories for sperm; these organs also serve as hotspots for the emergence of new genes, the raw material for the evolution of species.

Using fruit flies, a Rockefeller team has gained key insight into how nature’s attempts at innovation play out during the development of sperm. In research described August 16 in eLife, they mapped the presence of mutations to DNA at the single-cell level, and the activity of new genes arising from such changes.

“Our work offers an unprecedented perspective on a process that enables living things to adapt and evolve, and that ultimately contributes to the diversity of life on Earth,” says assistant professor Li Zhao, who led the research.

High stakes

In recent years, studies in animals from flies to humans have turned up a number of young genes that originated in the testes. These and other discoveries suggest the testes rank among the most productive sites in the body — male or female — for genetic innovation.

This mass production of genetic novelties comes with significant risks, however. In humans, for example, a father’s sperm acquires two to three times more new mutations than do a mother’s eggs in the course of normal development, leaving the sperm riddled with genetic mistakes. In some cases, such mistakes may harm his offspring, or even derail the prospect of fatherhood altogether.

In other words, the male stands to lose the one thing that matters in the game of evolution: the opportunity to propagate his gene pool into the next generation.

But whatever the potential downside genetic experimentation has for individual males and their offspring, the dynamics of reproduction nevertheless encourage it. Potential fathers face intense pressure to attract females and fend off competitors. Any advantage, such as brighter plumage or hardier sperm, for example, can make all the difference.

At the molecular level, this pressure drives an abundance of new genes within the testes. Scientists think that if these newcomers contribute to males’ ability to father healthy offspring, they rapidly acquire a fixed place in the genome and may even go on to contribute elsewhere in the body.

Searching cell by cell

Looking a little closer, however, the picture gets blurry. Scientists haven’t yet understood the dynamics by which genetic innovation occurs within the precursor cells from which sperm develops.

To find out more, Zhao and researchers in her lab tagged individual cells from fly testes, then identified and decoded the RNA sequences each contained. This approach allowed them to see how the activity of specific genes changed throughout the developmental stages. Within the RNA sequences isolated from stem cells and five intermediary cell types, the researchers examined innovation from two perspectives: that of mutations and that of genes.

Mutations known as substitutions, in which one letter of DNA’s code is swapped for another, are most abundant early on in the development of sperm, then decrease, they found. The sperm cells’ DNA-repair machinery follows a similar pattern — it is most active early on, then tapers off — which makes sense, according to Zhao, since the machinery is responsible for fixing errors like these.

Starting from scratch

Within the RNA sequences, Zhao’s team hunted for a particular type of young gene — one that arises from scratch rather than through duplication of an existing gene. For Zhao, these so-called de novo genes, which originate from sequences that originally did not code for protein, are the most interesting new genes from an evolutionary perspective. Her team found no less than 184 de novo genes, drawn from a set they had previously identified.

When they examined these de novo genes, the scientists uncovered complex patterns, with certain genes showing up primarily in certain cell types, but not in others. About 15 percent of these genes appeared early on, including in the stem cell stage — which is surprising, Zhao says, because scientists previously thought that new genes rarely show up at the start of development as this phase is tightly controlled. The most active period for de novo genes occurred midstream, however, in the so-called spermatocyte phase of developing sperm.

The scientists are now interested in understanding what purpose, if any, de novo genes serve when they first arise. And although it’s possible that some essentially fire at random, making no particular contribution, Zhao suspects that in many cases, these new genes play roles in the maturation of sperm cells.

“Precisely what these de novo genes are doing to move development along is an exciting open question,” Zhao says.

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Health24.com | How the build-up of proteins in the heart often goes undiagnosed, even though it’s potentially fatal

A potentially fatal build-up of abnormal proteins in the heart and other organs is being delayed in its diagnosis and undertreated – despite new drugs that can combat it, a new study suggests.

Although the condition, known as transthyretin amyloidosis, is still perceived as rare, advances in imaging techniques have led to greater awareness. Increasingly, it’s being recognised as a cause of heart failure in older adults, with autopsy studies showing these proteins in the hearts of 25% of the elderly.

Poor quality of life

A study published in the American Heart Association journal Circulation looked at data from 1 034 patients who had different types of amyloidosis in the United Kingdom between 2001 and 2017. Amyloidosis happens when abnormal proteins join and attach to organs, tissues, nerves and other places in the body, disrupting normal function.

Researchers found both hereditary and acquired amyloidosis are associated with a “markedly poor quality of life at the time of diagnosis” and many patients cycle in and out of the hospital before the disease is ever detected. The typical patient visited a hospital an average of 17 times in the three years leading up to a diagnosis.

The study also found that patients with a gene variant of the disease – mostly those of Afro-Caribbean ethnicity – typically have worse heart and kidney symptoms when they’re diagnosed and a poorer chance of survival.

Dr Julian D. Gilmore, the study’s lead author, said the results underscore the need for medical professionals to get better at detecting and treating amyloidosis.

“Our aim is to slow or stop the progression of this potentially fatal condition. But without specific treatment, patients invariably get worse,” said Gilmore, a professor at the National Amyloidosis Centre at University College London.

“Nobody really knows what the prevalence of this disease is, but the referrals we are getting are increasing pretty dramatically year after year. There’s no sign of that slowing down.”

Condition often misdiagnosed

Dr Mathew Maurer, a cardiologist who was not involved in the research, called it an important study that could convince doctors to consider the disease with the gravity it deserves. “The first issue is that it’s no longer rare – it’s common.”

In 2017, Maurer was lead author of a report in Circulation that concluded the condition “is often misdiagnosed and the delayed diagnosis has significant consequences for patients”. That report surveyed more than 500 patients with the disease and found the average time from initial symptoms to diagnosis was two years.

That lag time could shrink in the future. In the past, amyloidosis could only be diagnosed by a heart biopsy, but it can now be more easily detected with bone scans and a cardiac MRI, Maurer said.

“We have to leverage these imaging techniques early and avoid new amyloid from getting into the heart so we can meaningfully change outcomes for patients. And to do that, we have to get doctors to start thinking about this every day,” said Maurer, director of the Cardiac Amyloidosis Program at New York Presbyterian/Columbia University Medical Center.

Both Maurer and Gilmore said they were encouraged by two new drugs that seem to be successful in battling amyloidosis: tafamidis (Vyndaqel), which was approved in May by the US Food and Drug Administration, and AG10, which is currently being tested in clinical trials.

Gilmore said he’d like to see a future study that compares tafamidis with AG10, as well as a study that examines which drug might be best combined with other drugs.

Image credit: iStock

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Clatterbridge Cancer Centre ‘may lose proton beam therapy’

Aging proton beam technology at Clatterbridge Cancer Centre may not be replaced, health bosses warn.

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Women take legal action over breast implant cancer link

Twenty UK women are taking legal action over a rare type of breast implant-related cancer.

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People Are Praising Kourtney Kardashian for Showing Her Stretchmarks in Bathing Suit Pic

Kardashian photos and Photoshop go together like Kylie Jenner and wigs or Kris Jenner and Adidas tracksuits. But one famous sibling is foregoing the airbrush treatment and getting called out for it in the best way. Kourtney Kardashian, who's wrapping up an Italian vacation with her family to celebrate Kylie's birthday, posted a snapshot of herself in a high-cut bikini, straw boater's hat, and tiny sunglasses — but it was her stretchmarks that stole the show. Commenters applauded her for showing her real body, not an unattainable airbrushed ideal.

According to People, Kardashian posted the photo to Poosh's Instagram account. Followers zeroed in on her stretchmark and appreciated that Kardashian was showing them off instead of hiding them or editing them out. Some even noted that Kardashian's proud display was making them reconsider their own stretchmarks and embrace them instead of being ashamed of them. Kardashian even responded to a comment, calling her stretchmarks "little stripes."

RELATED: Kourtney Kardashian Shares Her Favorite Keto Cheesecake—and It Looks Amazing

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"Thank you so much for not editing out your stretch marks!!" a commenter wrote.

"Thank you for sharing this picture, I praise any woman that shows her true and beautiful body without any airbrushing," another added.

Others applauded the photo, too, writing, "I love when we get to see stretch marks..normal bodies," "I love the fact that you let your stretch marks show! Proud, hot Mama!!" and, "Oh wow not air brushed. You can actually see her stretch marks and this is what a real body looks like! I love it."

Kardashian responded to the praise, writing, "I love my little stripes."

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"Wow, I just had the most beautiful night with my kids watching the sunset, feeling overwhelmingly grateful for this past few weeks spent together in Italy and so in awe of God's creation there was nothing for me to do but cry (happy tears)," she captioned the photo.

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Health24.com | How sporting activities like martial arts and boxing can help kids with ADHD

Exercise has both physical and mental benefits, and has an added benefit for those with ADHD. A previous Health24 article notes that in children with ADHD, regular exercise significantly reduces the severity of ADHD symptoms and provides an enhancement of cognitive performance and brain function.

The study’s head researcher, professor Charles Hillman of the University of Illinois, said that physical activity is a good investment for all children, especially for kids who are hyperactive.

The ADHD brain has low levels of the neurotransmitters dopamine, serotonin and norepinephrine. Neurotransmitters impact things like motivation and the ability to think clearly. With physical activity, however, there is better brain function and focus as neurotransmitter levels are elevated. 

Another 2018 pilot study that examined the effects of physical exercise on attention while participants were engaged in a continuous task also found that attention was enhanced by arousal through exercise.  

Research suggests that a minimum of 30 minutes of moderate-to-high intensity cardio produces the right level of neurotransmitters as well as the special protein, brain-derived neurotrophic factor (BDNF). All kinds of exercise, however, benefits ADHD brains, and especially sporting activities like martial arts teach helpful, practical skills. 

Boxing and martial arts benefits the ADHD brain

In a BBC article, a group of teenagers with ADHD explain how their experience with boxing helps them channel their excess energy. Levi, a 14-year-old boy, said that the diagnosis and medication are helpful, but “it’s the boxing that really helps as I’m always so full of energy and struggle to concentrate”.

Since ADHD is a disorder that affects a person’s ability to control impulsive behaviours and pay attention to things, martial arts and boxing centre heavily on mental discipline and use repetitive motions to teach techniques and emphasise the connection between one’s body and mind, explains Evolve Daily.

Apart from improving one’s mental health, it teaches focus, patience and perseverance that can carry over into one’s personal and professional life. This is why the activity can be beneficial for those with ADHD. Taunton, a town in England, has a boxing club for kids with ADHD. The idea came from Ray Oliveira Jr. (27) who was also diagnosed with ADHD at the age of four. He developed an interest in pugilism (boxing) as an outlet for his energy and frustration. 

Developing an exercise programme that fits the ADHD lifestyle requires motivation and consistency. This may be challenging at first, but incorporating a variety of activities can help the process along. 

Image: iStock

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Health24.com | A dietitian’s take on health bars – are they actually healthy?

Energy bars, protein bars, fruit and nut bars, granola bars, cereal bars, carb free bars, etc., etc.

Living in our fast-paced world, where convenience is key, these bars offer a quick and easy, on-the-go snack, or even meal replacement for many of us.

However, how do these bars weigh up when it comes to incorporating them into a healthy diet?

It can be a challenge to categorise bars as “good” or “bad”, because it largely depends on our reason for consuming them. 

It’s important to assess the products by checking the contents on the label and not believing the manufacturer’s health claims.

Your selection should also be based on your goals. A high calorie protein bar may be a good choice if you train regularly and want to increase your muscle mass, but not ideal if you’re watching your weight.

More specifically, for a long-distance athlete, a higher carbohydrate and sugar content may be exactly what they need during an endurance race, while higher levels of protein may be ideal for a body builder trying to bulk up.

How to choose wisely

Ingredients are listed in descending order, with the most abundant ingredient listed first. If sugar is one of the top three ingredients, you’ll know that the bar is high in sugar. 

Many health bars are highly processed products, devoid of nutritious ingredients, while others are simple blends of nuts or other healthy ingredients without any added sugar, artificial colours or other additives.

After checking the list of ingredients, move on to the nutritional information panel.

The following components are important to consider:

Energy (kilojoules): This value is important if you’re trying to manage your weight or body fat. Many bars are high in kilojoules (around 1 000kJ) – close to what a chocolate bar contains or equal to the kilojoules in three and a half slices of bread. One medium apple weighing around 150g contains just 340kJ. 

Sugar: Words like sucrose, glucose syrup, honey, fructose and golden syrup all indicate sugar. Those with a sugar content of more than 23g per 100g are considered high in sugar. A challenge when looking at sugar content is that the labels do not distinguish between added sugar and naturally occurring sugar. For example, a bar that is made of just blended dates and nuts contains 39g of sugar per 100g. This is why it is important to look at both the ingredients list and nutritional panel.

Total fat: According to the South African food labelling legislation, a product is low fat when the total fat content is below 3g per 100g. It is important to consider the type of fat, as saturated fat increases cholesterol levels and inflammation, and ideally fat should be predominantly unsaturated. As with sugar, it’s important to look at the ingredients list as well because some bars made with just healthy ingredients, like nuts, may still exceed this cut-off.

Fibre: The higher the fibre content, the better the satiety value and benefit for your digestive health. We consider a product high in fibre if the content is 6g or more per 100g.

It may be difficult to find bars that meet all these criteria. We went shopping to look at some of the bars available and the list below provides some examples.

Be cautious of health claims

The descriptions and claims on some bars can be misleading. Claims such as “guilt free”, “gluten free”, “made with whole grains”, and “sugar free” all give the impression that the bar is healthy.

The reality is that it may still contain many ingredients that are far from desirable in terms of nourishment.

Many consumers perceive these bars to be healthy because they contain some healthy ingredients, such as seeds, nuts, oats or added vitamins or minerals. However, remember that some of the other added ingredients that are not so healthy, such as the fats and sugar, may outweigh the benefits of these, and some bars may still contain more sugar and kilojoules than a chocolate bar.

A final word

Health bars cannot replace the nutrients found in fresh, unprocessed foods and snacks, and it is advisable not to rely on them too often. If your diet already provides adequate energy, protein and nutrients, eating too many of them may add unwanted kilojoules. 

For some of us, however, health bars can be helpful in meeting nutritional requirements. Therefore, if you decide to include them in your diet, choose wisely.

The following five bars come up tops:

  • Primal protein bar
  • USN Trust crunch bar
  • Future Life high protein bar
  • Jungle nuts energy bar “Lite” 
  • Nakd cashew cookie bar

Image credit: iStock

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Health24.com | Anaemia linked to higher odds for dementia in seniors

Even mild anemia – low levels of haemoglobin in the blood – may raise a person’s odds for Alzheimer’s disease and other types of dementia, a new study finds.

The same Dutch research also found a correlation between heightened dementia risk and high blood levels of haemoglobin.

Important implications

“With around 10% of people over age 65 having anaemia in the Americas and Europe, and up to 45% in African and southeast Asian countries, these results could have important implications for the burden of dementia,” noted study lead author M. Arfan Ikram, of Erasmus Medical Centre in Rotterdam, the Netherlands.

Haemoglobin is the protein in red blood cells that transports oxygen.

The new study included more than 12 000 people averaging 65 years of age. None of the participants had dementia at the beginning of the research.

Haemoglobin levels were measured at the start of the study and 6% of the participants were found to have anaemia.

The participants’ health was then tracked for an average of 12 years. During that time, 1 520 developed dementia, including 1 194 who were diagnosed with Alzheimer’s disease, according to the report published online in Neurology.

The study was not designed to prove cause and effect. However, the research showed that people with anaemia were 41% more likely to develop Alzheimer’s disease and 34% more likely to develop any type of dementia than those without anaemia, the team reported.

Dementia expected to increase

In another finding, people with high levels of haemoglobin were also more likely to develop dementia. Those with the highest levels were 20% more likely to develop dementia than those with levels in the middle.

Those with the lowest haemoglobin levels were 29% more likely to develop dementia than those with levels in the middle, the research found.

In a journal news release, Ikram added that the findings could be significant, given that “the prevalence of dementia is expected to increase threefold over the next decades, with the largest increases predicted in the countries where the anaemia rate is the highest.”

The question of how haemoglobin levels affect dementia risk is still unclear, however.

“More research is needed to determine whether haemoglobin levels play a direct role in this increased risk or whether these associations can be explained by underlying issues or other vascular or metabolic changes,” Ikram explained.

Dr Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. Looking over the findings, he stressed that haemoglobin’s role as an oxygen transporter to the brain might be key.

The role of smoking

“Any quick or slow loss of oxygen will lead to a cognitive decline and manifest as dementia,” he noted. Conversely, Bhusri said, “elevated haemoglobin is a reaction to some underlying disease. That disease is forcing the body to produce more haemoglobin. This can result in an increase in thickness of blood and poor flow to the brain.”

Another expert believes the findings should serve as a reminder to doctors to pay attention to even mild anaemia when it occurs.

“I think that physicians should not write off mild anaemia in any age group, because it clearly is associated with brain dysfunction over time,” said Dr Guy Mintz. He directs cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, New York.

Mintz also noted that many of the participants in the study were still in their 60s and 70s, so “we are not looking at an elderly, frail group of patients”.

As for people with elevated levels of haemoglobin, he believes that in many instances this happened in response to the smoking habit.

So, the link between haemoglobin levels and dementia “can be another motivational tool to get these patients to stop smoking,” Mintz said.

Image credit: iStock

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‘Silent’ strokes common after surgery, linked to cognitive decline

Canadian researchers have discovered that covert — or ‘silent’ — strokes are common in seniors after they have elective, non-cardiac surgery and double their risk of cognitive decline one year later.

While an overt stroke causes obvious symptoms, such as weakness in one arm or speech problems that last more than a day, a covert stroke is not obvious except on brain scans, such as MRI. Each year, approximately 0.5 per cent of the 50 million people age 65 years or greater worldwide who have major, non-cardiac surgery will suffer an overt stroke, but until now little was known about the incidence or impacts of silent stroke after surgery.

The results of the NeuroVISION study were published today in The Lancet.

“We’ve found that ‘silent’ covert strokes are actually more common than overt strokes in people aged 65 or older who have surgery,” said Dr. PJ Devereaux, co-principal investigator of the NeuroVISION study. Dr. Devereaux is a cardiologist at Hamilton Health Sciences (HHS), professor in the departments of health research methods, evidence, and impact, and medicine at McMaster University, and a senior scientist at the Population Health Research Institute of McMaster University and HHS.

Dr. Devereaux and his team found that one in 14 people over age 65 who had elective, non-cardiac surgery had a silent stroke, suggesting that as many as three million people in this age category globally suffer a covert stroke after surgery each year.

NeuroVISION involved 1,114 patients aged 65 years and older from 12 centres in North and South America, Asia, New Zealand, and Europe. All patients received an MRI within nine days of their surgery to look for imaging evidence of silent stroke. The research team followed patients for one year after their surgery to assess their cognitive capabilities. They found that people who had a silent stroke after surgery were more likely to experience cognitive decline, perioperative delirium, overt stroke or transient ischaemic attack within one year, compared to patients who did not have a silent stroke.

“Over the last century, surgery has greatly improved the health and the quality of life of patients around the world,” said Dr. Marko Mrkobrada, an associate professor of medicine at University of Western Ontario and co-principal investigator for the NeuroVISION study. “Surgeons are now able to operate on older and sicker patients thanks to improvements in surgical and anesthetic techniques. Despite the benefits of surgery, we also need to understand the risks.”

“Vascular brain injuries, both overt and covert, are more frequently being detected, recognized and prevented through research funded by our Institute and CIHR,” says Dr. Brian Rowe, scientific director of the Institute of Circulatory and Respiratory Health, Canadian Institutes of Health Research (CIHR). “The NeuroVISION Study provides important insights into the development of vascular brain injury after surgery, and adds to the mounting evidence of the importance of vascular health on cognitive decline. The results of NeuroVISION are important and represent a meaningful discovery that will facilitate tackling the issue of cognitive decline after surgery.”

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Materials provided by McMaster University. Note: Content may be edited for style and length.

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