How can governments fight antimicrobial resistance with policy?

Governments have a wide variety of policy options at their disposal to respond to the growing threat of antimicrobial resistance, but many of these approaches have not been rigorously evaluated, according to a new study published this week in PLOS Medicine by Susan Rogers Van Katwyk of the University of Ottawa, Canada, and colleagues.

Antimicrobial resistance (AMR) is on the rise due to persistent misuse and overuse of antimicrobials, and has already rendered some infections untreatable with existing drugs. In the new work, researchers systematically searched seven global databases for studies that clearly described and evaluated a government policy intervention aimed at reducing human antimicrobial misuse. They identified 69 published evaluations of such interventions carried out around the world.

Described in these 69 studies were 17 different types of policies that governments have deployed and tested to reduce antimicrobial use, including public awareness campaigns, antimicrobial guidelines, vaccination, and tailored regulations for prescribing and reimbursement. Unfortunately, most existing policy options have not been rigorously evaluated, which limits their usefulness in planning future policy interventions. Of the studies, only 4 had a randomized controlled design, the gold standard for medical interventions, while 35 used rigorous quasi-experimental designs and the remaining 30 were uncontrolled and descriptive. The current systematic review was unable to directly investigate the impact of the different interventions on AMR, but reductions in antimicrobial use are likely to lead to lower levels of resistance over time.

“To avoid future waste of public resources, and in line with WHO recommendations for national action on AMR, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published,” the authors say.

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

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Engineers design nanostructured diamond metalens for compact quantum technologies

At the chemical level, diamonds are no more than carbon atoms aligned in a precise, three-dimensional (3D) crystal lattice. However, even a seemingly flawless diamond contains defects: spots in that lattice where a carbon atom is missing or has been replaced by something else. Some of these defects are highly desirable; they trap individual electrons that can absorb or emit light, causing the various colors found in diamond gemstones and, more importantly, creating a platform for diverse quantum technologies for advanced computing, secure communication and precision sensing.

Quantum technologies are based on units of quantum information known as “qubits.” The spin of electrons are prime candidates to serve as qubits; unlike binary computing systems where data takes the form of only 0s or 1s, electron spin can represent information as 0, 1, or both simultaneously in a quantum superposition. Qubits from diamonds are of particular interest to quantum scientists because their quantum-mechanical properties, including superposition, exist at room temperature, unlike many other potential quantum resources.

The practical challenge of collecting information from a single atom deep inside a crystal is a daunting one, however. Penn Engineers addressed this problem in a recent study in which they devised a way to pattern the surface of a diamond that makes it easier to collect light from the defects inside. Called a metalens, this surface structure contains nanoscale features that bend and focus the light emitted by the defects, despite being effectively flat.

The research was led by Lee Bassett, Assistant Professor in the Department of Electrical and Systems Engineering, graduate student Tzu-Yung Huang, and postdoctoral researcher Richard Grote from Bassett’s lab.

Additional Bassett Lab members David Hopper, Annemarie Exarhos and Garrett Kaighn contributed to the work, as did Gerald Lopez, director of Business Development at the Singh Center for Nanotechnology, and two members of Amsterdam’s Center for Nanophotonics, Sander Mann and Erik Garnett.

The study was published in Nature Communications.

The key to harnessing the potential power of quantum systems is being able to create or find structures that allow electron spin to be reliably manipulated and measured, a difficult task considering the fragility of quantum states.

Bassett’s lab approaches this challenge from a number of directions. Recently, the lab developed a quantum platform based on a two-dimensional (2D) material called hexagonal boron nitride which, due to its extremely thin dimensions, allows for easier access to electron spins. In the current study, the team returned to a 3D material that contains natural imperfections with great potential for controlling electron spins: diamonds.

Small defects in diamonds, called nitrogen-vacancy (NV) centers, are known to harbor electron spins that can be manipulated at room temperature, unlike many other quantum systems that demand temperatures approaching absolute zero. Each NV center emits light that provides information about the spin’s quantum state.

Bassett explains why it is important to consider both 2D and 3D avenues in quantum technology:

“The different material platforms are at different levels of development, and they will ultimately be useful for different applications. Defects in 2D materials are ideally suited for proximity sensing on surfaces, and they might eventually be good for other applications, such as integrated quantum photonic devices,” Bassett says. “Right now, however, the diamond NV center is simply the best platform around for room-temperature quantum information processing. It is also a leading candidate for building large-scale quantum communication networks.”

So far, it has only been possible to achieve the combination of desirable quantum properties that are required for these demanding applications using NV centers embedded deep within bulk 3D crystals of diamond.

Unfortunately, those deeply embedded NV centers can be difficult to access since they are not right on the surface of the diamond. Collecting light from those hard-to-reach defects usually requires a bulky optical microscope in a highly controlled laboratory environment. Bassett’s team wanted to find a better way to collect light from NV centers, a goal they were able to accomplish by designing a specialized metalens that circumvents the need for a large, expensive microscope.

“We used the concept of a metasurface to design and fabricate a structure on the surface of diamond that acts like a lens to collect photons from a single qubit in diamond and direct them into an optical fiber, whereas previously this required a large, free-space optical microscope,” Bassett says. “This is a first key step in our larger effort to realize compact quantum devices that do not require a room full of electronics and free-space optical components.”

Metasurfaces consist of intricate, nanoscale patterns that can achieve physical phenomena otherwise impossible at the macroscale. The researchers’ metalens consists of a field of pillars, each 1 micrometer tall and 100-250 nanometers in diameter, arranged in such a way that they focus light like a traditional curved lens. Etched onto the surface of the diamond and aligned with one of the NV centers inside, the metalens guides the light that represents the electron’s spin state directly into an optical fiber, streamlining the data collection process.

“The actual metalens is about 30 microns across, which is about the diameter of a piece of hair. If you look at the piece of diamond that we fabricated it on, you can’t see it. At most, you could see a dark speckle,” says Huang. “We typically think of lenses as focusing or collimating, but, with a metastructure, we have the freedom to design any kind of profile that we want. It affords us the freedom to tailor the emission pattern or the profile of a quantum emitter, like an NV center, which is not possible, or is very difficult, with free-space optics.”

To design their metalens, Bassett, Huang and Grote had to assemble a team with a diverse array of knowledge, from quantum mechanics to electrical engineering to nanotechnology. Bassett credits the Singh Center for Nanotechnology as playing a critical role in their ability to physically construct the metalens.

“Nanofabrication was a key component of this project,” says Bassett. “We needed to achieve high-resolution lithography and precise etching to fabricate an array of diamond nanopillars on length scales smaller than the wavelength of light. Diamond is a challenging material to process, and it was Richard’s dedicated work in the Singh Center that enabled this capability. We were also lucky to benefit from the experienced cleanroom staff. Gerald helped us to develop the electron beam lithography techniques. We also had help from Meredith Metzler, the Thin Film Area Manager at the Singh Center, in developing the diamond etch.”

Although nanofabrication comes with its challenges, the flexibility afforded by metasurface engineering provides important advantages for real-world applications of quantum technology:

“We decided to collimate the light from NV centers to go to an optical fiber, as it readily interfaces with other techniques that have been developed for compact fiber-optic technologies over the past decade,” Huang says. “The compatibility with other photonic structures is also important. There might be other structures that you want to put on the diamond, and our metalens doesn’t preclude those other optical enhancements.”

This study is just one of many steps towards the goal of compacting quantum technology into more efficient systems. Bassett’s lab plans to continue exploring how to best harness the quantum potential of 2D and 3D materials.

“The field of quantum engineering is advancing quickly now in large part due to the convergence of ideas and expertise from many disciplines including physics, materials science, photonics and electronics,” Bassett says. “Penn Engineering excels in all these areas, so we are looking forward to many more advances in the future. Ultimately, we want to transition this technology out of the lab and into the real world where it can have an impact on our everyday lives.”

This work was supported by the National Science Foundation through awards ECCS-1553511 and ECCS-1842655, and by the Netherlands Organisation for Scientific Research under the European Union’s Seventh Framework Programme, (FP/2007-2013)/ERC grant agreement no. 337328, Nano-EnabledPV. Facilities and instrumentation were supported by the NSF through Penn’s Materials Research Science and Engineering Center under grant DMR-1720530 and through the National Nano-technology Coordinated Infrastructure under grant ECCS-1542153.

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Sustainable method to produce lifesaving opiate antidotes at reduced cost

Overdose from opiates has skyrocketed. According to the National Center for Health Statistics, on average, 130 Americans die every day from an opioid overdose.1 The high cost of antidotes such as NARCAN® prevents many first responders from having access to lifesaving antidotes when they need it most.2 Researchers at the Donald Danforth Plant Science Center have identified a new method of producing these compounds using a microorganism discovered in a waste stream associated with the processing of opium poppy. This green chemistry process has the potential to greatly reduce the cost of the antidote drugs as well as decrease chemicals currently used that result in large amounts of harmful waste. Details of the discovery were published as the cover story in the journal Nature Sustainability: “Enzyme morphinan N-demethylase for more sustainable opiate processing.”

“Enzymes perform reactions at efficiencies that surpass synthetic chemistry, thereby reducing the cost and impact of drug production on the environment. We work now to optimize production levels of the enzyme to a scale sufficient for industrial processes. Greener manufacturing would make a difference in people’s lives,” said Megan Augustin, lead author and research associate in the Kutchan lab at the Danforth Center.

Naturally occurring opiates, such as morphine and thebaine, are produced in poppy species. Thebaine is converted into painkillers and opiate addiction treatments, the latter requiring a chemical reaction called N-demethylation. Current opiate N-demethylation utilizes noxious reagents, resulting in harmful waste. One way to make opiate production more sustainable is to use enzymes rather than chemicals. Microorganisms provide a rich source of enzymes useful for metabolizing unique compounds in their environment. Augustin and her colleagues probed an opium processing waste stream sample to identify an organism capable of catalyzing opiate N-demethylation. To identify a biocatalyst, a sludge sample was subjected to minimal medium containing thebaine as the sole carbon source. This led to the discovery of Thebainfresser, a Methylobacterium that metabolizes opiates by removing the N-methyl group. N-demethylation was induced following growth in minimal medium, a characteristic that led to discovery of the underlying gene MND (morphinan N-demethylase). The enzyme MND was found to be robust and versatile, N-demethylating structurally diverse substrates at varying temperatures and pH levels. In addition, MND tolerated selected organic solvents and maintained activity when immobilized. These properties make it an attractive candidate for further development for pharmaceutical manufacture.

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Materials provided by Donald Danforth Plant Science Center. Note: Content may be edited for style and length.

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Health24.com | Bedroom light at night might cause women weight gain

Women, beware: Sleeping with a light on or the TV going in your bedroom could make you put on weight.

That’s the finding of new research published in JAMA Internal Medicine. While the study doesn’t prove that sleeping with a light on causes weight gain, it suggests the two may be linked, the researchers said.

Exposure to artificial light

“Turning off the light while sleeping may be a useful tool for reducing a possibility of weight gain and becoming overweight or obese,” said lead author Dr Yong-Moon Mark Park. He is a postdoctoral fellow at the US National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina.

Park said that exposure to artificial light at night may suppress the sleep hormone melatonin and disrupt the natural sleep-wake cycle.

“It also may disturb day-to-day variations of stress hormones and affect other metabolic processes in ways that contribute to weight gain,” Park added.

Keeping a light on might also result in poorer sleep. Shorter sleep could prompt you to exercise less and eat more, he noted.

For the study, Park’s team relied on self-reported data from nearly 44 000 women, aged 35 to 74. They weren’t shift workers, daytime sleepers or pregnant when the study began.

Women who slept with a light on were 17% more likely to gain around 5kg or more over five years, the study found. And the level of artificial light seemed to matter, Park said.

Findings not directly related

“For example, using a small nightlight was not associated with weight gain, whereas women who slept with a light or television on were,” he explained.

The findings didn’t change when researchers accounted for women’s diet and physical activity, which suggests that light during sleep may be important in weight gain and obesity.

Dr David Katz, director of the Yale-Griffin Prevention Research Center in New Haven, Connecticut, reviewed the findings. He said the link between exposure to artificial light at night and obesity may not indicate that one causes the other.

“As with any study of association, two findings are true – true, but not directly related,” he said.

The key takeaway relates to poor sleep, Katz suggested.

“Sleep deficiency and impairment is a known obesity risk factor, for reasons ranging from mood and reduced restraint, to changes in hormonal balance,” he said.

It’s also possible that reliance on artificial light at night and obesity are both linked to other factors, such as “loneliness, anxiety or some form of social insecurity”, Katz said.

Image credit: iStock

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Health24.com | 5 tips to manage your child’s asthma

For many children with asthma, coughing is an early warning sign of a flare-up, an expert says.

Understanding asthma and knowing what to expect can help parents prevent or lessen the severity of asthma attacks, said Dr Ronald Ferdman, a paediatric allergist-immunologist at Children’s Hospital Los Angeles.

With proper management, children with asthma can exercise normally, sleep well at night, attend school and avoid the emergency room. Parents shouldn’t settle for less, Ferdman said.

He provided the following tips to help parents protect their children’s health:

Know the triggers

It’s important to minimise children’s exposure to asthma triggers you can control, such as tobacco smoke, dust and pet dander. Colds and weather changes are out of your control, but knowing they can exacerbate asthma can keep you ahead of flare-ups.

children with asthma

Don’t limit physical activity

In general, it’s better to give children a dose of their quick-relief medication (albuterol or levalbuterol) before they exercise and sometimes afterwards.

children with asthma

Be prepared

Store quick-relief medicine at every location where your child spends time, including school, home or day care. Refill these prescriptions before they run out.

children with asthma

Don’t wait to medicate

Any respiratory symptoms, such as coughing, may be an early sign of an asthma flare-up. Don’t wait until a child is wheezing to give asthma medication. It is safer to give children a dose of their rescue medicine early – even if it’s not entirely clear if their asthma is flaring up – than to wait until symptoms become severe. Lung infections are the most common trigger of asthma attacks in children. Kids with asthma should get a dose of their quick-relief medication as soon as they develop symptoms of a cold.

children with asthma

Stick to the treatment plan

Taking controller (preventative) medication each day is the most effective way to control chronic asthma. Children should take this medication even if they don’t have symptoms. This simply means their treatment is working. Stopping this medication without talking to a child’s doctor is risky.

children with asthma

Image credit: iStock

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Health24.com | Add a sweet surprise to your veggie juice: chocolate

Juicing nutrient-rich green vegetables like kale, broccoli and spinach gives you a brew of many vitamins and minerals, all in just one cup.

But green juices can have an overpowering flavour, so many people want to cut their “bite” with the natural sweetness of fruit and/or a bit of sweetener, such as plant-based stevia or a teaspoon of maple syrup or agave. Here’s how:

If you have an overripe banana on your counter, toss it into the juicer with your greens and an apple for a juice that tastes like a sweet banana shake.

Adding cherries, blueberries or blackberries will also mask the flavour of fresh greens while contributing plenty of antioxidants and other nutrients. If you’re a fan of spice, add a piece of peeled ginger root for extra kick.

Do you crave chocolate? Juicing blueberries and cocoa powder along with greens is a delicious way to satisfy the urge. This recipe also calls for some water to give your juice volume, plus vanilla extract for richness. Finish it with a hint of sweetener and you have a chocolate drink that’s fit for any sweet tooth.

Chocolate Juice

  • 1 cup blueberries, fresh or frozen
  • 1 teaspoon vanilla extract
  • 1 tablespoon cocoa powder
  • 2 cups baby spinach
  • 1/2 cup water
  • Sweetener or sugar substitute of your choice

If using frozen berries, defrost before juicing. Place all ingredients except the sweetener in your juicer and process. Add sweetener to taste and stir well.

Yield: 1 serving

Image credit: iStock

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Contaminated blood inquiry: ‘My four brothers died’

John Cornes, one of six brothers infected by contaminated blood, said his family had been “ripped apart”.

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How Does ASMR Work? The Science Behind Those Brain-Tingling Sounds

What’s with all the lip-smacking, slime-poking, plastic-crinkling content on YouTube lately? To some people, it’s a whole lot of woo-woo weirdness. But to those who experience ASMR, it’s a convenient form of self-care. They tune in to bliss out.

It can be hard to wrap your mind around ASMR if you haven’t personally experienced the head buzz that certain sights and sounds can elicit. People watch ASMR videos for the deeply calming, brain-tingling sensation that it produces. They say it helps them relax and fall asleep. (Others find ASMR really irritating. More on that later.)

A few big brands have even mimicked ASMR techniques in ads targeting young adults. Actress Zoë Kravitz famously whispered and tapped her way through a 2019 Super Bowl ad for Michelob Ultra. Ikea borrowed the technique for a 25-minute digital spot on dorm room products.

RELATED: 11 Relaxation Tips That Really Work

Researchers are trying to pin down the origin and potential health benefits of ASMR. At this point, the science woefully lags behind its cultural appeal. There’s no proof that ASMR is an antidote for anxiety, depression, chronic pain, or insomnia, as some users claim. That’s the hope, of course. But if you just want to unwind and de-stress, experts see little harm in giving it a whirl and watching a few videos.

Defining ASMR

ASMR stands for “autonomous sensory meridian response,” a term coined in 2010. People describe a deeply relaxing sensation with tingling in the scalp as a result of a certain stimulus—often a gentle sound. Some say the feeling cascades down their spine to their limbs.

You might have heard it called a “brain orgasm,” even though the static-like feeling isn’t necessarily sexual.

Real-life experiences, like having your hair shampooed and styled, can set off brain tingles. But even just watching videos with certain sounds and visuals trigger an ASMR response in some people.

What is ASMR video?

The glut of ASMR content on social media has spurred growing interest in the phenomenon. Reddit has an ASMR community of more than 183,000 members who share videos and experiences. ASMR videos are meant to appeal to a wide range of audiovisual senses, because what lulls one person’s brain into a blissful state may be a dud for someone else.

Hushed whispers are a top trigger. Other people respond to crisp sounds, gentle movements, or personal attention via role-playing scenarios, such as a video artist pretending to give you a head massage.

RELATED: 15 Everyday Sounds and How They Affect Your Hearing

Craig Richard, PhD, professor in the department of biopharmaceutical sciences at Shenandoah University in Winchester, Virginia, is the author of the book Brain Tingles, an ASMR user guide. He recalls experiencing ASMR as a kid coming home after school to watch Bob Ross, host of public television’s The Joy of Painting.

“He would turn my brain to fuzz—this enjoyable, relaxing fuzziness,” Richard tells Health. Turns out the late painter’s soothing instructions and wispy brush strokes have wide appeal in the ASMR community.

Nitin Ahuja, MD, a gastroenterologist and assistant professor of clinical medicine at the University of Pennsylvania, recently wrote about a specific genre of ASMR videos in which video artists “play doctor.” These clinical role-playing videos consist of everything from virtual vision testing and Reiki healing to pretend gynecologic exams.

Dr. Ahuja tells Health that this content raises an interesting question: Can people derive therapeutic benefit from the mere act of caregiving?

Is ASMR real?

It’s unclear how many people experience ASMR, since no one has conducted a nationally representative survey. Nor have researchers defined a “phenotype,” or set of traits defining people who get the vibe. With only 10 peer-reviewed studies published to date, ASMR research “is clearly in its embryonic stage,” says Richard, who is also the founder of ASMRUniversity.com, an ASMR repository.

The first rigorous study to assess the impact of ASMR on mood and physiology was published in 2018. Researchers found that watching ASMR videos aroused pleasant feelings, but only in people who self-identify as having ASMR and only watching ASMR videos (not non-ASMR videos). What’s more, the ASMR group showed significant reductions in heart rate (of more than three beats per minute) versus a control group that did not experience the sensation.

Separately, Richard and his colleagues conducted the first brain-scan study of people watching ASMR videos. The small study, involving just 10 participants, allowed researchers to compare images of people’s tingling and non-tingling moments.

RELATED: Unconventional Therapies for Anxiety and Depression

It turns out that the areas of the brain that light up when someone experiences tingles are very similar to the areas activated when someone is being groomed, cared for, or affectionately interacting with their partner, he explains.

What causes ASMR?

So what accounts the ASMR experience, and why do only some people experience it? Is it the release of mood-enhancing brain chemicals? Or could it be something more primitive, like a hardwired reaction to pleasurable sensations?

Dr. Ahuja says the current body of research “doesn’t really get at anything mechanistic.” Still, there seems to be something to it, he tells Health, because people feel better when they watch these videos. “At worst,” he reasons, “it’s a placebo effect.”

If you haven’t yet experienced ASMR, that doesn't necessarily mean you never will. The best way to know, says Dr. Ahuja, is probably to give some videos a try and see how you feel.

ASMR and other sensory conditions

Some research suggests ASMR may overlap with synesthesia, an unusual condition that involves hearing colors or textures, for example, or seeing or tasting sounds. But don’t confuse ASMR with the goose bumps you get when you hear a piece of music that moves you. That’s called frisson, a French word for shiver.

RELATED: 5 Surprising Things Men and Women Sense Differently

“Brain tingles are subtle, sparkly, and you feel them a little bit more in your head,” Richard explains.

And if you are completely, unreasonably annoyed by these videos of people tapping, crinkling, or chewing, there’s a perfectly good explanation for that, too. You might have something called misophonia, an extreme reaction to certain sights and sounds—actually the exact opposite of ASMR.

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Mom Kicked Out of Golden Corral for Crop Top Says She Was Discriminated Against Because of Weight

A woman says she was told to leave a Pennsylvania Golden Corral location because she was dressed “too provocatively” in a crop top.

Sueretta Emke explained the incident in a now-viral Facebook post last week. As she writes, she was at a Golden Corral location in Erie on Sunday, May 26 to celebrate her son’s birthday with her husband, her best friend and her friend’s kids.

Emke then alleges that she was approached by a male manager who told her she was dressed “too provocatively” and that another customer had complained. According to her account, the manager told her she needed to put on another piece of clothing or leave.

RELATED: A Mom and Her Toddler Were Kicked Off a Flight Because of This Insanely Rare Skin Condition

“He never would tell me exactly what I was showing too much of,” she wrote. “When I asked … he would respond that it wasn’t his place to say.”

In the end, Emke writes that she was forced to leave the restaurant — and she believes she was discriminated against because of her weight.

“I have seen people in there wearing less and nothing is said to them,” she wrote, “but I really do believe something was said to me because I’m not thin so it’s not considered sexy.”

RELATED: Teenager with Tourette Syndrome Says She Was Asked to Leave Theater Before Start of Avengers

In a statement to PEOPLE, Golden Corral said: “We strive to make all of our guests feel welcome and comfortable, but it appears we didn’t meet the mark in this situation.”

The statement added that the chain restaurant doesn’t “offer specific guidelines” on a dress code.

“While we don’t offer specific guidelines on attire for our franchise locations, it is never our intention to offend anyone. We are grateful the issue was brought to our attention because it represents an education opportunity and a chance to make amends with a guest we disappointed,” the statement said.

RELATED: Ex-KFC Employee Awarded More Than $1.5 Million in Breastfeeding Discrimination Case

According to Today, the manager at the location sent Emke an apology letter, as well as gift cards.

“I’ve never owned a crop top before and I was nervous at first about wearing it, but my husband loved the way it looked on me and encouraged me to wear it since I liked it so much,” Emke explained in her post. “I really felt cute in it and now I never wanna wear that shirt again.”

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Postcode lottery for speech therapy, says commissioner

England’s children’s commissioner highlights “enormous variation” in money spent across the regions.

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