Good and bad news for people with low back pain

Low back pain is a major cause of disability around the globe, with more than 570 million people affected. In the United States alone, health care spending on low back pain was $134.5 billion between 1996 and 2016, and costs are increasing.

“The good news is that most episodes of back pain recover, and this is the case even if you have already had back pain for a couple of months,” University of South Australia Professor Lorimer Moseley says.

“The bad news is that once you have had back pain for more than a few months, the chance of recovery is much lower. This reminds us that although nearly everyone experiences back pain, some people do better than others, but we don’t completely understand why.”

The systematic review and meta-analysis, conducted by an international team of researchers, included 95 studies with the goal of understanding the clinical course of acute (< 6 weeks), subacute (6 to less than 12 weeks) and persistent (12 to less than 52 weeks) low back pain.

For people with new back pain, pain and mobility problems lessened significantly in the first 6 weeks, but then recovery slowed.

This study filled a gap in a 2012 paper from the same research team, with new findings showing that many people with persistent low back pain (more than 12 weeks) continue to have moderate-to-high levels of pain and disability.

“These findings make it clear that back pain can persist even when the initial injury has healed,” Prof Moseley says.

“In these situations, back pain is associated with pain system hypersensitivity, not ongoing back injury. This means that if you have chronic back pain — back pain on most days for more than a few months — then it’s time to take a new approach to getting better.”

He notes that there are new treatments based on training both the brain and body that “focus on first understanding that chronic back pain is not a simple problem, which is why it does not have a simple solution, and then on slowly reducing pain system sensitivity while increasing your function and participation in meaningful activities.”

The authors state that identifying slowed recovery in people with subacute low back pain is important so that care can be escalated and the likelihood of persistent pain reduced.

Further research into treatments is needed to help address this common and debilitating condition, and to better understand it in people younger than 18 and older than 60 years.

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New reagent improves the process of making sulfur-containing compounds that may be used in medicines

During the past decade, there has been significant development of new sulfur containing compounds that are used in various industries, including pharmaceuticals and agricultural products. Sulfoximines, sulfonimidoyl fluorides and sulfonimidamides are types of sulfur-containing chemical compounds that have wide-ranging potential as therapeutic drugs. However, the synthesis process for these compounds is complex and has several limitations. In a new article published in Nature Chemistry, Moffitt Cancer Center researchers describe their development of a new reagent that allows a more efficient approach to make sulfoximines, sulfonimidoyl fluorides and sulfonimidamides that may be used in medicines.

There are four main chemical approaches that are commonly used to create sulfoximines, sulfonimidoyl fluorides and sulfonimidamides. Recently an additional approach called sulfur fluorine exchange (SuFEx) chemistry has gained attention. But the approach has several limitations to its widespread use, such as the requirement for the use of high pressures.

The Moffitt research team wanted to develop a more efficient process to create sulfoximines, sulfonimidoyl fluorides and sulfonimidamides. Through a variety of chemical experiments and processes, they developed a reagent called t-BuSF that serves as a hub in the SuFEx chemical process to synthesize these sulfur-containing compounds. The use of t-BuSF decreased the number of steps required to make these compounds and improved the reaction times and stability of their chemical precursors. The researchers further demonstrated the potential utility of t-BuSF in medicinal chemistry in over 70 examples and by preparing five therapeutical targets and intermediates. They showed that t-BuSF was able to create these products in high yields with fewer synthesis steps.

“Given the cost-effectiveness and the chemical space accessible from this reagent platform, it is expected to have positive impacts on the discovery sciences from the development of new medicines and agrochemicals to the discovery of new ligands, organocatalysts and materials,” said Justin Lopchuk, Ph.D., associate member of the Department of Drug Discovery at Moffitt.

This study was supported by the National Institutes of Health (R35-GM142577, P30-CA076292) and the University of South Florida’s Chemical Purification, Analysis, and Screening Core Facility.

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Measles jab campaign targets unprotected millions

More than three million children under 16 are at risk of becoming ill, NHS England says.

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Birmingham Children’s Hospital isolating measles patients

A&E consultant Chris Bird said the measures felt like going “back to Covid” in some ways.

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Sarah Ferguson’s ‘shock’ at skin cancer diagnosis

A spokesman says a cancerous mole was found while the duchess was having reconstructive surgery.

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Doctor uses Apple Watch to help passenger on flight

The medic intervenes while on a Ryanair flight to Verona for a skiing holiday.

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Medics told not to report illegal abortions to police

The Royal College of Obstetricians and Gynaecologists says women are being wrongly prosecuted.

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Endless biotechnological innovation requires a creative approach

Scientists working on biological design should focus on the idiosyncrasies of biological systems over optimisation, according to new research.

In a study, published today in Science Advances, researchers from the Universities of Bristol and Ghent have shown how exploring the unknown may be the crucial step needed to realise the continual innovation needed for the biotechnologies of the future.

Recognising the role of open-endedness in achieving this goal and its growing importance in fields like computer science and evolutionary biology, the team mapped out how open-endedness is linked to bioengineering practice today and what would be required to achieve it in the lab.

For success, algorithms used for biological design should not solely focus on moving toward a specific goal — such as better yield – but also consider the creation and maintenance of novelty and diversity in the solutions that have been found.

Dr Thomas Gorochowski, co-author and Royal Society University Research Fellow in the School of Biological Sciences at Bristol, explained: “When we try to design a complex biological process, it’s often tempting to just tweak something that partially works rather than take the risk of trying something completely new.

“In this work we highlight that in these situations the best solutions often come from unexpected directions, because we don’t always fully understand how everything works. With biology, there are lots of unknowns and so we need a vast and diverse toolkit of building blocks to ensure we have the best chance of finding the solution we need.”

Professor Michiel Stock, lead author from Ghent University, added: “Biological systems have a natural capacity for innovation that has led to the overwhelming biodiversity we see in nature today.

“Our own attempts to engineer biology, in contrast, lack this creativity — they are far more rigid, less imaginative, and often doesn’t make the best use of what biology is capable of.

“With all life around us originating from the open-ended process of evolution, wouldn’t it be awesome if we could harness some of that power for our own biological designs.”

The ability to create new biotechnologies is becoming increasingly important for tackling global challenges spanning the sustainable production of chemicals, materials and food, to advanced therapeutics to combat emerging diseases. Fueling this progress are innovations in how biology can be harnessed in new ways. This work supports this goal by offering a fresh direction for new research and design approaches.

The study was made possible due to a travel grant from the FWO Flanders and funding from the Royal Society, BBSRC and EPSRC.

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Ice age could help predict oceans’ response to global warming

A team of scientists led by a Tulane University oceanographer has found that deposits deep under the ocean floor reveal a way to measure the ocean oxygen level and its connections with carbon dioxide in the Earth’s atmosphere during the last ice age, which ended more than 11,000 years ago.

The findings, published in Science Advances, help explain the role oceans played in past glacial melting cycles and could improve predictions of how ocean carbon cycles will respond to global warming.

Oceans adjust atmospheric CO2 as ice ages transition to warmer climates by releasing the greenhouse gas from carbon stored within the deep ocean. The research demonstrates a striking correlation between global ocean oxygen contents and atmospheric CO2 from the last ice age to today — and how carbon release from the deep sea may rise as the climate warms.

“The research reveals the important role of the Southern Ocean in controlling the global ocean oxygen reservoir and carbon storage,” said Yi Wang, lead researcher and an assistant professor of Earth and Environmental Sciences at Tulane University School of Science and Engineering. Wang specializes in marine biogeochemistry and paleoceanography.

“This will have implications for understanding how the ocean, especially the Southern Ocean, will dynamically affect the atmospheric CO2 in the future,” she said.

Wang conducted the study with colleagues from the Woods Hole Oceanographic Institution, the world’s leading independent nonprofit organization dedicated to ocean research, exploration and education. She worked for the institute before joining Tulane in 2023.

The team analyzed seafloor sediments collected from the Arabian Sea to reconstruct average global ocean oxygen levels thousands of years ago. They precisely measured isotopes of the metal thallium trapped in the sediments, which indicate how much oxygen was dissolved in the global ocean at the time the sediments formed.

“Study of these metal isotopes on glacial-interglacial transitions has never been looked at before, and these measurements allowed us to essentially recreate the past,” Wang said.

The thallium isotope ratios showed the global ocean lost oxygen overall during the last ice age compared to the current warmer interglacial period. Their study revealed thousand-year global ocean deoxygenation during abrupt warming in the Northern Hemisphere, whereas the ocean gained more oxygen when abrupt cooling occurred during the transition from the last ice age to today. The researchers attributed the observed ocean oxygen changes to Southern Ocean processes.

“This study is the first to present an average picture of how the oxygen content of the global oceans evolved as Earth transitioned from the last glacial period into the warmer climate of the last 10,000 years,” said Sune Nielsen, associate scientist at WHOI and co-author of the research. “These new data are a really big deal, because they show that the Southern Ocean plays a critical role in modulating atmospheric CO2. Given that high latitude regions are those most affected by anthropogenic climate change, it is troubling that these also have an outsize impact on atmospheric CO2 in the first place.”

Other authors include Kassandra Costa, Sophie Hines, and Wanyi Lu.

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The megalodon was less mega than previously believed

A new study shows the Megalodon, a gigantic shark that went extinct 3.6 million years ago, was more slender than earlier studies suggested. This finding changes scientists’ understanding of Megalodon behavior, ancient ocean life, and why the sharks went extinct.

The Megalodon or megatooth shark is typically portrayed as a super-sized monster in popular culture, with recent examples in the sci-fi films “The Meg” (2018) and “Meg 2: The Trench” (2023). Previous studies assume that the shark likely reached lengths of at least 50 feet and possibly as much as 65 feet.

However, the Megalodon is largely known only from its teeth and vertebrae in the fossil record — a rather incomplete set of data from which to draw assumptions. Thus, the modern great white shark was traditionally used as a model for Megalodon bodies in previous studies. That model led researchers to conclude that the shark was round and stocky like great whites.

“Our team reexamined the fossil record, and discovered the Megalodon was more slender and possibly even longer than we thought. Therefore, a better model might be the modern mako shark,” said UCR biologist and paper first author Phillip Sternes. “It still would have been a formidable predator at the top of the ancient marine food chain, but it would have behaved differently based on this new understanding of its body.”

For the new study published in the journal Palaeontologia Electronica, a team of 26 scientists from around the world, co-led by Sternes and DePaul University paleobiology professor Kenshu Shimada, was inspired by differences in previously estimated body lengths for the Megalodon.

“It was a ‘eureka-moment’ when our research team realized the discrepancy between two previously published lengths for the same Megalodon specimen,” said Shimada.

The team then weighed in on a new comparison of Megalodon vertebra fossils to those of living lamniform shark relatives. “We measured the whole vertebral skeleton of a living great white shark with a CT scanner and compared that to the previous reconstruction of the Megalodon vertebral column,” Sternes said.

“It was still a giant, predatory shark. But the results strongly suggest that the Megalodon was not merely a larger version of the modern great white shark.”

A revised understanding of the Megalodon body type would in turn affect scientists’ understanding not only of the giant shark itself, but also of its impact on the ecology and evolution of marine ecosystems that shaped the present-day oceans.

There is no doubt the Megalodon is one of the largest marine predators ever to have lived. But a slimmer and more elongated body would suggest the Megalodon also had a longer digestive canal. Sternes explained that in this case, the sharks might have enjoyed enhanced absorption of nutrients, and may not have had to eat as often as previously believed.

“With increased ability to digest its food, it could have gone for longer without needing to hunt. This means less predation pressure on other marine creatures,” Sternes said. “If I only have to eat one whale every so often, whale populations would remain more stable over time.”

Some shark scientists have theorized that a natural decrease in prey led to the extinction of Megalodons. However, Sternes has another theory, in part supported by the revised understanding of its shape.

“I believe there were a combination of factors that led to the extinction, but one of them may have been the emergence of the great white shark, which was possibly more agile, making it an even better predator than the Megalodon,” Sternes said. “That competition for food may have been a major factor in its demise.”

The research team of shark experts from the U.S., UK, Austria, France, Japan, Mexico, Brazil, and Australia all feel that a revised understanding of ancient marine life would have a cascading effect on the oceans that are still visible today.

“Now that we know it was a thinner shark, we need to reinvestigate its lifestyle, how it really lived, and what caused it to die,” Sternes said. “This study represents a major stepping stone for others to follow up on.”

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