Ulcerative colitis: ‘I was going to the toilet up to 30 times a day’

Two young women with ulcerative colitis share photos of their stoma bags to normalise the condition.

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Urgent action required to protect world’s coral reefs from disappearing within three decades, warn experts

An international team of environmental scientists have published a series of significant recommendations to protect, conserve and study the world’s coral reefs — the ‘canaries in the coal mine’ of climate change.

The Vibrant Oceans Initiative presented their white paper on the future of the delicate and crucial habitats at the Our Oceans Conference held in Palau on Thursday.

Drawing on expertise from universities and wildlife conservation groups from across the world, including the University of Leicester, the group provide six key recommendations intended to promote the ‘persistence and survival’ of coral reefs.

Forecasts show that coral reef ecosystems around the globe — key to huge numbers of marine species and a source of food, livelihoods, and cultural heritage for half a billion people — are likely to become functionally degraded by 2050, if the goals of the Paris Agreement are not met.

Even with drastic emission reductions to ensure global warming is kept within 1.5°C above pre-industrial levels, up to 90% of the world’s corals could still vanish in the next three decades, leaving behind a reef structure that will lose many of its functions.

Jens Zinke is a Professor of Palaeobiology at the University of Leicester, whose research examines large coral habitats to track environmental and climate change over the last three centuries into the modern day. Speaking about the report, of which he is a co-author, Professor Zinke said:

“Coral reefs are the ‘canaries in the coal mine’ when it comes to sensing ecosystems under stress from ocean warming due to climate change. Corals can sense when ocean temperatures exceed a dangerous threshold and warn us when we need to take measures.

“Our research has shown that coral reefs have been severely impacted by ocean warming in the past three to four decades, yet some reef locations show lower rates of warming or benefit from mitigating circumstances due to local oceanography.

“Some reefs have the ability to resist or recover from thermal stress faster than others, and these reefs may serve as sanctuaries under future warming. This is a major new research direction — to find those locations and protect them before they are gone.”

In 2018 the Vibrant Oceans group identified 50 reefs that are most likely to resist and survive climate change. The habitats are located largely in the Pacific and Indian oceans, with further reefs in the Caribbean and east of Africa.

Previously the 50 reefs were mainly chosen at sites that escaped climate change. Now, the scientists call for a wider portfolio of reefs that should include resistant and fast-recovering reefs.

The group’s latest recommendations, presented in the white paper ‘Forecasting Climate Sanctuaries for Securing the Future of Coral Reefs’, include:

  • Continuation of the 50 Reefs approach as ‘climate change avoidance sanctuaries’ as a priority for investment in coral reef conservation.
  • Expansion of the 50 Reefs conservation portfolio for climate change to include coral resistance and recovery sanctuaries.
  • Increase in support for regional evaluations of the health of the 50 Reefs portfolio, and sustainable financing initiatives to support the implementation of regional portfolios.
  • Catalysing large-scale, data-driven coral reef monitoring efforts to test and develop new models and predictions of climate sanctuaries.
  • Use of the latest climate coral reef science to guide investments, especially as the impacts of climate change accelerate and produce novel environmental stresses and responses among reefs.
  • Embracing a far-reaching approach to the management of 50 Reefs sites, including connections to broader seascapes, fisheries and water quality management, mitigation of other pressures (for example, industrial development), so that effective and equitable management has measurable benefits for coral reefs and coastal communities.

‘Forecasting Climate Sanctuaries for Securing the Future of Coral Reefs’ is available in full from the Wildlife Conservation Society (WCS): https://wcs.org/coral-science-whitepaper

Funding partners for the initial Vibrant Oceans study include Bloomberg Philanthropies, while ongoing conservation work partners include Oceans 5, the Paul G. Allen Family Foundation, and Tiffany & Co. Foundation.

Conservation partners include the WCS, Rare, The Nature Conservancy, Blue Ventures, and Conservation Ecosystem Partnership Fund.

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

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Study finds infertility history linked with increased risk of heart failure

A new study finds that a history of infertility is associated with increased risk of heart failure. Published in the Journal of the American College of Cardiology, researchers from Massachusetts General Hospital (MGH) revealed that women who had experienced infertility had a 16% increased risk of heart failure compared with women who did not have an infertility history.

“We are beginning to recognize that a woman’s reproductive history tells a lot about her future risk of heart disease,” says first author Emily Lau, MD, MPH, cardiologist and director of the Menopause, Hormones & Cardiovascular Clinic at MGH. “Whether a woman has difficulty becoming pregnant, what happens during her pregnancies, when she transitions through menopause all influence her risk of heart disease later in life.”

Infertility affects about 1 in 5 US women and includes a spectrum of conception difficulties, but its link with heart failure has not been well-studied until recently. Partnering with the Women’s Health Initiative (WHI), which was designed in the early 1990s and queried a woman’s reproductive history, Lau and colleagues studied postmenopausal women from the WHI and examined whether infertility was associated with development of heart failure.

There are two types of heart failure: heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Ejection fraction is a measurement related to the volume percentage of blood that is pumped from the left ventricle of the heart during each beat. An ejection fraction less than 50% is commonly viewed as abnormal or reduced.

The team found an association between infertility and overall heart failure, specifically with HFpEF, a form of heart failure that is far more common in women regardless of fertility history. Among the 38,528 postmenopausal women studied, 14% of the participants reported a history of infertility. Over a 15-year follow up period, the researchers noted that infertility was associated with 16% future risk of overall heart failure. When they examined heart failure subtypes, they found that infertility was associated with a 27% increased future risk of HFpEF.

Over the past decade, HFpEF (where the heart muscle does not relax well) as opposed to HFrEF (where the left ventricle does not pump well), has become the dominant form of heart failure in both men and women. But it remains more common in women. “It’s a challenging condition because we still do not completely understand how HFpEF develops and we do not have very good therapies to treat HFpEF,” says Lau.

“I think our findings are particularly noteworthy because heart failure with preserved ejection fraction is more prevalent in women,” says Lau. “We don’t understand why we see HFpEF more in women. Looking back in a woman’s early reproductive life may give us some clues as to why.” Of note, the team observed that the link persisted regardless of whether an individual eventually conceived or had a live birth.

The increased risk was independent of traditional cardiovascular risk factors and other infertility-related conditions. “There has been some suggestion in previous studies that women with infertility do have more cardiometabolic risk factors,” says Lau, but the team did not find that cardiometabolic risk factors explained the link between infertility with heart failure in this study. They also looked to see if other infertility-related conditions like thyroid disease, irregular menses, and early menopause explained the association between infertility and heart failure but did not evidence to support that hypothesis either.

“So it really begs the question: what are the mechanisms driving the association between infertility and heart failure,” says Lau. Is it shared risk factors, or is infertility on the causal pathway? She mentions vascular and endothelial dysfunction may be involved and plans on eventually clarifying the mechanism underlying the link between infertility and heart failure. In the future, Lau hopes to conduct a prospective study of women with an infertility history involving exercise parameters, vascular measures, and more, to solve the mystery.

“We as scientists and doctors are beginning to recognize how important a woman’s reproductive history is for their future risk of heart disease. Infertility is one of many cardiovascular risk factors, such as hypertension and high blood pressure, but reproductive history is not routinely considered as part of the cardiovascular risk assessment,” says Lau. Since people do not tend to develop heart failure until well in their 60s and beyond, and infertility is mostly experienced in the 20s, 30s, and 40s, many physicians are not thinking about the connection. “We cannot change a woman’s history of infertility, but if we know a woman has had a history of infertility, we can be more aggressive about counseling her about other modifiable risk factors including high blood pressure, high cholesterol, smoking, and beyond.”

This research was supported in part by the National Institutes of Health and American Heart Association.

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What food sector needs to know about how to reduce sodium

Sodium is an essential micronutrient, but the amount we need is small. Three slices of bread or one teaspoon of table salt will do it, and chances are your daily sodium intake is far greater. More than 90% of Americans consume too much sodium, which can lead to hypertension, high blood pressure, and increased risk of heart disease and stroke.

Most of the excess sodium comes from processed and packaged foods, so the food industry and food scientists continuously look for ways to reduce sodium. A new paper from the University of Illinois provides a comprehensive review of scientific literature on sodium reduction strategies in food production.

“Sodium overconsumption is a huge health concern, and the FDA has recommended sodium reduction in food since the 1980s, but we haven’t succeeded yet. While the unit volume of salt in the food supply has not increased, the amount of sodium consumption has gone up, because we just consume a lot of food,” says Soo-Yeun Lee, professor in the Department of Food Science and Human Nutrition (FSHN) at U of I and co-author on the paper.

We only need around 450 milligrams (mg) of sodium per day, and the recommended maximum amount is 2,300 mg, or 1,500 mg for those at risk for hypertension. But average consumption exceeds 3,000 to 3,500 mg per day — or 50% to 100% above the upper limit. More than 70% of our sodium intake comes from processed and packaged foods, primarily cured meats, bread, cheese, and soups.

The researchers conducted a scoping review including primary studies, literature reviews, book chapters, and patents covering sodium reduction in food products. They focused on studies that included sensory data with human subjects, because palatability is essential for consumer acceptance.

“In this review, we looked at different food systems. The way you would reduce salt in a solid system, like a topical application on snack foods, such as salted peanuts or salted chips, would be very different from embedded application in semi-solid foods like cheese or bread. And in a liquid system like soup, where it is completely dissolved, it would be really different in the way we could reduce salt yet provide the palatability it gives,” Lee states.

“We’re hoping this work will provide insight into the wide variety of salt-reducing technologies that exist. This can help food companies be more informed to use different strategies than what they have been doing,” she adds.

The researchers identified five main strategies: Salt reduction, salt replacers, flavor modification, physical modification, and functional modification.

“The most obvious one is to remove salt from the recipe, and that is a key component in all of the strategies when sodium reduction is the goal,” says Aubrey Dunteman, graduate student in FSHN and lead author on the paper.

But it is not possible to completely eliminate sodium, because it has both sensory and functional properties. For example, it is used for meat preservation and to make bread dough rise.

“A lot of the studies we looked at combined more than one method, such as salt removal with salt replacers and flavor modification or salt removal and physical modification,” Dunteman says.

Many studies used salt replacers such as potassium chloride, calcium chloride, or other chloride or acid salts. However, these substitutes tend to have a bitter taste, so they are often used in combination with flavor modifications, such as umami substances or bitter blockers.

“Another method is physical modification. For example, you can encapsulate the salt crystals, which changes how the salt is dissolved in the mouth. This can alter the saltiness perception allowing for a reduction in the amount of sodium necessary to create the salty taste. You can also create an uneven distribution of the salt in a product that can further help enhance the perceived saltiness of the food product through taste contrast,” Dunteman explains.

“Finally, there is functional modification. For example, you could move away from a sodium-based preservative in cured meats, perhaps using a celery-powder preservative instead of sodium nitrate.”

Functional modification is less represented in the scoping review because this type of sodium reduction research typically does not incorporate a sensory component as a main assessment method, Dunteman notes.

If consumers want to reduce their salt intake, the best strategy is to cook your own food and limit your consumption of processed and packaged foods. You can also wean yourself off salt with practice, essentially go on a “salt diet.”

“If you’re cooking at home, you can intentionally reduce salt and you’ll appreciate the reduced saltiness perception as time goes on. People can adjust to the reduced salt level, but it’s a learning and adapting process. You can also add flavor enhancers such as herbs and spices,” Lee suggests.

“If you are a consumer of canned soup, for example, you can buy a low-sodium version and add salt. Then you can gradually modify the amount of salt you add, so you can make it palatable to your taste,” she notes.

The research was supported by the Institute for the Advancement of Food and Nutrition Sciences (IAFNS) through an ILSI North America Sodium Committee grant. IAFNS is a non-profit science organization that pools funding from industry collaborators and advances science through the in-kind and financial contributions from public and private sector participants. IAFNS had no role in the design, analysis, interpretation, or presentation of the data and results.

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Covid: Thousands of vaccinators get permanent NHS roles

The 11,483 people who have taken permanent NHS England jobs include former gym managers and air crew.

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I decided not to let cancer stop me dating

Katherine Crowson was 29 when she was diagnosed, and wanted to know when she would get her life back.

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Body’s response to different strains of tuberculosis could affect transmission

Two strains of the bacterium causing tuberculosis have only minor genetic differences but attack the lungs in completely different fashion, according to Rutgers researchers.

The findings, published in the journal Nature Communications, could help break the cycle of rapid transmission of TB, the second-leading infectious killer in the world after COVID-19, according to the World Health Organization. The disease mechanisms uncovered in the study could also provide answers about why treatments work in some patients but not others.

“These findings implicate strain differences as having an important effect on the response of lung alveolar macrophages and how tuberculosis manifests itself in the body and how it is transmitted,” said study author Padmini Salgame, associate director of the Public Health Research Institute at Rutgers New Jersey Medical School. “We also believe it will inform anyone hoping to devise more effective treatments.”

To better understand transmission and how it relates to treatment outcomes, the researchers focused on the impact these two strains of Mycobacterium tuberculosis have on the lungs. Though the strains differ slightly in their gene sequences, one is regarded as “high transmission” because it spreads easily and the second as “low transmission” because it does not infect as readily. TB bacteria are spread through the air when persons with TB disease in their lungs cough, speak or even sing.

Using strains identified in a Rutgers collaborative study with researchers at Núcleo de Doenças Infecciosas (NDI)in Brazil comparing “high transmission” and “low transmission” households of people with TB, the scientists studied the immune pathways that the pathogen triggered in the lungs of the infected mice.

In mice infected with the high transmission strain, their lungs quickly formed clumps of immune cells known as granulomas that encased the invading bacteria, stopping development of a more virulent disease. In most cases, the granulomas broke down eventually, spilling their contents. Researchers believe that if the escaped bacteria are close enough to the bronchial airway, they could be expelled into the air as infectious aerosols.

“By inducing granulomas with the potential to develop into cavitary lesions that aids bacterial escape into the airways, high transmission M. tuberculosis strains are poised for greater transmissibility,” said Salgame, who is also a professor in the Department of Medicine.

In mice infected with the low transmission strain, the invading bacteria were slow to activate the lung alveolar macrophages and ended up producing patches of inflammation within the lungs that did not allow the bacteria to escape into airways and allowed them to conglomerate and intensify the infection, Salgame said.

The discovery of the different trajectories taken by the strains gives hope to new approaches to stopping transmission and treatment.

“We have long known that some individuals with TB are more infectious than others,” Salgame said. “However, until now, the mechanisms responsible for this variability in transmission between individuals with TB have not been well understood.”

Other Rutgers authors included Arianne Lovey, Sheetal Verma, Vaishnavi Kaipilyawar and Jerrold Ellner, all at the Center for Emerging Pathogens, and Seema Husain of The Genomics Center.

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Materials provided by Rutgers University. Original written by Kitta MacPherson. Note: Content may be edited for style and length.

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What’s the problem with calories on restaurant menus?

The new rules are taking away the joy of going out for a meal for some people with eating disorders.

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‘My cancerous tumour was as big as a kettle bell’

Stephanie Coles found a strange lump growing in her stomach area.

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DIY digital archaeology: New methods for visualizing small objects and artifacts

The ability to visually represent artefacts, whether inorganics like stone, ceramic and metal, or organics such as bone and plant material, has always been of great importance to the field of anthropology and archaeology. For researchers, educators, students and the public, the ability to see the past, not only read about it, offers invaluable insights into the production of cultural materials and the populations who made and used them.

Digital photography is the most commonly used method of visual representation, but despite its speed and efficiency, it often fails to faithfully represent the artefact being studied. In recent years, 3-D scanning has emerged as an alternative source of high-quality visualizations, but the cost of the equipment and the time needed to produce a model are often prohibitive.

Now, a paper published in PLOS ONE presents two new methods for producing high-resolution visualizations of small artefacts, each achievable with basic software and equipment. Using expertise from fields which include archaeological science, computer graphics and video game development, the methods are designed to allow anyone to produce high-quality images and models with minimal effort and cost.

The first method, Small Object and Artefact Photography or SOAP, deals with the photographic application of modern digital techniques. The protocol guides users through small object and artefact photography from the initial set up of the equipment to the best methods for camera handling and functionality and the application of post-processing software.

The second method, High Resolution Photogrammetry or HRP, is used for the photographic capturing, digital reconstruction and three-dimensional modelling of small objects. This method aims to give a comprehensive guide for the development of high-resolution 3D models, merging well-known techniques used in academic and computer graphic fields, allowing anyone to independently produce high resolution and quantifiable models.

“These new protocols combine detailed, concise, and user-friendly workflows covering photographic acquisition and processing, thereby contributing to the replicability and reproducibility of high-quality visualizations,” says Jacopo Niccolò Cerasoni, lead author of the paper. “By clearly explaining every step of the process, including theoretical and practical considerations, these methods will allow users to produce high-quality, publishable two- and three-dimensional visualisations of their archaeological artefacts independently.”

The SOAP and HRP protocols were developed using Adobe Camera Raw, Adobe Photoshop, RawDigger, DxO Photolab, and RealityCapture and take advantage of native functions and tools that make image capture and processing easier and faster. Although most of these softwares are readily available in academic environments, SOAP and HRP can be applied to any other non-subscription based softwares with similar features. This enables researchers to use free or open-access software as well, albeit with minor changes to some of the presented steps.

Both the SOAP protocol and the HRP protocol are published openly on protocols.io.

“Because visual communication is so important to understanding past behavior, technology and culture, the ability to faithfully represent artefacts is vital for the field of archaeology,” says co-author Felipe do Nascimento Rodrigues, from the University of Exeter.

Even as new technologies revolutionize the field of archaeology, practical instruction on archaeological photography and three-dimensional reconstructions are lacking. The authors of the new paper hope to fill this gap, providing researchers, educators and enthusiasts with step-by-step instructions for creating high quality visualizations of artefacts.

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