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Newswise — In a research letter published Dec. 27, 2016, in JAMA, University of Chicago physicians describe a new concern for patients in the hospital: distractions caused by the misfortune of other patients. The researchers found that when one patient on a typical 20-bed hospital unit took a turn for the worse – a cardiac arrest, for example, or being transferred to an intensive-care unit – the other patients on that ward were at increased risk for their own setbacks. In the six hours after a critical-illness event, the odds that a second patient in the same unit would undergo a comparable crisis increased by about 18 percent. If there were two such events during a six-hour time period, the risk of yet another occurrence went up by about 53 percent. Risks were slightly higher when the initial critical illness events occurred at night. Cardiac arrests, urgent ICU transfers or patient deaths were also associated with delayed discharge from the hospital for the other patients on the same unit. “This should serve as a wake-up call for hospital-based physicians,” said study author Matthew Churpek, MD, MPH, PhD, assistant professor of medicine at the University of Chicago. “Our data suggests that after caring for a patient who becomes critically ill on the hospital wards, we should routinely check to see how the other patients on the unit are doing,” Churpek said. “Following these high-intensity events, our to-do list should include a thorough assessment of the other patients on the unit, to make sure none of them are at risk of slipping through the cracks.” Luckily, such events were relatively rare. Nearly 84,000 adult patients were admitted to non-ICU beds at the University of Chicago Medicine from 2009 to 2013. About five percent of those patients were subsequently transferred to an intensive-care unit (4,107) or experienced an in-hospital cardiac arrest (179). Patients who had a cardiac arrest or required ICU transfer tended to be a few years older and male. They had been in the hospital, on average, for 13 days, four times longer than patients who did not have a critical-illness event. “We suspected this phenomenon based on our own anecdotal experience,” said co-author Samuel Volchenboum, MD, PhD, associate professor of pediatrics at the University of Chicago and director of the University’s Center for Research Informatics. “But until we had access to a large, well-curated research-data warehouse, we couldn’t perform a study like this.” “Very few academic centers have access to the kinds of high-quality data needed to perform this type of investigation,” he added. The study was designed to detect and quantify any increased risk to neighboring patients. The researchers speculate that one potential factor may be that doctors and nurses could have been “temporarily diverted to help care for critically ill patients,” Volchenboum said. “Further study is needed to determine the causes of this effect.” The study was funded by the National Heart Lung and Blood Institute. Additional authors were Anoop Mayampurath, Gözde Göksu-Gürsoy, Dana P. Edelson and Michael D. Howell, all from the University of Chicago.

Newswise — Emergency rooms in communities with indoor smoking bans reported a 17 percent decrease in the number of children needing care for asthma attacks, according to new research from the University of Chicago Medicine. The study, led by pediatric allergy expert Christina Ciaccio, MD, assistant professor of pediatrics at the University of Chicago, examined 20 metropolitan areas around the country that introduced clean indoor air regulations prohibiting smoking in public places such as restaurants, hotels and workplaces. The study, co-authored by researchers from Brown University and Kansas University, was published in the Annals of Allergy, Asthma & Immunology. “Children are in a very unique situation in that they have very little control over their environment,” Ciaccio said, adding that changing public policies is one way to help control the environment for children in public spaces. “This study shows that even those short exposures to secondhand smoke in public spaces like restaurants can have a significant impact on asthma exacerbations.” The researchers reviewed asthma-related emergency department visits that occurred between July 2000 and January 2014. The data came from 20 hospitals in 14 different states and the District of Columbia. For each hospital, the researchers counted the number of visits during the three years before and the three years after indoor smoking bans took effect. “Combined with other studies, our results make it clear that clean indoor air legislation improves public health,” said study co-author Theresa Shireman, PhD, professor in the Brown University School of Public Health. All told, the team reviewed data from 335,588 emergency room visits. When making pre-ban and post-ban comparisons, they controlled for a variety of possible factors including seasonality and things like patient gender, age, race and socioeconomic status. Results varied by community, but declined in the majority of locales. In the aggregate across all 20 hospitals, the reduction in ER visits became deeper with every passing year following the bans. Children’s ER visits fell 8 percent after one year, 13 percent after two years and, finally, 17 percent after three years. The researchers also found there was no general, nationwide decline in children's asthma-related emergency room visits beyond those seen in communities with the smoking bans. The researchers acknowledged the study only shows an association and doesn’t prove the bans caused the drop in emergency room visits, but Shireman said the evidence strongly suggests it. “We should all breathe easier when our children do,” said Tami Gurley-Calvez, PhD, associate professor of health policy and management at Kansas University and the paper’s third author. The paper was titled “Indoor tobacco legislation is associated with fewer emergency department visits for asthma exacerbation in children.” SEE ORIGINAL STUDY

Newswise — ANN ARBOR, Mich. - “Why does a 30-year-old hit their foot against the curb in the parking lot and take a half step and recover, whereas a 71-year-old falls and an 82-year-old falls awkwardly and fractures their hip?” asks James Richardson, M.D., professor of physical medicine and rehabilitation at the University of Michigan Comprehensive Musculoskeletal Center. For the last several years, Richardson and his team set out to answer these questions, attempting to find which specific factors determine whether, and why, an older person successfully recovers from a trip or stumble. All this in an effort to help prevent the serious injuries, disability, and even death, that too often follow accidental falls. “Falls research has been sort of stuck, with investigators re-massaging over 100 identified fall ‘risk factors,’ many of which are repetitive and circular,” Richardson explains. “For example, a 2014 review lists the following three leading risk factors for falls: poor gait/balance, taking a large number of prescription medications and having a history of a fall in the prior year.” Richardson continues, “If engineers were asked why a specific class of boat sank frequently and the answer came back: poor flotation and navigational ability, history of sinking in the prior year and the captain took drugs, we would fire the engineers! Our goal has been to develop an understanding of the specific, discrete characteristics that are responsible for success after a trip or stumble while walking, and to make those characteristics measurable in the clinic.” Richardson’s latest research finds that it’s not only risk factors like lower limb strength and precise perception of the limb’s position that determine if a geriatric patient will recover from a perturbation, but also complex and simple reaction times, or as he prefers to refer to it, a person’s “brain speed.” The work is published in the January 2017 edition of the American Journal of Physical Medicine & Rehabilitation. “Our study wanted to identify relationships between complex and simple clinical measures of reaction time and indicators of balance in elderly subjects with diabetic peripheral neuropathy, nerve damage that can occur in those with diabetes,” Richardson says. “These patients fall twice as often as people their age typically do, so we wanted to examine each person’s ability to make a decision in less than half a second, or around 400 milliseconds. Importantly, this is also about the length of time the foot is in the air before landing while walking, and about the time available to recover from a stumble or trip.” He realized they needed a new, easy way to measure that rapid decision-making ability. Measuring simple and complex reaction time Using a device developed with U-M co-inventors James T. Eckner, Hogene Kim and James A. Ashton-Miller, simple reaction time is measured much like a drop-ruler test used in many school science classes, but is a bit more standardized. “The clinical reaction time assessment device consists of a long, lightweight stick attached to a rectangular box at one end. The box serves as a finger spacer to standardize initial hand position and finger closure distance, as well as a housing for the electronic components of the device,” Richardson says. To measure simple reaction time, the patient or subject sits with the forearm resting on a desk with the hand off the edge of the surface. The examiner stands and suspends the device with the box hanging between the subject’s thumb and other fingers and lets the device drop at varying intervals. The subject catches it as quickly as possible and the device provides a display of the elapsed time between drop and catch, which serves as a measurement of simple reaction time. Although measuring simple reaction time is useful, Richardson says that the complex reaction time accuracy has been more revealing. The initial set up of the device and subject is the same. However, in this instance, the subject’s task is to catch the falling device only during the random 50 percent of trials where lights attached to the box illuminate at the moment the device is dropped, and to resist catching it when the lights do not illuminate. “Resisting catching when the lights don’t go off is the hard part,” Richardson says. “We all want to catch something that is falling. The subject must perceive light illumination status and then act very quickly to withhold the natural tendency to catch a falling object.” In the study, Richardson and team used the device with a sample of 42 subjects, 26 with diabetic neuropathy and 16 without, with an average age of 69.1 years old, to examine their complex reaction time accuracy and their simple reaction time latency, in addition to the usual measures of leg strength and perception of motion. They then looked to see how well these measures predicted one-legged balance time, the ability to control step width when walking on a hazardous uneven surface in the research lab and major fall-related injuries over the next 12 months. Examining the results In the subjects with diabetic peripheral neuropathy, good complex reaction time accuracy and quick simple reaction time were strongly associated with a longer one-legged balance time, and were the only predictors of good control of step width on the uneven surface. In addition, they appeared to identify those who sustained major fall-related injury during the one-year follow up. Surprisingly, the measures of leg strength and motion perception had no influence on step width control on the hazardous surface and did not appear to predict major injury. “Essentially we found that those who were able to grab the device quickly, or quickly make the decision to let it drop, had quick brains that were somehow helping them stay balanced and avoid aberrant steps on the uneven surface,” Richardson says. He explains that the ability to avoid aberrant steps after hitting a bump while walking, and stay balanced while performing the trials, were likely based on the participant’s brain processing speed. In particular, the ability to quickly withhold, or inhibit, a planned movement is required for good complex reaction accuracy and responding to a perturbation while walking. In both cases, the original plan of action must be aborted and a new one substituted within approximately a 400 milliseconds time interval. “With this in mind, it makes perfect sense that brains fast enough to have good complex reaction time accuracy were also fast enough to quickly pay attention to the perturbation while walking, inhibit the step that was planned and quickly execute a safer alternative,” Richardson says. “The faster your brain can oscillate between various external stimuli, or events, and your own internal thinking clutter, the better off you are. When an elderly person falls, it seems likely that their brain is not keeping up with what is happening and so it is not able to quickly, and selectively, attend to a particular stimulus, such as hitting a curb.” Richardson says this assessment, which cannot be produced from a computer or pen/pencil tests, could be valuable to other health care providers, such as primary care physicians, neurologists, geriatricians and a variety of rehabilitation professionals. SEE ORIGINAL STUDY    

Newswise — By combining two treatment strategies, both aimed at boosting the immune system's killer T cells, Johns Hopkins researchers report they lengthened the lives of mice with skin cancer more than by using either strategy on its own. And, they say, because the combination technique is easily tailored to different types of cancer, their findings -- if confirmed in humans -- have the potential to enhance treatment options for a wide variety of cancer patients. "To our knowledge, this was the first time a 'biomimetic,' artificial, cell-like particle -- engineered to mimic an immune process that occurs in nature -- was used in combination with more traditional immunotherapy," says Jonathan Schneck, M.D., Ph.D., professor of pathology, who led the study together with Jordan Green, Ph.D., associate professor of biomedical engineering, both of whom are also members of the Kimmel Cancer Center. A summary of their study results will be published in the February issue of the journal Biomaterials. Scientists know the immune system is a double-edged sword. If it's too weak, people succumb to viruses, bacteria and cancer; if it's too strong, they get allergies and autoimmune diseases, like diabetes and lupus. To prevent the immune system's killer T cells from attacking them, the body's own cells display the protein PD-L1, which "shakes hands" with the protein PD-1 on T cells to signal they are friend, not foe. Unfortunately, many cancer cells learn this handshake and display PD-L1 to protect themselves. Once scientists and drugmakers figured this out, cancer specialists began giving their patients a recently developed class of immunotherapy drugs including a protein, called anti-PD-1, a so-called checkpoint inhibitor, that blocks PD-1 and prevents the handshake from taking place. PD-1 blockers have been shown to extend cancer survival rates up to five years but only work for a limited number of patients: between 15 to 30 percent of patients with certain types of cancer, such as skin, kidney and lung cancer. "We need to do better," says Schneck, who is also a member of the Institute for Cell Engineering. For the past several years, Schneck says, he and Green worked on an immune system therapy involving specialized plastic beads that showed promise treating skin cancer, or melanoma, in mice. They asked themselves if a combination of anti-PD1 and their so-called biomimetic beads could indeed do better. Made from a biodegradable plastic that has been FDA-approved for other applications and outfitted with the right proteins, the tiny beads interact with killer T cells as so-called antigen-presenting cells (APCs), whose job is to "teach" T cells what threats to attack. One of the APC proteins is like an empty claw, ready to clasp enemy proteins. When an untrained T cell engages with an APC's full claw, that T cell multiplies to swarm the enemy identified by the protein in the claw, Schneck explains. "By simply bathing artificial APCs in one enemy protein or another, we can prepare them to activate T cells to fight specific cancers or other diseases," says Green, who is also part of the Institute for NanoBioTechnology, which is devoted to the creation of such devices at Johns Hopkins. To test their idea for a combined therapy, the scientists first "primed" T cells and tumor cells to mimic a natural tumor scenario, but in a laboratory setting. In one tube, the scientists activated mouse T cells with artificial APCs displaying a melanoma protein. In another tube, they mixed mouse melanoma cells with a molecule made by T cells so they would ready their PD-L1 defense. Then the scientists mixed the primed T cells with primed tumor cells in three different ways: with artificial APCs, with anti-PD-1 and with both. To assess the level of T cell activation, they measured production levels of an immunologic molecule called interferon-gamma. T cells participating in the combined therapy produced a 35 percent increase in interferon-gamma over the artificial APCs alone and a 72 percent increase over anti-PD-1 alone. The researchers next used artificial APCs loaded with a fluorescent dye to see where the artificial APCs would migrate after being injected into the bloodstream. They injected some mice with just APCs and others with APCs first mixed with T cells. The following day, they found that most of the artificial APCs had migrated directly to the spleen and liver, which was expected because the liver is a major clearing house for the body, while the spleen is a central part of the immune system. The researchers also found that 60 percent more artificial APCs found their way to the spleen if first mixed with T cells, suggesting that the T cells helped them get to the right spot. Finally, mice with melanoma were given injections of tumor-specific T cells together with anti-PD-1 alone, artificial APCs alone or anti-PD-1 plus artificial APCs. By tracking blood samples and tumor size, the researchers found that the T cells multiplied at least twice as much in the combination therapy group than with either single treatment. More importantly, they reported, the tumors were about 30 percent smaller in the combination group than in mice that received no treatment. The mice also survived longest in the combination group, with 45 percent still alive at day 20, when all the mice in the other groups were dead. "This was a great indication that our efforts at immunoengineering, or designing new biotechnology to tune the immune system, can work therapeutically," says Green. "We are now evaluating this dual strategy utilizing artificial APCs that further mimic the shapes of immune cells, such as with football and pancake shapes based on our previous work, and we expect those to do even better." Other authors of the report include Alyssa Kosmides, Randall Meyer, John Hickey, Kent Aje and Ka Ho Nicholas Cheung of the Johns Hopkins University School of Medicine. This work was supported in part by grants from the National Institute of Allergy and Infectious Diseases (AI072677, AI44129), the National Cancer Institute (CA108835, R25CA153952, 2T32CA153952-06, F31CA206344), the National Institute of Biomedical Imaging and Bioengineering (R01-EB016721), the Troper Wojcicki Foundation, the Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, the JHU-Coulter Translational Partnership, the JHU Catalyst and Discovery awards programs, the TEDCO Maryland Innovation Initiative, the Achievement Rewards for College Scientists, the National Science Foundation (DGE-1232825), and sponsored research agreements with Miltenyi Biotec and NexImmune. Under a licensing agreement between NexImmune and The Johns Hopkins University, Jonathan Schneck is entitled to a share of royalty received by the university on sales of products derived from this article. Jordan Green is on the scientific advisory board for NexImmune. The terms of these arrangements are being managed by The Johns Hopkins University in accordance with its conflict of interest policies.    

Newswise — MANHATTAN, Kan. — An important part of holiday meal-planning is deciding which high-calorie foods to splurge on and which not to invite onto the plates, according to a Kansas State University researcher. Sam Emerson, doctoral student in food, nutrition, dietetics and health, Midlothian, Texas, offers tips for battling overindulgence of holiday treats. Emerson's No. 1 piece of advice for people trying to maintain weight and stay healthy over the holidays is to have a plan before they are faced with a buffet or table full of options. "Eating food that is not nutritious is commonly part of celebrating, but it can become problematic if we make no effort to curb the splurging," Emerson said. "We need to go in with a plan for how active we're going to be, how much we're going to eat, and whether we'll allow ourselves dessert. That way, you can know later to not eat a second piece of pie because you already ate the one piece of pie you were going to have." Emerson advocates moderation rather than strict avoidance because typically even if people plan to not eat dessert, they usually end up partaking. At that point, their "all or nothing" mentality switches to "all" and the floodgates open for seconds and thirds. Emerson, who specializes in post-meal metabolism research, said some desserts will impact your waistline more than others. Pecan pie is the heftiest of the traditional Christmas pies. A one-eighth piece, which is a small sliver, is about 500 calories. In comparison, the same size slice of pumpkin pie is 320 calories. Sweet potato pie is the least calorically dense, weighing in at just under 300 calories, Emerson said. To avoid saving room for dessert, Emerson advises loading your plate with green beans, salad or other plant-based offerings. He said the evidence is clear that if you fill your plate with vegetables first, you will eat up to 10 percent fewer calories overall. Non-dessert dishes and drinks that are calorically dense include stuffing, mashed potatoes and eggnog. According to Emerson, a standard 1-cup serving of stuffing has 350 calories; a cup of mashed potatoes has nearly 250 calories; and eggnog has about 450 calories per cup. "Many people don't drink just one cup," Emerson said. "If you drink two cups, that's nearly 1,000 calories, which is about half a moderately active person's recommended intake for the whole day." Emerson advocates exercising to help balance caloric intake and output. He said research shows just one session of exercise up to 15 hours before a large, high-fat meal helps the body to healthfully digest the meal with fewer effects on glucose levels, blood lipids and inflammation. "You could exercise in the morning, eat a really large meal that evening and still see benefits from your earlier exercise in terms of how your body processes the meal, which is pretty incredible," Emerson said. Between meals, Emerson advises putting away sweets, like chocolates or cookies. Research shows that when food is readily available, people eat more than is best. "If you leave sweets out where you'll walk past them several times a day, no matter how hard you try, you're going to grab that brownie every now and then," Emerson said. Emerson also offers these tips: • Don't skip meals. Some people avoid eating breakfast on Thanksgiving or skip dinner the night before a Christmas meal, thinking they are "saving up," but research shows they usually end up eating so many calories later at the larger meal that the calorie tally comes out to work against them. • Wait after your first portion. Before going for seconds, spend 5-10 minutes talking to the people around you. After you socialize, see if you're still hungry. "Overall, I recommend trying to focus on being with family and friends," Emerson said. "Eating is a part of the holidays, but if we aim to make it more about enjoying time with people and less about eating a lot, that can help us make more beneficial decisions for our health."

Newswise — Bethesda, Md. — Researchers from Oregon Health and Science University and Oregon State University have found that aspirin may slow the spread of some types of colon and pancreatic cancer cells. The paper is published in the American Journal of Physiology—Cell Physiology. Platelets are blood cells involved with clotting. They promote the growth of cancerous cells by releasing growth factors and increasing the response of certain proteins that regulate tumor cell development (oncoproteins). Low doses of aspirin, an anti-platelet drug, have been shown to reduce the risk of some types of gastrointestinal cancers, but the process by which aspirin hampers tumor growth has been unclear. “The current study was designed to determine the effect of inhibition of platelet activation and function by aspirin therapy on colon and pancreatic cancer cell proliferation,” the researchers wrote.The research team combined activated platelets primed for the clotting process with three groups of cancer cells:• metastatic colon cancer (cells that have spread outside the colon),• nonmetastatic colon cancer (cells that grow only within the colon) and• nonmetastatic pancreatic cancer cells. When they added aspirin to the mixture, they found that the platelets were no longer able to stimulate growth and replication in the pancreatic and nonmetastatic colon cancer cells. The metastatic colon cancer cells continued to multiply when treated with aspirin. In pancreatic cancer cells, low doses of aspirin stopped the platelets from releasing growth factor and hampered the signaling of the oncoproteins that cause cancer to survive and spread. Only very high doses—larger than are possible to take orally—were effective in stopping growth in the metastatic colon cells, explained the researchers. The findings detail the interaction among platelets, aspirin and tumor cells and are promising for the future treatment of nonmetastatic cancer, according to the researchers. “Our study reveals important differences and specificities in the mechanism of action of high- and low-dose aspirin in metastatic and nonmetastatic cancer cells with different tumor origins and suggests that the ability of aspirin to prevent platelet-induced c-MYC [an oncoprotein] expression might be selective for a nonmetastatic phenotype.” Read the full article, “Aspirin therapy reduces the ability of platelets to promote colon and pancreatic cancer cell proliferation: implications for the oncoprotein c-MYC,” published ahead of print in the American Journal of Physiology—Cell Physiology.

Newswise — Philadelphia, – Nationally, the highest rates of asthma-related deaths and hospitalizations are among low-income minority adults, but most existing research doesn’t focus on these patients. In particular, studies may not investigate patients where they live, in complicated, difficult circumstances. Many adult asthma patients have multiple diseases and exposure to tobacco smoke, but much research reflects the convenience of recruiting patients in clinics and on the relative simplicity of studying patients who do not have accompanying diseases such as hypertension, diabetes, and obesity. A new study analyzes patients at ground level, drawing on reports from community health workers who visit asthma patients at home, where extreme living conditions such as poor housing, neighborhood violence, and lack of social support impose steep barriers to public health care, as well as to high-quality research. The research team argues that home visits offer a fuller understanding of how the social environment of asthma patients impacts their overall health. Researchers from the Community Asthma Prevention Program (CAPP) at Children’s Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania describe those challenges in a study in the December 2016 issue of the Journal of Allergy and Clinical Immunology. The authors focused on 301 adults living in low-income Philadelphia neighborhoods who were prescribed an inhaled corticosteroid for asthma and required oral steroids for an exacerbation and/or had an emergency or inpatient visit within the last six months. Community health workers visited patients in their homes and found 71 percent rented, with many living in one-room apartments or overcrowded spaces with multiple family members. Many patients also live in typical Philadelphia rowhomes, which were built in the late 19th century and are difficult to maintain on a limited income. These patients are routinely exposed to common indoor asthma triggers, such as rodents, roaches, and mold. Only 25 percent of people who participated in the study were currently employed either part or full-time. Community health workers reported their impressions of these stark, and sometimes bleak, living conditions: “It’s not just the finances, it’s the violence, lack of education and job opportunities.”“Homes are in poor repair. Some are just unlivable.”“Depression survey seems to trigger a lot of emotions. Often patients are crying as we try to complete it.” “Many of these patients start to feel a sense of hopelessness, especially the very sick,” says Tyra Bryant-Stephens, MD, corresponding author and medical director of CAPP at CHOP. “They feel there is very little possibility of changing their current living situation, which includes poor housing, exposure to violent crime, and limited access to transportation. Some of these living conditions make it difficult or impossible for patients to get to their medical visits, which results in a further decline of their health.” Living in a high-stress environment encourages many patients to continue smoking, despite knowing it contributes to their asthma symptoms. Twenty-eight percent of those surveyed admitted they currently smoke. Other issues community health workers encountered were low education rates, limited access to healthy foods, and poor general health; 58 percent of patients had hypertension and 32 percent had diabetes. “Medical personnel no longer make house calls, so this research gives us a view of how poverty, unfavorable home conditions, and lack of social resources limit patients’ ability to access healthcare,” says Andrea J. Apter, MD, MSc, MA, principal investigator of the study and Chief of the Section of Allergy & Immunology at the Perelman School of Medicine at the University of Pennsylvania. “Without the knowledge of these barriers, health providers do not have the information needed to create a tailored and empathetic approach to asthma management.” Bryant-Stephens adds, “As long as there is poor housing, health disparities will continue to exist, despite medical advancements being made in the fight against asthma. The issue is not limited to Philadelphia and needs to be addressed on a national scale. Without addressing poor housing, we will never be able to truly eliminate disparities in outcomes among adult asthma patients.” Research reported was funded through a Patient-Centered Outcomes Research Institute (PCORI) Program Award. Tyra Bryant-Stephens, Shakira Reed-Wells, Maryori Canales, Luzmercy Perez, A. Russell Localio, Andrea J. Apter. “Home Visits are Needed to Address Asthma Health Disparities in Adults,” Journal of Allergy and Clinical Immunology. Published December 2016. http://dx.doi.org/10.1016/j.jaci.2016.10.006 # # #

Newswise — Rockville, Md. — Vision scientists may have discovered how to reduce pedestrian collisions in crowded and chaotic open space environments like bus terminals, shopping malls and city plazas involving individuals with partial blindness. Researchers have determined from which direction collisions with partially blind pedestrians are most likely to originate. This understanding will guide the development of new glasses that expand the sight of a person with limited peripheral vision. The paper, titled “The risk of pedestrian collisions with peripheral visual field loss” was recently published in the Journal of Vision. The authors created a mathematical model to determine collision risk and compared that risk to the limited vision of 42 patients with retinitis pigmentosa. “We found that the risk of collision is highest from pedestrians at an angle of 45 degrees from the patient’s walking path,” says lead author Eli Peli, OD, professor of ophthalmology at the Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School. “This means that any visual-field expanding device will be most effective if it can cover that angle.” Peli and his colleagues are developing new devices based on prism-containing eyewear they previously designed. Prisms are primarily prescribed to correct visual defects by bending light. To minimize the loss of peripheral vision, new prism-containing glasses would bend light to hit areas of the eye that still function, expanding what a patient could see. Patients with blindness in the left or right half of one of their eyes (hemianopia) caused by a stroke, brain tumor or trauma, or patients with limited peripheral vision from retinitis pigmentosa, Usher syndrome, choroideremia and advanced glaucoma may one day benefit from the vision-expanding devices currently under development. ###

Newswise — Bai jiu (白酒) are distilled spirits made and used throughout rural China for everyday use and special occasions. Distillation of bai jiu is regulated lightly or not at all and nearly every town or village has a distiller. Little is known about the composition of these Chinese spirits, a gap this study seeks to fill given the health risks associated with their high ethanol and high acetaldehyde concentrations. Researchers purchased 61 samples of Chinese white spirits from small-factory scale producers in central China, and an independent laboratory conducted analyses. Alcohol strength was determined by hydrometer. Gas chromatography was used to determine the concentration of volatile organic compounds: ethanol, methanol, acetaldehyde, ethyl acetate, and higher alcohols. Atomic absorption spectroscopy was used to determine the concentration of lead, arsenic, and cadmium. Guidelines developed by the Alcohol Measures for Public Health Research Alliance (AMPHORA) of the European Commission were used to assess risk. Results showed that alcohol strength ranged from 35.7 to 61.4 percent, and 58 of the 61 samples exceeded 40 percent. Although the concentration of methanol, ethyl acetate, lead, arsenic, and cadmium were below AMPHORA limits, 40 of the 61 samples had acetaldehyde levels above these limits. The high ethanol concentrations, coupled with a high percentage of samples with elevated acetaldehyde levels, have cumulative long-term health risks, particularly for the substantial proportion of people in China with a genetic trait for impaired acetaldehyde metabolism. SEE ORIGINAL STUDY

Newswise — Boston, Mass. — Massachusetts Eye and Ear recently opened the Center for Thyroid Eye Disease and Orbital Surgery, a multidisciplinary initiative to address complex conditions affecting the eye sockets, including orbital tumors and thyroid eye disease. Led by world-renowned experts with specialized training in ophthalmic plastic surgery, endoscopic orbital surgery, strabismus, thyroid gland disorders, neurosurgery and head and neck oncology, the Center will not only provide high quality care to patients with these conditions in one location, but will also support and promote an environment for pioneering novel treatments to improve upon current treatment strategies. The Center is based at the main campus of Mass. Eye and Ear at 243 Charles Street. “Thyroid eye disease and tumors of the eye socket (orbit) are complicated, and potentially sight threatening, clinical conditions,” said Suzanne Freitag, M.D., Director of the Ophthalmic Plastic Surgery Service and Co-director of the Center for Thyroid Eye Disease and Orbital Surgery at Mass. Eye and Ear and Associate Professor of Ophthalmology at Harvard Medical School (HMS). “The Center is one of the largest and most comprehensive of its kind in the United States that offers convenient, closely coordinated, subspecialty care and treatments that patients can readily access from a single location.” Thyroid eye disease is an inflammatory condition involving both the thyroid gland and the eye sockets. Patients often experience severe inflammation of the eye sockets and surrounding tissues that can cause a multitude of problems including disabling double vision or permanent vision loss. Advanced medical and surgical therapies may be necessary to manage this disease and preserve visual function. Orbital tumors can affect the bones of the eye socket, the eyeball, the eye socket muscles, the optic nerve and the surrounding fat and can cause a number of symptoms, including double vision or bulging eye. Surgeons at Mass. Eye and Ear are pioneering minimally invasive surgical techniques to remove these tumors and speed up recovery time. They are also well equipped to provide care to patients with vascular and lymphatic orbital malformations, a rare subset of orbital tumors that require highly specialized care. “Our team of multidisciplinary experts is conducting evidence-based research and pioneering minimally invasive, surgical techniques that are rapidly changing how we deliver care to our patients,” said Benjamin Bleier, M.D., an Assistant Professor of Otolaryngology at HMS and a nationally renowned endoscopic sinus and skull base surgeon. “These innovations are resulting in less pain, a faster recovery time, and overall better quality of care for our patients.” Dr. Bleier co-directs the Center with Dr. Freitag and Dean Cestari, M.D. Dr. Cestari is an Assistant Professor of Ophthalmology at HMS, and one of a handful of clinicians in the country who is board certified in both neurology and ophthalmology. “We are very fortunate to have physicians who are constantly pushing the envelope in the way we approach complex patient care through research and collaboration,” said John Fernandez, President and CEO of Mass. Eye and Ear. “The Center for Thyroid Eye Disease and Orbital Surgery represents a marriage of ophthalmology and otolaryngology care that will ensure that we’re delivering the highest quality of care for Mass. Eye and Ear patients." To Make an Appointment:617-573-5529 About Massachusetts Eye and EarMass. Eye and Ear clinicians and scientists are driven by a mission to find cures for blindness, deafness and diseases of the head and neck. Now united with Schepens Eye Research Institute, Mass. Eye and Ear is the world's largest vision and hearing research center, developing new treatments and cures through discovery and innovation. Mass. Eye and Ear is a Harvard Medical School teaching hospital and trains future medical leaders in ophthalmology and otolaryngology, through residency as well as clinical and research fellowships. Internationally acclaimed since its founding in 1824, Mass. Eye and Ear employs full-time, board-certified physicians who offer high-quality and affordable specialty care that ranges from the routine to the very complex. In the 2016–2017 “Best Hospitals Survey,” U.S. News & World Report ranked Mass. Eye and Ear #1 in the nation for ear, nose and throat care and #1 in the Northeast for eye care. For more information about life-changing care and research, or to learn how you can help, please visit MassEyeAndEar.org.