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Stem cells overflow with potential. Their ability to become other cell types is crucial to our bodies, both during development and throughout life. But this potential can be our very downfall if it goes wrong, turning some of our most useful cells into malignant cancers.
While investigating a pathway involved in stem cell differentiation, researchers at UC Santa Barbara found that rather than forming an assembly line or rigid structure, all the proteins involved coalesce into a liquid droplet. Through modeling and manipulation, the team began to reveal how cells use this droplet to process and relay information, and how it might malfunction in cancers. Their results appear in the Proceedings of the National Academy of Sciences.
“The same processes that organize dew drops on a spiderweb are happening in the cells to make this liquid, molecular computer appear or disappear on command,” said senior author Max Wilson, an assistant professor in the Department of Molecular, Cellular, and Developmental Biology. “And when it goes wrong, it causes basically 100% of colorectal cancers and is implicated in a large number of other cancers.”
An important process
A host of mechanisms guide a stem cell to differentiate into a specialized cell type. Among the most important is the Wnt pathway — short for “wingless-related integration site” — which takes input from outside the cell, processes it and relays instructions to the nucleus. This starts a chain of actions that tells the stem cell it’s time to differentiate, as well as what type of cell to become. The Wnt pathway is involved in determining the fate of every stem cell, Wilson explained, and it appears unchanged across virtually all animals.
Stem cell differentiation is quite important during embryonic development. However, there are areas of the body where we have stem cells even as adults, such as our intestines, bone marrow and skin, to name a few. The differentiation pathways play a big role in the function of these tissues and organs.

New research led by the National Institute for Health & Care Research (NIHR) Mental Health Policy Research Unit (MHPRU) at King’s College London and University College London (UCL), has shown that certain groups of people benefit from the freedom of choice that telemental health provides, but this is not true for all.
The research, published today in the Interactive Journal of Medical Research, investigates which telemental health approaches work (or do not work) for whom, in which contexts, and through which mechanisms. Telemental health was found to be effective overall, but researchers highlight that there is no ‘one size fits all’.
Telemental health (or telemedicine) is mental health care — patient care, administrative activities and health education — delivered via ‘telecommunications technologies’ e.g. video calls, telephone calls or SMS text messages. It has become increasingly widespread, as it can be useful in providing care to service users in remote communities, or during an emergency restricting face-to-face contact, such as the COVID-19 pandemic.
The study found telemental health can be effective in reducing treatment gaps and barriers, by improving access to mental health care across different service user groups (e.g. adult, child and adolescent, older adults, and ethnic minority groups) and across personal contexts (e.g. difficulty accessing services, caring responsibilities or condition). However, it is crucial that providers consider that there are a set of key factors which lead to variations in peoples’ response to telemental health; for example, variations in access to a private and confidential space, ability to develop therapeutic relationships, individual preferences and circumstances as well as the internet connection quality.
King’s researcher Dr Katherine Saunders, from NIHR MHPRU and joint lead author said, “We live in an increasingly digital world, and the COVID-19 pandemic accelerated the role of technology in mental health care. Our study found that, while certain groups do benefit from the opportunities telemental health can provide, it is not a one size fits all solution. Receiving telemental health requires access to a device, an internet connection and an understanding of technology. If real world barriers to telemental health are ignored in favour of wider implementation, we risk further embedding inequalities into our healthcare system.”
Important limitations have been reported that implementing telemental health could risk the reinforcement of pre-existing inequalities in service provision. Those who benefit less are people without access to internet or phone, those experiencing social and economic disadvantages, cognitive difficulties, auditory or visual impairments, or severe mental health problems (such as psychosis).
Professor Sonia Johnson from UCL and Director, NIHR MHPRU and senior author adds “Our research findings emphasise the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation. For those people, we recommend a need to ensure that face-to-face care of equivalent timeliness remains available”
The authors suggest the findings have implications across the board of clinical practice, service planning, policy and research. If telemental health is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed.
Professor Alan Simpson, from King’s and Co-Director, NIHR MHPRU concludes “As well as reviewing a huge amount of research literature, in this study we also involved and consulted with many clinicians and users of mental health services. This included young people, those that worked in or used inpatient and crisis services, and those who had personal lived experience of telemental throughout the pandemic. This gives this research a relevance that will be of interest to policy makers, service providers and those working in and using our services.”
Merle Schlief, joint lead author from NIHR MHPRU at UCL said “Working entirely online to conduct this study gave us access to experts and stakeholders who we simply would not have been able to include if we had been working in-person, including people living and working internationally, and those who would have been unable to travel. This highlights one of the key strengths of technology.”
The authors recommend that guidelines and strategies are co-produced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings.
The MHPRU is a joint enterprise between researchers at UCL and King’s College London with a national network of collaborators. We conduct research commissioned by the NIHR Policy Research Programme to help the Department of Health and Social Care and others involved in making nationwide plans for mental health services to make decisions based on good evidence. The MHPRU contributed research evidence to the national review of the Mental Health Act and is currently undertaking a number of studies.

People with the inherited disorder myotonic dystrophy (DM) often experience excessive daytime sleepiness and fatigue, as well as altered responses to anesthetics that can put them at risk for complications when hospitalized.
Emory researchers, in collaboration with colleagues at Columbia and University of Florida, now have evidence from a mouse model of DM’s central nervous system symptoms, indicating a link to the inhibitor neurotransmitter GABA — and a potential remedy.
The results are published in eNeuro.
“Problems with sleep and anesthetic responses are two major concerns for people with myotonic dystrophy,” says Gary Bassell, PhD, chair of cell biology at Emory University School of Medicine. “The behavioral, pharmacologic and molecular alterations we’ve uncovered help us understand where those aspects of the disorder come from.”
The lead author of the paper is Kamyra Edokpolor, PhD, a former Emory graduate student, with contributions from anesthesiologist Paul Garcia’s lab at Columbia and neurogeneticist Eric Wang’s lab at University of Florida.
The eNeuro paper describes how the DM model mice have enhanced sensitivity to GABA. They display a stronger response to benzodiazepines, a class of anti-anxiety and anti-insomnia drugs that act through GABA. Additional findings suggest that drugs that counteract benzodiazepines, such as the repurposed antidote flumazenil, might work against DM’s prolonged sleep and daytime sleepiness.

Scientists from Nanyang Technological University, Singapore (NTU Singapore) have mapped out the molecular structure of a key part of our chromosomes called telomeres, which play a pivotal part in ageing and cancer.
The NTU team discovered that the building blocks of telomeres are stacked in columns like a spring. They also found that the shape of telomeres leaves a part of the DNA exposed and unprotected, leaving it more susceptible to damage than previously thought.
The researchers said that their advance in genetic research would aid in explaining why humans age and develop cancer.
Telomeres are protective caps at the ends of the DNA molecules that make up our chromosomes. Like the plastic tips on the ends of shoelaces, the telomeres’ function is to cap and protect the ends of the chromosome from damaging themselves by sticking to each other or fraying.
Previously, due to its chemical instability and complex repetitive nature, scientists have struggled to duplicate enough telomeric DNA in the laboratory to be able to use electron microscopes to observe how it is structured.
In their study published this month in the journal Nature, the researchers adapted existing processes to replicate DNA and saw that in telomeres, the nucleosomes, which contain tightly packed strands of DNA (deoxyribonucleic acid), are stacked in columns around chromosomal proteins called histones.

More than 60% of family caregivers of individuals with Alzheimer’s disease (AD) experienced at least mild depressive symptoms already at the time the individual with AD was diagnosed. In one third of them, depressive symptoms worsened during a five-year follow-up.
The study carried out at the University of Eastern Finland included 226 family caregivers of individuals with AD. Depressive symptoms experienced by family caregivers were monitored for five years, starting from the diagnosis of the individual with AD. 61.5% of family caregivers experienced depressive symptoms at the time the individual with AD was diagnosed. In more than half of them, depressive symptoms remained mild during the follow-up and even diminished in some few cases, but one third experienced an increase in depressive symptoms. In family caregivers whose depressive symptoms worsened during the follow-up, symptoms increased especially in the third and fifth year after the diagnosis of the individual with AD.
Family caregivers whose symptoms worsened were typically women caring for their spouse, and the spouse had more neuropsychiatric symptoms. However, the functional ability of the individual with AD, or the severity of their disease, were not associated with family caregivers’ depressive symptoms.
Depressive symptoms weaken, for their part, family caregivers’ health. So far, data on how these symptoms change over the years of giving family care, and how family caregivers differ from one another, have been scarce.
Family caregivers’ health and well-being should be monitored, too
“According to this study, about one third of family caregivers experience persistent depression when giving family care. It seems that the severity or progression of the memory disorder does not explain family caregivers’ symptoms, but they are rather related to individual backgrounds,” says Adjunct Professor Tarja Välimäki from the Department of Nursing Science at the University of Eastern Finland.
“Family caregivers enter the caregiving situation, which often lasts many years, from different backgrounds, and these differences persist.”
The results support earlier findings of the ALSOVA study suggesting that it would be possible to identify those family caregivers who accumulate several strain factors during the years of giving care. Family care also involves maintaining the health and good life of family caregivers.
“It is important to consider the health of the family caregiver already when looking into the situation of the individual with AD. Assessment and continuous monitoring of family caregivers’ health and well-being should be included in the treatment of memory disorders,” Välimäki says.
The study was carried out as part of the ALSOVA study at the University of Eastern Finland, which has conducted a five-year follow-up of individuals with a recently diagnosed AD and their family caregivers. The multidisciplinary study combines medical, therapeutic, economic, pharmacological and psychological expertise. All study participants diagnosed with AD were examined and treated in accordance with the current care guidelines for Alzheimer’s disease.
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Every three seconds, someone in the world is diagnosed with dementia. And while there is no known cure, changes in the brain can occur years before a dementia diagnosis.
Now, a world-first study from the University of South Australia’s Australian Centre for Precision Health has found a link between metabolism and dementia-related brain measures, providing valuable insights about the disease.
Analysing data from 26,239 people in the UK Biobank, researchers found that those with obesity related to liver stress, or to inflammation and kidney stress, had the most adverse brain findings.
The study measured associations of six diverse metabolic profiles and 39 cardiometabolic markers with MRI brain scan measures of brain volume, brain lesions, and iron accumulation, to identify early risk factors for dementia.
People with metabolic profiles linked to obesity were more likely to have adverse MRI profiles showing lower hippocampal and grey matter volumes, greater burden of brain lesions, and higher accumulation of iron.
UniSA researcher, Dr Amanda Lumsden, says the research adds a new layer of understanding to brain health.

Early detection remains key to successfully treating many cancers, and early detection via cell-free DNA (cfDNA) circulating in the bloodstream — the so-called “liquid biopsy” — has become a research focal point. But using this method to detect cancer at its early stages has been challenging due to low tumor concentrations in DNA blood fragments and the genetic diversity of cancer.
Now, researchers at UCLA’s Jonsson Comprehensive Cancer Center and collaborating organizations report successful results from an experimental cancer-detection system that appears to have overcome these challenges in a novel, cost-effective way.
Their work, published in the journal Nature Communications, highlights an approach that offers more than 12-fold cost-savings over conventional methods to sequence cfDNA methylome, along with a computational model to extract information from this DNA sequencing to aid early detection and diagnosis.
Cell-free DNA methylation has been shown to be one of the most promising biomarkers for early cancer detection. However, the signatures of cfDNA aberrations from diverse cancer types, subtypes, stages and etiologies are heterogeneous, leading to challenges in identifying methylation markers suitable for early detection. This is especially of concern that the currently available sample sizes are small compared to the diversity of diseases and the patient population (age, gender, ethnicity, and comorbidity). Profiling cfDNA methylome can address this challenge, as it retains the genome-wide epigenetic profiles of cancer abnormalities, thereby permitting the classification models to learn and exploit newly significant features as training cohorts grow, as well as expanding their scope to more cancer types. However, the conventional way of profiling the cell-free DNA methylome (whole-genome bisulfite sequencing) is cost-prohibitive for clinical use.
“Our method, cfMethyl-seq, makes cfDNA methylome sequencing a viable option for clinical use,” says Xianghong “Jasmine” Zhou, professor of pathology and laboratory medicine at UCLA and a corresponding author for the study. “Despite the inherent challenges, our study shows tremendous potential for accurate early diagnosis of certain cancers from a single blood test.”
Zhou and colleagues in her UCLA lab focus on precision medicine — the use of patients’ genomic information to develop more personalized, targeted treatments — and big biodata analysis to integrate complex data from various platforms and modalities into practical methods that can be used in clinical settings.

The first study to systematically investigate flooding risk to hospitals on the Atlantic and Gulf Coasts from Category 1-4 storms finds that even relatively weak storms pose a serious flood risk to hospitals along the coast. Sea level rise expected in this century due to the effects of climate change increases the odds of hospital flooding by 22% according to a study, which was published today in the AGU journal GeoHealth by the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health, Boston University School of Medicine Department of Family Medicine, and PSE Healthy Energy.
“We now have a better sense of which hospitals are likely to flood from a hurricane today and those that need to prepare for greater risks in the future,” said senior author Dr. Aaron Bernstein, Interim Director of Harvard Chan C-CHANGE. “Hurricanes are expected to get more severe and may strike regions further north than in the past due to climate change. In places like my hometown of Boston, we can avoid crises that other hospitals have had to endure by learning from their experience and creating plans that build on best practices. But we must act now, before disaster strikes.”
Researchers identified 682 acute care hospitals in 78 metropolitan statistical areas located within 10 miles of the Atlantic and Gulf Coasts of the United States, covering a population just under 85 million people, or about 1 in 4 Americans. They found that 25 of the 78 metro areas studied have half or more of their hospitals at risk of flooding from a Category 2 storm.
The 10 metro areas where a Category 2 hurricane threatens access to hospital care most are: Miami-Fort Lauderdale-West Palm Beach, FL New York-Newark-Jersey City, NY-NJ-PA Boston-Cambridge-Newton, MA-NH Orlando-Kissimmee-Sanford, FL New Orleans-Metairie, LA Tampa-St. Petersburg-Clearwater, FL North Port-Sarasota-Bradenton, FL Jacksonville, FL Cape Coral-Fort Myers, FL Philadelphia-Camden-Wilmington, PA-NJ-DE-MDThe modeling shows that with sea level rise expected this century, the Baton Rouge, Virginia Beach, Corpus Christi, Philadelphia, and Boston metro areas have over 90% increases in the number of beds at risk of flooding from a Category 2 storm.
Recent storms have devastated hospital infrastructure. This study finds that even if hospital buildings may not be flooded the roads around them may be, restricting or preventing access to care. In 18 metro areas, at least half of the roads within one mile of hospitals were at risk of flooding from a Category 2 storm. Flooded roads have often been a major challenge to emergent patient transfer during hurricanes as well as patient and staff access to hospitals well after storms have passed.
The Southeast Louisiana Veterans Health Care Center built in 2016, which replaced the VA Hospital and Charity Hospital in New Orleans after Hurricane Katrina, provides a model for how coastal hospitals and health systems can improve their resilience to hurricanes, according to the study authors. It was designed to remain operational for seven days even if city utilities and infrastructure are compromised and features back-up fuel supplies, on-site sewage treatment facilities, and sufficient accommodations for up to 1,000 staff and patients to shelter in place. Critical mechanical and electrical equipment as well as patient care areas are located at least 20 feet above the 100-year floodplain.
This study is part of Harvard Chan C-CHANGE’s Climate MD program, which helps identify, support, and prepare health care workers to address climate-related impacts on health and health care delivery. The program helps health care providers buffer risks to the patients they serve, protect people most at risk from the climate crisis, and advance health equity.
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New research from UC shows that poor metabolic health parameters are linked to low breast milk production. The study was published in the journal Breastfeeding Medicine.
“We wanted to see if we could understand what stands out as different in these moms. So, we conducted a case control study to see why, despite their best efforts at doing everything right with breastfeeding, they were not making enough milk,” says Laurie Nommsen-Rivers, PhD, associate professor of nutrition, and the Ruth Rosevear Endowed Chair of Maternal and Child Nutrition in the UC College of Allied Health Sciences. “The prevailing dogma is if you try hard enough at breastfeeding, your body will be able to do this.”
Nommsen-Rivers and her team analyzed data from a randomized controlled trial from February 2015 to June 2016 involving women screened for a low-milk supply. Mothers who were aged 20 years or older and one to eight weeks postpartum with a healthy infant born at 37 weeks of gestation or later were included. Participants completed at-home infant test-weighing to measure milk output.
“We’ve seen hints in these large epidemiologic studies of factors related with insulin resistance, so that’s why we looked at the whole metabolic panel,” she says. “All those things that contribute to your risk of metabolic syndrome were examined: blood pressure, plasma lipids, fasting glucose, fasting insulin, insulin sensitivity. Across the board, all those measures were significantly worse in the moms with unexplained persistent low-milk supply as compared to the control group.”
Nommsen-Rivers says for the last decade or so, large epidemiologic studies have consistently shown that women with a higher body mass index (BMI) have a shorter breastfeeding duration. That sparked many theories, including lower motivation or lower effort, but these theories are really rooted in weight stigma, according to Nommsen-Rivers. She says this is an understudied area even though there is strong evidence of higher BMI being associated with worse metabolic health.
“This is the first study where we have validated their persistent low-milk supply,” Nommsen-Rivers says. “This is not just simply based on a woman thinking, ‘Oh, I didn’t have enough milk, that’s why I gave my baby formula.’ Our research results strongly point to there being a physiologic basis for their low-milk production. It wasn’t due to these women not trying hard enough.”
This study, according to Nommsen-Rivers, is getting researchers one step closer to developing clinical criteria for screening women in pregnancy to identify what the metabolic health picture looks like in women who succeed with exclusive breastfeeding as compared to those that are unable to produce sufficient breast milk despite following best practices for breastfeeding management.
“This was one area that’s severely understudied,” she says. “The reason I got a PhD was I felt that the evidence we used to provide breastfeeding management was way too thin. I wanted to contribute to research that would help build the evidence base for improving how we manage breastfeeding.”
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Materials provided by University of Cincinnati. Original written by Bill Bangert. Note: Content may be edited for style and length.

Treating superficial skin tumours especially when they are located above cartilage or bone with beta radiation can help protect sensitive structures during the delivery of treatment.
The use of short-range beta radiation in cancer treatment is not without its disadvantages, however, especially when it comes to the measurement of radiation exposure — dosimetry. When experimental dosimetry is not feasible, researchers use simulations and calculations to study the interaction of the ionizing radiation with matter and estimate the radiation dose delivered to a target organ.
A new paper published in EPJ Plus and authored by Eduardo De Paiva, from the Division of Medical Physics at the Institute of Radiation Protection and Dosimetry, Rio de Janeiro, Brazil, and his colleagues, pits the gold standard of simulation techniques — Monte Carlo (MC) simulation — against an alternative analytic method, the Loevinger formula.
“We measured the dose of a treatment applicator using mathematical techniques — a simple technique, no experiment needed and no practical challenges,” De Paiva says. “The comparison of MC simulation and Loevinger formula on the setup of our research was the novelty of our study.”
Nonexperimental dosimetry techniques like MC simulation are advantageous for their ability to handle different geometries and materials, but MC simulations require heavy computation and this can impede their implementation.
Analytic methods are another set of techniques for dosimetry of beta radiation that can produce results faster than MC methods. Thus far, these methods have been less favoured because they are associated with lower accuracy.
The team used MC simulation and analytical calculation — the Loevinger formula — for dosimetry of radiation dose from a multiwell skin brachytherapy applicator with two beta sources. The results of the two approaches were compared to see how accurate the analytical method is.
“The Loevinger formula, which is a quick method for dosimetry showed a good agreement with gold standard Monte Carlo methods,” Paiva concluded. “Thus, the Loevinger formula can be used, as the basis of a dosimetry software, for straightforward dosimetry of beta sources in simple geometries.”
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