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A new study suggests that therapeutic interventions to treat neurodevelopmental disorders may be more effective if done during the early stages of brain development.
“In order to stop the progression of neurodevelopmental disorders, it is important to identify how and when brain circuits are changing during development. Our study identifies when circuits are altered in addition to how brain circuits are corrected,” said the study’s senior author Molly Huntsman, PhD, associate professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences located on the University of Colorado Anschutz Medical Campus.
The study, published in The Journal of Neuroscience, looks at Fragile X Syndrome (FXS), a pervasive neurodevelopmental disorder and a common cause of intellectual disability, autism and anxiety disorders.
“Currently, there are no approved or effective therapies targeting specific pathophysiology underlying the clinical manifestations of FXS,” Huntsman said. “We’re hoping to provide answers for when and how to treat FXS to help with therapeutic options eventually.”
The CU Skaggs School of Pharmacy researchers identified potential causal circuit-level changes during a critical period of brain development susceptible to therapeutic intervention. They focused on the amygdala — the brain region where fear and anxiety are processed.
Using a mouse model of FXS, they identified a critical period of increased circuit plasticity occurring in early brain development. They showed that fear-learning emerges in in the brain during these periods of increased plasticity. At the same time, they demonstrated that early intervention ameliorates it.
The results suggest that critical period plasticity in the amygdala is increased and may be shifted to earlier developmental timepoints. This could cause a “maladaptive” form of plasticity and yet one that can be treated with therapeutic intervention at key developmental time points.
Age at the time of treatment, the study said, is important because early pharmacological intervention was shown effective in reducing fear-learning in the mouse model.
“This is highly significant and addresses a critical barrier for understanding how circuits develop in a mouse model of autism and intellectual disability and even more important for therapeutic intervention-directed treatment options,” Huntsman said.
The researchers said future clinical trials should focus on human critical periods of development.
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Materials provided by University of Colorado Anschutz Medical Campus. Original written by Julia Milzer. Note: Content may be edited for style and length.

A systematic review of twenty-three studies suggests that, during pregnancy, expectant parents’ feelings towards their unborn baby (fetus) can be positively enhanced by sonographers (specialist healthcare professionals who are trained to perform pregnancy ultrasound scans) making imaging examinations a truly parent-centred experience.
Such an experience can allay feelings of anxiety and stress in the parents, helping them to feel more informed about the health and well-being of their unborn baby, and reassured of their emotional investment in the on-going pregnancy.
Conducted by the Centre for Maternal and Child Health Research at City, University of London, the review provides a holistic interpretation of the current evidence on the effect of antenatal (before birth) imaging on expectant parents’ feelings towards their unborn baby.
To-date, whilst the provision of ultrasound scans during pregnancy has been generally regarded as a positive experience for parents, and may predict the quality of the parent-child relationship after birth, there is evidence to suggest that that the experience may also lead to increased anxiety and stress in parents, particularly those who are unable to interpret the scan images.
Seventeen of the studies analysed in the review related to the mother’s experience only, five included both parents and one study recruited fathers only. Six central themes were developed from analysis of the included studies: the scan experience begins before the scan appointment; including parents looking forward to the scan, but being simultaneously apprehensive of the potential to receive unexpected news about their baby the scan as a pregnancy ritual; parents regarded scans as a milestone event, which they expected, and wanted feeling actively involved in the scan; with the presence of fathers at scans important, not only for maternal support, but also as attending fathers felt closer to their unborn baby than those who were not parents’ priorities for knowledge and understanding of the scan change during pregnancy; at earlier stages of pregnancy, parents prioritised knowing that their pregnancy was viable, at later stages it was important for parents to know about the presence of fetal anomalies the importance of the parent-sonographer partnership during scanning; parents’ confidence in their sonographer was linked with narration of the scan, and limiting the use of non-medical terminology humanised the fetus, and implied to parents that the sonographer recognised their unborn baby as an individual rather than a medical entity scans help to create a social identity for the unborn baby; many parents centred their news about pregnancies around a scan, with some waiting until their first scan to tell friends and family about their pregnancies, and sharing their scan pictures or videos so that their support circle had a sense of knowing the baby even before birthThe review also identified a lack of published research studies exploring the impact of fetal MRI (magnetic resonance imaging) on expectant parents’ emotional connection to their unborn baby. Fetal MRI is becoming more commonly used to complement ultrasound imaging when a fetal anomaly is suspected. Hence, the authors stress that more research needs to be undertaken in this area to help understand the acceptability of this type of scan to parents and its potential effect on their feelings towards their unborn child.
Lead author, Emily Skelton, is a sonographer, lecturer and College of Radiographers Doctoral Fellow within the Department of Radiography and Midwifery at City, University of London. She said:
“We know how important scans during pregnancy are to provide clinical information about fetal growth and development, but there are additional benefits for expectant parents, who, in their transition to parenthood, may feel closer to their unborn babies after “seeing” them on scan. This review highlights the integral role of the sonographer in facilitating the developing connection between expectant parents and their unborn babies, through an informative, supportive and inclusive parent-centred approach to care that parents feel actively involved in.”
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Materials provided by City University London. Original written by Shamim Quadir. Note: Content may be edited for style and length.

Published32 minutes agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesDiners who fell quickly ill after eating at a restaurant outside Toronto likely ate food contaminated with toxic aconite, Canada health officials say.Twelve people were sent to hospital on Monday, with four needing intensive care.Health officials said they believe the toxin came from two powder products that have since been pulled from shelves. Aconite, a toxic herb, can severely affect the nervous system if ingested.York Region Public Health said the diners fell ill after eating a dish at Delight Restaurant & BBQ, located north of Toronto. Diners presented to hospitals nearby with symptoms resembling that of aconite poisoning. Most have since recovered, while others remain ill in hospital but are improving. Officials said they believe the accidental poisoning was caused by a contaminated spice product.They have since sent food and other samples to a lab for confirmation. The restaurant has cooperated with the investigation.Two products – a galangal powder common in Asian cuisine and a radix aconiti kusnezoffii powder traditionally used in Chinese medicine – have been pulled off retail shelves. Image source, York Region Public HealthAconite, also known as monkshood, wolf’s-bane or devil’s helmet, is a common plant that can be found at gardens and mountainous parts of North America, Europe and Asia. Its roots are extremely poisonous and lethal. If ingested, symptoms show up quickly and most fatalities occur within a few hours.Health officials said symptoms consistent with aconite poisoning are: Numbness of the tongue or limbsDiarrheaStomach crampsNauseaVomitingHeadacheIrregular or rapid heartbeat The plant has been used in traditional Chinese medicine for millennia, though it is processed before ingestion to remove the toxins.Dr David Juurlink, an internal medicine physician and toxicology researcher in Toronto, said the concern is that, when not processed thoroughly, toxic bits of the aconite will remain. “The usual story is someone takes [aconite] for medicinal reasons, and they just take too much of it or it’s not been treated properly, and they die,” Dr Juurlink said. He said one teaspoon of pure aconite poison is enough to kill several people. Several cases of accidental and intentional poisonings have made headlines in the past. Earlier this year, two people fell ill in British Columbia after eating a sand ginger powder product contaminated with aconite.In 2017, a San Francisco woman died after consuming herbal tea that had traces of aconite in it.And in 2010, a British woman was found guilty of murder after lacing her ex-partner’s food with aconite. The challenge for doctors, Dr Juurlink said, is there is no antidote for aconite poisoning. “Treatment is primarily supportive”, he said, like hooking patients onto breathing machines or trying to support their heartbeat in a specialised ICU through a bypass machine.He said people who suspect they have accidentally ingested aconite “can’t get to the hospital fast enough”.

The 5-month-old boy hadn’t gained any weight in three months. Why was he ‘failing to thrive’?The couple sat in silence as they drove home from Blank Children’s Hospital in Des Moines. Their 5-month-old seemed dwarfed by the baby carrier strapped into the back seat. He was tiny. He hadn’t grown since he turned 2 months old. He weighed just 10 pounds — barely three pounds more than when he was born. The baby had been breast-fed since birth, but his mother noticed right away that he had more trouble doing that than his three older brothers had. She tried putting her breast milk in a bottle to see if that was easier for her baby to manage. When that didn’t help, she tried adding baby formula. He spit up often; sometimes it looked as if more were coming out than was going in. His pediatrician started him on an acid-reducing medication. It didn’t seem to do much, either.Other than his size, he looked healthy. He was active. He was able to meet all his milestones. He could hold his head up. He could roll over. His fontanel, the soft spot on the top of his head, was flat — as it should be. His pediatrician counseled patience, but when the boy still hadn’t gained weight at his 4-month visit, she sent blood samples to the lab. The parents got a call with the results late the same afternoon. The baby had worrisome abnormalities in his blood chemistry. The salt level in his blood was very high, so high it could induce a seizure. It was so high, in fact, that if it wasn’t addressed, he could die. The parents hurried the tiny boy to Blank Children’s Hospital. Problem in the Brain? Or the Kidneys? Samples taken in the hospital emergency room quickly confirmed the abnormality. The child’s sodium level was 159, more than 10 points above normal. The high number told his doctors not just that he had too much sodium but also that he didn’t have enough water in his body, that he was very dehydrated. Normally when there is too much sodium in the body, the brain triggers the urge to drink to bring in more water. The brain also tells the kidneys to hold on to as much water as possible. The brain communicates all this with a hormone called vasopressin. Problems with vasopressin can cause a disorder first described in the 18th century as diabetes insipidus (D.I.) — a disease producing profuse and watery (insipid) urine. The child’s combination of high sodium and watery, dilute urine immediately made the doctors suspect he had D.I. His high sodium level should have made his brain send a vasopressin message to his kidneys to hold on to all the water they could. And yet his urine was almost all water. Why? Was the pituitary gland in his brain unable to make the hormone? Or was there a problem on the message-receiving end in his kidneys? No matter where the problem started, there were medications that could help. The doctors put the baby on two drugs usually used to control high blood pressure, which trigger the kidneys to dump sodium. Almost immediately, the baby’s sodium began to drop. That suggested that the baby did have D.I. If so, was the problem in the brain, where the hormone was made, or the kidneys? How the problem was treated depended on where it originated. An M.R.I. was done to look for signs of a problem in the pituitary. It looked normal. The problem, his doctors figured, was probably in his kidneys. They sent off samples to look for a genetic reason for his abnormality, but those results wouldn’t be back for weeks. In the meantime, they continued to give the baby the medications that helped him get rid of the salt. And slowly the levels came down. After a few days on these medications, the baby’s chemistries were completely normal. He should start gaining weight now, the parents were told. But he didn’t. On the day the doctors decided the baby was well enough to go home, he still hadn’t gained a single ounce. Photo illustration by Ina JangStill Not Thriving The parents were instructed to feed the child every three hours around the clock to help him get the maximum number of calories. They should follow up with their pediatrician and see a genetics specialist. Then they were sent home. They felt strongly that their baby was not ready to leave the hospital. He was admitted with the diagnosis “failure to thrive,” and he was still not thriving. On the growth chart, he was in the zero percentile. Zero. They made this argument to the boy’s doctors. He’ll gain weight now that his chemistries are normal, they were told. Just give him time.The child’s parents felt that he didn’t have time, that his life was still in danger. So early the next morning parents and baby were back in the car. They had talked their way into an appointment with the genetics specialists at the University of Iowa Stead Family Children’s Hospital in Iowa City, two hours away. Once they got there, the parents shared their concerns. Was the baby’s inability to gain weight because of his D.I.? Or was there something else going on? At Blank Hospital, the child had been tested for cystic fibrosis. The test was inconclusive. Dozens of other disorders could interfere with a baby’s growth. Parents and baby were sent to the lab to have blood taken to look for other genetic abnormalities and to the cardiology department to make certain his heart was normal. The geneticist also wanted the baby to be seen by a pediatric gastroenterologist. It was clear that he was having trouble feeding and seemed to spit up much of what he was able to take in. The geneticist reached out to Dr. Eyad Hanna, who saw the child later that day. It took only a few minutes for the gastroenterologist to decide that the child was too tiny to send home. Like the child’s parents, he worried that if the baby hadn’t been able to gain weight in the hospital, he might not be able to do it at home either. The baby was admitted to Hanna’s care and was started on round-the-clock feedings to try to help him get back on the growth curve. Hanna also reached out to a pediatric kidney specialist, Dr. Pat Brophy, who recommended the addition of plain water to help make up for all the water the boy had lost in his urine. Normally doctors advise mothers not to give their babies water because breast milk has enough water in it. But clearly this was not a normal baby. And because of the baby’s reflux and difficulty nursing, Brophy also recommended the placement of a tube into the baby’s stomach — a gastrostomy or G tube — to make certain he was able to take in enough calories, medications and the much-needed supplemental water.The baby continued to spit up enormous amounts of the milk and water he received. Usually this kind of spitting up resolves as an infant’s esophagus grows longer and the stomach larger. But this baby wouldn’t grow at all without more nutrition. Hanna recommended the addition of baby formula as well as dried baby food to the milk. He had them enlarge the hole in the bottle’s nipple so the thickened liquid could come through easily. Back on the Growth Curve And then they waited. Test results trickled in. He didn’t have cystic fibrosis. His heart was completely normal. But even as the negative results slowly arrived, the baby’s parents could see that he was improving just by getting the calories and especially the water he needed. Every night he would get the equivalent of an eight-ounce glass of water through his G tube. Every day he was fed every three hours to get a total of 1,300 calories. And slowly he began to gain weight — 30-40 grams a day. He stayed in the hospital for nearly two weeks, and by the time he and his parents could go home, he had put on over a pound. It took him a couple more months to get back on the growth curve. Only then did they get the results of the genetic testing, confirming what they already knew: The baby had D.I.That baby is now 7. He is learning to live with his D.I. He continues to take the medications that help him get rid of his sodium. He has to go to the bathroom often. And he must drink lots and lots of water to replace all that he loses in his urine. He’s not as big as his brothers — not yet, and maybe not ever. But he is still growing and thriving, and as far as his parents are concerned, that’s more than enough.Lisa Sanders, M.D., is a contributing writer for the magazine. Her latest book is “Diagnosis: Solving the Most Baffling Medical Mysteries.” If you have a solved case to share, write her at Lisa.Sandersmdnyt@gmail.com.

They get paid in formula and diapers, and their work hours are flexible, in a program that connects people across generations and brightens lives.TOKYO — Cooing, giggling and the patter of tiny feet mix with the sound of walkers and wheelchairs at a nursing home in southern Japan. In this graying nation, one home has been recruiting an unusual class of workers to enliven its residents’ days.These are “baby workers,” as the nursing home’s head calls them: 32 children so far, all under 4 years old, who spend time with its residents, who are mostly in their 80s. Residents strike up conversations with the young helpers. The babies, accompanied by their parents or guardians (usually mothers), offer the residents hugs.The visitors’ reward? Diapers, baby formula, free baby photo shoots and coupons for a nearby cafe.The facility, Ichoan Nursing Home, is in Kitakyushu, a city of 940,000 in Fukuoka Prefecture that is aging and shrinking like the rest of Japan. As families have become smaller and older people more isolated, the nursing home’s baby worker program has helped people connect across generations.“I don’t get to see my grandkids very often, so the baby workers are a great treat,” said Kyoko Nakano, 85, who has lived at the nursing home for over a year. While she enjoys knitting and watching TV, she said she drops everything to spend time with the babies and toddlers when they arrive.“They are just so cute, and they make the whole place brighter,” Ms. Nakano said. “Young energy is different.”As Japan’s population has aged, the use of nursing homes has grown rapidly. The number in such homes more than doubled, to 1.8 million, between 2005 and 2020, according to the Japanese government. Life can be lonely and dull there, but at Ichoan Nursing Home, residents said that the babies brought energy and light.Studies have linked social interaction with less loneliness, delayed mental decline, lower blood pressure and reduced risk of disease and death among older people. Socializing across generations has also been shown to draw older people out, making them smile and talk more. For children, these intergenerational interactions have been shown to enhance social and personal development.Residents said that the babies brought joy and energy to the nursing home.Ichoan Nursing HomeThe concept of letting nursing home residents interact with children is not new. In Seattle, residents of Providence Mount St. Vincent have shared their facility with a child care program for newborns to 5-year-olds since 1991. Among Ichoan’s 120 residents, the oldest is 101, said Kimie Gondo, 58, the nursing home’s director. The youngest baby worker, at 2 months old, can barely hold his head up, she said.Ms. Gondo said she was inspired to start the program last year when she took her newborn granddaughter with her to work and saw how the residents smiled and played with her. “I thought it was selfish to only have my granddaughter enjoy this special time,” she said, “so we decided to open it up to any baby that wanted to come do the same work.”Expectations are loose for the little visitors, since they can be hard to corral. Toddlers are asked to stroll around the nursing home and interact with the residents, and parents help the babies circulate. “Nothing is mandatory,” Ms. Gondo said. “The babies decide when they come and for how long they want to stay.”Parents at Ichoan, whose children are mostly too small for school or day care, said that the nursing home gave their children a rare opportunity to socialize safely at a time when Covid risks have kept many families cooped up. They said they trust that the nursing home has taken proper precautions against virus transmission to protect its vulnerable residents.One mother, Mika Shintani, 31, said she signed her daughter up because she wanted her to encounter people beyond her immediate family. She also said she felt more comfortable taking her to the nursing home than to a park or a friend’s home. “My daughter was spending the majority of her days only interacting with me,” she said, “so I thought seeing other faces would be good for her.”Ms. Gondo said that she had not yet seen a father accompanying a baby at Ichoan. Men in Japan do fewer hours of household chores and child care than in any of the wealthiest nations, according to the Organization for Economic Cooperation and Development.On her daughter’s first day, Ms. Shintani said, she was 5 months old and cried when she arrived at the facility in her stroller. But she quickly warmed up to the residents and started laughing and playing with the women there, so they started going every two weeks.The perks of the program are not just the tangible ones, like diapers and formula, she said: “On the days my daughter is hard at work, I don’t have to cook lunch!”

Pancreatic cysts have gained substantial attention in recent years because they represent one of the only precursors of pancreatic cancer identifiable through radiologic imaging. Although most of these cysts, also known as pancreatic intraductal papillary mucinous neoplasms (IPMNs), will remain benign, a subset of these neoplasms will progress to invasive cancer. While the immune system has been thought to play a role in the progression of IPMNs into pancreatic cancer, the specific mechanisms of its role has been unclear.
A UC San Francisco-led team of international researchers has outlined the comprehensive immune landscape and microbiome of pancreatic cysts as they progress from benign cysts to pancreatic cancer. Their findings, publishing August 31 in Lancet Gastroenterology and Hepatology, could reveal the mechanism of neoplastic progression and provide targets for immunotherapy to inhibit progression or treat invasive disease.
“This will have far reaching implications on how we think about utilizing immunotherapies to treat certain types of pancreatic cancer, and also potentially inhibit the formation and progression of cancer from pancreatic cysts,” said senior author Ajay V. Maker, MD, FACS, FSSO, a pancreatic surgeon, chief of UCSF’s division of surgical oncology, and Maurice Galante Distinguished professor of surgical oncology.
The immune tumor microenvironment of the IPMNs evolves during malignant progression. A tumor microenvironment is the cellular environment that surrounds a tumor and includes immune cells and a stroma that supports other cells and tissues. A tumor and its microenvironment are constantly interacting with the microenvironment influencing both healthy and abnormal cell development (dysplasia).
As neoplasms progress from low-grade dysplasia to high-grade dysplasia and then to invasive carcinoma, a cytotoxic immune response rich in CD8+T cells changes to an immunosuppressive environment with a measurable inflammatory response.
The researchers suggest that therapies that support cytotoxic T cells could be ideal for IPMNs with low-risk disease, whereas treatments that target regulatory T cells, myeloid-derived suppressor cells, and inhibitory macrophages could play a role in reducing malignant progression and treating high-risk disease. In addition to the treatment of IPMNs with an associated invasive carcinoma, addressing the immune tumor microenvironment could prevent the progression of IPMNs at high risk of malignant transformation.
The researchers discuss that with progressive amounts of dysplasia, the tumor microenvironment shows an increase in the concentration of pro-inflammatory and cyst fluid cytokines, which is indicative of a T-cell immunological response. The team’s research suggests that evaluation and characterization of the immune response to IPMNs could allow for early diagnosis, and potentially enhance treatments to halt progression or treat invasive disease.
The researchers also suggest that further studies addressing the tumor immune microenvironment of pre-invasive lesions are needed, including assessment of main-duct disease compared with branch-duct disease.
Funding: Ajay V Maker’s research in tumor immunology is funded through the National Institutes of Health Method To Extend Research in Time award (R37CA238435), and he has the following pending or issued patents: WO2018183603A1 (PCT/US2018/025027) and US9757457B2.
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Materials provided by University of California San Francisco Medical Center. Original written by Melinda Krigel. Note: Content may be edited for style and length.

An experimental combination of two drugs halts the progression of small cell lung cancer, the deadliest form of lung cancer, according to a study in mice from researchers at Washington University School of Medicine in St. Louis, Grenoble Alpes University in Grenoble, France, and The University of Texas MD Anderson Cancer Center in Houston.
One of the drugs, cyclophosphamide, is an outdated chemotherapy drug once used to treat small cell lung cancer. It was displaced in favor of platinum-based drugs in the 1980s. Both kinds of drugs work at first but falter after a few months as the cancer develops resistance. Platinum-based drugs became the standard of care mainly because they cause lesser side effects, but they have not substantially improved prognosis. Today, the typical patient survives less than a year and a half after diagnosis.
In this study, however, researchers showed that small cell lung cancer cells resist cyclophosphamide by activating a specific repair process, and demonstrated that throwing a wrench into the repair process makes the drug much more effective, at least in mice. The findings, available online in Cancer Discovery, suggest a pathway to better therapies for one of the least treatable forms of cancer.
“Small cell lung cancer has one treatment option — platinum-based chemotherapy — and that adds maybe two to six months of life,” said co-senior author Nima Mosammaparast, MD, PhD, an associate professor of pathology & immunology and of medicine at Washington University, and a researcher at Siteman Cancer Centerat Barnes-Jewish Hospital and Washington University School of Medicine. “The problem is that these tumors respond to treatment initially, but then they come back. This has not changed for 30 years. These tumors are just massively resistant to just about everything. So what this study shows is that we can actually combine a new target with an old drug to reduce resistance and potentially make the treatment much better and give these patients a much better chance.”
The study came together fortuitously. Co-senior author Nicolas Reynoird, PhD, a professor at Grenoble Alpes University, studies how internal signaling within cells — and deregulation of such signaling — can lead to cancer progression and drug resistance. A few years ago, his team discovered that a protein called RNF113A may play a role in small cell lung cancer, but the researchers could not determine what the protein does. Meanwhile, Mosammaparast was studying how cells repair injured DNA. In 2017, he published a paper in the journal Nature describing how cancer cells repair a kind of DNA damage known as alkylation damage, the kind caused by cyclophosphamide. The paper noted that RNF113A plays a role in the process. Reynoird essentially cold-called Mosammaparast, and the two teamed up — along with co-senior author Pawel K. Mazur, PhD, an associate professor of experimental radiation oncology at MD Anderson and a longstanding collaborator of Reynoird’s — to investigate how small cell lung cancer cells resist alkylation damage, and whether it’s possible to magnify the effects of alkylating chemotherapy drugs such as cyclophosphamide by interfering with that resistance.
The team discovered that RNF113A is regulated by a protein called SMYD3 that is highly expressed in small cell lung cancer and some other cancers. High levels of SMYD3 are associated with more invasive disease, increased resistance to alkylating chemotherapy and worse prognosis. Healthy lung tissue has very little SMYD3, which led the researchers to think that knocking it down might target cancerous cells while sparing healthy ones.
So they tried it. The researchers created mouse models of human disease by grafting cancerous cells from two people with small cell lung cancer onto separate groups of mice. One set of cells came from a patient who had not yet been treated, so the cells had not had a chance to develop resistance. The other came from a patient who had been treated with and become resistant to standard platinum-based therapy.
All of the mice grew tumors. When the tumors were big enough, the researchers treated the mice with an inhibitor of SMYD3, cyclophosphamide, both or an inactive solution. Inhibiting SMYD3 alone modestly slowed down the growth of the tumors. Cyclophosphamide initially halted the growth of tumors from both patients, but the tumors started to grow again after about two weeks, indicating that they had developed resistance. However, the combination of the two drugs stopped the tumors in their tracks. They did not restart growing for the duration of the experiment.
“We’re talking to a number of other groups about starting a phase 1 clinical trial as soon as possible,” Mosammaparast said. “One of the challenges we will face is convincing doctors to go back to an old drug. But the nice thing about this strategy is that it may work where current therapies have failed. This treatment worked just as well against the tumor from the patient who had already relapsed on platinum-based therapy as it did against the untreated patient. People with small cell lung cancer are in desperate need of better treatments, and I’m very excited about the possibilities here.”
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Materials provided by Washington University School of Medicine. Original written by Tamara Bhandari. Note: Content may be edited for style and length.

Dolutegravir-based antiretroviral therapies (ART) for HIV-1 are more effective for pregnant people than some other ART regimens commonly used in the U.S. and Europe, according to a study led by Harvard T.H. Chan School of Public Health researchers.
The study, which will be published online in NEJM on September 1, 2022, showed that pregnant people who took dolutegravir-based regimens had a high probability of being virally suppressed at delivery. There were no observed differences in the risks of adverse birth outcomes (preterm birth, low birth weight, small for gestational age, or neonatal death) between dolutegravir-based regimens and the other contemporary regimens.
“Globally, a dolutegravir-based regimen is currently recommended for treating HIV, and this is the first study to directly compare regimens including dolutegravir to other antiretroviral regimens, such as raltegravir-based regimens, that are also listed as ‘Preferred’ in U.S. perinatal guidelines” said Kunjal Patel, senior research scientist in the Department of Epidemiology at Harvard Chan School and lead author of the study.
Dolutegravir, a more recently approved antiretroviral drug, is part of a once-a-day regimen that has been shown to be more effective, easier to tolerate, and less likely to create new drug resistance in people with HIV-1 compared with other antiretroviral drugs. However, limited data have been available about its effectiveness and safety in pregnancy compared with regimens that commonly have been used during pregnancy in the U.S. and Europe.
In the current observational study, the researchers compared dolutegravir use in pregnancy with atazanavir/ritonavir, darunavir/ritonavir, and raltegravir antiviral regimens that are currently classified as “Preferred” for use in pregnancy in the U.S. About half of the participants started ART before conception. At delivery, 96.7% of pregnancies of participants who received dolutegravir were virally suppressed, whereas those of participants who took atazanavir/ritonavir or raltegravir had viral suppression of 84.0% and 89.2%, respectively.
“We think the observed differences are due to dolutegravir’s ability to rapidly decrease viral loads and its ease of use as part of a once-daily regimen that’s available as a fixed-dose combination,” said Patel. “Our results highlight the continual need for systematic studies that compare new antiretroviral regimens with those already in clinical practice to help inform the evolution of guidelines and clinical practice over time.”
Other Harvard Chan co-authors include Yanling Huo, Paige Williams, Deborah Kacanek, Denise Jacobson, Sean Brummel, and George Seage. The authors dedicate this work to the memory of their colleague and friend, Seage, who passed away in 2020.
This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, National Institute of Dental and Craniofacial Research, National Institute of Allergy and Infectious Diseases, National Institute of Neurological Disorders and Stroke, National Institute on Deafness and Other Communication Disorders, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute (grants U01HD052102, U01HD052104, and P01HD103133), and the Swiss National Science Foundation (grant 201369).
“Dolutegravir in Pregnancy as Compared with Current HIV Regimens in the United States,” Kunjal Patel, Yanling Huo, Jennifer Jao, Kathleen M. Powis, Paige L. Williams, Deborah Kacanek, Lynn M. Yee, Ellen G. Chadwick, Stephanie Shiau, Denise L. Jacobson, Sean S. Brummel, Leila Sultan-Beyer, Christian R. Kahlert, Rebecca Zash, and George R. Seage III, for the Pediatric HIV/AIDS Cohort Study and the Swiss Mother and Child HIV Cohort Study, NEJM, online September 1, 2022.

For many Americans, the convenience of pre-cooked and instant meals may make it easy to overlook the less-than-ideal nutritional information, but a team led by researchers at Tufts University and Harvard University hope that will change after recently discovering a link between the high consumption of ultra-processed foods and an increased risk of colorectal cancer.
In a study published Aug. 31 in The BMJ, researchers found that men who consumed high rates of ultra-processed foods were at 29% higher risk for developing colorectal cancer — the third most diagnosed cancer in the United States — than men who consumed much smaller amounts. They did not find the same association in women.
“We started out thinking that colorectal cancer could be the cancer most impacted by diet compared to other cancer types,” said Lu Wang, the study’s lead author and a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts. “Processed meats, most of which fall into the category of ultra-processed foods, are a strong risk factor for colorectal cancer. Ultra-processed foods are also high in added sugars and low in fiber, which contribute to weight gain and obesity, and obesity is an established risk factor for colorectal cancer.”
The study analyzed responses from over 200,000 participants — 159,907 women and 46,341 men — across three large prospective studies which assessed dietary intake and were conducted over more than 25 years. Each participant was provided with a food frequency questionnaire every four years and asked about the frequency of consumption of roughly 130 foods.
For the study in BMJ, participants’ intake of ultra-processed foods was then classified into quintiles, ranging in value from the lowest consumption to the highest. Those in the highest quintile were identified as being the most at risk for developing colorectal cancer. Although there was a clear link identified for men, particularly in cases of colorectal cancer in the distal colon, the study did not find an overall increased risk for women who consumed higher amounts of ultra-processed foods.
The Impacts of Ultra-Processed Foods
The analyses revealed differences in the ways that men and women consume ultra-processed foods and the prospective associated cancer risk. Out of the 206,000 participants followed for more than 25 years, the research team documented 1,294 cases of colorectal cancer among men, and 1,922 cases among women.

New research reveals unpaid labour is associated with poorer mental health in employed women, but the effects are less apparent for men.
Published in the Lancet Public Health, University of Melbourne researchers have conducted a review — the first of its kind — to bring together and assess the existing evidence examining the gendered association between unpaid labour and mental health.
Of the 14 studies included — totalling more than 66,800 participants worldwide — five examined unpaid labour (inclusive of care), nine examined housework time and, of these, four also examined childcare.
Researchers found that in addition to the economic penalty women experience shouldering most of the world’s unpaid labour load, there is a mental health cost as well.
Overall, in 11 of the 14 studies examined, women self-reported increased depressive or psychological distress symptoms with increasing unpaid labour demands. For men, only three out of a possible 12 studies reported any negative association.
“We found substantial gender differences in exposure to unpaid labour, with women uniformly doing more in every geographical and time setting — in more than 35 countries — around the world,” research lead Jen Ervin said.
“This double burden of paid and unpaid work exposures women to greater risk for overload, time poverty and poorer mental health. Crucially, women are also routinely trading off paid work hours to meet their disproportionally high unpaid labour responsibilities.”
Ms Ervin said the study highlights the need for greater attention and meaningful action to drive greater equity in the division of unpaid labour.
“There is an undeniable mental load that accompanies unpaid labour and family responsibilities. Reducing the disproportionate unpaid labour burden on women, by enabling men to take on their equal share, has the potential to improve women’s mental health,” she said.
In addition, researchers say substantive policy changes, such as universal childcare and normalising flexible working arrangements for men are urgently required to enable real change.
Researchers conclude that this review highlights the need for further high-quality longitudinal research in this area, the need to better understand nuances within different dimensions of unpaid labour, as well as the need for a consistent approach in how unpaid labour is defined and measured.
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Materials provided by University of Melbourne. Note: Content may be edited for style and length.