Riviste scientifiche

Another lost tribe feared massacred – how can we save the rest?

New Scientist - Gi, 21/09/2017 - 13:12
Should we leave uncontacted tribes alone or try to usher them into the modern world to protect them from violence and disease, wonders Curtis Abraham

Hurricane Maria confirms dire warnings for 2017 hurricane season

New Scientist - Me, 20/09/2017 - 21:36
As Hurricane Maria continues to cause destruction, predictions that 2017 could be the worst hurricane season since 2010 are being borne out

Robots can hitch-hike on sharks thanks to ultrastrong sucker

New Scientist - Me, 20/09/2017 - 21:00
A suction cup modelled on how a strange faeces-eater attaches to other fish can withstand a pull of 340 times its weight, letting robots ride sharks and whales

Handheld scanner divines how nutritious your food really is

New Scientist - Me, 20/09/2017 - 20:00
Climate change and soil degradation are depleting the nutrients in crops, but now a scanner can analyse grain to help farmers mitigate problems as it grows

Why has a UK team genetically edited human embryos?

New Scientist - Me, 20/09/2017 - 20:00
The aim of the work is to better understand embryonic development, rather than to see if genome editing could prevent diseases in children

Old fathers pass on more mutations to kids than old mothers

New Scientist - Me, 20/09/2017 - 20:00
A huge study of Icelanders suggests that older men pass on four times as many new mutations to their kids than women  

3D-printed alloys could lead to lighter planes that fly further

New Scientist - Me, 20/09/2017 - 20:00
Modern aeroplanes are held together with thousands of rivets and fasteners. That could change soon, thanks to 3D-printed weldable alloys

Infamous three-body problem has over a thousand new solutions

New Scientist - Me, 20/09/2017 - 19:02
A long-standing maths puzzle has 1223 new solutions, more than doubling the number of possible paths three objects can take as they orbit one another

Hundreds of UK women are seeking illegal abortions online

New Scientist - Me, 20/09/2017 - 18:20
Women legally entitled to abortions are attempting to buy pills online because they cannot access clinics due to distance, waiting times and domestic abuse

Our closest star system may be home to a stolen star and planet

New Scientist - Me, 20/09/2017 - 17:26
Proxima b, the nearest exoplanet to Earth, may have been captured along with its star instead of born in the dangerous three-star system where it now lives

Kids everywhere have damaging gender stereotyping set by age 10

New Scientist - Me, 20/09/2017 - 16:00
Global study reveals that gender stereotypes become ingrained in "tween" years, leading to life-long health consequences - particularly for girls

Mexico hit by second huge quake caused by same tectonic strain

New Scientist - Me, 20/09/2017 - 13:15
The country has been struck by its second big earthquake in less than two weeks, causing dozens of buildings to collapse

Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis

PLoS Medicine - Ma, 19/09/2017 - 23:00

by Katherine L. Tucker, James P. Sheppard, Richard Stevens, Hayden B. Bosworth, Alfred Bove, Emma P. Bray, Kenneth Earle, Johnson George, Marshall Godwin, Beverly B. Green, Paul Hebert, F. D. Richard Hobbs, Ilkka Kantola, Sally M. Kerry, Alfonso Leiva, David J. Magid, Jonathan Mant, Karen L. Margolis, Brian McKinstry, Mary Ann McLaughlin, Stefano Omboni, Olugbenga Ogedegbe, Gianfranco Parati, Nashat Qamar, Bahman P. Tabaei, Juha Varis, Willem J. Verberk, Bonnie J. Wakefield, Richard J. McManus

Background

Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension.

Methods and findings

Medline, Embase, and the Cochrane Library were searched for randomised trials comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016). Two reviewers independently assessed articles for eligibility and the authors of eligible trials were approached requesting IPD. Of 2,846 articles in the initial search, 36 were eligible. IPD were provided from 25 trials, including 1 unpublished study. Data for the primary outcomes—change in mean clinic or ambulatory BP and proportion controlled below target at 12 months—were available from 15/19 possible studies (7,138/8,292 [86%] of randomised participants). Overall, self-monitoring was associated with reduced clinic systolic blood pressure (sBP) compared to usual care at 12 months (−3.2 mmHg, [95% CI −4.9, −1.6 mmHg]). However, this effect was strongly influenced by the intensity of co-intervention ranging from no effect with self-monitoring alone (−1.0 mmHg [−3.3, 1.2]), to a 6.1 mmHg (−9.0, −3.2) reduction when monitoring was combined with intensive support. Self-monitoring was most effective in those with fewer antihypertensive medications and higher baseline sBP up to 170 mmHg. No differences in efficacy were seen by sex or by most comorbidities. Ambulatory BP data at 12 months were available from 4 trials (1,478 patients), which assessed self-monitoring with little or no co-intervention. There was no association between self-monitoring and either lower clinic or ambulatory sBP in this group (clinic −0.2 mmHg [−2.2, 1.8]; ambulatory 1.1 mmHg [−0.3, 2.5]). Results for diastolic blood pressure (dBP) were similar. The main limitation of this work was that significant heterogeneity remained. This was at least in part due to different inclusion criteria, self-monitoring regimes, and target BPs in included studies.

Conclusions

Self-monitoring alone is not associated with lower BP or better control, but in conjunction with co-interventions (including systematic medication titration by doctors, pharmacists, or patients; education; or lifestyle counselling) leads to clinically significant BP reduction which persists for at least 12 months. The implementation of self-monitoring in hypertension should be accompanied by such co-interventions.

Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: Results of the Compass pilot randomised trial

PLoS Medicine - Ma, 19/09/2017 - 23:00

by Karen Canfell, Michael Caruana, Val Gebski, Jessica Darlington-Brown, Stella Heley, Julia Brotherton, Dorota Gertig, Chloe J. Jennett, Annabelle Farnsworth, Jeffrey Tan, C. David Wrede, Philip E. Castle, Marion Saville

Background

Using primary human papillomavirus (HPV) testing for cervical screening increases detection of high-grade cervical intraepithelial neoplastic lesions and invasive cancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) compared to cytology, but no evaluation has been conducted in a population previously offered HPV vaccination. We aimed to assess colposcopy referral and CIN2+ detection rates for HPV-screened versus cytology-screened women in Australia’s HPV-vaccinated population (by 2014, resident women ≤33 years had been age-eligible for HPV vaccination, with 3-dose uptake across age cohorts being about 50%–77%).

Methods and findings

Compass is an open-label randomised trial of 5-yearly HPV screening versus 2.5-yearly liquid-based cytology (LBC) screening. In the first phase, consenting women aged 25–64 years presenting for routine screening at 47 primary practices in Victoria, Australia, provided a cervical sample and were randomised at a central laboratory at a 1:2:2 allocation to (i) image-read LBC screening with HPV triage of low-grade cytology (‘LBC screening’), (ii) HPV screening with those HPV16/18 positive referred to colposcopy and with LBC triage for other oncogenic (OHR) types (‘HPV+LBC triage’), or (iii) HPV screening with those HPV16/18 positive referred to colposcopy and with dual-stained cytology triage for OHR types (‘HPV+DS triage’). A total of 5,006 eligible women were recruited from 29 October 2013 to 7 November 2014 (recruitment rate 58%); of these, 22% were in the group age-eligible for vaccination. Data on 4,995 participants were analysed after 11 withdrawals; 998 were assigned to, and 995 analysed (99.7%) in, the LBC-screened group; 1,996 assigned to and 1,992 analysed (99.8%) in the HPV+LBC triage group; and 2,012 assigned to and 2,008 analysed (99.8%) in the HPV+DS triage group. No serious trial-related adverse events were reported. The main outcomes were colposcopy referral and detected CIN2+ rates at baseline screening, assessed on an intention-to-treat basis after follow-up of the subgroup of triage-negative women in each arm referred to 12 months of surveillance, and after a further 6 months of follow-up for histological outcomes (dataset closed 31 August 2016). Analysis was adjusted for whether women had been age-eligible for HPV vaccination or not. For the LBC-screened group, the overall referral and detected CIN2+ rates were 27/995 (2.7% [95% CI 1.8%–3.9%]) and 1/995 (0.1% [95% CI 0.0%–0.6%]), respectively; for HPV+LBC triage, these were 75/1,992 (3.8% [95% CI 3.0%–4.7%]) and 20/1,992 (1.0% [95% CI 0.6%–1.5%]); and for HPV+DS triage, these were 79/2,008 (3.9% [95% CI 3.1%–4.9%]) and 24/2,008 (1.2% [95% CI 0.8%–1.6%]) (p = 0.09 for difference in referral rate in LBC versus all HPV-screened women; p = 0.003 for difference in CIN2+ detection rate in LBC versus all HPV-screened women, with p = 0.62 between HPV screening groups). Limitations include that the study population involved a relatively low risk group in a previously well-screened and treated population, that individual women’s vaccination status was unknown, and that long-term follow-up data on disease detection in screen-negative women are not yet available.

Conclusions

In this study, primary HPV screening was associated with significantly increased detection of high-grade precancerous cervical lesions compared to cytology, in a population where high vaccine uptake was reported in women aged 33 years or younger who were offered vaccination. It had been predicted that increased disease detection might be associated with a transient increase in colposcopy referral rates in the first round of HPV screening, possibly dampened by HPV vaccine effect; in this study, although the point estimates for referral rates in women in each HPV-screened group were 41%–44% higher than in cytology-screened women, the difference in referral rate between cytology- and HPV-screened women was not significant. These findings provide initial support for the implementation of primary HPV screening in vaccinated populations.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12613001207707

Shaken baby syndrome is not definitive proof of child abuse

New Scientist - Ma, 19/09/2017 - 16:51
While a debate over the medical diagnosis of shaken baby syndrome rages on, one thing is clear: it is no longer proof of child abuse, says Deborah Tuerkheimer

Sacrificial virgin spiders let their nieces eat them alive

New Scientist - Ma, 19/09/2017 - 16:00
In one species of spider, unmated females not only care for other spiders’ offspring, they allow the tiny spiderlings to devour their insides

Tool-wielding monkeys push local shellfish to edge of extinction

New Scientist - Ma, 19/09/2017 - 14:12
Long-tailed macaques on an island in Thailand are doing such a good job of cracking shellfish with stone tools, they are driving down their prey's numbers and body size

Global services and support for children with developmental delays and disabilities: Bridging research and policy gaps

PLoS Medicine - Lu, 18/09/2017 - 23:00

by Pamela Y. Collins, Beverly Pringle, Charlee Alexander, Gary L. Darmstadt, Jody Heymann, Gillian Huebner, Vesna Kutlesic, Cheryl Polk, Lorraine Sherr, Andy Shih, Dragana Sretenov, Mariana Zindel

Pamela Collins and colleagues explain the research and policy approaches needed globally to ensure children with developmental delays and disabilities are fully included in health and education services.

Secrets of butterfly wing patterns revealed by gene hacking

New Scientist - Lu, 18/09/2017 - 22:00
Butterflies' wings have extraordinary patterns and colours, and it turns out they are controlled by a single "master gene" that performs many roles

Thousands likely to be killed by Hurricane Irma’s deadly legacy

New Scientist - Lu, 18/09/2017 - 20:02
Toxic chemicals released by floodwaters, stress, infection and dangerous working conditions will all contribute to hurricane death toll years after winds die
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