Depression screening tool works for people with chronic pain

A new study found that a widely used depression screening questionnaire is accurate for people with and without chronic pain,

The finding debunks a common misconception that the screening inflates depression scores for people with chronic pain.

Some clinicians and researchers believed a person with chronic pain might score higher on the eight-item Patient Health Questionnaire, or PHQ-8, because they can’t sleep or experience fatigue, which are symptoms of both pain and depression.

“Could pain symptoms artificially inflate depression screening scores among those with chronic pain? It’s a reasonable question, but it had not yet been definitively answered,” says lead author Jennifer S. De La Rosa, strategy director for the University of Arizona Comprehensive Center for Pain and Addiction and an assistant research professor in the U of A College of Medicine–Tucson’s family and community medicine department.

“Using nationally representative population data, we rigorously evaluated this question and found no evidence to support this long-standing concern.”

The paper appears in the Journal of Affective Disorders.

De La Rosa and her team analyzed data from nearly 32,000 US adults who participated in the 2019 National Health Interview Survey. The team used sophisticated data science techniques to assess measurement invariance—ensuring there was no bias—in the PHQ-8 questionnaire.

When comparing the variance of scores for people with or without chronic pain, the data showed that the screener achieved an excellent level of consistency in both groups.

“Clinicians need to know that a positive depression screening is just as reliable in their patients with chronic pain as patients without chronic pain, and they should not hesitate to offer mental health supports to any patient with unmet mental health needs,” De La Rosa says.

“These conversations require sensitivity to ensure patients feel supported by these conversations rather than stigmatized.

“Right now, there’s a national push underway to address treatment-resistant depression, yet for the vast majority of clinical trials, people with chronic pain are excluded from participating,” De La Rosa adds.

“This study provides robust evidence that there would be no scientific problem with including folks living with chronic pain in depression research to help develop treatments capable of meeting the needs of this uniquely underserved population.”

The research underscored the way chronic pain and depression are intertwined, reinforcing De La Rosa’s previous research, which found that while 1 in 5 people with chronic pain have depression, more than half of those with clinically significant depression symptoms also have chronic pain.

A follow-up paper showed that adults with chronic pain are more likely to experience anxiety and depression than those without chronic pain, yet they access mental health care at lower rates and are less likely to have their mental health needs met in treatment.

“People with chronic pain are, in fact, the most typical patients living with unmet mental health needs, and they are wildly overrepresented among people with treatment resistant depression,” De La Rosa says.

“Many of them want to participate in trials. They can benefit just as much as others from inclusion, and, critically, it will improve the real-world effectiveness of the new therapies being developed.

“Now is the time to meaningfully consider the unmet mental health needs of people with chronic pain and prioritize their outcomes within the mental health research, policy and advocacy landscape,” she adds.

In 2023, approximately 64 million US adults experienced chronic pain, according to the Centers for Disease Control and Prevention.

Additional coauthors are from the University of Arizona, Arizona State University, and Johns Hopkins School of Medicine.

The study received support from the National Institutes of Health.

Source: University of Arizona

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Drought in the southwest is shrinking wildlife habitat

As people in the United States are coping with historic drought conditions, the country’s wildlife is also facing problems because of the extreme aridity.

Herbivores, omnivores, and carnivores in the southwestern US have all seen the extent of their suitable habitat shrink due to drought, according to a new study.

“The take-home message is that the effects of drought are huge and widespread. These results aren’t just from one small study system,” says Kirby Mills, a lead author of the new study in the journal Communications Earth and Environment.

Mills, now with the Institute for Wildlife Studies in California, helped lead the work as a postdoctoral researcher at the University of Michigan Institute for Global Change Biology.

The study analyzed 12 years worth of data collected by GPS collars worn by mule deer, black bears, and cougars—herbivores, omnivores, and carnivores, respectively—in Nevada and Utah (currently, Utah is one of nine states completely covered by some level of drought). During severe drought conditions, each species saw at least a 10% reduction in the area of highly selected, or highly suitable, habitat.

“We found that drought was negatively impacting life across Utah and Nevada statewide for species that have very different ecologies,” Mills says.

“We just looked at these three large mammals, but drought is probably affecting all the wildlife living in this region and could threaten their persistence into the future if droughts get worse.”

The study, which was supported by federal funding from NASA, also showed that, under extreme drought, the number of new fawn mule deer per doe can decline by more than 30%.

“What we’re seeing is that drought is having a major impact not just on habitat suitability, but also on fitness, on the survival of wildlife,” says Martin Leclerc, who co-led the study as a postdoctoral researcher at the UM School for Environment and Sustainability, or SEAS. Leclerc is now an assistant professor at the University of Quebec at Chicoutimi.

In quantifying the impact of drought conditions in the southwest, which are becoming more intense and frequent on a warming planet, the study underscores how entwined climate and conservation are, the authors say.

“The study highlights the growing intersection of climate patterns, including drought and wildfire, with landscape planning and management, natural resource management, vegetation dynamics, wildlife behavior, and management—all of these things that are often looked at separately,” says Neil Carter, associate professor at SEAS and a senior author of the study.

“Now we’re finding that they’re enmeshed so tightly and that demands different management strategies moving forward.”

The team’s analysis included information from more than 3,000 animals across a nearly 200,000-square-mile range between 2010 and 2022, resulting in what Leclerc described as a “painfully massive” amount of data.

The team credited David Stoner, another senior author and associate professor at Utah State University, for knowing where to look and who to contact to collect the data from many separate sources. In bringing all that information together, the researchers could dig into how much area each species inhabited as drought conditions changed over time and space.

“The study really shows the value and importance of long-term datasets, especially for big questions related to climate change,” Leclerc says.

The team’s analysis revealed that, when it came to habitat reduction, the impact of drought amplified from prey to predators. In severe drought, mule deer saw reductions of 10% in their highly selected habitat, compared with 14% for black bears and 18% for cougars.

Initially, the numbers were surprising. As drought conditions kill vegetation, the researchers anticipated that could have had the greatest impact on the herbivorous deer. But the team does have an explanation for how the opposite is true.

“Cougars can’t just go and chomp on whatever they find that’s green like deer can,” Mills says. “That means cougars have to work harder for their food and they’re more limited in their opportunities to find food, so their populations can be more sensitive to perturbations.”

Furthermore, population densities tend to decrease as you move up the food web—for example, the study included more than 2,800 mule deer and 105 cougars. So cougars may not only be more sensitive to the impacts of drought, but impacts on individual cougars are going to be felt more at a community level. While this amplification makes cougars and other predators more vulnerable than one might expect, it could also create new opportunities in conservation.

“People are typically managing deer populations, not deer and cougar simultaneously, so I think there will start to be more conversation and communication around that,” Carter says.

And such broader conversations could benefit wildlife writ large.

“There’s pretty robust planning going on for mitigating human vulnerability to climate change, but we don’t have the same level of planning for mitigating wildlife vulnerability,” Carter says.

“I certainly think there are opportunities to bring those together.”

Source: University of Michigan

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Armadillos inspire new tech to protect soft machines

Researchers have drawn inspiration from armadillos to create a protective structure that responds to external threats by curling into a protective ball to protect electronic devices or other payloads.

The structure is designed to automatically respond when it detects strain and can be tuned to respond to anything from a delicate touch to a significant impact.

“There has been a great deal of growth in the fields of soft robotics and flexible electronics, but those devices are often also fragile,” says Yong Zhu, corresponding author of a paper on the work and a professor of mechanical and aerospace engineering at North Carolina State University.

“Our goal was to develop a solution that allows these fragile technologies to function but protects them when necessary.”

“In its relaxed state, the structure we’ve developed is fairly flexible, but it can be activated to curve into a rigid external structure,” says Jianyu Zhou, first author of the paper and a postdoctoral researcher at NC State.

“We could see this technology being used to protect many types of objects—essentially anything it is capable of curving around.”

The robo-armadillo, which the researchers call the morpho-interlocking protective module (MIPM), consists of three general layers:

1. The outer layer, or exoskeleton, consists of a series of segmented, curved scales which are made from a 3D printed resin.
2. The middle, “sensing and actuation” layer, consists of four parts: a liquid-crystal elastomer (LCE), that contracts when heated; a strain sensor made of elastic polymer embedded with silver nanowires; a layer of kapton tape that expands when heated; and then a thin layer of conductive fabric that serves as a “heater” layer.
3. Lastly, there is an endoskeleton layer that consists of heavy-duty paper folded into a series of ridges, which hold a row of rigid polymer “segmental scales” in place.

When the strain sensor detects a touch or impact it signals a control unit, which then sends power to the heater layer. As the heater layer warms up, it causes the LCE layer to contract and the kapton tape layer to expand, causing the entire structure to curve. The end result is that the MIPM structure curls into a protective circle with the exoskeleton facing out.

“As the layers curve into a circle, the segmental scales in the MIPM’s endoskeleton lock into each other—creating a robust internal ‘skeleton’ that contributes to the sturdiness of the structure,” says Zhou.

In proof-of-concept testing, the researchers found the MIPM works as intended, with the sensor layer detecting increased strain and triggering the transformation into a protective shell. The researchers also found that increasing the number of segmental scales in the endoskeleton significantly improves the structure’s internal rigidity and strength.

“Through mechanics-guided design, we established a trade-off between endoskeleton segmentation and structural lightweighting,” says Zhu. “As an example, 10 segmental scales were capable of withstanding around 10 newtons of force.

“We’ve demonstrated a combination of flexibility and mechanical protection that has a lot of potential, and we welcome collaborations from those who are interested in exploring possible applications,” says Zhu.

“We’re also very interested in pursuing additional opportunities to advance work on flexible yet protective technologies that draw on nature for inspiration.”

The paper appears in the journal Science Advances.

This work was done with support from the National Science Foundation and the Department of Defense.

Source: North Carolina State University

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AI shows how your brain cleans out harmful waste

A new approach combines MRI scans and AI tools to measure fluid flow linked to diseases such as Alzheimer’s.

When a person goes into deep sleep, water-like fluid circulates around the brain, washing away metabolic waste linked to diseases such as Alzheimer’s.

This process, known as the glymphatic system, was first described in 2012 by Maiken Nedergaard—a pioneering neuroscientist and codirector of the University of Rochester’s Center for Translational Neuromedicine.

But questions remain about the system’s mechanics—notably, how quickly the fluid circulates. Studying the circulation within a living brain is difficult without causing irreparable harm to a subject.

“You can put a microscope on a small patch of the brain and watch what’s happening there with a lot of detail, and we’ve worked with that type of data in the past, but it’s only a tiny view of the overall process,” says Professor Douglas Kelley from URochester’s mechanical engineering department.

“If you want to image whole brains, an MRI is a great approach because it gives you a three-dimensional view. But an MRI has serious limitations, too, the biggest of which is that it does not capture the fluid flow velocity, at least not for flows this slow.”

Kelley and his colleagues turned to artificial intelligence for help.

In a new study in Science Advances, they outline how they used physics-informed AI to determine fluid flow velocities from magnetic resonance imaging (MRI) data. Using videos of dye spreading across brain tissue over time, the neural networks the researchers built were able to deduce how fast the fluid flows and how permeable the brain tissue is.

The results showed that there are two main ways that the glymphatic system washes away particles in the brain such as the amyloid beta proteins linked to Alzheimer’s disease—and one of these ways is much faster than the other.

The fast flow of the glymphatic system’s waterlike fluid moves at a few microns per second around the brain’s open regions such as the surface between the skull and the brain, while the slower flow of the waterlike fluid trickles through the brain’s deep tissue at a rate about 50 times slower.

So far, the researchers have been working to get baseline measurements of fluid flow in the brains of animals such as mice to inform the AI tools. In the future, they hope to be able to compare the fluid flow in healthy and sick brains as well as young and old brains, with aspirations to eventually study circulation in humans.

“We’re working hard toward being able to measure the flow of waterlike fluids in and around human brains because then the clinical applications get a lot more important and exciting,” says Kelley.

“We hope to someday be able to see whether an Alzheimer’s patient has poor circulation in their brain or even screen for poor circulation earlier in life to try to stave off Alzheimer’s. Or we could check when somebody has been concussed to see whether the fluid circulation in their brain is disrupted. This study gets us a step closer.”

Additional collaborators on the study are from Brown University, URochester, and University of Copenhagen.

The NIH National Center for Complementary and Integrative Health and the NIH BRAIN Initiative supported this research.

Source: University of Rochester

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High-puff vapes may become more toxic with use

A new study finds that heavily used high-puff electronic cigarettes may contain higher levels of harmful chemicals than fresh e-cigarettes, raising concerns about potential health risks for users.

E-cigarettes, also called ECs or vapes, are sold with an advertised puff count—roughly how many inhalations the device is designed to deliver before it is depleted. A high-puff EC is one rated for many puffs, typically in the thousands. Because they hold more e-liquid and are designed for extended use, users can vape on a single device for days or weeks.

The researchers analyzed liquid from popular disposable vape devices collected from users and discarded products in Southern California. They compared the leftover liquid in used devices with fresh, unused versions of the same brands and flavors to see how the chemical makeup changed over time.

The study in ACS Omega focused on chemicals known as aldehydes, which form when vape liquids are heated.

When e-liquid is aerosolized or heated to produce vapor, the solvents and flavor chemicals undergo thermal degradation and chemical breakdown. Aldehydes are a well-documented class of by-products from that process. Some, like formaldehyde, are already recognized as harmful constituents.

The researchers wanted to know whether prolonged use of a device, with more puffs and more heating cycles, would cause these compounds to accumulate in the remaining fluid over time. They found several toxic aldehydes, including methylglyoxal (MGO), glyoxal (GO), and formaldehyde, increased significantly after the devices were used.

“Several aldehydes we measured are known toxicants,” says Esther Omaiye, a postdoctoral scholar in the molecular, cell, and systems biology department at the University of California, Riverside and the paper’s first author.

“Formaldehyde is a recognized carcinogen. MGO and GO, for example, reached milligrams-per-milliliter concentrations in some of the vaped fluids we analyzed. These are not trace amounts. When tested on human lung cells, these aldehydes caused measurable damage.”

The researchers were concerned that a person using a high-puff device toward the end of its life might inhale significantly more of these compounds than someone using a fresh device. To better understand the health impact, they exposed human lung cells to MGO and acetaldehyde. MGO caused significant cell damage, disrupted normal cell structure, interfered with energy production, and increased oxidative stress, a process linked to inflammation and disease. The study found MGO was 10 to 100 times more toxic than acetaldehyde.

“Our findings suggest that the fluid remaining in a heavily used device has a very different and measurably more toxic chemical profile than fresh e-liquid,” says Prue Talbot, a professor of the graduate division at UCR and Omaiye’s advisor.

“Chemical levels varied across brands, but our overall findings show extended use of high-puff disposable vapes may lead to greater accumulation of harmful byproducts.”

Electronic cigarettes have been widely used in the United States since about 2007, and newer disposable devices are designed to deliver thousands of puffs before disposal.

“Our study highlights the need for greater attention to how prolonged device use affects chemical exposure,” Omaiye says.

Talbot and Omaiye advise vapers to exercise caution with high-puff devices, particularly as the devices approach the end of their life.

“Until regulatory standards catch up and require testing across the full use cycle of a device, consumers have no way of knowing what they are actually inhaling late in a device’s life,” Omaiye says.

The researchers says the message is clear for researchers and regulators.

“Puff count is not just a marketing figure; it is a variable that directly affects chemical exposure and must be incorporated into safety assessments,” Talbot says.

Additional contributors to work are from UCR and Portland State University in Oregon.

The research was supported by grants from the National Institutes of Health, the Food and Drug Administration Center for Tobacco Products, and California’s Tobacco-Related Disease Research Program.

Source: UC Riverside

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Support for youth in military families can boost mental health

Youth in military families need support from parents and peers to maintain a healthy mental well-being, according to a new study.

Researchers found these relationships are connected to adolescents’ abilities to utilize adaptive coping skills, such as problem-solving and self-reliance, which in turn promote their well-being.

The potential to have a parent deployed overseas, regular moves, and other obstacles make adolescence a particularly challenging time for young people in military families.

“Relationships are important for all youth and for military youth in particular,” says Evin Richardson, corresponding author of the study and an assistant research scientist in the University of Georgia’s College of Family and Consumer Sciences.

“For military youth who are highly transitional, relationships may be a little bit more challenging for them—especially non-familial relationships—because their community often changes so frequently.”

By fostering connections both in and out of the home, military youth can have the stable support they need to better focus on their own self-efficacy and long-term mental health.

Researchers analyzed responses of more than 1,000 adolescents between the ages of 11 and 18 with at least one active-duty military parent. The youth were asked to identify supportive relationships in their lives and to rate their engagement in school, their confidence and any feelings of depression or anxiety.

Of their non-family relationships, the researchers found that nearly 65% of participants felt most supported in their personal lives by their peers, including friends and boyfriends or girlfriends.

Over half of adolescents identified their mother as their primary source of familial support. This could be, the researchers says, due to parent gender or military status since most fathers identified as service members and mothers were typically civilians.

The transitions military youth experience can separate them from extended family, friends and trusted adults including coaches or teachers, so recreating these social networks is key to their well-being.

“Building strong family relationships is important but so is building strong relationships outside the family,” says Catherine Walker O’Neal, coauthor of the study and an associate professor in UGA’s department of human development and family science.

“Does someone care about you? Do they listen to you? Do they understand you? That is the heart of what this paper is about.”

A key finding of the study is the link between relationships, adaptive coping, and mental health.

Supportive relationships provided youth with repeated, meaningful encounters with role models and peers who demonstrated positive ways to cope with stress and emotions. These relationships may also function as safe spaces for adolescents to put aside their worries about external challenges, such as upcoming relocations or possible feelings of isolation. They could instead focus more on building self-sufficiency, managing their stress, and nurturing their own optimism.

O’Neal says some of the ways to reinforce adaptive coping as a mentor would be to model behaviors that encourage compromising, working hard, and talking things out.

“Demonstrating those behaviors and setting up situations so that they can engage in that is a big part of adaptive coping,” she says.

“It’s important that they know how to cope on their own but also that they know it’s OK to ask for help from the people in their lives, both inside and outside of their family.”

Youth who reported higher coping levels were also more engaged in school, had a greater belief in their ability to handle life’s hurdles and had fewer symptoms of depression.

Because military moves come with many unknowns, having areas in kids’ lives that can be positively influenced through quality relationships are important.

Encouraging adolescents to participate in extracurricular activities, both on and off military bases, could help kids build these key connections. Efforts by parents to spend time with their kids while getting involved in the local community are also a good idea, Richardson says.

“Meet adolescents where they are,” she says. “We don’t want to force anybody to go be social if they don’t want to but help them find where their interests might align with someone else’s interests. Start small or look at doing things as a family.”

The study appears in Children and Youth Services Review.

Source: University of Georgia

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Listen: Experts sort quantum tech hype from reality

In a new podcast, scientists demystify quantum, separate hype from reality, and explore potential applications—from cybersecurity to medical sensors to computers.

Quantum technology is at a pivotal moment. No longer the faraway dream of scientists, the field is rapidly developing across the world, fueled by major investments from governments, industry, and universities racing to lead its promising future.

But what exactly is quantum technology? And how will it affect our lives today—and in the coming decades?

In a new episode of the Big Brains podcast, three renowned scientists—Professor David Awschalom, Fred Chong, and Nadya Mason—discuss how the University Chicago is leading innovative research, in partnership with its affiliated labs Argonne and Fermilab, as well as other universities across the Midwest.

They explain how quantum has the potential to revolutionize our world—from creating unhackable communications to supercharging quantum computers to detecting disease at the cellular level.

They discuss the challenges as well as the opportunities, especially for the next generation of quantum engineers and scientists needed to make these dreams a reality.

The event also included a Q&A with audience members. Watch video of the full event or listen below:

Source: University of Chicago

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