New flame retardants, old problems

New flame retardants escaping from our TVs, other electrical and electronic products, and children’s car seats are just as toxic as the flame retardants they’re intended to replace, according to a peer-reviewed study published today in Environmental Science & Technology Letters. The authors found that the replacement chemicals, called organophosphate flame retardants, have been associated with lower IQ in children, reproductive problems, and other serious health harms.

Flame retardants pose a particularly grave threat to children. Babies are born with the same level as their mothers and are further exposed through hand-to-mouth behavior. Young children can have 3 to 10 times the flame retardant levels of adults, or even more. This can harm their developing brains and reproductive organs at the most vulnerable time.

“We need to realize that these flame retardants threaten the brain development of a whole generation,” said retired NIEHS Director Linda Birnbaum.

Flame retardant chemicals aren’t necessary, or even effective, for reducing fire hazard in many products. These chemicals are added to meet flammability regulations. But research shows they often delay ignition only a few seconds, and make fires more dangerous.

After years of research and advocacy, dangerous flame retardants called polybrominated diphenyl ethers (PBDEs) were phased out of use in furniture foam, electronics, and children’s products. While their phaseout was initially celebrated as a victory for human health, PBDEs have been swapped out with organophosphate flame retardants in many products.

Like the old PBDE flame retardants, organophosphate flame retardants are continuously migrating out of products and dropping into dust. When dust contaminated with flame retardants gets on your hands, you can end up eating the flame retardants along with your sandwich. The scientists also found that levels of organophosphate flame retardants are often 10 to 100 times higher in air, dust, and water than the previous flame retardants.

Most concerning of all, organophosphate flame retardants were found in nearly every person studied. Several were found at levels high enough to threaten fertility in adults and healthy brain development in children.

“These results show the danger of the whack-a-mole approach to chemical policy,” said Dr. Marta Venier, an Associate Scientist at Indiana University. “When manufacturers have to stop using a toxic chemical, they often replace it with a similar chemical with similar harms. In the case of flame retardants, we’re jumping out of the frying pan and into the fire.”

For this study, the investigators reviewed nearly one hundred peer-reviewed scientific papers on flame retardants. They compared research findings on the health effects, environmental harms, and chemical properties of the older PBDEs and newer organophosphates.

They found that the replacement chemicals are carried by wind and water far from their origin — even to the ocean depths, icy mountain tops, and Earth’s poles. “Organophosphates are now found worldwide, polluting areas where flame retardants were never used,” according to Professor Miriam Diamond from the University of Toronto.

The authors call for manufacturers to increase fire safety in furniture, electronics, and children’s products with creative designs and inherently fire-resistant materials. “Our findings demonstrate the importance of dealing with these chemicals as a class rather than individually,” said Veena Singla at the University of California, San Francisco Program on Reproductive Health and the Environment. “While policies are heading in that direction, we can act now to reduce unnecessary use to protect human and environmental health.”

“It’s disheartening that after years of health harm to our children from PBDE flame retardants, the most widely used replacements appear to be just as bad,” said Dr. Arlene Blum, Executive Director of the Green Science Policy Institute. “To protect future generations, manufacturers can and must stop the cycle of toxic substitutions and avoid unneeded flame retardants altogether.”

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Materials provided by University of Toronto. Note: Content may be edited for style and length.

The secret of classic Belgian beers? Medieval super yeasts!

An international team of scientists, led by Prof. Kevin Verstrepen (VIB-KU-Leuven) and Prof. Steven Maere (VIB-UGent), has discovered that some of the most renowned classic Belgian beers, including Gueuze and Trappist ales, are fermented with a rare and unusual form of hybrid yeasts. These yeasts combine DNA of the traditional ale yeast, Saccharomyces cerevisiae, with that of more stress-resistant feral yeasts such as Saccharomyces kudriavzevii.

Mixed origins

“These yeasts are hybrids between two completely different species” says Dr. Jan Steensels (VIB — KU Leuven Center for Microbiology), who coordinated the lab work of this study. “Think of lions and tigers making a super-baby.”

Such interspecific hybridizations are rare and seem to be favored by the domestication process. In this case, the new hybrid yeasts combined important characteristics of both parental species, with the fermentation capacity of normal beer yeasts and the stress tolerance and capacity to form special aromas of more feral ancient yeasts like S. kudriavzevii that haphazardly made their way into the brewery.

The team, from the VIB-KU Leuven Center for Microbiology and the University of Munich, supported by industrial partners, has spent five years characterizing the different yeasts used in today’s production of beer, wine, bread and biofuels. The genetic analysis of these yeasts was quite a piece of work, because none of the existing pipelines for DNA sequencing can deal with such mixed origins.

For this the team could, surprisingly, count on the plant expertise of professor Steven Maere, a bioinformatics expert from the VIB-UGent Center for Plant Systems Biology. Maere explains: “Plants have some of the most complex genomes of all living organisms. It is fascinating that complex interspecific hybrids with doubled genomes feature prominently both among domesticated yeasts and domesticated plants.”

A surprise in DNA

“It was a bit of a surprise for us” says Dr. Brigida Gallone (VIB-KU Leuven Center for Microbiology), the lead author on the paper that appeared today in Nature Ecology and Evolution. “In 2016, we reported that most industrial yeasts belong to, or arose from the species Saccharomyces cerevisiae, the traditional baker’s and brewer’s yeast. We found that these industrial yeasts are quite different from their wild progenitors, with different subfamilies having adapted to beer, wine and bakery environments. We also noticed that some of the yeasts that were isolated from ancient Belgian beer styles, like Gueuze and Trappist beers, are even more unusual and contained DNA of two different yeast species.”

“It really seems that these unique natural yeasts allowed the development of some of the most renowned beers that Belgium is so famous for,” says Dr. Philippe Malcorps, Senior Scientist at the Global Innovation and Technology Center of AB InBev, the world’s largest brewer. The team of Malcorps helped with the isolation of yeasts from some of their spontaneous fermentation beer cellars. Those natural super-yeasts are living witnesses of brewing from pre-industrial ages, adapted to harsh conditions of fermentation of the strong Trappist beers, or survival in the long lagering typical for Gueuze beers.

“One could say that the unique habitat in wooden fermentation barrels created by adventurous Medieval Belgian brewers allowed these new species to thrive until today,” says Prof. Kevin Verstrepen (VIB-KU Leuven Center for Microbiology).

A history of yeasts

Apart from the special Belgian yeasts, the team also collected a large number of hybrids from S. eubayanus and S. cerevisiae, or from S. uvarum strongly adapted to cold fermentation. While it was already known that lager yeasts were hybrids, the complete DNA analysis of a large number of these yeasts showed how these specific hybrids originated in medieval Germany and later spread across different European breweries as the pilsner beers grew more popular.

“It is no coincidence that the origin of today’s beer yeasts lies in Belgium and Germany, arguably the two countries that are most associated with the art of brewing,” says Prof. Mathias Hutzler (TU Munich).

In addition to isolating and characterizing additional yeasts from classic breweries, the Verstrepen team is now also using these new insights to create novel hybrids that are even better at making flavorful beer. By crossing different natural yeasts isolated from all over the world, the team hopes to generate new beer yeasts that allow brewers to create new aroma patterns, or brew in a more ecological and sustainable way, for example by limiting cooling or allowing fermentation with a better use of local raw materials.

Here’s Why Your Doctor Might Prescribe a Biologic for Your Psoriasis

If you’ve tried every topical cream under the sun to treat your psoriasis, you know how frustrating it can be when none of them actually do that much for you. And, sometimes, trying to find the best way to treat your condition can just add to the frustration.

“Luckily there are a lot of available options,” Shari Lipner, M.D., Ph.D., dermatologist at Weill Cornell Medicine and New York-Presbyterian, tells SELF. And a board-certified dermatologist can tailor the treatment plan to what type of psoriasis you have, how much of your body it covers, and if you have any signs of arthritis along with it.

Once at least 5 percent of your body is affected by psoriasis, you start to qualify for biologic medications, Kyle Cheng, M.D., Health Sciences Assistant Clinical Professor at the David Geffen School of Medicine and Director of the UCLA Psoriasis Specialty Clinic at UCLA Medical Center, tells SELF. These medications, which act on parts of your immune system, may sound a little intimidating, but they can be an effective part of your overall treatment plan. Here’s what you need to know if your doctor suggests one.

Here’s what a biologic actually is.

A biologic is a drug that treats the symptoms of psoriasis by acting on the immune system, SELF explained previously. They can be delivered by IV, but most of them are injected, which you can do at home or in your doctor’s office depending on how often you need to do them.

There are three main categories of biologics for psoriasis—drugs that target TNF-a, IL-17, and IL-23—and they all act on different parts of the immune system. Essentially, they work by inhibiting parts of the immune system that are overactive in psoriasis. Although older drugs targeted parts of the immune system that worked on the body more broadly, newer ones are more specific and, therefore, tend to have fewer side effects.

Biologics aren’t usually first-line treatments.

For most people with psoriasis, topical creams are the first line of treatment that their doctor will prescribe. If that doesn’t work for you, then they might suggest something like light therapy or a biologic treatment. “I’ll give it a few months of topical treatments, and if that’s not [helping] then I’ll go with a biologic,” Dr. Cheng explains.

But if your psoriasis is on a part of your body that’s particularly difficult to treat like your scalp, hands, feet, nails, armpit, or groin area, your doctor might go straight to suggesting a biologic, Dr. Cheng says. Also, if your psoriasis covers a larger amount of your skin or you’re developing any symptoms of psoriatic arthritis, a topical treatment isn’t going to do much for you, he says. So your doctor might suggest a biologic.

“Someone with one or two plaques on the legs could probably be treated with topical therapy very well,” Dr. Lipner says, “but the biologic therapy is used for more widespread disease or hard to treat areas, as well as [in] patients who may have psoriatic arthritis [where] you want to be more aggressive.”

Your doctor should also take your quality of life into account, Dr. Lipner says. Even if you only have psoriasis on a small part of your body, it can still cause you to be self-conscious if it’s on a particularly visible area of skin, for instance. So, in that case, your doctor may want to treat it more aggressively.

What should you expect when on a biologic?

Older biologics, like infliximab, can be given via IV. But more recently developed biologics are given as subcutaneous injections (meaning they go under the skin). You may need an injection as often as every week or two, or as little as every few months, depending on your symptoms.

If you need to get them more often, you may be given the option to do them yourself at home, Dr. Cheng says. Generally, the best place to inject it will be a large fatty area of your body, most commonly the thigh, Dr. Lipner says. But you’ll need to be careful to switch up where you inject the medications so you don’t get too sore in one spot, she cautions.

Different biologics produce noticeable changes at different rates, Dr. Cheng says. And, of course, every patient is different. But many people with psoriasis plaques start to see improvement within a month and see their maximum results in another two months.

“[Biologics] tend to be the quickest out of all the treatments we have for psoriasis but they do vary,” Dr. Lipner says. For instance, patients with nail psoriasis should give a biologic drug a solid six months to decide if it’s working, because cell turnover in your nails goes more slowly than other parts of the body.

As with any medication, biologics come with some possible side effects.

The most common side effects of getting a biologic are irritation and soreness around the injection site. But, like any medication that alters the way your immune system works, you will be more vulnerable to pathogens while taking a biologic. In practice, for most patients, that amounts to “about one more cold per year,” Dr. Cheng says.

But it’s a risk that’s worth talking over carefully with your doctor. They’ll likely want to make sure you’re up-to-date on all of your vaccinations before starting the biologic, Dr. Lipner says. Not only does being on a biologic increase your risk for new infections, but in some cases it also increases the risk that latent illnesses in your body might reappear, especially tuberculosis. So, if you show any reactivity to tuberculosis in particular, you’ll need to be treated for that before starting the medication, Dr. Lipner explains.

Once you’re on the biologic, you’ll have to be careful to avoid live vaccines, like the MMR vaccine, Dr. Cheng says. Attenuated (inactive vaccines), like the flu shot, are safe and recommended, though. The one exception is the nasal flu vaccine, which is a live vaccine, Dr. Cheng explains.

And know that biologics are frequently prescribed alongside other types of treatment, like topical medications, UV therapy, and oral medications. So don’t be surprised if your doctor wants to give you some kind of a combination.

However, there are some people who definitely shouldn’t be on biologics, including people who are pregnant or trying to get pregnant. Also, people with Crohn’s disease shouldn’t take certain biologics for psoriasis, but there are some biologics that could help with both conditions.

So, as helpful as biologics can be for some patients, they aren’t right for everyone. And figuring out the right treatment for you can be complex.

Because so many new treatments for psoriasis (including biologics) are coming out so quickly, “it’s a very exciting time in dermatology right now,” Dr. Lipner says. Treatments like these “can really change the patient’s quality of life,” she continues, so it’s crucial to see a dermatologist and find a treatment regimen that works for you.


What Exactly Are Biologics for Psoriasis?

Psoriasis—and the dry, itchy, scaly patches of skin that it causes—doesn’t usually go down without a fight. And, if your symptoms haven’t responded to topical treatments or you have certain types of psoriasis that can be challenging to treat, your doctor might recommend trying biologics as a treatment for your psoriasis. To which you might say, understandably, “What the heck is a biologic?”

They definitely sound a little sci-fi, but these types of treatments are very real and may be helpful if other treatments haven’t worked for you.

Wait, what are biologics?

Biologic treatments are a type of drug given by IV or injection every few weeks or months, Kyle Cheng, M.D., Health Sciences Assistant Clinical Professor at the David Geffen School of Medicine and Director of the UCLA Psoriasis Specialty Clinic at UCLA Medical Center, tells SELF. Psoriasis is an autoimmune disease—meaning that it results from a situation in which the immune system attacks a part of the body as if it were a pathogen—so biologics work by dampening the immune system response.

There are, generally, there major kinds of biologics used today to treat psoriasis, Shari Lipner, M.D., Ph.D., dermatologist at Weill Cornell Medicine and New York-Presbyterian, tells SELF. They’re categorized by the specific component of the immune system they act on: tumor necrosis factor alpha (TNF-alpha), interleukin-17 (IL-17), and interleukin-23 (IL-23).

How do biologics work to help treat psoriasis?

As we mentioned, drugs like these work because they target a specific part of the immune system that’s involved in psoriasis, Dr. Cheng explains. But they accomplish that in slightly different ways.

Biologics that target TNF-alpha are generally older drugs (like adalimumab and infliximab) and, because TNF-alpha is involved in a lot of normal bodily processes outside of psoriasis, targeting it could come with more side effects than newer options. Specifically, TNF-alpha is a type of protein called a cytokine, and it has actions all over the body related to infections and inflammation. That’s why, in addition to helping treat the symptoms of psoriasis, drugs that modulate TNF-alpha can also be helpful in treating conditions like inflammatory bowel disease and rheumatoid arthritis.

Those newer options—biologics that target IL-17 (such as brodalumab and ixekizumab) or IL-23 (like risankizumab-rzaa and guselkumab)—are working on parts of the immune system that seem to play a large role in the formation of psoriasis plaques. So, targeting them is less likely to affect the rest of your body than a TNF-alpha biologic might. Interleukins, another type of cytokine, are produced by white blood cells, which play a crucial role in the body’s immune responses. But different interleukins have different jobs and pathways in the body. Although IL-17 and IL-23 do seem to have minor roles in fighting infections, Dr. Cheng says, their most major role seems to be in psoriasis. Still, no biologic treatment is going to be 100 percent specific, Dr. Lipner says.

Depending on your exact symptoms, your doctor may recommend combining your biologic with another treatment, like topical medications or UV therapy. But biologics aren’t usually combined with each other, Dr. Cheng says.

Depending on the exact treatment, patients may see improvements with biologics within a month, Dr. Cheng says, and they’ll see maximum results within three months. That said, if you stop using the biologic, you can expect your psoriasis to come back. So, patients who find success with biologics can probably expect to be on them for a while, Dr. Lipner says.

Biologics are just one option to treat psoriasis.

The right treatment for you depends on the severity of your psoriasis symptoms, how much of your body is affected by those symptoms, and how much they’re affecting your overall quality of life. Additionally, if you have psoriasis patches in notoriously hard-to-treat areas like your hands, feet, or scalp, or if you’ve developed symptoms of psoriatic arthritis, your doctor may want to give you a more intense treatment like a biologic earlier on.

But, ultimately, there’s no one treatment plan that’s going to be a winner for everyone. And figuring out what works for you—or what combination of treatments works for you—may be a long process involving some trial and error. So, it’s crucial to talk over your options with your doctor.


There’s No Such Thing as a Mistake-Free Life But Here’s How to Make the Best of Your F*ck-ups

I’ve been writing an advice column for almost 10 years. That column, “Ask a Queer Chick,” covers sex, love, and life for LGBTQ people as well as the straight people who want to support our community. It’s been around since the beginning of 2011 (first for The Hairpin, then for Splinter, and most recently for Rewire News) and yet I still find myself stunned (and humbled) by the vulnerability entrusted to me, a third party and outsider, with people’s most personal struggles.

People write to me in real anguish, often torn between two courses of action, incompatible with each other but equally necessary to consider. “I love my husband, but I can’t shake the feeling that I’m meant to spend my life with another woman,” one letter read. I can imagine the sleepless, tearful nights she’s spent sitting with this seemingly unworkable problem, the outcome of which has huge implications for her, for her partner, and for their relationship.

This question—should I stay with what’s familiar and risk being unsatisfied or should I try something new and risk losing something—is one I’ve gotten in countless forms and permutations over the years. Almost always, when people ask me a version of this question they are also asking some version of another question: “What if I regret this?” What if I break up with my boyfriend and no one else ever loves me this much again? What if I come out to my family and they reject me? What if I turn down a job offer in a new city to stay with my partner, but then we break up anyway? What if…?

People write to advice columnists, I’ve found, when they’re facing an important decision and seeking reassurance or permission—when they’re afraid the thing they want to do will have serious repercussions and they’re craving encouragement to go for it anyway, or when they’re hoping to be talked out of doing something unwise but extremely appealing.

Look, I get it. Who doesn’t want an unbiased outsider to tell us what the “right” choice is in any situation? Of course, the rub is that only rarely is there ever a “right” choice, let alone a way of knowing that from the start.

Even though I realized early on that I was often being asked not just for advice but to provide someone with guidance that would safeguard their future happiness, I didn’t really understand at first that I couldn’t provide what they were asking for. For a long time, I struggled with these questions, scared I would give someone advice they’d end up resenting. I’d often advise the course of action that seemed least risky, counseling acceptance and patience.

But in the first year of writing my column, I was also planning my wedding—to someone I met when he was on a date with my friend, who agreed to move to a new state with me just a few months into our relationship. It occurred to me that a great deal of my happiness had come from doing things I would caution others against. I had taken risks that, if they hadn’t worked out, would have seemed terribly foolish in hindsight.

I finally realized that there are few objectively “right” or “wrong” choices in life. Some things are morally wrong, like lying or harming other people—I couldn’t accommodate one woman who wrote in asking for permission to sleep with a man who didn’t know she’d also had sex with his sister. But in terms of possible outcomes, most decisions will have both benefits and drawbacks, and every option is likely to leave you with some doubts about what might have been. The best advice I can give—and I give it, phrased in lots of different ways, to just about everyone—is this: Get comfortable with the knowledge that you are going to screw up.

That doesn’t mean you should be reckless; it means we all have to face the possibility that things won’t turn out the way we want them to, and know that we should have compassion for ourselves anyway. It also means you may never feel 100 percent confident about the path you chose. Still, you can’t live in the shadow of what might have been. It’s wise to think a few steps ahead, and to have a plan for how you’d get through your worst-case scenario, but don’t spend so much time constructing contingencies that you never actually get around to doing the thing.

After all, no one can live a life without mistakes. It’s not possible, and I’m not even sure it would be desirable.How would you ever learn or grow as a person? Besides, one thing I’ve learned from years of anonymous emails from throwaway accounts is that those who have made the fewest obvious mistakes seem to live with the heaviest regrets. I often hear from people (mostly women) who have perfect lives on the surface—good jobs, happy marriages, children—but are eaten up inside wondering about the misadventures they never had. Obviously there’s some selection bias here; people who are totally satisfied with their existence don’t write to advice columnists. Still, it seems to me that dutifully avoiding risk or failure doesn’t predict happiness. Trying to minimize regrets may be less productive than learning to accept and move beyond them.

Sometimes I think the only meaningful advice it’s possible to give is: Take responsibility for what you can, and let go of what you can’t. No one has ever gotten a perfect score in life. You will overreact, speak too soon, break someone’s heart, make a mess, and have to start over. The trick is in realizing that these are all things you can learn from. Sure, think about your next move, consider your actions, and make decisions from a place of kindness and compassion—for you and for others. But after that, you just have to know that your mistakes aren’t detours from your proper path; they’re the entire journey. I can’t tell you what the right decision is. I can, however, remind you that you no matter what decision you make, you can still be a content person whose life is full of fulfillment and love. Take a wrong turn and see where it leads you.

Lindsay King-Miller lives in Denver with her partner, their two children, and an absolutely terrible cat. She is the author of Ask A Queer Chick: A Guide to Sex, Love, and Life for Girls who Dig Girls (Plume, 2016).


Training parents is key to helping children eat a variety of foods

Families dealing with the stress and frustration of their child’s overly picky eating habits may have a new addition to their parental toolbox. Pediatric researchers recently described a brief group cognitive-behavioral therapy program that provides parents with specific techniques to improve their child’s mealtime behaviors and expand the range of foods their children will eat. Although the study size was small, the parents involved reported “life-changing” improvements.

Researchers from Children’s Hospital of Philadelphia (CHOP) and The University of Pennsylvania published this study in the August 2019 issue of Cognitive and Behavioral Practice.

“Our research shows the acceptability, feasibility and positive outcomes of the Picky Eaters Clinic, a seven-session, parent-only, group-based intervention intended to train parents of children with Avoidant/Restrictive Food Intake Disorder (ARFID),” said study leader Katherine Dahlsgaard, PhD, ABPP, Clinical Director of the Anxiety Behaviors Clinic at CHOP. “In the Clinic, parents are taught to act as behavioral therapists who promote long-term improvements in food acceptance and positive mealtime behaviors.”

This study included 21 patients and their parents, who were referred to the Picky Eaters Clinic at CHOP. Families, including the child, attended a diagnostic evaluation and were assessed for treatment eligibility. The children ranged in age from 4 to 12 years and were diagnosed with ARFID, due to excessive picky eating and associated functional impairment.

The families reported that picky eating caused considerable stress. Parental stress resulted from: diet containing less than 20 foods; refusal of entire food groups (typically vegetables, meats or fruits); the need to make a separate meal; difficulty traveling, socializing or going to restaurants; high child distress/refusal to eat when presented with a new or non-preferred food; and lack of child’s motivation to change or unwillingness to receive treatment.

The seven clinic sessions occurred over a 6-month period. The first four sessions were held one week apart; the fifth and sixth were spaced two 3 to 4 weeks apart, allowing families time to practice the assigned behavior strategies at home. Children were challenged at home to chew and swallow a portion of a new or non-preferred food and a successful challenge resulted in a post-meal reward. The majority chose screen time.

The seventh “reunion” session was held 3 months later, to allow parents to catch up and share gains. The researchers administered post-treatment feeding measures and a parent satisfaction survey at the last sessions.

Dahlsgaard is interested in the long-term effects of the treatment and wants to follow up with the families, now that at least 2 years have passed since treatment. “I occasionally receive emails from the parents, telling me that their children are trying everything or eating in restaurants with no problem,” Dahlsgaard says. “But I’m interested to research this systematically and report on the long-term outcomes for all the families.”

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Materials provided by Children’s Hospital of Philadelphia. Note: Content may be edited for style and length.

Twin study shows what’s good for the heart is good for the brain

Emory University researchers are giving us double the reasons to pay attention to our cardiovascular health — showing in a recently published study in the Journal of Alzheimer’s Disease that good heart health can equal good brain health.

The American Heart Association defines ideal cardiovascular health (CVH) across seven modifiable risk factors (blood sugar, serum cholesterol, blood pressure, body mass index, physical activity, diet and cigarette smoking). Higher CVH scores point to better heart health and lower risk for cardiovascular disease (CVD).

Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging. However, it was unclear how genes and/or environment played into the relationship between cardiovascular risk factors and cognitive decline.

By studying pairs of twin brothers from the Vietnam Era Twin (VET) registry, researchers were able to observe the relationship between CVH and cognitive performance across all participants that may be explained by genetics and/or exposures or behaviors that are shared by members of the same family.

Twin studies are a special type of epidemiological study that allow researchers to examine the overall role of genes and environment in a behavioral trait or disorder. Identical twins share 100 percent of their genetic material, while fraternal twins share on average 50 percent of genetic material. For a given trait or medical condition, any excess similarity between identical twins compared with fraternal twins, is likely suggestive of genes rather than environment. Twin studies can serve to differentiate between “nature vs. nurture.”

“Our study across the entire sample of twins confirmed that better CVH is associated with better cognitive health in several domains,” says senior author Viola Vaccarino, MD, PhD, Wilton Looney Professor of Cardiovascular Research, Rollins School of Public Health, and professor, division of cardiology, Emory University School of Medicine. “The analyses further suggested that familial factors shared by the twins explain a large part of the association and thus could be important for both cardiovascular and brain health.”

To determine whether these familial factors were genetically or environmentally driven, researchers further stratified the within-pair analysis to determine whether the relationship between CVH and cognitive function was different between identical and fraternal twins.

The within-pair association was similar in identical and fraternal twins. Therefore familial factors, such as early family environment, early socioeconomic status and education, and parenting — rather than genetics — may be important precursors of both cardiovascular and brain health — thus explaining some of the association between CVH and cognition.

“Improving population-level CVH scores, which are extremely low in the United States, has the potential to reduce the burden of dementia along with heart disease,” says study co-author Ambar Kulshreshtha, MD, PhD, assistant professor of family and preventive medicine, Emory University School of Medicine. “Because CVH factors are modifiable, prevention of cardiovascular risk factors and promotion of a healthy lifestyle beginning early in life should achieve the best results for promoting not only cardiovascular health, but also cognitive health.”

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Materials provided by Emory Health Sciences. Note: Content may be edited for style and length.

A 15-Minute Dumbbell Arms Workout You Can Do Anywhere

There’s so much you can do with just a single set of dumbbells. They’re relatively inexpensive, easy to use, and small enough to keep tucked under your bed. And while there are plenty of effective bodyweight exercises out there, adding a few pounds to your strength training workout is a simple way to increase the intensity. And that’s exactly where this dumbbell arm workout comes in.

Kara Faulk, personal trainer and instructor at Barry’s Bootcamp in New York City, put together this 15-minute dumbbell arm workout for SELF readers. Requiring nothing more than a pair of dumbbells, this workout focuses on the arm muscles, and you can do it pretty much anywhere you want.

Faulk says that the benefit of concentrating on one part of the body is that you can work that body part fully. Fifteen minutes is enough to hit every major muscle group—in this case, those that comprise the biceps, triceps, and shoulders—until fatigue.

Many of the moves below are compound exercises, meaning they involve two or more joints of the body, and therefore work more than one muscle group at a time. Faulk says since these moves require total-body coordination, they force your body to work harder to stabilize itself—which translates to a secret core workout. “Any time you’re balancing, your core is working in overdrive,” says Faulk. And when more muscles are engaging to keep you stable, you’re using more energy.

The details:

Faulk designed this dumbbell arm workout to be done with dumbbells that are medium weight. What is “medium” will be different for everyone, so she suggests starting with 5- or 8-pound dumbbells, maybe a set of 10s if you’re already lifting. As your muscles adapt, what you consider “medium” will start to increase. Instead of going for a certain number of reps, Faulk says to do as many reps as possible (AMRAP) in the allotted time frames, while still maintaining proper form.

Over time, as the workout starts to get easier, you can either lift more quickly (while maintaining proper form) OR increase your weight, whichever you feel more comfortable with. Either method will progress your workout and further challenge your muscles.

Faulk suggests doing this workout twice a week, either on its own or added on the end of a cardio or other full-body workout.

The workout:

Consumers: Online restaurant reviews are not all equal

People searching online restaurant reviews give less value to those written on mobile devices than on other platforms, according to new research in the published journal Marketing Science.

In a study of 275,000 restaurant reviews, researchers from the University of Connecticut, Boston College, and Peking University found differences in reader perception based on the platform where the review was generated.

With the increasing prevalence of mobile devices and apps such as TripAdvisor, Yelp, and Google, consumers have ready access to real-time reviewing platforms.

“While consumers initially value real-time mobile content similarly to nonmobile content, over time they seem to observe distinct differences in platform-specific content and, as the mobile platform matures, they come to view mobile reviews as less helpful,” said Nicholas Lurie.

Lurie, Voya Financial Professor in the UConn School of Business, co-authored the study with former associate professor of marketing Hongju Liu, now of Peking University; and Sam Ransbotham of Boston College.

The authors analyzed the writings of 117,827 reviewers who described their experiences at 13,976 restaurants, along with a dual-platform sample of 21,026 reviews that were written by 673 reviewers who wrote at least four mobile, and four non-mobile reviews.

Mobile reviews were associated with 10 to 40% less likes than the reviews generated on laptop or desktop computers.

An analysis of how word-of-mouth value changed after the introduction of the mobile application shows that, although mobile word of mouth initially had equal or greater consumption value, over time it became significantly lower than computer generated word-of-mouth.

One reason may be that the real-time nature of mobile device reviews does not allow reviewers enough time to reflect. The real-time creation process associated with mobile platforms affected the consumption through associations with the mobile label and information quality.

The results indicate that writing reviews on mobile platforms may not be useful to an end-user, they may be valuable to the writer. “Writing reviews may be therapeutic and help consumers make sense of their experiences — raising the value for review writers if not for those who read reviews,” the authors note.

“Encouraging word-of-mouth through mobile reviews has pros and cons,” said Ransbotham. “Because mobile reviews may not benefit from reflection, mobile platforms may actually be encouraging feedback from less-engaged customers.”

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Materials provided by University of Connecticut. Note: Content may be edited for style and length.

Your healthcare provider’s expectations on whether a treatment works may impact its effectiveness

If a doctor expects a treatment to be successful, a patient may experience less pain and have better outcomes, according to a new Dartmouth study published in Nature Human Behaviour. The findings reveal how social interactions between hypothetical healthcare providers and patients have the power to influence how patients perceive the effectiveness of a treatment, even when it is a placebo.

To investigate these social dynamics, the study simulates a series of clinical interactions between participants playing the roles of doctors and patients, who are tasked with evaluating the effectiveness of two different treatments while undergoing thermal pain. When the doctors believed that a treatment would work, patients appeared to experience less pain based on their subjective reports of how much pain they experienced, their physiological responses and their facial expression behaviors.

“These findings demonstrate how subtle social interactions can impact clinical outcomes. Even though the study participants were role playing and weren’t actual health professionals or patients, you can imagine that in a real clinical context, if the healthcare providers seemed competent, empathetic and confident that a treatment may work, the impact on patient outcomes could be even stronger. Additional research however, is needed to see how this plays out in the real world,” explained senior author Luke J. Chang, an assistant professor of psychological and brain sciences and director of the Computational Social Affective Neuroscience Laboratory (Cosan Lab) at Dartmouth.

The overall study was comprised of three experiments using two creams intended to alleviate thermal pain by targeting skin pain receptors. The creams, “thermedol” and a control cream, were two different colors; however, both were actually just a placebo, the petroleum-based jelly, Vaseline. After each topical cream was applied to a participant’s arm, they received thermal heat (47 degrees Celsius/116.6 degrees Fahrenheit) and assessed the effectiveness of the cream. Before interacting with the patient, each doctor was informed about the properties of the two creams and was conditioned to believe that thermedol was more effective than the control. Unbeknownst to the doctor, lower levels of heat were applied to the arm that had been treated with the thermedol.

The first study (a single blind study) was comprised of 24 pairs of doctor-patient teams for which there were 48 participants. The patient was unaware of which cream was which; only the doctor knew. However, under this condition, the same amount of thermal heat was applied to each arm. With the thermedol treatment, patients reported less pain and indicated that they believed this treatment was more effective than the control cream. In addition, patients had a lower skin conductance response with the thermedol, demonstrating decreased psychophysiological arousal with this treatment.

Participants wore GoPro cameras that recorded their facial expressions during their interactions, such as raising their eyebrows, wrinkling their noses or raising their upper lips. The researchers used a machine learning model of pain developed for the study, to demonstrate that patients also appeared to display less pain through their facial expressions when receiving the thermedol treatment.

The other two studies that were part of this research switched up the order in which the two creams were administered, so as to rule out that the relationship between doctors’ expectations about the efficacy of a treatment and patients’ experiences of pain was not due to habituation or extinction (that is, the decrease or disappearance of a conditioned response).

“When the doctor thought that the treatment was going to work, the patient reported feeling that the doctor was more empathetic. The doctor may have come across as warmer or more attentive. Yet, we don’t know exactly what the doctor was doing differently to convey these beliefs that a treatment works. That’s the next thing that we’re going to explore,” said Chang. “What we do know though is that these expectations are not being conveyed verbally but through subtle social cues,” he added.

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Materials provided by Dartmouth College. Note: Content may be edited for style and length.