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Major trial shows increasing bone density fails to cut fracture risk in brittle bone disease

An international clinical trial involving Aston University researchers has challenged long held assumptions about how brittle bone disease is treated in adults, after finding that substantially increasing bone density did not reduce the risk of fractures. The study, published in the Journal of the American Medical Association (JAMA), examined whether a two stage treatment using the bone building drug teriparatide followed by the bone preserving drug zoledronic acid could reduce fractures in adults with osteogenesis imperfecta, often referred to as brittle bone disease, a rare genetic condition that causes bones to break easily throughout life. Researchers followed 349 adults treated at 27 specialist centres across the UK and Europe. While the treatment led to clear increases in bone density in the spine and hip, fracture rates were no lower than among patients receiving standard care, suggesting that bone quality may matter more than bone density alone in preventing fractures in people with the condition. The findings underline a key distinction between brittle bone disease and more common bone conditions such as osteoporosis, where increasing bone density is known to reduce fracture risk. In osteogenesis imperfecta, the study suggests that bones can become denser without becoming less likely to break, indicating that the underlying quality and structure of bone tissue may play a greater role in fracture risk than density alone. Dr Zaki Hassan Smith, an endocrinologist at Aston Medical School who contributed to the research, said: “This study shows that in osteogenesis imperfecta, simply increasing bone density doesn’t necessarily translate into fewer fractures. That’s important, because it tells us that the disease is more complex than what we see on a scan. The findings help shift the focus towards understanding bone quality and how bones behave in real life, which is essential if we are to develop more effective treatments that genuinely reduce harm for patients.” Osteogenesis imperfecta is a genetic condition that affects collagen, leaving bones fragile and prone to fracture throughout life. There is currently no licensed treatment specifically approved to prevent fractures in adults with the condition, and patients often experience repeated fractures, chronic pain and long term disability. The trial tested a sequential treatment strategy commonly used in osteoporosis, where a bone building drug is followed by a treatment designed to preserve gains in bone strength. Although this approach successfully increased bone density in people with osteogenesis imperfecta, it did not reduce fracture rates, suggesting that treatment strategies effective in osteoporosis may not directly translate to rare bone diseases. Researchers did observe improvements in some quality of life measures among participants receiving the treatment, including reduced pain interference and improved mobility. However, fracture prevention remained unchanged, reinforcing the need for new approaches that target the fundamental properties of bone in osteogenesis imperfecta rather than density alone. The study was led by the University of Edinburgh and funded by the Medical Research Council and the National Institute for Health and Care Research. Aston University contributed clinical and academic expertise through Aston Medical School as part of the large international collaboration, which involved specialist centres across the UK and Europe. The study was led by the University of Edinburgh, with Aston University contributing clinical and academic expertise as part of a wider international collaboration involving multiple specialist centres across the UK and Europe. The research was funded by the Medical Research Council and the National Institute for Health and Care Research. Researchers say the findings provide important guidance for future research, helping to steer efforts towards treatments that focus on bone quality, strength and resilience in everyday life. They also highlight the value of large scale clinical trials in rare diseases, where learning what does not reduce harm is an essential step towards better care. The paper, Teriparatide Plus Zoledronic Acid for Osteogenesis Imperfecta, is published in JAMA. https://doi.org/10.1001/jama.2026.6889

Beyond the Recipe: Rebecca Sharpless Explores the Hidden History of Southern Baking

Recently published stories exploring the history of baking traditions are shedding light on how many beloved holiday treats are rooted in centuries of trade, survival and innovation. According to Rebecca Sharpless, professor of history in Texas Christian University’s AddRan College of Liberal Arts, staples like gingerbread and fruitcake carry surprisingly deep historical connections, from medieval spice routes to 19th-century preservation methods that allowed cakes to survive nearly year-long journeys. Sharpless, whose upcoming book People of the Wheat examines the history of wheat culture in North Texas, says many foods now associated with “traditional” Southern baking are actually far more modern than people realize. From red velvet cake to pecan pie, marketing and industrial food production played a major role in shaping today’s culinary traditions. Her research also highlights the social and economic realities behind baking history, including how access to ingredients like wheat and sugar once reflected class, geography and race. The full article and interview is attached below - and if you're a baker, a foodie or a journalist looking to know more about this popular topic - it's a must read. For journalists exploring food history, holiday traditions, agriculture, or the cultural roots of Southern cuisine, Sharpless offers expert insight into how everyday recipes reveal larger stories about migration, labor, trade and identity. And if you're looking to connect with Rebecca Sharpless, simply contact Holly Ellman, Associate Director of Communication, today at h.ellman@tcu.edu.

Expert Insight: The Hidden Costs of Staying Neutral

Considering the number of hot-button issues and divisiveness in American culture, choosing a middle-of-the-road attitude might be seen as the best way to navigate an often volatile environment. But what about those individuals who choose neutrality as a means of staying below the radar and, thereby, avoiding the need to take any action? This is the question that Laura Wallace, assistant professor of organization and management at Emory’s Goizueta Business School, and coauthors ask in their new paper, The Preference for Attitude Neutrality. Published in the Journal of Experimental Psychology: General, the researchers explore individuals with a preference for neutrality and how their uncompromising commitment to neutral opinions, not only discourages rigorous debate but could have a deleterious impact on society. Emory Business recently caught up with Wallace to discuss her research. Emory Business: What sparked your interest in the preference for neutrality? Wallace: When we think about the problems in the world, often people point to too many extreme opinions as the source of much social ill, and, of course, they can be. But, when I thought about a lot of the issues that I cared about, like addressing climate change or gun violence, I felt that sometimes the issue was too much neutrality in the face of issues that were themselves pretty extreme. When I talk about this work, people can often picture someone who seems like a “Pref Neutral,” as we have affectionately nick-named them, that is someone who in the face of information suggesting that there is an extreme problem is not moved to address the issue. I could think of people in my life who had these reactions, and I was interested in understanding more about them. Emory Business: How did you identify these individuals? Wallace: We developed a scale to assess the extent to which people view neutrality as truer, more socially desirable, and more moral. For example, we ask people how much they agree with items like, “If you have all the facts about a topic, your opinion will generally end up somewhere neutral” and “There is something noble about remaining in the middle about controversial topics.” The more someone agrees with these items, the more we would say they have a preference for neutrality. Emory Business: How does this study fit in with your larger body of work? Wallace: I generally think of my program of research as studying the “psychology of social change.” Within that broad category, I study 1) how to change minds and build trust and 2) how to address societal disadvantage. I view this work as fitting in the first bucket about how we change people’s minds. What interests me about people who are high in the preference for neutrality is the fact that they seem to NOT change their minds in the face of extreme information suggesting that they should. These individuals represent a significant barrier to our ability to address pressing issues, so I view this work as very much tied into the overarching goal of my research program to understand social change (or the lack thereof). Laura Wallace is an assistant professor of organization and management at Emory University’s Goizueta Business School. Wallace studies how to build trust with implications for addressing societal disadvantage, changing minds, and fostering growth. View her profile Emory Business: Would you describe a preference for neutrality to be a mindset, strategy, or attitude/value? Wallace: I think of the preference for neutrality like an ideology or value system that guides people’s reactions across many issues and situations. Emory Business: Talk about the study design. It’s quite detailed and multilayered, with eight hypotheses and six different measures to account for potential bias that were then randomized to create different questionnaires given to a large pool of individuals. How did the coauthors agree on the structure? Wallace: First, I should take the opportunity to shout out Thomas Vaughan-Johnston, who led this work. He is a faculty member at Cardiff University and is just a very thoughtful, interesting researcher, and he’s great to work with. Second, there are a number of studies in the paper. For each, our research team worked together to design and interpret the studies. The paper paints a relatively negative view of Pref Neutrals. We did take measures to resist bias in our design. For instance, we didn’t just ask people how much they dislike extremists (which would have been biased towards making those with a preference for neutrality look bad), but also asked about attitudes towards neutrals (where those with a preference for neutrality may seem like “the nice people”). We are now starting research on contexts where a preference for neutrality can offer some advantages, hopefully without artificially striking a false balance. For instance, we are considering whether they can help reduce group polarization effects, especially where groups drift towards radicalism in conversation. Also, we have some preliminary data where they seem to be a bit more accurate when detecting neutral emotions and attitudes in others, which is a remarkable plus side. Basically, we think the preference for neutrality is a social concern, but we are trying to be fair-minded when considering why they think this about neutrality and when this trait is useful for the world. Emory Business: In the study, you note that preference for neutrality can be a sign of arrogance and that Pref Neutrals are uninterested in learning more or changing their stance. How is this arrogance exhibited? Wallace: I would say that they are more close-minded than arrogant and that they don’t seem to be particularly thoughtful. One way we have assessed this is by measuring their “intellectual humility,” which essentially captures how much people recognize the limits of their own perspectives and are open to changing their minds. Pref Neutrals tend to score low on intellectual humility. They also score a little low on the “need for cognition,” which captures how much people like to think. Emory Business: In one section it reads: “preference for neutrality (preference for extremity) should relate to seeing other people as moral, competent, and likeable, when those individuals have generally neutral (extreme) opinions.” Does this mean that they align with people who have their same opinion structure? Wallace: We find that people who score high on the preference for neutrality scale tend to have more favorable impressions of others who are more neutral and tend to be more persuaded by others who are labeled as holding neutral attitude positions. Emory Business: How would one identify this trait in a person, particularly, when the research shows they tend to self-censor? Wallace: In general, they are really hesitant to take stances on issues or they tend to avoid taking sides or expressing strong positions. And yes, they tend to self-censor, meaning they often avoid sharing their opinion at all. Emory Business: How does this preference for neutrality play out in a political sense? Specifically, if they are averse to extremes would they vote based on their values? Wallace: We have a lot of evidence that Pref Neutrals tend to be political centrists. We don’t have evidence for this, but I suspect that they sit out a lot of elections, and to the extent that they do vote, they favor more moderate candidates. They probably would not vote for a position or individual with an extreme view unless it was framed as neutral. This may sound like a silly, cerebral point, but I actually think it’s critical to the point we are making, as what is viewed as “extreme” in a given time is often socially determined. For example, now it would be viewed as an extreme stance to support slavery. However, in the early 1800s in the U.S., it would have been viewed as an extreme stance to oppose slavery. I imagine at the time, many Pref Neutrals were supportive of slavery as a means of being politically moderate. Emory Business: What was the most interesting result in this study for you? Wallace: We find that if you give Pref Neutrals the exact same information but label it as extreme or neutral, they are more persuaded by the exact same information when it is labeled as neutral. This results in a kind of ironic effect where they actually end up with a more extreme opinion when information has been labeled as neutral. Emory Business: Research wise, what’s next for you? Wallace: There are a few ways that we are following up on our work that I am excited about: First, we’re trying to understand more about how Pref Neutrals maintain neutral opinions in the face of extreme information. So, we are giving Pref Neutrals true, extreme facts, and then examining their thoughts to determine how they resist taking the extreme positions information would suggest that they should. Second, we thought that Pref Neutrals would be particularly likely to trivialize social issues, to say they are unimportant. We are actually finding that they rate all social issues as extremely important, which we are trying to understand more about. We suspect they might do this as a strategy to avoid taking action on social issues. If stubbed toes and human trafficking are both “extremely” important, then there are just too many issues to take action on, and so they are able to justify a lack of action. Third, we are interested in understanding what it is like to make decisions in a group with a Pref Neutral. There is a lot of evidence that groups tend to make bad decisions because people want to agree with each other. This might actually be an area where Pref Neutrals would shine – the fact that they don’t want to take a stance may force groups they are a part of to really think things through and make better decisions. This is all super preliminary, but it reflects the exciting work ahead and that there is much more to understand about these folks!

UD experts break down the 2026 World Cup

As the world gears up for the 2026 FIFA World Cup, experts from the University of Delaware are available to provide timely insight on the science, business, and human impact behind the global tournament. Player Safety, Concussions and the Future of the Game Tom Kaminski, professor of kinesiology and applied physiology, is a leading authority on player safety and head injuries. As the sole U.S. representative on FIFA’s Heading Expert Group, Kaminski is helping shape international guidelines around heading in soccer—particularly for youth athletes. He can speak to concussion risks, prevention strategies, and how evolving safety standards are influencing the modern game. Joining him is Tom Buckley, who also specializes in concussion research and athlete health, offering additional perspective on injury trends and recovery in elite competition. The Business of the World Cup: Tourism and Global Impact Matt Robinson from UD’s Lerner College of Business and Economics explores how mega-events like the World Cup drive tourism, economic growth, and global connection. Robinson can discuss how host cities benefit, the long-term economic ripple effects, and how sports act as a powerful unifier across cultures. Youth, Development and the Next Generation of Fans Sara Goldstein brings expertise in adolescent development, offering insight into how traditions with family shape youth identity, social development, and engagement with physical activity. Her perspective is especially relevant for younger audiences experiencing the World Cup through schools and community programs, including UD’s Lab School initiatives. Inside the Game: Sports Analytics in Action With the rise of data-driven performance, UD’s new Sports Performance Analytics major is preparing students to analyze gameplay at the highest level. Martin Heintzelman, department chair, can connect media with program leaders and practitioners including Jack Davis and Christina Rasnake, who are helping students apply real-time analytics to global competitions like the World Cup. The Science Beneath the Game: Playing Surfaces World Cup matches are required to be played on natural grass—a costly and complex requirement, especially for indoor stadiums. Erik Ervin can discuss how turfgrass systems have evolved, the science behind maintaining elite playing surfaces, and the massive investment required to meet international standards. Why Watching Together Matters Amit Kumar studies the psychology of happiness and shared experiences. He can speak to why gathering to watch World Cup matches—whether in stadiums, bars, or living rooms—boosts well-being and strengthens social bonds, making the tournament as meaningful off the field as it is on it. Connect with UD experts to explore every angle of the 2026 World Cup – from the pitch to the people. Email mediarelations@udel.edu to connect with these experts. 

Why disaster recovery in the Himalayas needs a rethink

After five weeks of fieldwork across Nepal, Bhutan and Northwest India, Aston University researcher Dr Komal Raj Aryal is calling for a more locally grounded approach to resilience and post-disaster recovery in one of the world’s most hazard-prone regions. What happens after the headlines fade from a disaster? That question sits at the heart of new field research led by Dr Komal Raj Aryal, Lecturer in Crisis and Disaster Management at Aston Business School. After returning from a five-week research visit across Nepal, Bhutan and Northwest India, Dr Aryal says the evidence points to a troubling reality: many communities remain highly vulnerable long after major recovery programmes are supposed to have helped them rebuild. The trip brought together field visits, stakeholder consultations and community observations linked to ongoing UKRI, NERC and ISPF-supported research on earthquake risk, disaster governance, resilience and post-disaster recovery in the Himalayan region. The aim was not only to understand current conditions, but to ask why repeated losses continue despite years of international development assistance, scientific research and investment. Across the region, the research found that resilience is being undermined by a combination of persistent governance challenges, fragmented institutions, weak local preparedness systems, livelihood insecurity and mounting environmental pressures. In other words, recovery is not simply about rebuilding infrastructure; it is about whether communities are genuinely better equipped to cope with the next shock. This challenge is especially striking in places still living with the legacy of the 2015 Nepal earthquakes, where long-term vulnerabilities remain visible despite the scale of international support directed towards recovery and reconstruction. Reflecting on his findings, Dr Aryal said: “One of the most striking observations from the field is that many communities affected by the 2015 Nepal Earthquakes continue to face similar vulnerabilities today, despite significant international support allocated for recovery and reconstruction. This raises important questions about how disaster recovery is planned, implemented, and sustained over time.” The fieldwork also highlighted the growing complexity of future disaster risks in the Himalayas. Large-scale earthquakes do not exist in isolation; they interact with environmental degradation, cascading hazards, climate-related stresses and rapid urbanisation in fragile mountain settings. He added: “The Himalayan region is entering a period of growing uncertainty where environmental change, socio-economic inequality, weak governance systems, and seismic risks are becoming increasingly interconnected. There is an urgent need to rethink conventional development approaches and invest more seriously in locally grounded, community-centred resilience strategies.” For Aston University, this work reflects a broader commitment to international research on disaster risk reduction, resilience governance and humanitarian response across South Asia. Aston researchers are working with government agencies, local authorities, universities, emergency responders and humanitarian organisations to strengthen evidence-based approaches to preparedness and recovery. The findings feed into wider international debates about sustainable development, climate resilience, risk communication and the future of disaster governance in vulnerable mountain regions. They also underline the importance of moving beyond short-term recovery models towards approaches that are participatory, practical and rooted in local knowledge. Dr Aryal’s research emphasises the value of integrating community knowledge, participatory governance, youth engagement and long-term livelihood security into resilience planning. As future collaborations and policy discussions develop, these themes are likely to be central to how the region prepares for the risks ahead. The recent fieldwork is expected to inform future international research partnerships, policy dialogue and resilience-focused initiatives between the UK and South Asian partners.

Why Shrinking the Pay Gap is a Question of Dollars, Not Percentages

The gender wage gap shows no sign of improving any time soon. If anything, evidence suggests it’s growing in the United States. Recent stats show that for every dollar earned by men, women in the same job earn just 92 cents—that equates to one month of salary less in a given year. That gap widens even more for Black and other minority women. In the meantime, men’s wages are increasing—just shy of 4% in the last two years—while women’s income hasn’t budged. Organizations should take note, warn Goizueta’s Karl Schuhmacher and Kristy Towry. Wage inequity is an issue that undermines the concept of equal pay for equal work. It’s also bad for business. Employers that don’t pay or play fair with their workers stand to lose talent to competitors who offer better conditions, not to mention customers or investors who care about fairness. And that’s not all. In meritocracies, employees are incentivized to engage more, care more, and create more value because they understand their compensation is pegged to the effort they make and outcomes they achieve—to merit itself, regardless of demographics. The gender wage gap in the United States is inherently unmeritocratic. And fixing it has proved elusive—at least until now. In their new study, co-authored by Goizueta PhD graduate, Hayden T. Gunnell 25PhD of the University of Texas in Austin, Schuhmacher and Towry have come up with a novel approach to addressing the gender wage gap; one as practicable as it is simple. And it’s all down to percentages. Pay Gaps Baked In Most employers review employee salaries on an annual basis—usually yoking them to performance reviews. Overwhelmingly, managers will frame raises in terms of percentages: those doing well might be awarded a five or even 10 percent pay raise, for example. The problem with this, argues Schuhmacher, is that percentage-based raises are tied to initial salaries. And if that baseline is biased from the start, handing out similar percentage raises will only compound the problem, and perpetuate inequities—whatever the intention. If women start out getting paid less than men for the same job, and your raise budgets are framed in percentages, you end up baking those gaps in more, even if you don’t mean to. Karl Schuhmacher, Assistant Professor of Accounting “That five percent raise you’re giving everyone for the same job well done sounds fair and effective,” says Schuhmacher. “But it’s only actually fair if the initial salary is equitable—if Jane has been making the same as John from the off. And if she hasn’t—if John is being overcompensated relative to Jane—then all you’re doing is perpetuating that gap.” Awarding similar percentage raises doesn’t recognize or acknowledge preexisting, unfair discrepancies in initial salaries. A better approach, he and Towry argue, is to reframe pay raise budgets in terms of absolute dollars. “Budgeting for raises in absolute terms—a $150,000 pool for all raises in a group, say, versus a budgeted pool of 5% per person—automatically unshackles raises from preexisting unfairness in people’s pay,” says Schuhmacher. “You reduce the risk of perpetuating pay gaps by giving managers a way of assessing and evaluating work and assigning a dollar value that recognizes that work. It’s a fairer, more meritocratic approach.” It also has the effect of “nudging the cognitive processes” that employers use. Percentages are a ubiquitous way of determining raise budgets because they feel fair and easy to use, says Towry. A five percent raise for employees sounds reasonable, equitable, and doesn’t tax managers cognitively, making it simple to implement again and again—a norm or procedural “anchor” within most organizations. Substituting dollars for percentages, however, should provide enough of a nudge that managers focus more on the actual value their employees contribute to the organization. And it shouldn’t require a major rehaul of the system: a win-win for employees and organizations looking to retain talent, says Towry, where the gains significantly outweigh the effort involved. Thinking in Dollars, Not Percentages To put this idea to the test, Towry, Schuhmacher, and Gunnell enlisted Goizueta MBA students to participate in a lab experiment, taking on the role of manager at a hypothetical bank. Participants were given the salary details of four high-performing employees—two male, two female—with gender discrepancies baked into initial pay. Importantly, in this setting, male and female employees do the same job and perform equally well. Participants were divided into two camps: the first instructed to hand out percentage raises, the second dollar raises. All participants had to allocate the same pay raise budget of $30,800—5% of total salaries—among the two male and two female employees, the sole difference being that one group received a percentage budget, while the other group received a dollar budget. The results support the theory, says Towry. When participants use percentages, the individual pay raises cluster around the 5% mark, meaning that existing pay gaps are perpetuated. Kristy Towry, Professor Emerita of Accounting “Our fictional male employees, Jason and Gary, walk away with higher overall raises than Martha and Sarah, because they are already earning more than the women,” says Towry. “And this happens even though our participants know about initial pay discrepancies, and women and men perform equally well in the same job.” When participants use absolute dollars, however, this clustering effect around the 5% mark disappears. Participants give pay raises that better reflect employees’ value contributions to the organization. As such, pay raises are less dependent on initial pay gaps. In some cases, participants even award more cash to the women than the men to counteract the initial gap. “Martha ends up with a higher raise than Gary, but their initial salaries are $116,000 and $192,000, respectively,” says Towry. “So, what we’re seeing here is that our managers are asked to take out the percentage and think in dollars, they effectively redress the balance. The preexisting pay gap is reduced in recognition of equal merit.” Reproducing this in real-word settings shouldn’t be difficult for organizations. And at a time when gaps are becoming more entrenched and progress on equitable pay is stagnating in the United States, there is a clear imperative ahead of employers interested in sending clear signals to existing and future male and female talent, says Schuhmacher. Pay that reflects performance fairly is inherently meritocratic and we know that being a meritocracy is attractive to employees—to your existing workforce and to the workforce that you want to attract. Karl Schuhmacher “When people know they’re being evaluated based on their results, regardless of their gender or background, they are more motivated to work hard,” says Schumacher. “The beauty of this solution is that it supports a more meritocratic way of rewarding talent. It’s also easy to implement—easier than interventions like bias training or organizational audits that consume time and resources. Using dollars instead of percentages is something that organizations can do that translates into real impact. And it’s something that they can do in a day. Our advice: start tomorrow!”

TV News Talent Looks to Build Their Brand on Nontraditional Platforms

Mark Lukasiewicz, dean of The Lawrence Herbert School of Communication, was interviewed by The Hollywood Reporter for the article “With TV News In Free Fall, Anchors Try Breaking Away,” about the trend of TV news veterans leaving the declining world of linear media to build businesses and their brand on social media, podcasts, and other platforms.

TCU Faculty Expert Answers: Why Do We Love Our College Sports?

Sports fandom runs deep. Nowhere is this stronger than in college sports, where traditions, game-day rituals and formative life experiences create bonds and memories that last long after graduation. Dustin Hahn, associate professor of film, television and digital media in the Bob Schieffer College of Communication, recently offered his expertise in a Q&A and completed an Explained in 60 Seconds video in TCU’s social media series to illuminate why we love our college sports and how they shape both identity and community. Read his Q&A from Schieffer College and watch his Explained in 60 Seconds video: