Culture

An article published in Geographical Research examines how the COVID-19 pandemic has impacted international higher education and the mobility of students around the globe, noting that universities face the urgent task of reimagining alternative futures for themselves.

While much hope is invested in vaccines, travel restrictions and health concerns may continue to hamper student mobility and encourage more remote learning. New study destinations, different modes of study, and partnerships with technology providers can be anticipated.

With these changes, regulatory and ethical oversight will be required. "Policymakers and university leaders must look beyond goals of revenue generation and education exports. A commitment to student learning and wellbeing is overdue," said corresponding author Ravinder Sidhu, PhD, of the University of Queensland, in Australia. "The pandemic has revealed the need for more sustainable, ethical, and socially just modes of global higher education."

Microplastics--small plastic pieces less than 5 millimeters in length--are ubiquitous in the environment, and they can have significant effects on wildlife. A new study published in Environmental Toxicology and Chemistry reveals that there are multiple impacts of different microplastics--with varying sizes, shapes, and chemical makeup--to the survival, growth, and development of larval fathead minnows, an important prey species in lakes and rivers in North America.

By demonstrating that microplastics are both physical and chemical stressors, the study supports the need for research that considers microplastics a multiple stressor rather than a single contaminant. Importantly, current test methods used in most microplastic studies do not sufficiently investigate the chemical dimension of microplastic pollution.

"The chemical cocktail that is associated with microplastics in the environment consists of additives from manufacturing and contaminants sorbed from the surrounding environment; however this dimension is often missing from toxicity testing, where pristine microplastics purchased from a manufacturer are often used," said corresponding author Kennedy Bucci, a PhD candidate at the University of Toronto. "Our research shows that the chemical cocktail is an important driver of effects, and suggests that a new framework for risk assessment that captures the multi-dimensionality of microplastic pollution may be necessary."

Kiwi are iconic birds that have been severely impacted by deforestation and predation from invasive mammals since the arrival of humans in New Zealand. The remaining kiwi can be split into 14 clusters that are now treated as separate conservation management units. A review published in Ibis examines the latest information on kiwi genetics to investigate the legitimacy for maintaining these differences.

Although studies indicate that kiwi differ genetically between areas, there is little understanding of the extent of local adaptations and breeding changes on populations. The work highlights the need for a more detailed understanding of the genetics of different species for wildlife conservation.

"Using kiwi as an example, we hope to convey that results from any genetic studies cannot be easily translated into genetic management policy. On the contrary, studies using informative markers and strategic sample regimes are required if the goal is diverse and long-term successful populations," said lead author Malin Undin, PhD, of Massey University, in New Zealand.

Despite virtual reality (VR) technology being more affordable than ever, developers have yet to achieve a sense of full immersion in a digital world. Among the greatest challenges is making the user feel as if they are walking.

Now, researchers from the Toyohashi University of Technology and The University of Tokyo in Japan have published a paper to the journal Frontiers in Virtual Reality describing a custom-built platform that aims to replicate the sensation of walking in VR, all while sitting motionlessly in a chair.

"Walking is a fundamental and fun activity for human in everyday life. Therefore, it is very worthwhile to provide a high-quality walking experience in a VR space," says Yusuke Matsuda.

Matsuda is a project assistant professor at the Department of Computer Science and Engineering at the Toyohashi University of Technology and a corresponding author of the paper.

"We believe that the general public is also very likely to be interested in this study that combines walking and VR experiences which has seen rapid growth in demand as a result of Covid-19," he adds.

How it works

The purpose of the study was to investigate whether a full-body or hands-and-feet-only walking avatar seen through either the first-person or third-person perspective can convey the sensation of walking in a virtual environment through optic flows and rhythmic foot vibrations.

When the participant moves their digital avatar, the platform syncs with these movements to "feel as if the hands-and-feet-only avatar is their own body", the researchers wrote.

40 participants were split evenly between both the first-person and third-person perspective experiments. What they saw in the virtual world and the head of their full-body avatar were linked to the user's actual head movements.

While sitting down on a stool, each participant was connected to 4 vibro-transducers made from aluminum springs and wood plates, each placed on their feet. When their avatar moved, the pads would vibrate to replicate movement.

To eliminate the sound of the vibration system, participants wore headphones emitting white noise. They then travelled down a virtual corridor which consisted of a textured floor and sidewalls made of wood, with mirrors regularly distributed on either side of their avatar's path.

VR mirrors

The researchers said that not being able to see their avatar had a significant impact on a person's perception of walking while sitting motionlessly. However, the inclusion of mirror reflections mitigated this.

"Our study showed that a walking avatar in a first-person perspective enhanced the sensation of walking," Matsuda said.

"The effects were observed not only when the full-body avatar was used, but also when only the hands and feet were presented without the hands-and-feet-only avatar."

The researchers noted participants felt no walking-like sensation when seeing the avatar from the third-person perspective.

The researchers said that from this perspective, both the full-body and hands-and-feet avatars "impaired the self-motion sensation and telepresence, irrespective of the foot vibrations in comparison to the no-avatar condition".

Easier than walking

Looking to the future, Matsuda and the rest of his team sees the concept - once further developed - as being a way to enhance VR users at home.

"We believe that low cost and miniaturization can be accomplished," Matsuda said. "The proposed device consists of 4 vibro-transducers and amplifiers. The configuration is relatively simple, inexpensive - between $300 and $500) - and compact."

In addition to gamers, the researchers see its potential among those who may live with mobility issues.

"One of the most important features of the walking device we proposed is that it gives tactile and visual stimuli to seated users," Matsuda said.

"Besides, for those without mobility issues, the proposed method is simply less fatiguing than moving the legs by oneself. Therefore, we will be able to easily experience virtual walking for a relatively long time."

Marine ecosystems are in the midst of a conservation crisis, with coral reefs in particular facing numerous challenges as a result of climate change. In an effort to better understand these environments and the threats they face, researchers collect huge image libraries of these underwater environments, using 3D imagery collected from divers and snorkelers, as well as 2D images collected from satellites. These approaches provide researchers with huge amounts of data, but to extract value from these libraries requires a method to quickly analyze for patterns or 'classifications'.

In a new study in Frontiers in Marine Science, researchers at NASA's Ames Research Center's Laboratory for Advanced Sensing automated this process through the use of an artificial intelligence tool called a convolutional neural network (CNN), as lead author Jarrett van den Bergh of the Bay Area Environmental Research Institute explains:

"Vast amounts of 3D coral reef imagery need to be classified so that we can get an idea of how coral reef ecosystems are faring over time. Making this classification process as efficient as possible drove us to look at automation with CNNs."

CNNs are an artificial intelligence model loosely based on biological neurons and brains that are used to analyze images and look for features, such as different coral species on a reef, or even fish swimming through an underwater scene, as well as where these features are in relation to everything else in the image. This layered depth is what makes CNNs such a good fit for analyzing complex images, such as coral reefs.

Jarrett van den Bergh explains, however, that using CNNs can also present additional challenges when classifying data: "CNNs require lots of training data to function correctly, so it was vital for us to build a large database of data that we could use to train the CNN on how to classify these complex 3D images of coral reefs."

To overcome this challenge, the researchers used a citizen science approach in the form of a video game called NeMO-Net, which harnesses the power of citizen scientists to generate training datasets. As players explore virtual underwater worlds, they can learn about and classify coral species, and their classification labels are then used to train NeMO-Net's CNN.

Mr van den Bergh also highlights the more rewarding aspects of the NeMO-Net project: "NeMO-Net collects data primarily, but it is also an educational tool that gives people a more intimate understanding of our coral reefs. To date the game has reached over 300 million people in the 7 months since release."

The researchers are hopeful that their work in developing the NeMO-Net video game and CNN will be valuable for other conservation and mapping projects, and further research into the potentials of machine learning should be explored:

"As our technology progresses, machine learning might be able to give us a good estimation of what our coral reefs will look like 2 or 5 years from now. This could be extremely useful for coral reef conservationists who want to see the impact of their work. We are only just beginning to see the impacts of machine learning in conservation."

Humans and animals have a preferred walking speed. This is, in part, influenced by the amount of energy required: they prefer to walk at the speed at which they use the lowest possible amount of energy. One of the ways to achieve this is using something called resonance.

You already know how it works: when you are on a swing, you can't just swing at any speed. If you want to do it properly, you have to get the timing right, and swing in the rhythm of the swing. In other words: you have to resonate with it. And when you're on a nice relaxing walk, the parts of your body resonate, too. Walking slightly slower doesn't require less energy: you notice that it's actually harder.

This works for animals that walk on four feet, and for two-legged animals like humans and ostriches. Pasha van Bijlert, student Human Movement Sciences at the Vrije Universiteit in Amsterdam (VU), applied the idea to an animal that walked differently from anything walking the earth right now: Tyrannosaurus rex. These carnivorous dinosaurs didn't just have two legs, they also had an enormous tail that helped them move around.

Like the bones in our necks, the bones in tails are held together by ligaments. "You could compare it with a suspension bridge", Van Bijlert explains. "A suspension bridge with a ton of muscle in it." Every step the tail swings up and down. That means that like the swing, it has a natural frequency at which it resonates.

To find out what that frequency is, Van Bijlert and his professors Anne Schulp (Naturalis/Utrecht University) and Knoek van Soest (VU) built a 3D model of Trix, the Tyrannosaurus rex on display at the Dutch National Museum of Natural History, Naturalis. They added digital muscles to the famous skeleton, and on this muscular model they could perform biomechanical analyses. From these, they derived the natural frequency and a prefered walking speed: 4.6 km/h (2.9 mph). So, when Trix was out on a stroll, she walked at roughly the same speed as you do. If you had a pet T. rex, you would have no problem walking it - in terms of speed, at least.

Van Bijlert, Van Soest and Schulp published their findings in the journal Royal Society Open Science this Wednesday. "There were already some studies investigating dinosaur walking speed, but they mostly looked at the legs and ignored the tail - which is what makes dinos so unique", Van Bijlert says. "They usually found much higher walking speeds. The one we calculated is lower, but it's similar to that of other animals."

Listening to music before going to be can improve sleep quality among older adults, according to an analysis of all relevant published clinical trials.

In the analysis, which is published in the Journal of the American Geriatrics Society, five randomized trials met the investigators' criteria. Older adults who listened to music experienced significantly better sleep quality than those who did not listen to music. Also, older adults who listened to sedative music experienced a greater improvement in sleep quality than those who listened to more rhythmic music. Furthermore, listening to music for longer than four weeks was especially effective at improving sleep quality.

"Music intervention is an effective strategy and is easy to administer by a caregiver or healthcare worker," the authors wrote. "Music therapy might be the first line of therapy to recommend in older adults with sleep disturbances, which would reduce the need for dependence on sedatives and sleeping medication."

Shift-work and irregular work schedules can cause several health-related issues and affect our defence against infection, according to new research from the University of Waterloo.

These health-related issues occur because the body's natural clock, called the circadian clock, can be disrupted by inconsistent changes in the sleep-wake schedule and feeding patterns often caused by shift work. To study this, researchers at Waterloo developed a mathematical model to look at how a disruption in the circadian clock affects the immune system in fighting off illness.

"Because our immune system is affected by the circadian clock, our ability to mount an immune response changes during the day," said Anita Layton, professor of Applied Mathematics, Computer Science, Pharmacy and Biology at Waterloo. "How likely are you to fight off an infection that occurs in the morning than midday? The answer depends on whether you are a man or a woman, and whether you are among quarter of the modern-day labour force that has an irregular work schedule."

The researchers created new computational models, separately for men and women, which simulate the interplay between the circadian clock and the immune system. The model is composed of the core clock genes, their related proteins, and the regulatory mechanism of pro- and anti-inflammatory mediators. By adjusting the clock, the models can simulate male and female shift-workers. 

The results of these computer simulations conclude that the immune response varies with the time of infection. Model simulation suggests that the time before we go to bed is the "worst" time to get an infection. That is the period of the day when our body is least prepared to produce the pro- and anti-inflammatory mediators needed during an infection. Just as importantly, an individual's sex impacts the severity of the infection.

"Shift work likely affects men and women differently," said Stéphanie Abo, a PhD candidate in Waterloo's Department of Applied Mathematics. "Compared to females, the immune system in males is more prone to overactivation, which can increase their chances of sepsis following an ill-timed infection."

The Endangered dryas monkey (Cercopithecus dryas), endemic to the Democratic Republic of the Congo, is one of Africa's most mysterious primates. The discovery of the dryas monkey killed by a hunter in the buffer zone of Lomami National Park in 2014 has prompted field research of this small species (5-7 pounds). However, they are difficult to detect because they live in dense vegetation in secondary forest thickets.

Using non-invasive research and no-flash camera traps from 2014 to 2019, scientists from Florida Atlantic University in collaboration with researchers from the FZS-Lomami Project, Democratic Republic of the Congo, now have picture-perfect details on this elusive species. They have confirmed the occurrence of the dryas monkey at seven locations in both Lomami National Park and its buffer zone spanning a total area of 3,453 square kilometers, based on opportunistic reports provided by local village residents and park patrols.

Their findings, published in Oryx--The International Journal of Conservation, indicate that Lomami National Park and its buffer zone contain the greatest extent of the species' known range, and Lomami is the only national park with a confirmed population.

Although camera traps - a method for capturing wild animals on film when researchers are not present - are widely used to detect and survey cryptic species, the FAU scientists had to develop specific camera trap methods and placements to reliably detect the dryas monkeys.

Daniel Alempijevic, M.S., first author and a doctoral student at FAU, and Kate Detwiler, Ph.D., senior author and an associate professor in the Department of Anthropology in FAU's Dorothy F. Schmidt College of Arts and Letters, developed a species-specific multi-strata (0 to 29 meters) camera-trap technique to detect the species with a placement of three camera traps at each survey point, one each monitoring the ground, understory and canopy.

Alempijevic positioned the camera traps on game paths (0.2 to 0.5 meters above ground), shrubs and liana tangles (1.5 to 10 meters), and horizontal limbs (14.9 to 29 meters) forming pathways to adjacent tree crowns. He used a single rope technique to access the canopy, and a double-rope technique to move to the desired camera-trap location when needed. With the solicited information on the dryas monkeys from the residents of villages, he selected specific sites for camera-trap surveillance.

"We selected Bafundo Forest in the buffer zone for camera-trap surveillance, starting at the location where the first reported dryas monkey was killed by a hunter," said Detwiler. "We established the second survey site 40 kilometers west of Bafundo Village, at Camp Bartho in Lomami National Park after a ranger patrol team saw a dryas monkey there in 2014."

Camera traps accumulated 1,742 trap days on the ground, 2,821 trap days in the understory and 2,927 trap days in the canopy. Understory camera traps recorded 32 dryas monkey events, canopy camera traps detected a single event, and dryas monkeys were not detected by camera traps at ground level. The cameras that detected the species most frequently were those in the lower strata of the canopy and understory, at 2 to 10 meters above ground. At least 365 trap days are required to achieve a 95 percent detection probability, although dryas monkeys may be detected sooner in suitable habitats.

"Our camera-trap placements detected dryas monkeys almost exclusively in the understory across all surveys, regardless of canopy structure, which supports our hypothesis that the species appear to prefer structurally complex understories and forest edges," said Alempijevic. "Because our camera traps on the ground did not detect dryas monkeys, it seems unlikely that they travel on the ground. Only one camera trap in the canopy detected a dryas monkey, suggesting that they rarely travel in the upper canopy."

The researchers note that high heterozygosity and low inbreeding measures from genomic analysis of a hunter-killed dryas monkey (collected on Oct. 26, 2014) from Bafundo Forest suggest that it was a representative of a larger contiguous population.

"We recommend that researchers and conservationists working in the central basin of the Democratic Republic of the Congo mobilize local knowledge to identify other areas where the dryas monkey occurs and confirm any reports using our species-specific camera-trap placement technique," said Detwiler.

Protons are the next big thing when it comes to fuel cell technology. The subatomic exchange produces power on a scale that challenges contemporary solid-state fuel cell technology, used to help power space shuttles. To realize the proton-based technology sooner, an international team of researchers have developed a hybrid material that effectively transports protons at high temperatures and humidity -- two major challenges in past attempts.

The results were published on April 19 in ACS Applied Materials & Interfaces, a journal of the American Chemical Society.

The team, led by the University of Tokyo in Japan, focused on a material called polyoxometalates (POMs), which they previously fabricated into a composite with another polymer and compounds to help provide structural stability.

"POMs are attractive as building blocks for the design and synthesis of new materials with desirable properties and functions -- they can efficiently transport protons, for example, but only at low temperatures and in low humidity," said paper author Masahiro Sadakane, professor in the Graduate School of Advanced Science and Engineering, Hiroshima University. "Unfortunately, a huge problem remained to be solved is that our composite decomposed at higher temperatures and humidity."

To solve this problem, the researchers investigated how to better tune the composite by encapsulating positively charged ions in the material's internal cavities. Positive ions, known as cations, help balance negatively charged ions, known as anions, to stabilize conductivity in a material.

They settled on incorporating europium, a metallic element that is solid at room temperature, into the material. Europium is particularly attractive to water molecules, which brings external oxygen into the material. Protons move through the system by attaching to the oxygen. The more oxygen, the more proton-conductive the process is.

"Our goal is to produce stable high proton-conductive materials," said paper author Sayaka Uchida, associate professor in the Department of Basic Science, School of Arts and Sciences, The University of Tokyo. "Through fine control of the components, we produced such a material."

The material continued to demonstrate high proton conductivity at temperatures of 368 degrees Kelvin (202.73 degrees Fahrenheit) and 50% humidity. The researchers plan to increase the stability and proton conductivity further.

"We plan to increase the stability and proton conductivity so that this material can be used as an electrolyte in fuel cells, enhancing their performance," Sadakane said. "This work could provide guidance for the design of solid-state proton conductors."

A new Portland State study challenges the idea that youth with cognitive disabilities are unable or lack potential to pursue a career in science, technology, engineering and mathematics.

In a study using national data on more than 15,000 adolescents, the researchers found that undergraduates with medicated ADHD or autism appear to be more likely to major in STEM than youth without cognitive disabilities, and youth with autism have the most positive STEM attitudes.

Dara Shifrer, the lead author and an associate professor of sociology at PSU, says that increasing access to STEM fields for youth with disabilities depends not only on encouraging them to pursue STEM majors but also to enroll in college because STEM occupations often require bachelor's degrees at higher rates.

"We need a diverse STEM workforce so innovation and technologies are meeting the needs of the whole populace," she said.

Shifrer said the findings counter the notion that all youth with cognitive disabilities lack potential and ability. Instead, she says their potential often remains untapped due to inconsistent and subjective disability classifications, placement in lower-level courses, and lower expectations that are then likely to lead to self-fulfilling prophecies of poorer academic achievement and attitudes.

Both achievement and attitudes are important for postsecondary STEM outcomes, she said. The study found that if a student identifies as a math or science person, feels efficacious in their abilities and perceives math and science as useful for their goals, they're more likely to major in STEM. While achievement is important for college enrollment, attitudes are more strongly associated with pursuing a degree in a STEM field.

"People don't feel like they belong in STEM classes even in high school and it impacts their likelihood of choosing a STEM major, persisting in STEM and choosing a STEM job," Shifrer said. "STEM faculty and STEM employers write off lack of representation of people with cognitive disabilities as inevitable, perceiving them as having no potential, but they don't consider the roles of attitudes and don't consider their contributions to those attitudes. They're part of the reason why people don't feel like they belong."

Results showed that higher levels of high school achievement typically mattered more than STEM-positive attitudes for increasing the likelihood that a student enrolls in college, regardless of disability status and type. In contrast, STEM-positive attitudes mattered more than achievement for increasing the likelihood that a student majors in STEM, regardless of disability status and type.

The findings were published in the journal Socius: Sociological Research for a Dynamic World. Shifrer and her co-author, Ph.D. student Daniel Mackin Freeman, are now looking into what explains why some youth with cognitive disabilities are high-achieving and others are low-achieving.

"Often in research and policy, people with disabilities are treated as a monolithic category but that's problematic," Mackin Freeman said.

Osaka, Japan - Catalysts lie at the heart of a greener and more sustainable future for chemical production. However, many of the catalysts currently in widespread use have limitations that affect their efficiency. Researchers from Osaka University have reported a stable and reusable nickel phosphide nanoalloy catalyst for the hydrogenation of maltose to maltitol that outperforms conventional catalysts. Their findings are published in ACS Sustainable Chemistry & Engineering.

Maltitol is a sugar alcohol that is widely used as a sweetener and food additive. It can be produced by hydrogenating maltose; however, the reaction must be selective to avoid generating unwanted side products such as glucose. Ruthenium catalysts have been found to be efficient for this conversion, but are expensive, while cheaper nickel alternatives have low activity and are difficult to handle and reuse.

The researchers have now reported a nickel phosphide nanoalloy catalyst on a hydrotalcite (HT) support (nano-Ni2P/HT) that shows high activity for the selective hydrogenation of maltose to maltitol. The catalyst is also stable in air making it easy to handle.

"Our catalyst outperformed conventional catalysts for maltitol synthesis, showing high activity even at ambient temperature," says study first author Sho Yamaguchi. "The HT support was found to be key to the enhanced performance. In fact, the turnover number of the supported catalyst was more than 300 times higher than that of the same catalyst without a support."

The catalyst and support were found to work together in so-called cooperative catalysis. The nickel sites on the nano-Ni2P are thought to activate the hydrogen gas, while the HT is believed to be an electron donor and to activate the maltose.

nano-Ni2P/HT could be filtered from the reaction mixture and reused directly, without the need for time-consuming regeneration steps. The same amount of maltitol was produced on the fifth use as when the catalyst was fresh, showing that the activity and selectivity were conserved after multiple uses.

The catalyst even achieved high yields when the reaction mixture had a high maltose concentration (>50 wt%), which indicates that it would be appropriate for use on an industrial scale.

"The cooperative role of the support in the high activity of nano-Ni2P/HT is particularly exciting because this area has not been widely explored," study corresponding author Takato Mitsudome explains. "We believe that this mechanism, supported by the excellent properties we have demonstrated, means our catalyst is perfectly positioned to make a significant contribution to the sustainable production of maltitol."

INDIANAPOLIS -- Patients who suffer from traumatic brain injuries (TBI) often need a great deal of healthcare services after the injury, but the extent of care utilization is unknown. A new study from research scientists affiliated with the U.S. Department of Veterans Affairs (VA), Regenstrief Institute and IUPUI is one of the first to analyze how much care TBI patients use and identify areas of unmet need.

"There is not a lot of information about traumatic brain injury care utilization available," said primary study author Johanne Eliacin, PhD, a Regenstrief research scientist and core investigator at the VA Health Services Research and Development Center for Health Information at Richard L. Roudebush VA Medical Center. "In fact, until a few years ago, TBI was viewed as a one-time event. The goal of this study was to look at the care sought by survivors in order to understand the struggles they face and address them."

The study used the Indiana TBI registry for its cohort. The registry, funded by the Indiana Department of Health, contains all individuals diagnosed with mild, moderate and severe TBI listed in the Indiana Network for Patient Care (INPC), which is managed by Indiana Health Information Exchange. The research team looked at patients who were hospitalized with a TBI from 2005 through 2014 and examined healthcare utilization data for one year after the TBI event. That data was broken down into three categories: emergency department, inpatient and outpatient care.

Researchers found that many TBI survivors needed extensive healthcare services in the year after their injury, and a quarter of them were super-utilizers, having three or more emergency department visits or inpatient encounters or more than 26 outpatient visits during the year.

The results indicate that health insurance impacted the amount and type of care utilized, as did race, gender and residency status. Study authors say these potential disparities are an important area to focus on in future research.

"Because this is one of the first studies looking at these data, we are just beginning to identify patterns," said Dr. Eliacin. "More work is needed to dig into the social determinants of health that impact a TBI survivor's outcomes and to understand the struggles faced by those who are high utilizers of the healthcare system."

A previous qualitative study published by Dr. Eliacin presented some of the challenges patients and caregivers reported, which included the struggle to understand what care was available and where to access it.

"The Indiana TBI registry is an important resource to be able to understand the healthcare journeys of TBI patients," said study author Brian Dixon, PhD, MPA, Regenstrief and Indiana University Richard M. Fairbanks School of Public Health at IUPUI director of public health informatics. "We can leverage these data to identify population needs and develop interventions to improve quality of life as well as the access to and utility of their care."

"Characterizing health care utilization following hospitalization for a traumatic brain injury: a retrospective cohort study" was published in the journal Brain Injury.

In addition to Drs. Eliacin and Dixon, authors on the paper are Ziyi Yang, M.S. of IUPUI and Jacob Kean, PhD, of the VA Salt Lake City Health Care System and the University of Utah School of Medicine.

This work was supported, in part, by the Indiana Spinal Cord & Brain Injury Research Fund from the Indiana Department of Health. It was also supported by a VA Rehabilitation Research and Development Career Development Award IK2RX000879 to Dr. Kean.

IHIE is a non-profit, software development organization that operates the INPC -- the nation's largest inter-organizational clinical data repository which houses more than 14 billion pieces of patient data from 95% of Indiana.

UNIVERSITY PARK, Pa. -- Have you recently turned to your mobile device or computer to find out if your cough, sniffle or fever could be caused by COVID-19?

The online symptom checker you used may have advised you to stay home and call your medical provider if symptoms worsen, or perhaps told you that you may be eligible for COVID-19 testing. But why did it make the recommendation it did? And how should you know if you can trust it?

Those are questions that researchers at the Penn State College of Information Sciences and Technology recently explored through a project in which they augmented online symptom checkers by offering explanations of how the system generated its probable diagnoses and suggestions -- while also studying users' perceptions of those recommendations.

"People are confused about why online symptom checkers ask certain questions and how they make certain recommendations and decisions," said Chun-Hua Tsai, assistant research professor and first author on the research paper. "These interactions are not very transparent, which is OK if you just have a common cold, but with COVID it could be pretty serious."

Tsai explained that current online symptom checkers, which are powered by machine learning algorithms, use information that users provide to guide the checker in its next steps toward a possible diagnosis. However, the AI-driven systems' lack of transparency and comprehensible language could result in unintended -- and potentially tragic -- consequences if a user does not fully understand the recommendations it provides.

For example, if an online symptom checker simply recommended that a user get tested for COVID-19 based on the user's input, it could cause undue worry or unnecessary trips to a medical facility. Conversely, if a user learned from an online symptom checker that they could possibly have the coronavirus, it could lead them to make a poor medical decision such as taking medication on their own instead of being tested or seeking proper medical treatment.

"Explanation in medical diagnosis interactions emphasizes the importance of pragmatics," said Jack Carroll, distinguished professor of information sciences and technology and one of the research paper's authors.

The team's work has potential application beyond COVID-19, said Xinning Gui, assistant professor of information sciences and technology and another collaborator on the project.

"Even before COVID-19, tens of millions of people have used symptom checkers to self-diagnose or self-triage for numerous health conditions," she said. "However, little attention is paid to critical issues such as legitimacy, safety, trust and transparency from a user's perspective. Our work is just the start to fill this gap."

In their work, the researchers reproduced a user's interaction with an online symptom checker and added explanations for why the chatbot asked certain questions and how the recommendations were generated -- for example, if the suggestion was drawn from Centers for Disease Control and Prevention guidelines.

"Based on these explanations, our findings showed that the users were more confident (in the accuracy of the symptom checker) when they received these recommendations," said Tsai. "Transparent symptom checkers could be really useful for people to understand their own situation to make a better medical decision. Potentially, this could [also] be a tool to use in responding to the pandemic public health crisis that we're facing today."

In their study, the researchers interviewed users of online symptom checkers to understand if explanations would improve their user experience and their trust in the online tools. The interviews yielded that users are often confused by the questions that chatbots ask and which symptoms and information led to the suggested diagnosis and advice.

"For the possible causes listed to me, (the chatbot) doesn't tell me why my symptoms have a match. It just says something in a statistical way, like how many people might have this cause. I think the app should show the relations, like explain why it thinks this might be a possible cause, which question it asked, and which answers I gave have led me to this diagnosis," said one survey participant, as published in the research paper.

Then, the researchers designed a COVID-19 online symptom checker to include three types of explanation styles: rationale-based, providing an explanation after each question the system promoted to the user; feature-based, offering a personalized summary based on the user's answers; and example-based, highlighting an identical example of a patient who received the same clinical recommendation as the user based on identical answers.

They found that the explanations not only could significantly improve the user experience, but also could facilitate medical decision-making and improve user trust in the diagnosis.

"Explanation could empower health consumers to make informed decisions," said Gui. "Without explanation about how the symptom checkers come to the results and the underpinning evidence, health consumers will face challenges in comprehending or trusting the diagnostic results."

She added, "Our study proves that providing suitable explanations can help users better interpret the results and make informed decisions."

The researchers' findings could inform future design of online symptom checkers, helping users to potentially navigate a number of medical issues beyond COVID-19.

"Our findings could advance the research area of health recommender systems and explainable AI [artificial intelligence] in terms of personal health care, fairness and user trust," said Tsai.

Astronauts who spend extended time in space face stressors such as isolation, confinement, lack of privacy, altered light-dark cycles, monotony and separation from family. Interestingly, so do people who work at international research stations in Antarctica, where the extreme environment is characterized by numerous stressors that mirror those present during long-duration space exploration.

To better understand the psychological hurdles faced by astronauts, University of Houston professor of psychology Candice Alfano and her team developed the Mental Health Checklist (MHCL), a self-reporting instrument for detecting mental health changes in isolated, confined, extreme (ICE) environments. The team used the MHCL to study psychological changes at two Antarctic stations. The findings are published in Acta Astronautica.

"We observed significant changes in psychological functioning, but patterns of change for specific aspects of mental health differed. The most marked alterations were observed for positive emotions such that we saw continuous declines from the start to the end of the mission, without evidence of a 'bounce-back effect' as participants were preparing to return home," reports Alfano. "Previous research both in space and in polar environments has focused almost exclusively on negative emotional states including anxiety and depressive symptoms. But positive emotions such as satisfaction, enthusiasm and awe are essential features for thriving in high-pressure settings."

Negative emotions also increased across the study, but changes were more variable and predicted by physical complaints. Collectively, these results might suggest that while changes in negative emotions are shaped by an interaction of individual, interpersonal and situational factors, declines in positive emotions are a more universal experience in ICE environments. "Interventions and counter measures aimed at enhancing positive emotions may, therefore, be critical in reducing psychological risk in extreme settings," said Alfano.

At coastal and inland Antarctic stations, Alfano and her team tracked mental health symptoms across a nine-month period, including the harshest winter months, using the MHCL. A monthly assessment battery also examined changes in physical complaints, biomarkers of stress such as cortisol, and the use of different emotion regulation strategies for increasing or decreasing certain emotions.

Study results also revealed that participants tended to use fewer effective strategies for regulating (i.e., increasing) their positive emotions as their time at the stations increased.

"Both the use of savoring - purposely noticing, appreciating, and/or intensifying positive experiences and emotions - and reappraisal - changing the way one thinks about a situation - decreased during later mission months compared to baseline. These changes likely help explain observed declines in positive emotions over time," said Alfano.