Culture

This is part 3 of a three-part series examining the effects of robots and automation on employment, based on new research from economist and Institute Professor Daron Acemoglu.

CAMBRIDGE, Mass. -- Modern technology affects different workers in different ways. In some white-collar jobs -- designer, engineer -- people become more productive with sophisticated software at their side. In other cases, forms of automation, from robots to phone-answering systems, have simply replaced factory workers, receptionists, and many other kinds of employees.

Now a new study co-authored by an MIT economist suggests automation has a bigger impact on the labor market and income inequality than previous research would indicate -- and identifies the year 1987 as a key inflection point in this process, the moment when jobs lost to automation stopped being replaced by an equal number of similar workplace opportunities.

"Automation is critical for understanding inequality dynamics," says MIT economist Daron Acemoglu, co-author of a newly published paper detailing the findings.

Within industries adopting automation, the study shows, the average "displacement" (or job loss) from 1947-1987 was 17 percent of jobs, while the average "reinstatement" (new opportunities) was 19 percent. But from 1987-2016, displacement was 16 percent, while reinstatement was just 10 percent. In short, those factory positions or phone-answering jobs are not coming back.

"A lot of the new job opportunities that technology brought from the 1960s to the 1980s benefitted low-skill workers," Acemoglu adds. "But from the 1980s, and especially in the 1990s and 2000s, there's a double whammy for low-skill workers: They're hurt by displacement, and the new tasks that are coming, are coming slower and benefitting high-skill workers."

The new paper, "Unpacking Skill Bias: Automation and New Tasks," will appear in the May issue of the American Economic Association: Papers and Proceedings. The authors are Acemoglu, who is an Institute Professor at MIT, and Pascual Restrepo PhD '16, an assistant professor of economics at Boston University.

Low-skill workers: Moving backward

The new paper is one of several studies Acemoglu and Restrepo have conducted recently examining the effects of robots and automation in the workplace. In a just-published paper, they concluded that across the U.S. from 1993 to 2007, each new robot replaced 3.3 jobs.

In still another new paper, Acemoglu and Restrepo examined French industry from 2010 to 2015. They found that firms that quickly adopted robots became more productive and hired more workers, while their competitors fell behind and shed workers -- with jobs again being reduced overall.

In the current study, Acemoglu and Restrepo construct a model of technology's effects on the labor market, while testing the model's strength by using empirical data from 44 relevant industries. (The study uses U.S. Census statistics on employment and wages, as well as economic data from the Bureau of Economic Analysis and the Bureau of Labor Studies, among other sources.)

The result is an alternative to the standard economic modeling in the field, which has emphasized the idea of "skill-biased" technological change -- meaning that technology tends to benefit select high-skilled workers more than low-skill workers, helping the wages of high-skilled workers more, while the value of other workers stagnates. Think again of highly trained engineers who use new software to finish more projects more quickly: They become more productive and valuable, while workers lacking synergy with new technology are comparatively less valued.

However, Acemoglu and Restrepo think even this scenario, with the prosperity gap it implies, is still too benign. Where automation occurs, lower-skill workers are not just failing to make gains; they are actively pushed backward financially. Moreover, Acemoglu and Restrepo note, the standard model of skill-biased change does not fully account for this dynamic; it estimates that productivity gains and real (inflation-adjusted) wages of workers should be higher than they actually are.

More specifically, the standard model implies an estimate of about 2 percent annual growth in productivity since 1963, whereas annual productivity gains have been about 1.2 percent; it also estimates wage growth for low-skill workers of about 1 percent per year, whereas real wages for low-skill workers have actually dropped since the 1970s.

"Productivity growth has been lackluster, and real wages have fallen," Acemoglu says. "Automation accounts for both of those." Moreover, he adds, "Demand for skills has gone down almost exclusely in industries that have seen a lot of automation."

Why "so-so technologies" are so, so bad

Indeed, Acemoglu says, automation is a special case within the larger set of technological changes in the workplace. As he puts it, automation "is different than garden-variety skill-biased technological change," because it can replace jobs without adding much productivity to the economy.

Think of a self-checkout system in your supermarket or pharmacy: It reduces labor costs without making the task more efficient. The difference is the work is done by you, not paid employees. These kinds of systems are what Acemoglu and Restrepo have termed "so-so technologies," because of the minimal value they offer.

"So-so technologies are not really doing a fantastic job, nobody's enthusiastic about going one-by-one through their items at checkout, and nobody likes it when the airline they're calling puts them through automated menus," Acemoglu says. "So-so technologies are cost-saving devices for firms that just reduce their costs a little bit but don't increase productivity by much. They create the usual displacement effect but don't benefit other workers that much, and firms have no reason to hire more workers or pay other workers more."

To be sure, not all automation resembles self-checkout systems, which were not around in 1987. Automation at that time consisted more of printed office records being converted into databases, or machinery being added to sectors like textiles and furniture-making. Robots became more commonly added to heavy industrial manufacturing in the 1990s. Automation is a suite of technologies, continuing today with software and AI, which are inherently worker-displacing.

"Displacement is really the center of our theory," Acemoglu says. "And it has grimmer implications, because wage inequality is associated with disruptive changes for workers. It's a much more Luddite explanation."

After all, the Luddites -- British textile mill workers who destroyed machinery in the 1810s -- may be synonymous with technophobia, but their actions were motivated by economic concerns; they knew machines were replacing their jobs. That same displacement continues today, although, Acemoglu contends, the net negative consequences of technology on jobs is not inevitable. We could, perhaps, find more ways to produce job-enhancing technologies, rather than job-replacing innovations.

"It's not all doom and gloom," says Acemoglu. "There is nothing that says technology is all bad for workers. It is the choice we make about the direction to develop technology that is critical."

Making pure red LEDs from nitride crystals is a goal that has so far frustrated engineers. However, these LEDs are vital for building the next generation of energy-efficient micro-LED displays to follow OLED displays and for creating lighting with color tuning. Now, for the first time, a team of electrical engineers at KAUST has succeeded in making these LEDs.

"Electrical engineers can already make bright LEDs using varying materials to produce different colors. But to improve display technologies, engineers must integrate the three primary color LEDs, red, green and blue, onto one chip," explains Daisuke Iida, an electrical engineer at KAUST. This means they need to find one material that is suitable for manufacturing all three colors. The material should be able to produce each color with high intensity, and ideally, it should have a high-power output, but use relatively little battery voltage.

The best candidates for generating all three colors are a family of compounds called nitride semiconductors. These are crystals containing nitrogen that in theory can be used to create LEDs that produce light with wavelengths between ultraviolet and infrared, which includes the entire visible spectrum. Engineers usually use gallium nitride to make blue and green LEDs, but they have struggled to make bright red LEDs with this crystal. "Red vision has been almost impossible--other groups have only really succeeded in making orange, not apple red," says group leader, Kazuhiro Ohkawa. "Now, we have developed a crystal growth system to realize pure red LEDs."

Replacing a large portion of the gallium with the element indium gives the desired red, but it is hard to do because indium easily evaporates from the crystal. So Iida, Ohkawa and colleagues created a reactor with extra indium vapor above the crystal's surface, a process known as metalorganic vapor-phase deposition. This added pressure prevents the indium in the crystal from escaping. "This gives us a higher indium concentration at the surface," says Ohkawa. "That's our secret!"

But there was another hurdle to overcome. Indium is made of larger atoms than gallium, so when it is introduced, it creates defects in the crystal, degrading the quality of output light. The team's trick was to also add aluminum, which has small atoms. "The introduction of the small atoms reduces the strain on the crystal, resulting in fewer crystal defects," says Iida.

"Another advantage is that the LEDs operate at about half the voltage of its competitors," says Ohkawa. "This will give you a longer lifetime for batteries."

Exposure to bisphenol A (BPA), an industrial chemical used to make certain plastics and resins, inner coatings for food cans and bottle tops, thermal paper used in store receipts, dental sealants and so on, is a concern because of possible adverse health effects, including a reduction in fertility.

A study performed at Harvard Medical School (HMS) in the United States by Maria Fernanda Hornos Carneiro and her research group shows that the harmful effects of BPA can be reversed by administering a supplement known as CoQ10 (coenzyme Q10), a substance naturally produced by the human body and found in beef and fish. Hornos Carneiro is a former São Paulo Research Foundation - FAPESP scholarship awardee.

The article published in the journal Genetics is the first to present this strategy for reversing the effects of BPA in the organism. In this study, the researchers tested the antioxidant action of CoQ10 in nematodes of the species Caenorhabditis elegans exposed to BPA.

As an excellent antioxidant, CoQ10 is an electron donor. By donating its electrons, it stabilizes free radicals, reducing the oxidative stress and cell damage caused by BPA.

"BPA has oxidation potential as it's chemically unstable and produces reactive oxygen and nitrogen species. When the antioxidant reserves in cells [electron donors] run out, the amount of reactive oxygen and nitrogen increases. Because of their chemical instability, they 'poach' electrons from mitochondria and other cellular organelles, cell membranes, proteins, and even DNA, damaging cells significantly and potentially causing cell death. If this problem becomes extensive, it poses a major threat to the organism," Hornos Carneiro told.

The study measured the number of fertilized eggs laid and hatched and the number of progeny that reached adulthood. The problems detected can be compared to difficulty in becoming pregnant, miscarriages and chromosome anomalies in humans.

"BPA is a chemical contaminant that acts as an endocrine disruptor, causing cellular oxidative stress [an imbalance between oxidant and antioxidant molecules], which results in damage to gametes and embryos," said Hornos Carneiro, who conducted the study under the supervision of HMS Professor Monica Paola Colaiácovo. "In the study, the worms exposed to BPA and given CoQ10 displayed lower egg cell death rates, less DNA breakage and fewer abnormalities in chromosomes during cell division, as well as less cellular oxidative stress."

In the experiment, worms were exposed to different combinations of BPA, CoQ10 and a solvent (DMSO): solvent only, solvent and CoQ10, BPA only, and BPA plus CoQ10.

The amount of exposure to BPA mimicked the estimated amount in humans. "We know it's practically impossible to avoid exposure to BPA and similar contaminants in this day and age, so we looked for a strategy to minimize the harm done. Many studies have shown that age reduces fertility in women, and because exposure to BPA [and other endocrine disruptors] occurs throughout life, it's not yet possible to estimate separately the extent to which observed infertility is due to exposure to toxic chemicals in the external environment and how much is due to aging," Hornos Carneiro said.

The nematodes used in the study were transgenic, with a fluorescent protein sequence inserted into their DNA to enable in vivo observation of protein expression. Fluorescent antibodies were also used, as well as advanced microscopy and molecular biology techniques. The researchers were thereby able to observe in real time the effects produced at the cellular and molecular levels during the process of cell division (meiosis) and embryo formation in the worms.

Estrogen mimic

According to Hornos Carneiro, BPA's chemical structure is similar to that of estrogen, a female sex hormone that plays a key role in ovulation. As a result, BPA can bind to estrogen receptors in humans, leading to a number of significant effects. "Depending on the tissue, the effects may be pro-estrogenic or anti-estrogenic, with an impact not just on the reproductive system but also on other systems and processes that are important to a person's health," she said.

Hornos Carneiro is currently a professor in the School of Chemistry and Pharmacy at the Pontifical Catholic University of Chile. She conducted the study at the University of São Paulo's Ribeirão Preto School of Pharmaceutical Sciences (FCFRP-USP) in Brazil with the support of a FAPESP scholarship for postdoctoral research internship abroad.

DNA breakage and mitochondrial dysfunction

According to Hornos Carneiro, exposure of the worms to BPA alone resulted in more DNA breaks. "This was potentially due to the action of reactive oxygen species formed as a result of the presence of the contaminant in the organism," she said. "We found that the breaks were not correctly repaired in this group of worms."

The damage was observed by monitoring a protein involved in DNA breakage and repair when genetic material is exchanged between homologous chromosomes during meiosis.

This exchange of genetic material, known as crossing over, is important for increasing genetic diversity and driving evolution. "One hypothesis is that the increase in DNA breakage [and inefficient repair] was due to a rise in gonad oxidative stress caused by BPA," she said.

Another finding was that mitochondrial dysfunction increased. Mitochondria are energy-producing organelles in cells. "Because of oxidative stress, mitochondrial membrane potential was significantly altered in the worms exposed only to BPA, while in the group that received the CoQ10 supplement, this marker was much improved," Hornos Carneiro said.

Effect on embryos

The effect of BPA on embryos was also studied in this experiment. As a hermaphrodite, C. elegans self-fertilizes, and it is therefore possible to observe in its gonads all stages of germinative cell development in meiosis up to the polar corpuscle and embryo formation.

"In the study, we observed embryo formation in vivo using a technique called live imaging," Hornos Carneiro explained. "The benchmark for analysis of the occurrence of defects was the first cell division [the precise moment at which the unicellular embryo divides in two]. In the group exposed only to BPA, a larger number of defects were observed, such as formation of chromatin bridges and cell division cessation."

The bacteria Thermus thermophilus likes it hot. It was first discovered in the hot springs at Izu in Japan, where it thrives at an optimal temperature of about 65 degrees Celsius. Like all bacteria, Thermus thermophilus has developed mechanisms to adjust to changing environmental conditions. The bacteria changes its genetic material by exchanging DNA with other bacteria, or absorbing DNA fragments from its environment. These might come from dead bacteria cells, plants or animals. The bacteria incorporate the DNA fragments into their genetic material and keep it if the DNA proves useful.

Microbiologists at Goethe University led by Professor Beate Averhoff from the Molecular Microbiology & Bioenergetics of the Department of Molecular Biosciences together with a team of scientists led by Dr Vicky Gold from the "Living Systems" Institute of the University of Exeter in Great Britain have now studied the tiny hairs (called pili) on the surface of the Thermus bacteria. The scientists discovered that there are two types of pili with different functions. High-resolution electron microscope images from Great Britain allow thick and thin pili to be distinguished, and the Frankfurt scientists used biochemical and molecular biological methods to demonstrate that the thick pili are for DNA capture, and the thin pili for moving on surfaces.

"We want to find out exactly how Thermus thermophilus absorbs DNA from its environment using its pili, as the precise mechanism is unknown," explains Professor Beate Averhoff from the Institute for Molecular Biosciences at Goethe University. "Through our most recent investigations we have learned that Thermus bacteria have distinct pili for motion. Therefore, the thick pili possibly serve the purpose of DNA absorption, which demonstrates how important this process is for the bacteria. In our structure analyses we also found an area on the thick pili where DNA could bind."

The interplay of electron microscopy and molecular biology also allowed the scientists to better understand the mechanics of the pili. For both motion and DNA absorption, pili have to be dynamic, i.e., able to be extended and retracted. "For the first time, the high resolution structure of both pili gave us insights not only into the structure of the pili, but also into the dynamics," Averhoff explains.

Since pili are widespread and in pathogenic bacteria are also responsible for attaching to the host, this may lead to new points of attack for preventing infectious processes.

COVID-19 is a pandemic that has forced many states to declare restrictive measures in order to prevent their wider spread. These measures are necessary to protect the health of adults, children and people with disabilities. Long quarantine periods could cause an increase in anxiety crisis, fear of contagion and post-traumatic stress disorder (frustration, boredom, isolation, fear, insomnia, difficulty concentrating).

Post-traumatic stress disorder (PTSD) develops as a consequence of one or more physical or psychological traumatic events, such as exposure to natural disasters such as earthquakes, fires, floods, hurricanes, tsunamis; wars, torture, death threats; road accidents, robbery, air accidents; diseases with unfavorable prognosis; complicated or traumatic mourning; physical and sexual abuse and abuse during childhood; victimization and discrimination based on gender, sexual orientation, gender identity. It can also develop following changes in lifestyle habits caused by the COCOVID-19 epidemic. The arrival of the pandemic caused by the Coronavirus (Covid-19) in the world is bringing families, teachers, educators and all the people who care for children every day. Long quarantine periods could cause an increase in anxiety crisis, fear of contagion and post-traumatic stress disorder (frustration, boredom, isolation, fear, insomnia, difficulty concentrating). It is important to speak calmly and directly to children.

The child may also be told that isolation is needed to avoid contact with the virus until we have effective drugs or a vaccine. For children, staying at home is not a problem, they are used to holidays; they spend their time playing, watching television, talking with family members, in some cases where the restrictive measures are not too strict, I can play outdoors. In these cases it is essential to reassure the children, to structure their day, to divide the times and spaces according to patterns and rhythms. We can say that based on previous quarantine experiences that long periods of isolation can lead to psychological symptoms such as emotional disturbances, depression, stress, mood disturbances, irritability, insomnia and signs of traumatic post-stress disorders. Therefore it is important to be able to explain to children what is happening and how to manage this traumatic event following the COVID-19 pandemic.

At a glance:

New report offers insights on differentiating COVID-19 from other infections that can present with similar symptoms

Early differentiation remains critical in the absence of universal and reliable point-of-care diagnostic testing

Analysis based on data from patient visits to an outpatient COVID-19 clinic in Greater Boston during the month of March

Since the early days of the COVID-19 pandemic, scientific literature and news reports have dedicated much attention to two groups of patients--those who develop critical disease and require intensive care and those who have silent or minimally symptomatic infections.

Such accounts have mostly overlooked another large and important category of patients--those with symptoms concerning enough to seek care, yet not serious enough to need hospital treatment.

Now, a new analysis by researchers at Harvard Medical School and Harvard-affiliated Cambridge Health Alliance offers insights into this in-between category based on data collected from people presenting at an outpatient COVID-19 clinic in Greater Boston.

The team's observations, published April 20 in the journal Mayo Clinic Proceedings, are based on data from more than 1,000 patients who visited the clinic for respiratory illness since COVID-19 was declared a pandemic in March.

The findings offer a compilation of clues that can help clinicians distinguish between patients with COVID-19 infections and those with other conditions that may mimic COVID-19 symptoms.

Such clues are critical because early triage and rapid decision-making remain essential even now that testing is becoming more widely available than it was in the early days of the pandemic, the research team said. Testing remains far from universal, and even when available, tests still may have a turnaround time of one to three days. Additionally, some rapid point-of-care tests that have emerged on the market have not been entirely reliable and have caused false-negative readings.

"Early recognition and proper triage are especially important given that in the first days of infection, people infected with SARS-CoV-2 may experience symptoms indistinguishable from a variety of other acute viral and bacterial infections," said study lead author Pieter Cohen, an associate professor of medicine at Harvard Medical School and a physician at Cambridge Health Alliance. "Even when point-of-care diagnostic tests are available, given the potential for false-negative results, understanding the early natural history of COVID-19 and good old-fashioned clinical skills will remain indispensable for proper care."

A nuanced understanding of the typical presentation of COVID-19 in the outpatient setting can also help clinicians determine how often to check back with patients, the researchers added. For example, those who have started developing shortness of breath demand very close monitoring and frequent follow-up to check how the shortness of breath is evolving and whether a patient may be deteriorating and may need to go to the hospital.

According to the report, COVID-19 typically presents with symptoms suggestive of viral infection, often with low-grade fever, cough and fatigue, and, less commonly, with gastrointestinal trouble. Shortness of breath usually emerges a few days after initial symptoms, becomes most pronounced upon exertion and may involve sharp drops in blood oxygen levels.

Chief among the team's findings:

Fever is not a reliable indicator. If present, it could manifest only with mild elevations in temperature.

COVID-19 may begin with various permutations of cough without fever, sore throat, diarrhea, abdominal pain, headache, body aches, back pain and fatigue

It can also present with severe body aches and exhaustion.

A reliable early hint is loss of the sense of smell in the first days of disease onset.

In serious COVID-19, shortness of breath is a critical differentiator from other common illnesses.

Almost no one, however, develops shortness of breath, a cardinal sign of the illness, in the first day or two of disease onset.

Shortness of breath can appear four or more days after onset of other symptoms.

The first days after shortness of breath begins are a critical period that requires close and frequent monitoring of patients by telemedicine visits or in-person exams.

The most critical variable to monitor is how the shortness of breath changes over time. Oxygen saturation levels can also be a valuable clue. Blood oxygen levels can drop precipitously with exertion, even in previously healthy people.

A small number of people may never develop shortness of breath, but may have other symptoms that could signal low oxygen levels, including dizziness or falling.

Anxiety--common among worried patients with viral symptoms suggestive of COVID-19--can also induce shortness of breath.

Distinguishing between anxiety-induced shortness of breath and COVID-19-related shortness of breath is critical. There are several ways to tell the two apart.

Key differentiators include:

Time of onset: Anxiety-induced shortness of breath occurs rapidly, seemingly out of the blue, while COVID-19 shortness of breath tends to develop gradually over a few days.

Patient description of sensation: Patients whose shortness of breath is caused by anxiety often describe the sensation occurring during rest or while trying to fall asleep but does not become more pronounced with daily activities. They often describe a sensation of inability to get enough air into their lungs. By contrast, shortness of breath induced by COVID-19-related drops in oxygen gets worse with physical exertion, including performing simple daily activities like walking, climbing stairs or cleaning.

Anxiety-related shortness of breath does not cause drops in blood oxygen levels

During a clinical exam, a commonly used device, the pulse oximeter, can be valuable in distinguishing between the two. The device measures blood oxygen levels and heart rate in a matter of seconds when clipped onto one's finger.

Several types of pneumonia--a general term denoting infection in the lungs--can present with striking similarity to COVID-19. For example, COVID-19 respiratory symptoms appear to closely mimic symptoms caused by a condition known as pneumocystis pneumonia, a pulmonary infection predominantly affecting the alveoli, the tiny air sacs lining the surface of the lungs. Both COVID-19 patients and patients with pneumocystis pneumonia experience precipitous drops in oxygen levels with exertion and shortness of breath. However, in the case of pneumocystis pneumonia, the shortness of breath typically develops insidiously over weeks, not within days, as is the case with COVID-19. Here, a careful patient history detailing evolution of symptoms would be critical, the authors said.

Likewise, during the initial days of infection, both the flu and COVID-19 may have identical presentations, but thereafter the course of the two infections diverges. People with uncomplicated flu rarely develop significant shortness of breath. When they do experience trouble breathing, the shortness of breath is mild and remains stable. On the rare occasion of when flu causes a viral pneumonia, patients deteriorate rapidly, within the first two to three days. By contrast, patients with COVID-19 don't begin to develop shortness of breath until several days after they first become ill.

INFORMS Journal Management Science New Study Key Takeaways:

Under-represented minorities are more than twice as likely to have a ride canceled compared to Caucasians.

The racial bias is lessened during peak demand times.

Rides are more likely to be canceled for people who show support for the LGBT community with no changes during peak demand times.

CATONSVILLE, MD, May 6, 2020 - New research to be published in the INFORMS journal Management Science has found popular rideshare platforms exhibit racial and other biases that penalize under-represented minorities and others seeking to use their services.

The study, "When Transparency Fails: Bias and Financial Incentives in Ridesharing Platforms," was conducted by Jorge Mejia of Indiana University and Chris Parker of American University. In addition to finding racial biases persist, similar phenomena were also documented against people who show support for the LGBT community.

Data was analyzed from a major rideshare platform in Washington, D.C., between early October to mid-November 2018. The experiment manipulated rider names and profile pictures to observe drivers' behavior patterns in accepting and canceling rides. To illustrate support for LGBT rights a rainbow profile picture filter was used. In addition, times of ride requests varied to determine how peak and non-peak price periods impact bias.

"We found under-represented minorities are more than twice as likely to have a ride canceled than Caucasians, that's about 3% versus 8%," said Mejia, an assistant professor in the Kelley School of Business at Indiana. "Along with racial bias, LGBT biases are persistent, while there is no evidence of gender bias."

Peak timing was found to have a moderating effect, with lower cancelation rates for minority riders, but the timing doesn't appear to change the bias for riders that signal support for the LGBT community.

"Data-driven solutions may exist wherein rider characteristics are captured when a driver cancels, and the platform penalizes the driver for the biased behavior. One possible way to punish drivers is to move them down the priority list when they exhibit biased cancelation behavior, so they have fewer ride requests. Alternatively, less-punitive measures may provide 'badges' for drivers that exhibit especially low cancelation rates for minority riders," concluded Mejia.

Oncotarget Volume 11, Issue 12 reported that the p16 tumor suppressor is coded by CDKN2A and plays an important role during carcinogenesis and tumor progression in numerous tumor entities.

P16 positivity was found in 30.2% of AC and 13.9% of SCC and CDKN2A deletion in 32.1% of AC and 33.5% of SCC. In AC Ki67 positivity was associated with high tumor stage, presence of lymph node metastasis, high UICC stage and poor grading.

Dr. Nathaniel Melling from the Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany said, "Despite recent advances in the management of the disease, esophageal cancer (EC) is the sixth most lethal malignant disease with nearly half a million novel cases and over 400,000 deaths worldwide."

"Despite recent advances in the management of the disease, esophageal cancer (EC) is the sixth most lethal malignant disease with nearly half a million novel cases and over 400,000 deaths worldwide."

- Dr. Nathaniel Melling, Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf

The p16 tumor suppressor has been reported to play a pivotal role in cancer, since it inhibits cyclin-dependent kinases 4 and 6 at the G1 to S-phase transition of the cell cycle and thus prevents phosphorylation of the retinoblastoma protein.

P16 plays an important role during carcinogenesis and tumor progression in numerous tumor entities including cancers of the colon, liver, gallbladder, and skin.

Its expression is associated with unfavorable or favorable tumor phenotype depending on the analyzed tumor entity.

To elucidate the potential role of both p16 expression and CDKN2A deletion as prognostic biomarkers the authors examined our preexisting EC tissue microarray built from tumor samples of more than 690 individual EC patients.

The Melling Research Team concluded in their Oncotarget Research Paper, "the results of our study show that loss of p16 expression - but not CDKN2A deletion - is linked to shortened overall survival in patients with esophageal AC. Furthermore, strong Ki67LI is an independent prognosticator of poor survival in AC. Rare homozygous 9p21 deletions can be considered as catastrophic events leading to complete loss of p16 expression."

In a fair society, education is expected to be the great equalizer. This is based on the belief that education enabled people to escape poverty and join the middle class. In the United States, education is listed as a key strategy to achieve the American dream, even for people born to poor families. Education also protects individuals against heart disease. People's risk of heart disease is lowest in the most and highest in the least educated people.

In the most recent issue of The Open Cardiovascular Medicine Journal, Assari and colleagues explored the racial and ethnic variation in the link between education and heart disease in a nationally representative sample of American adults. The authors analyzed data of 25,659 American adults who participated in the first wave of the Population Assessment of Tobacco and Health (PATH- 2013). They categorize individuals based on education to less than a high school diploma, high school graduate, and college graduate. Then they compared race/ethnicity by education groups for the prevalence of heart disease.

Individuals with highest education had the lowest prevalence of heart disease. However, this protective effect was weaker for Hispanic and Black than for non-Hispanic and White individuals. That means, highly educated Black and Hispanic people remained at high risk of heart disease.

This finding is an extension of the Marginalization related Diminished Returns (MDRs) which refer to the weaker health benefits of education for racial and ethnic minority groups compared to Whites. While we knew that highly educated Black and Hispanic Americans remain at risk of obesity, poor diet, depression, tobacco use, and sedentary lifestyle, this was the first study to document the same pattern for heart disease.

Possibly due to the racism and social stratification, in the US, education is not the great equalizer but a source of health inequalities.

Unplanned extubations in adult and pediatric populations have long been associated with poor clinical outcomes and increased costs to health care systems.

A very common adverse event in intensive care unit settings, the long-term outcomes of unplanned extubations in critically ill, preterm infants have never been studied until now.

UEs are defined as any removal of the endotracheal tube that the medical team did not plan in advance. These include breathing tubes dislodged by the patient, removed accidently during routine nursing and medical care and those intentionally removed during an acute resuscitation event.

In a retrospective matched cohort study, a team of investigators at Monroe Carell Jr. Children's Hospital at Vanderbilt led by Dupree Hatch, MD, MPH, assistant professor of Pediatrics, Neonatology Division, was the first to describe the impact that unplanned extubations (UEs) have on preterm infants.

"While our findings were congruent with the adult and pediatric intensive care unit populations, we discovered preterm infant outcomes after UE were worse and the magnitude was more severe," he said.

The study, published in Pediatrics this month, documented that neonates experienced worse in-patient outcomes, extended length of stay and increased hospital costs.

"Our study was the first to describe what these UEs mean for the baby as well as what impact it has on the Neonatal Intensive Care Unit (NICU)," said Hatch, "The findings are helpful for those working to lower rates of UEs and gives us the ammunition to continue to do this important quality improvement work.

"Spending money on prevention will help save lives and costs. If teams have more resources to deal with unplanned extubations, they can not only improve patient care, but save money."

The research team looked at a cohort of very low birthweight infants, born less than 3.3 pounds, who required mechanical ventilation. The short-term results of UEs includes reintubation, oxygen desaturation and the need for CPR.

The study was able to determine that UEs in preterm infants are associated with significantly poorer hospital outcomes and increased financial costs.

According to study results, exposure to one or more UEs was associated with a nearly one- week increase in the duration of mechanical ventilation, an additional 10 days in the hospital and nearly $50,000 increase in total hospital costs.

UEs were also associated with worsened respiratory outcomes, which could also prolong the need for mechanical ventilation.

Conservative estimates show direct hospital costs of about $60 million as a result of UEs in babies less than 28 weeks at birth, said Hatch.

With national efforts to decrease the rate of UEs drawing more attention by quality improvement teams, Hatch hoped evidence-based interventions to prevent UEs, such as using multi-person teams for re-taping the breathing tube and transferring or moving patients, will become standard practice in the NICU.

Scientists have been studying cyanobacteria and its many potential applications for decades, from cutting CO2 emissions to creating a substitute for oil-based plastics, but there wasn't a deep understanding of the full life cycle and metabolism of specialized compartments within these common bacteria - until now.

New CU Boulder research published today in Science Advances shows how these specialized compartments, known as carboxysomes, work and how their activity can be accurately measured. The research findings could ultimately lead to increased plant yields, novel antibiotics and improved production efficiency of renewable fuels.

"This was a 50-year question, a long-standing thing that people could never tackle," said Jeffrey Cameron, an assistant professor in the Department of Biochemistry and coauthor of the new research.

In his work as a postdoctoral researcher, Cameron figured out how carboxysomes are formed: from the inside out. But he couldn't determine their function in the cells because they struggled to grow under the microscope.

He wanted to answer the questions of, how long do carboxysomes last? How long are they active? What happens to cells without carboxysomes?

So, Cameron and his colleagues tracked specific enzymes within these cells' carboxysomes, by tagging them with a green fluorescent marker. They then added chemicals to curb the ability of the cell to make new carboxysomes. Researchers tracked them for several days using live cell imaging as they were passed from mother to daughter cells.

Because the cells' ability to grow was dependent on their ability to fix carbon, in this way they could directly track the effect of the carboxysome on the cells' growth. The researchers found that by adjusting the amount of CO2 available to cells without carboxysomes, they could switch their growth on and off - effectively reactivating them at will from a dormant state.

And by filming thousands of cells and measuring all of them in the population, they uncovered several practical applications for engineering.

About 5% of these carboxysomes were ultra-productive and could maintain their growth rate for over seven generations.

"This would be like having the same brain passed on from your great, great, great, great, great grandmother that's still functioning over that many generations," said Cameron. "If we could understand the principles of why these ones are so active, we might be able to significantly improve plant growth."

There is now a huge push to try to put carboxysomes into plants to improve photosynthesis, which could greatly enhance plant yields, said Cameron, also of the Renewable and Sustainable Energy Institute (RASEI) at CU Boulder.

Carboxysomes also have potential to serve as mini bioreactors, increasing the metabolism for the processes that create biofuels.

Meantime, pathogenic bacteria, such as Salmonella, contain similar microcompartments that give them metabolic advantage in certain environments. Because humans do not have cyanobacteria or bacterial microcompartments, it may be possible to develop novel antibiotics that specifically target these bacterial structures, he added.

"I want to know, how can I elucidate the basic principles that will allow engineers to move forward?" said Cameron.

Modern society relies on polymers, such as polypropylene or polyethylene plastic, for a wide range of applications, from food containers to automobile parts to medical devices. However, like people, polymers age, and when they do, the materials become prone to cracking or breaking. Now, researchers reporting in ACS Central Science have developed a method to visualize variations in polymers that arise with age.

Heat, sunlight, oxygen and humidity can all cause polymers to degrade over time. At early stages, polymer chains break, producing functional groups, such as hydroxyl groups, and generating free radicals that speed up the aging process. Scientists have developed methods to study more advanced signs of polymer aging, but these techniques don't provide a microscopic 3D picture, and most aren't sensitive enough to detect early aging. Rui Tian, Chao Lu and colleagues wanted to find a way to visualize the aging process of polypropylene and polyethylene polymers in 3D. Such a technique could be used to detect aged polymers so they can be repaired or replaced with new parts before they fail.

The researchers based their method on a commercially available fluorescent dye, called DBPA, that can specifically attach to hydroxyl groups in polymers as the chains break. The team heated a thin sheet of polypropylene or polyethylene at 140 F and then soaked the plastic in a DPBA solution to dye the aged sites with hydroxyl groups. When the researchers observed the sheets under a confocal microscope, they found that the aged sites in the polymers -- as revealed by the fluorescently tagged hydroxyl groups -- grew deeper, wider and more frequent with time. The method detected faster polymer aging when the sheets were exposed to higher temperatures. To the researchers' knowledge, the fluorescent technique is the first that can sensitively monitor polymer aging in 3D, which will assist in identifying deteriorating polymers at the earliest stages.

A team of astronomers from the European Southern Observatory (ESO) and other institutes has discovered a black hole lying just 1000 light-years from Earth. The black hole is closer to our Solar System than any other found to date and forms part of a triple system that can be seen with the naked eye. The team found evidence for the invisible object by tracking its two companion stars using the MPG/ESO 2.2-metre telescope at ESO's La Silla Observatory in Chile. They say this system could just be the tip of the iceberg, as many more similar black holes could be found in the future.

"We were totally surprised when we realised that this is the first stellar system with a black hole that can be seen with the unaided eye," says Petr Hadrava, Emeritus Scientist at the Academy of Sciences of the Czech Republic in Prague and co-author of the research. Located in the constellation of Telescopium, the system is so close to us that its stars can be viewed from the southern hemisphere on a dark, clear night without binoculars or a telescope. "This system contains the nearest black hole to Earth that we know of," says ESO scientist Thomas Rivinius, who led the study published today in Astronomy & Astrophysics (doi: 10.1051/0004-6361/202038020).

The team originally observed the system, called HR 6819, as part of a study of double-star systems. However, as they analysed their observations, they were stunned when they revealed a third, previously undiscovered body in HR 6819: a black hole. The observations with the FEROS spectrograph on the MPG/ESO 2.2-metre telescope at La Silla showed that one of the two visible stars orbits an unseen object every 40 days, while the second star is at a large distance from this inner pair.

Dietrich Baade, Emeritus Astronomer at ESO in Garching and co-author of the study, says: "The observations needed to determine the period of 40 days had to be spread over several months. This was only possible thanks to ESO's pioneering service-observing scheme under which observations are made by ESO staff on behalf of the scientists needing them."

The hidden black hole in HR 6819 is one of the very first stellar-mass black holes found that do not interact violently with their environment and, therefore, appear truly black. But the team could spot its presence and calculate its mass by studying the orbit of the star in the inner pair. "An invisible object with a mass at least 4 times that of the Sun can only be a black hole," concludes Rivinius, who is based in Chile.

Astronomers have spotted only a couple of dozen black holes in our galaxy to date, nearly all of which strongly interact with their environment and make their presence known by releasing powerful X-rays in this interaction. But scientists estimate that, over the Milky Way's lifetime, many more stars collapsed into black holes as they ended their lives. The discovery of a silent, invisible black hole in HR 6819 provides clues about where the many hidden black holes in the Milky Way might be. "There must be hundreds of millions of black holes out there, but we know about only very few. Knowing what to look for should put us in a better position to find them," says Rivinius. Baade adds that finding a black hole in a triple system so close by indicates that we are seeing just "the tip of an exciting iceberg."

Already, astronomers believe their discovery could shine some light on a second system. "We realised that another system, called LB-1, may also be such a triple, though we'd need more observations to say for sure," says Marianne Heida, a postdoctoral fellow at ESO and co-author of the paper. "LB-1 is a bit further away from Earth but still pretty close in astronomical terms, so that means that probably many more of these systems exist. By finding and studying them we can learn a lot about the formation and evolution of those rare stars that begin their lives with more than about 8 times the mass of the Sun and end them in a supernova explosion that leaves behind a black hole."

The discoveries of these triple systems with an inner pair and a distant star could also provide clues about the violent cosmic mergers that release gravitational waves powerful enough to be detected on Earth. Some astronomers believe that the mergers can happen in systems with a similar configuration to HR 6819 or LB-1, but where the inner pair is made up of two black holes or of a black hole and a neutron star. The distant outer object can gravitationally impact the inner pair in such a way that it triggers a merger and the release of gravitational waves. Although HR 6819 and LB-1 have only one black hole and no neutron stars, these systems could help scientists understand how stellar collisions can happen in triple star systems.

(Boston)--High blood pressure (hypertension) is the leading cause of death in the world affecting more than 1.4 billion people and accounting for more than 28,000 deaths each day. Today, the International Society of Hypertension (ISH) has released the "ISH 2020 Global Hypertension Practice Guidelines" to help reduce the burden of this significant health threat affecting people from every country and socio-economic group.

Developed by a world-wide panel of leading hypertension specialists from across the world, including Boston University School of Medicine (BUSM) researcher Richard Wainford, PhD, the guidelines outline the best approaches to the management of hypertension and provide simple, clear recommendations for health professionals and those affected by the condition.

According to the ISH these are the first guidelines developed specifically for the management of hypertension regardless of population or resources. This is particularly important because approximately 72 percent of the global hypertensive population reside in low and middle income countries. "We believe these simplified guidelines will be of use globally and may be of most use in countries that do not have their own national hypertension practice guidelines," said Wainford, associate professor of pharmacology and medicine at BUSM.

The goal is for the guidelines to be used globally versus a specific region and to be concise, simplified and easy to use by clinicians, nurses and community health workers. "The inclusion of optimal and essential treatment paradigms throughout the guidelines attempts to address the issue that in resource poor settings it may not be possible to access cutting-edge medical equipment and technology - however it is still possible to address hypertension prevalence and treatment," he added.

It has been seven years since the International Society of Hypertension issued global treatment guidelines. Wainford and the ISH Hypertension Guideline Committee hope that by improving the global awareness of hypertension and providing guidance in a simple easy to reference format, significant progress can be made in reducing the global public health burden of hypertension.

Several clinical trials have reported beneficial effects of organic nitrates on bone health, which could lead to a reduced risk of fractures. Some of these trials have been retracted because of scientific misconduct; however. A new study published in the Journal of Bone and Mineral Research found that organic nitrates do not have clinically relevant effects on bone mineral density or bone turnover in postmenopausal women, and the medications caused significant side effects.

The study was a double-blind, randomized, placebo-controlled trial of three different nitrate preparations and two different doses in postmenopausal women with bone loss. There were no differences in changes in bone mineral density or bone turnover markers between organic nitrate treatment and placebo.

The results call into question the validity of previous clinical research reporting large positive effects of nitrates on bone health.

"Based on previous clinical trials, we had high hopes that treatment with nitrates might be a safe and highly effective treatment for preventing age-related bone loss and fractures. We assessed several different doses and forms of nitrates and our results show clearly that no preparation or dose had any effect on bone density or bone turnover, but they did cause significant side-effects for women," said lead author Mark Bolland, MBChB, PhD, of the University of Auckland, in New Zealand. "Sadly, this research area has recently had several studies with strongly positive results retracted because of scientific misconduct. We think our paper provides closure, with fairly definitive evidence that nitrates do not affect surrogate measures of bone health and thus there is no reason to think they would prevent fractures."