Culture

Proactive, frequent rapid testing of all students for COVID-19 is more effective at preventing large transmission clusters in schools than measures that are only initiated when someone develops symptoms and then tests positive, Simon Fraser University researchers have found. Professors Caroline Colijn and Paul Tupper used a mathematical model to simulate COVID-19's spread in the classroom and published their research results today in the journal PLOS Computational Biology.

The simulations showed that, in a classroom with 25 students, anywhere from zero to 20 students might be infected after exposure, depending on even small adjustments to transmission rates for infected individuals or environments.

"When schools have reopened during the COVID-19 pandemic, in some places there have been large clusters of infections, and in others very little transmission," says Colijn, SFU mathematics professor and Canada 150 Research Chair in Mathematics for Evolution, Infection and Public Health. "In our simulations, we explored what factors affect cluster size, and what interventions can be used to prevent large clusters."

The researchers tested the effectiveness of two different transmission control strategies.

In the first, when a student (or teacher/staff member) develops symptoms, they are told to stay home, tested using a PCR test, and if the test result is positive, control measures are introduced in the classroom, such as telling the infected individual's close contacts to stay home.

In the second strategy, all students in the class are tested using rapid tests on a regular basis, whether they have symptoms or not. When a student tests positive, there is an intervention to prevent further transmission.

The researchers found that in scenarios with high transmission rates, interventions used in the first control strategy, where preventive actions took effect after a positive test result, were too slow to prevent large outbreaks. Using rapid tests to screen the whole population and catch infections before symptoms developed, as in the second strategy, led to preventing large outbreaks.

"We found that interventions that only took effect after someone developed symptoms and tested positive were too slow to prevent large clusters; only regular monitoring of asymptomatic individuals could prevent the worst outcomes," says Colijn.

Their study is timely as B.C. is expected to enter Step 4 of its reopening in September and concerns remain about a resurgence of COVID-19 in the fall. Regular screening for COVID-19 in the form of rapid testing has not been widely used in B.C. schools, though Alberta and Saskatchewan have plans to deploy rapid testing in schools in the fall, and Nova Scotia has long embraced rapid testing in a variety of settings.

Tupper says they hope to use data on transmission and cluster sizes in schools to estimate key unknowns about COVID-19 in schools, such as the rate of transmission, and how much it varies from classroom to classroom.

"We could then see how transmission depends on preventative measures that are put in place, such as mask use, improved ventilation and hand washing," he says. "This would inform which interventions, after a case is detected, would be the most effective."

The research results could be applied to other settings in which people spend multiple hours per day with the same group of approximately 20-30 others.

"Our results were based on simulations of a classroom, but the same considerations apply to other settings such as workplaces, or communal living settings such as long-term care homes," says Tupper, noting that their previous work points to the effectiveness of regular rapid testing in protecting residents of long-term care homes.

Researchers at Johns Hopkins Medicine have shown that a type of echocardiogram, a common test to evaluate whether a person's heart is pumping properly, may be useful in predicting which patients with COVID-19 are most at risk of developing atrial fibrillation -- an irregular heartbeat that can increase a person's risk for heart failure and stroke, among other heart issues. The new findings, published online May 30 in the Journal of the American Society of Echocardiography, also suggest that patients with COVID-19 who go on to develop atrial fibrillation more commonly have elevated levels of heart-related proteins called troponin and NT-proBNP in blood test samples.

If further studies confirm the findings, "this could lead to new therapies to prevent strokes and heart attacks in certain COVID-19 patients who are at the highest risk," says Allison Hays, M.D., medical director of echocardiography programs at The Johns Hopkins Hospital and senior author of the published paper.

The COVID-19 pandemic has affected more than 170 million people around the world, and previous studies of complications and long-term effects of SARS-CoV-2 infection have found that patients who are hospitalized with COVID-19 have more than double the rate of arrhythmias, including atrial fibrillation and atrial flutter, a similar rapid rhythm that can lead to heart failure and stroke.

But exactly how the virus causes these heart complications, and who is most at risk of developing atrial fibrillation because of COVID-19, has been poorly understood.

In this study, Hays and her colleagues compared 80 patients with COVID-19 with 34 patients who did not have COVID-19 who were also treated at The Johns Hopkins Hospital in the intensive or intermediate care units for respiratory issues. None of the patients had a history of heart arrhythmia.

In the study, carried out between March and June 2020, the researchers analyzed echocardiograms of hospitalized patients, applying a special kind of analysis called speckle-tracking strain to determine how well the left atrium of the heart moves with each heartbeat.

The team found that, overall, patients with COVID-19 had reduced function of their left atrium, the chamber of the heart that receives oxygenated blood from the lungs. Left atrial strain -- a measure of the movement of the left atrium's walls -- was significantly lower in patients with COVID-19 (28.2% compared with 32.6%, p=0.026; normal >38%) and left atrial emptying fraction -- a measure of how much blood the atrium empties with each contraction -- was also lower in the patients with COVID-19 (55.7% compared with 64.1%, p

Moreover, left atrial strain was even lower among the 30% of patients with COVID-19 who developed atrial fibrillation or flutter during their hospital stay compared with other patients with COVID-19 (22.3% compared to 30.4%, p

"A lot of patients already get echocardiograms while in the hospital; the addition of strain analysis requires no extra scanning of the patient," says Erin Goerlich, M.D., a cardiology fellow at the Johns Hopkins University School of Medicine and first author of the new paper. "So this is a safe and affordable new data point that can clue us in about who might develop atrial fibrillation." Echocardiograms cost on average about $2,000, and are generally covered by health insurance.

When the researchers looked at the blood of patients with COVID-19 who developed atrial fibrillation, they saw some differences compared with other patients with COVID-19. People who developed atrial fibrillation had higher levels of troponin (0.07 versus 0.03, p=0.011) and NT-proBNP (946 versus 231, p=0.0007), two known markers of heart stress.

"This tells us that COVID-19 patients with high levels of these biomarkers should be followed more closely and may benefit from an echocardiogram," says Goerlich.

Hays cautioned that the current study didn't test whether treating patients with COVID-19 with blood thinners could help prevent the complications that can result from atrial fibrillation, which has been suggested by some clinicians. Blood thinners are generally prescribed to atrial fibrillation patients to lower the risk of blood clots and strokes.

However, the new study suggests that treating certain people -- those with especially low left atrial strain, for instance -- could be one path forward. More research is needed in this area, Hays says.

"We're also actively studying how these effects on the heart might persist after SARS-CoV-2 infection," she adds. "It's important to know whether those measures of strain and emptying fraction improve over time."

Our gut microbiome -- the ever-changing "rainforest" of bacteria living in our intestines -- is primarily affected by our lifestyle, including what we eat or the medications we take, most studies show.

But a University of Notre Dame study has found a much greater genetic component at play than was once known.

In the study, published recently in Science, researchers discovered that most bacteria in the gut microbiome are heritable after looking at more than 16,000 gut microbiome profiles collected over 14 years from a long-studied population of baboons in Kenya's Amboseli National Park. However, this heritability changes over time, across seasons and with age. The team also found that several of the microbiome traits heritable in baboons are also heritable in humans.

"The environment plays a bigger role in shaping the microbiome than your genes, but what this study does is move us away from the idea that genes play very little role in the microbiome to the idea that genes play a pervasive, if small, role," said Elizabeth Archie, professor in the Department of Biological Sciences and a principal investigator on the study who is also affiliated with the Eck Institute for Global Health and the Environmental Change Initiative.

The gut microbiome performs several jobs. In addition to helping with food digestion, it creates essential vitamins and assists with training the immune system. This new research is the first to show a definitive connection with heritability.

Previous studies on the gut microbiome in humans showed only 5 to 13 percent of microbes were heritable, but Archie and the research team hypothesized the low number resulted from a "snapshot" approach to studying the gut microbiome: All prior studies only measured microbiomes at one point in time.

In their study, the researchers used fecal samples from 585 wild Amboseli baboons, typically with more than 20 samples per animal. Microbiome profiles from the samples showed variations in the baboons' diets between wet and dry seasons. Collected samples included detailed information about the host, including known descendants, data on environmental conditions, social behavior, demography and group-level diet at the time of collection.

The research team found that 97 percent of microbiome traits, including overall diversity and the abundance of individual microbes, were significantly heritable. However, the percentage of heritability appears much lower -- down to only 5 percent -- when samples are tested from only a single point in time, as is done in humans. This emphasizes the significance of studying samples from the same host over time.

"This really suggests that in human work, part of the reason researchers haven't found that heritability is because in humans they don't have a decade and half of fecal samples in the freezer, and they don't have all the initial host (individual) information they need to tease these details out," said Archie.

The team did find evidence that environmental factors influence trait heritability in the gut microbiome. Microbiome heritability was typically 48 percent higher in the dry season than in the wet, which may be explained by the baboons' more diverse diet during the rainy season. Heritability also increased with age, according to the study.

Because the research also showed the significant impact of environment on the gut microbiomes in baboons, their findings agreed with previous studies showing that environmental effects on the variation in the gut microbiome play a larger role than additive genetic effects. Combined with their discovery of the genetic component, the team plans to refine its understanding of the environmental factors involved.

But knowing that genes in the gut microbiome are heritable opens the door to identifying microbes in the future that are shaped by genetics. In the future, therapies could be tailored for people based on the genetic makeup of their gut microbiome.

The Amboseli Baboon Project, started in 1971, is one of the longest-running studies of wild primates in the world. Focused on the savannah baboon, the project is located in the Amboseli ecosystem of East Africa, north of Mount Kilimanjaro. Research teams have tracked hundreds of baboons in several social groups over the course of their entire lives. Researchers currently monitor around 300 animals, but have accumulated life history information on more than 1,500 animals.

Hundreds of millions of years ago, in the middle of what would eventually become Canada's Yukon Territory, an ocean swirled with armored trilobites, clam-like brachiopods and soft, squishy creatures akin to slugs and squid.

A trove of fossils and rock layers formed on that ancient ocean floor have now been unearthed by an international team of scientists along the banks of the Peel River a few hundred miles south of the Arctic's Beaufort Sea. The discovery reveals oxygen changes at the seafloor across nearly 120 million years of the early Paleozoic era, a time that fostered the most rapid development and diversification of complex, multi-cellular life in Earth's history.

"It's unheard of to have that much of Earth's history in one place," said Stanford University geological scientist Erik Sperling, lead author of a July 7 study detailing the team's findings in Science Advances. Most rock formations from the Paleozoic Era have been broken up by tectonic forces or eroded over time. "There's nowhere else in the world that I know of where you can study that long a record of Earth history, where there's basically no change in things like water depth or basin type."

Oxygen was scarce in the deep water of this and other oceans at the dawn of the Paleozoic, roughly 541 million years ago. It stayed scarce until the Devonian, roughly 405 million years ago, when, in a geological blink - no more than a few million years - oxygen likely rocketed to levels close to those in modern oceans and the diversity of life on Earth exploded. Big, predatory fish appeared. Primitive ferns and conifers marched across continents previously ruled by bacteria and algae. Dragonflies took flight. And all of this after nearly four billion years of Earth's landscapes being virtually barren.

Scientists have long debated what might have caused the dramatic shift from a low oxygen world to a more oxygenated one that could support a diverse web of animal life. But until now, it has been difficult to pin down the timing of global oxygenation or the long-term, background state of the world's oceans and atmosphere during the era that witnessed both the so-called Cambrian explosion of life and the first of Earth's "Big Five" mass extinctions, about 445 million years ago at the end of the Ordovician.

"In order to make comparisons throughout these huge swaths of our history and understand long-term trends, you need a continuous record," said Sperling, an assistant professor of geological sciences at Stanford's School of Earth, Energy & Environmental Sciences (Stanford Earth).

Context for past life

With permission from the Na Cho Nyak Dun and Tetlit Gwitch'in communities in Yukon, Sperling's team, which included researchers from Dartmouth College and the Yukon Geological Survey, spent three summers at the Peel River site. Arriving by helicopter, the research team hacked through brush with machetes beside Class VI rapids to collect hundreds of fist-sized samples of rock from more than a mile of interbedded layers of shale, chert and lime mudstone.

Back at Sperling's lab at Stanford, a small army of summer undergraduates and graduate students worked over five summers to help analyze the fossils and chemicals entombed in the rocks. "We spent a lot of time splitting open rocks and looking at graptolite fossils," Sperling said. Because graptolites evolved a vast array of recognizable body shapes relatively quickly, the pencil-like markings left by the fossils of these colony-dwelling sea creatures give geologists a way to date the rocks in which they're found.

Once the researchers had finished identifying and dating graptolite fossils, they ground the rocks in a mill, then measured iron, carbon, phosphorous and other elements in the resulting powder to assess the ocean conditions at the time and place where the layers formed. They analyzed 837 new samples from the Peel River site, as well as 106 new samples from other parts of Canada and 178 samples from around the world for comparison.

Winners and losers

The data show low oxygen levels, or anoxia, likely persisted in the world's oceans for millions of years longer than previously thought - well into the Phanerozoic, when land plants and early animals began to diversify. "The early animals were still living in a low oxygen world," Sperling said. Contrary to long-held assumptions, the scientists found Paleozoic oceans were also surprisingly free of hydrogen sulfide, a respiratory toxin often found in the anoxic regions of modern oceans.

When oxygen eventually did tick upward in marine environments, it came about just as larger, more complex plant life took off. "There's a ton of debate about how plants impacted the Earth system," Sperling said. "Our results are consistent with a hypothesis that as plants evolved and covered the Earth, they increased nutrients to the ocean, driving oxygenation." In this hypothesis, the influx of nutrients to the sea would have given a boost to primary productivity, a measure of how quickly plants and algae take carbon dioxide and sunlight, turn them into new biomass - and release oxygen in the process.

The change probably killed off graptolites. "Although more oxygen is really good for a lot of organisms, graptolites lost the low oxygen habitat that was their refuge," Sperling said. "Any environmental change is going to have winners and losers. Graptolites might have been the losers."

Tooth loss is a risk factor for cognitive impairment and dementia--and with each tooth lost, the risk of cognitive decline grows, according to a new analysis led by researchers at NYU Rory Meyers College of Nursing and published in JAMDA: The Journal of Post-Acute and Long-Term Care Medicine. However, this risk was not significant among older adults with dentures, suggesting that timely treatment with dentures may protect against cognitive decline.

About one in six adults aged 65 or older have lost all of their teeth, according to the Centers for Disease Control and Prevention. Prior studies show a connection between tooth loss and diminished cognitive function, with researchers offering a range of possible explanations for this link. For one, missing teeth can lead to difficulty chewing, which may contribute to nutritional deficiencies or promote changes in the brain. A growing body of research also points to a connection between gum disease--a leading cause of tooth loss--and cognitive decline. In addition, tooth loss may reflect life-long socioeconomic disadvantages that are also risk factors for cognitive decline.

"Given the staggering number of people diagnosed with Alzheimer's disease and dementia each year, and the opportunity to improve oral health across the lifespan, it's important to gain a deeper understanding of the connection between poor oral health and cognitive decline," said Bei Wu, PhD, Dean's Professor in Global Health at NYU Rory Meyers College of Nursing and co-director of the NYU Aging Incubator, as well as the study's senior author.

Wu and her colleagues conducted a meta-analysis using longitudinal studies of tooth loss and cognitive impairment. The 14 studies included in their analysis involved a total of 34,074 adults and 4,689 cases of people with diminished cognitive function.

The researchers found that adults with more tooth loss had a 1.48 times higher risk of developing cognitive impairment and 1.28 times higher risk of being diagnosed with dementia, even after controlling for other factors.

However, adults missing teeth were more likely to have cognitive impairment if they did not have dentures (23.8 percent) compared to those with dentures (16.9 percent); a further analysis revealed that the association between tooth loss and cognitive impairment was not significant when participants had dentures.

The researchers also conducted an analysis using a subset of eight studies to determine if there was a "dose-response" association between tooth loss and cognitive impairment--in other words, if a greater number of missing teeth was linked to a higher risk for cognitive decline. Their findings confirmed this relationship: each additional missing tooth was associated with a 1.4 percent increased risk of cognitive impairment and 1.1 percent increased risk of being diagnosed with dementia.

"This 'dose-response' relationship between the number of missing teeth and risk of diminished cognitive function substantially strengthens the evidence linking tooth loss to cognitive impairment, and provides some evidence that tooth loss may predict cognitive decline," said Xiang Qi, a doctoral candidate from NYU Meyers.

"Our findings underscore the importance of maintaining good oral health and its role in helping to preserve cognitive function," said Wu.

DALLAS, July 8, 2021 -- The stress of experiencing discrimination in multiple ways, including transphobia, interpersonal discrimination, violence and public policies specifically targeting transgender and gender diverse (TGD) people, is linked to higher rates of heart disease among the TGD population, according to a new scientific statement from the American Heart Association, published today in Circulation, the Association's flagship journal. A scientific statement is an expert analysis of current research and may inform future guidelines.

The statement, Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse, examines existing research about TGD-specific cardiovascular health disparities, identifies research gaps and provides suggestions for systematically improving overall heart health and care of TGD people. The statement writing group suggests improving overall heart health within the TGD community will require a multi-pronged approach that includes health care professionals, educators, researchers and policymakers.

In terms of health, transgender, gender diverse and gender non-conforming people are considered "gender minorities." Expanding on the minority stress theory, statement writing group members documented how chronically high levels of stress faced by members of stigmatized, underrepresented populations associate with poor health outcomes and health disparities. They concluded that higher rates of cardiovascular prevalence and deaths among TGD people, while related to traditional cardiovascular risk factors, are also significantly driven by psychosocial stressors across the lifespan at multiple levels, including structural violence, discrimination, lack of affordable housing and access to health care.

"Heart health of transgender and gender diverse people is an important and understudied topic, and it's critical we highlight what we know and what we need to know about heart health among these populations," said Carl G. Streed, Jr., M.D., M.P.H., chair of the writing group for the statement, an assistant professor of internal medicine at Boston University School of Medicine and the research lead at the Center for Transgender Medicine and Surgery at Boston Medical Center. "Addressing these issues will require a focus on 'traditional' risk factors for heart attack and stroke, and a commitment to fight transphobia in order to decrease the additional stress experienced by this population."

This statement, specific to TGD persons, builds upon the Association's 2020 scientific statement, Assessing and Addressing Cardiovascular Health in Lesbian, Gay, Bisexual, Transgender and Queer (or Questioning) Adults, which noted that more than half (56%) of LGBTQ adults and 70% of those who are transgender or gender non-conforming reported experiencing some form of discrimination from a health care professional.

The new statement notes a growing body of research indicates TGD populations may be at a significantly greater risk for cardiovascular disease compared to their cisgender peers. Transgender men are twice as likely to have a heart attack than cisgender men and four times as likely than cisgender women. TGD people are also more likely to experience blood clots when undergoing estrogen hormone therapy. The writing group points out more investigation is urgently needed to explain these disparities.

TGD populations also face unique psychological stressors, including gender non-affirmation (e.g., being called by the incorrect pronoun), discrimination, rejection or concealment of gender identity and violence based on gender identity. These factors contribute to higher overall levels of stress, which, in turn, negatively affect heart health. Additionally, TGD people who are also part of historically excluded racial or ethnic groups experience multiple layers of stress, such as lower income levels or limited access to health care. Research on how these complex and intertwined factors affect heart health within TGD populations is limited.

Most gender identification options in a clinical or research setting include only "male" and "female," so while population-based studies can help in understanding some cardiovascular health risk factors, data on TGD people is scarce. The statement suggests studies should standardize measures of gender identity and expression to collect larger samples of underrepresented groups among TGD populations.

Data collected through electronic health records (EHRs) does present an advancement in terms of data access, however, EHRs often lack the ability to capture sociocultural factors relevant to heart health among TGD persons. It's important to note that TGD individuals who do not regularly access health care services are less likely to be included in EHR data, and TGD people who are uncomfortable disclosing gender identity to health care professionals will be unlikely to be identified as TGD in EHR systems.

While the ability to document sexual orientation and gender identity has been required for electronic health records since 2018, additional steps are needed to ensure culturally responsive and supportive care. The statement details the critical need for researchers and clinicians to use gender-affirming pronouns and obtain an anatomy inventory where appropriate, noting that assumptions about a TGD person's identity or anatomy may negatively impact clinical decisions.

The writing group suggests increased training across health professions would enhance clinical practices and foster more compassionate care for TGD persons. While many institutions acknowledge the need for TGD educational content, efforts to include these topics into clinical curricula have not progressed. The statement suggests a collaborative effort with organizational-level mandates across governing bodies is needed to create a curriculum that encompasses gender affirming hormone therapy, surgical procedures, anatomy-based preventive health, social determinants of health and the proper assessment of sex and gender in health care settings.

While the statement emphasizes existing data is limited, it reviews research on disparities among TGD people as it relates to the American Heart Association's Life's Simple 7 to measure ideal heart health and how hormone therapy may affect heart health for TGD people. Current research on blood pressure, lipid profiles or blood sugar levels for TGD persons is too sparse and inconclusive, although the writing group does suggest several areas of Life's Simple 7 that are directly linked to heart attacks and strokes. The evaluation of existing research found:

TGD people are more likely (24%) to report tobacco use than the remainder of the U.S. population (18%).

Transgender men are less likely to exercise, especially in older age.

TGD persons undergoing gender-affirming hormone therapy are more physically active, which may be because they report being more satisfied with their bodies.

TGD youth report eating more fast food and using unsafe ways of trying to manage their weight (e.g., diet pills, fasting or laxative abuse).

TGD people report overall higher body mass index (BMI), yet they may experience additional stress about their weight since many surgeons have strict BMI cut-offs above which they will not perform gender-affirming surgeries.

"Discrimination also contributes to disparities in social determinants of health among TGD populations, and many TGD persons are at even greater risk of heart disease and stroke due to transphobia and experiences of discrimination based on gender non-conformity," said Lauren B. Beach, Ph.D., J.D., vice-chair of the statement writing group and research assistant professor in the department of medical social sciences at Northwestern University's Feinberg School of Medicine in Chicago. "Systematic transphobic discrimination results in a higher burden of workplace discrimination, job loss and unemployment among TGD populations. Combined with experiences of discrimination in health care settings, lack of access to a stable income further limits health care access among TGD people. These structural factors combine to result simultaneously in higher levels of chronic stress and in lower levels of resources to prevent or manage a broad variety of health conditions including cardiovascular disease."

The writing group also cited studies showing that TGD persons experience disproportionate burdens of additional cardiovascular risk factors, including living with HIV, vascular dysfunction, trouble sleeping and alcohol abuse.

The writing group acknowledges limited data and encourages further research to understand the numerous and complex issues faced by TGD individuals and as a community. The statement emphasizes available information does illustrate that TGD people often experience challenges due to unique stressors, including internalizing gender identity, sexual victimization and concerns about hormone therapies and gender-affirming surgeries.

"Data specific to transgender and gender diverse persons lag behind what is needed to understand and improve individual and community heart health. The information available is rapidly improving, though," Streed said. "This statement summarizes the available evidence showing that addressing traditional cardiovascular risk factors and decreasing stigma-linked stress, together, would improve the heart health of TGD people. By focusing on the unique issues affecting the well-being of transgender and gender diverse persons, we have the potential to do better for everyone."

In women in their mid-40s to early 50s, endometriosis--a condition in which tissue that normally lines the uterus grows outside the uterus--was linked with poor work ability and more sick days, but not with unemployment or early retirement.

The findings, which are published in Acta Obstetricia et Gynecologica Scandinavica and stem from a population-based group of Finnish women across all employment sectors, provide insights on how endometriosis can impact women's professional lives.

"To our knowledge, this is the first general population-level study on the association between endometriosis and work ability, including a life course approach to disability retirement," the authors wrote.

We're currently living in what many scientists are calling the Anthropocene, the period during which human activity has been the dominant influence on climate and the environment. An article published in the Journal of Multicultural Counseling and Development discusses how counselors can promote environmental justice during this time.

The Environmental Protection Agency defines environmental justice as "the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies."

The article accomplishes three goals:

It builds awareness about climate change and the Anthropocene among counselors.

It expands knowledge regarding how climate change may exacerbate issues of social inequality.

And it demonstrates how counselors can address environmental justice issues affecting clients and their communities.

The article's author, Alexander J. Hilert, PhD, LPC, CCTP, of William & Mary, provides examples of how counselors can make a difference, noting that they can use their skills, such as group facilitation, to help educate communities on the climate crisis or to help environment activists process their grief to help prevent burnout. Also, counselor educators can help lead the way by focusing research on the implications of the climate crisis on marginalized communities.

"As counselors, it is our ethical duty to respond to issues of systemic injustice that affect the lives of our clients," said Hilert. "Using the framework of environmental justice, counselors can better understand the disproportionate impacts of climate change on communities experiencing marginalization and oppression, and how we can respond through advocacy and outreach."

Experiencing a variety of positive emotions--or emodiversity--may benefit high school students, according to a study published in the British Journal of Educational Psychology.

Positive emodiversity was associated with greater engagement (which has cognitive, behavioral, and emotional components) and academic achievement.

The diversity of negative emotions, such as experiencing anxiety and frustration, did not seem to provide any motivational benefits.

"Students with greater positive emodiversity have a more diverse emotional life, which perhaps helps them respond and adapt specifically to various school situations," said corresponding author Cherry Eron Frondozo, of The Education University of Hong Kong.

Integrated Assessment Models (IAMs) connect trends in future socio-economic and technological development with impacts on the environment, such as global climate change. Critics have taken issue with the transparency of IAM methods and assumptions as well as the transparency of assessments of IAMs by the Intergovernmental Panel on Climate Change (IPCC), the United Nations body for assessing the science related to climate change.

An article published in WIREs Climate Change that's co-authored by officials at the IPCC documents various activities underway to enhance the transparency of IAMs and their assessments.

"The purpose of this paper is to document how both the IAM community and IPCC are working to enhance transparency and to suggest some criteria for judging the success of these efforts," the authors wrote. "Transparency does not in itself guarantee scientific closure, but it facilitates debate and provides a clearer evidence base for policymakers."

Using single cell technology, a new study sheds light on the significance of genetic risk factors for, and the diversity of cells involved in, the development of coronary artery disease. The researchers analysed human atherosclerotic lesions to map the chromatin accessibility of more than 7,000 cells. The chromatin accessibility is known to reflect active regions and genes in the genome. The findings were published in Circulation Research.

Genome-wide association studies of the human genome have identified over 200 loci associated with coronary artery disease. More than 90% of them are located outside protein-coding genes, in so called cis-regulatory elements, whose significance in the pathogenesis of coronary artery disease remains unclear.

Previous research has demonstrated that the development of coronary artery disease involves a variety of different cells and their subtypes. The now-published study is the first to use single cell technology to map epigenetic changes in these cells. The researchers used the ATAC-seq sequencing method to discover the nuclear chromatin structure of endothelial cells and smooth muscle cells, as well as immune system monocytes, macrophages, NK/T and B cells, providing a unique resource to study the cell-type specific activity of the cis-regulatory elements in the disease affected vessel wall.

The study demonstrated that genetic risk variants associated with coronary artery disease are particularly enriched in cis-regulatory elements specific to endothelial and smooth muscle cells, indicating that these cells play a significant role in transmitting susceptibility to the disease. Based on chromatin accessibility mapping and gene expression data, the researchers were able to identify putative target genes for approximately 30% of all known loci associated with coronary artery disease. In addition, the researchers performed genome-wide experimental fine-mapping of the variants, allowing them to identify potential causal single-nucleotide polymorphisms and the associated target gene for over 30 loci that have been linked to coronary artery disease. The study also presented a number of examples of how the chromatin accessibility and gene expression data can be used to predict target cells via which the function of the genetic changes associated with the disease is transmitted in the tissue. This is a significant step forward that helps to understand the real functional significance of risk variants in the pathophysiology of coronary artery disease. In the future, this information can be used to develop more effective, safer and more individualised treatments for coronary artery disease.

If you've watched Netflix, shopped online, or run your robot vacuum cleaner, you've interacted with artificial intelligence, AI. AI is what allows computers to comb through an enormous amount of data to detect patterns or solve problems. The European Union says AI is set to be a "defining future technology."

And yet, as much as AI is already interwoven into our everyday lives, there's one area of the globe where AI and its applications are in their infancy, says Ekaterina Kim, an associate professor at the Norwegian University of Science and Technology's (NTNU) Department of Marine Technology. That area is the Arctic, an area where she has specialized in studying sea ice, among other topics.

"It's used a lot in marketing, in medicine, but not so much in Arctic (research) communities," she said. "Although they have a lot of data, there is not enough AI attention in the field. There's a lot of data out there, waiting for people to do something with them."

So Kim and her colleagues Ole-Magnus Pedersen, a PhD candidate from the Department of Marine Technology and Nabil Panchi, from the Indian Institute of Technology Kharagpur, decided to see if they could develop an app that used artificial intelligence to identify sea ice in the Arctic.

You may think there's not much difference between one chunk of sea ice and another, but that's just not so.

In addition to icebergs, there's deformed ice, level ice, broken ice, ice floes, floe bergs, floe bits, pancake ice and brash ice.

The researchers wanted the app to be able to distinguish between the different kinds of ice and other white and blue objects out there, like sky, open water and underwater ice.

Different kinds of ice really matter to ship captains, for example, who might be navigating in icy waters.  Actual icebergs are nothing like brash ice, the floating bits of ice that are 2 metres in diameter or less. Think of it --the Titanic wouldn't have sunk if it had just blundered into a patch of brash ice instead of a big iceberg.

Another factor that adds urgency to the situation is climate change, which is dramatically altering sea ice as oceans warm. Even with the help of satellite images and onboard ship technologies, knowing what's in icy waters ahead can be a difficult challenge, especially in fogs or storms.

"Ice can be very difficult for navigation," Kim said. "From the water (at the ship level) It can be hard to detect where there is strong ice, multiyear ice, and different ice.  Some ice is much more dangerous than other types.

The team began teaching their app's AI system using a comprehensive collection of photographs taken by another NTNU ice researcher, Sveinung Løset.

But an AI system is like a growing child -- if it is to learn, it needs to be exposed to lots of information. That's where turning the AI into an app made sense. Although the COVID-19 pandemic has shut down most cruise operations, as the pandemic wains, people will begin to take cruises again -- including to the Arctic and Antarctic.

Kim envisions tourists using the app to take pictures of different kinds of ice to see who finds the most different kinds of ice. And every one of those pictures helps the app learn.

"If the app is used for 'infotainment,'  accuracy isn't that important," Kim said.  "It can even be fun when the model makes mistakes."

As the AI learns, Kim says, the increasingly complex dataset could be taken into the classroom, where navigators could learn about ice in a much more sophisticated way.

Currently, students just look at pictures or listen to a PowerPoint presentation, where lecturers describe the different kinds of ice.

"So this could revolutionize how you learn about ice," she said. "You could have it in 3-D, you could emerge yourself and explore this digital image all around you, with links to different kinds of ice types."

The researchers are planning an AI in the Arctic workshop in September to explore AI applications in these remote areas.

"There are extreme challenges unique to the Arctic, from human activities and impacts in remote Arctic locations to Arctic data acquisition, sharing, and quality," Kim said. "We need to direct AI applications towards solving Arctic challenges that are important for the world as well as to highlight the 'black holes' or knowledge gaps and raise awareness on what does not work, needs improvements."

Researchers from University of Mannheim published a new paper in the Journal of Marketing that examines the effect of wage inequality on customer satisfaction and firm performance.

The study, forthcoming in the Journal of Marketing, is titled "Wage Inequality: Its Impact on Customer Satisfaction and Firm Performance" and is authored by Boas Bamberger, Christian Homburg, and Dominik M. Wielgos.

Irrespective of wage cuts and employee layoffs, the wages of top managers rose to record levels during the pandemic and wage inequality continues to grow worldwide. However, according to a 2015 OECD report, "wage inequality is harmful to long-term economic growth and undermines societal cohesion." This situation raises the question: Do firms have an incentive to raise wage inequality?

This new study addresses this question by examining the impact of wage inequality on customer satisfaction and firm performance. The researchers surveyed more than 100 top sales and marketing managers in public firms selling to businesses in three countries. They analyzed the responses and company financial data to understand how wage inequality impacts customer satisfaction and firm performance.

Results show that unequal wages between top managers and employees can boost the short-term profitability of a firm. As Bamberger explains, "In the long run, however, this benefit fades. What persists is that wage inequality motivates employees to opportunistically exploit customers and weakens a firm's customer-oriented culture, thereby harming customer satisfaction.

How does this happen? Suppose a firm has high wage inequality. Thus, the ultimate prize in a tournament setting, to gradually rise to top management, is a strong incentive for employees at all levels. But in the process, they may engage in opportunistic behaviors and also collaborate less with coworkers.

For example, to enhance her chances for promotion, an employee might show more effort by interacting with customers more frequently to better understand and fulfill their needs to boost sales. By contrast, she could also distort facts about products to close deals more quickly.

Non-customer-facing employees could also be affected. Take, for instance, an R&D employee. He could interact with customers more often to learn and adapt innovations to their needs to increase sales. Conversely, he could also design products to fail to force customers to buy a product over and over again.

"Through customer-directed effort or opportunism, employees may improve their chances of getting promoted to the next higher level. Our results show that wage inequality does raise customer-directed effort and opportunism," says Homburg.

At the same time, wage inequality might also weaken collaboration among coworkers. An employee who worries about advancing to the next higher level is less concerned about their coworkers. But less collaboration impairs the flows of information and knowledge about customers throughout the firm. This, in turn, can lead to worse coordination between departments. Ultimately, the firm becomes less responsive to the changing needs of customers. Thus, wage inequality weakens the customer-oriented culture of a firm.

The adverse impact wage inequality has on opportunism and customer-oriented culture extends to customer satisfaction and reduces the short-term profitability of a firm. At the same time, wage inequality also raises a firm's short-run profits through a direct path. Despite the harm through the customer path, the total impact of wage inequality on short-term profitability is slightly positive.

This slightly positive effect on short-term profitability holds in a different sample with more than 500 observations of U.S. firms selling to consumers. Wielgos explains that "When we analyzed how wage inequality plays out in the long run, the situation reverses. The harm that wage inequality causes to customer satisfaction leads to long-term performance decline. In sum, a firm sees no profitability lift from wage inequality in the long run."

Do firms have an incentive to raise wage inequality? In terms of bottom-line impact, the answer is: "Yes" in the short run and "No" in the long run. However, when looking at the customer impact, the answer is "No" because of the negative impact of wage inequality on customer satisfaction, which weakens firm profits.

What can managers learn? If the goal is short-term profitability, go with higher wage inequality, but keep an eye on customer satisfaction. If managers are interested in the long-term success of the firm, consider reducing wage inequality to help employees orient toward customers.

What can shareholders learn? Suppose that you care about the long-term profitability of your investment. In that case, make sure to reward top managers for achieving sustainable profitability and good customer relationships.

What can policymakers learn? Wage inequality is not in a firm's long-term interest. This argument can help to create a consensus with managers to restrain wage inequality. However, short-term-oriented managers might care little about the damage wage inequality does to society. It thus might be necessary to disincentivize them from raising wage inequality.

PULLMAN, Wash. - Even before the pandemic made Zoom ubiquitous, Washington State University researchers were using the video conferencing app to research a type of cannabis that is understudied: the kind people actually use.

For the study, published in Scientific Reports, researchers observed cannabis users over Zoom as they smoked high-potency cannabis flower or vaped concentrates they purchased themselves from cannabis dispensaries in Washington state, where recreational cannabis use is legal. They then gave the subjects a series of cognitive tests.

The researchers found no impact on the users' performance on decision-making tests in comparison to a sober control group but did find some memory impairments related to free recall, source memory and false memories.

While the findings are in line with previous research on low-potency cannabis, this study is one of the few to investigate cannabis that contains much more than 10% tetrahydrocannabinol (THC), the plant's main psychoactive ingredient. This is only the second known study to examine the effect of cannabis concentrates.

"Because of federal restrictions to researchers, it was just not possible to study the acute effects of these high-potency products," said Carrie Cuttler, WSU psychologist and lead researcher on the study. "The general population in states where cannabis is legal has very easy access to a wide array of high- potency cannabis products, including extremely high-potency cannabis concentrates which can exceed 90% THC, and we've been limited to studying the whole plant with under 10% THC."

While 19 states and Washington D.C. have legalized cannabis for recreational use, the U.S. federal government still classifies it as a Schedule 1 drug, implying it has a high potential for abuse and no medicinal benefits. Until recently, researchers interested in studying cannabis were limited to using low-potency plants of around 6% THC supplied by the National Institute of Drug Abuse. In June, the U.S. Drug Enforcement Administration indicated it may allow some companies to start growing cannabis for research purposes.

For this study, which began in 2018, Cuttler and her colleagues found a way to study the effects of high-potency cannabis while still complying with federal guidelines. The study participants bought their own products and used them in their own homes. They were never in a laboratory on federal property, and the researchers never handled the cannabis themselves. Participants were not reimbursed for their purchase. Instead they were compensated for their time with Amazon gift cards. All participants were over 21 and experienced cannabis users who reported no past negative reactions to cannabis like panic attacks. The study's method was cleared by WSU Division of the Office of the Attorney General and the university's research ethics board.

The 80 participants were divided into four groups: two groups used cannabis flower with more than 20% THC but one containing cannabidiol (CBD), a non-psychoactive component of cannabis, and the other without CBD. Another group vaped cannabis concentrates with more than 60% THC that included CBD. A fourth group remained sober.

For all cannabis using groups, the researchers found no effect on a range of decision-making tests including risk perception and confidence in knowledge. On a few memory tests there were also no significant differences between the cannabis-using and sober groups, including prospective memory, the ability to remember to do things at a later time, such as attend an appointment. The cannabis-using participants also did well on temporal order memory, the ability to remember the sequence of previous events.

However, the groups that smoked cannabis flower with CBD did worse on verbal free recall trials- they were unable to recall as many words or pictures that were shown to them compared to the sober group. This finding was contrary to a small number of previous studies indicating CBD might have a protective effect on memory. The groups that used cannabis without CBD and the group that used concentrates, performed worse on a measure of source memory which means being able to distinguish the way previously learned information was presented.

Finally, all three cannabis-using groups did poorly on a false memory test - when given a new word and asked if it had been presented before, they were more likely to say it had when it had not.

There was also an unexpected finding: people who vaped the high-potency concentrates with more than 60% THC performed comparably to those who smoked cannabis flower. This may have been because they tended to self-titrate - using less of the drug to achieve a similar level of intoxication and impairment as the people who smoked the less-potent cannabis flower.

Cuttler said this was cause for cautious optimism on the little-studied but widely available concentrates.

"There's been a lot of speculation that these really high-potency cannabis concentrates might magnify detrimental consequences, but there's been almost zero research on cannabis concentrates which are freely available for people to use," said Cuttler. "I want to see way more research before we come to any general conclusion, but it is encouraging to see that the concentrates didn't increase harms."

Mandatory covid-19 vaccination for care home workers is unnecessary, disproportionate and misguided, warn experts

And is based on unreliable data

In The BMJ today, experts argue that mandatory vaccination is "unnecessary, disproportionate, and misguided."

The government decision to remove the right of care home staff in England to choose whether or not to be vaccinated against covid-19 is a profound departure from public health norms. The intended next step is a rapid and massive expansion of compulsory vaccination to legally require covid-19 and flu vaccination of all frontline health and social care workers, subject to consultation.

But Lydia Hayes, Professor of Law at Kent University and Allyson Pollock, Professor of public health at Newcastle University, say vaccination "is not a panacea for safety" and "will not remedy the serious shortcomings of the care sector in England."

They note government consultation documents and subsequent media reports have claimed that mandatory vaccination is necessary because of low vaccination take up rates in some care homes.

But figures show that by 20 June 2021, over 90% of care home residents in England had received two doses of a covid-19 vaccine, 84% of care workers in England had received a first dose, and 72% of care workers had received a second dose - in line with Scientific Advisory Group recommendations.

Their closer scrutiny of the data shows that uptake of the first dose of covid-19 vaccination among care workers is below 80% (68-74%) in only three English local authorities but these numbers are an artefact of very low numbers of staff employed by care homes in these London areas.

Moreover, they highlight that the government's own methodology note warns that reliable information on vaccination uptake cannot be directly derived from the data the government is using.

According to regulatory law, safety in care homes "is achieved through adequate staffing levels, training, equipment, cleanliness, personal protective equipment, risk assessment, and consultation with staff and residents," they write.

Vaccination protects individuals from covid-19 and reduces the risk of transmission of disease to others, but neither duration of protection nor efficacy against new variants are known.

Wales and Scotland have rejected compulsory vaccination for care workers and invested in systems of mandatory registration for care workers designed to professionalise the sector, increase access to training, and embed a culture of continuous professional development, they add.

But in England, successive ministers have rejected national care worker registration. "Hence, the Department of Health and Social Care and the CQC don't know who England's care workers are and training of the care workforce is woefully inadequate."

"Civil liberty is a necessary component of strong public health. Mandatory vaccination is unnecessary, disproportionate and misguided, they warn. "Safety can be assured only by taking steps to build trust and to mitigate outbreaks."

"Care workers need paid time in which to access vaccination and good training, decent wages (including sick pay), personal protective equipment, and strong infection control measures," they conclude.