Culture

Air pollution spikes linked to lower test scores for Salt Lake County third graders

image: Salt Lake County case study area map showing the locations of 156 Salt Lake County public primary schools and five school districts.

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Mullen at al. (2020) Int. Journal of Enviro Res and Public Health

Fine particulate matter (PM2.5), the tiny particles responsible for hazy air pollution, are detrimental to children's health even inside the classroom. Mounting evidence has linked chronic exposure with poor academic performance in K-12 students. Until now, no research had examined the impact of "peak" air pollution events, the 24-hour spikes of extremely high PM2.5 levels. For students in Salt Lake County, Utah, these episodes are a dangerous reality--the county's largest city, Salt Lake City, was among the top 10 most polluted American cities for short-term particle pollution in the latest American Lung Association report.

In a new study, University of Utah researchers found that more frequent peak air pollution exposure was associated with reduced math and English language arts (ELA) test scores for third graders in all primary public schools in Salt Lake County during the 2016-2017 year. The minimum peak pollution levels in this study are below what the U.S. Environmental Protection Agency (EPA) determines are "safe" levels of PM2.5. The results stress the need for legislators to enact policies that reduce the number of peak pollution days, and to advocate for lower federal pollution standards.

"The huge takeaway is that this isn't about school location--it's not just the schools in the most polluted parts of the city. Everyone is impacted by peak pollution," said lead author Casey Mullen, doctoral student in sociology at the University of Utah.

The study highlights the environmental injustice of Salt Lake County's air pollution problem-- schools with a higher proportion of students of color and from households experiencing poverty were exposed to higher mean concentrations of fine particulates and more peak pollution days than were schools serving middle- to upper- class and predominately white students. Though peak exposures had a stronger effect on lower math proficiency in more socially advantaged schools.

"There are so many studies showing us that air pollution damages our brain's cognitive processing ability," said co-author Sara Grineski, professor of sociology at the University of Utah. "Utah has made great strides to lower pollution in the past decades, but we need to keep pushing forward policies to reduce pollution. We already know it will improve Utahns respiratory health, but it also can help kids do a little bit better in schools."

The paper published online on Sept. 22, 2020, in the International Journal of Environmental Research and Public Health. This research was funded by the Interdisciplinary Exchange for Utah Science at the University of Utah.

Air quality impacts test scores

The researchers looked at the Student Assessment of Growth and Excellence (SAGE) math and ELA scores of third graders in 156 primary public schools in Salt Lake County in 2017. They focused on the percentage of students whose scores were lower than grade-level expectations.

In order to ensure that air pollution was the only variable affecting test scores, the researchers created a school disadvantage variable that took into account Title I school status; Hispanic students; the percentage of non-Hispanic minority students who were Black, Asian/Pacific Islander or Native American/Alaska Native; and the percentage of students on free and/or reduce-priced meals. They also accounted for the school's neighborhood context.

"It is important to account for social disadvantage since social factors are tightly linked with standardized test scores. Students from low-income families have additional struggles that don't tend to affect more affluent students, such as food insecurity. Students from racial/ethnic minority backgrounds often have unequal educational experiences in the U.S. In some cases, they are immigrants themselves or the children of immigrants, and they might still be learning English," said Grineski. "These factors influence standardized test scores."

Then, they evaluated each school's chronic and peak air pollution concentrations. For chronic air pollution levels, they analyzed the daily PM2.5concentrations for each school using daily concentrations in the census tract housing each school from the U.S. EPA's Downscaler data. On average, schools had chronic PM2.5 levels of just over 8 micrograms per cubic meter. To establish peak air pollution episodes, the researchers identified the number of days each school was exposed to PM2.5 levels in the 95th percentile of PM2.5 concentrations for the year, which was 23 micrograms per cubic meter. The U.S. EPA's unhealthy air standard is 35 micrograms per cubic meter.

While chronic pollution exposure was associated with lower test scores, the effect disappeared when researchers controlled for the social disadvantage factors. In contrast, the frequency of peak pollution exposure was associated with a higher percentage of students who tested below grade proficiency in math and ELA, even after controlling for social disadvantage.

"Research shows that air pollution is associated with brain cell inflammation. That is well-established," said Mullen. "With that in mind, our study findings suggest that future research should examine if repeated peak exposures to concentrations of fine particulate matter might be more damaging to children's brain functioning than chronic exposures."

Reduce air pollution

The authors suggest that legislators could advance public health initiatives that protect children's exposure to air pollution. The researchers have consulted with urban planners about creating cleaner air routes for children to move around their communities. For the future, the state could improve regulations that would prevent schools from being built in high pollution areas. For now, investing in better air filtration systems in classrooms could help mitigate the poor air quality already exists. In the face of growing evidence that even low PM2.5 concentrations does damage to the human body, legislators should advocate for lower federal air pollution standards.

"Here, with constant air quality issues throughout the seasons, we need to increase awareness about air pollution exposures," Mullen said. "This is a conversation everyone should be having--people need to be informed about what's at stake."

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University of Utah

How smart cities can serve citizens

image: At the Dentons Rodyk Dialogue 2020, Minister for National Development Desmond Lee joined a panel of experts to discuss how digitalisation can help to transform cities.

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Singapore Management University

SMU Office of Research & Tech Transfer - Although cities and urban areas only make up a small proportion of the world's land mass, they are home to more than half the global population and that number is going to keep rising. As cities swell to capacity with more and more inhabitants, city planners have turned to technology to cope with the challenges that accompany urban density.

The role of digital technologies in overcoming urban development challenges have become even more apparent in the COVID-19 pandemic, said Mr Desmond Lee, Minister for National Development and Minister-in-charge of Social Services Integration.

"This pandemic has starkly shown us that we need to transform the way we design, build and maintain our city so that we move away from a heavy reliance on manpower and labour, [and that] the use of digital tools and technology has a potential to create good jobs and opportunities for Singaporeans," Minister Lee said.

Minister Lee was the guest of honour at the Dentons Rodyk Dialogue 2020, held online on 25 September 2020. A partnership between Singapore law firm Dentons Rodyk and Singapore Management University's (SMU) Centre for Cross-Border Commercial Law in Asia (CEBCLA), the yearly Dialogue serves as a forum for thought leaders to share ideas and interrogate key trends shaping the future. This year, the Dialogue explored the opportunities and challenges posed by the rise of global smart cities, and was moderated by Mr Philip Jeyaratnam, Global Vice Chair and ASEAN CEO, Dentons Rodyk.

Planning for people in Singapore and beyond

"Even before COVID-19, many cities including Singapore had already been striving to deal with increasingly complex and global problems," Minister Lee said. "We have harnessed data and digital tools to better plan and design urban Singapore, and make our city more green, livable and sustainable."

Some of the technologies Singapore has employed to overcome the challenges of living in a densely populated city state includes the Housing & Development Board's (HDB) Smart Hub, a central data repository which acts as a 'brain' for municipal operations to help HDB's planners better understand the usage patterns of common amenities.

HDB also uses environmental modelling tools and computer simulations to analyse wind flow, solar heat and noise within towns to design and position homes in a manner that conserves energy and optimises resident comfort. "Singapore is an equatorial and very densely urban country, and these technologies can bring about real benefits," said Minister Lee.

These benefits are a topic of particular interest to SMU President Professor Lily Kong, a social scientist who has studied the impact of technologies in smart cities on their inhabitants' lives. In her keynote presentation, Professor Kong explained how the ASEAN Smart Cities Network (ASCN), a network of 26 cities established in 2018 to foster cooperation on smart city development, could best promote the use of smart technologies as a method of city management.

Considering the challenges

While it is tempting to think that digital solutions could be a panacea for problems caused by rapid urbanisation and urban density, it may be necessary to get a deeper understanding of the challenges involved, she said.

"There is the antecedent challenge, the issue of divergent infrastructural developments, privatisation and formalisation of city spaces, power and inequality, vertical and horizontal integration, and the balance between speed and efficacy," said Professor Kong. "These challenges are rooted largely in a single danger - that we forget that cities are not passive backdrops for digital technologies," she said.

In explaining each of the challenges, Professor Kong also stressed the importance of not neglecting material infrastructure development in favour of its digital counterparts. "Efficient bus timetables and smart traffic lights are no substitute for wider roads and fewer potholes," she explained, adding that overemphasising digital development could distract from material improvements and exacerbate existing inequalities.

"Nothing as powerful as technology can be implemented without some impact," added the next speaker, Ms Chantal Bernier, National Practice Leader, Privacy and Cybersecurity at Dentons Canada. "Many of these digital innovations are predicated upon the use of personal information, which is where privacy law is engaged."

While governments are allowed to process personal data without consent when it is necessary, Ms Bernier said that the possibilities afforded by current data collection methods are so immense and varied that the line between necessary to collect and simply convenient have started to blur. According to privacy laws, personal data collected for one purpose cannot be used for another purpose; however, there have been examples of government technology being used by third parties without consent.

"During the London 2012 Olympics, one of the security measures introduced was smart bins with the capacity to push notifications of security alerts to devices of people passing by," she explained. "That was certainly a laudable objective - except that in 2013 it was discovered that a private sector actor was using it to push advertisements, which is inconsistent with the reasons why the bins had been put in."

"Go slow and go small"

Privacy concerns aside, another key consideration for smart city technologies is that they should be inclusive, said Minister Lee. "In our anxiety to go digital, we should not leave behind a whole generation of citizens," he said, sharing the example of a 90-year-old man who requested for help but was directed to a website he was unable to read.

Agreeing, Professor Kong shared that the most important strategy for governments is to focus on the real needs of people. Such inclusive and critical thinking is key to ensure no segment of the population is left behind, she said.

"If we're not addressing fundamental issues in society, then introducing a form of tracking and formalisation actually exacerbates some of the challenges that the poor face," Professor Kong said, citing the example of how, in a particular Third World City context where smart technology was introduced, formal GPS tracking of garbage truck routes prevent their drivers from engaging in simultaneous work on the side to make ends meet.

But for all the challenges that may undermine the transition to smarter cities, there is still plenty of impetus for Singapore to push forward with its digitalisation efforts. "In the coming years, technology and digitalisation will play an even greater role in the life cycle of the urban built environment and infrastructure that we enjoy today," said Minister Lee. "Becoming a smart nation, making it a reality, and bringing everyone along with it, is integral to our future."

To navigate the challenges in the journey towards this digital future, Professor Kong had two pieces of advice: go slow and go small. "Go slow to minimise the potentially negative effects that come with speed," she said. "Smart solutions are not quick fixes to systemic problems; they are a catalysing glue that is only as effective as the policy regime and material environment within which it is deployed."

"Second, go small to minimise the potentially negative effects of transformation. Compared to major transformations, small incremental steps are often more in sync with the material conditions of the city in question."

Credit: 
Singapore Management University

When businesses behave badly

image: We've all heard of corporate social responsibility, but what happens when companies do the opposite? This was the question of the hour at the Conference on Green and Ethical Finance, jointly organised by SMU.

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Singapore Management University

SMU Office of Research & Tech Transfer - On a fateful April night ten years ago, the Deepwater Horizon oil rig exploded - taking the lives of 11 crew members and triggering the largest marine oil spill in history. Nearly five million barrels of oil spilled into the Gulf of Mexico, polluting around 2,100 kilometres of shoreline and killing thousands of marine mammals.

A federal probe later pinned the explosion on cost-cutting measures by British oil supermajor BP, owner of the doomed rig. Not only did BP pay US$20 billion in fines to resolve claims from the catastrophic spill, but the company was also blocked for two years from seeking new contracts with the US government owing to their perceived "lack of business integrity".

However, BP is not the only corporation to have landed in hot water for its lapses in judgment. In 2018, US tech giant Google was hit with a US$1.7 billion fine for stifling competition in online advertising. Such negative incidents resulting from the unscrupulous behaviour of corporations can be considered as instances of corporate social irresponsibility (CSI).

Yet, little research has been done on the impacts of CSI on the corporations themselves. To address this gap in literature, Drs Chloe Ho, Thu Ha Nguyen and Van Vu examined how negative environmental and social-related (E&S) incidents affected corporate policies in a study published in SSRN.

As part of the Conference on Green and Ethical Finance held from 16 to 18 September 2020, their findings were tackled in the environmental, social and governance (ESG) session chaired by Professor Dave Fernandez, Director of Singapore Management University's (SMU) Sim Kee Boon Institute for Financial Economics (SKBI). The virtual conference was jointly organised by SKBI, Asian Development Bank Institute and the Journal of Banking and Finance.

A financial trail of misbehaviour

According to Dr Vu, a Lecturer at La Trobe University who presented the paper on behalf of her co-authors, existing studies tend to focus on corporate social responsibility (CSR), but there is still no consensus on how such activities influence corporate policymaking. This is partly because CSR activities are typically disclosed by firms themselves, making their reports prone to greenwashing biases that distort the company's true impact, said Dr Vu.

This limitation can be overcome by examining negative E&S incidents. As these incidents are 'exogenous shocks' - that is, they are covered by external news reports - focusing on them avoids the problem of firms self-reporting. "Instead of looking at CSR performance, we looked at negative events and asked: what would happen to the firm's activities following these events?" explained Dr Vu.

To answer their primary research question, the authors collected data on E&S incidents dating from 2010 to 2018 and obtained the financial information of the firms involved. They found that following such incidents, the cash holdings, net equity issuances and capital expenditure of firms decrease, while their net debt issuances and leverage increase to buffer the negative shock of the incident.

According to Dr Vu, these findings suggest that firms tend to follow the pecking order theory. This means that after such incidents, firms first draw down on their internal funds to pay penalties and other reputational costs, after which they rely on debt financing rather than equity financing to manage the scandal. Further investigation by the authors also revealed that firms rely more heavily on long-term debt after E&S incidents, due to the liquidity risk posed by short-term debt.

However, companies appear to react differently to the incidents depending on their financial constraints. "Financially constrained firms are unable to raise additional equity in the equity market, which is why they have to cut back on their capital expenditure," Dr Vu said. "This is in contrast to non-financially constrained firms, who tend to be able to rely on the debt market to raise additional funds. This could explain why they don't have to cut back on their investment."

Proving that a little goodwill goes a long way, the authors also observed that firms with a high CSR reputation were more capable of cushioning the impacts of E&S incidents. This was reflected in the fact that firms with high reputational capital do not change their investment and financing decisions compared to low-reputation firms. "CSR is important in a sense that when the firm experiences a negative incident, there are less adverse effects on their business," Dr Vu said.

Zooming out from firm to industry

While the study of Dr Vu and her colleagues certainly addressed a gap in literature, SMU Associate Professor Liang Hao, who was the discussant of the Dr Vu's paper, suggested that their arguments could have been strengthened by the presence of an overarching theory. "We know that CSR affects corporate policies. What's the one story that can expand the results across five dimensions - cash holdings, net equity issuance, capital expenditure, net debt issuance and leverage?" asked Professor Liang.

For instance, CSR could be framed as a risk-management tool. "You do CSR in advance such that after negative shocks, firms and stakeholders will still view you positively and are less likely to punish you," he explained. Alternatively, CSR could also be used as a strategic signalling tool. "Some firms use CSR as a public-relations strategy to signal that they are actually good firms, even though they experience negative shocks." Regardless of which narrative the authors would have chosen, linking the findings to a particular mechanism would have benefitted the paper, Professor Liang said.

Though the authors report on exogenous shocks, Professor Liang argued that E&S incidents are a wider reflection of the firm's corporate governance quality. "There's a high correlation between E&S and governance. This means that well-governed firms have certain patterns of corporate policies," he explained. "What you're probably capturing is a governance effect rather than an E&S effect. Therefore, the results could be driven by poor governance."

Some firm-level E&S incidents may also be emblematic of wider industry-level issues, Professor Liang suggested. Hence, future research could examine the policies of peer firms that did not experience negative shocks following the E&S incidents of other firms. Incidents at the firm level and at the industry level could also be separately analysed, as the latter are considered more exogenous compared to firm-level incidents, Professor Liang noted.

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Singapore Management University

Scientists uncover the mysterious origin of canal grass in Panama

image: Because its tiny seeds blow in the wind, canal grass readily invades clearings and spreads to form impenetrable stands. Its white flowers and its historical association with the Panama Canal area inspired the common names paja blanca or paja canalera for this sugarcane relative, Saccharum spontaneum L..

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Kristin Saltonstall

Urban legends about the origins of canal grass in Panama abound, but the Smithsonian has new evidence that puts the question to rest. Canal grass is an invasive weed, native to Asia. Because its tiny seeds blow in the wind, it readily invades clearings and spreads to form impenetrable stands by budding from tillers and rhizomes. Once established, canal grass is challenging to eliminate. Fire burns the tops and stimulates the roots. Glassy hairs edging its leaf blades cut skin and dull machetes.

The most widespread story is that the Panama Canal Co. imported canal grass (paja canalera or paja blanca in Spanish, Latin name: Saccharum spontaneum L.) for erosion control. In other versions, the U.S. Army brought it to landscape areas for military exercises or it arrived on ships transiting the canal during the 1950s or 1960s. Another study suggested that seeds or fragments of roots may have washed into the canal from a piece of earth-moving equipment from Thailand or Vietnam shipped through the canal in the 1970s.

"These explanations are all unlikely," said Kristin Saltonstall, STRI staff scientist. "The first documentation of its presence in Panama is a report by the Missouri Botanical Gardens from 1948."

A parent of sugarcane, S. spontaneum often arrives in out-of-the-way places as an escapee from breeding collections. Several previous reports from the Tropical Agriculture and Higher Education Research Center suggested that canal grass escaped from a U.S. Department of Agriculture sugarcane breeding program at the Canal Zone Experimental Gardens (now Summit Nature Park) in the early 1940s. Saltonstall's new genetic results support this idea.

In 1939, the U.S. Department of Agriculture sent more than 500 different varieties of sugarcane and close relatives to the Gardens. Breeders may have been concerned that they could be damaged by hurricanes at the sugarcane experimental station in Canal Point, Florida. The plants were allowed to flower in the gardens as part of ongoing sugarcane breeding trials between 1940 and 1945.

Saltonstall compared DNA extracted from leaves of plants she collected in Panama to DNA samples from a large, international collection of sugarcane and sugarcane relatives maintained by colleagues in Australia, including many of the accessions that were likely brought to Panama in 1939.

"The conditions were right, the plants were there and the timing is right," Saltonstall said. "We can never say with 100% certainty that it came from the Gardens, but it certainly looks like it, because DNA from canal grass in Panama is very similar to accessions from Indonesia in the germplasm collection. All of these plants also have high ploidy levels [many copies of the chromosomes in each cell] and come from the same maternal lineage."

Sugarcane is the world's largest crop. In 2018, Panama produced 2.9 million tons of sugarcane. It was first domesticated in Southeast Asia in the eighth millennium B.C. and gradually spread around the world. Today, a hectare of sugarcane (a cross between S. spontaneum and S. officinarum) yields between 30 and 180 tons of sugar. Sugarcane breeders are eager to improve yield by producing hybrids with other species of grasses, but as they continue to experiment, the possibility of escapes like this continues.

"This was not an intentional introduction," Saltonstall said. "No one was thinking about invasive species at that time. More recently there have been escapes in the U.S. in Florida and Louisiana. Germplasm collections need to be monitored and if there is an escape, it needs to be dealt with before it becomes a problem."

Saltonstall will continue to study canal grass, fascinated by the way these large, invasive plants can take over an area and change its whole ecosystem. And as the world's climate changes, Panama may become drier and more subject to fires, which often start in urban patches of canal grass near burning garbage or roads and then burn into the forest and clear new areas for the canal grass to invade. Canal grass can tolerate drier conditions and outcompete other plants that are not resistant to drought, which may give it an advantage if the climate becomes drier.

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Smithsonian Tropical Research Institute

Link found between drought and HIV among women in less-developed countries

Current research predicts that by 2025, 1,800 million people are expected to be living in countries or regions with insufficient water resources, and models show increased severity of droughts in years to come. Food insecurity and other consequences of droughts will become intensified, influencing disease vulnerabilities among populations in less-developed countries. New research from Kelly Austin, associate professor of sociology at Lehigh University, explores how droughts shape gender inequalities in the HIV burden, indirectly through increased food insecurity.

The paper, "Drying Climates and Gender Suffering: Links Between Drought, Food Insecurity, and Women's HIV in Less-Developed Countries," is published in Social Indicators Research.

This study builds on previous attempts to explain women's disproportionate share of global HIV cases through biological, cultural and socioeconomic inequalities by bringing the environment and climate-related disasters into the discussion.

"While many infectious diseases like HIV/AIDS do not have a direct link to the environment in their transmission patterns or vectors, disasters such as drought can still have a significant influence on the social conditions that shape and enhance vulnerabilities," said the researchers, adding that hunger and food insecurity are key factors motivating women's engagement in early marriage, commercial sex, transactional sex relationships, and other forms of risky sex engagements.

Using a structural equation modeling approach, Austin and her colleagues were able to test the indirect and direct links between food insecurity and HIV as well as the causal chain of factors involving drought, food insecurity, and women's HIV.

The results from the study found that drought escalates food insecurity, and food insecurity has indirect, negative impacts on women's status, including lower participation in education, higher fertility rates and reduced access to medical care. Since women's status and the use of contraceptives are tightly linked, these impediments directly increase the percentage of HIV cases among women, confirming the researchers' hypothesis.

"Uncovering these mechanisms would not have been possible with more mainstream approaches," said Austin.

It's common to see strict gender norms in place where women are typically the household managers, carrying the responsibility for growing and harvesting food, collecting firewood, fetching water, and other tasks that provide household needs through environmental resources. In less-developed countries, droughts are the most common cause of severe food shortages, affecting agriculture first. As a result, changes to the environment are likely to compromise women's health in these unique ways.

According to the research, when a crisis hits, women are typically the first to sacrifice their own food to ensure their children and others have enough to eat. Food insecurity directly leads to infection risks through nutrient deficiencies. Additionally, food insecurity indirectly intensifies gendered inequalities that limit women's access to healthcare, education, and improved autonomy, potentially putting women in a more vulnerable position of contracting HIV.

"Women in less-developed countries disproportionately bear the burden in terms of ill health when facing food insecurity or a shock or disaster like drought that impacts the ability to get food or harvest food," said Austin. "This information would be useful for policy makers and people working in international development and disaster response."

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Lehigh University

Study explores how telemedicine may ease ER overcrowding

image: Dr. Shujing Sun, assistant professor of information systems in the Naveen Jindal School of Management at UT Dallas is lead author of the study.

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UT Dallas

Overcrowding in emergency rooms is a costly and concerning global problem, compromising patient care quality and experience. In a new study, a researcher from The University of Texas at Dallas investigated whether telemedicine could enhance ER care delivery.

"This longstanding problem is mainly driven by the imbalance between increasing patient flow and the shortage of emergency room capacity," said Dr. Shujing Sun, assistant professor of information systems in the Naveen Jindal School of Management and lead author of the study.

"While the ER is supposed to be a safety net of the health care system, the overcrowding problem has strained this safety net and posits various threats," Sun said. "For example, long waiting times and treatment delays cause adverse patient outcomes, such as high readmission and mortality rates. They also increase financial costs, reduce patients' satisfaction and impair physician efficiency."

In the study, published online Aug. 27 and in the September print issue of the INFORMS journal Information Systems Research, Sun and her colleagues investigated the potential of telemedicine as a generic solution to reduce ER congestion.

Sun said telemedicine, defined as the remote delivery of health care services and clinical information using telecommunications technology, has been gradually adopted in recent years, but there is little evidence on the impact of its applications within the ER setting.

"Telemedicine application in the ER has two distinguishing features from home-based telemedicine," Sun said. "First, patients present in the ER. Second, on-site assistance is available to connect patients and off-site physicians throughout the telemedicine service. Off-site physicians can be within the same hospital, in a different hospital, or even at home, as long as they can connect with emergency patients through videoconferencing tools and have access to patients' health records."

According to the National Hospital Ambulatory Medical Care Survey, from 2000 to 2015, the number of ER visits in the U.S. increased 27% from 108 million to nearly 137 million. With the sharp rise in ER visits and critical shortages of emergency care physicians, ER overcrowding is not abating, particularly as the COVID-19 pandemic strains the capacity of hospitals nationwide.

Using a large data set covering all emergency visits in New York state from 2010 to 2014, the researchers found that the adoption of telemedicine in the ER significantly shortened average length of stay and wait time.

ER telemedicine improves an on-call physician's efficiency through transportation elimination and smoother workflow, which can shorten a patient's wait for physicians.

For example, when there is an in?ux of emergency patients, telemedicine enables on-site nurse practitioners or physician assistants to treat patients with minor conditions under the remote supervision of off-site physicians. Sun said this is important because many hospitals require that all patients be seen by an attending physician. With telemedicine, on-call physicians can work from their office without traveling to the ER. Having an on-call physician available through telemedicine also can speed up the ordering of lab work, so that those processes can start long before they otherwise would, and physicians can pivot to their administrative tasks more quickly in between visits.

The researchers replicated the analysis using annual U.S. hospital data and found that ER telemedicine adoption significantly reduces average wait times documented in Medicare.gov's Hospital Compare, or the average time a patient spends in the ER before being seen by a health care professional. That finding suggests that the reduction in length of stay -- the total time from the first documented time after arrival at the ER to the time the patient is discharged from the ER -- partially comes from the reduction of waiting time.

Telemedicine could achieve greater efficiencies through several channels, Sun said. In addition to more efficient information exchange, the study showed telemedicine can significantly improve ER care delivery through flexible resource allocation, especially when there is a shortage of on-site physician staffing or a hospital lacks certain expertise.

For example, whether to administer tissue plasminogen activator after stroke symptoms is a time-sensitive and complicated medical decision. However, some hospitals lack such expertise. Through a telestroke program, a type of ER telemedicine application, on-site emergency physicians can immediately consult remote stroke specialists to perform real-time diagnoses and recommend treatment plans in a timely manner.

"Although the ER seems to be an unlikely place for telemedicine to play its role, it is happening, and in fact, is very promising," Sun said. "We believe our findings are critical for ERs, considering the unique setting of unscheduled arrivals and unpredictability of patient traffic."

It's important to note that the improvement in care delivery does not come at the expense of care quality or patient cost, Sun said.

The study provides health care decision-makers with a careful examination of the causal implications of ER telemedicine on care delivery efficiency, care quality and medical expenditure.

"Due to the lack of evidence and the inflexibility of reimbursement policy, the adoption rate of telemedicine in the ER remains low and is growing only slowly," Sun said. "Policymakers can incentivize adoption of ER telemedicine by reducing regulatory barriers, such as lifting restrictions regarding cross-state practitioners' licensure and providing better reimbursement coverage."

With the current global COVID-19 pandemic and the expanded use of telemedicine applications in recent months, Sun said telemedicine has shown its promise to protect patients and providers without compromising health care access.

"When more and more hospitals join the resource-sharing network, telemedicine will have great potential to rebalance the geographically imbalanced health care resources and reduce health care access disparity," she said.

The use of telemedicine during the pandemic offers researchers an opportunity to take a more in-depth look. Sun plans to conduct further research to gather a better understanding of whether, how and why telemedicine functions in various health care situations.

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University of Texas at Dallas

Does your pain feel different in English and Spanish?

We take for granted the fact that feelings such as love, happiness, or pain are described with different words and expressions across languages. But are these differences in the ways we express these feelings in different languages also tied to differences in the sensations themselves? Would a painful event like a stubbed toe or a bee sting hurt less if a bilingual chose to describe or think about it in Spanish as opposed to English?

These sorts of question were central to the development of a recent study by Morgan Gianola, University of Miami psychology graduate student, along with his advisor, Dr. Elizabeth Losin, director of the Social and Cultural Neuroscience lab at the University of Miami, and Dr. Maria Llabre, professor and associate chair of the Department of Psychology at the University of Miami. The study, entitled "Effects of Language Context and Cultural Identity on the Pain Experience of Spanish-English Bilinguals," is published in the journal Affective Science and will appear as part of the journal's special issue on "Language and Affect."

The Social and Cultural Neuroscience lab uses experimental interactions among research participants to assess how social factors, like the language one speaks or the cultural identity they express, can influence pain responses and other clinically relevant behaviors. Gianola joined this lab to research how social environments and cultural learning can be relevant to perceptions as seemingly objective and inherent as pain.

In the study, 80 bilingual Hispanic/Latino participants from the University of Miami and Miami-Dade County communities visited the lab to participate in separate English and Spanish testing sessions; during both sessions, they received a pain-induction procedure, when an experimenter applied painful heat to their inner forearm. The primary difference between the two experimental visits was the language being spoken (English or Spanish), while the painful procedure itself did not change. Participants provided subjective ratings of their pain, and their physiological responses (i.e. their heart rate and palm sweating) were also monitored.

Gianola explained that this study was inspired by previous research in the field of "linguistic relativity," which has shown differences between English and Spanish speakers in cognitive processes like memory for specific events or categorization of objects. These cognitive differences are also seen among bilinguals when they switch between English and Spanish contexts. Gianola hoped to clarify how such psychological differences across languages might also relate to changes in physical and emotional experiences, like pain.

"All of our participants identified as bicultural," said Gianola. "After each experimental session, we had them fill out surveys about things like how often they use each language [English and Spanish] and how strongly they relate to and identify with both the Hispanic and U.S.-American sides of their cultural identity. The interesting thing we found was, rather than participants always showing higher pain ratings in Spanish, for example, they tended to report more intense pain and show larger physiological responses to pain when they spoke the language of their stronger cultural identity."

According to the study findings, participants who engaged more with Hispanic culture showed higher pain when speaking Spanish, while more U.S.-American identified participants reported higher pain in English. People who were fairly balanced in their engagement with U.S.-American and Hispanic culture had pain outcomes that didn't differ much across languages. The study also suggests that bodily responses to the pain played a larger role in determining pain ratings among more Hispanic oriented bilingual participants.

"This study highlights, first, that Hispanic/Latino communities are not monolithic, and that the factors affecting bilinguals' psychological and physiological responses to pain can differ across individuals," said Gianola. "We also see that language can influence such a seemingly basic perception as pain, but that the cultural associations people carry with them may dictate to what extent the language context makes a difference."

Moving forward, the researchers are developing new experiments to further address the role language plays in influencing cognition and perception among bilinguals. As part of a dissertation project, Gianola plans to investigate the brain processes that contribute to the effects found in this most recent study.

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University of Miami

Math enables custom arrangements of liquid 'nesting dolls'

video: Princeton researchers have developed a new way to examine, predict and engineer interactions between multiple liquid phases. The method uses graph theory to track which phases contact each other. In these simulations, four phases are indicated by colored dots; lines show which phases are touching. Time is indicated in arbitrary units. Governed by the phases' relative volumes and surface energies, small droplets morph into larger droplets over time.

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Video by Sheng Mao et al.; GIF by Bumper DeJesus

While the mesmerizing blobs in a classic lava lamp may appear magical, the colorful shapes move in response to temperature-induced changes in density and surface tension. This process, known as liquid-liquid phase separation, is critical to many functions in living cells, and plays a part in making products like medicines and cosmetics.

Now Princeton University researchers have overcome a major challenge in studying and engineering phase separation. Their system, reported in a paper published Nov. 19 in Physical Review Letters, allows for the design and control of complex mixtures with multiple phases -- such as nested structures reminiscent of Russian matryoshka dolls, which are of special interest for applications such as drug synthesis and delivery.

Their system provides researchers a new way to examine, predict and engineer interactions between multiple liquid phases, including arrangements of mixtures with an arbitrary number of separated phases, the researchers said.

The arrangement of phases is based on the minimization of surface energies, which capture the interaction energies between molecules at the interfaces of phases. This tends to maximize the contact area between two phases with low surface tension, and minimize or eliminate contact between phases with high surface tension.

The new method uses the mathematical tools of graph theory to track which phases contact each other within a mixture. The method can predict the final arrangements of phases in a mixture when the surface energies are known, and can also be used to reverse-engineer mixture properties that give rise to desired structures.

"If you tell us which phases you have and what the surface tensions are, we can tell you how phases will arrange themselves. We can also do it the other way around -- if you know how you want the phases to be arranged, we can tell you what surface tensions are needed," said senior author Andrej Košmrlj, an assistant professor of mechanical and aerospace engineering.

"The approach is very general, and we think it will have an impact on many different fields," from cell biology and pharmaceuticals to 3D printing and carbon sequestration technologies, said Košmrlj.

The work began as the junior paper of Milena Chakraverti-Wuerthwein, a physics concentrator from Princeton's Class of 2020. She was working with Sheng Mao, then a postdoctoral research associate in Košmrlj's group, building on previous research that explored phase-separated mixtures. That work developed a computational framework for predicting the number of separated phases and their composition, but did not systematically investigate the actual arrangements of phases.

Chakraverti-Wuerthwein started drawing examples of multicomponent mixtures, with each phase represented by a different color. At one point, she said, she felt like she was "going in circles," but then "took a step back and thought about the distinguishing feature that makes one of these morphologies different from another. I came up with the idea that it's really the edges where phases are touching each other. That was the birth of the idea of using the graphs," in which each phase is represented by a colored dot, and the lines between dots indicate which phases touch one another in a mixture.

"That was the spark we needed, because once you can represent it in terms of graphs, then it's very easy to enumerate all the possibilities" for different arrangements of phases, said Košmrlj.

Chakraverti-Wuerthwein is a co-lead author of the paper along with Mao, who is now an assistant professor at Peking University in China. Coauthor Hunter Gaudio, a 2020 graduate of Villanova University, helped run simulations to produce all distinct arrangements of four phases during summer 2019 as a participant in the Princeton Center for Complex Materials' Research Experience for Undergraduates program.

"Normally, liquids like to make simple droplets, and not much else. With this theory, one can program droplets to spontaneously organize into chains, stacks, or nested layers, like Russian dolls," said Eric Dufresne, a professor of soft and living materials at ETH Zürich in Switzerland, who was not involved in the research. "This could be useful for controlling a complex sequence of chemical reactions, as found in living cells. The next challenge will be to develop experimental methods to realize the interactions specified by the theory."

Košmrlj is part of a group of Princeton faculty members exploring various facets and applications of liquid-liquid phase separation -- a major focus of an Interdisciplinary Research Group recently launched by the Princeton Center for Complex Materials with support from the National Science Foundation.

In liquid environments, there is a tendency for small droplets to morph into larger droplets over time -- a process called coarsening. However, in living cells and industrial processes it is desirable to achieve structures of specific size. Košmrlj said his team's future work will consider how coarsening might be controlled to achieve mixtures with targeted small-scale structures. Another open question is how multicomponent mixtures form in living systems, where active biological processes and the basic physics of the materials are both contributing factors.

Chakraverti-Wuerthwein, who will begin a Ph.D. program in biophysical sciences at the University of Chicago in 2021, said it was gratifying to see "that this kernel of an idea that I came up with ended up being something valuable that could be expanded into a more broadly applicable tool."

Credit: 
Princeton University, Engineering School

Bacteria in iron-deficient environments process carbon sources selectively

When humans have low iron levels, they tend to feel weak, fatigued and dizzy. This fatigue prevents patients with iron-deficient anemia from exercising or exerting themselves in order to conserve energy.

Similarly, in low-iron environments, microbes survive by slowing down carbon processing and extracting iron from minerals. However, this strategy requires microbes to invest precious food sources into producing mineral-dissolving compounds. Given this paradox, researchers wanted to understand how microbes sustain survival strategies in environments with too little iron to thrive.

Iron is critical to carbon metabolism because it's required by the proteins involved in processing carbon. But because oxygen makes soluble iron less abundant in the environment, bacteria often operate under iron limitation and need to shut down or dramatically decrease carbon intake.

Looking at a group of bacteria from soil, researchers at Northwestern University discovered that these organisms overcome limitation in their carbon processing machinery by rerouting their metabolic pathways to favor producing iron-scavenging compounds. The study is the first to use metabolomics, a high-resolution technique to monitor carbon flow in the cells, to study the impact of iron on the carbon cycling in bacterial cells.

The study was published today (Nov. 30) in the journal Proceedings of the National Academy of Sciences.

Ludmilla Aristilde, an associate professor of civil and environmental engineering at the McCormick School of Engineering, led the research. Her research group focuses on understanding environmental processes that involve organics, with implications for ecosystem health, agricultural productivity and environmental biotechnology.

Within the network of metabolism in bacteria, the citric acid cycle provides the carbon skeletons needed to make iron-scavenging compounds. Metabolism of certain carbon sources generates better carbon and fuel from the citric acid cycle. Iron-starved bacteria favor carbon processing through the citric acid cycle in order to produce more iron-scavenging compounds. Aristilde said this finding is significant because the research reveals that inorganic nutrients can have a direct impact on organic processes.

"The hierarchy in carbon metabolism highlights that selectivity in specific carbon usage is strongly linked to something that is inorganic," Aristilde said. "To put this in the context of climate change, we need to understand what conditions control soil carbon cycling and its contribution to carbon dioxide."

By focusing on the Pseudomonas species in soils, the research group was able to make inferences about other species. The Pseudomonas bacteria also exist as human and plant pathogens, in our gut and elsewhere in the environment. Aristilde hopes that because the bacteria she and her researchers chose to study are so ubiquitous, future research will be able to use her group's findings as a roadmap.

Past research studied organism behavior with a lower resolution of information. While scientists have used genomics to predict what may happen in metabolism of species based on identifying and measuring genes, the Aristilde lab uses metabolomics of the species to capture what is actually happening in metabolism. Their research provides clues that imply many other organisms and systems might also employ similar metabolic strategies.

As an environmental engineer, Aristilde said that her area of study is all about understanding mechanisms and making predictions about how environmental processes like the carbon cycle behave. Beyond carbon cycling and climate change, the study also has implications in plant and human health. Understanding how bacteria that cause inflections change carbon metabolism to compete for iron in their plant or human hosts can enable researchers to better design target treatments.

Credit: 
Northwestern University

Area burned by severe fire increased 8-fold in western US over past four decades

WASHINGTON--The number of wildfires and the amount of land they consume in the western U.S. has substantially increased since the 1980s, a trend often attributed to ongoing climate change. Now, new research finds fires are not only becoming more common in the western U.S. but the area burned at high severity is also increasing, a trend that may lead to long-term forest loss.

The new findings show warmer temperatures and drier conditions are driving an eight-fold increase in annual area burned by high severity fire across western forests from 1985-2017. In total, annual area burned by high severity wildfires -- defined as those that kill more than 95% of trees -- increased by more than 450,000 acres.

"As more area burns at high severity, the likelihood of conversion to different forest types or even to non-forest increases," said Sean Parks, a research ecologist with the U.S. Forest Service Rocky Mountain Research Station and lead author of the new study. "At the same time, the post-fire climate is making it increasingly difficult for seedlings to establish and survive, further reducing the potential for forests to return to their pre-fire condition."

Parks will present the results Wednesday, 9 December at AGU's Fall Meeting 2020. The findings are also published in AGU's journal Geophysical Research Letters, which publishes high-impact, short-format reports with immediate implications spanning all Earth and space sciences.

Scientists have known for years that wildfires are on the rise in the western U.S., coincident with recent long-term droughts and warmer temperatures. Many western states, especially parts of California, have undergone several multi-year droughts over the past four decades, a fact scientists attribute to human-caused changes to the climate. However, it is less clear how fire severity has changed over the past half century.

In the new study, Parks and John Abatzoglou, an atmospheric scientist at the University of California Merced, used satellite imagery to assess fire severity in four large regions in the western U.S. from 1985 to 2017. Rather than analyze the amount of area burned each year, they instead looked at the area burned at high severity, which is more likely to adversely impact forest ecosystems and human safety and infrastructure.

"The amount of area burned during a given year is an imperfect metric for assessing fire impacts," Parks said. "There was a substantial amount of fire in the western U.S. prior to Euro-American colonization, but that fire did not likely have the extreme effects that we're seeing now."

Beneficial fires

Wildfires were historically a common component of many forest ecosystems, especially in dry areas that receive little or sporadic rainfall. Fire was such a common occurrence in some regions that many tree species - especially certain species of pine - evolved traits that allow them to not only survive fires but to facilitate their ignition as well.

In the mountainous slopes of California, for example, ponderosa pines, sugar pines and giant sequoias sport thick bark that keeps the living tissue underneath insulated from extreme heat. Some tree species also drop the branches growing closest to the ground, which might otherwise allow fires to climb up into the canopy.

Species like jack pines are so dependent on fire that their seeds are unable to effectively disperse until a passing blaze melts the resinous coating surrounding their cones. And the slender, needle-like leaves of pines dry out more quickly than the broad leaves of deciduous hardwoods, making them excellent kindling.

The catch is these trees evolved to cope with frequent, low-intensity fires. During a severe fire, even the most well-adapted plants can succumb to mortality. If too many trees die, forest regrowth can be impeded by the lack of viable seeds.

"Forest burned at high severity bears the biggest ecological impacts from a fire," said Philip Dennison, a fire scientist at the University of Utah who was unaffiliated with the study. "These are the areas that are going to take the longest to recover, and in many places that recovery has been put into question due to higher temperatures and drought."

A 2019 study authored by Parks found up to 15% of intermountain forests in the western U.S. are at risk of disappearing. In dry regions, such as the southwestern U.S., that number increases to 30% when assuming fires burn under extreme weather.

As western North America continues to reel from the vice-like grip of droughts and increasing temperatures, scientists expect severe fires will become even more common.

"One take home message is that fire severity is elevated in warmer and drier years in the western U.S., and we expect that climate change will result in even warmer and drier years in the future," Parks said.

Credit: 
American Geophysical Union

HIV-like virus edited out of primate genome

image: Dr. Kamel Khalili and Dr. Tricia Burdo at the Lewis Katz School of Medicine at Temple University

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Temple University

(Philadelphia, PA) - Taking a major step forward in HIV research, scientists at the Lewis Katz School of Medicine at Temple University have successfully edited SIV - a virus closely related to HIV, the cause of AIDS - from the genomes of non-human primates. The breakthrough brings Temple researchers and their collaborators closer than ever to developing a cure for human HIV infection.

"We show for the first time that a single inoculation of our CRISPR gene-editing construct, carried by an adeno-associated virus, can edit out the SIV genome from infected cells in rhesus macaque monkeys," said Kamel Khalili, PhD, Laura H. Carnell Professor and Chair of the Department of Neuroscience, Director of the Center for Neurovirology, and Director of the Comprehensive NeuroAIDS Center at the Lewis Katz School of Medicine at Temple University (LKSOM).

Dr. Khalili was a senior co-investigator on the new study, with Tricia H. Burdo, PhD, Associate Professor and Associate Chair of Education in the Department of Neuroscience at LKSOM, who is an expert on the utilization of the SIV (simian immunodeficiency virus)-infected antiretroviral therapy (ART)-treated rhesus macaque model for HIV pathogenesis and cure studies; and with Andrew G. MacLean, PhD, Associate Professor at the Tulane National Primate Research Center and the Department of Microbiology and Immunology at Tulane University School of Medicine, and Binhua Ling, PhD, Associate Professor at the Southwest National Primate Research Center, Texas Biomedical Research Institute. Dr. Ling was previously Associate Professor at the Tulane National Primate Research Center and the Department of Microbiology and Immunology at Tulane University School of Medicine. Pietro Mancuso, PhD, an Assistant Scientist in Dr. Khalili's laboratory in the Department of Neuroscience at LKSOM, was first author on the report, which was published online November 27 in the journal Nature Communications.

Of particular significance, the new work shows that the gene-editing construct developed by Dr. Khalili's team can reach infected cells and tissues known to be viral reservoirs for SIV and HIV. These reservoirs, which are cells and tissues where the viruses integrate into host DNA and hide away for years, are a major barrier to curing infection. SIV or HIV in these reservoirs lies beyond the reach of ART, which suppresses viral replication and clears the virus from the blood. As soon as ART is stopped, the viruses emerge from their reservoirs and renew replication.

In non-human primates, SIV behaves very much like HIV. "The SIV-infected rhesus macaque model studied in Dr. Burdo's lab is an ideal large animal model for recapitulating HIV infection in humans," explained Dr. Khalili.

For the new study, the researchers began by designing an SIV-specific CRISPR-Cas9 gene-editing construct. Experiments in cell culture confirmed that the editing tool cleaved integrated SIV DNA at the correct location from host cell DNA, with limited risk of potentially harmful gene editing at off-target sites. The research team then packaged the construct into an adeno-associated virus 9 (AAV9) carrier, which could be injected intravenously into SIV-infected animals.

Dr. Burdo, in collaboration with colleagues at Tulane National Primate Research Center, randomly selected three SIV-infected macaques to each receive a single infusion of AAV9-CRISPR-Cas9, with another animal serving as a control. After three weeks, the researchers harvested blood and tissues from the animals. Analyses showed that in AAV9-CRISPR-Cas9-treated macaques, the gene-editing construct had been distributed to a broad range of tissues, including the bone marrow, lymph nodes, and spleen, and had reached CD4+ T cells, which are a significant viral reservoir.

Moreover, the Temple researchers demonstrated that the SIV genome was effectively cleaved from infected cells, based on genetic analyses of tissues from treated animals. "The step-by-step excision of SIV DNA occurred with high efficiency from tissues and blood cells," Dr. Mancuso explained. Excision efficiency varied by tissue but reached notably high levels in the lymph nodes.

The new study is a continuation of efforts by Dr. Khalili and colleagues to develop a novel gene-editing system using CRISPR-Cas9 technology - the subject of the 2020 Nobel Prize in Chemistry - to specifically remove HIV DNA from genomes harboring the virus. The researchers have shown previously that their system can effectively eliminate HIV DNA from cells and tissues in HIV-infected small animal models, including HIV-1 humanized mice.

Co-corresponding author Dr. MacLean is encouraged by the findings. "This is an important development in what we hope will be an end to HIV/AIDS," says MacLean. "The next step is to evaluate this treatment over a longer period of time to determine if we can achieve complete elimination of the virus, possibly even taking subjects off of ART."

Dr. MacLean is hopeful that this treatment strategy will translate to the human population. The biotech company Excision BioTherapeutics, of which Dr. Khalili is a scientific founder and where Dr. Burdo contributes to preclinical research and development and serves on the Scientific Advisory Board, will assist with funding and infrastructure for larger scale studies and future clinical trials after approval by the Food and Drug Administration.

"We hope to soon move our work into clinical studies in humans as well," Dr. Khalili added. "People worldwide have been suffering with HIV for 40 years, and we are now very near to clinical research that could lead to a cure for HIV infection."

Credit: 
Temple University Health System

Linking medically complex children's outpatient team with hospitalists improved care

image: Ricardo Mosquera, MD, with one of his patients at the UT Physicians High Risk Children's Clinic, which is linking with hospitalists for continuity of care during a child's hospitalization.

Image: 
Dwight Andrews, UTHealth

When medically complex children are hospitalized, linking hospitalists to their regular outpatient providers through an inpatient consultation service were more likely to improve outcomes, according to researchers at The University of Texas Health Science Center at Houston (UTHealth).

Results from the quality improvement trial, which showed the inpatient consultation service was more likely to reduce total hospital days, hospital admissions and readmissions, days in pediatric intensive care (PICU), and health care system costs, were published today in JAMA Pediatrics.

"We expected to see an improvement in parent satisfaction, but I was surprised to see how significantly an inpatient consultation from the outpatient providers reduced admissions, readmission, and PICU days, as well as total hospital days and health system costs," said Ricardo Mosquera, MD, first and corresponding author and associate professor of pediatrics at McGovern Medical School at UTHealth. Mosquera is director of the UTHealth High Risk Children's Program, a collaboration between UTHealth and Children's Memorial Hermann Hospital.

Jon E. Tyson, MD, MPH, professor and assistant dean in the Department of Pediatrics, was the senior author.

During a one-year period from 2016 to 2017, 167 children were randomized to inpatient consultation service and 175 to usual hospital care for the trial. Results showed that with the inpatient consultation service, the probability of reduced hospital days was 91%; of PICU days was 89%, and of mean total health care system costs was 94%.

In total numbers comparing inpatient consultation service to usual care, there were 296 versus 636 total hospital days; and $24,928 versus $42,276 per child year in costs. The economic analysis was done by health care economist and second author Elenir Avritscher, MD, PhD, associate professor in the Department of Pediatrics at McGovern Medical School.

The trial also revealed that parents were more likely to give an overall rating of 9 or 10 (with 10 being the highest) to the providers of inpatient care.

"We knew that families were concerned about not seeing their regular health care provider while their children were in the hospital," Mosquera said. "It was reassuring for them to see us when necessary for visits in the hospital."

Children with complex medical needs account for 0.4% of U.S. children but are responsible for approximately 40% of pediatric deaths and 54% of all pediatric hospital charges.
To help these fragile children have the best outcomes, the UT Physicians High Risk Children's Clinic was established by Mosquera and a multidisciplinary team of health care specialists 10 years ago, growing from one patient to 800.

A UTHealth study published in JAMA in 2014 showed that the outpatient comprehensive care program for high-risk children with medical complexity reduced emergency department visits, hospital and pediatric intensive care unit admissions and stays, and health systems costs. In 2018, the program was named to the national network for Children and Youth Special Health Care Needs, established by the U.S. Maternal and Child Health Bureau.

The UTHealth team recognized a gap because when patients did need to be hospitalized for acute illness, the hospitalists were unfamiliar with the child and their outpatient care, which could provide key insight to their needs while the child was in the hospital.

"In order to avoid fragmented care, we recognized that we should extend comprehensive care to all settings, including hospitalization," said Mosquera. The clinic also offers telemedicine and, when possible, in-person home visits for its patients.

During the trial, parents of children randomized to the inpatient consultation service were asked to contact the outpatient care team when an emergency department doctor was considering hospitalization for the patient. A study nurse also reviewed the daily log to identify admissions of all study children, including those randomized to usual hospital care.

For the inpatient consultation service, an outpatient clinic provider spoke with a member of the child's in-hospital team before or soon after admission, at discharge, and intermittently during the stay for patients with more complicated care, if needed. The clinic team also participated in the post-hospitalization plan, called the patient within 36 hours of discharge, and scheduled a clinic appointment for no more than 10 days after discharge.

"Our physicians consulted with the hospitalists or emergency department physician to determine if the patient should be hospitalized, the course of treatment and care, and discharge and transition back to the outpatient setting," Mosquera said. "But the hospitalist team still retains full responsibilities. I think this model is important not just for children, but for any risk population regardless of age."

Credit: 
University of Texas Health Science Center at Houston

Worst-case emissions projections are already off-track

image: A plenary at the 25th Conference of the Parties, held by the United Nations Framework Convention on Climate Change in December 2019.

Image: 
UNFCCC / UNclimatechange, Flickr

Under the worst-case scenarios laid out in the United Nations’ climate change projections, global temperatures could increase as much as 7.2 degrees Fahrenheit (more than 4 degrees Celsius) by 2100, leading to as much as 3 feet (0.98 meters) in global sea level rise and an array of disastrous consequences for people and planet. But new research from CU Boulder finds that these high-emissions scenarios, used as baseline projections in the UN’s Intergovernmental Panel on Climate Change (IPCC) global assessments, have not accurately reflected the slowing rate of growth in the global economy and we are unlikely to catch up to them anytime soon.

The new study, published today in Environmental Research Letters, is the most rigorous evaluation of how projected climate scenarios established by the IPCC have evolved since they were established in 2005.

The good news: Emissions are not growing nearly as fast as IPCC assessments have indicated, according to the study's authors. The bad news: The IPCC is not using the most accurate and up-to-date climate scenarios in its planning and policy recommendations.

"If we're making policy based on anticipating future possibilities, then we should be using the most realistic scenarios possible," said Matt Burgess, lead author on the study and a fellow at the Cooperative Institute for Research in Environmental Sciences (CIRES) at CU Boulder. "We'll have better policies as a result."

The IPCC was established in 1988 and provides policymakers around the globe with regular research-based assessments on the current and projected impacts of climate change. Its reports, the sixth of which is due out in 2022, play an instrumental role in shaping global climate policy.

To see if IPCC scenarios are on track, the researchers compared projections from the latest report, published in 2014, and data used to prepare the upcoming report, to data gathered from 2005 to 2017 on country-level gross domestic product (GDP), fossil-fuel carbon dioxide emissions, likely energy use and population trends during this century. Burgess and his co-authors show that even before the pandemic, due to slower-than-projected per-capita GDP growth, as well a declining global use of coal, these high-emissions scenarios were already well off-track in 2020, and look likely to continue to diverge from reality over the coming decades and beyond. The COVID-19 pandemic's dampening effect on the global economy only accentuates their findings, they said.

As a result, they contend that these high-emissions scenarios should not be used as the baseline scenarios in global climate assessments, which aim to represent where the world is headed without additional climate mitigation policy.

When it comes to climate change scenarios, some scientists and climate experts fear that economic growth will be higher than the projected scenarios, and we'll be taken by surprise by climate changes. But that is unlikely to happen, according to Burgess, assistant professor in environmental studies and faculty affiliate in economics.

This new research adds to a growing literature that argues that economic growth and energy use are currently over-projected for this century. The research also points out that the high-emissions scenarios used by the IPCC don't fully account for economic damages from climate change.

The researchers recommend that these policy-relevant scenarios should be frequently recalibrated to reflect economic crashes, technological discoveries, or other real-time changes in society and Earth's climate. Anticipating the future is difficult and updates are to be expected, according to Roger Pielke Jr., co-author on the paper and professor of environmental studies.

Their study does not mean that people can let their guard down when it comes to addressing climate change, the authors stress. No matter the scenario, the only way to get to net zero emissions as a society is to dramatically reduce carbon dioxide emissions from our energy sources.

"We're still affecting the climate and the challenge of reducing emissions is as hard as ever," said Pielke Jr. "Just because it's not the worst-case scenario doesn't mean that the problem goes away."

Credit: 
University of Colorado at Boulder

Preschool children can't see the mountains for the cat

COLUMBUS, Ohio - Imagine seeing an image of a cat in front of a wide scene of mountains and being told just to remember the mountains if you saw them in a later picture. As an adult, that's not hard to do.

But a new study shows that, even when told to pay attention to the mountain, preschool children focus so much on the cat that they won't later recognize the same mountain.

The results suggest that young children have a bias toward paying attention to objects rather than scenes, even when the task is to attend to the scenes, said Kevin Darby, lead author of the study, who received his doctorate in psychology at The Ohio State University.

"Children really struggled to ignore objects that were irrelevant to what we told them to do," said Darby, who is now a postdoctoral researcher in psychology at the University of Virginia.

The study was published recently in the journal Child Development.

It's not that children can't focus on scenes, said study co-author Vladimir Sloutsky, professor of psychology at Ohio State. They can, when objects do not compete for attention with the scenes.

"Our findings suggest that children failed to filter irrelevant objects, rather than failed to focus on relevant scenes," Sloutsky said.

The study involved 69 preschool children with an average age of 5 and 80 adults.

Participants were first shown a photograph of an object (tree, cat, car, slide or person) superimposed on a scene (beach, street, office, mountain or kitchen). The were told to remember either the object or the scene.

They then viewed a series of photos showing more objects and scenes and were told to indicate if they again saw the scene or object that they were told to remember from the first photo.

Adults had little problem attending to either the relevant object or to the scene and remembering when they saw it again. But children had trouble recognizing a scene when it appeared in the second photo.

"If we showed a child a tree in front of a beach scene and told them to remember the beach, they couldn't do that," Darby said.

"When the child saw a later image with a car in front of the beach, they would be paying attention to the car and would not recognize the beach," Darby said.

So why do children have a bias toward paying attention to objects? This study can't say, but other research offers some possible explanations, according to the researchers.

For one, objects are the main things to focus on early in development, beginning in early infancy, from parents to toys that they are given, Darby said.

"Objects take up a lot of visual space when you're young and hold them in your hands, so they are easy to focus on," he said.

In addition, objects play a big role in language development. Many of the first words children learn are labels for objects.

There is also evidence that during brain development, regions supporting object recognition develop earlier than regions supporting scene recognition, the researchers said.

Credit: 
Ohio State University

Unexpected similarity between honey bee and human social life

image: An image obtained from the system showing barcoded bees inside the observation hive. Outlines reflect whether a barcode could be decoded successfully (green), could not be decoded (red), or was not detected (no outline). The hive entrance is in the lower-right corner, and the inset reveals two bees that were automatically detected performing trophallaxis.

Image: 
Tim Gernat, University of Illinois

Bees and humans are about as different organisms as one can imagine. Yet despite their many differences, surprising similarities in the ways that they interact socially have begun to be recognized in the last few years. Now, a team of researchers at the University of Illinois Urbana-Champaign, building on their earlier studies, have experimentally measured the social networks of honey bees and how they develop over time. They discovered that there are detailed similarities with the social networks of humans and that these similarities are completely explained by new theoretical modeling, which adapts the tools of statistical physics for biology. The theory, confirmed in experiments, implies that there are individual differences between honey bees, just as there are between humans.

The study, which measures the extent of individual differences in honey bee networking for the first time, was carried out by first author physics PhD student Sang Hyun Choi, postdocs Vikyath D. Rao, Adam R. Hamilton and Tim Gernat, Swanlund Chair of Physics Nigel Goldenfeld and Swanlund Chair of Entomology Gene E. Robinson (GNDP). Goldenfeld and Robinson are also faculty at the Carl R. Woese Institute for Genomic Biology at Illinois, of which Robinson is the director. The collaboration comprised experimental measurements of honey bee social behavior performed by Hamilton, Gernat and Robinson, with data analysis by Rao and theoretical modeling and interpretation by Choi and Goldenfeld. Their findings were published in a recent article in the journal Proceedings of the National Academy of Science.

"Originally, we wanted to use honey bees as a convenient social insect to help us find ways to measure and think about complex societies," said Goldenfeld. "A few years ago, Gene, Tim, Vikyath and I collaborated on a large project that put "bar codes" on bees so that we could automatically monitor everywhere they went in the hive, every direction in which they pointed, and every interaction partner. In this way, we could build a social network in time, something known as a temporal network."

That study, done a few years ago, involved high-resolution imaging of barcode-fitted honey bees, with algorithms detecting interaction events by mapping the position and orientation of the bees in the images. In those studies, researchers focused on trophallaxis -- the act of mouth-to-mouth liquid food transfer -- when measuring the social interactions between honey bees. Trophallaxis is used not only for feeding but for communication, making it a model system for studying social interactions.

"We chose to look at trophallaxis because it is the type of honey bee social interaction that we can accurately track," said Choi. "Since honey bees are physically connected to each other by proboscis contact during trophallaxis, we can tell whether they are actually engaging in an interaction or not. In addition, each honey bee is tagged so we can identify each individual engaged in each interaction event."

"In our earlier work, we asked how long bees spend between events where they meet other bees, and we showed that they interact in a non-uniform way," said Goldenfeld. "Sang Hyun and I took the same data set, but now asked a different question: What about the duration of interaction events, not the time between interactions?"

In looking at the individual interactions, the time spent varied from short interactions to long interactions. Based on these observations, Choi developed a theory where bees exhibited an individual trait of attractiveness that could be likened to human interaction. For example, humans might prefer to interact with friends or family members rather than strangers.

"We developed a theory for this based on a very simple idea: if a bee is interacting with another bee, you can think of that as a sort of "virtual spring" between them," said Goldenfeld. "The strength of the spring is a measure of how attracted they are to each other so if the spring is weak, then the bees will quickly break the spring and go away, perhaps to find another bee with whom to interact. If the spring is strong, they may stay interacting longer. We call this theoretical description a minimal model, because it can quantitatively capture the phenomenon of interest without requiring excessive and unnecessary microscopic realism. Non-physicists are often surprised to learn that detailed understanding and predictions can be made with a minimum amount of descriptive input."

Goldenfeld explained that the mathematical framework for their theory originated from a branch of physics called statistical mechanics, originally developed to describe gas atoms in a container, and since extended to encompass all states of matter, including living systems. Choi and Goldenfeld's theory made correct predictions about the experimental honey bee dataset that was previously collected.

Out of curiosity, the theory was then applied to human datasets, revealing similar patterns as with the honey bee dataset. Choi and Goldenfeld then applied an economic measure for wealth and income disparities in humans -- termed the Gini coefficient -- to show that bees displayed disparities in attractiveness in their social interactions, although not as different as humans. These results indicate a surprising universality of the patterns of social interactions in both honey bees and humans.

"It is obvious that human individuals are different, but it is not so obvious for honey bees," said Choi. "Therefore, we examined the inequality in the activity level of the honey bees in a way that is independent of our theory to verify that honey bee workers are indeed different. Previous work done in our group has used the Gini coefficient to quantify the inequality in honey bee foraging activity so we thought that this method would also work to examine the inequality in trophallaxis activity."

"Finding such striking similarities between bees and humans spark interest in discovering universal principles of biology, and the mechanisms that underlie them," said Robinson.

The researchers' findings suggest that complex societies may have surprisingly simple and universal regularities, which can potentially shed light on the way that resilient and robust communities emerge from very different social roles and interactions. The researchers predict that their minimal theory could be applied to other eusocial insects since the theory does not involve honey bee-specific features.

In future studies, the same techniques from statistical mechanics can be applied to understand the cohesiveness of communities through well-characterized pair interactions, said Choi and Goldenfeld.

"This was my first project after I joined Nigel's group, and it took a long time for me to figure out the right way to approach the problem," said Choi. "It was fun and challenging to work on such an interdisciplinary project. As a physics student studying biological systems, I had never expected myself to use concepts from economics."

"It was very exciting to see how simple physical ideas could explain such a seemingly complex and widespread social phenomenon, and also give some organismal insights," said Goldenfeld. "I was very proud of Sang Hyun for having the persistence and insights to figure this out. Like all transdisciplinary science, this was a really tough problem to solve, but incredibly fascinating when it all came together. This is the sort of advance that arises from the co-location of different scientists within the same laboratory -- in this case the Carl R. Woese Institute for Genomic Biology."

Credit: 
Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign