Culture

INDIANAPOLIS - Researchers from Regenstrief Institute and Indiana University School of Medicine have conducted the first time-motion study in more than a decade to assess the impact of geographic cohorting of hospitalists.

Geographic cohorting -- restricting or localizing hospitalists and their patients to one or two inpatient units rather than having hospitalists travel from floor to floor, across wings or between buildings to care for patients -- is becoming increasingly popular with health care systems and hospitals. But what is the impact of this method of staffing?

The new time-motion study found potential benefits from geographic cohorting such as increased number of bedside visits and time spent by the hospitalist with patients, yet the researchers also reported that geographically cohorted hospitalists were observed to be interrupted more frequently than hospitalists caring for patients spread across the hospital. Cohorted hospitalists were also observed spending more time working on a computer.

"We found that there are definitely tradeoffs in having hospitalists focus on patients in one or two units rather than care for patients throughout the hospital," said study senior author and Regenstrief Institute research scientist Michael Weiner, M.D., MPH. "While patients and their families may be pleased that geographically cohorted hospitalists are not too far away so the doctor can spend time examining and evaluating the patient, explaining and engaging in shared decision-making, hospitalists assigned to only one or two units may not be working optimally as they are frequently interrupted because they are frequently present.

"Intriguingly, we don't yet know why geographically cohorted hospitalists spend more time on the computer than non-geographically cohorted counterparts," Dr. Weiner, a health services researcher, noted.

Much of the meaningful work that a hospitalist must accomplish takes time -- reviewing diagnostic test results, consulting with colleagues, conversing with nurses. It occurs away from the patient and requires the hospitalist to determine an appropriate balance between direct care at the bedside and indirect care during which the patient is not present. A significant percentage of hospitalists work an intense schedule of one week on followed by one week off and are often assigned 12-hour shifts.

Hospital medicine is the fastest growing medical specialty with more and more hospitals and health care systems employing hospitalists, physicians who work exclusively in hospitals, to care for inpatients.

"Our study paints a unique picture that we need to be aware of, explore and address to make the maturing specialty of hospital medicine better for patients and hospitalists," said study corresponding author Areeba Kara, M.D., M.S., an IU School of Medicine assistant professor of clinical medicine. "Knowing what goes on during the workday of geographically cohorted hospitalists and contrasting that with what non-geographically restricted hospitalists encounter on the job will help researchers and administrators enable hospitalists to carry out their patient care missions at the highest level possible." Dr. Kara has been a hospitalist with IU Health since 2003.

EAST LANSING, Mich. - Michigan State University's Sleep and Learning Lab has conducted one of the largest sleep studies to date, revealing that sleep deprivation affects us much more than prior theories have suggested.

Published in the Journal of Experimental Psychology: General, the research is not only one of the largest studies, but also the first to assess how sleep deprivation impacts placekeeping - or, the ability to complete a series of steps without losing one's place, despite potential interruptions. This study builds on prior research from MSU's sleep scientists to quantify the effect lack of sleep has on a person's ability to follow a procedure and maintain attention.

"Our research showed that sleep deprivation doubles the odds of making placekeeping errors and triples the number of lapses in attention, which is startling," Fenn said. "Sleep-deprived individuals need to exercise caution in absolutely everything that they do, and simply can't trust that they won't make costly errors. Oftentimes - like when behind the wheel of a car - these errors can have tragic consequences."

By sharing their findings on the separate effects sleep deprivation has on cognitive function, Fenn - and co-authors Michelle Stepan, MSU doctoral candidate and Erik Altmann, professor of psychology - hope that people will acknowledge how significantly their abilities are hindered because of a lack of sleep.

"Our findings debunk a common theory that suggests that attention is the only cognitive function affected by sleep deprivation," Stepan said. "Some sleep-deprived people might be able to hold it together under routine tasks, like a doctor taking a patient's vitals. But our results suggest that completing an activity that requires following multiple steps, such as a doctor completing a medical procedure, is much riskier under conditions of sleep deprivation."

The researchers recruited 138 people to participate in the overnight sleep assessment; 77 stayed awake all night and 61 went home to sleep. All participants took two separate cognitive tasks in the evening: one that measured reaction time to a stimulus; the other measured a participant's ability to maintain their place in a series of steps without omitting or repeating a step - even after sporadic interruptions. The participants then repeated both tasks in the morning to see how sleep-deprivation affected their performance.

"After being interrupted there was a 15% error rate in the evening and we saw that the error rate spiked to about 30% for the sleep-deprived group the following morning," Stepan said. "The rested participants' morning scores were similar to the night before.

"There are some tasks people can do on auto-pilot that may not be affected by a lack of sleep," Fenn said. "However, sleep deprivation causes widespread deficits across all facets of life."

More and more bacterial pathogens of infectious diseases become resistant to customary antibiotics. Typical hospital germs such as Escherichia coli and Klebsiella pneumoniae have become resistant to the most - and in some cases even all - currently available antibiotics. Their additional external membrane makes these bacteria difficult to attack. It protects the bacteria particularly well by preventing many substances from getting into the cell interior. Especially for the treatment of diseases caused by these so-called gram negative bacteria, there is a lack of new active substances. An international team of researchers, with the participation of scientists from Justus Liebig University Giessen (JLU), has now discovered a novel peptide, that attacks gram negative bacteria at a previously unknown site of action.

"Since the 1960s scientists have not succeeded in developing a new class of antibiotics effective against gram negative bacteria, but this could now be possible with the help of this peptide," said Prof. Till Schäberle from the Institute of Insect Biotechnology at JLU and project leader at the DZIF. His research group is involved in the discovery. The researchers use a screening, a classical approach from the natural product research. Thereby the team of Prof. Kim Lewis, Northeastern University in Boston, Massachusetts (USA), tested extracts of bacterial symbionts of insect-pathogenic nematodes to verify the activity against E. coli. Thus, the researchers were able to isolate a peptide that they have called Darobactin.

Darobactin consists of seven amino acids and shows structural characteristics. Several amino acids are linked via unusual ring closures. The substance shows no cell toxicity - a prerequisite for the use as an antibiotic. "We have already been able to gain insights about how the bacteria synthesize this molecule," said Prof. Schäberle. "Currently we are working in the field of natural product research at the Institute of Insect Biotechnology of the JLU to increase the production of this substance and to generate analogues."

The researchers also determined the site of action of Darobactin. They found that Darobactin binds to the BamA protein, located in the external membrane of gram negative bacteria. As a result, the establishment of a functional external membrane is disrupted and the bacteria die off. "It is particularly interesting to note that this previously unknown weak point is located on the outside of the bacteria where substances can easily reach it," explains Prof. Schäberle.

Darobactin exhibited an excellent effect in the case of infections with both wild-type, as well as antibiotic-resistant Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae strains. Thus, Darobactin presents a very promising lead substance for the development of a new antibiotic. The urgency of this matter is also emphasised by the fact that the World Health Organisation (WHO) has attributed the necessity of research and development against resistant pathogens the highest priority for human health.

Can ethics be taught? New research suggests yes, offering the first large-sample study on how rules and ethics training affects behavior and employment decisions in the financial sector.

"Can Ethics be Taught? Evidence from Securities Exams and Investment Adviser Misconduct" is forthcoming in the Journal of Financial Economics from Zachary Kowaleski, assistant professor of accountancy in the University of Notre Dame's Mendoza College of Business, along with Andrew Sutherland from the MIT Sloan School of Management and Felix Vetter, a doctoral candidate at the London School of Economics.

"Skeptics often criticize the lack of empirical evidence that shows ethics training works," Kowaleski says. "A key barrier has been difficulty observing both training and subsequent behavior. We overcome this barrier by using a change to the ethics content on a qualification exam and an investment adviser's record of misbehavior."

The researchers studied nearly 1.2 million investment advisers and financial representatives working at U.S. broker-dealers between 2007 and 2017, with a focus on the consequences of a 2010 change in the investment adviser qualification exam. That year, coverage shifted from the rules and ethics section to the technical material section. The rules and ethics section covers allowable forms of compensation, disclosure requirements and prohibitions of unethical business practices, while the technical section covers such topics as capital market theory, investment vehicle characteristics, ratios and financial reporting. Prior to the change, rules and ethics questions received an 80 percent weight. After the change, they were weighted only 50 percent.

The authors compared individuals with similar current employers, locations, qualifications and experience, but who took different versions of the exam.

They discovered those passing the older exam containing more rules and ethics coverage were one-fourth less likely to commit misconduct, including obvious offenses such as fraud, theft or deception. This reveals the exam alters individuals' perception of acceptable conduct and not just their awareness of specific rules.

Kowaleski notes it's surprising to see an effect.

"Behavioral ethics research shows that business people often do not recognize when they are making ethical decisions," he says. "They approach these decisions by weighing costs and benefits, and by using emotion or intuition."

These results are consistent with the exam playing a "priming" role, where early exposure to rules and ethics material prepares the individual to behave appropriately later. Those passing the exam without prior misconduct appear to respond most to the amount of rules and ethics material covered on their exam. Those already engaging in misconduct, or having spent several years working in the securities industry, respond least or not at all.

The study also examines what happens when people with more ethics training find themselves surrounded by bad behavior, revealing these individuals are more likely to leave their jobs.

"We study this effect both across organizations and within Wells Fargo, during their account fraud scandal," Kowaleski explains. "That those with more ethics training are more likely to leave misbehaving organizations suggests the self-reinforcing nature of corporate culture."

Kowaleski studies the effect of the institutional setting on behavior. He previously worked in PwC's audit practice, and served as an economic research fellow, studying broker-dealer audits, at the Public Company Accounting Oversight Board.

Farmers rely on seed systems for access to high-quality, disease-free planting material at the start of the season. Good seed systems ensure access to seed for a variety of crops that are affordable and fully available at the start of the season. Unfortunately, this is not a reality for many smallholder farmers in developing countries, where seed systems often serve as conduits for the spread of crop disease.

Orange-fleshed sweet potatoes are an important source of Vitamin A and a staple crop for Uganda, which is why researchers analyzed a sweet potato system in Northern Uganda for its resilience to potential introduction of a pathogen. This research evaluated the important sellers and villages in the Gulu region, analyzing their potential role for spreading disease and distributing improved varieties of seed. The research team included scientists at University of Florida and Gulu University, as part of the CGIAR Research Program on Roots, Tubers and Bananas and with support from the Bill and Melinda Gates Foundation.

The researchers used this data for "War Room" style simulation analyses that highlighted the potential paths that a pathogen could take in advance of its spread. This analysis identified the villages that were best for surveillance and the best for management, in order to effectively slow pathogen spread. Their results showed that villages key for surveillance and for management were not necessarily the same.

"This is an important practical finding, as when a new pathogen is introduced into a region there is often a tradeoff between resources allocated to surveillance to detect new occurrences of the disease and to management to slow the epidemic," said Kelsey Andersen, the lead author of the study. "The findings of our study suggest that selecting locations should be done strategically to maximize the ability to stop or slow an epidemic," said Karen Garrett, the senior author of the study.

The methods developed in this research can be applied to other plant diseases. For example, some of this research team are now applying the methods to cassava mosaic disease that is currently threatening cassava production in Southeast Asia. Similar modeling approaches can also be applied to the management of animal or human epidemics, such as the ongoing Ebola epidemic in Sub-Saharan Africa.

Emerging pathogens have the potential to spread rapidly and, because of this, methods like the one developed in this research are necessary to strategically and quickly deploy management strategies and detect the occurrence of new diseases.

MIT researchers have invented a way to efficiently optimize the control and design of soft robots for target tasks, which has traditionally been a monumental undertaking in computation.

Soft robots have springy, flexible, stretchy bodies that can essentially move an infinite number of ways at any given moment. Computationally, this represents a highly complex "state representation," which describes how each part of the robot is moving. State representations for soft robots can have potentially millions of dimensions, making it difficult to calculate the optimal way to make a robot complete complex tasks.

At the Conference on Neural Information Processing Systems next month, the MIT researchers will present a model that learns a compact, or "low-dimensional," yet detailed state representation, based on the underlying physics of the robot and its environment, among other factors. This helps the model iteratively co-optimize movement control and material design parameters catered to specific tasks.

"Soft robots are infinite-dimensional creatures that bend in a billion different ways at any given moment," says first author Andrew Spielberg, a graduate student in the Computer Science and Artificial Intelligence Laboratory (CSAIL). "But, in truth, there are natural ways soft objects are likely to bend. We find the natural states of soft robots can be described very compactly in a low-dimensional description. We optimize control and design of soft robots by learning a good description of the likely states."

In simulations, the model enabled 2D and 3D soft robots to complete tasks -- such as moving certain distances or reaching a target spot --more quickly and accurately than current state-of-the-art methods. The researchers next plan to implement the model in real soft robots.

Joining Spielberg on the paper are CSAIL graduate students Allan Zhao, Tao Du, and Yuanming Hu; Daniela Rus, director of CSAIL and the Andrew and Erna Viterbi Professor of Electrical Engineering and Computer Science; and Wojciech Matusik, an MIT associate professor in electrical engineering and computer science and head of the Computational Fabrication Group.

"Learning-in-the-loop"

Soft robotics is a relatively new field of research, but it holds promise for advanced robotics. For instance, flexible bodies could offer safer interaction with humans, better object manipulation, and more maneuverability, among other benefits.

Control of robots in simulations relies on an "observer," a program that computes variables that see how the soft robot is moving to complete a task. In previous work, the researchers decomposed the soft robot into hand-designed clusters of simulated particles. Particles contain important information that help narrow down the robot's possible movements. If a robot attempts to bend a certain way, for instance, actuators may resist that movement enough that it can be ignored. But, for such complex robots, manually choosing which clusters to track during simulations can be tricky.

Building off that work, the researchers designed a "learning-in-the-loop optimization" method, where all optimized parameters are learned during a single feedback loop over many simulations. And, at the same time as learning optimization -- or "in the loop" -- the method also learns the state representation.

The model employs a technique called a material point method (MPM), which simulates the behavior of particles of continuum materials, such as foams and liquids, surrounded by a background grid. In doing so, it captures the particles of the robot and its observable environment into pixels or 3D pixels, known as voxels, without the need of any additional computation.

In a learning phase, this raw particle grid information is fed into a machine-learning component that learns to input an image, compress it to a low-dimensional representation, and decompress the representation back into the input image. If this "autoencoder" retains enough detail while compressing the input image, it can accurately recreate the input image from the compression.

In the researchers' work, the autoencoder's learned compressed representations serve as the robot's low-dimensional state representation. In an optimization phase, that compressed representation loops back into the controller, which outputs a calculated actuation for how each particle of the robot should move in the next MPM-simulated step.

Simultaneously, the controller uses that information to adjust the optimal stiffness for each particle to achieve its desired movement. In the future, that material information can be useful for 3D-printing soft robots, where each particle spot may be printed with slightly different stiffness. "This allows for creating robot designs catered to the robot motions that will be relevant to specific tasks," Spielberg says. "By learning these parameters together, you keep everything as synchronized as much as possible to make that design process easier."

Faster optimization

All optimization information is, in turn, fed back into the start of the loop to train the autoencoder. Over many simulations, the controller learns the optimal movement and material design, while the autoencoder learns the increasingly more detailed state representation. "The key is we want that low-dimensional state to be very descriptive," Spielberg says.

After the robot gets to its simulated final state over a set period of time -- say, as close as possible to the target destination -- it updates a "loss function." That's a critical component of machine learning, which tries to minimize some error. In this case, it minimizes, say, how far away the robot stopped from the target. That loss function flows back to the controller, which uses the error signal to tune all the optimized parameters to best complete the task.

If the researchers tried to directly feed all the raw particles of the simulation into the controller, without the compression step, "running and optimization time would explode," Spielberg says. Using the compressed representation, the researchers were able to decrease the running time for each optimization iteration from several minutes down to about 10 seconds.

The researchers validated their model on simulations of various 2D and 3D biped and quadruped robots. They researchers also found that, while robots using traditional methods can take up to 30,000 simulations to optimize these parameters, robots trained on their model took only about 400 simulations.

Deploying the model into real soft robots means tackling issues with real-world noise and uncertainty that may decrease the model's efficiency and accuracy. But, in the future, the researchers hope to design a full pipeline, from simulation to fabrication, for soft robots.

NASA's Terra satellite captured an image of Tropical Storm Fung-Wong as it continued weakening in the Northwestern Pacific Ocean.

In the Philippines, tropical cyclone warning Signal #1 was in effect for the Luzon province of Batanes on Nov. 21 as the storm tracks northward and away from the Philippines. The storm is expected to stay to the east of Taiwan and affect the northeastern part of the country.

On Nov. 21, the Moderate Resolution Imaging Spectroradiometer or MODIS instrument that flies aboard NASA's Terra satellite provided a visible image of Fung-Wong. The MODIS image showed strong thunderstorms around the low-level center of circulation. The Joint Typhoon Warning Center noted, "A microwave image that depicts tight shallow banding wrapping into a defined low level circulation center with deep convection (strong rising air that forms the clouds and storms that make up a tropical cyclone) sheared to the northeast due to strong southwesterly flow aloft."

At 10 a.m. EST (1500 UTC) on Nov. 21, Tropical Storm Fung-Wong was located near latitude 21.1 degrees north and longitude 124.2 degrees east which is 379 nautical miles south-southwest of Kadena Air Base, Okinawa Island, Japan. Fung-Wong is moving to the north and had maximum sustained winds of 55 knots (63 mph/102 kph).

The Central Weather Bureau of Taiwan issued an "Extremely Heavy Rain Advisory" for the extreme northeastern part of the country. That includes Keelung North Coast, New Taipei City Mountain Area, and the Taipei City Mountain Area and Yilan County.

A Strong Wind Advisory was also issued for Keelung North Coast, New Taipei City, Taoyuan City, Hsinchu City, Hsinchu County, Miaoli County, Taichung City, Changhua County, Yunlin County, Chiayi County, Tainan City, Hengchun Peninsula, Yilan County, Hualien County, Taitung County, Lanyu and Ludao Islands, Penghu County, Kinmen Area, and the Matsu Area.

Fung-Wong is moving north and weakening rapidly.

NASA's Terra satellite is one in a fleet of NASA satellites that provide data for hurricane research.

Typhoons and hurricanes are the most powerful weather event on Earth. NASA's expertise in space and scientific exploration contributes to essential services provided to the American people by other federal agencies, such as hurricane weather forecasting.

BIRMINGHAM, Ala. - Charitharth Vivek Lal, M.D., and University of Alabama at Birmingham colleagues have used a novel and first-of-its-kind newborn mouse model to study the effect of high oxygen concentrations, or hyperoxia, on lung development of newborn mice that are germ-free -- meaning no microbes colonizing their lungs.

Their goal is to learn how differences in the types of microbes that already colonize human lungs at birth -- including extremely premature infants -- can protect or make an infant more susceptible to bronchopulmonary dysplasia, or BPD. BPD is a chronic, life-threatening lung disease of prematurity.

Lal, an associate professor in the UAB Pediatrics Division of Neonatology, has previously shown that an early microbial imbalance, or dysbiosis, is predictive for the development of BPD in extremely low birth-weight infants. These infants, who had an average birthweight of 1 pound, 8 ounces, often needed to be given high concentrations of oxygen because their lungs had not fully developed.

"For the current study, we hypothesized that the lungs of germ-free mice would have an exaggerated phenotypic response to hyperoxia compared to non-germ-free mice," Lal said. "Instead, we found that germ-free mice in hyperoxia showed protected lung structure, lung mechanics and decreased markers of inflammation compared to non-germ-free mice."

The hyperoxia conditions were 85 percent oxygen. In room air, which is 21 percent oxygen, both the germ-free mice and non-germ-free mice had normal lung development.

Why the partial protection for the germ-free newborns under hyperoxia?

Lal speculates that presence of some pathogenic bacterial in the non-germ-free mice may promote BPD pathogenesis through pro-inflammatory signaling and inflammation from neutrophils in the lungs. "Manipulation of the airway microbiome," Lal said, "may be a potential therapeutic intervention in BPD and other lung diseases."

In an editorial accompanying Lal's study in the American Journal of Physiology-Lung, Cellular and Molecular Physiology, Kent Willis, M.D., University of Tennessee-Memphis, said, "This report sets the stage for future studies evaluating complex processes involved in microbiome effects on lung development and injury. It would be essential to evaluate the effect of specific microbiome colonization on BPD pathogenesis in a germ-free model, in addition to assessing the efficacy of microbial transplantation in devising therapeutic strategies."

In general, Lal and colleagues found that germ-free mice had decreased hyperoxia-induced lung injury as compared to non-germ-free mice, as measured by enlarged alveolar spaces with diminished septation; the germ-free newborns had better lung function in hyperoxia, as measured by lung resistance and total lung compliance; and the germ-free mice had decreased inflammation, as measured by myeloperoxidase, interleukin 1-beta and interferon-gamma.

"We speculate that the presence of predisposing pathogenic microbiota in non-germ-free and humanized mice may accentuate the proinflammatory cascade in hyperoxia, thus leading to a worse phenotype as compared to germ-free animals," Lal said. "In the absence of these pathogenic microbiota, germ-free animals may not mount the inflammatory response and hence may have relative phenotypic protection. This finding is consistent with our previous human neonatal airway microbiome study where we found increased neutrophilic activity and a dysbiotic airway microbiome with proteobacterial preponderance in severe BPD patients."

A study out of the University of Arkansas investigated whether bulbs can flower and persist in warm-season lawns while providing nutrition for pollinating insects.

Michelle Wisdom, Michael Richardson, Douglas Karcher, Donald Steinkraus, and Garry McDonald sought to determine the parameters by which bulbs can survive and be serviceable beyond their peak seasons.

Their findings are illustrated in the article "Flowering Persistence and Pollinator Attraction of Early-Spring Bulbs in Warm-season Lawns" as published in HortScience.

Early-spring flowering bulbs can increase biodiversity while adding color to lawns and other grassy areas. Flowering bulbs are known to naturalize in grassy areas such as meadows and pastures, but they must be vigorous enough to compete with the grass, and grass systems must be managed in a way to not damage the bulbs. It can be a delicate balance.

Thirty early-spring flowering bulbs were established in bermudagrass and buffalograss lawns in late August. Those bulbs were then assessed over three growing seasons for flowering characteristics, persistence, and their ability to attract pollinating insects.

A growing degree-day model was also developed to predict peak flowering times. Numerous bulb entries produced abundant flowers in both bermudagrass and buffalograss lawns in the first year after planting, but persistence and flower production were reduced in both the second and third years of the trial.

Among the useful results from this study was to discover a possible method for slowing the phenomenon of pollinator decline. Pollinator decline has been widely documented in recent years and has been associated with habitat and biodiversity loss, wide-spread planting of monocultures, pesticide usage, pollinator pests and diseases, and climate change.

Pollinator health is enhanced when diverse floral resources are available throughout the seasons when pollinators are active. "Establishing a season-long succession of flowers is critical in providing forage for pollinating insects throughout the growing season, which coincides with their life cycles" says Wisdom. "We observed pollinator activity on species of Crocus and Muscari (grape hyacinth) from January-March, providing honey bees with pollen and nectar during normal times of severe food shortage.'' Significant expanses of managed turfgrass, such as roadsides, cemeteries, and lawns, represent land areas that might be designed and managed to support pollinating insects.

Some flowering bulbs, such as crocus and grape hyacinth, have been documented to provide forage resources for honey bees in early spring, but information on pollinator preference over a wide range of bulbs is limited.

Native bees and other pollinators are typically not active during late winter months, but honey bees will forage on mild winter days, although they may be limited by temperature to short-distance flights.

Five bulbs persisted for multiple years in both turfgrass species and continued to produce flowers, including crocus, spring snowflake, daffodil, Narcissus 'Rip Van Winkle', and Narcissus 'Tete-a-Tete'. Several bulbs, primarily crocuses and grape hyacinth, were also observed to attract pollinating insects, principally honey bees.

The researchers demonstrated that some early-spring bulbs can persist in competitive warm-season lawns, providing pollinator forage, but species and cultivar selection is critical for long-term success. Wisdom says, "As not all flowers provide nutrition to pollinating insects, make certain to incorporate proven forage sources into the landscape."

Financial therapy - a relatively new field that combines the emotional support of a marriage counselor with the money mindset of a financial planner -- could help couples navigate disagreements, money concerns and financial conflicts before these issues tear relationships apart.

"Money is a big thing and ignoring it is impeding satisfaction in relationships," said Megan Ford, a couples and financial therapist at the University of Georgia who studies money and relationship satisfaction. "Therapists need to work together to solve problems that occur around financial behaviors of couples and learn how to connect to all of their emotions."

Ford, the clinical director of the ASPIRE Clinic at UGA that provides counseling and educational services, including financial therapy, is collaborating with John Grable, Athletic Association Endowed Professor of Family and Consumer Sciences. The two are exploring what influence financial therapy can have on relationship outcomes and how gaining a better understanding of these issues might affect a couple's decision to seek help from a financial planner and a family therapist.

The duo has been studying the issue for the past decade and believe that financial therapy improves a couple's overall well-being and financial stability if they understand that many financial behaviors are tied to feelings and beliefs.

Grable, a financial planner, was involved in starting the Financial Therapy Association in 2008 and Ford, a graduate student at the time, worked as a financial therapist at the country's first financial therapy clinic, started at Kansas State University with help from Grable.

In their most recent study at UGA, published in Contemporary Family Therapy, Ford and Grable worked with six couples, ranging in age from 21-76, who shared their financial goals with a family therapist and financial planner and discussed how their money history related to their current situation.

In three, 30-50-minute sessions over five weeks, the couples were encouraged to talk about their feelings regarding money in a nonjudgmental space. Afterward, nearly all of those who participated said they wanted to learn more about their financial behaviors, realized they needed to communicate better and would consider seeking the help of a financial planner.

"One woman was close to tears listening to her husband explain an early memory in their relationship about money that she didn't understand at the time," Grable said. "The story helped explain his odd behavior that she always thought of as just being mean. They left clearly closer emotionally and financially feeling more powerful."

The two researchers said there is a lot of anecdotal information about how the inability of couples to talk about their financial goals, money history or past experiences causes serious relationship problems but not much concrete evidence-based research to back it up.

"The No. 1 reason for arguments is often money," Ford said. "We know it and believe it but there is not a huge body of literature on the topic."

Although there are more than 80,000 certified financial planners and 50,000 family therapists in the United States, the FTA - which just began a certification program in 2019 - lists less than 50 certified financial therapists throughout the country, a figure the two UGA researchers think needs to increase.

Since money can be such an emotional trigger, they believe that financial therapy - even just a few sessions - needs to be incorporated into a family therapist's practice because financial planners, like Grable, are not traditionally trained to deal with the psychological issues that surrounds money.

"I'm a financial planner; I love money," said Grable. "But the last thing I want to happen is a couple coming in crying or yelling. I'm uncomfortable with that, it makes me nervous. That's why we need therapists trained in this area."

ABERDEEN PROVING GROUND, Md. (Nov. 21, 2019) -An Army-led research team developed new algorithms and filled in knowledge gaps about how robots contribute to teams and what robots know about their environment and teammates.

Dr. Kristin Schaefer-Lay, an engineer with the U.S. Army Combat Capabilities Development Command's Army Research Laboratory, is part of a multidisciplinary team of reseachers from the Army, Carnegie Mellon University, University of Minnesota and the University of Central Florida -- amongst others, who developed specific algorithms and novel artificial intelligence approaches to support the development of a shared context between team members through effective bidirectional communication.

"The idea of integrating context to AI development is a difficult process," Schaefer-Lay said. "Researchers tend to have very different ideas about what is meant by context and the best practices for integrating context into AI development."

A number of researchers and institutions have looked a smaller pieces of this problem set, but this team looked at a more holistic approach for how to develop and integrate different types of context related to environmental context, mission context and social context to advance human-autonomy teaming through advanced bidirectional communication capabilities.

This has directly advanced science in robotics and AI processes in the areas of natural language communication, world model development, multi-modal communication and human-autonomy teaming, Schaefer-Lay said.

The collaborative team seeks to identify critical scientific advances made by the Army's Robotics Collaborative Technology Alliance, or RCTA, on techniques for developing and advancing context-driven artificial intelligence to support future human-autonomy teams.

Strategic investments in Army-led foundational research as part of the RCTA resulted in advanced science in four critical areas of ground combat robotics that effect the way U.S. Warfighters see, think, move and team. This research supports the Army Modernization Priority for the Next Generation Combat Vehicle by advancing science for integrating context-driven artificial intelligence within human-autonomy teams.

"Government investment in ground combat robotics is critical to ensuring U.S. maneuver forces maintain a marked combat advantage," Schaefer-Lay said.

The researchers published their findings in the Sept. 30, 2019, edition of the AI Magazine as part of an invited issue on AI and Context: "Integrating Context into Artificial Intelligence: Research from the Robotics Collaborative Technology Alliance."

Integration of context-driven AI is important for future robotic capabilities to support the development of situation awareness, calibrate appropriate trust, and improve team performance in collaborative human-robot teams.

This article highlights advances in context-driven AI for human-robot teaming.

Avenues of research discussed include how context enables robots to fill in the gaps to make effective decisions more quickly, supports more robust behaviors, and augments robot communications to suit the needs of the team under a variety of environments and team organizations and across missions.

The article''s findings will be used to support the laboratory's continued research in the Human-Autonomy Teaming Essential Research Program. In particular, this research will help to develop effective bidirectional communication methods and interventions for calibrating appropriate team trust and shared situation awareness in high risk, complex operations.

It is not enough to just develop new algorithms and approaches, Schaefer-Lay said, "but it is important to understand the impact these have on effective teaming across operations."

The advancement of this research line will extend to include larger teams and crew station technologies that support the Next Generation Combat Vehicle, she said.

WEST LAFAYETTE, Ind. -- The gas turbines powering aircraft engines rely on ceramic coatings that ensure structural stability at high temperatures. But these coatings don't control heat radiation, limiting the performance of the engine.

Researchers at Purdue University have engineered ceramic "nanotubes" that behave as thermal antennas, offering control over the spectrum and direction of high-temperature heat radiation.

The work is published in Nano Letters, a journal by the American Chemical Society. An illustration of the ceramic nanotubes will be featured as the journal's supplementary cover in a forthcoming issue.

"By controlling radiation at these high temperatures, we can increase the lifetime of the coating. The performance of the engine would also increase because it could be kept hotter with more isolation for longer periods of time," said Zubin Jacob, an associate professor of electrical and computer engineering at Purdue.

The work is part of a larger search in the field for a wide range of materials that can withstand higher temperatures. In 2016, Jacob's team developed a thermal "metamaterial" - made of tungsten and hafnium oxide - that controls heat radiation with the intention of improving how waste heat is harvested from power plants and factories.

A new class of ceramics would expand on ways to more efficiently use heat radiation.

Jacob's team, in collaboration with Purdue professors Luna Lu and Tongcang Li, built nanotubes out of an emerging ceramic material called boron nitride, known for its high thermal stability.

These boron nitride nanotubes control radiation through oscillations of light and matter, called polaritons, inside the ceramic material. High temperatures excite the polaritons, which the nanotubes - as antennas - then couple efficiently to outgoing heat radiation.

The antennas could bring the ability to accelerate the radiation, perform enhanced cooling of a system or send information in very specific directions or wavelengths, Jacob said.

The researchers plan to engineer more ceramic materials with polaritonic features for a host of different applications.

"Polaritonic ceramics can be game changing and we want them to be used widely," Jacob said.

This research was performed in the Purdue Discovery Park Birck Nanotechnology Center and is supported through Nascent Light-Matter Interactions, a program by the Defense Advanced Research Projects Agency. The program is led by Purdue University's School of Electrical and Computer Engineering.

Despite restrictions on paid advertising cannabis on social media, most teenagers reported seeing marijuana marketing on Facebook, Twitter and Instagram, according to a public health study authored by University of Massachusetts Amherst injury prevention researcher Jennifer Whitehill.

Some 94% of adolescents surveyed said they had been exposed to marijuana marketing either on social media, print media or on a billboard. Because cannabis is an illegal drug under federal law, federal restrictions prohibit or severely restrict cannabis companies from running ads, even in states where marijuana sales have been legalized for adults age 21 and over. Nationwide, as with alcohol, the sale of marijuana to anyone under age 21 is illegal. For both alcohol and marijuana marketing, additional state and federal advertising regulations exist, especially when a certain portion of the audience is under the age of 21. Facebook, Twitter and Instagram prohibit marijuana ads, but cannabis companies can develop a social media presence by establishing a business profile and sharing posts and tweets.

These are the latest findings from the first U.S. study to examine youth exposure to marijuana marketing in states that have legalized cannabis for adult recreational use. Whitehill and colleagues found that exposure to marijuana marketing on social media is not only widespread but also associated with recent use of marijuana by adolescents. For example, teens who reported seeing marijuana promotions on Instagram were more than twice as likely to have used marijuana in the past year, compared to youth who did not see such promotions.

The research, published in the Journal of Adolescent Health, suggests that "current restrictions on social media content do not go far enough because it's clearly making its way to youth," says Whitehill, assistant professor of health promotion and policy in the School of Public Health and Health Sciences. Whitehill is part of the Cannabis Advertising and Social Media study team, led by Dr. Megan Moreno, professor of pediatrics at the University of Wisconsin School of Medicine and Public Health. The investigative team also includes researchers from the Boston University School of Public Health and the University of North Carolina at Chapel Hill.

"Youth who can't buy or use non-medical marijuana shouldn't have to see these promotions, particularly on a platform like Instagram, whose audience is mostly youth," Moreno says. A related study by the same team looking at social media engagement, rather than exposure, found that one in three youth in states with legal recreational marijuana engage with marijuana brands by following, liking or otherwise interacting with them. This social media engagement was linked to higher rates of marijuana use.

The investigators point out that "decades of research on alcohol and tobacco - other legal substances with abuse potential - show strong correlations between youth exposure to marketing and both earlier initiation and higher consumption among those already using."

With retail cannabis shops already operating in seven states and the $10 billion-plus cannabis market expected to grow as more states follow suit, the impact of cannabis marketing - especially in the understudied social media arena - has crucial public health implications and requires further study, Whitehill says.

Using an online panel, the study surveyed 469 youth, ages 15 to 19, in California, Colorado, Nevada and Washington - four of the 11 states with legalized adult marijuana use. Participants were asked about their social media use, marijuana use and exposure to marijuana marketing. "First we found out what social media platforms they used, and then we asked, when you use this platform, do you see marijuana ads or promotions," Whitehill explains.

Tellingly, more youth reported seeing marijuana promotions on social media than billboards. "Across marijuana users and nonusers, 73% said they had seen marijuana advertisements outdoors on billboards," Whitehill says. "But the figure was even higher on social media, with 79% reporting exposure - even in a space where they are not supposed to be seeing cannabis marketing."

The study was co-authored by Pamela Trangenstein of the University of North Carolina, David Jernigan of Boston University and Marina Jenkins of the University of Wisconsin.

The researchers conclude, "Current policies to help prevent exposure to cannabis marketing online are not effective. While larger, longitudinal studies about exposure to cannabis marketing on social media and onset of adolescent cannabis use are needed, states should consider adopting the most restrictive cannabis marketing policies feasible, combined with an accountability and enforcement infrastructure that will help protect the current generation of adolescents."

East Hanover, NJ. November 21, 2019. A team of researchers published new findings about the role of sensory processing and disease characteristics in the functional status of individuals with multiple sclerosis. This is one of the first studies to look at the implications of sensory processing deficits in this population. The article, "The role of sensory processing difficulties, cognitive impairment, and disease severity in predicting functional behavior among patients with multiple sclerosis", (doi: 10.1080/09638288.2019.1653998) was epublished on August 27, 2019 by Disability and Rehabilitation.

The authors are Batya Engel-Yeger, PhD, OT, of the University of Haifa, John DeLuca, PhD, and Patrick Hake of Kessler Foundation, and Yael Goverover, OTR/L, PhD, of New York University and Kessler Foundation. Link to abstract: https://www.tandfonline.com/doi/full/10.1080/09638288.2019.1653998

Little research has been done on the sensory processing difficulties affecting persons with multiple sclerosis, and the impact of these difficulties on their daily activities. This team of researchers examined the association between sensory processing deficits and cognitive impairments in individuals with MS, and the effects of sensory processing difficulties on functional behavior and disease severity.

Researchers enrolled 61 participants with multiple sclerosis, aged 23 to 63 years, and 36 healthy controls. The MS participants comprised 43 participants with cognitive impairments and 18 without impairments. Data collected included the Adolescent/Adult Sensory Profile, Functional Behavior Profile, and MS Functional Composite scores. Testing revealed the presence of differences in sensory processing including low ability to register sensory input, high sensory sensitivity, and sensory avoidance.

Compared with healthy controls, the participants with MS were more likely to score higher on tests for sensory difficulties; there were no differences between the two MS groups. For the functional behavior profile, the control group had higher scores than both MS groups. Analyses of sensory findings, cognitive status, functional behavior profiles and disease severity showed a lack of effect of cognitive status on functional behavior. Disease severity and sensory processing deficits, however, did affect functional performance of everyday life activities.

"This study underscores the influence of sensory processing in MS, and the importance of screening patients for these disorders," said Dr. Goverover. "Further research is needed to explore whether sensory processing difficulties could be of predictive value for disease severity and cognitive decline," she continued. "This approach may lead to interventions that improve function and support the full participation of people with MS in everyday life."

MINNEAPOLIS, MN- November 21, 2019 - New University of Minnesota Medical School research finds postpartum women are generally getting prescribed more narcotics than they need.

The study, co-authored by Cresta Jones, MD, FACOG, who is an associate professor in the Department of Obstetrics, Gynecology and Women's Health, was published in "American Journal of Obstetrics & Gynecology MFM." Designed to evaluate what is being done to treat women's pain after delivery in different types of hospitals across the country, the study looked at what medications are being prescribed, how much of those medications are being prescribed and if there are differences between hospitals, as well as between providers within those hospitals.

Dr. Jones found that there is a huge opportunity for improving patient care after deliveries. Her research showed very apparent, regional differences for what is being prescribed and how much of those medications are being prescribed. However, despite those differences, she found that there is a general trend among all hospitals of patients being prescribed more narcotics after delivery than they need, leaving them with excess pills.

"Before we are able to attack the nationwide opioid problem, we need to know where the problem is," Dr. Jones said. "We need to figure out what is going on in different places throughout the country when it comes to postpartum opioid prescriptions, and then use that information to initiate further research that figures out the appropriate prescription standards for women after delivery."

Dr. Jones believes that establishing a standard guideline will keep patients and their families safer.

"We know that a small percentage of women who leave the hospital with opioids can go on to develop opioid use disorder. We also know that many individuals who suffer from opioid misuse from prescription pills get them from friends and family," she said. "We don't want to increase that problem."

A standard guideline would allow patients to get the medications they need without putting them and their families in danger of unnecessary opioids.

"Our hope is to eventually adopt a standard guideline for postpartum opioid prescriptions, so we can train the next generation of new learners in the medical field to use the right amount of opioids and keep our patients safe," Dr. Jones said.