Culture

TAMPA, Fla. (March 5, 2019)- More than 50 children died in hot cars in 2018, making it the deadliest year on record. Many of the cases involve parents who unknowingly left a child behind, often for an entire day. University of South Florida Psychology Professor David Diamond has studied this phenomenon for over a decade and has served as an expert witness on many high-profile cases. In his latest publication, he describes the psychological and neural basis of how responsible people make such fatal errors.

His study, published in Medicine, Science and the Law, explains how the brain can fail to remember to do something in the future (prospective memory). Examples of prospective memory are remembering to call a friend after lunch or to stop at the store on the way home from work, as well as prospective memory errors which result in a loss of life, in airplane crashes and when children are forgotten in cars. Diamond described how the frontal and parietal cortices allow us to use stored information to make a plan and then to execute that plan in the future. The hippocampus is critical for consciously remembering to retrieve the memory and that the task was completed. The basal ganglia enable us to go into an "autopilot" mode, in which we follow a well-traveled route, but in the process, lose awareness of the plan to take the child to daycare.

According to Diamond, as someone goes into an 'autopilot' mode, habitual behavior, such as getting ready for work and driving directly to the office on a typical day, can cause a parent to lose awareness of the child in the car. Extensive research has shown that competing factors can cause the execution of a plan to fail rapidly, even in a matter of seconds. Examples of factors that cause prospective memory to fail include stress, a disrupting phone call, and sleep deprivation. A lack of visual or verbal reminders, like a sleeping child or a misplaced diaper bag, increases the chances for a person to lose awareness of the child in the back of a car.

Diamond's study also included research on false memories, in which people create strong memories of events that were implied but did not happen. In the cases he has handled, the brain somehow creates the false memory that the parents had dropped off their children, as planned, at daycare. Diamond recalls the horror conveyed by the parents he has interviewed - 'they return to their car with the plan to pick their child up at daycare, only to find the child had suffered from heatstroke during the day.'

Many of the parents that forget children in cars have been charged with manslaughter, and even murder. Diamond has worked with defense attorneys and legal scholars to address the legal ramifications for child deaths in hot cars. His study included a review of an absence of mens rea, in which harm caused by an individual without intent or awareness, should negate prosecution of cases where parents and caretakers unknowingly and unintentionally leave a child in a car. That's because neuroscience research confirms that when brain systems compete the subconscious (habit) neural system can overpower the conscious mind when it comes to maintaining awareness of a sleeping child in the back of a car.

"The brain memory systems that fail when people forget children in cars are the same as those systems that cause us to forget to shut off the headlights when we arrive at a destination," said Diamond. "Just as auto manufacturers have built-in systems that shut off headlights, we must have built-in systems that detect a forgotten child in a car."

Many efforts are underway to find a solution, such as proposed federal legislation that requires vehicles to alert drivers when a child is left in the car.

Cold Spring Harbor, NY - It's no secret that our genes are what makes us... us! But genes are often also the basis for debilitating diseases. One of the major clues to understanding any illness is seeing which genes are acting unusually during disease onset. But it's not often clear if unusual gene activity is unique to the disease at hand, or is merely a more general symptom of an unhealthy body. Now, scientists at Cold Spring Harbor Laboratory (CSHL) have crafted a ranked list of usual suspects that could prove invaluable for researchers and clinicians.

"Imagine a psychic," prompts CSHL computational biologist Jesse Gillis, who worked on the study. "When they do a 'cold reading' for an audience, they say 'someone here has the name Dave or David' and so on, right? They make guesses that are very probable."

In that moment, the audience isn't thinking about the popularity of the name David, making it exciting that onlooker Dave has been singled out.

Gillis and postdoctoral researcher Maggie Crow noticed that the trap in thinking this way can be problematic for studies comparing the gene activity of healthy cells to that of cells involved in disease - something called "differential expression."

They figured that if someone predicted which gene would be identified during a search for differential expression, that gene might appear to be associated with the disease, but only because it's associated with almost any disease.

The pair, along with Paul Pavlidis at University of British Columbia, conducted a computational analysis of 635 data sets across about 27,000 samples. They found that there are genes like the name "Dave": they are so likely to be affected by any disease that their appearance is unsurprising. Uncovering this effect let the team identify genes that are likelier to be unique to specific conditions.

The results, detailed in the journal PNAS, "should come as no big surprise, but quantifying them precisely is valuable," Gillis says. "The genius of Maggie on this work was tunneling down and saying there are biological processes that drive the variability."

Crow points to the genes that drive inflammation as an example of these biological processes. Those genes are remarkably active in cancer patients, but also in other conditions, like Alzheimer's. This information, embedded in Gillis and Crow's list, provides context for interpreting these genes.

"We have one ranked list and we tried to make it extremely easy to use and build upon," adds Crow.

The hope is that the new data will aid researchers in designing better experiments, discovering new drug targets, and developing treatments for a vast range of diseases.

BOSTON, MA - Daily bathing with an antiseptic soap, plus nasal ointment for patients with prior antibiotic resistant bacteria, reduced hospital acquired infections among patients with central venous catheters and other devices that pierce the skin, according to results of the ABATE Infection Trial. The trial was a 53 hospital randomized trial involving approximately 340,000 patients led by researchers from the Harvard Pilgrim Health Care Institute, the University of California Irvine, Rush University and HCA Healthcare (HCA). The study, "Chlorhexidine versus Routine Bathing to Prevent Multi Drug-Resistant Organisms and All-Cause Bloodstream Infection in General Medical and Surgical Units: The ABATE Infection Cluster Randomized Trial," was published March 5 in The Lancet, Online.

The ABATE Infection Trial evaluated whether daily bathing with an antiseptic soap for all patients, plus nasal mupirocin antibiotic ointment in the nose of patients with a history of methicillin resistant Staphylococcus aureus (MRSA), reduced hospital infections and antibiotic-resistant bacteria. The investigators found that patients with devices, such as central venous catheters, midline catheters, and lumbar drains, benefitted from the intervention, while there was no significant benefit in the entire population of non-ICU patients. These patients with devices experienced a 30% decrease in bloodstream infections and a nearly 40% decrease in antibiotic resistant organisms, specifically MRSA and vancomycin-resistant enterococcus. Patients with these devices are at higher risk for infection and that may explain why they benefitted. Overall, patients with devices account for over half of all bloodstream infections that occur in the hospital setting.

"Several ICU trials have shown striking reductions in infections and antibiotic resistant bacteria using daily chlorhexidine bathing and nasal decolonization with mupirocin. We wanted to know if patients outside the ICU could benefit from a similar decolonization strategy," said lead author Susan S. Huang, M.D., MPH., Professor of Medicine, Division of Infectious Diseases, University of California, Irvine School of Medicine.

"Until additional data becomes available, we believe it will be worthwhile to adopt this decolonization strategy as best practice in non-ICU patients with devices like these to reduce bloodstream infection and antibiotic resistant organisms," said senior author Richard Platt, M.D, M.Sc., Professor and Chair of the Department of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School. "Following the ICU trials, many hospitals adopted antiseptic bathing for patients with devices outside of the ICU ahead of scientific evidence to do so. This trial provides support for that strategy, while also pointing to the need for additional information."

Incorporating the arts--rapping, dancing, drawing--into science lessons can help low-achieving students retain more knowledge and possibly help students of all ability levels be more creative in their learning, finds a new study by Johns Hopkins University.

The findings were published on Feb. 7 in Trends in Neuroscience and Education and support broader arts integration in the classroom.

"Our study provides more evidence that the arts are absolutely needed in schools. I hope the findings can assuage concerns that arts-based lessons won't be as effective in teaching essential skills," says Mariale Hardiman, vice dean of academic affairs for the School of Education at the Johns Hopkins University and the study's first author.

While research already shows that the arts improve students' academic outcomes and memory, it remains unclear whether general exposure to the arts, adding arts to lesson plans, effective instruction, or a combination are responsible for these benefits, says Hardiman.

"When we talk about learning, we have to discuss memory. Children forget much of what they learn and teachers often end up reteaching a lot of content from the previous year. Here we're asking, how exactly can we teach them correctly to begin with so they can remember more?"

In this study, the research team sought to determine whether an arts-integrated curriculum had any direct effects on learning, specifically students' memory for science content.

Throughout the 2013 school year, 350 students in 16 fifth grade classrooms across six Baltimore, Maryland schools took part in the study. Students were randomly assigned into one of two classroom pairs: astronomy and life science, or environmental science and chemistry.

The experiment consisted of two sessions, each lasting three to four weeks, in which students first took either an arts-integrated class or a conventional class. In the second session, students received the opposite type of class; thus, all students experienced both types and all eleven teachers taught both types of classes.

Examples of activities in the arts-integrated classes include rapping or sketching to learn vocabulary words, and designing collages to separate living and non-living things. These activities were matched in the conventional classrooms with standard activities such as reading paragraphs of texts with vocabulary words aloud in a group and completing worksheets.

The research team analyzed students' content retention through pre-, post-, and delayed post-tests 10 weeks after the study ended, and found that students at a basic reading level retained an average 105 percent of the content long term, as demonstrated through the results of delayed post-testing. The researchers discovered that students remembered more in the delayed post-testing because they sang songs they had learned from their arts activities, which helped them remember content better in the long term, much like how catchy pop lyrics seem to get more and more ingrained in your brain over time.

This addresses a key challenge and could be an additional tool to bridging the achievement gap for students who struggle most to read, says Hardiman, because most conventional curriculum requires students to read to learn; if students cannot read well, they cannot learn well.

The research team also found that students who took a conventional session first remembered more science in the second, arts-integrated session and students who took an arts-integrated session first performed just as well in the second session. While not statistically significant, the researchers suggest the possibility of students applying the creative problem-solving skills they learned to their conventional lessons to enhance their learning.

Looking forward, Hardiman hopes that educators and researchers will put their fully-developed intervention to use to expand on their study and improve understanding of arts integration in schools.

"Our data suggests that traditional instruction seems to perpetuate the achievement gap for students performing at the lower levels of academic achievement. We also found that students at advanced levels of achievement didn't lose any learning from incorporating arts into classrooms, but potentially gained benefits such as engagement in learning and enhanced thinking dispositions. For these reasons, we would encourage educators to adopt integrating the arts into content instruction," says Hardiman.

Ottawa, Mar. 5, 2019 - Two Canadian biologists are proposing a better way to assess the conservation value of old-growth forests in North America--using lichens, sensitive bioindicators of environmental change.

Dr. Troy McMullin, lichenologist at the Canadian Museum of Nature, and Dr. Yolanda Wiersma, landscape ecologist at Memorial University of Newfoundland, propose their lichen-focussed system in a paper published today in the Ecological Society of America journal, Frontiers in Ecology and the Environment.

"We are presenting a paradigm shift for the way we assess forests and manage them," says McMullin. "How do we select the forests with highest conservation value? How do we decide what to protect and what to cut? Lichens are part of the answer."

Old-growth forests, especially those in North America, are perceived to be rich in biodiversity, in addition to capturing aesthetic and spiritual values. These forests are usually defined by the age of the trees, with conservation and management practices developed accordingly. McMullin and Wiersma say this is an over-simplification, as it overlooks the importance of biodiversity in those habitats.

"Forests with old trees in them are certainly awesome and important," says Wiersma. "However, forests change through time and something that is an older forest now may not always be a forest."

The approach of the researchers lets them look at the presence of forests in the context of the broader landscape.

"If we think of the landscape as a patchwork quilt of different types of forests of different ages, some of those patches of forest will stick around for a long time, while others might wink in and out over different time frames. Our approach lets us identify which patch has been a forest for the longest period of time, even if it's not the one with the oldest trees."

McMullin and Wiersma argue that old trees are only a proxy for biodiversity in old-forest ecosystems and that biodiversity should be measured directly--with lichens as the ideal candidates.

"The advantage of lichens as indicators for this biodiversity is that they don't go anywhere, you can study them anytime of the year, and they 'eat the air', which makes them one of the most sensitive organisms in the forest ," explains McMullin.

Many old-growth forests have high sustained moisture and a high number of microhabitats suitable for certain species, which can't disperse easily. Having these forests in the landscape provides a refuge for the seeds and spores that helps with the continued preservation of this biodiversity.

In their paper, McMullin and Wiersma propose that suites of lichens associated with known old-growth areas can be used to develop "an index of ecological continuity" for forests of interest. This scorecard of lichen species could then be used as a tool by conservation biologists and forest mangers--the more species that are old-growth dependent, then the higher the forest's conservation value.

The scientists note that lichens are already being used to assess old-growth value and forest continuity in parts of Europe, less so in North America. As examples, they cite the studies of British botanist Dr. Francis Rose, who developed an index of about 30 lichens associated with Britain's Royal Forests or medieval parklands, which have been relatively untouched going back hundreds or even thousands of years.

McMullin has also built on the work of Dr. Steven Selva at the University of Maine. Selva has documented that species of stubble lichens (the calicioids), which tend to be found predominantly in old-growth areas, can be good indicators of continuously forested lands in Acadian forests.

So, what next? McMullin and Wiersma propose they can build on this knowledge to develop lists of appropriate lichen suites for forest types such as Carolinian, Boreal or Great Lakes-St. Lawrence. Next steps could include training those responsible for assessing the forests, offering access to the expertise of trained lichenologists, and taking advantage of new technologies such as DNA barcoding.

Lichens 101

There are an estimated 2,500 species of lichens in Canada. Lichens are found on every continent and can grow in frigid polar regions, harsh deserts, as well as your backyard! A lichen is part fungus and part green alga or a cyanobacterium (sometimes both). Some lichens fix nitrogen for the soil and lichens play important roles in ecosystems: they are among the first colonizers of bare rock and prevent erosion by stabilizing soil, they provide food for animals, habitats for insects, and they can serve as monitors for air-pollution. The Canadian Museum of Nature houses the National Herbarium of Canada, which includes about 150,000 specimens of lichens.

Demand for science, technology, engineering and math (STEM) degrees is on the rise. However, there are many barriers to gaining one.

One may be the appearance of the student seeking the degree, according to a new Rice University study. The extent to which students look racially stereotypical - that is, more or less like members of their racial group - influences how likely they are to persist in a STEM-related field.

"The Face of STEM: Racial Phenotypic Stereotypicality Predicts STEM Persistence by - and Ability Attributions About - Students of Color" appears in the Journal of Personality and Social Psychology.

Researchers Mikki Hebl, the Martha and Henry Malcom Lovett Chair of Psychological Sciences and Professor of Management at Rice; Melissa Williams, Goizueta Foundation Term Associate Professor of Organization and Management at Emory University; and Julia George-Jones, Ph.D. candidate in Educational Psychology at the University of Texas at Austin, were not interested in looking at differences across races. Rather, they were interested in focusing on differences within races.

Examining five years' worth of students who entered college intending to pursue a STEM degree, the researchers measured their persistence at remaining in a STEM discipline. They coded photos on the extent to which students exhibited physical features considered stereotypical for their races (white, black or Asian).

Using logistic regression analysis, the researchers found that Asian students who looked more (versus less) racially stereotypical were significantly more likely to complete a bachelor's degree in STEM. However, black students who looked more racially stereotypical were less likely to complete a STEM degree. There were no meaningful differences reported for white students.

"I think we live in a presumed meritocracy where people believe what you get on tests and how you do in the classroom is what matters," Hebl said. "Our research says that your looks do matter and can impact your likelihood to depart or remain in a STEM field. And that is pretty shocking."

In an attempt to identify the source of such biases, the researchers invited academic advisers from 50 top U.S. universities to participate in a follow-up study. Advisers were shown two photos (one higher and one lower in stereotypicality but always of the same race and gender) and told to recommend which of the two should take a STEM-related class.

The responses were consistent with the findings in the first part of the study. Advisers were considerably more likely to choose Asian male and female students who looked more stereotypically Asian to take the STEM class. Advisers were less likely to choose those who looked more stereotypically black among women.

The researchers found one inconsistency with the earlier findings: The pattern that academic advisers showed for black women did not extend to black men. That is, the advisers were more likely to say that a black male with a more (versus less) stereotypical appearance would be more successful in STEM. Hebl thinks a possible cause that this finding emerges because of heightened sensitivities to black men in the current political culture and movements such as #BlackLivesMatter. She suggested very stereotypical black men may have led participants to double check their behavior.

"We have some evidence that the extent to which people tried to suppress their motivation to be prejudiced predicted their responses to black men, but only to them," Hebl said.

When the researchers controlled for the motivation to control prejudice, indeed they found that the pattern for black men resembled the pattern for black women - that is, the less-stereotypical face led to perceptions of greater STEM ability.

Nevertheless, the researchers are encouraged by this finding.

"We think it may demonstrate that some level of awareness about biases exist, and individuals are capable of altering their actions. Whether it is political correctness, a true change of heart or something in between, a change of behavior is possible," Hebl said.

Hebl has been examining the construct of stereotypicality for nearly 10 years. Motivated by the findings of a 2006 Stanford study that showed black men were more likely to get the death penalty if they look more (versus less) racially stereotypical, Hebl began research to identify other outcomes potentially linked to stereotypicality. In 2010, she published research that showed one's level of stereotypicality is negatively correlated with the size of that person's social network. That is, she found that those who look more stereotypical of their race (unless they are white) are less likely to have as large a social network and be as central within it.

The authors of the STEM study said they don't think society and researchers have done enough to understand how differences within races, versus between races, lead to different outcomes.

"This study is important because it raises awareness about how decisions based on stereotypes can amount to very real negative outcomes for STEM students," the authors wrote. "We hope that by bringing attention to this topic, it will create ripples of awareness and behaviors that lead to more authentic, meritocratically based outcomes."

Using computer simulations and 3D models, palaeontologists from the University of Bristol have uncovered more detail on how Mesozoic sea dragons swam.

The research, published today in the journal Proceedings of the Royal Society B, sheds new light on their energy demands while swimming, showing that even the first ichthyosaurs had body shapes well adapted to minimise resistance and maximise volume, in a similar way to modern dolphins.

Ichthyosaurs are an extinct group of sea-going reptiles that lived during the Mesozoic Era, around 248-93.9 million years ago.

During their evolution, they changed shape substantially, from having narrow, lizard-like bodies to more streamlined fish-shaped bodies.

It was assumed that the change in body shape made them more efficient swimmers, especially by reducing the drag of the body, in other words, the resistance to movement.

If they could produce less resistance for a given body mass, they would have more power for swimming, or swimming would take less effort. Then they could swim longer distances or reach faster speeds.

Susana Gutarra, a PhD student in palaeobiology at the University of Bristol's School of Earth Sciences, said: "To test whether fish-shaped bodies helped ichthyosaurs reduce the energy demands of swimming, we made 3D models of several different ichthyosaurs.

"We also created a model of a bottlenose dolphin, a living species which can be observed in the wild, so we could test if the method worked."

Dr Colin Palmer, a hydrodynamics expert and a collaborator, added: "Susana used classic methods from ship design to test these ancient reptiles.

"The software builds a "virtual water tank" where we can control variables like the temperature, density and speed or water, and that allow us to measure all resulting forces.

"The model ichthyosaurs were put into this "tank", and fluid flow conditions modelled, in the same way ship designers test different hull shapes to minimize drag and improve performance."

Professor Mike Benton, also from Bristol's School of Earth Sciences and a collaborator, said: "Much to our surprise, we found that the drastic changes to ichthyosaur body shape through millions of years did not really reduce drag very much.

"All of them had low-drag designs, and body shape must have changed from long and slender to dolphin-like for another reason. It seems that body size mattered as well."

Susana Gutarra added: "The first ichthyosaurs were quite small, about the size of an otter, and later ones reached sizes of 5-20 metres in length.

"When we measured flow over different body shapes at different sizes, we found that large bodies reduced the mass-specific energy demands of steady swimming."

Dr Benjamin Moon, another collaborator from Bristol's School of Earth Sciences, said: "There was a shift in swimming style during ichthyosaur evolution. The most primitive ichthyosaurs swam by body undulations and later on they acquired broad tails for swimming by beating their tails (more efficient for fast and sustained swimming).

However, we found that some very early ichthyosaurs, like Utatsusaurus, might have been well suited for endurance swimming thanks to their large size, in spite of swimming by body undulations. Our results provide a very interesting insight into the ecology of ichthyosaurs."

Susana Gutarra concluded: "Swimming is a very complex phenomenon and there are some aspects of it that are particularly hard to test in fossil animals, like motion.

"In the future, we'll probably see simulations of ichthyosaurs moving through water.

"At the moment, simulating the ichthyosaurs in a static gliding position, enables us to focus our study on the morphology, minimizing our assumptions about their motion and also allow us to compare a relatively large sample of models."

An Australian study of more than 1200 women has found regular phone calls between first time mothers and other volunteer mothers with previous breastfeeding experience may be the key to boosting national breastfeeding rates.

La Trobe University and the Royal Women's Hospital's Ringing Up about Breastfeeding EarlY (RUBY) trial involved more than 1000 new mothers from the Women's, Monash and Sunshine hospitals, and 230 women with personal breastfeeding experience who volunteered to become telephone support peers.

Half of the first time mothers in the study received the usual maternal health care provided to mothers when they leave hospital following birth, while the other half also received scheduled, regular phone calls from an assigned peer.

Lead researcher, Professor Della Forster from La Trobe's Judith Lumley Centre and the Royal Women's Hospital said researchers surveyed the mothers about their feeding practices when their babies reached six months.

"At the end of the two year trial we compared breastfeeding rates across both groups and found mother-to-mother proactive telephone support was an effective way to increase breastfeeding among first-time mothers," Professor Forster said.

"Seventy five per cent of the mothers who received telephone support were giving their babies some breast milk at six months of age, compared with 69 per cent of those in the usual care group.

"If applied to Australia's annual birth rate, a six per cent increase would translate to at least 180,000 more infants being breastfed for at least six months - thereby reaping all the associated benefits."

La Trobe co-researcher and lactation expert, Associate Professor Lisa Amir, said the mothers in the telephone support group were also better able to cope with breastfeeding challenges.

"Having someone to talk to, who had themselves breastfed for at least six months and was trained to listen and be empathetic, meant those who faced difficulties were more likely to persevere than give up altogether," Associate Professor Amir said.

"While Australia has a high breastfeeding initiation rate of 96 per cent, only 60 per cent of babies are receiving any breast milk at six months, and just 15 per cent are exclusively breastfed at five months. This is far below the recommended guidelines* and we need to find ways to improve this."

The peer volunteer mothers who took part in the study received four hours of training, provided in conjunction with the Australian Breastfeeding Association (ABA). On average, the volunteers supported two mothers during the RUBY study, but some supported up to 10. The feedback from the volunteer mothers was overwhelmingly positive, and most would volunteer again.

The RUBY study follows a smaller Canadian trial and involved researchers from La Trobe's Judith Lumley Centre, the Royal Women's Hospital, the Australian Breastfeeding Association, Monash University, Deakin University and the University of Toronto.

The researchers, whose findings appear in the Lancet's online journal EClinicalMedicine, believe the RUBY model has potential for widespread implementation.

"Given the ease with which we recruited, trained and retained telephone support peers, we believe such as model could easily be introduced at the population level with little cost and extra resources needed," Professor Forster said.

"Rather than replacing existing models, we think it could complement the work being done by health professionals and other agencies in promoting and supporting breastfeeding."

La Trobe University has recently launched a new trial using the same model as the RUBY study to explore if telephone peer support could also help mothers at risk of postnatal depression and anxiety.

Those of us who drive regularly are keenly aware of gas prices and their daily fluctuations. Many of the factors that influence the price per gallon -- the cost of crude oil, regional taxes and processing and transportation charges -- affect all pumps in a given area. Why then do some stations charge more for fuel than others in the same general geographic location?

This was the question UC Santa Barbara geographers Alan Murray and Jing Xu sought to answer when they conducted their survey of gas prices in Santa Barbara County. Using a spatial analytic framework incorporating exploratory spatial data analysis, remote sensing, geographic information systems and spatial statistics to explore data from the real-time gas price app Gas Buddy, they investigated how the locations of these pumps could influence the prices they charge.

"We were interested in looking at the spatial features in and around stations, and whether there was any predictability to pricing variation," said Murray, who with Xu authored a paper in the Asia-Pacific Journal of Regional Science. Over the two weeks of their study, the researchers examined features related to land use and socioeconomic conditions, performed onsite observations and assessed the individual stations' proximity and connectedness to features of the built environment, such as roads, shopping centers, schools and other gas stations.

A few of the results confirm what we all might intuit: Proximity to highly trafficked areas can influence higher gas prices.

"You're always going to pay for convenience," Murray said. Stations near shopping centers (within 2.75 miles) and major thoroughfares tended to charge relatively higher prices, likely targeting shoppers and visitors who were already there for another reason.

"People usually do not travel just for gas," Xu said. "We travel for work and for school, and we're filling our tanks while doing other things." This could explain, for instance, why one station in the Santa Ynez Valley near a small local airport might have relatively lower prices than a counterpart in the same vicinity that is closer to shopping and restaurants, she said. "The one with higher prices is likely to provide more direct access to food and goods."

Likewise, stations closest to freeway on- and off-ramps tended to charge more than those located on the interior streets of a municipality. And, of those stations near the freeways and highways, the ones at the interfaces between urban and rural areas tended to charge more.

"If you enter from a rural area to the urban area, or leave from the urban area to a rural area, that urban fringe location usually has higher prices," Xu said.

Among the factors that might dampen prices, according to the researchers, is a rural or relatively less urban location, the presence of a carwash or convenience store, ownership by nearby supermarkets and proximity to other gas stations, which indicates market competition. In fact, the nearby presence of market competition is among the most significant determinants of pump prices, and can override the effect of proximity to nearby food and goods.

"Modeling-wise, the pricing behavior of one station is not independent of others," Murray said. "What we found is that the pricing of your closest competitors matters in terms of your own pricing behavior." This happens irrespective of whether the station is a major brand or a lesser-known retailer, he added, and despite the notion that major brands offer "better" gas (though it is also true that major brand stations generally price their gas higher than minor brand stations).

The researchers found some interesting outliers in their survey. Among them is a gas station in Carpinteria, which, while located closer to the center of town, charged more than its counterparts closer to the 101 freeway. That pricing could be taking advantage of its proximity to the business and tourist district, they surmised.

"If you're just coming up the coast, it's one of the most populated areas you first encounter, and it's in a beach community," Murray said.

But by far the biggest outlier is a gas station located in western Goleta, situated just off the 101 freeway, whose prices were roughly 68 percent higher than the county average. At the time of the study, that equated to about $2 more per gallon than other stations in Santa Barbara County.

"We were very interested in price gouging behavior," said Murray, who defined it in this case as taking unfair advantage of a location to set excessive prices. Indeed, the station in question has good freeway access, and is the last major gas brand along the freeway between western Goleta and Solvang.

"You have sort of a captive market," Murray said. One of the local characteristics is its location near Dos Pueblos High School, where "young drivers maybe don't appreciate" the huge discrepancy in gas prices, he added.

"You also have this traffic coming off the 101, going over to Home Depot and Costco, so you have a mix of people that are patronizing the local area and are therefore captured on their journey to goods and services," Murray said. All this, he noted, despite the fact that the surrounding suburban neighborhood is relatively less affluent than other, more expensive neighborhoods that have gas stations with more average pricing. This is an important point, he added, in the sense that "this higher, predatory pricing might be impacting certain socioeconomic groups more than others."

Deeper investigation revealed that the markedly higher prices at that station in western Goleta might also be turning away customers. Onsite observations demonstrated that the majority of visitors to the gas station came from the 101 freeway, supporting the speculation that the target customers are those coming from the highway. The researchers noted that most of the customers either limited their purchases to items from the convenience store or they left the station without buying anything.

Gas station owners have myriad reasons for choosing to set their prices one way or another, and not all of them are location-specific. But this study, the researchers say, "offers a first attempt at detecting normal gasoline pricing behavior, and the spatial factors associated with these conditions." As they note in the paper, "The hope is that this work provides government agencies, urban planners and policy makers with capabilities to investigate regional gasoline price variation and potential gouging behavior."

March 4, New Delhi: Living in districts with air pollution from intense crop residue burning (CRB) is a leading risk factor for acute respiratory infection (ARI), especially among children less than five years, in northern India. Additionally, CRB also leads to an estimated economic loss of over USD 30 billion annually. These are the key findings of a new study from researchers at the International Food Policy Research Institute (IFPRI) and partner institutes. The study estimates--for the first time--the health and economic costs of CRB in northern India.

"Poor air quality is a recognized global public health epidemic, with levels of airborne particulate matter in Delhi spiking to 20 times the World Health Organization's safety threshold during certain days. Among other factors, smoke from the burning of agricultural crop residue by farmers in Haryana and Punjab especially contributes to Delhi's poor air, increasing the risk of ARI three-fold for those living in districts with intense crop burning," said IFPRI Research Fellow and co-author of the study, Samuel Scott. The study also estimated the economic cost of exposure to air pollution from crop residue burning at USD 30 billion or nearly Rs. 2 lakh crore annually for the three north Indian states of Punjab, Haryana and Delhi.

The study, "Risk of acute respiratory infection from crop burning in India: estimating disease burden and economic welfare from satellite and national health survey data for 250,000 persons," co-authored by IFPRI's Samuel Scott and Avinash Kishore; CGIAR Research Program on Agriculture for Nutrition and Health's Devesh Roy; University of Washington's Suman Chakrabarti; and Oklahoma State University's Md. Tajuddin Khan, will be published in an upcoming edition of the International Journal of Epidemiology. The study analyzed health data from more than 250,000 individuals of all ages residing in rural and urban areas in India. It used NASA satellite data on fire activity to estimate the health impact of living in areas with intense crop burning by comparing them with areas not affected by CRB.

The researchers observed that as crop burning increased in the northern Indian state of Haryana, respiratory health worsened. Health was measured by the frequency of reported hospital visits for ARI symptoms [see attached chart]. They also examined other factors that could contribute to poor respiratory health such as firecracker burning during Diwali (it usually coincides with time of CRB) and motor vehicle density. In fact, economic losses owing to exposure to air pollution from firecracker burning are estimated to be around USD 7 billion or nearly Rs. 50 thousand crore a year. In five years, the economic loss due to burning of crop residue and firecrackers is estimated to be USD 190 billion, or nearly 1.7 per cent of India's GDP.

"Severe air pollution during winter months in northern India has led to a public health emergency. Crop burning will add to pollution and increase healthcare costs over time if immediate steps are not taken to reverse the situation. The negative health effects of crop burning will also lower the productivity of residents and may lead to long-term adverse impacts on the economy and health," said Suman Chakrabarti.

"Our study shows that it is not only the residents of Delhi, but also the women, children and men of rural Haryana who are the first victims of crop residue burning. Much of the public discussion on ill-effects of crop residue burning ignores this immediately affected vulnerable population," said Kishore.

Even though air pollution has been linked to numerous health outcomes, and respiratory infections are a leading cause of death and disease in developing countries, none of the existing studies have directly linked crop burning to ARI. This study suggests that targeted government initiatives to improve crop disposal practices are worthy investments.

"Programs and policies must simultaneously address indoor and outdoor pollution through a possible combination of bans and agricultural subsidies. Other important interventions for improving respiratory health are increasing household access to clean cooking fuels, electricity, and improved drainage systems," Kishore added.

Crop burning is a widespread global practice and in India is concentrated in northwest India, though has spread to other regions of the country in the past decade as new crop harvesting technology is adopted. Farmers try to maximize their yields by planting the next crop as soon as possible after the previous crop has been harvested (generally wheat after rice). To quickly clear the field for the next crop, they burn the leftover stubble rather than using the traditional method of clearing it by hand.

Despite efforts from the Indian government, farmers continue to burn crop residues due to lack of convenient and affordable alternatives. Eliminating crop burning will not only improve human health but will also contribute to soil and plant biodiversity and will reduce greenhouse gas emissions.

Outbreaks of mosquito-borne illnesses like yellow fever, dengue, Zika and chikungunya are rising around the world. Climate change has created conditions favorable to mosquitoes' spread, but so have human travel and migration and accelerating urbanization, creating new mini-habitats for mosquitoes.

In today's Nature Microbiology, a large group of international collaborators combined these factors into prediction models that offer insight into the recent spread of two key disease-spreading mosquitoes -- Aedes aegypti and Aedes albopictus. The models forecast that by 2050, 49 percent of the world's population will live in places where these species are established if greenhouse gas emissions continue at current rates.

"We find evidence that if no action is taken to reduce the current rate at which the climate is warming, pockets of habitat will open up across many urban areas with vast amounts of individuals susceptible to infection," says Moritz Kraemer, PhD, of Boston Children's Hospital and the University of Oxford (UK). Kraemer was co-first author on the study with Robert Reiner of the University of Washington (Seattle), Oliver Brady of the London School of Hygiene and Tropical Medicine, Jane Messina of the University of Oxford and Marius Gilbert of the Universite Libre de Bruxelles (Belgium).

A spatial-temporal analysis

The team gathered historic data on the distributions of Aedes aegypti and Aedes albopictus over time in more than 3,000 locations in Europe and the U.S., going back as far as the 1970s and 1980s. They also mapped the locations based on their present-day suitability as mosquito habitats, then projected their suitability in 2020, 2050 and 2080 based on various climate models, projections of urban growth and other variables. They also included human migration and travel patterns, using data from census data and mobile phone records.

In recent times, they found, Aedes aegypti has tended to spread over long distances, while Aedes albopictus's spread has been more localized. Within the U.S., Aedes aegypti spread north at a relatively constant rate, about 150 miles per year. Aedes albopictus spread most quickly between 1990 and 1995; its advance has since slowed to about 37 miles per year. In Europe, Aedes albopictus has spread faster, advancing about 62 miles per year increasing to 93 miles per year in the past five years.

"We observed striking differences in the spread of both mosquito species, which has direct implications for surveillance and control strategies," says Kraemer. "We hope that these high-resolution maps will be used to target specific geographic areas for surveillance, control and elimination of these harmful mosquito populations."

What's next for mosquitos?

The models suggest that under current climate conditions and population densities, both mosquito species will continue to spread globally over the coming decades.

Aedes aegypti is predicted to spread mostly within its current tropical range, but also in new temperate areas in the U.S. and China, reaching as far north as Chicago and Shanghai, respectively, by 2050. In the U.S., this spread is expected to occur in large urban areas, through long-distance introductions of the insect. Aedes aegypti is expected to decline in the central southern United States and Eastern Europe, which climate models predict will become more arid. It's not expected to reach Europe except for parts of southern Italy and Turkey.

Aedes albopictus, however, is forecast to spread widely throughout Europe, ultimately reaching large areas of France and Germany over the next 30 years. It's also expected to establish a toe-hold in parts of the northern U.S. and the highland regions of South America and East Africa.

Climate change: the wild card

In the next 5 to 15 years, the models predict that spread of both species will be driven by human movement, rather than environmental changes. But thereafter, expansion will be driven by changes in climate, temperature and urbanization that create new mosquito habitats. And if climate change isn't curbed by 2050, the spread is predicted to be even greater.

"With this new work, we can start to anticipate how the transmission of diseases like dengue and Zika might be influenced by a variety of environmental changes," says Simon I. Hay, director of Geospatial Science at IHME and Professor of Health Metrics Sciences at the University of Washington. "Incorporating this information into future scenarios of risk can help policymakers predict health impacts and help guide strategies to limit the spread of these mosquito species, an essential step to reduce the disease burden."

It's time to strengthen support for the 28% of people who provide care for an ageing family member, friend or neighbour in Canada, argues an editorial in CMAJ (Canadian Medical Association Journal).

"Our ability to support informal caregiving remains one of Canada's most pressing health care and societal issues," says Dr. Nathan Stall, associate editor, CMAJ.

The pool of caregivers in Canada is shrinking as the ageing population increases, while the need for caregiving will increase.

Caregiving has become increasingly demanding and stressful as many untrained people provide medical and nursing care, help with daily living and navigate the complexities of the health and long-term care system. Many caregivers are stressed, which negatively effects their mental and physical health and can lead to increased risk of death.

More than one-third (35%) of the population is both working and providing caregiver support, with more women juggling both roles.

As well, caregivers often provide financial support to their loved ones and may miss out on full-time employment, raises and other monetary benefits. We must support these people by protecting caregivers from financial and retirement insecurity.

While financial support exists, mainly through tax breaks, it is difficult to access and varies by province.

"Addressing this pressing health care and societal issue is undoubtedly complex, but innovative, effective and potentially scalable programs and policies already exist in pockets across the country. It's time Canada cared more about its caregivers," he concludes.

There is broad support for building health care systems that are patient centered, seen as a means of improving health outcomes and as morally worthy in itself. But the concept of patient-centered care has increasingly merged with the concept of patients as consumers, which "is conceptually confused and potentially harmful," write Michael K. Gusmano, a Hastings Center research scholar and an associate professor at Rutgers University; Karen J. Maschke, a Hastings Center research scholar; and Hastings Center president Mildred Z. Solomon in an article in the March 2019 issue of Health Affairs.

The metaphor of patients as consumers, long used by advocates of patient-centered care, has recently been co-opted by critics of government health care regulation and advocates of market solutions to health care costs. Gusmano, Maschke, and Solomon discuss why the consumer metaphor is inappropriate.

Health Care is not a Market

Patients can be construed as consumers only if they are operating within a market. But there are several key differences between health care and typical commercial markets. Patients often lack the information and time to select the best health care on the basis of quality and price. Even if health care were to be made more like a conventional market--for example, by increasing the number of competitive health care choices--patients still could not act like consumers because they would often lack the time and knowledge to "shop" for different options.

The High Cost of Health Care is not Due to Excessive "Consumer" Demand

Some commentators believe that health care costs are high because patients overuse health care, and that one way to reduce costs is to make patients pay more out of pocket. Though requiring patients to pay more for their care has been shown to reduce overall health care spending, this tactic also reduces patient usage of appropriate or essential medical care. What does drive up health care costs, the authors write, is the common practice of compensating physicians for each service they provide and the U.S. government's failure to sufficiently negotiate prices of hospital, physician, and other health care services.

Price Transparency Won't Lower Costs, Either

In conventional markets, knowing the price of different items might help customers make informed choices about what to purchase. While it is helpful for patients to consider the costs of different treatments as part of deciding the best course of action with their provider, there is little evidence that price transparency reduces health care spending. Patients may have little time or insufficient knowledge to shop around for health care options that provide treatments at the best value.

The Consumer Metaphor Could Erode Physicians' Professionalism

Physicians rely on their knowledge, skill, and obligations to patients' well-being to recommend the best course of treatment. But if "the customer is always right," physicians might feel compelled to defer to what patients ask them to do, for example, when patients insist on unproven, ineffective, or even harmful treatments, such as cardiopulmonary resuscitation for terminally ill patients. Avoiding or devaluing physician expertise in health care decision-making would erode medical professionalism and could result in poorer patient outcomes.

The concept of patients as consumers does not bolster patient-centered care but instead places undue burdens on patients to reduce health care costs and erodes medical professionalism, the authors write. "Pursuing the sensible goal of creating a patient-centered health system will be undermined if consumer metaphors prevail," they conclude.

Using steroids during cardiopulmonary bypass surgery did not reduce the risk of acute kidney injury in people at increased risk of death, according to a study conducted in 18 countries published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.181644.

The multisite randomized controlled trial, funded by the Canadian Institutes of Health Research, included patients in Canada, China, India, United States, Colombia, Australia, Italy, Iran, Czech Republic, Greece, Spain, Brazil, Austria, Belgium, Hong Kong, Argentina, Chile and Ireland, which broadens the reach of the study's findings.

About one-fifth of the millions of bypass surgeries performed around the world each year result in acute kidney injury, which in its most severe forms greatly increases the chance of death and the need for life-sustaining dialysis treatments. Bypass surgery can trigger widespread inflammation, which is thought to be a key culprit in the development of kidney injury. Prior studies suggested that steroids might help reduce inflammation and acute kidney injury.

"Administering steroids to prevent inflammation during surgery did not reduce the risk of acute kidney injury in people at moderate or high risk of adverse effects," says author Dr. Amit Garg, a scientist at Lawson Health Research Institute and professor at Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

The study included 7286 patients, of whom about half (3647) were randomized to receive steroids and the remaining 3639 to placebo. The rate of acute kidney injury was similar in both groups.

"Given the broad range of countries and populations represented in the study, these findings further support a shift away from using steroids as an effective method of preventing the complications from inflammation during bypass surgery," states Dr. Garg.

Alien species are the main driver of recent extinctions in both animals and plants, according to a new study by UCL researchers.

They found that since 1500, alien species have been solely responsible for 126 extinctions, 13% of the total number studied.

Of 953 global extinctions, 300 happened in some part because of alien species, and of those 300, 42% had alien species alone listed as the cause of their demise.

The study, published today in Frontiers in Ecology and the Environment, used data from the 2017 IUCN Red List on the total numbers of species that are considered to have gone extinct globally since 1500.

In total, 261 out of 782 animal species (33.4%) and 39 out of 153 plant species (25.5%) listed aliens as one of their extinction drivers. In contrast, native species impacts were associated with only 2.7% of animal extinctions and 4.6% of plant extinctions.

"Some people have suggested that aliens are no more likely than native species to cause species to disappear in the current global extinction crisis, but our analysis shows that aliens are much more of a problem in this regard," said lead researcher Professor Tim Blackburn (UCL Biosciences).

"Our study provides a new line of evidence showing that the biogeographical origin of a species matters for its impacts. The invasion of an alien species is often enough to cause native species to go extinct, whereas we found no evidence for native species being the sole driver of extinction of other natives in any case."

The IUCN Red List identifies 12 broad categories of extinction drivers, including alien species, native species, biological resource use (hunting and harvesting) and agriculture. Alien species ranked first as a driver of animal extinctions, well ahead of the second place driver, biological resource use, which affected 18.8% of those lost.

Overall, the number of animal extinctions caused in some part by alien species is more than 12 times greater than those caused in part by native species.

Some of the worst offenders are mammalian predators, such as black, brown and Pacific rats and feral cats, with island habitats hit the hardest. Some of these animals first invaded by stowing away on boats, though some, like cats and foxes, have been introduced deliberately.

Many plants were also intentionally introduced, such as plantation tree species or ornamental plants for gardens. Once in place, they start to spread and threaten the native flora and fauna around them; alien plants are several times more likely than natives to achieve a maximum cover of at least 80%.

The origin of some species is unknown, so Professor Blackburn and his team assumed these were native for the study. "However," he said, "it is more likely that they are alien. Our results are therefore conservative in terms of the extent to which we implicate alien species in extinction. Also, many regions of the world have not been well studied, and there are likely to be further extinctions that haven't been captured in these data."

The research team believes better biosecurity is needed to prevent future invasions, and in many cases measures to control or even eradicate alien species must be considered.