Tech

As Hurricane Florence ground its way through North Carolina, it released what might politely be called an excrement storm. Massive hog farm manure pools washed a stew of dangerous bacteria and heavy metals into nearby waterways.

More efficient oversight might have prevented some of the worst effects, but even in the best of times, state and federal environmental regulators are overextended and underfunded. Help is at hand, however, in the form of machine learning - training computers to automatically detect patterns in data - according to Stanford researchers.

Their study, published in Nature Sustainability, finds that machine learning techniques could catch two to seven times as many infractions as current approaches, and suggests far-reaching applications for public investments.

"Especially in an era of decreasing budgets, identifying cost-effective ways to protect public health and the environment is critical," said study coauthor Elinor Benami, a graduate student in the Emmett Interdisciplinary Program on Environment and Resources (E-IPER) in Stanford's School of Earth, Energy & Environmental Sciences.

Optimizing resources

Just as the IRS can't audit every taxpayer, most government agencies must constantly make decisions about how to allocate resources. Machine learning methods can help optimize that process by predicting where funds can yield the most benefit. The researchers focused on the Clean Water Act, under which the U.S. Environmental Protection Agency and state governments are responsible for regulating more than 300,000 facilities but are able to inspect less than 10 percent of those in a given year.

Using data from past inspections, the researchers deployed a series of models to predict the likelihood of failing an inspection, based on facility characteristics, such as location, industry and inspection history. Then, they ran their models on all facilities, including ones that had yet to be inspected.

This technique generated a risk score for every facility, indicating how likely it was to fail an inspection. The group then created four inspection scenarios reflecting different institutional constraints - varying inspection budgets and inspection frequencies, for example - and used the score to prioritize inspections and predict violations.

Under the scenario with the fewest constraints - unlikely in the real world - the researchers predicted catching up to seven times the number of violations compared to the status quo. When they accounted for more constraints, the number of violations detected was still double the status quo.

Limits of algorithms

Despite its potential, machine learning has flaws to guard against, the researchers warn. "Algorithms are imperfect, they can perpetuate bias at times and they can be gamed," said study lead author Miyuki Hino, also a graduate student in E-IPER.

For example, agents, such hog farm owners, may manipulate their reported data to influence the likelihood of receiving benefits or avoiding penalties. Others may alter their behavior - relaxing standards when the risk of being caught is low - if they know their likelihood of being selected by the algorithm. Institutional, political and financial constraints could limit machine learning's ability to improve upon existing practices. The approach could potentially exacerbate environmental justice concerns if it systematically directs oversight away from facilities located in low-income or minority areas. Also, the machine learning approach does not account for potential changes over time, such as in public policy priorities and pollution control technologies.

The researchers suggest remedies to some of these challenges. Selecting some facilities at random, regardless of their risk scores, and occasionally re-training the model to reflect up-to-date risk factors could help keep low-risk facilities on their toes about compliance. Environmental justice concerns could be built into inspection targeting practices. Examining the value and trade-offs of using self-reported data could help manage concerns about strategic behavior and manipulation by facilities.

The researchers suggest future work could examine additional complexities of integrating a machine learning approach into the EPA's broader enforcement efforts, such as incorporating specific enforcement priorities or identifying technical, financial and human resource limitations. In addition, these methods could be applied in other contexts within the U.S. and beyond where regulators are seeking to make efficient use of limited resources.

"This model is a starting point that could be augmented with greater detail on the costs and benefits of different inspections, violations and enforcement responses," said co-author and fellow E-IPER graduate student Nina Brooks.

SAN ANTONIO, TX (October 1, 2018)­­- Disruption of the refill of patients' regular combination inhaled corticosteroid therapy brand may have impacted symptoms and disease control and potentially lead to an increased rate of costly exacerbations and hospitalizations.

A retrospective pharmacy analysis was conducted on 44,832 patients from age 12 and older who had Medicare Part D coverage in 2016 and 2017 and received budesonide/formoterol fixed dose combination (BUD/FORM FDC) as their inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA) medication in 2016. Each of these patients were followed through December 31, 2017 to observe ICS/LABA switches, changes in controller medications and use of acute medications like oral corticosteroids, antibiotics, and rescue inhalers.

About half (49%) of patients within the study attempted to fill a BUD/FORM FDC prescription at a pharmacy after the formulary block on January 1, 2017. Of the patients who attempted to fill the respiratory medication, only 46% were approved for more than one refill of BUD/FORM FDC, and 52% had their refill rejected. Of the patients who were rejected a refill, 37% switched to another ICS/LABA fixed dose combination, 27% of stopped their controller medication, 10% received monotherapy, 10% received triple therapy, and 16% received other controller combinations. Of the patients who did not switch to an alternate controller medication, 37% filled a prescription for an acute medication. Overall, a third of the 44,832 patients did fill any controller medication post-block, 12% switched to monotherapy, and 17% had no inhaled medication fills.

"This Medicare Part D formulary switch was associated with a disruption in the management of patients' respiratory conditions," says Dr. Katie Devane, lead researcher. "Approximately 45% of the patients did not receive an ICS/LABA after the formulary block, which may have impacted patients' symptoms and disease control and potentially lead to an increased rate of costly exacerbations and hospitalizations."

Further results from these two studies will be shared at CHEST Annual Meeting 2018 in San Antonio on Monday, October 8, 2:15 PM - 2:30 PM at the Henry B. Gonzalez Convention Center, Room 207A. The study abstracts can be viewed on the journal CHEST® website.

NEW YORK, NY--October 1, 2018--FAIR Health has released an online interactive heat map at fairhealth.org/states-by-the-numbers/map showing new findings on opioid abuse and dependence diagnoses and procedures for each of the 50 states and the District of Columbia. The innovative visualizations, issued in conjunction with a white paper on regional and state variations in opioid-related treatment, allow Americans throughout the country to see a snapshot of the opioid crisis in their particular state or across states.

A national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information, FAIR Health created the visualizations by drawing on data from its database of more than 26 billion privately billed medical and dental claim records dating back to 2002--the nation's largest repository of private healthcare claims. Using that database, the national heat map represents opioid abuse and dependence claim lines as a percentage of total medical claim lines by state in 2017. The colors of the states reveal which states have the highest or lowest percentages.

Clicking on a state displays an infographic for that state in 2017. The infographic includes the top five procedures associated with opioid abuse and dependence by utilization and aggregate cost, such as methadone administration, naltrexone injection and group psychotherapy. The lists of procedures vary considerably from state to state. Each infographic also shows the percentages of opioid abuse and dependence diagnoses by age group and gender in the state.

The white paper that accompanies the release of the heat map is the fourth in a series of studies released by FAIR Health on the opioid epidemic. The first white paper examined national trends in the epidemic; the second, the impact of the epidemic on the healthcare system; and the third, geographic variations in the epidemic.

FAIR Health can create customized States by the Numbers data analyses and visualizations to meet the specific needs of healthcare stakeholders, such as federal and state governments, policy makers and researchers. Such analytics and visualizations can be used to study a variety of diseases and conditions at the level of a state, a location within a state, a multistate region or the nation.

FAIR Health President Robin Gelburd stated: "Our interactive heat map on opioid abuse and dependence opens a new geographic window into this serious epidemic. FAIR Health stands ready to assist healthcare stakeholders with similar analytics and visualizations for other pressing public health concerns."

Scientists using machine learning - a type of artificial intelligence - with data from hundreds of children who struggle at school, identified clusters of learning difficulties which did not match the previous diagnosis the children had been given.

The researchers from the Medical Research Council (MRC) Cognition and Brain Sciences Unit at the University of Cambridge say this reinforces the need for children to receive detailed assessments of their cognitive skills to identify the best type of support.

The study, published in Developmental Science, recruited 550 children who were referred to a clinic - the Centre for Attention Learning and Memory - because they were struggling at school.

The scientists say that much of the previous research into learning difficulties has focussed on children who had already been given a particular diagnosis, such as attention deficit hyperactivity disorder (ADHD), an autism spectrum disorder, or dyslexia. By including children with all difficulties regardless of diagnosis, this study better captured the range of difficulties within, and overlap between, the diagnostic categories.

Dr Duncan Astle from the MRC Cognition and Brain Sciences Unit at the University of Cambridge, who led the study said: "Receiving a diagnosis is an important landmark for parents and children with learning difficulties, which recognises the child's difficulties and helps them to access support. But parents and professionals working with these children every day see that neat labels don't capture their individual difficulties - for example one child's ADHD is often not like another child's ADHD.

"Our study is the first of its kind to apply machine learning to a broad spectrum of hundreds of struggling learners."

The team did this by supplying the computer algorithm with lots of cognitive testing data from each child, including measures of listening skills, spatial reasoning, problem solving, vocabulary, and memory. Based on these data, the algorithm suggested that the children best fit into four clusters of difficulties.

These clusters aligned closely with other data on the children, such as the parents' reports of their communication difficulties, and educational data on reading and maths. But there was no correspondence with their previous diagnoses. To check if these groupings corresponded to biological differences, the groups were checked against MRI brain scans from 184 of the children. The groupings mirrored patterns in connectivity within parts of the children's brains, suggesting that that the machine learning was identifying differences that partly reflect underlying biology.

Two of the four groupings identified were: difficulties with working memory skills, and difficulties with processing sounds in words.

Difficulties with working memory - the short-term retention and manipulation of information - have been linked with struggling with maths and with tasks such as following lists. Difficulties in processing the sounds in words, called phonological skills, has been linked with struggling with reading.

Dr Astle said: "Past research that's selected children with poor reading skills has shown a tight link between struggling with reading and problems with processing sounds in words. But by looking at children with a broad range of difficulties we found unexpectedly that many children with difficulties with processing sounds in words don't just have problems with reading - they also have problems with maths.

"As researchers studying learning difficulties, we need to move beyond the diagnostic label and we hope this study will assist with developing better interventions that more specifically target children's individual cognitive difficulties."

Dr Joni Holmes, from the MRC Cognition and Brain Sciences Unit at the University of Cambridge, who was senior author on the study said: "Our work suggests that children who are finding the same subjects difficult could be struggling for very different reasons, which has important implications for selecting appropriate interventions."

The other two clusters identified were: children with broad cognitive difficulties in many areas, and children with typical cognitive test results for their age. The researchers noted that the children in the grouping that had cognitive test results that were typical for their age may still have had other difficulties that were affecting their schooling, such as behavioural difficulties, which had not been included in the machine learning.

Dr Joanna Latimer, Head of Neurosciences and Mental Health at the MRC, said: "These are interesting, early-stage findings which begin to investigate how we can apply new technologies, such as machine learning, to better understand brain function. The MRC funds research into the role of complex networks in the brain to help develop better ways to support children with learning difficulties."

MONTRÉAL (29 September 2018)--A coalition of the world's top bone health experts, physicians, specialists, and patient advocacy groups today released their clinical recommendations to tackle the public health crisis in the treatment of osteoporosis and the debilitating and often deadly hip and spine fractures caused by the disease.

The recommendations from the American Society for Bone and Mineral Research Secondary Fracture Prevention Initiative Coalition - more than 40 top U.S. and international bone health experts, health care professional organizations and patient advocacy organizations dedicated to reducing avoidable secondary fractures - were presented at the ASBMR 2018 Annual Meeting in Montréal, the premier global scientific meeting on bone, mineral and musculoskeletal science. The full recommendations and more data about the crisis in osteoporosis treatment are available on the Coalition's new website: http://www.secondaryfractures.org.

The Coalition's recommendations are the first to outline the best course of clinical care for women and men, age 65 years or older, with a hip or vertebral (spine) fracture. They were developed in response to growing evidence of an alarming trend of an increase in the expected number of hip fractures and high-risk osteoporosis patients who need treatment but are either not being prescribed appropriate medications, or if prescribed, are simply not taking them despite research showing their effectiveness in preventing fractures. Recent patient surveys also show that critical information about the connection between osteoporosis and fracture risk is not getting through to patients.

"I think many people are shocked to learn that these conversations are not happening and simple steps not being taken," said Michael Econs, M.D., ASBMR President and Division Chief of the Division of Endocrinology and Metabolism and Professor of Medicine at the Indiana University School of Medicine. "As doctors, it's our duty to help our patients and their loved ones understand what they can do to prevent another fracture. We must do a better job communicating with them and one another to help rein in this crisis."

According to a recent survey by the National Osteoporosis Foundation, 96 percent of postmenopausal women who say they have not been diagnosed with osteoporosis and have experienced a fracture or break were not told by their doctor it could be linked to osteoporosis. The survey also found that one-third of women in the survey with a fracture were not referred for follow-up visits by health care providers.

"Heart attack patients don't leave the hospital without beta blockers to prevent another one. But every day, patients hospitalized for hip or spine fractures are not receiving treatments that research shows help prevent a second fracture that could lead to disability or death," said Coalition Co-Chair Douglas P. Kiel, M.D., MPH, and past President of ASBMR, who serves as the Director of the Musculoskeletal Research Center at the Institute for Aging Research, Hebrew SeniorLife and a Professor of Medicine at Harvard Medical School. "We've joined forces to provide a roadmap to ensure all care givers from orthopedists to primary care doctors, and many other health professionals, understand what they need to be doing to prevent fractures and how they can partner with patients to make informed choices about osteoporosis treatment options."

The Problem

Only 23 percent of elderly patients who suffer a hip fracture receive osteoporosis medication to reduce future fracture risk compared to 96 percent of heart attack patients who receive beta blockers to prevent a future heart attack.

The risk of further fractures after a first major osteoporotic fracture is greatest immediately following the first event.

Recently, a 30-year downward trend in the number of hip fractures in the United States has plateaued, raising concerns that this may be due to doctors and patients not following diagnostic and treatment guidelines.

The Costs: Human and Economic

While osteoporosis is a highly treatable disease, it is on the rise globally and responsible for more than two million fractures in the United States alone. It is also one of the 10 most costly chronic conditions to Medicare.

Of the 300,000 hip fractures each year in the U.S., one of every two patients never reaches their previous functional capacity.

One of every four hip fracture patients ends up in a nursing home.

One of every four hip fracture patients dies within one year.

Barriers to Care

Although there are many reasons for the "gap" in the treatment of osteoporosis, a major factor is physician and patient concerns over the risk of very rare side effects, especially atypical femur fractures (AFFs) related to the use of osteoporosis drugs called bisphosphonates.

"Patients who have suffered hip or vertebral fractures are at very high risk for suffering from serious and life-threatening fractures in the first one to two years after those fractures. These recommendations focus on actions they can take to reduce their risk of future fractures, that include medication, exercise, nutrition, and reducing their risk of falling," said Sundeep Khosla, M.D., co-chair of the Coalition and past President of ASBMR, who serves as Director of the Center for Clinical and Translational Science at the Mayo Clinic in Rochester, Minnesota. "The research shows that risks for atypical femur fractures are very rare and the benefits of taking bisphosphonates far outweigh the risks."

The following top recommendations for clinical care for women and men, age 65 years or older, with a hip or vertebral fracture, were developed by Coalition members through a consensus process.

The ASBMR Secondary Fracture Prevention Initiative Clinical Care Recommendations

An overarching principle for these recommendations is that women and men, age 65 years or older, with a hip or vertebral fracture, optimally should be managed in the context of a multi-disciplinary clinical system that includes case management, such as a fracture liaison service, to assure that they are appropriately evaluated and treated for osteoporosis and risk of future fractures.

1. Communicate three simple messages to patients and their family/caregivers throughout the fracture care and healing process:

their broken bone likely means they have osteoporosis and are at high risk for breaking more bones, especially over the next 1-2 years;

breaking bones means they may, for example, have to use a walker, cane, or wheelchair, or move from their home to a residential facility) and will be at higher risk for dying prematurely;

most importantly, there are actions they can take to reduce their risk.

2. Ensure that the patient's primary healthcare provider is made aware of the occurrence of the fracture. If unable to determine whether the patient's primary healthcare provider has been notified, take action to be sure the communication is made.

3. Regularly assess the risk of falling of women and men, age 65 or older, who have ever had a hip or vertebral fracture.

At a minimum, take a history of their falls within the last year.

Minimize use of medications associated with an increased risk for falls.

Evaluate patients for conditions associated with an increased risk for falls.

Strongly consider referring patients to physical and/or occupational therapy or a physiatrist for evaluation and interventions to improve impairments in mobility, gait, and balance, and to reduce the risk for falls.

4. Offer pharmacologic therapy for osteoporosis to women and men, age 65 years or older, with a hip or vertebral fracture, to reduce their risk of additional fractures.

Pharmacologic therapy (oral or intravenous) can begin in the hospital and be included in their discharge orders, although some practitioners prefer to delay intravenous zoledronic acid for a few weeks.

Do not delay initiation of therapy for bone mineral density ("BMD") testing. Although BMD testing may be performed to monitor responses to treatment, therapy should be offered regardless of BMD levels.

Consider patients' oral health before starting therapy with bisphosphonates or denosumab.

5. Because osteoporosis is a life-long chronic condition, routinely follow and re-evaluate women and men, age 65 years or older, with a hip or vertebral fracture, who are being treated for osteoporosis. Purposes include:

reinforcing key messages about osteoporosis and associated fractures

identifying any barriers to treatment adherence;

assessing the risk of falling;

evaluating the effectiveness of the treatment plan;

monitoring for adverse effects;

determining whether any changes in treatment should be made, including whether any osteoporosis pharmacotherapy should be changed or discontinued.

"All patients with hip or vertebral fractures need to be told that their broken bone most likely means they have osteoporosis and they are at very high risk for breaking more bones. Our goal is for patients, families, and their health care professionals to understand this and take actions to prevent future fractures, said Dr. Econs."

To read the full recommendations and learn more about the ASBMR Secondary Fracture Prevention Initiative, go to: http://www.secondaryfratures.org

East Hanover, NJ - September 28, 2018 - Model system researchers have examined the factors associated with mortality among individuals aged 16 years and older who were more than one year post- traumatic brain injury (TBI). Their article: O'Neil-Pirozzi- T, Ketchum JM, Hammond FM, Phillipus A, Weber E, Dams-O'Connor K. "Physical, cognitive, and psychosocial characteristics associated with mortality in chronic TBI survivors: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study" was published by the Journal of Head Trauma Rehabilitation 2018 Jul/Aug;33(4):237-245. (doi: 10.1097/HTR.0000000000000365).

The research team, which included investigators from five regional TBI Model Systems, analyzed data from the database of the TBI Model System National Data and Statistical Center. They identified 1,163 decedents and 10,839 matched controls, and examined the following physical, cognitive and psychosocial outcomes: Functional Independence Measure (FIM), Extended Glasgow Outcome Scale, Disability Rating Scale, Participation Assessment with Recombined Tool Objective, and Satisfaction With Life Scale.

"Among individuals who died, we found significantly poorer performance on all measures," noted co-author Erica Weber, PhD, research scientist in TBI Research at Kessler Foundation, and an investigator with the Northern New Jersey TBI Model System. "Most significant was the difference in FIM Motor scores, which points to independence in mobility as an important factor for long-term survival in this population. Another big difference was in community participation," she added.

The study shows the need for longer and more detailed study of health and lifestyle factors in the TBI population. "By identifying modifiable risk factors, we can develop strategies for prevention and early intervention, which will reduce the risk of death and improve the lives of individuals and caregivers," concluded Dr. Weber.

MADISON -- An ideal biorefinery would turn renewable crops into a variety of fuels and products with little waste. A significant challenge in realizing this vision is what to do with lignin, a fibrous and difficult-to-break-down material in the cell walls of plants that gives them their sturdiness.

Lignin makes up about a quarter of plant biomass and is the most abundant source of renewable aromatics on Earth. Aromatics are materials with six carbon rings usually derived from petroleum that are the building blocks for a wide array from products - from plastics to pharmaceuticals.

Despite its high energy density, researchers have struggled to find ways to realize lignin's value, but this naturally-occurring substance could, if harnessed, transform agricultural markets.

Now, scientists at the University of Wisconsin-Madison and Great Lakes Bioenergy Research Center (GLBRC) with partners at the Center for Bioenergy Innovation (CBI) have shown that a recently-discovered variety of the substance, catechyl lignin (C-lignin), has attributes that could make it well-suited as the starting point for a range of bioproducts. Their findings have been published today in Science Advances.

GLBRC researcher John Ralph, a UW-Madison professor of biochemistry and biological systems engineering, examined C-lignin's chief characteristics in collaboration with CBI's Richard Dixon, University of North Texas distinguished research professor of biochemistry and molecular biology, who found the substance in the seeds of an office cactus. Ralph's lab revealed a linear and homogeneous nature to the substance, uncommon traits for lignin.

Through further examination, Yanding Li, a UW-Madison biological systems engineering graduate student in the Ralph lab, was able to determine that C-lignin, also found in the coating of vanilla seeds, represents an ideal lignin for a bioenergy refinery.

The two groups discovered that the substance is made up of only one type of monomer, or lignin molecule, and each monomer is held together in the same way. Li and Ralph reasoned that it could therefore be refined into a single platform molecule, or a small array of such molecules, that can build a variety of products. Li also uncovered a particularly favorable trait: C-lignin doesn't lose its form when chemically pretreated.

Lignin often contains several kinds of monomers and becomes malformed when processed, making it a difficult puzzle to solve for academic researchers and their industrial counterparts. Paper factories, for example, often burn it as fuel rather than attempt to convert lignin into commercial bioproducts.

The sample that Li analyzed was comprised solely of C-lignin, promising because its uniformity allows for easier processing.

"Biofuel refineries like to use a 'pure' compound rather than a mixture of several," says Li. "The less complicated our product is, the more value it has."

Because C-lignin monomers are held together by only one kind of bond, called ether linkages, they can be cleaved cleanly into units with the right chemical treatment. These building blocks can then be transformed in different ways depending on the desired output.

"The regular and linear nature of this lignin, combined with the relatively simple chemistry to depolymerize it, makes producing high yields of simple monomers fairly straightforward," says Ralph.

When plants are refined into biofuels and bioproducts, the lignin first gets stripped away, leaving sugars to be converted into marketable materials. This pretreatment usually causes lignin to ball up into a tangled mess.

C-lignin's structure, however, survives even the harshest pretreatment methods and doesn't get twisted.

"Even the weakest of acid or alkali treatments destroys other lignin, but every time I checked the C-lignin after a reaction, it was almost entirely intact," says Li. "We can then create a good quality monomer in high yield for use as a platform chemical."

Ralph and Li exposed C-lignin to hydrogenolysis, a technique for deconstructing lignin developed at UW-Madison in 1938 by chemistry pioneer Homer Adkins.

The duo suspected hydrogenolysis would be able to cleave the ether bonds that hold C-lignin monomers together. In this case, the approach produced a simple pair of monomers in roughly 90 percent yield. Choosing the right catalyst could narrow it down to a single monomer -- a striking result for a plant component oft-maligned for its obstinance.

Isolating the genetic code that makes C-lignin so well-suited for production, the Ralph team and collaborators at CBI are working to insert such lignins into bioenergy crops that can be cultivated on a larger scale.

The team now has a vital blueprint for making use of a large part of plants that is used to being shoveled into an incinerator.

"Yanding took a step back and said, 'What more can we do with this?' " says Ralph. "The bigger thing was to realize a new paradigm, a new lignin ideotype, and a new way of thinking about the perfect lignin for a biorefinery."

At a time of "fake news" and a growing mistrust of scientific experts, researchers at York University's Global Strategy Lab are working to increase the likelihood that policy decisions will be informed by the best available science.

Steven J. Hoffman, Professor of Global Health, Law, and Political Science at York University, and his team at the Global Strategy Lab, convened an international group of experts from several disciplines to prepare 12 journals articles offering a broad suite of insight into how to effectively create and manage scientific advisory committees (SACs). The project was undertaken to support the World Health Organization in improving its own SACs that produce clinical, health systems and public health guidance.

The findings of the three-year-long effort were published this week as part of a special issue of the journal Global Challenges.

The special journal issue draws important lessons to be learned about SACs and their design, with two of the articles specifically considering SACs at the World Health Organization. These insights may help maximize the application of high-quality scientific research towards future policy and program decisions.

"The effectiveness of scientific advice depends greatly on having well-designed processes for generating that advice," said Hoffman. "With these 12 journal articles, we provide governments and international agencies with evidence-based guidance for setting up scientific advisory committees, tailoring them for each unique context, and ensuring that their work can be most impactful."

The special journal issue explores SACs in a number of areas including environmental policy in California and globally as well as malaria control and HIV/AIDS in sub-Saharan Africa. The special issue also includes insights from interviews with 35 senior World Health Organization staff.

It approaches SACs through an institutional design lens, by analyzing their formation, their size, and their functionality among other criteria.

"The good news is that small design changes can greatly improve the effectiveness of scientific advisory committees for greater public benefit. The composition of a committee matters, so does its chair, diversity, decision-making rules, stakeholder engagement, and many other factors. Governments and agencies like the World Health Organization that convene many scientific advisory committees can take a leadership role in further developing the science of scientific advice by studying their own processes and drawing lessons for improvement over time," said Hoffman.

Some of the other key findings about scientific advisory committees include:

Members of SACs must be transparent about their own conflicts, commitments, and biases which can then be appropriately managed

SACs must balance the need to involve stakeholders in discussions without compromising the independence and integrity of the scientific process

SACs facing scientific uncertainty should be transparent in how they evaluate evidence and should continuously discuss what it means to develop and provide scientific advice in political contexts

York University champions new ways of thinking that drive teaching and research excellence. Our students receive the education they need to create big ideas that make an impact on the world. Meaningful and sometimes unexpected careers result from cross-disciplinary programming, innovative course design and diverse experiential learning opportunities. York students and graduates push limits, achieve goals and find solutions to the world's most pressing social challenges, empowered by a strong community that opens minds. York U is an internationally recognized research university - our 11 faculties and 25 research centres have partnerships with 200+ leading universities worldwide. Located in Toronto, York is the third largest university in Canada, with a strong community of 53,000 students, 7,000 faculty and administrative staff, and more than 300,000 alumni.

Visible imagery from NASA's Aqua satellite revealed that strong wind shear was adversely affecting Tropical Cyclone Liua in the Southern Pacific Ocean.

On Sept. 28 at 0315 UTC (Sept. 27 at 11:15 p.m. EDT) the Moderate Resolution Imaging Spectroradiometer or MODIS instrument aboard NASA's Aqua satellite provided a visible image of Tropical Cyclone Liua. Liua appeared as a swirl of clouds around its center with most of its clouds and thunderstorms pushed southeast of center. Strong westerly to northwesterly vertical wind shear were tearing the storm apart.

In general, wind shear is a measure of how the speed and direction of winds change with altitude. Tropical cyclones are like rotating cylinders of winds. Each level needs to be stacked on top each other vertically in order for the storm to maintain strength or intensify. Wind shear occurs when winds at different levels of the atmosphere push against the rotating cylinder of winds, weakening the rotation by pushing it apart at different levels.

On Sept. 28, the Joint Typhoon Warning Center issued the final bulletin on Tropical Cyclone Liua. At that time, Liua was centered near 12.0 degrees south latitude and 161.1 degrees east longitude. That's 540 miles northwest of Port Vila, Vanuatu. Liua was moving slowly to the west-northwest and had maximum sustained winds near 35 knots (40 mph/62 kph).

Liua is forecast to dissipate under adverse atmospheric conditions.

An analysis of data directed by Jonathan Hiskey, associate professor of political science, and his co-authors shows that being a victim of crime is a powerful motivation for migrants to come to the United States, despite understanding the risks of the journey and challenges of the U.S. immigration system.

The findings, Hiskey says, suggest that current migration deterrence policies, which mainly target economic migrants, are ineffective against migrants fleeing violence. The research will be published in the forthcoming issue of Latin American Research Review. Political scientists Mary Fran Malone of the University of New Hampshire and Vanderbilt Ph.D. graduates Abby Córdova of the University of Kentucky and Diana Orcés of the American Immigration Council also contributed to the research.

In 2014, the United States saw a dramatic spike in migration from Central America, creating a humanitarian crisis along the U.S.-Mexico border. In response, the Obama administration implemented a number of efforts to detain and deport the newcomers, as well as launching "know before you go"-type multimedia campaigns throughout Central America to deter potential migrants by warning them about the dangers of the journey north and the high risk of detention and deportation upon arrival.

However, these efforts did little to stem that migration.

Since several of these nations have exceptionally high crime rates, and there is anecdotal evidence that crime is a heavy driver of migration from these countries, the researchers sought to measure the phenomenon empirically. To do so, they analyzed data from Vanderbilt's Latin American Public Opinion Project's 2014 AmericasBarometer survey, which included questions about respondents' personal experience with crime and whether they intended to migrate to the U.S. in the next three years. (The AmericasBarometer survey, which is conducted entirely in person by fieldworkers, is considered to be the gold standard for public opinion research, making the data highly reliable.)

Crime is a powerful migration motivator

"We found that one of the most powerful predictors of migration is if the person has been victimized by crime in the previous 12 months, and an even more powerful predictor is if that person has been victimized multiple times by crime," Hiskey said.

Of those from El Salvador expressing an intent to migrate who said they had been the victim of a crime in the previous year, 35 percent had been victimized once, and 44 percent had been victimized multiple times. Of those from Honduras, 39 percent had been victimized once, while 56 percent had been victimized more than once.

In El Salvador and Honduras, Hiskey said, the violence is often a widespread daily occurrence, where families are routinely extorted, and where children are recruited by force into gangs or to participate into violent initiation rituals. "It's a situation of constantly being exposed to violence and crime, in addition to a government that is either unwilling or unable to do anything to improve the situation," Hiskey explained. "Once individuals have lived through this for several years, they reach a point where they just say, simply, 'I don't care what lies in front of me, I have to leave, I have to get my kids out.'"

While Guatemala also has a high crime rate, it didn't appear to be influencing the immigration decision nearly as strongly. This was likely due to the difference in the type and distribution of crime in that country, though it is a question the authors plan to explore more thoroughly in future research.

Migrants know the risks

They then tested the reach of the deterrence campaign with a special survey conducted by LAPOP in Honduras and found that people were overwhelmingly aware of the U.S. warnings. Nearly nine in ten understood that crossing the U.S. border was more difficult, while 8 in 10 understood it to be less safe and that deportations were increased. Two-thirds also believed that migrants were being treated worse in the U.S. than they used to be.

Hiskey said this suggests that migrants who have been repeatedly victimized are likely so desperate to leave that they are willing to take their chances in the U.S., no matter how hard it seems. These are not the kind of migrants who are likely to respond to measures designed to stem economic migrants, Hiskey said. "What we see is a very different demographic profile of the individuals arriving now. The U.S. policy approach to unauthorized migration at the Southwest border, in my mind, has to change fundamentally to match who's arriving."

Though Hiskey said their findings may not be all that surprising, given how violent these three Central American countries are known to be and given the stories that migrants have been telling, it's important to be able to attach real numbers to the problem in order to solve it. "I think what our survey-based research does, through the work of the Latin American Public Opinion Project, is provide empirical, statistical support for the anecdotal and qualitative evidence that's already out there."

Visible imagery from NASA's Aqua satellite revealed Typhoon Trami was symmetrical and had a large eye on its approach to Japan's southern islands.

At 1:05 a.m. EDT (0505 UTC) on Sept. 28 the Moderate Resolution Imaging Spectroradiometer or MODIS instrument aboard NASA's Aqua satellite provided a visible image of Typhoon Trami in the Northwestern Pacific Ocean. The image showed the northwestern edge of Trami beginning to affect the Ryukyu Arc, a chain of Japanese islands that stretch southwest from Kyushu to Taiwan. Infrared satellite imagery shows Trami continues to have a wide eye with convection around the eye beginning to re-intensify.

On Sept. 28, the Joint Typhoon Warning Center or JTWC noted that Trami had maximum sustained winds near 90 knots (103.6 mph/166.7 kph). It was centered near 24.2 degrees north latitude and 127.0 degrees east longitude. That's 168 nautical miles south-southwest of Kadena Air Base, Okinawa, Japan. Trami was moving north-northwest and is forecast to turn to the north-northeast.

JTWC has forecast the eye of Trami to pass just to the west of Okinawa Island, Japan and Omami Oshima Island as it moves in a north-northeasterly direction.

For warnings and watches from the Japan Meteorological Agency, visit: http://www.jma.go.jp/en/typh/.

CORVALLIS, Ore. - Scientists have determined for the first time that Amazon's waterlogged coastal mangrove forests, which are being clear cut for cattle pastures and shrimp ponds, store significantly more carbon per acre than the region's famous rainforest.

The long-term study, recently published in the journal Biology Letters, provides a better understanding of how mangrove deforestation contributes to the greenhouse gas effect, one of the leading causes of global warming, said J. Boone Kauffman, an ecologist at Oregon State University who led the research.

The Brazilian mangrove forest fringes the entirety of the Atlantic Coast at the mouth of the Amazon, the largest river in the world with the largest mangrove forest. Although preservation of the Amazon rainforest has been the subject of intense awareness efforts over the last few decades, less attention has been paid to the Amazon mangroves.

Mangroves represent 0.6 percent of all the world's tropical forests but their deforestation accounts for as much as 12 percent of greenhouse gas emissions that come from all tropical deforestation.

"Over 25 years, we found two to three more times more carbon stored in the mangroves than in the rainforest," said Kauffman, a senior research professor in OSU's College of Agricultural Sciences. "When those forests are cut down they lose carbon, creating far more greenhouse gases than when the rainforests are cleared. Mangroves deserve conservation and participation in climate change mitigation actions throughout the world."

Mangroves are a group of trees and shrubs that live in tropical coastal intertidal zones. There are about 80 different species of mangrove trees. All of these trees grow in areas of waterlogged soils, where slow-moving waters allow fine sediments to accumulate. In these environments, mangroves sequester significant quantities of carbon that is stored for centuries.

For the study, the researchers visited nine mangroves and three salt marshes within the Brazilian Amazon. The Oregon coast, like much of the United States, features salt marshes along its coast and estuaries. Salt marshes, mangroves and sea grass communities are collectively referred to as "blue carbon" because they hold vast carbon reservoirs and their conservation is of value with respect to climate change mitigation.

Mangrove forests are also important for biodiversity. They are known as "kindergarten of the seas." This is where young fish spawn and reproduce and spend the early parts of their lives.

Clear-cutting mangroves presents another threat: The people who live along the coast just behind these forests become more vulnerable to storms when they are cut down, Kauffman said.

"Mangroves are important for storm surge protection," he said. "When we destroy the mangroves, we make populations much more vulnerable to damage and death during hurricanes. More often these are some of the poorest people on the planet."

Scientists at the Medical University of South Carolina (MUSC) have uncovered mechanisms by which high levels of a hormone called FGF23 can reduce brain health.

In results published in the journal PLoS ONE on September 7th, 2018, high levels of fibroblast growth factor 23 (FGF23) were associated with structural changes in the brain's frontal lobes. High FGF23 levels are thought to lead to the vascular calcification seen in patients with chronic kidney disease. The study showed that such a process may also affect the brain in patients without chronic kidney disease but with elevated cardiovascular risk factors, according to Leonardo Bonilha, M.D., Ph.D., associate professor of neurology in the MUSC Department of Medicine and director of the study.

"We found that there is a relationship between high levels of FGF23 and a form of structural compromise in the brain," said Bonilha.

FGF23 is produced in the bone. Normally, FGF23 works in the kidneys and the gut to regulate levels of calcium and phosphate in the body. It is thought to be increased in people who eat a diet high in phosphates, which are often found in foods with preservatives. In people with chronic kidney disease or in those who consume a diet high in phosphates, can be a calcification of their arteries, which can cause heart attack or stroke. FGF23 may be the reason.

Bonilha and graduate student Barbara Marebwa were interested in knowing if FGF23 could cause brain problems in people who had elevated cardiovascular risk factors, such as high blood pressure, diabetes, or high cholesterol. The idea was to determine if a high FGF23 level, present in people who did not have chronic kidney disease, was an indicator of problems in the brain.

Bonilha and Marebwa tested the idea that FGF23 and cardiovascular risk factors put together were an indicator of problems with communication in different parts of the brain. They recruited 50 patients for the study, about half of whom had elevated cardiovascular risk factors and about half of whom did not. All of the patients had normal kidney function. The researchers used magnetic resonance imaging to examine the connectomes in patients' brains, which was a way to see how different regions of their brains were connected. The method allows researchers to examine the white matter of the brain, which is more vulnerable to the type of stress that can occur when vessels become calcified. The frontal lobes, which control learning and complex cognitive functions, have a particularly high density of white matter, and thus may be most vulnerable to this type of stress.

The team looked at a feature of the connectome called modularity, which can reveal how well different parts of the brain are organized. People with abnormally high modularity have higher levels of disconnection in the brain, which may indicate problems with brain health in those areas. The researchers found that, in patients with high levels of FGF23 and cardiovascular risk factors, modularity was also high. In patients without cardiovascular risk factors, FGF23 levels were not associated with increased modularity. These results mean that FGF23 is associated with problems with brain health in people who already have high blood pressure, diabetes, or high cholesterol. As a result, elevated FGF23 levels may lead to structural damage in parts of the brain that may put people at a higher risk of stroke or problems with stroke recovery.

"It is important to understand the factors that relate to brain health, because brain health is associated with aging and resilience to injury. For example, if you get a stroke and you already have compromised brain health, the stroke may be more severe and you may not recover as well," explained Bonilha.

The work was part of a strategically focused research network (SFRN) grant funded by the American Heart Association to MUSC to examine disparities in stroke recovery. Myles Wolf, holder of an SFRN grant in cardiac and kidney research at Duke, contributed to the work. Together, the research team may have found a potential disparity in stroke recovery by highlighting vulnerability in the brains of patients with high FGF23 levels. For example, people without access to fresh foods may have high levels of FGF23 and thus an increased risk of stroke.

The next step, according to Bonilha, is to determine if lowering FGF23 levels in patients with cardiovascular risk factors can lead to better brain health or even to better outcomes following stroke. Previous work in other laboratories has revealed that FGF23 levels are elevated in people with cardiovascular risk factors and who consume a diet high in phosphates. The new results build on this finding and highlight the importance of a healthy diet in protecting the brain.

"This study is an important first step to lead to strategies to improve dietary habits and improve brain health," said Bonilha.

Hartford, Conn. - A new study of parents' fast-food restaurant purchases for their children finds that 74 percent of kids still receive unhealthy drinks and/or side items with their kids' meals when they visit one of the four largest restaurant chains--McDonald's, Burger King, Wendy's, and Subway--despite restaurants' commitments to offer healthier options with kids' meals. This finding is part of a new report from the Rudd Center for Food Policy and Obesity at the University of Connecticut.

Study authors say children continue to receive these unhealthy options because many fast-food restaurants still automatically provide sugary sodas and French fries with kids' meal orders and that restaurants continue to widely promote their unhealthy options inside the restaurants on menu boards and signs. Healthier kids' meal sides and drinks available include fruit and yogurt and 100 percent juice, low-fat milk, and water.

"While most fast-food restaurants do have healthier kids' meal drinks and sides available, many do little to make parents aware of the healthier options or to encourage parents to choose the healthier options instead of unhealthy ones. If restaurants are serious about children's health, they will make the healthiest choice the easiest choice for parents and the most appealing choice for children," said Jennifer Harris, Director of Marketing Initiatives for the UConn Rudd Center, and lead author of the report.

The study surveyed approximately 800 parents in 2010, 2013, and 2016 about what they ordered for their 2- to 11-year-old child in the past week from one of the top four fast-food restaurants. Sixty-one percent of those surveyed were moms aged 25-40, and most had two or more children aged 2-11 years.

Since 2010, the four largest fast-food restaurant chains have pledged to offer healthier drinks and side options in kids' meals, and not list sugary soda as a kids' meal option on menu boards. A previous UConn Rudd Center study conducted in 2016 found wide variation in how well individual restaurant locations implemented those commitments.

Study authors say restaurants should automatically provide healthy drinks and sides as the default choices with kids' meals and point to the need for regulations that would mandate those policies. The state of California, several cities and counties there, and cities like Baltimore, Md., have all passed policies requiring restaurants to offer healthier drinks as the automatic option with kids' meals, and New York City, Washington, DC, and others are considering similar legislation. In Louisville, Ky., legislation

was recently enacted requiring healthier drinks as well as fruit, vegetable, whole grain, or lean protein as part of a kids' meal. Subway is the only fast-food restaurant studied that voluntarily includes only healthier side and drink options with kids' meals in their restaurants nationwide.

Kids Are Eating Fast Food More Frequently

The study also found children are eating fast food more often. In 2016, 91 percent of parents reported purchasing lunch or dinner for their child in the past week at one of the four largest chains, up from 79 percent in 2010. Families visited McDonald's the most.

Study authors say low cost and/or increased value of fast-food meals, convenience and easy access, and a documented increase in fast-food advertising to children could account for the increase in consumption of fast food meals.

"We know that fast food offers parents a convenient, affordable option for feeding their families. But restaurants have a responsibility to make these affordable, convenient foods healthier. Most fast-food meals--even kids' meals--have more fat, sugar, and sodium than children need, and eating this kind of unhealthy food can have negative health consequences over time, such as obesity, diabetes, heart disease, and other health issues," said Harris.

Other 2016 findings in the report include:

Nearly all parents responded positively to healthier kids' meal policies at the specific restaurant they visited and said the policy would make them purchase food for their child at that restaurant more often.

One-third of parents who purchased lunch or dinner for their child at a fast-food restaurant did not purchase a kids' meal, and this was true for both younger children (ages 2-5) and older children (ages 6-11). They purchased regular menu items, which include adult-sized portions and tend to be less nutritious than kids' meal items.

Fifty percent of children who received a kids' meal got a healthier side item, and 59 percent received a healthier kids' meal drink.

In general, parents are purchasing healthier options for their younger children (ages 2-5) than for older kids (ages 6-11) at fast-food restaurants. Across all three years studied, parents were significantly more likely to buy only a kids' meal, and not another menu item on top of it, for a younger child than for an older child (64 percent versus 46 percent, respectively). Parents were also more likely to receive a healthier drink when purchasing a kids' meal for a younger child than for an older child (66 percent versus 50 percent, respectively).

Some restaurants have implemented new practices that add on extra fat, sugar, and calories, such as providing desserts with kids' meals (some Dairy Queen and some Subway locations), or offering a dessert in place of a kids' meal toy (some Burger King locations).

"Given parents' positive attitudes about kids' meal policies, and how often families are visiting these restaurants today, fast-food companies have a substantial marketing opportunity to better promote the healthier options inside their restaurants," said Harris.

"They should also make more meaningful changes on the menu. Fast-food restaurants have said they want to be part of the solution to childhood obesity. They can start by making the healthier drinks and sides the default options in kids' meals and introducing healthier kids' meal main dishes, which remain high in fat, sodium, and calories," she said.

Researchers at the University of Waterloo have made progress towards predicting who is likely to feel sick from virtual reality technology.

In a recent study, the researchers found they could predict whether an individual will experience cybersickness (motion sickness caused by virtual reality) by how much they sway in response to a moving visual field. The researchers think that this knowledge will help them to develop counteractions to cybersickness.

Cybersickness involves nausea and discomfort that can last for hours after participating in virtual reality (VR) applications, which have become prevalent in gaming, skills training and clinical rehabilitation.

"Despite decreased costs and significant benefits offered by VR, a large number of users are unable to use the technology for more than a brief period because it can make them feel sick," Séamas Weech, a postdoctoral research fellow at the Department of Kinesiology and lead author of the paper. "Our results show that this is partly due to differences in how individuals use vision to control their balance. By refining our predictive model, we will be able to rapidly assess an individual's tolerance for virtual reality and tailor their experience accordingly."

In conducting their work, the researchers collected several sensorimotor measures, such as balance control and self-motion sensitivity, from 30 healthy participants aged 18-30.

The researchers then exposed the participants to VR with the aim of predicting the severity of motion sickness. Using a regression model, they significantly predicted how much cybersickness participants experienced after being exposed to a zero-gravity space simulator in VR.

"Knowing who might suffer from cybersickness, and why, allows us to develop targeted interventions to help reduce, or even prevent, the onset of symptoms," said Michael Barnett-Cowan, neuroscience professor in the Department of Kinesiology and senior author of the paper. "Considering this technology is in a growth phase with industries such as gaming, design, medicine and automotive starting to use it, understanding who is negatively impacted and how to help them is crucial."