Doctoral student recruiting volunteers in effort to quadruple number of known active asteroids

Thousands of ‘Citizen Scientists’ needed to scan the night sky for rare solar system objects

Business Announcement

NORTHERN ARIZONA UNIVERSITY

 

IMAGE: THE ACTIVE ASTEROIDS PROJECT IS HOSTED ON THE ZOONIVERSE PLATFORM. view more 

CREDIT: COLIN CHANDLER, NORTHERN ARIZONA UNIVERSITY

The study of active asteroids is a relatively new field of solar system science, focusing on objects that have asteroid-like orbits but look more like comets, with visual characteristics such as tails.

Because finding an active asteroid is such a rare event, fewer than 30 of these solar system bodies have been found since 1949, so there is still much for scientists to learn about them. Roughly only one out of 10,000 asteroids are classified as active asteroids, so an enormous number of observations will be needed over the span of many years to yield a larger sample for study.

Through funding from a National Science Foundation (NSF) Graduate Research Fellowship Program (GRFP) award in 2018, doctoral student Colin Orion Chandler in Northern Arizona University’s Department of Astronomy and Planetary Science just launched an ambitious new project, Active Asteroids, which is designed to engage volunteers in the search for more of these enigmatic objects. The highly competitive and prestigious program, awarded to only 15 percent of the more than 2,000 yearly applicants, provides three years of funding for Chandler’s research.

“With the generous help of ‘Citizen Scientists’,” said Chandler, project founder and principal investigator, “we hope to quadruple the number of known active asteroids and encourage study of an ambiguous population of solar system objects, knowledge of which is currently hampered due to a very small sample size.”

The implications of finding more active asteroids for science and engineering are far-reaching, including:

• Helping to answer key unsolved questions about how much water was delivered to Earth after it formed, and where that water originated.
• Advising searches for life about where water—a prerequisite for life as we understand it—is found, both in our own solar system and other star systems, too.
• Informing spaceflight engineers seeking more practical, inexpensive and environmentally responsible sources of fuel, air and water.
• Appraising volatile availability for prospective asteroid mining efforts and sample-return missions.

In preparation for the launch, Chandler, an NAU Presidential Fellow, conducted the beta review phase of the project, enlisting the help of more than 200 volunteers, who completed 4,798 classifications of 295 objects.

“I am very, very excited the project is finally launching,” he said. “The project has been years in the making, from selection by the NSF until this launch. Even during the preparations for the project launch, we have made several important discoveries, including discovering a new active object and uncovering information about several previously known objects. These discoveries have led to three publications in peer-reviewed scientific journals, with another one in the works right now.”

As part of the testing phase, the team noticed an unusual "smudge" kept showing up around one particular object. The object was a Centaur, an icy body with an orbit between Jupiter and Neptune. The team carried out follow-up observations with other telescopes and discovered the object was active, one of only about 20 active Centaurs discovered since 1929, and published their findings in the Astrophysical Journal Letters (see related article).

Although it will depend on the number of volunteers participating and how quickly they complete classifications, the duration of the project could be up to one year. Chandler hopes to recruit thousands of volunteers to participate. No previous astronomy experience is needed; training is provided through Zooniverse, an online platform for people-powered research hosting the Active Asteroids project.

“We need to examine 5,000 square degrees of the sky in the Southern Hemisphere, which means there are many—more than 10 million—asteroid images to classify!” he said.

Co-founders of the project are Jay Kueny of Lowell Observatory and the University of Arizona, who began collaborating with Colin in creating the project when he was a senior at NAU—and who has since then also received a GRFP award from the NSF—and NAU associate professor Chad Trujillo, who serves as the project's Chief Science Advisor. Other contributors are graduate students Annika Gustaffson and William Oldroyd.

The project’s Science Advisory Board consists of several eminent scientists, including Henry Hsieh of the Planetary Science Institute, NAU professor David Trilling, NAU assistant professor Tyler Robinson and NAU assistant professor Michael Gowanlock.

Ready to classify objects? Visit the Active Asteroids project site to get started.

This project was supported through NASA grants 80NSSC21K0114 and 80NSSC19K0869.

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About Northern Arizona University

Northern Arizona University is a higher-research institution providing exceptional educational opportunities in Arizona and beyond. NAU delivers a student-centered experience to its nearly 30,000 students in Flagstaff, statewide and online through rigorous academic programs in a supportive, inclusive and diverse environment. Dedicated, world-renowned faculty help ensure students achieve academic excellence, experience personal growth, have meaningful research opportunities and are positioned for personal and professional success.

Unease beyond the uncanny valley: How people react to the same faces

Researchers examined people’s emotional response to cloned faces, which could soon become the norm in robotics

Peer-Reviewed Publication

RITSUMEIKAN UNIVERSITY

 

IMAGE: AN EDITED PHOTO THAT SHOWS ONE OF THE STUDY AUTHOR’S FACE AS AN EXAMPLE OF A CLONE IMAGE. PARTICIPANTS IN THE RESEARCH WERE ASKED TO RATE THE SUBJECTIVE EERINESS, EMOTIONAL VALENCE, AND REALISM OF CLONE AND NON-CLONE IMAGES. view more 

CREDIT: DR. FUMIYA YONEMITSU FROM KYUSHU UNIVERSITY

Increasingly, movies featuring humanoid robots, like Terminator or Ex Machina, are showing the titular “robot” akin to humans not only in intelligence but also appearance. What if Terminator-esque robots became the norm, making it difficult for us to tell them apart from actual human beings?

This is the premise of a new study published in PLOS ONE, which evaluated how human beings respond to images of people with the same face. It is not too far-fetched to imagine a future where human-like androids are mass-produced and are indistinguishable from flesh-and-blood human beings. Robotics and artificial intelligence are advancing at an unprecedented rate, with very closely human-like robots and CG characters, such as Geminoid, Saya, and Sophia already having been produced. Developers are optimistic they will one day create robots that surpass the uncanny valley—a well-known phenomenon where humanoids elicit unpleasant and negative emotions in viewers when their appearance becomes similar to that of humans.

In such a future, how would we react?

A team of researchers from Kyushu University, Ritsumeikan University, and Kansai University, collaboratively conducted a series of six experiments involving different batches of hundreds of people to try and find that answer.

The first experiment involved rating the subjective eeriness, emotional valence, and realism of a photoshopped photograph of six human subjects with the exact same face (clone image), six people with different faces (non-clone image), and one person (single image). The second experiment comprised rating another set of clone images and non-clone images, while the third experiment consisted of rating clone and non-clone images of dogs. The fourth experiment had two parts: rating clone images of two sets of twins and then rating clone faces of twins, triplets, quadruplets, and quintuplets. The fifth experiment involved clone images of Japanese animation and cartoon characters. And the sixth and final experiment involved evaluating the subjective eeriness and realism of a different set of clone and non-clone images while also answering the Disgust Scale Revised to analyze disgust sensitivity.

The results were striking. Participants from the first study rated individuals with clone faces as eerier and more improbable than those with different faces and a single person's face.

The researchers termed this negative emotional response as the clone devaluation effect.

“The clone devaluation effect was stronger when the number of clone faces increased from two to four,” says lead author Dr. Fumiya Yonemitsu from Graduate School of Human-Environment Studies at Kyushu University, who is also a Research Fellow of Japan Society for the Promotion of Science. “This effect did not occur when each clone face was indistinguishable, like animal faces in experiment three involving dogs.”

According to him, “We also noticed that the duplication of identity, that is the personality and mind unique to a person, rather than their facial features, has an important role in this effect. Clone faces with the duplication of identity were eerier, as the fourth experiment showed. The clone devaluation effect became weaker when clone faces existed in the lower reality of the context, such as in the fifth experiment. Furthermore, the eeriness of clone faces stemming from improbability could be positively predicted by disgust, in particular animal-reminder disgust, as noticed in the sixth experiment. Taken together, these results suggest that clone faces induce eeriness and that the clone devaluation effect is related to realism and disgust reaction.”

These results show that human faces provide important information for identifying individuals because human beings have a one-to-one correspondence between face and identity. Clone faces violate this principle, which may make humans misjudge the identity of people with clone faces as being the same.

So, what does this mean for a future in which humanoids are inevitable? According to the researchers, we need to think critically about introducing new technology in robotics or human cloning because of the potential for unpleasant psychological reactions other than the uncanny valley phenomenon.

“Our study clearly shows that uncomfortable situations could occur due to the rapid development of technology. But we believe our findings can play an important role in the smooth acceptance of new technologies and enhance people’s enjoyment of their benefits”, observes co-author Dr. Akihiko Gobara, Senior Researcher from BKC Research Organization of Social Science at Ritsumeikan University

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CAPTION

Researchers examined people’s emotional response to cloned faces, which could soon become the norm in robotics

CREDIT

Ritsumeikan University, Kyushu University, Kansai University, Japan

USAGE RESTRICTIONS

Joint press release from Ritsumeikan University, Kyushu University, and Kansai University, Japan

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0254396 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The clone devaluation effect: A new uncanny phenomenon concerning facial identity

ARTICLE PUBLICATION DATE

12-Jul-2021

OPIUM HAS ONLY BEEN AROUND FOR FIVE HUNDRED YEARS

At least 80% of opioid overdoses aren’t fatal, WVU researchers want to know how they affect the brain

Peer-Reviewed Publication

WEST VIRGINIA UNIVERSITY

 

IMAGE: SCIENTISTS STILL KNOW LITTLE ABOUT HOW OPIOID OVERDOSES AFFECT THE BRAIN AND COGNITION. WVU SCHOOL OF MEDICINE RESEARCHERS ERIN WINSTANLEY AND JAMES MAHONEY PERFORMED A SYSTEMATIC REVIEW OF JOURNAL ARTICLES THAT TACKLE THE TOPIC. THEY FOUND THAT WHILE EVIDENCE EXISTS TO SUPPORT A LINK BETWEEN OVERDOSE, COGNITIVE IMPAIRMENT AND BRAIN ABNORMALITIES, MORE RESEARCH IS NEEDED IN THIS AREA. view more 

CREDIT: WVU PHOTO ILLUSTRATION/AIRA BURKHART

An opioid overdose isn’t a death sentence. In fact, estimates indicate that in the United States, only 4% to 18% of opioid overdoses that are treated in a hospital or pre-hospital setting—such as an ambulance or someone’s home—actually kill the patient. But there’s a lot that scientists still don’t know about what nonfatal overdoses do to the brain.

To better understand the topic, Erin Winstanley and James Mahoney—researchers with the West Virginia University School of Medicine and Rockefeller Neuroscience Institute—reviewed 79 studies of neurocognitive impairments and brain abnormalities associated with nonfatal opioid overdoses in humans. The studies all had limitations, a sign that more precise research is needed in this area. Yet despite the studies’ shortcomings, their findings still suggested that brain abnormalities and cognitive impairments are linked to overdose.

“I think there’s probably a host of morbidities associated with experiencing a nonfatal opioid-related overdose that’s largely neglected in the published literature and—to a certain extent—from a public health standpoint,” said Winstanley, an associate professor in the Department of Behavioral Medicine and Psychiatry and the Department of Neuroscience. “We should first focus on saving lives. That’s definitely the appropriate step. But we probably should start paying attention to some of these other issues, too. Given the proportion of people who have experienced a nonfatal overdose, the number of deaths is just the tip of the iceberg.”

Their findings appear in Drug and Alcohol Dependence.

Winstanley, Mahoney and their colleagues—Felipe Castillo and Sandra Comer of Columbia University—performed a systematic review of journal articles published between 1973 and 2020.

Overall, the studies lacked the level of detail and consistency that would have made many direct comparisons and inferences possible.

For instance, fewer than half of the studies reported toxicology results confirming an opioid overdose. Only 27.8% reported results of neuropsychological testing, and only 64.6% reported magnetic resonance imaging—or MRI—results of the brain.

The team discovered that all of the studies were at risk of one form of bias or another. Some studies, for example, failed to measure participants’ intellectual functioning, consider whether they had received prompt overdose treatment or reported whether they were using anything besides opioids.

“Independent of overdose, addiction research is complicated in general because of all these numerous confounding variables,” said Mahoney, an associate professor and clinical neuropsychologist in the WVU Department of Behavioral Medicine and Psychiatry and the Department of Neuroscience. “There are often medical and psychiatric comorbidities and several other factors that may be impacting the cognition of these individuals. On top of that, co-occurring substance use in addition to opioids is more the norm than the exception.”

The overdose itself complicates matters further. How long was the individual’s brain deprived of oxygen? Did they receive adequate treatment in time? How long post-overdose was neuroimaging or cognitive testing done? All of these variables—and many others—can influence a study’s results.

“Also, there are so many different measurements that are used to test cognitive functioning, making it even more difficult to compare findings across the literature,” Mahoney said.

Despite these inconsistencies, the studies provided evidence that an opioid overdose has the potential to change how someone’s brain appears or behaves. In turn, those changes could influence someone’s attention span, memory, executive function or other higher-order thinking skills.

“This news is quite positive in the sense that if we can start to do early identification and screening for neurocognitive deficits—whether they’re associated with overdose or not—we might actually have the right kind of rehabilitation therapy for them, including some promising new treatments for cognitive deficits,” Winstanley said.

That’s important because neurocognitive deficits make poor treatment outcomes more likely for people who want to stop using opioids or other substances.

“If we are able to target those at a higher risk of cognitive impairment—perhaps those who have had five or six overdoses—and individualize their treatment plans to address those deficits as early in the treatment process as possible, we may be able to improve their outcomes, given what is known about cognition and treatment dropout,” Mahoney said.

To gain more insight into those deficits and how they can be addressed, Winstanley, Mahoney and their colleagues at WVU and Columbia University have begun a new project. They’re comparing the cognition of two groups of people with opioid use disorder: those with a past history of overdose and those without any overdose history.

The researchers have had all participants complete the same comprehensive battery of neurocognitive tests. As they gather and analyze the data, the researchers will take into account characteristics such as the participants’ age, education level and intellectual functioning; how long they have been using substances; and which substances they have used.

In addition, the team has used functional MRI to form images of some of the participants’ brains to provide insight into how the brain is actually working as they completed working-memory tasks.

“While the neurocognitive testing lets us know how these individuals are actually performing on various thinking tasks, the fMRI data will also give us a sense neuroanatomically of how the brain is functioning, how the various brain networks are engaged and how different areas of the brain are interacting with one another,” Mahoney said. “We will have the opportunity to gain better insight into what factors other than their opioid use and overdose—such as the co-occurring use of other substances—may be impacting these brain networks.”

Insights into how opioid use, overdose and other variables affect the brain could lead to novel neuromodulation treatments, including ones that Mahoney is now exploring.

Neuromodulation involves altering the activity of specific brain areas and networks through the application of electrical pulses, a magnetic field, of other forms of stimulation.

In 2019, Mahoney was part of a team of scientists from RNI and WVU Medicine that launched the world’s first Food and Drug Administration–approved clinical trial of deep brain stimulation to treat opioid use disorder. 

He’s also investigating the use of transcranial magnetic stimulation—another form of neuromodulation—to fight addiction, as well as low-intensity focused ultrasound, which has been studied for several disorders but is in the infancy of exploration as a potential treatment for substance use disorder. 

“By helping to rewire those areas of the brain that are involved in craving and cognition, such as disinhibition, decision making, attention and higher-order executive functions, we can hopefully improve cognitive functioning, which would subsequently improve treatment outcomes,” he said. “It’s unrealistic to think that neuromodulation will simply ‘fix’ addiction, but when used in combination with the standard of care—comprehensive behavioral treatment with medication for opioid use disorder—we will hopefully be able to provide another strategy to help people achieve abstinence.”

Link: https://www.sciencedirect.com/science/article/pii/S0376871621003331?via%3Dihub

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JOURNAL

Drug and Alcohol Dependence

DOI

https://doi.org/10.1016/j.drugalcdep.2021.108838 

ARTICLE TITLE

Neurocognitive impairments and brain abnormalities resulting from opioid-related overdoses: A systematic review

ARTICLE PUBLICATION DATE

1-Sep-2021

 POSTMODERN ASIAN ALCHEMY

The flower clock: How a small protein helps flowers to develop right and on time

Researchers from Nara Institute of Science and Technology and Nanjing University find that KNUCKLES, a small multi-functional protein, supports the correct timing of floral development for the proper formation of flower reproductive organs

Peer-Reviewed Publication

NARA INSTITUTE OF SCIENCE AND TECHNOLOGY

 

IMAGE: THE IMAGE SHOWS AN EARLY STAGE FLOWER OF ARABIDOPSIS THALIANA. USING CONFOCAL MICROSCOPY, SHANG ERLEI ET AL. FOUND THAT KNUCKLES (KNU), ENCODING A C2H2-TYPE ZINC FINGER REPRESSOR, EXPRESSES IN FLORAL MERISTEM (SHOWN IN RED) FROM FLORAL STAGE 6 AND OVERLAPS WITH THE STEM CELL MARKER GENE CLVTAVA3 (CLV3) EXPRESSING CELLS (SHOWN IN GREEN). FURTHER, KNU DIRECTLY REPRESSED CLV3 AND MEDIATES A REGULATORY FRAMEWORK FOR THE TIMELY CONTROLLED FLORAL MERISTEM DETERMINACY. view more 

CREDIT: BO SUN

Ikoma, Japan – How flowers form properly within a limited time frame has been a mystery, at least until now. Researchers from Japan and China have discovered how a multi-tasking protein helps flowers to develop as expected.

In a study published in Proceedings of the National Academy of Sciences U.S.A., researchers from Nanjing University and Nara Institute of Science and Technology have revealed that a small protein plays multiple roles to ensure that floral reproductive organs are formed properly within a short space of time.

Flowers develop from floral meristems, which differentiate to produce the sepals, petals, stamens, and carpels. The proper development of these floral organs depends on meristem development being completed within a certain time period. In the early stages of flower development, stem cells provide the cell source for floral organ formation. In floral meristems, stem cell activities are maintained via a feedback loop between WUSCHEL (WUS), a gene that identifies floral stem cells, and CLAVATA3 (CLV3), a stem cell marker gene that is activated and sustained by WUS.

“A small protein called KNUCKLES (KNU) represses WUS directly, which leads to the completion of floral stem cell activity at the right time,” says lead author Erlei Shang of the study. “What isn’t fully understood is how the robust floral stem cell activity finishes within a limited time period to ensure carpel development.”

“The team’s research revealed that in Arabidopsis thaliana, KNU can completely deactivate the robust floral meristems at a particular floral stage, thanks to the multiple functions that KNU carries out via its position-specific roles,” says senior author Toshiro Ito.

KNU both represses and silences WUS, and directly represses CLV3 and CLV1 (a gene that encodes a receptor for the CLV3 peptide). Consequently, KNU eliminates the CLV3-WUS feedback loop via transcriptional and epigenetic mechanisms (i.e., those that do not involve changes in the underlying DNA sequences). Additionally, KNU interacts physically with the WUS protein, which inhibits WUS from sustaining CLV3, disrupting interactions that are required for the maintenance of floral meristems.

“Our results reveal a regulatory pathway where KNU plays a key role in supporting the completion of floral meristem development within a short time window, and ensures that flower reproductive organs are properly formed,” says corresponding author Bo Sun.

The results of this research will be useful for genetic studies of food crop species such as rice, tomatoes, and maize. An understanding of the floral meristem termination mechanism discovered in this study will benefit crop yields for food production globally.

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Resource

Title: Robust control of floral meristem determinacy by position-specific multifunctions of KNUCKLES

Authors: Erlei Shang, Xin Wang, Tinghan Li, Fengfei Guo, Toshiro Ito & Bo Sun

Journal: Proceedings of the National Academy of Sciences U.S.A.

Information about Ito's lab can be found at the following website: https://bsw3.naist.jp/eng/courses/courses112.html

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JOURNAL

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2102826118 

ARTICLE TITLE

Robust control of floral meristem determinacy by position-specific multifunctions of KNUCKLES

CHOP researchers find bystander CPR with rescue breathing leads to better outcomes in pediatric cardiac arrest

Study shows that in infants experiencing cardiac arrest, bystander CPR using only chest compression has similar outcomes to not using CPR at all

Peer-Reviewed Publication

CHILDREN'S HOSPITAL OF PHILADELPHIA

 

IMAGE: MARYAM Y. NAIM, MD, MSCE, A PEDIATRIC CARDIAC INTENSIVE CARE PHYSICIAN IN THE DIVISION OF CARDIAC CRITICAL CARE MEDICINE AT CHILDREN'S HOSPITAL OF PHILADELPHIA AND FIRST AUTHOR OF THE STUDY view more 

CREDIT: CHILDREN'S HOSPITAL OF PHILADELPHIA

Philadelphia, August 30, 2021—When children and adolescents go into cardiac arrest outside of a hospital setting, CPR with rescue breathing – rather than CPR using only chest compressions – leads to better outcomes, according to a new study by researchers at Children’s Hospital of Philadelphia (CHOP). The findings, published today in the Journal of the American College of Cardiology, support the use of bystander CPR with rescue breathing in children experiencing cardiac arrest. 

“At the moment, most lay people are trained in compression-only CPR because that is the standard of care in adults,” said Maryam Y. Naim, MD, MSCE, a pediatric cardiac intensive care physician in the Division of Cardiac Critical Care Medicine at Children's Hospital of Philadelphia and first author of the study. “However, children are not simply small adults, and our study shows there is a tremendous need for education in all communities about the benefits of CPR with rescue breathing in the pediatric population. For infants in particular, our study shows that CPR with rescue breathing is the only type of CPR that is associated with good neurological outcomes; infants who received compression-only CPR had similar outcomes to infants who did not receive bystander CPR.”

Fewer than 10% of children who experience cardiac arrest outside of a hospital setting survive. The rates of survival improve when a bystander performs CPR, but prior to this study, the frequency and type of bystander CPR in out-of-hospital pediatric cardiac arrest in different age groups was unknown. In adults, compression-only CPR has been shown to be as effective as CPR with rescue breathing, so since 2010, the American Heart Association (AHA) and European Resuscitation Council (ERC) have recommended compression-only CPR for bystanders who witness an adult in cardiac arrest. However, the researchers suspected this form of CPR might be less effective in children, as pediatric cardiac arrest most often stems from breathing problems.

To better understand the frequency, type, and outcomes of bystander CPR for children, the researchers analyzed 10,429 out-of-hospital cardiac arrests between 2013 and 2019 in patients between 0 and 18 years of age. The data for the study was derived from the Cardiac Arrest Registry to Enhance Survival (CARES) database, a registry maintained by the Centers for Disease Control and Prevention in collaboration with the Department of Emergency Medicine at the Emory University School of Medicine, which includes an overall catchment area of nearly 145 million people in 28 states across the United States. 

The researchers found that less than half (46.5%) of those who experienced pediatric cardiac arrest outside of the hospital received bystander CPR. Of those who did receive CPR, the majority (55.6%) received compression-only CPR. Those children who received CPR with rescue breathing were nearly 1.5 times as likely to have better neurological outcomes than those who received compression-only CPR. In children and adolescents, both types of CPR had better neurological outcomes than no CPR at all, but to the researchers’ surprise, infants receiving compression-only CPR had essentially the same outcomes as infants who received no CPR.   

Additionally, the researchers examined the changes in rates and types of CPR over the six-year study period and found that although the rates of bystander CPR did not change, the proportion of compression-only CPR increased, with no change in neurologically favorable survival.

“While public health efforts to teach compression-only CPR have benefited adults who have cardiac arrests, children have likely been disadvantaged by these efforts. The results of this study have important implications on bystander CPR education and training, which should continue to emphasize rescue breathing CPR for children – and especially infants –in cardiac arrest and teach lay rescuers how to perform this type of CPR,” Naim said. 

Naim et al. “Compression-only versus Rescue-breathing Bystander Cardiopulmonary Resuscitation in Pediatric Out-of-Hospital Cardiac Arrests,” Journal of the American College of Cardiology, online August 30, 2021, DOI: 10.1016/j.jacc.2021.06.042

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About Children’s Hospital of Philadelphia: Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. In addition, its unique family-centered care and public service programs have brought the 595-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu 

 

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JOURNAL

Journal of the American College of Cardiology

DOI

10.1016/j.jacc.2021.06.042 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Compression-only versus Rescue-breathing Bystander Cardiopulmonary Resuscitation in Pediatric Out-of-Hospital Cardiac Arrests

ARTICLE PUBLICATION DATE

30-Aug-2021

Mouth-to-mouth bystander CPR preferable method for pediatric cardiac arrest

Compression-only CPR still recommended for adults

Peer-Reviewed Publication

AMERICAN COLLEGE OF CARDIOLOGY

Rescue breathing cardiopulmonary resuscitation (CPR) had superior neurological outcomes compared with compression-only CPR or no CPR at all in infants, children and adolescents, according to a new analysis published today in the Journal of the American College of Cardiology.

Over 5,000 Americans under the age of 18 experience an out-of-hospital cardiac arrest (OHCA) each year. CPR is a life-saving emergency technique used to help a person whose breathing or heart may have stopped. National and statewide efforts focus on teaching compression-only CPR (CO-CPR) to improve the likelihood of bystander CPR. While current guidelines recommend CO-CPR for adults with OHCA, children more commonly experience OHCA caused by asphyxiation for which CO-CPR may be less effective, leading to worse neurological outcomes compared to rescue breathing CPR (RB-CPR).

Data for this study came from the Cardiac Arrest Registry to Enhance Survival (CARES) database, an established collaboration between the Centers for Disease Control and Prevention and the Department of Emergency Medicine at Emory University School of Medicine, which includes data from 145 million people in 28 states across the United States. A total of 10,429 pediatric cases were pulled from January 2013 to December 2019. Age groups included infants (less than one year of age), children (one to 11 years) and adolescents (12 to 18 years). Bystander CPR was defined as being administered by a family member, layperson, or a layperson with medical training.

Pediatric CPR was most commonly performed due to cardiac problems (44.4% of cases), respiratory problems (32.8%), drowning (8.8%), drug overdose (1.8%), electrocution or exsanguination (both at 0.2%) or other medical causes (11.9%). Cardiac arrests were more common in infants, males, and white and Black children compared to children of other races/ethnicities. Family members or laypersons were most likely to perform CO-CPR, whereas laypersons with medical training were more likely to perform RB-CPR.

In analyzing the data, the researchers found that OHCAs with RB-CPR and CO-CPR independently had better neurological outcomes compared with no CPR performed at all. However, compared with CO-CPR, RB-CPR was associated with higher odds of favorable neurological outcomes for infants, children and adolescents. The analysis found RB-CPR was also associated with higher odds of overall survival compared with CO-CPR.

Compared with children and adolescents, infants were found to have different outcomes when it came to CO-CPR and RB-CPR. The researchers found RB-CPR resulted in better outcomes than CO-CPR for all pediatric age groups. However, the researchers also found performing CO-CPR was better than no CPR in children and adolescents, but not infants; neurologically favorable survival in infants was only observed with RB-CPR. The researchers concluded that RB-CPR should continue to be the recommended form of CPR for infants.

“One of the most important findings of our investigation is that compression-only CPR is currently the most commonly performed type of CPR for pediatric cardiac arrest in the United States,” said Maryam Y. Naim, MD, MSCE, a pediatric cardiac intensive care physician in the division of cardiac critical care medicine at Children’s Hospital of Philadelphia, and lead author of the study. “Current public health campaigns focus on teaching compression-only CPR, and while this has improved outcomes in adults, it is possible this had disadvantaged children, particularly infants who did not show a benefit in outcome with compression-only CPR. Bystander CPR education should continue to emphasize rescue breathing CPR for those under 18, especially infants, and teach lay rescuers how to perform rescue breathing CPR.”

“This new study adds important data to the limited published literature on this topic,” said Gene Yong-Kwang Ong, MBBS, consultant in the department of pediatric emergency medicine in Kandang Kerbau Hospital in Singapore, and author of the accompanying editorial comment. “Given that infants were consistently reported to suffer the worst clinical outcomes, and with this finding that bystander rescue breathing CPR could improve neurologically favorable survival, it behooves us to look into this in a timely manner. There needs to be important discussions in light of this data.”

This study has several limitations, including utilizing observational data, and a lack of data on dispatcher instruction, the quality of CPR and training of the lay rescuer. In addition, the type of bystander CPR included in CARES registry was not available for all arrests. The researchers recommend the findings to be validated in larger studies.

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The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

The ACC’s family of JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology (JACC) — and family of specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC.org.

 

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JOURNAL

Journal of the American College of Cardiology

DOI

10.1016/j.jacc.2021.06.042 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Compression-Only Versus Rescue-Breathing Cardiopulmonary Resuscitation After Pediatric Out-of-Hospital Cardiac Arrest

ARTICLE PUBLICATION DATE

7-Sep-2021

Reliable oxygenation conceivable with new design for portable concentrators

Simulation-based optimization determines most favorable design for oxygen concentrators

Peer-Reviewed Publication

TEXAS A&M UNIVERSITY

As health workers around the world provide care to those infected with SARS-CoV-2 and its many variants, the shortages in medical oxygen continue to deeply impact hospitals already stretched thin. While portable oxygen concentrators have provided some relief to many with respiratory distress, these machines sometimes do not generate enough medical oxygen to meet the fluctuating demands of a patient with worsening symptoms, requiring them to be rehospitalized.

Anticipating the increased need for better oxygen concentrators as the fight against COVID-19 rages on, researchers at Texas A&M University have laid a computational framework to design the most optimal concentrator to filter ambient air and produce oxygen that can scale with patient demand.

“The COVID-19 pandemic has caused significant stress to our medical and emergency facilities and a surge of people requiring medical attention, and hospitals have a limited number of ventilation equipment,” said Dr. Faruque Hasan, associate professor and the ​Kim McDivitt ’88 and Phillip McDivitt ’87 Endowed Faculty Fellow in the Artie McFerrin Department of Chemical Engineering. “But we could prevent some cases of hospitalization if we designed a more advanced, compact and portable oxygen concentrator that has flexible operating conditions to deliver as much oxygen as the patient requires.”

The researchers noted that oxygen concentrators based on their design would also help those suffering from other respiratory conditions, like chronic obstructive pulmonary disease, pneumonia and asthma. 

A description of the study appeared online in the journal Nature Scientific Reports.

Unlike oxygen tanks that provide patients with a continuous supply of pure oxygen, portable oxygen concentrators remove nitrogen from ambient air. The stripping away of nitrogen is due to a process called adsorption, whereby certain species of air molecules get trapped on the surface of solids. Among the many options available for adsorbents, naturally or synthetically made materials known as zeolites act like sieves, holding on to the nitrogen while allowing oxygen to pass through. 

But despite their overall advantages, oxygen concentrators are often designed with fixed specifications, thereby limiting their use in meeting oxygen demands caused by a change in a patient’s medical condition or activity. For example, a patient’s oxygen needs could vary both in terms of flow rate and purity, and current oxygen concentrators cannot be used for several different patients within the same hospital setting who require very different ventilation. 

“In the ideal case, we need a system that can rapidly switch between different operating regimes for on-demand oxygen production while fulfilling different product specifications,” said Dr. Akhil Arora, former graduate student in Hasan’s laboratory and lead author on the study.

To enhance the design of current medical oxygen concentrators, Arora first selected three types of zeolites — LiX, LiLSX and 5A — for his analysis. Next, he ran a physics-based simulation that modeled different properties of the zeolites along with characteristics of the oxygen concentrator, including the size of the adsorption chamber and the different stages within the adsorption process.

Then, using a high-performance computing cluster at Texas A&M, he varied all these inputs of the simulation simultaneously to arrive at the most optimal operating range that would yield a compact, easy-to-transport and high-performance medical oxygen concentrator. In particular, he found that the LiLSX performed better than LiX and 5A zeolites, producing 90% pure oxygen at a high rate. In addition, researchers found the LiLSX-based system could be used to generate different levels of oxygen purity and flow rates.

The experts said their study is also a first step in creating portable cyber-physical systems for home use that can change oxygen supply depending on the patient’s needs. So, if a patient requires more oxygen as symptoms worsen, built-in algorithms could analyze data from oxygen sensors to predict if more ventilation is needed, relay that information to off-site physicians who can then use their judgement to remotely change settings on the medical oxygen concentrator. 

“Right now, medical professionals are needed to administer oxygen based on the condition of the patient, so at-home monitoring is not possible,” said Hasan. “We hope to design a more cost- effective, flexible, controllable medical oxygen concentrator that can provide a personalized oxygen supply at home.”

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JOURNAL

Scientific Reports

DOI

10.1038/s41598-021-93796-3 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Flexible oxygen concentrators for medical applications

ARTICLE PUBLICATION DATE

12-Jul-2021