USA; FOR PROFIT HEALTHCARE

Hospitals sustained huge financial losses from lost revenues during COVID-19 pandemic as patients lost timely access to surgical services

Researchers provide lessons learned after nationwide pause of most elective operations during 2020

Reports and Proceedings

AMERICAN COLLEGE OF SURGEONS

 

IMAGE: THE FINANCIAL IMPACT OF COVID-19 ON A SURGICAL DEPARTMENT: THE EFFECTS OF SURGICAL SHUTDOWNS AND THE IMPACT ON A HEALTH SYSTEM. view more 

CREDIT: AMERICAN COLLEGE OF SURGEONS

Key takeaways

• Curtailing surgical services for even a short time can seriously impact a hospital’s financial security
• Maintaining access to surgical care is not all about revenue; it’s about how to efficiently manage surgical patients’ needs
• Health care systems should make long-term preparations so they can safely provide elective surgical care during future peaks in COVID-19 caseloads

CHICAGO: Postponement of nonessential surgical procedures early in the coronavirus pandemic not only disrupted surgical care at U.S. hospitals, but also took away a large portion of hospitals’ total income, results from two studies reveal. These findings (from the two studies, which took place at the University of Pennsylvania, Philadelphia, and Children’s Hospital of Philadelphia) were presented at the virtual American College of Surgeons (ACS) Clinical Congress 2021.

Surgical services are typically an important financial engine for hospitals, and the new study findings showed that curtailing surgical procedures for even two months can seriously impact a hospital’s financial security. Most elective, nonurgent operations in the country stopped from mid-March to early May 2020, to conserve resources for patients with coronavirus disease 2019 (COVID-19). Results of one study found that this two-month suspension cost a single university health care system 42 percent of its net revenue for five months.

Nationwide, hospitals lost $1.53 billion from missed elective pediatric procedures alone, the other study investigators estimated as part of their study, for approximately the same period, March to May 2020. Hospitals were slow to make up the surgical backlog and the lost income from children’s operations, with a median, or middle, time to recovery of one year, the investigators estimated.

As COVID-19 cases reportedly continue to remain high in many states, some hospitals are again triaging cases and delaying selected operations.1,2 Consequently, the researchers said their findings demonstrate the need for better long-term planning by hospitals to prevent further shutdowns to ensure patients have access to the surgical services that they need.

CAPTION

Hospital Financial Risk Due to Procedural Cancellations During the Covid-19 Pandemic.

CREDIT

American College of Surgeons

USAGE RESTRICTIONS

Reasons for not delaying surgical care

“Whenever possible, we should not delay surgical care for our patients,” said the first study’s lead investigator, Daniel M. Mazzaferro, MD, MBA, a plastic surgery resident at the Perelman School of Medicine at the University of Pennsylvania. “Surgery is a critical asset to the survivability of a health care system.”

Moreover, delays in surgical care also can lead to patients’ medical conditions worsening, affecting their quality of life, or sometimes even shortening it. Another result is patients may require more treatments, raising health care costs down the line, Dr. Mazzaferro noted.

The pandemic resulted in an unprecedented temporary postponement of many elective operations across the country, as recommended by the American College of Surgeons (ACS) and other organizations in March 2020 to free hospital beds and other resources for COVID-19 patients.3 The ACS provided guidance for how hospitals could triage surgical cases—that is, select which operations to prioritize and which to defer until after COVID-19 caseloads decreased.4

Financial impact

Dr. Mazzaferro and his coworkers calculated the net revenues of three hospitals in their health care system during the first surge, or “wave,” of COVID-19 cases from March to July 2020, compared with the same period in 2019. A total of more than $99 million of net revenue was lost from all surgical departments and $58 million from the department of surgery in the first wave. The researchers reported a median net revenue loss of $636,952 per month per division for the department of surgery in the first wave, using updated data presented during the virtual Clinical Congress. However, the system lost significantly less money—$274,626 each month for each division—during a second COVID wave between October 1, 2020, and February 29, 2021.

The surgical department did not suspend elective operations during the second surge, said Liza Wu, MD, FACS, senior investigator of this study and professor of surgery at the Perelman School of Medicine.

“We were in a better position than the first time around to continue with elective surgery,” Dr. Wu said. “We had more personal protective equipment or PPE, better COVID-19 therapies, and a better understanding of the virus, and we probably were able to get COVID patients out of the hospital faster.”

Their surgical department, she added, also began triaging elective surgical patients using a new scoring system called the Medically Necessary, Time-sensitive Scoring, or MeNTS, which University of Chicago physicians described in the Journal of the American College of Surgeons.5

After elective operations resumed in June 2020, surgeons quickly regained their productivity, Dr. Mazzaferro reported. He made this conclusion based on a measure of surgeon productivity that insurance payers use for reimbursement, called work relative value units (RVUs). Work RVUs decreased significantly less in the second COVID-19 wave than the first: 7.8 versus 13.2 percent.

For the second study, researchers led by Sourav Bose, MD, MBA, MSc, then a postdoctoral research fellow at Children’s Hospital of Philadelphia, assessed the financial impact of COVID-related pediatric procedural cancellations. To project lost surgical revenues, they used the 2016 Kids’ Inpatient Database, which represents approximately 80 percent of pediatric hospital admissions nationally.

Dr. Bose, a general surgery resident at Brigham and Women’s Hospital in Boston, said the nation’s children’s hospitals delayed or canceled an estimated more than 51,000 elective procedures from March to May 2020.

Lessons learned

“Our message isn’t all about revenue. It’s about how to efficiently manage surgical patients’ needs,” Dr. Bose said. “Hospital systems must assess their operations management strategies to optimize the availability of surgical resources for patients with the greatest need.”

He proposed that hospitals optimize any excess resource capacity that existed before the pandemic or increase their capacity for performing procedures based on their resources, such as expanding hours for operations.

Dr. Mazzaferro also recommended that health care systems make long-term preparations so they can safely provide elective surgical care during future peaks in COVID-19 caseloads. He suggested the following:

• Increase hospital bed and resource capacity through alternate solutions, such as sending an overflow of surgical patients to other patient care units or facilities that can accommodate them.
• Appropriately triage elective operations following ACS guidelines4 and other published surgical triage tools.
• Ensure sufficient PPE for health care workers and patients.
• Help keep staff healthy by mandating COVID-19 vaccines or frequently testing them against the virus.

VIDEO Author video [VIDEO] | EurekAlert! Science News Releases

Dr. Mazzaferro and Dr. Wu’s fellow University of Pennsylvania researchers were Viren Patel, Nelson Asport, MSHI, CPC, Robert L. Stetson, MHA, David Okawa, MBA, Deborah Rose, MBA, Natalie M. Plana, MD, Joseph M. Serletti, MD, FACS, and Ronald DeMatteo, MD.

Citation: Mazzaferro, DM, et al. The Financial Impact of Covid-19 on a Surgical Department: the Effects of Surgical Shutdowns and the Impact on a Health System.  Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.

Dr. Bose’s co-investigators were Serena Dasani, MD, MBA, Brandon White, MSE, Nick S. Adzick, MD, FACS, and William H. Peranteau, MD, FACS, all with Children’s Hospital of Philadelphia.

Citation: Sourav B, et al. Hospital Financial Risk Due to Procedural Cancellations During the Covid-19 Pandemic.  Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.

“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.

The authors report no relevant disclosures.

________________________

1 Advisory Board. Hospitals Are Delaying Elective Surgeries Again. But This Time, They're Doing It Differently. Daily Briefing. https://www.advisory.com/daily-briefing/2021/08/18/elective-surgeries. August 18, 2021. Accessed September 29, 2021.

2 Paavola A. 106 Hospitals Postponing Elective Procedures Amid the COVID-19 Resurgence. Beckers Hosp Rev. June 1, 2021. Accessed September 29, 2021.

3 American College of Surgeons. COVID-19: Recommendations for Management of Elective Surgical Procedures. https://www.facs.org/covid-19/clinical-guidance/elective-surgery. March 13, 2020. Accessed September 20, 2021.

4 American College of Surgeons. COVID-19: Guidance for Triage of Non-emergent Surgical Procedures. https://www.facs.org/about-acs/covid-19/information-for-surgeons/triage. March 17, 2020. Accessed September 20, 2021.

5 Prachand VN, Milner R, Angelos P, et al. Medically Necessary, Time-Sensitive Procedures: Scoring System to Ethically and Efficiently Manage Resource Scarcity and Provider Risk During the COVID-19 Pandemic. J Coll Am Surg. 2020;231(2):281-288.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

‘Powerful new model’ to engage underserved patients

Researchers propose ‘community-engaged health care’ model to improve service delivery

Peer-Reviewed Publication

UNIVERSITY OF HOUSTON

Poverty, mental health and the fragmented structure of health care systems are some factors keeping many Americans from receiving appropriate health care, resulting in significant health disparities that increase costs for everyone. Efforts to better engage with this currently underserved population have been ineffective, but researchers are now challenging providers to integrate a community-engaged health care model to more effectively treat those with chronic diseases and health issues created by social circumstances, such as homelessness.

The community-engaged health care (CEH) model transfers power over health decision-making processes to patients to advocate for their own health or social solutions, and enables them to design their own interventions with support from health providers rather than expert directives. The conceptual framework developed by researchers at the University of Houston and University of Southampton is detailed in a research review published in the journal SSM – Population Health.

Dr. David Buck, senior author of the study and associate dean for community health at the UH College of Medicine, said this “powerful new model” may be radical, but necessary to improve service delivery, leadership and governance.

“In emergency situations when lives are on the line, of course you still need an expert doctor or captain of the ship to make the best quick decisions for patients. But that model doesn’t work for improving chronic diseases. You can’t just give a vaccine to change behavior, which is what’s really needed,” said Buck. “So rather than an expert model, we need a partnership model where patients are empowered to have a stronger voice in their care. If we don’t listen to what matters most to them, they’re not even going to come to the table.”

Traditional health care assumes that the physician is the most important person in the relationship and the doctor alone determines the best treatment path. After all, they’re the medical expert, right? While effective in many circumstances, this strategy is inefficient when dealing with chronic and/or socially determined health, according to the researchers.

In the United States, 5% of the population are responsible for half of health care spending, of which 47% are underserved patients. These patients frequently lack services beyond expensive and episodic emergency and hospital care that fail to address underlying illness and barriers, or the societal factors that contribute to poor health – housing, employment, food insecurity and the environment.

Joining Buck, a medical doctor, on the study are co-authors Stephanie Barker and Nick Maguire, University of Southampton School of Psychology; Robin Gearing, Monit Cheung and Sarah Narendorf, UH Graduate College of Social Work; and Dan Price, UH Honors College.

“Any community-engaged health model needs to account for the shift in power from the medical establishment within the community being served. This is no less than a revolutionary step, as medicine and medical services have set themselves up as the agents of change related to health. The CEH proposition is that the agents of change are members of the community themselves, engaging medicine only when they deem it necessary,” the researchers wrote.

Buck contends this research analysis serves as an evidence-based “playbook” of sorts for the new University of Houston College of Medicine, founded last year on a social mission to improve health in underserved communities in Houston and across Texas. 

“We have established a mission at the medical school to address the needs of the underserved and to partner with communities, so it’s important that we share with the broader health care system why that’s important and what works best. The current health care model is very outdated, but we’re working to make it more efficient,” he said.

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JOURNAL

SSM - Population Health

DOI

10.1016/j.ssmph.2021.100905 

METHOD OF RESEARCH

Literature review

ARTICLE TITLE

Community-engaged healthcare model for currently under-served individuals involved in the healthcare system

ARTICLE PUBLICATION DATE

10-Sep-2021

“Alternative”: An experimental model to study the effects of pollutants on cardiac tissue

A collaborative project, coordinated by Politecnico di Torino in the framework of the “European Green Deal”, will realise an in vitro model of the cardiac tissue to monitor the toxicity of chemical substances and drugs, in particular on elderly patients,

Business Announcement

POLITECNICO DI TORINO

People are continuously exposed to a huge amount and variety of potentially toxic chemicals present in the surrounding environment, such as pesticides or drugs traces in water, soil, air and living organisms. The combined action of pollutants can increase the risk of toxic effects. At the same time, a growing occurrence of cardiovascular diseases has been observed. These diseases have been among the top-ranked causes of death in mature and aged populations for the last 30 years. Scientists think that this increase may be related to the environmental exposure to exogenous toxic chemicals.

ALTERNATIVE (environmentAL Toxicity chEmical mixtuRes through aN innovative platform based on aged cardiac tissue model) project, coordinated by Prof. Gianluca Ciardelli with the Biomedical Lab team (Susanna Sartori, Monica Boffito) from DIMEAS-Department of Mechanical and Aerospace Engineering of Politecnico, will produce an innovative in vitro platform able to evaluate the cardiotoxicity of single chemicals or a mixture of chemical components. The platform is made by a tri-dimensional model of bioengineered human functional cardiac tissue cultured in a bioreactor, together with a system allowing “omic” analysis to understand the response of the model to different substances. Artificial Intelligence algorithms will be implemented to estimate the risk. Additionally, the project will develop a model of aged cardiac tissue to evaluate the impact of toxics on the fragile population.

The model will be initially validated on existing toxicity data and after it will be used to make predictions on chemical and pharmaceutical substances.

This project aims at finding impact also at regulatory level. The European bodies responsible for regulating chemicals such as fertilizers or detergents, industrial chemicals or pharmaceutical products are seeking an exhaustive evaluation of the toxicity of single substances or mixtures. ALTERNATIVE proposes a new method to make this information available for what concerns cardiotoxicity, allowing to obtain more reliable results with a viable technology which will have a lower impact on the environment and minimize ethical concerns through the reduction of animal testing,

This project has been financed in the framework of the European Green Deal Actions and put together different expertise (in silico systems, machine learning algorithms, toxicology, epidemiology, regulatory affairs) to deliver, in the end, increased awareness of cardiovascular risks related to pollutants (a poorly investigated field so far). A significant support to the regulatory framework for the management of the production and disposal of chemicals and pharmaceuticals is also expected.

“With colleagues at Politecnico di Torino, I am thrilled to start this exciting interdisciplinary research, hoping to contribute with the development of new biomedical technologies to solve problems which are currently impacting the population significantly – says professor Gianluca Ciardelli - The project aims are challenging, but achievable, having put together, with the unvaluable help of Dr. Federico Vozzi (CNR, Pisa), a well-composed international consortium with all the required competencies. In the end, we envisage a significant contribution for making our Technosphere greener and increasingly sustainable.”

ALTERNATIVE project will be developed by an international consortium with complementary capabilities:

Politecnico di Torino, Italy, project coordinator

SCIENSANO, Belgium

CST Ltd, Bulgaria

Elvesys SAS, France

CONSIGLIO NAZIONALE DELLE RICERCHE, Italy

Fundació EURECAT, Spain

Eurescom GmbH, Germany

Istituto di Ricerche Farmacologiche Mario Negri, Italy

IVTech, Italy

Utrecht University, Netherlands

Medical University Innsbruck, Austria

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METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Human tissue samples

Disclaimer: AAAS and EurekAlert! are not 

 

Experiences in prison reduce perceptions of corrections officers’ fairness, regardless of time served

Peer-Reviewed Publication

CRIME AND JUSTICE RESEARCH ALLIANCE

Numerous studies have examined the coercive nature of prisons, but few have considered the role of in-prison experiences (e.g., confinement in restrictive housing) and time served in prison in incarcerated people’s perceptions of corrections officers’ fairness. A new study examined whether in-prison experiences among a nationally representative sample of inmates varied in their effect across different lengths of time served on incarcerated people’s perceptions of procedural justice. The study found that most incarcerated individuals’ in-prison experiences lessened their perceptions of procedural justice and fairness.

The study, by researchers at Iowa State University and Kent State University, appears in Justice Quarterly, a publication of the Academy of Criminal Justice Sciences.

            “Past research has not evaluated whether the in-prison experiences and attitudes associated with perceptions of treatment by correctional staff vary by the amount of time served in prison,” explains Daniel Butler, assistant professor of sociology in criminal justice studies at Iowa State University, who led the study. “Such an investigation is essential as policymakers and researchers question how managerial strategies and policies in correctional settings influence the well-being of incarcerated people.”

One way to measure correctional inmates’ perceptions of corrections staff is to examine whether their behaviors are perceived by incarcerated people to be procedurally just. Corrections officers and others in criminal justice who treat individuals with dignity and respect, make decisions based on facts, and allow inmates opportunities to express themselves are more likely to be perceived as procedurally just.

Using the National Inmate Survey (NIS), 2011-2012, a nationally representative sample of incarcerated individuals who self-report on pre- and in-prison experiences, researchers examined more than 31,000 adults incarcerated at almost 200 state confinement facilities across different categories of time served in a facility.

Researchers measured the effects of a variety of in-prison experiences—including confinement to restrictive housing (e.g., solitary confinement), institutionalized resistance (i.e., filing a complaint), incidences of assault by staff and fellow inmates, perceived crowding, and family visits—on incarcerated individuals’ perceptions of staff members’ procedural justice. They also considered the effect of inmates’ experiences of staff support, inmate support, and mental health.

Procedural justice was defined by looking at eight measures, including staff fairness, staff treatment of inmates with respect, and staff members’ attempts to meet the needs of inmates. The study gauged how inmates’ perceptions varied based on the length of time incarcerated, categorizing  time in prison as less than one year, between one and five years, and more than five years.

The study found that most of inmates’ in-prison experiences reduced their perceptions of staff members’ procedural justice, regardless of how much time they had served. This finding contradicts past study results, perhaps because the experiences measured in this study differ from those measured in other research.

Specifically, the study found that:

• Decreased perceptions of staff members’ procedural justice were highest among inmates who had been incarcerated for less than a year.
• Confinement in restrictive housing (up to 13 percent of the study’s participants served more than 30 days in restrictive housing) significantly decreased inmates’ perceptions of procedural justice for those who had served less than five years in prison.
• Inmates who had served more than five years perceived prison to be more dangerous than other inmates, and this decreased their perceptions of staff members’ procedural justice. In addition, inmates who had served more than five years who reported having mental health problems were more likely to perceive staff as less procedurally just.
• Inmates’ race and ethnicity influenced their perceptions of procedural justice across each category of time serve: Black and Hispanic inmates perceived correctional staff as less procedurally just than White inmates.
• Inmates who filed a grievance, received support from other inmates, and were younger also perceived correctional staff as less procedurally just.
• Inmates who had served between one and five years and who perceived the facility as crowded had more negative perceptions of staff procedural justice than did inmates who had served less than a year.

Among the study’s limitations, the authors note that they did not examine characteristics of the facilities or staff that prior research had identified as important predictors of correctional officers’ legitimacy and fairness. In addition, the NIS data included information on experiences within the past 12 months of confinement or since admission to the current facility, which excluded some in-prison experiences.

            “The discretion and power afforded to correctional staff creates an imbalance,” notes Starr Solomon, assistant professor of sociology at Kent State University, who coauthored the study. “As correctional agencies develop strategies to help incarcerated people adjust to prison, it is important to recognize that the coercive nature of prisons makes it difficult for individuals to perceive treatment by staff as procedurally just.”

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The research was funded by the Sam Houston State External Grant Application Development System.

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JOURNAL

Justice Quarterly

DOI

10.1080/07418825.2021.1985159 

ARTICLE TITLE

Time Served in Prison, in-Prison Experiences, and Perceptions of Procedural Justice

ARTICLE PUBLICATION DATE

19-Oct-2021

 

Nurses think about suicide more than other workers

Peer-Reviewed Publication

MAYO CLINIC

ROCHESTER, Minn. ― Mayo Clinic researchers report that nurses in the U.S. experience suicidal ideation in greater numbers than other general workers and those who do are less likely to tell anyone about it. The findings appear in the American Journal of Nursing.

More than 7,000 nurses responded to a national survey on well-being, with questions ranging from burnout to depression. More than 400 nurses reported having suicidal ideation within the past year. That's 5½% of the respondents, which is nearly 1% higher than the general workforce sample at 4.3%.

Those who reported suicidal ideation also said they were less likely than other respondents to seek professional help for their emotional issues. More than one-third of the nurses had at least one symptom of burnout and 40% screened positive for symptoms of depression.

The researchers say their findings indicate that the situation needs urgent attention, and systems- and practice-based interventions need to be developed and implemented to address burnout and suicidal ideation.

It's important to note that this survey was conducted, beginning in late 2017, with data collection in 2018, before any of these nurses were confronted with effects of the COVID-19 pandemic.

"While the findings of our study are serious enough, we recognize the impact of the current pandemic has dramatically compounded the situation," says Liselotte Dyrbye, M.D., a Mayo Clinic internist and the senior author. "The need for system-level interventions to improve the work lives of nurses and other members of the health care team is greater than ever before."

The questionnaire was sent in November 2017 to 86,858 nurses and a sample of 5,198 general workforce members.

The other authors are Elizabeth Kelsey, D.N.P., Mayo Clinic; Colin West, M.D., Ph.D., Mayo Clinic; Daniel Satele, Mayo Clinic; Pamela Cipriano, Ph.D., University of Virginia; Cheryl Peterson, American Nurses Association; and Tait Shanafelt, M.D., Stanford University.

Funding for this study was provided by the Mayo Clinic Program on Physician Well-Being and the American Nurses Association. This study was based on work partially supported by National Science Foundation grant No. 2041339. Any opinions, findings, and conclusions or recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the National Science Foundation. Funding sources had no role in study design; collection, analysis and interpretation of data; or writing and publication of this article.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. For information on COVID-19, including Mayo Clinic's Coronavirus Map tracking tool, which has 14-day forecasting on COVID-19 trends, visit the Mayo Clinic COVID-19 Resource Center.

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JOURNAL

AJN American Journal of Nursing

ARTICLE PUBLICATION DATE

22-Oct-2021

Disclaimer: AAAS a

Fossils of two early Cretaceous species discovered in southwest Arkansas

A new study describes the decades-long investigation, providing information on the distribution and variety of animals inhabiting North America 110 million years ago.

Peer-Reviewed Publication

UNIVERSITY OF ARKANSAS

 

IMAGE: AN ILLUSTRATION OF THE NEW SPECIES OF SKINK, SCIROSEPS PAWHUSKAI, DISCOVERED IN SOUTHWEST ARKANSAS. view more 

CREDIT: PALEOART BY BRIAN ENGH

Two new species dating back to the Early Cretaceous Period were recently discovered in Sevier County in southwest Arkansas. One is a small skink researchers named Sciroseps pawhuskai and the other is a new fish named Anomoeodus caddoi.

The discoveries serve both to underscore the variety of fossils found at this site, including dinosaurs, mammals, fish, amphibians and reptiles, and to reinforce the overall lack of variety of fossils found throughout North America during the Early Cretaceous, roughly 110 million years ago.

The discoveries were highlighted in a recent paper published in PeerJ, titled “A new vertebrate fauna from the Lower Cretaceous Holly Creek Formation of the Trinity Group, southwest Arkansas, USA.” Celina Suarez, associate professor of geosciences at the U of A, served as primary author on the article, which pulls together decades of research in the area, known as the Holly Creek Formation.

While Arkansas is not traditionally considered a fertile source of Early Cretaceous fossils, this location has been unusually rich in them — including dinosaur tracks. Since the 1970s, thousands of sauropod and theropod tracks have been discovered in the area.

More recent work reveals that this ancient coastal plain of Arkansas was inhabited by a wide variety of freshwater and land animals, including long-necked dinosaurs, large carnivores, raptor-like carnivores and armored dinosaurs. But the site also provides a wide assortment of fossilized bones and teeth of much smaller creatures, such as sharks, fish, frogs, lizards, turtles and crocodilians, providing a clearer picture of the overall ecosystem at that time.

While the study enriches our knowledge of ancient fauna in Arkansas, it also serves to confirm that North America did not have as wide a variety of species in the Early Cretaceous as it did in the Late Cretaceous (roughly 70 million years ago). By and large, the majority of fauna found in the Holly Creek Formation are similar to fauna found throughout North America at the same time.

What caused increased diversity of life between the Early and Late Cretaceous Periods? The papers suggest that plate tectonics, which created mountains in the west, and climate changes, which drove rising sea levels, led to increased geographic isolation among similar species, spurring evolutionary changes in separated populations.

“When habitats are fragmented it can cause evolutionary changes,” Suarez explained. “One way this and other discoveries from the Cretaceous of North America can help us understand the modern world is how climate change can affect evolution of animals, be it extinction or the origination of new species. Given that the Cretaceous was a period of rapidly warming and cooling worlds, understanding these time periods is important for understanding how future warming worlds will react to climate change.”

Suarez also noted that she and her colleagues from other universities have been working to describe and catalogue many discoveries from southwest Arkansas since she arrived at the U of A in 2012. This paper is the first time so many specimens have been reported from a single site.

Suarez’s co-authors included Joseph Frederickson, Richard L. Cifelli, Jeffrey G. Pittman, Randall L. Nydam, ReBecca K. Hunt-Foster and Kirsty Morgan.

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JOURNAL

PeerJ

DOI

https://doi.org/10.7717/peerj.12242 

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

A new vertebrate fauna from the Lower Cretaceous Holly Creek Formation of the Trinity Group, southwest Arkansas, USA

ARTICLE PUBLICATION DATE

21-Oct-2021

PROMOTING H2 INTERNAL COMBUSTION 

Toyota exec: Not everyone should drive a battery electric vehicle

Paul Lienert
Thu, October 21, 2021

Gill Pratt, CEO of the Toyota Research Institute (TRI), speaks by a research vehicle equipped with Toyota Guardian, a accident avoidance system that assists drivers, during a Toyota news conference at the 2019 CES in Las Vegas


By Paul Lienert

(Reuters) -Many people are passionate about climate change, but not everybody should drive a battery electric vehicle as a means to combat climate change, Toyota Motor Corp Chief Scientist Gill Pratt said on Thursday at the Reuters Events Automotive Summit.

Pratt's comments, during a discussion on electric vehicles, appeared to amplify remarks made over the past year by Toyota President Akio Toyoda.

Toyoda and other company officials have said that electric vehicles will play a greater role in reducing emissions, but other solutions should be used, Toyota's gasoline-electric hybrid models or hydrogen-powered fuel cell electric vehicles. [nL4N2MX23C]

At Thursday's conference, Pratt said Toyota believes in "diversity of drivetrains" to give customers different tools to reduce CO2.

"It's not for us to predict which solution is the best or say only this will work," he said.

Government incentives should be aimed at reducing carbon emissions, not picking which car technology is the best way to achieve those goals, Pratt added, in a reference to proposed bans on internal combustion engine (ICE) vehicles, including hybrids, as a means of achieving carbon neutrality.

Toyota was among major automakers that supported the Trump administration in its attempt to bar California from setting its own zero-emission requirements, but the company dropped that support earlier this year.

Toyota has said it plans to invest $13.5 billion through 2030 on EV batteries, but so far its plans to roll out new battery electric vehicles (BEVs) seem relatively modest compared with those of U.S. automakers General Motors Co and Ford Motor Co, which are spending around $30 billion each through 2025 to electrify more of their vehicle lines.

Toyota executives continue to tout the merits of the company's hybrid vehicles, which have been on the market for more than 20 years.

How did humans evolve, and will we evolve more?


Evan Simons, Postdoctoral Research Associate in Anthropology, University at Buffalo
Sun, October 24, 2021

This skull, found in France, was among the first fossils to be recognized as belonging to our own species. DEA /G. Cigolini via Getty Images

Curious Kids is a series for children of all ages. If you have a question you’d like an expert to answer, send it to curiouskidsus@theconversation.com.

How did humans evolve, and will they evolve more? – Anya T., 13, Brookline, Massachusetts

Everything that is alive today has evolved, including human beings.

Our ancestors evolved many traits that helped them survive in their environments, and we still have many of those traits today. Two of the most important and consequential traits are walking on two legs and having a large brain.

I’m a scholar of human evolution. I study how evolution works, including how it has changed the shape of the bones in the skull and ankle of humans and other primates.

So how did humans evolve, and where will evolution take us in the future?
What evolution is

People pass traits to their children through genes. We can have different versions of the same genes – called alleles – and evolution occurs when the proportion of these alleles in the population changes over multiple generations.

Alleles in a population often help certain individuals survive in their own environment. This means that evolution isn’t about becoming the fastest, or the strongest, or the smartest, because it all depends on the environment.

Early ancestors of humans evolved to walk upright on two legs around 6 million years ago.

Scientists are still trying to figure out why our ancestors started walking on two legs. Today, the most common hypothesis is that walking on two legs probably helped our ancestors to move between forest patches that were shrinking due to a changing climate.

What about our brains?

Relative to the size of our bodies, humans have the largest brains on the planet. Elephants have bigger brains, but their bodies are even bigger than ours.

Without big brains we wouldn’t be able to innovate, such as by creating an alphabet, sending machines to Mars or creating vaccines that protect us against measles and other dangerous diseases. Our big brains make it possible to share information culturally through books, storytelling or even movies, rather than only passing our genes to the next generation.

Our ancestors’ brains got bigger over the course of human evolution until about 200,000 to 300,000 years ago when modern humans, known as Homo sapiens, showed up.

After that, human brains actually started to get a bit smaller, possibly because our bodies have gotten smaller or perhaps because a slightly smaller brain may not use as much energy.

Humans are still evolving. For example, because they have a largely vegetarian diet like their ancestors did, many people who live in the city of Pune, India, have a mutation that helps them more efficiently process omega-3 and omega-6 fatty acids. Vegetarians can have trouble getting enough of those nutrients, which are important for having a healthy brain.

Humans in the future

Nobody knows where human evolution will lead.

All organisms, including humans, adapt to their environments. And those environments can change – sometimes in entirely unpredictable ways.

It may disappoint you to hear that people aren’t likely to evolve superpowers like those in the “X-Men” movies or characters in the Marvel Cinematic Universe, at least for the most part.

However, there is one Marvel character humans have evolved to be like: Iron Man.

Like Iron Man, humans are smart enough to invent things that can make some of us live longer or have more fun, whether it’s a device that keeps an ailing heart beating or an airplane that makes it possible to fly without wings.

It’s unlikely that humans will ever evolve laser beam eyes or wings out of our backs like the X-Men characters Cyclops and Archangel. But other abilities that humans have evolved over millions of years of evolution allow us to do many of those same things, through innovation.

Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to CuriousKidsUS@theconversation.com. Please tell us your name, age and the city where you live.

And since curiosity has no age limit – adults, let us know what you’re wondering, too. We won’t be able to answer every question, but we will do our best.

This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts. It was written by: Evan Simons, University at Buffalo.

Myanmar activist arrested in junta raid: wife

Issued on: 24/10/2021 

Kyaw Min Yu pictured on his release from prison in 2012

 Soe Than WIN AFP

Bangkok (AFP)

Myanmar has been in turmoil since the generals ousted civilian leader Aung San Suu Kyi in a February coup, triggering nationwide protests that have seen more than 1,100 people killed by security forces.

Junta opponents -- including allies of Suu Kyi's National League for Democracy party and activists -- have gone into hiding across the country, while some villagers have taken up arms, forming local militias to defend themselves.

On Saturday evening, 52-year-old Kyaw Min Yu, better known as Ko Jimmy, was arrested when soldiers raided a housing complex in the North Dagon township of Yangon.

"He was staying in a safe house together with two other activists who escaped from the back door," his wife Nilar Thein told AFP, adding that police had not informed her of his whereabouts.

Nilar Thein and Ko Jimmy are part of the so-called 88 Generation movement that challenged Myanmar's previous military government.

They also played a major role in anti-government protests in 2007 -- nicknamed the "Saffron Revolution" for the participation of orange-robed monks.

The couple have been in and out of prison for their activism.

Ko Jimmy's last stint behind bars was from 2007 to 2012. He was released as the generals loosened their grip to start opening up Myanmar in preparation for 2015 elections.

After the February 1 putsch this year, the junta issued an arrest warrant for him alleging that he had incited unrest with his social media posts.

Another 88 Generation member, Ko Ko Gyi, confirmed Ko Jimmy's arrest, expressing worry for him and his family.

While the couple are intimately aware of the risks of activism in Myanmar, Nilar Thein said the situation is "riskier" under the current regime, which has dubbed itself the State Administration Council.

"I am afraid that I won't see him alive" again, she said, adding that she was afraid to go to the police for fear of her own arrest.

"I urge the international community to keep their eyes (on the situation) to save the lives of Myanmar people."

Groups including the Assistance Association for Political Prisoners -- which tracks arrests under the regime -- have alleged that torture has taken place during the interrogation of dissidents.

The United Nations special rapporteur on Myanmar on Saturday raised alarm about troops amassing in the country's north, warning the international community to be prepared for "more mass atrocity crimes".

  

Myanmar junta rules out talks with dissidents, including Suu Kyi's ousted government

Issued on: 24/10/2021 - 
Text by: NEWS WIRES|

Video by :FRANCE 24

Myanmar's junta on Saturday said it would not engage in talks with coup dissidents, including members of Aung San Suu Kyi's ousted government, after a loyalist said dialogue was necessary to save the country.

The Southeast Asian nation has been in chaos since a February coup, with more than 1,100 killed in a crackdown on dissent, according to a local monitoring group.

On Friday a spokesman for the military-aligned Union Solidarity and Development Party called on junta leader Min Aung Hlaing to open dialogue with coup opponents to find a way out of the crisis.

But late Saturday the junta said it "cannot accept ... dialogue and negotiation with terrorist armed groups", including a shadow government of lawmakers from Suu Kyi's ousted adminstration.

Suu Kyi's National League for Democracy party trounced the USDP in elections last year, a result the military has alleged was due to fraud.

Almost nine months after seizing power, and unable to stamp out opposition to their rule, the generals are under increasing international pressure to engage with their opponents.

The United Nations said Friday it feared an even greater human rights catastrophe amid reports of thousands of troops massing in the north and west of the country, where soldiers have clashed regularly with local "self-defence forces".

Local fighters in the western Chin state were battling to stop 60 military vehicles from advancing further into the remote, mountainous region, a member of a local militia told AFP on Saturday.

Dissidents had also blown up a bridge to prevent the military from entering the town of Thantlang, he said, adding army "jet fighters" had flown several times over the group's base.

AFP was unable to verify reports from the remote region.

(AFP)

Picasso works fetch more than $100 million at Sotheby’s Las Vegas auction



Issued on: 24/10/2021 

Pablo Picasso's 1938 painting of Marie Therese is seen at the Bellagio Gallery of Fine Art Tuesday, Oct. 19, 2021 in Las Vegas.

 © Wade Vandervort, AP

Text by:NEWS WIRES
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Eleven Picasso paintings and other works that helped turn Las Vegas into an unlikely destination for art were sold at auction on Saturday for more than $100 million.

The Sotheby's auction was held at the Bellagio hotel in Las Vegas, where the works had been on display for years, and took place two days before the 140th birthday of the Spanish artist on Oct. 25.

Five of the paintings had hung on the walls of the Bellagio's fine dining restaurant, Picasso. The restaurant will continue to display 12 other Picasso works.

The highest price was fetched by the 1938 painting "Femme au beret rouge-orange" of Picasso's lover and muse Marie-Therese Walter, which sold for $40.5 million, some $10 million over the high pre-sale estimate.

The large-scale portraits "Homme et Enfant" and "Buste d'homme" sold for $24.4 million and $9.5 million respectively, while smaller works on ceramic, like "Le Dejeuner sur l'herbe" which sold for $2.1 million, went for three or four times their pre-sale estimate.

The buyers' names were not disclosed.

Saturday's sale was part of a bid by casino and hotel group MGM Resorts to further diversify its vast collection to include more art from women, people of color and emerging nations as well as from LGBTQ artists and artists with disabilities.

American museums and art galleries have been working to broaden their collections in the wake of the widespread cultural reckoning in 2020 over racism at all levels of U.S. society.

A 2019 Public Library of Science study of 18 leading U.S. museums found that 85% of the artists on display are white and 87% are men.

The MGM Resorts Fine Arts Collection boasts about 900 works by 200 artists, including modern pieces by Bob Dylan and David Hockney. It was started more than 20 years ago by Steve Wynn, former owner of the Bellagio and former chief executive of Wynn Resorts.

(REUTERS)