No glacial fertilization effect in the Antarctic Ocean

International study led by the University of Bonn records 1.5 million years of climate in the drill core

Peer-Reviewed Publication

UNIVERSITY OF BONN

 

IMAGE: DRILLSHIP "JOIDES RESOLUTION" WITH CHARACTERISTIC DERRICK. view more 

CREDIT: IODP

Changes in the concentration of atmospheric carbon dioxide (CO2) are considered to be the main cause of past and future climate change. A long-standing debate centers on whether the roughly 30 percent lower CO2 content of the ice-age atmosphere was caused by iron fertilization. It is argued that iron-rich dust is carried into the ocean by wind and water, where it stimulates the growth of algae that absorb more CO2. As the algae die and then sink permanently into the depths of the ocean, the CO2 also remains there like in a trap. Although there is clear evidence that dust input increased during the ice ages, the fertilization effect is controversial, at least for the Antarctic Ocean.

In a recent study, an international team of 38 researchers from 13 countries led by Dr. Michael Weber from the Institute for Geosciences at the University of Bonn investigated this question. As part of the Integrated Ocean Discovery Program (IODP), the team traveled to the Scotia Sea on the drillship "JOIDES Resolution" and spent two months in 2019 bringing up cores from the seafloor at depths of 3,000 to 4,000 meters. Weber: "We collected the highest-resolution and longest climate archive ever obtained near Antarctica and its main dust source, Patagonia."

CAPTION

Crew sampling a drill core on the "catwalk."

CREDIT

IODP

CAPTION

Thomas Ronge with a drill core in the laboratory.

CREDIT

IODP

1.5 million years of climate history

In the 200-meter-long deep-sea core U1537, the climate history of the last 1.5 million years was recorded in detail. This allows the reconstruction of the dust input to be nearly doubled, since Antarctic ice cores only cover the last 800,000 years. Current records from the deep ocean show that dust deposition during the ice ages was actually five to 15 times higher. This is also reflected in the ice cores.

However, the researchers found no evidence of a fertilization effect from dust in the Antarctic Ocean during the ice ages. Rather, the production of algae, for example, and thus carbon CO2 sequestration, was high only during warm periods when dust input into the Scotia Sea was low. This means that during cold periods, other processes prevented the CO2 captured in the ocean from escaping into the atmosphere and triggering warming. The main factors here are much more extensive sea ice cover, more intense stratification in the ocean, and reduced dynamics of the current systems, which contributed to a reduction in the CO2 content of the atmosphere during cold periods.

The opposing trends in dust deposition and oceanic productivity during the ice ages and interglacial periods of the Pleistocene are accompanied by long-term, gradual changes in the climate system in the southern polar region. Bioproductivity was particularly high during the interglacial periods of the last 400,000 years, but during the mid-Pleistocene transition 1.2 million to 700,000 years ago, it differed little from that during cold periods. As the transition progressed, the dust input covered larger and larger areas in the Southern Hemisphere. Abrupt changes continued to occur 900,000 years ago, indicating greater glaciation of Antarctica.

"There is indeed evidence of a fertilization effect during the ice ages in cores outside the Antarctic zone," Weber concludes. "However, our study shows that atmospheric CO2 fluctuations do not depend solely on iron fertilization from dust deposition. In the Antarctic Ocean, it is rather a complex interplay of a westerly wind system, productivity, and feedback with sea ice. This relationship has been consistent over the last 1.5 million years."

CAPTION

Iceberg in the Scotia Sea.

CREDIT

Thomas Ronge

CAPTION

IODP core store at the Center for Marine Environmental Sciences (marum) in Bremen.

CREDIT

IODP

CAPTION

Co-chiefs Michael Weber, Maureen Raymo and expedition manager Trevor Williams.

CREDIT

IODP

Publication: Weber, M.E., Bailey, I., Reilly, Hemming, S., Martos, Y.M., Reilly, B.T., Ronge, T., Brachfeld, S., Williams, T., Raymo, M.E., Belt, S.T., Smik, L., Vogel, H., Peck, V., Armbrecht, L., Cage, A., Cardillo, F.G., Du, Z., Fauth, G., Fogwill, C.J., Garcia, M., Garnsworthy, M., Glueder, A., Guitard, M., Gutjahr, M., Hernandez-Almeida, I., Hoem, F., Hwang, J.-H., Iizuka, M., Kato, Y., Lee, B.,O’Connell, S., Pérez, L.F., Seki, O., Stevens, L., Tauxe, L., Tripathi, S., Warnock, J., and Zheng, X.: Antiphased dust deposition and productivity in the Antarctic Zone over the past 1.5 Ma. Nature Communications, DOI: https://doi.org/10.1038/s41467-022-29642-5.

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JOURNAL

Nature Communications

DOI

10.1038/s41467-022-29642-5 

ARTICLE TITLE

Antiphased dust deposition and productivity in the Antarctic Zone over the past 1.5 Ma

ARTICLE PUBLICATION DATE

19-Apr-2022

Three Gorges Dam: Friend or foe of riverine greenhouse gases?

Peer-Reviewed Publication

SCIENCE CHINA PRESS

 

IMAGE: PANORAMIC VIEW OF THE THREE GORGES DAM ON THE YANGTZE RIVER, CHINA view more 

CREDIT: ©SCIENCE CHINA PRESS

Dams are conventionally regarded as emitters of GHGs in large rivers. A team from Peking University of China, however, has disrupted this perception, based on whole system thinking applied to the Three Gorges Dam (TGD) on the Yangtze River in China.

This study is led by Professor Jinren Ni. “We spent over eight years to complete this work” Ni says. The team used 30 water quality indices for 25 years and measured greenhouse gases (GHGs) along 4,300 km of the Yangtze River. Huge datasets and data-driven models were established using machine learning tools for riverine greenhouse gases. This revealed the effect of initial emission of GHGs on pristine river ecosystems and provided a reliable methodology for robust assessment of the change in GHGs induced by dams.

Since commencing operation in 2003, the TGD has altered carbonate equilibrium in the reservoir area, enhanced methanogenesis in the upstream, but restrained methanogenesis and denitrification via modifying anoxic habitats through long-distance scouring in the downstream. It is necessary to include both the upstream and downstream reaches, when examining the spatiotemporal scope of “large-dam effects” of the TGD.

A quantitative division was discovered between new emissions resulting from impoundment and operation of the TGD and pristine emissions that occurred naturally before its construction. This leads to an unexpected finding that the TGD has caused considerable reductions in the annual average emissions of CO2, CH4, and N2O in the Yangtze River. Using a whole-system approach, the team finds that the impact of TGD extends thousands of kilometers downstream along the Yangtze River, far beyond the reservoir and its immediate surroundings (with only the latter considered in most previous studies). “Their approach is based on the logic that a full accounting of GHG consequences of the dam should encompass the full sphere of the dam’s influence. This methodology led to the result that aquatic emissions have declined rather than increased since the dam went into operation.” says Professor Emily Stanley from University of Wisconsin-Madison.

As a clean energy source, hydropower can help to reduce dependence on traditional fossil fuel energy (such as coal, oil, and natural gas) and significantly reduce GHGs emissions. In recent years, some researchers suggested that dams would increase GHGs emissions from rivers. This issue received renewed attention, stimulating much debate on changes in GHGs emissions before and after TGD operation. By providing a panoramic view of CO2, CH4, and N2O fluxes along the Yangtze River, the present study helps settle the debate on GHGs induced by large dams. According to Professor Ni, “this means that the TGD facilitate the reduction of GHGs emissions, even when leaving aside the huge benefits of GHGs reduction from fossil fuel substitution by hydropower.”

Whole system analysis provides new insights into GHGs emissions caused by the operation of large dams, which are essential prerequisites in understanding their implications for the biogeochemical cycles of large rivers. As Professor Stanley notes, “Although TGD is unique in its size, it is unlikely to be unique in the scale and scope of its influence.”

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See the article:

Three Gorges Dam: Friend or Foe of Riverine Greenhouse Gases? 

https://doi.org/10.1093/nsr/nwac013

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JOURNAL

National Science Review

DOI

10.1093/nsr/nwac013 

Disclaimer: AAAS and EurekAlert

A study of two wastewater treatment plants in Cordoba equipped with different technology evaluates their odorous impact

Peer-Reviewed Publication

UNIVERSITY OF CÓRDOBA

 

IMAGE: RESEARCHERS THAT CARRIED OUT THE STUDY view more 

CREDIT: UNIVERSITY OF CORDOBA

The study shows that degrading wastewater pollution by means of mechanical aeration results in fewer odorous compounds than with intensive systems. Another study was carried out demonstrating that the use of biofilters filled with pruning and sludge compost are efficient systems to minimize the odorous impact of sewage treatment plants.

The odor emitted by wastewater treatment plants in cities is one of the social problems that technology has been trying to solve for years. The control and management systems of this type of infrastructure have been concerned with minimizing the environmental and odorous impact of this waste, which directly affects quality of life, especially for those who live near treatment plants. Among the latest systems that biotechnology has devised there are two that are on the rise, their effectiveness having been gauged: mechanical ventilation and biofiltration. Both were evaluated in two independent studies carried out by two scientific teams at the University of Córdoba and published in the Process Safety and Environmental Protection journal. The first of these studies describes the work carried out at real scale at the Wastewater Treatment Plants (WWTP) in two Cordoba towns: Espiel and Villaviciosa; while the second analyzed the operation of pilot-scale biofilters operated at the facilities of the Chemical Engineering area of the University of Córdoba.

In the first work, the analysis of different biological treatments of wastewater showed that the process known as the extended aeration of activated sludge, which is employed at the WWTP in Espiel, emits slightly a higher odor rate per inhabitant than the rotating disc system used in Villaviciosa. It was also found that the system in Espiel is more efficient and intensive for the treatment of wastewater, and generates a greater amount of sludge, a by-product that can be properly treated, thus favoring the development of the Circular Economy. In addition, as the analysis of the sludge genome has shown, the presence of nitrifying and denitrifying bacteria allows for the elimination of nitrogenous contaminating compounds from wastewater. 

The second publication analyzed the effectiveness of biofiltration in eliminating odoriferous compounds in systems filled with different organic waste: pruning waste, exclusively, or mixing them with sludge compost from the treatment plant itself. The results of this work showed that when biofilters are used to remove acidic and water-soluble odorous compounds, such as butyric acid, their efficacy was greater but less lasting than in the removal of less water-miscible compounds, such as D-Limonene. Butyric acid is a compound that is generated in  fermentation processes, featuring a characteristic rancid odor, while D-Limonene is a compound characterized by a citrus odor.

In any case, as María Ángeles Martín Santos, a professor of Chemical Engineering at the UCO, explained: "it must be taken into account that all the plants studied comply with the established discharge limits, and that the smell of a treatment station does not always reach the nearby populations. There is a whole process of transport and dilution of polluting odors through the environment that diminishes their perception. The wind, for example, can disperse them. Hence, an essential aspect in wastewater management is where treatment plants are located. The problem is that, as a result of urbanization and rezoning, many sewage treatment plants are very close to towns, so they must be better outfitted with systems to reduce odor emissions."

References:
P. Márquez, M. C. Gutiérrez, M. Toledo, J. Alhama, C. Michán, M. A. Martín, "Activated sludge process versus rotating biological contactors in WWTPs: Evaluating the influence of operation and sludge bacterial content on their odor impact", Process Safety and Environmental Protection, vol. 160, April 2022, pp 775-785, https://doi.org/10.1016/j.psep.2022.02.071.

P. Márquez, J. A. Siles, M. C. Gutiérrez, J. Alhama, C. Michán, M. A. Martín, “A comparative study between the biofiltration for air contaminated with limonene or butyric acid using a combination of olfactometric, physico-chemical and genomic approaches”, Process Safety and Environmental Protection, vol. 160, April 2022, pp 362-375, https://doi.org/10.1016/j.psep.2022.02.024.
 

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JOURNAL

Process Safety and Environmental Protection

DOI

10.1016/j.psep.2022.02.071 

METHOD OF RESEARCH

Observational study

ARTICLE TITLE

Activated sludge process versus rotating biological contactors in WWTPs: Evaluating the influence of operation and sludge bacterial content on their odor impact

When the rust settles: Uncovering the movements of coffee leaf rust disease

Incidence of coffee leaf rust in Vietnam, possible original sources and subsequent pathways of migration

Peer-Reviewed Publication

UNIVERSITY OF TSUKUBA

Researchers from the University of Tsukuba and Ibaraki University find a high incidence of coffee leaf rust disease in Vietnam, as well as potential origins and routes of spread, and a close genetic relationship with Central and South American rust fungus populations

Tsukuba, Japan—Coffee is one of the world's most popular drinks, yet there are still many unknowns in the coffee-growing business. Now, researchers from Japan have shed new light on the nature of a disease that seriously affects coffee plants.

In a study published this month in Frontiers in Plant Science, researchers from the University of Tsukuba and Ibaraki University have revealed that coffee leaf rust (CLR) disease is widespread in the main coffee-growing regions of Vietnam, the world's second-largest coffee producer.

Rusts are plant diseases named after the powdery rust- or brown-colored fungal spores found on the surfaces of infected plants. CLR fungus, Hemileia vastatrix, causes CLR disease in Coffea plants—the source of coffee beans. This disease severely affects the plants, resulting in high yield losses and lowering bean quality; developing effective and practical ways of managing the disease is essential for mitigating this problem. The best way to control CLR is by using disease-resistant plant varieties. However, there have been recent reports of CLR outbreaks in coffee-growing regions where rust-resistant varieties are planted.

"To control this disease, we need to understand rust population diversity," says senior author of the study, Associate Professor Izumi Okane. "We must also identify the genetic variations that underpin it, and anticipate potential future variations."

To do this, the researchers examined the occurrence of CLR disease in key coffee-producing regions of Vietnam, assessed the current population structure and genetic diversity of the CLR fungus via genetic sequencing, and estimated the geographic region where H. vastatrix first established, as well as its direction of migration between Vietnam's main coffee-producing areas.

The results showed a high incidence of CLR disease in most of the regions investigated, and that H. vastatrix populations in Vietnam shared a close genetic relationship with several Central and South American populations. The study also uncovered potential starting points and migration routes of H. vastatrix in Vietnam's coffee-growing regions. The spread of CLR from northern to southern Vietnam revealed that agents other than wind and monsoon were involved in moving spores from an infected region to other areas.

"Our study highlights the need to consider human-mediated activities, because they may quickly accelerate the genetic diversification of rust fungi populations," explains Associate Professor Okane.

The results of this study have revealed new information on the genetic diversity of H. vastatrix in Vietnam and Central and South America. The researchers' findings will help to predict the spread of this fungus in the future. Furthermore, seedling sources and human activities have been highlighted as factors that should be considered in the coffee-growing industry for the control of CLR disease.

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This research was financially supported by Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 20H03006 (IO), the annual fund of the Biotechnology Center of Ho Chi Minh City and the fund for student research from the Ministry of Education, Culture, Sports, Sciences, and Technology of Japan.

Original Paper

The article, "Incidence of coffee leaf rust in Vietnam, possible original sources and subsequent pathways of migration," was published in Frontiers in Plant Science at DOI: 10.3389/fpls.2022.872877

A dangerous delay: Why it can take years to diagnose life-threatening rare diseases

Researchers from Osaka University reveal the experiences of patients who waited years to be diagnosed with a potentially life-threatening rare disease, highlighting the need to raise the awareness of rare diseases

Peer-Reviewed Publication

OSAKA UNIVERSITY

 

IMAGE: DIAGRAM ILLUSTRATING PROBLEMS LEADING TO DELAYED DIAGNOSIS OF RARE DISEASES view more 

CREDIT: 2022 M. ISONO ET AL. WHY DOES IT TAKE SO LONG FOR RARE DISEASE PATIENTS TO GET AN ACCURATE DIAGNOSIS?—A QUALITATIVE INVESTIGATION OF PATIENT EXPERIENCES OF HEREDITARY ANGIOEDEMA. PLOS ONE

Osaka, Japan – Regular episodes of severe pains in the abdomen and mysterious swellings had become the new normal for Yuki - for 20 years. Finally, she was diagnosed with a rare disease, hereditary angioedema (HAE), and given a specialized treatment that brought much-needed relief. But what happened during those years of delay, and why did it take so long? In a study published in PLOS ONE, researchers from Osaka University revealed the experiences of patients with a rare disease who remained undiagnosed for many years. The findings highlight the importance of raising patients’ and clinicians’ awareness of rare diseases.

“There are around ten thousand rare diseases,” says lead author of the study, Moeko Isono. “Altogether, they affect over four hundred million people. There are many people who struggle to find the right diagnosis, and in certain cases the failure to do so can be fatal.”

Previous studies that looked at diagnostic delays for rare diseases usually focused on the time taken to reach a diagnosis, and other measures that can be quantified.

“For our study, we used a qualitative approach,” says Isono. “This meant that we could explore why the delays were so long and how the correct diagnosis was finally achieved. We hoped to identify areas that could be improved.”

The research team focused on patients with hereditary angioedema, a disease that typically involves long diagnostic delays. The condition causes swelling in different parts of the body, such as the skin and digestive system. It can be life-threatening if the swelling affects the airways. An accurate diagnosis is important, as the mortality rate is around three times higher if left undiagnosed.

Interviews were conducted with nine patients with the disease who had remained undiagnosed for more than five years. Patients were invited to share their experiences from initial symptoms to diagnosis with HAE. The responses revealed that many patients had become resigned to living with the symptoms and had stopped trying to find a cause.

“What was striking was that, in most cases, the possibility of a rare disease was simply not considered,” says senior author Kazuto Kato. “Symptoms were sometimes put down to ‘psychological stress’ or ‘stomach flu’ and left at that. This is concerning, because the condition needs to be treated so as to avoid worst-case scenarios and improve patients’ quality of life.”

Kato believes that raising the awareness of rare diseases is key to improving the diagnostic delays. “It’s important that the possibility of a rare disease is considered, both by clinicians and by patients. Our findings strongly suggest the need for measures to make it easier for patients and health care providers to recognize the possibility of rare diseases. For example, all clinicians should be trained to be able to realize the possibility of rare disease. Additionally, raising awareness among the public by mass media or other stakeholders is important. Health care providers sometimes cannot be fully aware of their patient’s overall condition, so patients should be encouraged to raise their suspicion and act themselves. This could reduce the diagnostic delays.”

Note: The patient’s name has been changed for reasons of confidentiality.

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The article, “Why does it take so long for rare disease patients to get an accurate diagnosis?—A qualitative investigation of patient experiences of hereditary angioedema,” was published in PLOS ONE at DOI: https://doi.org/10.1371/journal.pone.0265847

 

About Osaka University

Osaka University was founded in 1931 as one of the seven imperial universities of Japan and is now one of Japan's leading comprehensive universities with a broad disciplinary spectrum. This strength is coupled with a singular drive for innovation that extends throughout the scientific process, from fundamental research to the creation of applied technology with positive economic impacts. Its commitment to innovation has been recognized in Japan and around the world, being named Japan's most innovative university in 2015 (Reuters 2015 Top 100) and one of the most innovative institutions in the world in 2017 (Innovative Universities and the Nature Index Innovation 2017). Now, Osaka University is leveraging its role as a Designated National University Corporation selected by the Ministry of Education, Culture, Sports, Science and Technology to contribute to innovation for human welfare, sustainable development of society, and social transformation.

Website: https://resou.osaka-u.ac.jp/en

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0265847 

METHOD OF RESEARCH

Content analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Why does it take so long for rare disease patients to get an accurate diagnosis?—A qualitative investigation of patient experiences of hereditary angioedema

Product label changes do not prevent accidental acetaminophen overdoses

Peer-Reviewed Publication

CANADIAN MEDICAL ASSOCIATION JOURNAL

Changes to acetaminophen product labels did not decrease rates of hospitalization for accidental acetaminophen overdoses, according to a new Canadian study in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210842.

"We found that changes to acetaminophen labels that communicated the risks of overdose and the presence of acetaminophen in over-the-counter products did not affect rates of hospital admission for accidental acetaminophen overdose, ICU admission for accidental acetaminophen overdose and admission for acetaminophen overdoses involving opioids," writes Dr. Tony Antoniou, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, with coauthors.

Acetaminophen is a medication commonly used by millions of people worldwide for pain relief, and although it is generally safe if taken correctly, accidental overdoses can occur because the drug is found in many over-the-counter products for treating pain and the common cold. In Canada, the percent of acetaminophen-related injuries related to accidental overdose in Canada increased from 27% in 2006 to 45% in 2011.

To increase awareness of potential harm, product label changes were made in Canada in October 2009 to warn of the risk of possible liver damage. In 2016, they were updated with additional labelling for safe dosing and to identify products containing acetaminophen.

However, in this study of more than 12 000 hospital admissions for accidental acetaminophen overdose in 9 provinces and 3 territories in Canada between 2004 and 2020, researchers found there was no impact from the updated labeling on admissions.

The authors suggest these findings have several implications for public health.

"Because of the human and economic burden imparted by accidental acetaminophen overdoses, additional measures for preventing these episodes are required, beyond those that attempt to inform consumers about the potential risks of acetaminophen through product labels and package inserts. This is especially important when considered in light of previous research that showed that fewer than 50% of patients regularly read labelled instructions for use of over-the counter analgesics, and only 26% read the active ingredients before first use."

As well, 4.5% to 6% of patients exceed the maximum daily dosage, perhaps because acetaminophen is found in other cough and cold medications, according to studies from the United Kingdom and the United States.

Suggestions for preventing accidental acetaminophen overdoses include removal of acetaminophen from other nonanalgesic over-the-counter medications, discontinuing opioid–acetaminophen combination products and restricting maximum doses of 325 mg per unit.

A Practice article https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210703  about treating acetaminophen overdose provides easy-to-follow guidance for health care providers on treatment for this potentially life-threatening condition. Most deaths occur after deliberate overdose or from excessive dosing for fever or pain over several days.

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JOURNAL

Canadian Medical Association Journal

DOI

10.1503/cmaj.210842 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Impact of acetaminophen product labelling changes in Canada on hospital admissions for accidental acetaminophen overdose: a population-based study

ARTICLE PUBLICATION DATE

19-Apr-2022

About 30% of COVID patients develop “Long COVID,” UCLA research finds

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - LOS ANGELES HEALTH SCIENCES

 

IMAGE: COVID-19 view more 

CREDIT: PIXABAY

FINDINGS

New UCLA research finds that 30% of people treated for COVID-19 developed Post Acute Sequelae of COVID-19 (PASC), most commonly known as “Long COVID.” People with a history of hospitalization, diabetes, and higher body mass index were most likely to develop the condition, while those covered by Medicaid, as opposed to commercial health insurance, or had undergone an organ transplant were less likely to develop it. Surprisingly, ethnicity, older age, and socioeconomic status were not associated with the syndrome even though those characteristics have been linked with severe illness and greater risk of death from COVID-19.

Of the 309 people with long COVID studied, the most persistent symptoms were fatigue and shortness of breath (31% and 15%, respectively) in hospitalized persons, and loss of sense of smell (16%) in outpatients.

BACKGROUND

The incidence and risk factors of Long COVID, and even how to define the syndrome, have remained unclear throughout the pandemic. The researchers sought evaluate its association with demographics and clinical characteristics in order to devise the most effective treatments.

METHOD

The UCLA researchers studied 1,038 people who were enrolled in the UCLA COVID Ambulatory Program between April 2020 and February 2021. Of those, 309 developed Long COVID. A person was determined to have the syndrome if they reported persistent symptoms on questionnaires 60 or 90 days after infection or hospitalization.

Potential weaknesses in the study include the subjective nature of how patients rated their symptoms, the limited number of symptoms the researchers evaluated, and limited information about patients’ pre-existing conditions.

IMPACT

“This study illustrates the need to follow diverse patient populations longitudinally to understand the Long COVID disease trajectory and evaluate how individual factors such as pre-existing co-morbidities, sociodemographic factors, vaccination status and virus variant type affect type and persistence of Long COVID symptoms,” said Dr Sun Yoo, health sciences assistant clinical professor at David Geffen School of Medicine at UCLA and medical director of the Extensivist Program.  “Studying outcomes in a single health system can minimize variation in quality of medical care. Our study also raises questions such as: Why were patients with commercial insurance twice as likely to develop Long COVID than patients insured through Medicaid? Because persistent symptoms can be subjective in nature, we need better tools to accurately diagnose Long COVID and to differentiate it from exacerbations of other emerging or chronic conditions. Finally, we need to ensure equitable access to outpatient Long COVID care.”

AUTHORS

Additional study authors are Dr. Teresa Liu, Yash Motwani, Myung Sim, Dr. Nisha Viswanathan, Dr. Nathan Samras, Dr. Felicia Hsu, and Dr. Neil Wenger of UCLA.

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JOURNAL

Journal of General Internal Medicine

DOI

10.1007/s11606-022-07523-3 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Factors associated with post-acute sequelae of SARS-CoV-2 (PASC) after diagnosis of symptomatic COVID-19 in the inpatient and outpatient setting in a diverse cohort

Personalized feedback can reduce opioid prescribing rates, new study shows

Peer-Reviewed Publication

AMERICAN COLLEGE OF EMERGENCY PHYSICIANS

WASHINGTON, D.C.—While drug overdose deaths reached an all-time high in 2021, opioid prescribing by physicians and clinicians dropped significantly in emergency departments that prioritized personalized feedback between peers, according to a new analysis in Annals of Emergency Medicine.

From January 2019 to July 2021, opioid prescribing dropped 35% among physicians and 41% among nurse practitioners and physician assistants, according to the analysis of care teams from one physician group spanning 102 emergency departments in 17 states.

“The impact of peer-to-peer feedback on opioid prescribing was immediate and profound,” said Jesse Pines, MD, MBA, FACEP, national director of clinical innovation at US Acute Care Solutions, professor of emergency medicine at Drexel University and the study’s senior author. “Emergency physicians are leading efforts to evolve the culture of prescribing. Sometimes, all it takes to bring about meaningful change is a data-driven conversation that details the evidence behind the many non-opioid options that can achieve similar or even better pain control.”

The study, “Opioid Prescription Reduction After Implementation of a Feedback Program in a National Subset of Emergency Departments,” appearing in the May edition of Annals of Emergency Medicine is the largest known analysis of emergency clinician prescribing interventions to date. The authors assessed the impact of conversations between clinicians and site directors about prescribing rationale and patterns, education on using alternatives to opioids whenever feasible, and the use of a prescription drug management program. Each conversation was personalized and informed by national data gathered by the participating clinicians’ staffing group.  

Decreases in opioid prescribing were evident across the most common diagnoses, according to the study. Opioid prescribing for injury or poisoning decreased 15% while prescribing for symptoms of illness dropped 25%, as did prescribing for respiratory disease (40%), infection or parasite (54%), blood circulation issues (36%), and endocrine or nutritional issues (28%).

Although emergency departments are not a significant source of opioid prescriptions overall, emergency physicians continue to lead programs that reduce opioid prescribing and can be adapted by other health care professionals.

“This research gives clinicians and administrators a promising model for limiting opioid prescribing in a variety of different ED settings,” said the study’s lead author Jonathan Oskvarek, MD, MBA, emergency physician and innovation fellow at US Acute Care Solutions. “Emergency physicians are setting a strong example for prescribers by prioritizing alternatives to opioids when appropriate, a choice that goes a long way toward preventing opioid overdoses.” 

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Annals of Emergency Medicine is one of the peer-reviewed scientific journals for the American College of Emergency Physicians (ACEP), the national medical society representing emergency medicine. Annals of Emergency Medicine is the largest and most frequently cited circulation peer-reviewed journal in emergency medicine and publishes original research, clinical reports, opinion, and educational information related to the practice, teaching, and research of emergency medicine.

For further information: Steve Arnoff | sarnoff@acep.org | Twitter: @EmergencyDocs

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JOURNAL

Annals of Emergency Medicine

DOI

10.1016/j.annemergmed.2021.12.009 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Opioid prescription reduction after implementation of a feedback program in a national emergency department group

ARTICLE PUBLICATION DATE

1-May-2022

Fruit snack or edible? Study finds some cannabis products look like popular snacks

Copycat edibles increase risk for accidental ingestion by children, include high THC content

Peer-Reviewed Publication

NEW YORK UNIVERSITY

 

IMAGE: "COPYCAT" EDIBLES LOOK REMARKABLY LIKE POPULAR SNACK FOODS. view more 

CREDIT: OMPAD/NYU

Some cannabis edibles look remarkably like popular snack foods and may be easily confused for them, finds a new study led by researchers at NYU School of Global Public Health published in Drug and Alcohol Dependence.

These “copycat” edibles also have levels of tetrahydrocannabinol or THC—the main psychoactive compound in cannabis—that far exceed the limits set by state cannabis regulations.

“At first glance, most of the packages look almost exactly like familiar snacks. If these copycat cannabis products are not stored safely, there is the potential for accidental ingestion by children or adults,” said Danielle Ompad, associate professor of epidemiology at NYU School of Global Public Health and the study’s lead author.

Edibles are a popular and growing segment of the cannabis market. In states where cannabis use is legal, more than half (56%) of people who use cannabis consume edibles, with younger people more likely to do so.

Recent news reports have drawn attention to edibles that use similar branding and imagery to mimic popular snack foods. These copycat cannabis products are a public health concern given that people—including children—could mistake them for snacks and accidentally consume them. From 2017 to 2019, U.S. Poison Control Centers handled nearly 2,000 cases of young children ages 0 to 9 consuming edibles.

To gain a deeper understanding of copycat edibles, the researchers collected hundreds of photos of cannabis products and analyzed their packaging, including branding, names, imagery, and THC content. They focused on photos for 267 edibles and found that 8% (22 photos) closely resembled 13 different snack products.

Twelve of the products were candies or sweet snacks (fruit chews, fruit snacks, rice and marshmallow treats, and gummies) and one was a salty snack (chips). Eight of the 13 packages used the exact brand or product name of the original product; the remaining five used names that were similar (for instance, “Stoner Patch Dummies” instead of “Sour Patch Kids”). Seven of the packages used the same cartoon or brand character as the original product.

Most states that have legalized cannabis limit the amount of THC in edibles—typically 5 mg or 10 mg of THC per dose and 100 mg per package. According to information listed on the packaging of the lookalike products, these edibles contained an average of 459 mg of THC and a range of 300 to 600 mg per package, greatly exceeding the maximum limits.

“While each package is likely intended to include multiple doses, few packages indicate the serving size or number of servings,” said Ompad, who is also the deputy director of the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU School of Global Public Health. “Moreover, if we’re considering 10 mg a standard dose, these products could contain an alarming 30 to 60 doses per package.”

The findings highlight the risk that these copycat products could be attractive to children, given the colorful packaging and use of familiar branding and characters.

“Policies to prevent cannabis packaging from appealing to children haven’t stopped copycat products from entering the market—nor have food brands taking legal action against cannabis companies for copyright infringement,” said Ompad. “People who purchase edibles that look like snack foods should store them separately from regular snacks and out of reach of children.”

In addition to Ompad, study authors include Kyle Snyder, Simon Sandh, Daniel Hagen, Emily Goldmann, and Melody Goodman of NYU School of Global Public Health; Kewanda Collier of Morgan State University; and Andy Tan of the University of Pennsylvania. The research was supported by the National Institute on Drug Abuse (P30DA011041, R21DA052421, and R01DA054236) and National Cancer Institute (R01CA237670).

About the NYU School of Global Public Health

At the NYU School of Global Public Health (NYU GPH), we are preparing the next generation of public health pioneers with the critical thinking skills, acumen, and entrepreneurial approaches necessary to reinvent the public health paradigm. Devoted to employing a nontraditional, interdisciplinary model, NYU GPH aims to improve health worldwide through a unique blend of global public health studies, research, and practice. The School is located in the heart of New York City and extends to NYU's global network on six continents. Innovation is at the core of our ambitious approach, thinking and teaching. For more, visit: http://publichealth.nyu.edu/

About CDUHR

The mission of the Center for Drug Use and HIV/HCV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national, and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041).  It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the NYU School of Global Public Health. For more information, visit www.cduhr.org.

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JOURNAL

Drug and Alcohol Dependence

DOI

10.1016/j.drugalcdep.2022.109409 

ARTICLE TITLE

Copycat and lookalike edible cannabis product packaging in the United States

ARTICLE PUBLICATION DATE

19-Apr-2022