Medicaid expansion in southern states associated with earlier and more comprehensive breast cancer treatment

Patients living in Southern states that expanded Medicaid under the Affordable Care Act were more likely to have insurance and be diagnosed with less advanced-stage breast cancer

Peer-Reviewed Publication

AMERICAN COLLEGE OF SURGEONS

 

VIDEO: RESEARCHERS SOUGHT TO UNDERSTAND THE IMPACT OF MEDICAID EXPANSION ON BREAST CANCER TREATMENT IN EIGHT SOUTHERN STATES, GIVEN THE LARGE GEOGRAPHIC HEALTH DISPARITIES THAT EXIST IN THAT REGION AND THE VARIATION IN MEDICAID COVERAGE. view more 

CREDIT: AMERICAN COLLEGE OF SURGEONS.

Key takeaways

• Filling a research gap: Researchers sought to understand the impact of Medicaid expansion on breast cancer treatment in eight Southern states, given the large geographic health disparities that exist in that region and the variation in Medicaid coverage.

• Improved access to insurance and earlier diagnosis: Patients in Southern states that expanded Medicaid were less likely to be uninsured and diagnosed with stage IV cancer.
• Access to Medicaid may only be part of the picture: Patients in Southern states that expanded Medicaid were more likely to receive breast cancer treatment overall, but data also suggests that other healthcare barriers may exist for cancer patients.

CHICAGO: Patients diagnosed with invasive breast cancer in a Southern state that expanded access to Medicaid were more likely to receive treatment and less likely to be diagnosed with advanced-stage disease, according to new research published in the Journal of the American College of Surgeons (JACS).

Under the Affordable Care Act (ACA), Medicaid was expanded in 2010 to provide coverage for all adults 18 to 64 for up to 138% of the Federal Poverty Level (about $17,774 for an individual in 2021).1 However, in 2012, the Supreme Court made it optional for states to adopt the expansion. To date, 40 states have expanded Medicaid, with the majority of these states being located outside of the South.1

“A lot of research on the Affordable Care Act has looked at trends at the national level. But if you look at a map of where states actually expanded Medicaid, the South is under-represented,” said lead author Amy Laughlin, MD, MSHP, chief quality officer at the Orlando Health Cancer Institute. “We wanted to make sure that the impact of Medicaid expansion on breast cancer was assessed at the Southern state level to understand the impact specifically in that region and perhaps to inform policy for the rest of the region.”

Some prior research has shown that expanded access to Medicaid can improve access to cancer screening services, such as mammograms,2 but little research has specifically compared neighboring populations in the South, where many vulnerable patients live in rural areas and have less access to affordable care, said senior author Quyen Chu, MD, MBA, FACS, a surgical oncologist with the Orlando Health Cancer Institute. In his former position at the Louisiana State University Health Sciences Center, Dr. Chu sometimes encountered patients who traveled, in search of cancer treatment, from Texas, which did not adopt the expansion, to Louisiana, which expanded Medicaid in 2016.

“Those encounters are something you don’t really hear about. But, from my personal experience, that’s what I saw during my time when I was practicing in Louisiana,” he said. “There are vulnerable patients who don’t have access to care, and we wanted to look at the facts to know whether the ACA expansion had an impact on those patients. We wanted to be apolitical about it; we didn’t know the answer before doing the study.”

Using the North American Association of Central Cancer Registries (NAACCR) database, the researchers identified patients on Medicaid or without insurance who were between the ages of 40-64 and diagnosed with invasive breast cancer from 2011 to 2018.

The researchers compared data from patients who lived in Southern states that expanded access to Medicaid (Louisiana, Kentucky, and Arkansas) to patients in states that did not expand access to Medicaid (Tennessee, Alabama, Mississippi, Texas, and Oklahoma). Oklahoma expanded coverage in 2020, but data from that state was included in the non-expanded group because this research only included data up until 2018.

Key findings

• Among 21,974 patients, those living in states that expanded Medicaid were less likely to be uninsured than patients living in states that did not expand (18.9% vs. 41.1%).
• Compared with breast cancer patients in states that expanded Medicaid, patients in states that did not expand access were younger and more likely to be uninsured, Hispanic, and live in an urban area with less poverty.
• Patients living in a state that expanded Medicaid were less likely to be diagnosed with stage IV disease, with odds of being diagnosed with advanced-stage breast cancer decreasing by 7% every year after expansion. The authors hypothesize that this decrease may be attributed to increased access to mammogram screenings among low-income patients.
• Unrelated to Medicaid expansion, just by being diagnosed in a state that expanded Medicaid, patients had 2.27 higher odds of receiving treatment for breast cancer. “And this is regardless of expansion, so more likely due to intrinsic factors in the state,” Dr. Laughlin noted. These intrinsic factors were not specifically identified in the study but could be related to other infrastructure or services available in states that expanded Medicaid, independent of policy changes.

However, the study also revealed that Medicaid may only be part of the picture when it comes to receiving quality cancer care. Even though patients diagnosed in states that expanded Medicaid were more likely to receive treatment overall, the proportion of patients undergoing treatments for their breast cancer actually decreased in all states regardless of Medicaid expansion.

“This trend raises concern,” Dr. Laughlin said. “We know from other studies that cancer diagnoses are increasing. If we’re then having less treatment received, are we not meeting that demand? That was a surprising finding to me.”

Katharine Yao, MD, FACS, Chair of the National Accreditation Program for Breast Centers (NAPBC) of the American College of Surgeons and a surgical oncologist with NorthShore University Health System, agreed that the decline in treatment noted by the researchers is concerning. “Future studies may be warranted to understand whether this trend is due to stage migration, access issues, patient preferences, or another reason,” said Dr. Yao, who was not involved with the study.

The decrease in uninsured rates in states that expanded Medicaid found in this study is striking, Dr. Yao added. “Since Medicaid expansion resulted in a greater than 50% drop in the rate of uninsured for those states that underwent expansion, it seems like a missed opportunity for those states that did not adopt Medicaid expansion,” she said. “While observational and only focused on a cohort of patients, this research brings awareness to the widespread disparities in healthcare in the Southern states and how much further these states have to go before patients receive the healthcare they need.”

Next steps

The study represents an initial step to understand treatment patterns and was limited by the data included in the NAACCR database, the authors noted. In future studies, they hope to understand if earlier detection and increased access to care improved survival rates. Investigating potential racial or socioeconomic disparities in breast cancer treatment between states that expanded Medicaid or did not may also reveal important findings.

“As a society, we have made tremendous gains in terms of finding novel therapies, such as immunotherapy or targeted drug therapy. But the question is, how many of these patients actually benefit from those discoveries?” Dr. Chu said. “Theoretically speaking, everyone should benefit from those discoveries. For the next step, we would like to look at if we see an impact for those who live in rural areas or belong to vulnerable populations.”

Study coauthors are Tingting Li, MPH; Qingzhao Yu, PhD; Xiao-Cheng Wu, MD, MPH; Yong Yi, PhD; Mei-Chin Hsieh, PhD, MSPH; William Havron, MD, FACS; and Margo Shoup, MD, MBA, FACS. All authors are affiliated with the Orlando Health Cancer Institute or the Louisiana State University Health Sciences Center.

The study authors have no relevant disclosures to report. Dr. Wu and Dr. Hsieh were supported by the National Cancer Institute under award number HHSN261201800007I/HHSN26100002.

This research was also presented at the Southern Surgical Association 134th Annual Meeting in Palm Beach, Florida, December 2022. This study is published as an article in press on the JACS website.

Citation: Laughlin AI, Li T, Yu Q et al. Impact of Medicaid Expansion on Breast Cancer Diagnosis and Treatment in Southern States. Journal of American College of Surgeons. DOI: 10.1097/XCS.0000000000000550.

_____________

1. “Status of State Medicaid Expansion Decisions: Interactive Map,” Kaiser Family Foundation, November 9, 2022.
2. Toyoda, Yoshiko, Eun Jeong Oh, Ishani D. Premaratne, Codruta Chiuzan, and Christine H. Rohde. “Affordable Care Act state-specific Medicaid expansion: impact on health insurance coverage and breast cancer screening rate.” Journal of the American College of Surgeons 230, no. 5 (2020): 775-783.

# # #

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

The Journal of the American College of Surgeons (JACS) is the official scientific journal of ACS. Each month, JACS publishes peer-reviewed original contributions on all aspects of surgery, with the goal of providing its readership the highest quality rapid retrieval of information relevant to surgeons.

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JOURNAL

Journal of the American College of Surgeons

DOI

10.1097/XCS.0000000000000550 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Impact of Medicaid Expansion on Breast Cancer Diagnosis and Treatment in Southern States

ARTICLE PUBLICATION DATE

1-Feb-2023

COI STATEMENT

The study authors have no relevant disclosures to report. Dr. Wu and Dr. Hsieh were supported by the National Cancer Institute under award number HHSN261201800007I/HHSN26100002.

Seeing the same midwives improves birthing experience for high-risk mothers

Peer-Reviewed Publication

KING'S COLLEGE LONDON

Seeing the same midwives throughout the perinatal period makes a substantial difference to a women’s feelings of calm and confidence during pregnancy and birth, a study has found.

The study, published recently in Women and Birth by researchers from King’s College London, highlight the improvements in a woman’s experience of care under the continuity of care model.

This is the first study which looks at women’s experience of care when they are at a higher risk of pre-term birth.

The model of continuity of care is designed to provide mothers with a dedicated team of midwives who are on call 24/7 to provide support, including answering questions, provide antenatal and postanal appointments and be there for them when they go into labour.

One woman said the experience had completely changed her attitude to birth. She said: “I’m very happy that I will be able to pass on a positive message about birth to friends, my own daughter, and I don’t what it would have been like without the POPPIE team.”

The continuity of care model was set out in the NHS Long Term Plan in 2019 and the ambition is for continuity to be the default model of care for maternity services.

In reality, though, implementation of sustainable continuity models requires all building blocks to be in place such as staffing and appropriate resourcing; which can be challenging in the current NHS climate.

Interviews of women who took part in the study found they felt at ease just knowing someone was there for them all the time. Women reported never feeling rushed during appointments, and feeling like they could trust their midwife with personal information, which in turn developed trust in their midwives.

One woman said: “[It] felt like they were friends, you know, because we’d seen them for so long, they were just friends with lots of skills.”

Women felt their midwives advocated for them better and navigated institutional bureaucracy for them, ensuring they were getting the best treatment.

Author Lia Brigante, a researcher from King’s College London and the Policy & Practice Advisor at the Royal College of Midwives, said: “Previous research has shown that continuity of midwifery care has a positive impact in women who are low risk or mixed risk. This paper focuses on the experience of women at higher risk of preterm birth and it shows that the model acts as a safety net, improving trust, advocacy, access and consistency of care, and reducing anxiety and stress. This study will hopefully inform policy and care provision planning for women at higher risk of preterm birth.” 

Previous research has found the continuity of care model reduces the rate of preterm birth, fetal loss and neonatal death.

Lia Brigante added: “Adequate staffing and added investment is essential to ensure all women have access to the continuity model, otherwise we are in danger of implementing a two-tier system.’

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JOURNAL

Women and Birth

DOI

10.1016/j.wombi.2023.01.003 

ARTICLE TITLE

“She was there all the time”. A qualitative study exploring how women at higher risk for preterm birth experience midwifery continuity of care

Better eyewitness lineup improves accuracy, detecting innocence

Peer-Reviewed Publication

IOWA STATE UNIVERSITY

 

IMAGE: NYDIA AYALA, LEFT, AND ANDREW SMITH IN PSYCHOLOGY HAVE DEVELOPED A REVISED METHOD FOR AN EYEWITNESS LINEUP. view more 

CREDIT: CHRISTOPHER GANNON/IOWA STATE UNIVERSITY

AMES, IA – Iowa State researchers have developed a new procedure to capture more information from eyewitnesses during police investigations and better detect a suspect's guilt or innocence.

During a typical eyewitness lineup, police display a “six pack” of photos. One is the police suspect. The other five are “fillers;” they fit the description of the culprit, but the investigators know they are innocent. The witness selects the person who best matches their memory or rejects the whole lineup if they don’t think the culprit is present. Investigators following best practices then ask the witness to rate how confident they are in their decision.

Previous studies have found a high confidence rating from eyewitnesses (i.e., 90% or more) implies greater accuracy. But when an eyewitness picks a filler or rejects the whole lineup, which happens in an estimated 24% and 35% of lineups, respectively, investigators miss out on potentially valuable evidence.

“The standard eyewitness line-up is a helpful tool for investigators, but it could be better and provide a lot more information,” said Andrew Smith, a cognitive psychologist and assistant professor at Iowa State.

Smith and Nydia Ayala, a fourth-year Ph.D. student, are interested in memory and decision-making in the context of the criminal justice system. Over the last three years, they’ve developed and repeatedly tested what they call the “Simultaneous Lineup Plus Rule Out Procedure.” Their latest study, published in Psychology, Public Policy and Law, adds to their findings that the procedure improves the accuracy of lineups and can help inform investigations.

Enhancing, not erasing

“One of the benefits of the rule out procedure is it’s highly feasible,” said Ayala. “We're not asking investigators to stop doing standard simultaneous lineups with six packs. We’re just asking them to tack six confidence questions onto the end."

With the researchers’ proposed change, eyewitnesses would still make an initial selection or rejection of the whole lineup and give a confidence rating for their decision. But then they’d look again at each of the photos they did not select from the first round and answer: how confident are you this is not the culprit?

“This ensures that even when a witness picks a filler or rejects a lineup, they still tell police something that speaks directly to the likelihood that the suspect is guilty or innocent. We’re not getting that with the standard lineup,” said Smith.

To show how this could be beneficial, Ayala gave the example of an eyewitness who selects the second face in a six pack with 60% confidence. If the second face was a filler, police following the standard lineup procedure would not receive any information about their suspect, the fourth face. With the new method, the eyewitness might look at the fourth face in the lineup and say the individual was not the culprit with 100% confidence. This could indicate that the police’s suspect is innocent.

“If cops use this procedure, they're going to do much better at knowing if they’re on the right track or need to go back to the drawing board,” said Smith. “It might also make for compelling evidence in court cases when defense lawyers have a witness who is able to say, ‘I’m 100% sure it is not that guy.’”

Results

In the researchers’ latest study, 3,281 participants watched a 90-second simulated crime video. The culprit’s face was in view for 45 seconds. After, the participants worked on word scrambles for four-five minutes to prevent them from rehearsing the image of the culprit. The researchers explained this was built into the experiment to mimic the natural passage of time real eyewitness experience between viewing a crime and completing a lineup.

The participants were randomly assigned to the standard lineup or rule out procedure and informed that they may or may not see the culprit from the video among the photographs.

With the standard lineup experiment, the researchers found that 11% of the participants who viewed a lineup that did not include the culprit were 100% confident in rejecting the whole lineup. They were accurate 81% of the time. But with the rule out procedure, nearly half (43%) of the participants said they were 100% confident that the innocent suspect was not the culprit, and their accuracy increased to 87%.

“That bump in accuracy from 81% to 87% was relatively small, but it’s not the whole story because the rule out procedure also drastically kicked up the number of people who can give high confidence rejections, which are highest in accuracy,” said Smith.

Essentially, the rule out procedure could mean more witnesses are able to indicate the likelihood that the suspect is guilty or innocent. Smith and Ayala say it’s time for the criminal justice system to move beyond standard lineups and adopt the rule out procedure.

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JOURNAL

Psychology Public Policy and Law

DOI

10.1037/mac0000018 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The rule-out procedure: Increasing the potential for police investigators to detect suspect innocence from eyewitness lineup procedures.

Digital revolution inspires new research direction in ecosystem structural diversity

Peer-Reviewed Publication

PURDUE UNIVERSITY

 

IMAGE: A SPECIAL ISSUE OF THE JOURNAL FRONTIERS IN ECOLOGY AND THE ENVIRONMENT HIGHLIGHTS HOW A REVOLUTION IN DIGITAL TECHNOLOGY HAS CREATED THE NEED FOR A NEW RESEARCH FRAMEWORK TO ASSESS THE ECOLOGICAL ROLE OF STRUCTURAL DIVERSITY. PURDUE UNIVERSITY PHOTO/SONGLIN FEW view more 

CREDIT: PURDUE UNIVERSITY PHOTO/SONGLIN FEI

 WEST LAFAYETTE, Ind. — A special issue of the journal Frontiers in Ecology and the Environment lays the foundation for pursuing structural diversity as a new research direction in ecology. The issue, funded by the National Science Foundation, also describes the digital data collection methods that enable the new research direction, and the applications of the work in various ecosystems.

   “Structural diversity is thinking about what elements occupy a space and how they have been arranged in the space,” said the special issue’s lead editor, Songlin Fei, a professor of forestry and natural resources and the Dean’s Chair of Remote Sensing at Purdue. “The hope is that we’re providing a framework that can be applied regardless of the system that you’re working in, from terrestrial to aquatic.”

   As Fei and three co-editors wrote in their overview, the special issue’s contributions “provide a new framework for structural diversity, new applications to ecological theory, and case studies.”

   The co-editors were Purdue’s Brady Hardiman, associate professor of urban ecology in Purdue’s Department of Forestry and Natural Resources; Elizabeth LaRue, assistant professor of biological sciences at the University of Texas at El Paso; and Kyla Dahlin, associate professor of geography, environment and spatial sciences at Michigan State University.

   Six of the seven lead authors in the special issue are early-career scientists who are developing applications for the 3D technologies that could result in new ecological theories. These technologies include light detection and ranging (lidar), and data sensors mounted on drones and satellites.

   “Adopting these emerging digital tools and technologies will enable the next generation of ecologists to gracefully operate a fleet of sensors to measure ecosystems and swim freely in the resulting ocean of data,” the editors wrote.

   Such methods form the basis of Purdue’s new Center for Digital Forestry, which Fei directs. As one of the five strategic investments in Purdue’s Next Moves, the center leverages digital technology and multidisciplinary expertise to measure, monitor and manage urban and rural forests to maximize social, economic and ecological benefits.

   “In the past, as scientists we measured the Earth as a flat entity,” said LaRue, a former postdoctoral researcher mentored by Fei and Hardiman. “That’s in part because we didn’t have good technology to measure 3D aspects of the planet.”

   Those aspects include elevation differences and fine-scale features such as the branching patterns of trees. Previously, researchers had to make such measurements by hand.

   “The technology is rapidly advancing. We need to catch up on the science and the theory that are being enabled by these 3D technologies,” she said. 

   The special issue notes that despite key work already started in forestry, more needs to be done in ecosystem types like wetlands, grasslands and marine ecosystems.

“Our knowledge is still quite limited about structural diversity in different ecosystem types,” LaRue said.     

Traditionally, scientists have sought to measure biodiversity by counting species and assessing their genetic diversity.

   “These existing measures come back to this basic question: How much of the available ecological space has been occupied by different organisms?” Hardiman said. “The more ecological space that has been occupied by different species, the more stable the system might be, because missing one species would not cause the collapse of the system.”

   But with the new 3D digital technologies, researchers can now quickly determine the layered arrangement of species within an environment, along with their size and number. Such capabilities benefit land managers as well as researchers. Managers now can often collect higher-quality data much faster and at less expense to help their decision-making. Sometimes they can simply use a cellphone app to make measurements that previously required a tape measure.

   The editors and authors of the special issue highlight four challenges that researchers need to address to realize the full potential of such digital advances in ecology. 

   The first challenge is for ecologists and environmental scientists to collaborate more extensively with colleagues in other specialties. The needed expertise ranges from aviation technology, engineering and computer science to graphic design, information science and the social sciences. 

   The second challenge is to apply supercomputers, cloud computing, machine learning and artificial intelligence to process the massive 3D data sets that digital technology now generates.     

   “A lot of the data we work with is publicly accessible and available,” Fei said. But researchers sometimes lack the expertise to take advantage of it. “They don’t have the computational capacity or the right tools to handle it,” he said.

   The third challenge is to adopt new approaches to better assess the hundreds of variables in ecosystem structure that 3D data sets now often present. Instead of depending on traditional hypothesis testing, the editorial team recommended that researchers should take data-driven approaches or combine the two.

   And finally, the editors emphasized the critical importance of training the next generation of ecologists in digital technology.

“New data-oriented skills such as acquisition, visualization, analysis, and management of large datasets must become essential parts of ecological training,” they wrote.

3D structural diversity in southern New Mexico

These images contain 3D data collected by drone-mounted sensors. The images compare structural diversity in a native grassland (top) with an area invaded by shrubs after cattle grazing (bottom) in the Jornada Experimental Range of southern New Mexico. The invaded area shows higher structural diversity.

CREDIT

Photo courtesy of Elizabeth LaRue/University of Texas at El Paso

JOURNAL

Frontiers in Ecology and the Environment

DOI

10.1002/fee.2520 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Special Issue of Frontiers in Ecology and the Environment

ARTICLE PUBLICATION DATE

1-Feb-2023

Mistaken fossil rewrites history of Indian subcontinent for second time

A fossil turned out to be just a beehive, and the correction puts the geologic and life history of India back into contention

Peer-Reviewed Publication

UNIVERSITY OF FLORIDA

 

IMAGE: WHAT AT FIRST LOOKED LIKE A DICKINSONIA FOSSIL (ON THE LEFT) HAD DECAYED AND STARTED PEELING OFF THE ROCK IN JUST A FEW SHORT YEARS (ON THE RIGHT), A SIGN IT WAS SOMETHING MUCH MORE MODERN. view more 

CREDIT: GREGORY RETALLACK/JOE MEERT

In 2020, amid the first pandemic lockdowns, a scientific conference scheduled to take place in India never happened.

But a group of geologists who were already on site decided to make the most of their time and visited the Bhimbetka Rock Shelters, a series of caves with ancient cave art near Bhopal, India. There, they spotted the fossil of Dickinsonia¸ a flat, elongated and primitive animal from before complex animals evolved. It marked the first-ever discovery of Dickinsonia in India.

The animal lived 550 million years ago, and the find seemed to settle once and for all the surprisingly controversial age of the rocks making up much of the Indian subcontinent. The find attracted the attention of The New York Times, The Weather Channel and the scientific journal Nature as well as many Indian newspapers.

Only, it turns out, the “fossil” was a case of mistaken identity. The true culprit? Bees.

University of Florida researchers traveled to the site last year and discovered the object had seemingly decayed significantly – quite unusual for a fossil. What’s more, giant bee’s nests populate the site, and the mark spotted by the scientists in 2020 closely resembled the remains of these large hives.

“As soon as I looked at it, I thought something’s not right here,” said Joseph Meert, a UF professor of geology and expert on the geology of the area. “The fossil was peeling off the rock.”

The erstwhile fossil was also lying nearly vertical along the walls of the caves, which didn’t make sense. Instead, Meert says, fossils in this area should only be visible flat on the floor or ceiling of the cave structures.

Meert collaborated on the investigation with his graduate students Samuel Kwafo and Ananya Singha and University of Rajasthan professor Manoj Pandit. They documented the rapid decay of the object and photographed similar remains from nearby beehives. The team published their findings of the mistaken identity Jan. 19 in the journal Gondwana Research, which previously published the report of the serendipitous Dickinsonia fossil find.

Gregory Retallack, professor emeritus at the University of Oregon and lead author of the original paper, says he and his co-authors agree with Meert’s findings that the object is really just a beehive. They are submitting a comment in support of the new paper to the journal.

This kind of self-correction is a bedrock principle of the scientific method. But the reality is that admitting errors is hard for scientists to do, and it doesn’t happen often.

“It is rare but essential for scientists to confess mistakes when new evidence is discovered,” Retallack said in an email.

Correcting the fossil record puts the age of the rocks back into contention. Because the rock formation doesn’t have any fossils from a known time period, dating it can be difficult.

Meert says the evidence continues to point to the rocks being closer to one billion years old. His team has used the radioactive decay of tiny crystals called zircons to date the rocks to that time period. And the magnetic signature of the rocks, which captures information about the Earth’s magnetic field when the rocks formed, closely matches the signatures of formations confidently dated to a billion years ago.

Other scientists have reported findings supporting a younger age. The time period is essential to understand because of its implications for the evolution of life in the area and how the Indian subcontinent formed.

“You might say, ‘Okay, well what's the big deal if they are 550 million or a billion years old?’ Well, there are lots of implications,” Meert said. “One has to do with the paleogeography at the time, what was happening to continents, where the continents were located, how they were assembled. And it was a period when life was going through a major change, from very simple fossils to more complex fossils.”

“So trying to figure out the paleogeography at the time is very, very important. And in order to figure out the paleogeography, we have to know the age of the rocks,” he said.

The caves near Bhopal, India, host prehistoric cave art. Because they don't have any fossils, they are hard to date.

Large beehives dot the site. After they are abandonded and decay, they briefly resemble fossils of the primitive animal Dickinsonia.

CREDIT

Joseph Meert

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JOURNAL

Gondwana Research

DOI

10.1016/j.gr.2023.01.003 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Stinging News: ‘Dickinsonia’ discovered in the Upper Vindhyan of India not worth the buzz

Looking beyond microplastics, Oregon State researchers find that cotton and synthetic microfibers impact behavior and growth of aquatic organisms

Peer-Reviewed Publication

OREGON STATE UNIVERSITY

 

IMAGE: LARVAL INLAND SILVERSIDES WITH COTTON MICROFIBERS IN THEIR DIGESTIVE TRACTS. view more 

CREDIT: OREGON STATE UNIVERSITY

CORVALLIS, Ore. – While microplastics have received significant attention in recent years for their negative environmental impacts, a new study from Oregon State University scientists found microfibers from synthetic materials as well as cotton impacted the behavior and growth of water organisms.

“We’re trying to shift the narrative a little bit because so much of the focus has been just on the plastics, but really we need to focus more generally on microfibers of all types,” said Susanne Brander, an associate professor and ecotoxicologist at Oregon State. “What we are seeing is that even the cotton, while it has less of an impact than the synthetic materials, still has an impact on the growth and behavior of the organisms we studied.”

The study, published this week in the journal Frontiers in Marine Science, is being released at a time of increased attention on regulating microfibers. Like microplastics, microfibers are of concern because scientists are increasingly identifying them in water samples and finding they are causing adverse impacts in organisms and ecosystems.

A bill was recently introduced in Oregon that would require new clothes washers sold in the state be equipped with a microfiber filtration system. France recently approved a similar measure and several other countries, states and provinces are considering bills. Related, a study from Canada in 2021 found that washing machine filters reduce microfiber emissions.

Brander, who studies the responses of aquatic organisms to environmental stressors, believes other measures could be taken to reduce the release of microfibers, including increasing the sustainability of clothing so that it sheds less and passing laws that would require filters on both clothes washers and dryers. Previous studies have found dryers are an underestimated source of microfibers being released into the environment.

“The answer isn’t to stop using cotton but to have a better awareness and better control over the release of fibers,” Brander said.

For the new study, Brander’s lab, with support from the lab of Stacey Harper, a professor of toxicology and environmental engineering at Oregon State, created microfiber samples of different sizes from ropes made of cotton, polyester and polypropylene, all of which are commonly found in coastal waters, including in wild organisms such as rockfish and zooplankton that Brander’s students study.

The researchers then exposed larval and juvenile inland silverside and mysid shrimp, both model organisms for estuaries and coastal ecosystems, to the three microfiber types at three concentrations and different levels of salinity meant to mimic conditions in an estuary and measured behavioral responses, growth and ingestion levels in the two organisms.

Among their findings:

• Cotton had no effect on growth in silversides but did reduce growth in the mysids at the two lower salinities. This finding surprised Brander, who thought the researchers would find growth impacts on both organisms or neither, not just one. She speculated that the finding may be a result of the silversides being better at breaking down the cotton than the shrimp.
• Synthetic fibers reduced growth in both organisms over just a few days of exposure.
• Polyester and polypropylene had more of an effect on behavior than cotton did in both organisms. Brander believes this could be due to residual chemicals on the polyester and polypropylene, which could remain despite the researchers rinsing the microfibers.
• Cotton was not detected in the digestive tracts of silversides, however polyester and polypropylene were detected in the silversides’ stomach and gut lining. None of the fiber types were detected in mysid shrimps.
• Cotton impacted both organisms’ behavior more at higher salinities, whereas polyester and polypropylene had more behavioral impacts at lower salinities. This could be due to differences in the densities of the different materials, which influences how long they stay in suspension.

“Increasing amounts of microfibers are being detected in environmental samples and we really need to identify the risk associated with them, especially at sensitive early life stages of organisms,” Harper said. “This study and others begin to do that, but more research is needed.”

The research is supported by a National Science Foundation Growing Convergence Research Big Idea grant. The grant supports the Oregon State-based Pacific Northwest Consortium of Plastics, which Harper and Brander co-lead.

Harper and Brander are based in the Oregon State College of Agricultural Sciences. Harper also has an appointment in the College of Engineering. This research was led by Samreen Siddiqui, a former postdoctoral fellow in Brander’s lab. Graduate students Sarah Hutton and John Dickens and technician Emily Pedersen also contributed.

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JOURNAL

Frontiers in Marine Science

DOI

10.3389/fmars.2022.991650 

ARTICLE TITLE

Natural and synthetic microfibers alter growth and behavior in early life stages of estuarine organisms

ARTICLE PUBLICATION DATE

31-Jan-2023

CAPTION

Larval inland silversides with polyester microfibers in their digestive tracts.

Larval inland silversides with polypropylene microfibers in their digestive tracts. 

Photo: Oregon State University.