AI in the ICU

Carnegie Mellon University Assist in Developing AI-Based System To Recommend Clinical Treatments

Reports and Proceedings

CARNEGIE MELLON UNIVERSITY

Clinicians in an intensive care unit need to make complex decisions quickly and precisely, monitoring critically ill or unstable patients around the clock.

Researchers from Carnegie Mellon University's Human-Computer Interaction Institute (HCII) collaborated with physicians and researchers from the University of Pittsburgh and UPMC to determine if artificial intelligence could help in this decision-making process and if clinicians would even trust such assistance.

The team gave 24 ICU physicians access to an AI-based tool designed to help make decisions and found that most incorporated the assistance into some of their decisions.

"It feels like clinicians are excited about the potential for AI to help them, but they might not be familiar with how these AI tools would work. So it's really interesting to bring these systems to them," said Venkatesh Sivaraman, a Ph.D. student in the HCII and member of the research team.

Using the AI Clinician model introduced in Nature by a group of researchers in 2018, the team designed an interactive clinical decision support (CDS) interface — called the AI Clinician Explorer — that provides recommendations for treating sepsis. The model was trained on a data set of more than 18,000 patients who met standard diagnostic criteria for sepsis at some point during their ICU stays. The system enables clinical experts to filter and search for patients in the data set, visualize their disease trajectories, and compare the model predictions to actual treatment decisions delivered at the bedside.

"Clinicians are always entering a lot of data about the patients they see into these computer systems and electronic health records," Sivaraman said. "The idea is that maybe we can learn from some of that data so we can try to speed up some of their processes, make their lives a little bit easier and also maybe improve the consistency of care."

The team put their system to the test via a think-aloud study with 24 clinicians who practice in the ICU and have experience treating sepsis. During the study, participants used a simplified AI Clinician Explorer interface to assess and make treatment decisions for four simulated patient cases.

"We thought the clinicians would either let the AI make the decision entirely or ignore it completely and make their own decision," Sivaraman said.

But the results were not so binary. The team identified four common behaviors among the clinicians: ignore, rely, consider and negotiate. The "ignore" group did not let the AI influence their decision and mostly made their decisions before even looking at the recommendation. By contrast, the "rely" group consistently accepted at least part of the AI's input in every decision. In the "consider" group, physicians thought about the AI recommendation in every case and then either accepted or rejected it. Most participants, however, fell into the "negotiate" group, which includes practitioners who accepted individual aspects of the recommendations in at least one of their decisions, but not all.

The team was surprised by these results, which also provided insight on ways to improve the AI Clinician Explorer. Clinicians expressed concerns that the AI did not have access to more holistic data, such as the patient's general appearance, and were skeptical when the AI made recommendations contrary to what they were taught.

"When the CDS deviates from what clinicians would normally do or consider to be best practice, there was not a good sense of why," Sivaraman said. "So right now, we're focusing on determining how to provide that data and validate these recommendations, which is a challenging problem that will require machine learning and AI."

The team's research doesn't attempt to replace or replicate clinician decision-making, but instead hopes to use AI to reveal patterns that may have gone unnoticed in past patient outcomes.

"There are a lot of diseases, like sepsis, that might present very differently for each patient, and the best course of action might be different depending on that," Sivaraman said. "It's impossible for any one human to amass all that knowledge to know how to do things best in every situation. So maybe AI can nudge them in a direction they hadn't considered or help validate what they consider the best course of action."

Sivaraman's collaborators include Adam Perer, an assistant research professor in the HCII; Leigh Bukowski, a senior research manager at the University of Pittsburgh's School of Public Health; Joel Levin, a doctoral candidate in Pitt's Katz Graduate School of Business; and Jeremy Kahn, a physician in UPMC's Department of Critical Care Medicine and associate professor of critical care medicine and health policy in Pitt's School of Medicine and School of Public Health.

Sivaraman presented the team's paper "Ignore, Trust or Negotiate: Understanding Clinician Acceptance of AI-Based Treatment Recommendations in Health Care" this month at the Association for Computing Machinery's Conference on Human Factors in Computing Systems (CHI 2023) in Hamburg, Germany.

What makes “junk food” junk?

Study examines how three decades of U.S. policies define junk food for taxation and other regulations

Peer-Reviewed Publication

NEW YORK UNIVERSIT

How is “junk food” defined for food policies like taxes? A combination of food category, processing, and nutrients can determine which foods should be subject to health-related policies, according to a new analysis examining three decades of U.S. food policies by researchers at the NYU School of Global Public Health and the Friedman School of Nutrition Science and Policy at Tufts. 

Junk food—a term that typically describes sweet or salty snacks and desserts with low nutritional value—makes up 15% of all calories consumed in the United States. 

“There is a growing recognition that an unhealthy diet stems from overconsumption of what we colloquially refer to as ‘junk food,’ ” said Jennifer Pomeranz, assistant professor of public health policy and management at NYU School of Global Public Health and the first author of the study, published in the journal Milbank Quarterly. “However, public health efforts to address junk food are hindered by a lack of a uniform method to define junk food for policy purposes.”

One policy example where a definition for junk food is needed is a junk food tax, which raises the price of such products to reduce consumption and generate revenue for other programs to improve the nutrition and health of communities in need. Previous research by NYU and Tufts shows that taxes on junk food are administratively and legally feasible. 

While junk food taxes are not widely used in the United States, several countries have successfully implemented them. Hungary taxes unhealthy food that falls into certain categories and have elevated levels of nutrients, such as sugar and salt—an approach that has led to lower consumption of junk food, increased awareness about nutrition, and has nudged manufacturers to reformulate their products to make them healthier.

“People often say it would be too difficult to define ‘junk food’ for taxation or other policies. Our new results indicate numerous U.S. examples of existing policies that define junk food and identify the common threads between them,” said study senior author Dariush Mozaffarian, dean for policy at the Friedman School at Tufts.

To gain a deeper understanding of how existing policies determine what constitutes junk food, the researchers evaluated policies where federal, state, or tribal governments defined categories of food for taxation or other related regulatory purposes. Not all policies targeted junk food—federal regulations define foods covered under food assistance programs, while several states sought to exempt the sale of home- or farm-made foods from retail requirements.

They identified and analyzed 47 laws and bills from 1991 through 2021, including one active junk food tax law implemented by the Navajo Nation, three state snack food sales taxes that were later repealed, and numerous junk food tax bills that have not been enacted. (Their analysis did not include policies that solely focused on beverages such as soda taxes.)

They found that existing policies used several criteria to define foods, including product categories (e.g. candy, chips), processing (e.g. added preservatives), place of preparation or sale (e.g. homemade, farmers’ market, vending machine), nutrients (e.g. levels of salt, saturated fat, or sugar or calories), and serving size. Of the 47 policies, 26 used multiple criteria to define foods. 

Two themes emerged: first, policies used categories of food products to help differentiate between necessary or staple foods and non-staple foods. For instance, bread was often excluded from junk or snack food policies, as it is widely considered a staple food, while sweets and chips were considered non-staple foods. 

Second, policies commonly added a combination of processing and/or nutrient criteria to further determine which products within food categories would be subject to or exempt from regulation, generally favoring products with lower levels of processing and additives. This combined approach—which may provide a path forward for new junk food policies—is used in a Navajo Nation junk food tax that defines which food is taxed based on category, processing, and nutrients, including saturated fat, salt, and sugar. 

The researchers were surprised that no state tax laws or bills directed the state’s public health department to define the foods subject to the tax, a practice regularly used at the federal level and a mechanism that states could use to have experts define the foods to be taxed.

The researchers further concluded that their analysis supports the use of junk food taxes implemented as excise taxes paid by manufacturers or distributors, rather than sales taxes that need to be administered by retailers and paid directly by consumers. Revenue from excise taxes can be earmarked for particular uses, including improving access to healthy food in low-resource communities. 

“An advantage of excise taxes is that food companies may be motivated to reformulate their products to be healthier to avoid taxation,” said study co-author Sean Cash of the Friedman School at Tufts. “Defining foods to be taxed is not a static exercise, as existing products are reformulated and thousands of new packaged foods are introduced each year—so how we tax foods is not just a tool for steering consumers away from the least healthy options, but also for encouraging healthy innovations in what ends up on the supermarket shelves.”

This research was supported by the National Institutes of Health (2R01HL115189-06A1).

 

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: publichealth.nyu.edu

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JOURNAL

Milbank Quarterly

DOI

10.1111/1468-0009.12652 

ARTICLE TITLE

US Policies That Define Foods for Junk Food Taxes, 1991–2021

ARTICLE PUBLICATION DATE

26-Apr-2023

“We are dying out here”: Study hears Ukrainian voices on depopulation crisis

Peer-Reviewed Publication

UNIVERSITY OF SOUTHAMPTON

 

AUDIO: UNAVAILABLE view more 

CREDIT: UNIVERSITY OF SOUTHAMPTON

Ukraine is facing a depopulation crisis that was being felt by ordinary Ukrainians even before the Russian invasion, according to new research by the University of Southampton.

Researchers are now calling on policy makers to support Ukrainians with jobs, housing, and policies to help them start families to help stop spiralling depopulation.

Ukraine has one of the highest rates of population decrease in Europe. Its population has been steadily declining since 1993 and this was exacerbated by the annexation of Crimea in 2014, the rebellion by pro-Russian separatists in the east, and the COVID-19 pandemic. By 2021, Ukraine’s population had shrunk by over 10 million people in 20 years.

“Before the Russian invasion, Ukraine was already facing a triple burden of depopulation - low fertility, high mortality and substantial emigration,” says Professor Brienna Perelli-Harris from the Centre for Population Change at the University of Southampton.

“The Russian invasion has accelerated this decline in ways we could scarcely have imagined when we conducted our research just six months earlier.”

To understand how Ukrainians were experiencing this depopulation, researchers conducted online focus groups in several locations in eastern Ukraine: rural villages; Mariupol, which was then receiving internally displaced people; the large city of Kharkiv; and Donetsk, held by Russian-backed separatists.

‘Bleak’ rural villages

The ‘triple burden’ was particularly apparent in rural areas. According to the participants, a lack of job opportunities, the degradation of infrastructure, and limited public transport had resulted in more and more people, especially young people, leaving villages.

‘Thriving’ Mariupol and Kharkiv

At the time of the study, the cities of Mariupol and Kharkiv were growing due to people coming from surrounding villages and an influx of internally displaced people who had arrived from eastern Ukraine after 2014.

Most participants in Kharkiv and Mariupol acknowledged the benefits of specialists and experts coming to their cities, but some were concerned about straining infrastructure and resources.

Professor Perelli-Harris says: “It’s horrific that cities which our focus groups described as vibrant, bustling, and optimistic about their future have been devastated by war with Russia. Places which had been safe havens for people displaced by conflict have now found themselves in a warzone.”

‘Empty’ Donetsk

Donetsk experienced armed conflict in 2014, followed by a massive outflow of people in subsequent years. Residents spoke of empty apartments, deserted neighbourhoods, and eerily quiet streets. The 10pm curfew, which had been in effect since the start of the war, stifled any evening activity or nightlife.

The study says that even before the Russian invasion, depopulation was having dire consequences for Ukraine, leading to a shrinking labour force, severe ageing, and a general lack of development.

“People in the areas we studied have now been displaced, made destitute, detained, forcibly deported, conscripted into the Russian army, or worse,” says Professor Perelli-Harris. “Looking to a post-war future, policymakers across the world must recognise the issue of depopulation in Ukraine, and provide support to its people in rebuilding, regenerating, and stopping the spiral of depopulation. In the short-term, Ukrainians should be supported with jobs, housing, and policies to help them start families.”

The study The triple burden of depopulation in Ukraine: examining perceptions of population decline has been published in the Vienna Yearbook of Population Research and is available to view online.             

Ends

Notes to Editors

1. The triple burden of depopulation in Ukraine: examining perceptions of population decline is available online at https://www.austriaca.at/0xc1aa5576_0x003e1c35.pdf
2. For further information and interviews with Professor Brienna Perelli-Harris, please contact: Steve Williams, Media Relations, University of Southampton. press@soton.ac.uk 023 8059 3212.
3. Audio clip of Professor Brienna Perelli-Harris discussing the research available for download at: https://safesend.soton.ac.uk/pickup?claimID=qM9oeYfpysAtB2DH&claimPasscode=wpNjqSVSdo7Hzn2T&emailAddr=119347
4. The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2023). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 22,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 200,000 alumni. www.southampton.ac.uk
5. The ESRC Centre for Population Change (CPC) was established in January 2009. It is funded by the Economic and Social Research Council (ESRC), tasked with investigating how and why our population is changing and what this means for people, communities and governments. The Centre is a joint partnership between the Universities of Southampton, St. Andrews, and Stirling. The research agenda is planned in collaboration with the Office for National Statistics and the National Records of Scotland. CPC is a founding partner of Population Europe, the network of Europe's leading research centres in the field of policy-relevant population studies. The Centre is directed by Professor Jane Falkingham, with co-investigators Professor Maria Evandrou and Professor Hill Kulu. www.cpc.ac.uk | Twitter @CPCPopulation
6. The Economic and Social Research Council (ESRC) is part of UK Research and Innovation (UKRI). ESRC is the UK's largest organisation for funding research on economic and social issues. They support independent, high quality research which has an impact on business, the public sector and civil society. At any one time ESRC supports over 4,000 researchers and postgraduate students in academic institutions and independent research institutes. www.esrc.ukri.org 
7. UK Research and Innovation (UKRI) is a non-departmental public body funded by a grant-in-aid from the UK government. It brings together the UK’s seven research councils, Innovate UK and Research England to maximise the contribution of each council and create the best environment for research and innovation to flourish. www.ukri.org

www.southampton.ac.uk/news/contact-press-team.page

Follow us on twitter: http://twitter.com/unisouthampton

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JOURNAL

Vienna Yearbook of Population Research

DOI

10.1553/p-azcj-d4f4 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The triple burden of depopulation in Ukraine: examining perceptions of population decline

Sounds from nature: A soothing remedy for gambling addiction

Researchers explore the benefits of using calming sounds from nature to lower the stress levels of individuals with gambling addiction

Peer-Reviewed Publication

CHIBA UNIVERSITY      

 

IMAGE: FIG 1. OXYHEMOGLOBIN (OXY-HB) CONCENTRATION IN THE PREFRONTAL CORTEX IN RESPONSE TO AUDITORY STIMULATION USING NATURE SOUNDS WAS REMARKABLY LOW IN PARTICIPANTS, INDICATING POSITIVE PHYSIOLOGICAL EFFECTS. FIG 2. USING THE MODIFIED SEMANTIC DIFFERENTIAL QUESTIONNAIRE, WHICH EVALUATES THE EMOTIONAL RESPONSE OF PARTICIPANTS TO AUDITORY STIMULI USING THREE SETS OF INDICES (COMFORTABLE TO UNCOMFORTABLE, RELAXED TO AWAKENING, AND NATURAL TO ARTIFICIAL), RESEARCHERS FOUND POSITIVE PSYCHOLOGICAL EFFECTS OF NATURE-DERIVED SOUND. view more 

CREDIT: YOSHIFUMI MIYAZAKI FROM CHIBA UNIVERSITY

Gambling addiction, also called “pathological gambling” and “gambling disorder (GD),” is known to have severe economic, social, mental, and physical consequences on those affected. One of the major factors contributing to the development and relapse of this disorder is stress. However, studies show that replacing gambling with alternative leisure activities may reduce the likelihood of developing the disorder. In recent years, forest bathing, or “shinrin-yoku,” a form of nature therapy, has emerged as an effective and convenient way to alleviate stress. In addition, numerous scientific studies have indicated that exposure to nature can lower stress levels and help the body relax.  

 

In the wake of proposals to introduce commercial casinos in Japan, a research team led by Yoshifumi Miyazaki, Professor Emeritus at the Centre for Environment, Health, and Field Sciences at Chiba University, Japan, sought to explore the potential of nature therapy, particularly insect sounds, in reducing stress responses among individuals with GD. The team aimed to compare the physiological and psychological effects of nature and city sounds on patients with GD. The research team, which comprised Hiroko Ochiai from the Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center; assistant professor Harumi Ikei and research fellow Hyunju Jo from the Center for Environment, Health and Field Sciences, Chiba University; and Masayuki Ohishi from Ohishi Clinic, Yokohama, Japan, made their study available online on March 27, 2023, and it is all set to be published in the Journal of Integrative and Complementary Medicine.

 

The study recruited 22 Japanese male participants aged between 25 and 60 years with a diagnosis of pathological gambling based on a total score of 5 or higher on the South Oaks Gambling Screen scale. The participants were randomized into two groups and exposed to either digital nature sounds of insects or traffic sounds at a city intersection, which were presented in a counterbalanced manner. As part of testing the physiological effects of exposure, the autonomic nervous activity of the participants was measured using sensors for heart rate variability, and a near-infrared spectroscopy system was used to measure changes in oxyhemoglobin (oxy-Hb) concentrations in their bilateral prefrontal cortex. Participants’ subjective evaluation was done using the modified version of the semantic differential method questionnaire, and the Profiles of Mood States, second edition (POMS2); this formed part of the psychological effects assessment.

 

The results of the study strongly indicated that nature-based stimulus exposures induced physiological relaxation and other positive responses among individuals with GD. There was a significant decrease in oxy-Hb concentration in the bilateral prefrontal cortex of participants while listening to nature sounds. Put simply; it made them feel more relaxed and positive. This was corroborated by the low POMS2 negative emotions subscale scores and was attested by improvement in participants’ overall mood, a sense of comfort, and relaxation.

 

Noting the importance of the study, Prof. Miyazaki says, “It has also been reported that people are spending more time at home and are under stress related to the COVID-19 pandemic. These circumstances strongly point to the need for familiar relaxation methods. The results of this experiment suggest that the auditory stimulation of nature-derived sounds is also beneficial for patients with GD.”

 

In all fairness, the findings of this study highlight the importance of nature sounds in managing negative emotional states in patients with GD.

 

“Nature therapy may be useful for stress reduction in various patient groups and the general population, especially as our society becomes more artificialized and stress levels increase. As scientific evidence continues to accumulate, various nature-derived stimuli, including the auditory stimulus used in this study, may contribute to reducing stress in people,” concludes Prof. Miyazaki.

 

Although further research is needed to explore its long-term implications for individuals with GD, nature-derived sounds could be viable stress-relieving nature therapy for people with serious addictions as well as healthy individuals.   

 

About Professor Yoshifumi Miyazaki
Yoshifumi Miyazaki is a Professor Emeritus from the Centre for Environment, Health and Field Sciences at Chiba University, Japan. He holds a doctorate in medicine from the Tokyo Medical and Dental University. He has published over 200 academic articles and has authored dozens of books on the effects and benefits of nature therapy. In honor of his research efforts, Professor Miyazaki has received awards from the Japanese Ministry of Agriculture, Forestry, and Fisheries & the Japan Society of Physiological Anthropology.

 

Funding

This study was supported by JKA and received promotion funds from KEIRIN RACE (2020P-224 and 2022P-277).

 

Reference:

Title of original paper: Relaxation Effect of Nature Sound Exposure on Gambling Disorder Patients: A Crossover Study

Authors: Hiroko Ochiai1*, Harumi Ikei2*, Hyunju Jo2, Masayuki Ohishi3, Yoshifumi Miyazaki2

Affiliations:

1. Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Meguro-ku, Japan
2. Center for Environment, Health and Field Sciences, Chiba University, Kashiwa, Japan
3. Ohishi Clinic, Yokohama, Japan

 

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JOURNAL

Journal of Integrative and Complementary Medicine

DOI

10.1089/jicm.2022.0611 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Relaxation Effect of Nature Sound Exposure on Gambling Disorder Patients: A Crossover Study 

Racism prevalent in US labor and delivery rooms

An analysis of 46 million births provides statistical evidence of 'obstetric racism' and suggests it's fueling a rise in questionable labor inductions

Peer-Reviewed Publication

UNIVERSITY OF COLORADO AT BOULDER

Systemic racism is ubiquitous in U.S. labor and delivery rooms and contributing to a sharp rise in medically questionable inductions that could be harming Black and Latina mothers and babies, according to new CU Boulder research.

The study of 46 million births across nearly three decades is among the first to provide population-level statistical evidence of “obstetric racism,” a term coined recently to describe a concerning pattern of maltreatment of non-white pregnant women, including a disregard for their birthing wishes.

The findings come amid rising concerns about high maternal mortality rates among Black mothers, who are nearly three times more likely to die of pregnancy-related causes than white mothers, and their infants, who are twice as likely to die in their first year.

“We found that obstetric care in the United States is not being centered on the needs of the Black and Latina childbearing population, but instead is responding to the needs and preferences of white women,” said senior author Ryan Masters, an associate professor of sociology who studies health and mortality trends.

The research, published April 26 in the Journal of Health and Social Behavior, shows that medical induction of labor nearly tripled between 1990 and 2017 in the U.S., growing from 12.5% of births in 1990 to 34.4% in 2017.

That trend alone is concerning because, as the authors’ previous research has shown, early induction can lead to low birthweight babies and a host of associated problems later in life.

While the increase in inductions among white women can largely be explained by an increase in higher-risk pregnancies among the white childbearing population, the same cannot be said for Black and Latina women, the study found. Instead, decisions about their care are being based on trends in the white population.

“The U.S. medical system has a long history of centering care on the needs of dominant or majority populations, i.e. white patients, rather than considering the specific needs of marginalized populations,” said Tilstra, who earned her PhD in sociology from CU Boulder and is now a postdoctoral researcher at the Luverhulme Centre for Demographic Science at Oxford University in the United Kingdom. “Our results show systemic racism is also shaping U.S. obstetric care.”

Centering care on white women

The study builds on the groundbreaking work of medical anthropologist Dána-Ain Davis who first coined the phrase “obstetric racism” in 2018 after spending years interviewing Black women about their birthing experiences.

Her ethnographies described clinicians neglecting, dismissing or disrespecting laboring women of color, coercing them to undergo procedures they did not want or performing procedures without their consent.

“When Black women express wanting to have control over their births, some nurses and doctors … punish Black moms. It is like they don’t deserve to have the kind of birth they want,” expressed one Black mother Davis interviewed.

Subsequent studies have shown that Black women are also more likely to have their pain minimized or ignored, in part due to long-held and false assumptions that Black people have a higher tolerance for pain, and are more likely to report mistreatment during childbirth.

To explore whether obstetric racism is happening at the population level, the researchers used state-level data from the National Vital Statistics Systems to analyze single-child first-births among 26.4 million white women, 6.2 million Black women and 8.4 million Latina women, looking at whether induction occurred and at the health of the mother.

Maternal high blood pressure, obesity, diabetes, advanced age and a history of smoking can all boost the risk of problems during labor and, at times, justifiably warrant an induction.

“Labor induction can be a very important tool,” stressed Tilstra.

Among white women, increases in the rates of induction of labor were strongly associated with changes in such risk factors over time. In Black and Latina women, however, there was no such association. The trend appears to be medically unexplainable.

While the study does not explicitly show that increased induction rates are contributing to high maternal mortality rates among women of color, the authors suggest this link should be further explored.

In previous work, they showed that not only is induction of labor increasing, but it is occurring earlier in pregnancy, shortening the average U.S. pregnancy by about a week and, concerningly, driving birthweights down.

“We've completely shifted when births occur and how births occur and that can have dramatic implications on birth weight and the subsequent health of the child,” said Masters.

A systemic problem

The authors stress that they generally do not intend to blame individual clinicians for obstetric racism, but instead view the problem as a result of a systemic lack of training in medical school, a continued lack of attention to the healthcare needs of women of color and a need for everyone, including clinicians, to look closely at their own implicit biases.

They hope their work will encourage policymakers and clinicians to do more to address those biases and realize that even brief micro-interactions in the labor and delivery room can add up, leading to differences in care between different racial and ethnic populations.

 “Pregnancy and childbirth are an incredibly vulnerable and difficult time in one's life,” said Tilstra. “Everyone deserves to have equal access to good care.”

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JOURNAL

Journal of Health and Social Behavior

DOI

10.1177/00221465231165284 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Differences in Determinants: Racialized Obstetric Care and Increases in U.S. State Labor Induction Rates

ARTICLE PUBLICATION DATE

26-Apr-2023

New start-up develops aquafarms for macroalgae

AWI and Carbonwave spin-off: Large algae simultaneously bind CO2 and create raw materials for the chemical industry

Business Announcement

ALFRED WEGENER INSTITUTE, HELMHOLTZ CENTRE FOR POLAR AND MARINE RESEARCH

 

IMAGE: THE MACROALGA SARGASSUM NATANS BELONGS TO THE GENUS OF THE SO-CALLED GULFWEED (SARGASSUM). view more 

CREDIT: ALFRED-WEGENER-INSTITUT, FRANZISKA ELMER

It all started with the idea of using natural ocean resources to develop new climate-friendly raw materials for industry. To this end, committed researchers from AWI, Carbonwave, GEOMAR, Helmholtz Centre for Ocean Research Kiel, and the start-up Seafields joined forces, with the support of BASF. In January 2022 they founded the project "C-CAUSE" (Chemical CARBON Utilization through Sargassum Economy). A short time later, in May 2022, they won a grant of 700,000 euros as part of the "Carbon to Value Challenge" of the Federal Agency for Disruptive Innovation (SPRIND).

In this first funding phase a novel value chain was developed: starting with the cultivation of free-floating macroalgae (Sargassum fluitans and natans) in open-ocean aquafarms, biological and renewable carbon feedstocks will be produced for the chemical industry. The goal is to contribute to the decarbonization of the chemical industry while creating products that store carbon over long time periods.

In order to drive further development activities in a second SPRIND funding phase and technical upscaling in an even more agile way, the company MACROCARBON SL was spun out of AWI and Carbonwave on March 23, 2023 and now has received further funding of 2.3 million euros from SPRIND to further develop its innovation. Regarding the goals of the AWI and Carbonwave spin-off, founder and MACROCARBON CEO Dr. Mar Fernández Méndez explains: "MACROCARBON will develop integrated supply chains for the cultivation and processing of Sargassum seaweed. Because Sargassum itself floats, we do not need expensive longlines to be stretched out in the water for this purpose. In addition, the algae grows quickly and thrives in many regions. It binds CO2 very efficiently through natural photosynthesis."

After harvesting the algae, the carbon-rich biomass will be processed into raw materials for the chemical industry (such as bio-naphtha), which will replace products previously derived from fossil fuels. In this way, MACROCARBON aims to contribute to decarbonization, sequestering 100 million tonnes of CO2 per year by 2040 and one gigatonne by 2050.

AWI, Carbonwave and its spin-off MACROCARBON plan to continue cooperating with each other. To this end, AWI will contribute its biological process understanding to monitor carbon fluxes and environmental sustainability, thus supporting MACROCARBON in building an innovative value chain.  Carbonwave will develop processing methodologies based on their existing operations and production of valuable products from Sargassum in the Caribbean.

Las Palmas, on Gran Canaria, was chosen as the company's headquarters, mainly because its location in the subtropical Atlantic where Sargassum thrives well and because MACROCARBON has access to an ocean platform with a test environment (Oceanic Platform of the Canary Islands, PLOCAN) here. This platform is suitable for large-scale experiments and tests of pilot processing plants. The location in the Atlantic Ocean is also easy to reach and at the same time offers the necessary marine high seas conditions. The Canary Islands belong to the EU, which is relevant for SPRIND funding and possible further EU funding. Furthermore, they offer - especially in the context of the so-called Blue Bioeconomy - an attractive start-up "ecosystem".

In addition to the funding from SPRIND, the two companies Carbonwave and Seafields plan to participate in MACROCARBON. It is also expected that Jason Cole, currently Head of Innovation at Carbonwave, will join MACROCARBON's founding team. Seafields and Carbonwave are already involved in aquaculture and the utilization of Sargassum seaweed, respectively, and can contribute valuable experience to the company.

The AWI spin-off MACROCARBON was invited to present itself at the Investor Day of the four non-university research organizations Helmholtz, Max Planck, Fraunhofer and Leibniz in Munich at the end of March. At the event, 39 selected start-ups presented themselves in front of 100 investors. For MACROCARBON this was a very good opportunity to introduce itself to investors and to exchange ideas with other spin-offs from non-university research organizations. As the lively discussion following the MACROCARBON pitch and numerous inquiries from investors at the poster stand showed, the concept is extremely interesting, not only ecologically but also economically.

"For me as a marine biologist, this company foundation is a very exciting but also challenging process. I also learned a lot at this investor event," says Mar Fernández Méndez. "It's good that we are accompanied in this by a dedicated SPRIND coach and the AWI technology transfer office." She adds: "In its latest synthesis report, the Intergovernmental Panel on Climate Change again pointed out the great urgency to finally take action. This motivates me to move into broad commercial application by upscaling our research results."

 

Links:

Video zur SPRIND Carbon-to-Value-Challenge: https://www.sprind.org/en/challenges/carbon-to-value (C-CAUSE ab 10:28)

C-CAUSE: https://www.awi.de/ueber-uns/service/presse/presse-detailansicht/default-0f90dfdb88-1.html

Helmholtz YIG SiDe-EFFECT of Mar Fernández Méndez: https://www.awi.de/forschung/biowissenschaften/polare-biologische-ozeanographie/arbeitsgruppen/helmholtz-nachwuchsgruppe-side-effect.html

Oceanic Platform of the Canary Islands (PLOCAN): https://plocan.eu/en

Carbonwave: https://carbonwave.com/

Seafields: https://www.seafields.eco/

You can find printable images in the online version of this press release: https://www.awi.de/en/about-us/service/press.html

Follow the Alfred Wegener Institute on Twitter (https://twitter.com/AWI_Media), Instagram (https://www.instagram.com/awiexpedition/) and Facebook (www.facebook.com/AlfredWegenerInstitute).

The Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI) conducts research in the Arctic, Antarctic and oceans of the high and mid-latitudes. It coordinates polar research in Germany and provides major infrastructure to the international scientific community, such as the research icebreaker Polarstern and stations in the Arctic and Antarctica. The Alfred Wegener Institute is one of the 18 research centres of the Helmholtz Association, the largest scientific organisation in Germany. 

Scientists discover antibiotic resistance genes in clouds

Peer-Reviewed Publication

UNIVERSITÉ LAVAL

Québec City, April 27, 2023–The atmosphere is a large-scale dissemination route for bacteria carrying antibiotic-resistance genes. A research team from Université Laval and Université Clermont Auvergne has shown that these genes can be transported by clouds. 

"This is the first study to show that clouds harbor antibiotic resistance genes of bacterial origin in concentrations comparable to other natural environments," says Florent Rossi, first author of the study and postdoctoral fellow in the team of Caroline Duchaine, a professor at Université Laval's Faculty of Science and Engineering and a researcher at the Quebec Heart and Lung Institute-Université Laval. 

To observe this phenomenon, the team sampled clouds at the Puy de Dôme summit, a dormant volcano in France's Massif Central. At an atmospheric research station perched 1,465 meters above ground, the scientists conducted 12 cloud sampling sessions over two years using high-flow rate "vacuums."  

Analysis of these samples revealed that they contained about 8,000 bacteria per milliliter of cloud water, on average. "These bacteria usually live on the surface of vegetation or soil. They are aerosolized by the wind or by human activities, and some of them rise into the atmosphere and participate in the formation of clouds," explains Florent Rossi. The concentrations are variable: they range from 330 to more than 30,000 bacteria per milliliter of cloud water. Between 5% and 50% of these bacteria could be alive and potentially active. 

Various sources 

With all their data, the scientists measured the concentration of 29 subtypes of antibiotic-resistance genes carried in atmospheric air masses. The clouds contained, on average, 20,800 copies of antibiotic-resistance genes per milliliter of cloud water.  

"Oceanic clouds and continental clouds each have their signature of antibiotic resistance genes. For example, continental clouds contain more antibiotic resistance genes used in animal production," explains Florent Rossi. 

Although airborne transport of antibiotic resistance genes is a natural phenomenon, the widespread use of antibiotics in agriculture and medicine has contributed to the proliferation of these resistant strains and their dissemination in the environment.   

"Our study shows that clouds are an important pathway for antibiotic-resistance genes spreading over short and long ranges. Ideally, we would like to locate emission sources resulting from human activities to limit the dispersal of these genes." 

The health effect of the spread of these antibiotic-resistant genes will be something to investigate in future research. 

The study was published in the journal Science of The Total Environment. The authors are Florent Rossi, Raphaëlle Péguilhan, Nathalie Turgeon, Marc Veillette, Jean-Luc Baray, Laurent Deguillaume, Pierre Amato, and Caroline Duchaine. 

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JOURNAL

Science of The Total Environment

DOI

10.1016/j.scitotenv.2022.161264 

ARTICLE TITLE

Quantification of antibiotic resistance genes (ARGs) in clouds at a mountain site (puy de Dôme, central France)

University of Cincinnati research examines the role of genetics in opioid use disorder

Study identifies genetic variants that could provide therapeutic targets in the future

Peer-Reviewed Publication

UNIVERSITY OF CINCINNATI

New research out of the University of Cincinnati examines the association between genetics and the presence of opioid use disorder (OUD). The study identified six single nucleotide polymorphisms (SNPs) or genetic variants that are linked to OUD.

The study was published in the journal Clinical Pharmacology & Therapeutics.

“We are trying to identify some of the genetic variants that might play into OUD,” says Caroline Freiermuth, MD, associate professor in the Department of Emergency Medicine at the UC College of Medicine and principal investigator for the study. “Patients received an oral swab that gets put inside their cheek, and those swabs were sent off for genetic testing looking for 180 single nucleotide polymorphisms.”

According to the Centers for Disease Control and Protection, more than 107,000 people in the U.S. died in 2021 from drug overdose, with overdose deaths involving synthetic opioids increasing 23% from the year before. The economic cost of OUD and opioid-related overdose mortality exceeds $1 trillion annually in the United States.

The study enrolled about 1,300 patients within three large urban emergency departments in Ohio, which has ranked in the top five for opioid overdose deaths since 2014.

“We wanted to determine for any random person who comes to the emergency department what their genetic link might be and do they now or did they ever have opioid use disorder in their life, and do we think their genetics have played a role in that,” says Freiermuth. “We found that there were quite a few single nucleotide polymorphisms that seem to be associated with opioid use disorder.”

The study found that although genetics play a role in disease, there is also significant interaction from the environment. Freiermuth says further study is needed to highlight the true impact of the genetic variants and how external factors contribute to the development of OUD. Further exploration of biogeographical genetic ancestry groups and their association with OUD is warranted, the study concluded,

“I think this is really exciting because it should help us try to figure out who is truly at risk when they are exposed to opioids and that could make it easier for us to decide who we can and can’t prescribe opioids to,” Freiermuth says. “This could help determine who might need further monitoring in the future instead of just blanket saying ‘nobody should ever get more than a certain amount."

 

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JOURNAL

Clinical Pharmacology & Therapeutics

DOI

10.1002/cpt.2864 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Genetic Variants Associated With Opioid Use Disorder