Inclusion 2.0: How to bring a scientific approach to urban design?

Reports and Proceedings

ESTONIAN RESEARCH COUNCIL

 

IMAGE: SENSORS ON THE CITIZEN TO MEASURE HER STRESS LEVEL IN DIFFERENT PLACES view more 

CREDIT: FINEST CENTRE FOR SMART CITIES

The quality of public space and urban environment has become an increasingly important issue, especially in the light of the green transition. On one hand, it’s great that people want to have a say in shaping the environment in which they live. On the other hand, the increased focus on participatory processes has brought attention to significant shortcomings, which research can play a key role in addressing.

Stakeholder involvement in urban planning is full of challenges. How and at what stage to involve key groups interested in planning? How to generate constructive debate and find common ground at an early stage? Prioritizing conflicting interests and achieving a satisfactory outcome for all parties is difficult. It is also important how to communicate the solution and ensure that all parties understand it in the same way. Planning is an art of negotiation, balancing different interests and needs.​

​The current practice of inclusion in urban planning is largely based on the collection of subjective judgements from city dwellers. In other words, surveys are used to find out how people like the (proposed) urban space. Planners, however, are struggling with satisfaction surveys, because unfortunately most of them declare that they are very satisfied with their living environment. “It’s like living in North Korea,” was how one expert summed it up at a recent planning conference. Apparent contentment with everything, however, does not help planners. More data and research are needed to bring about positive change. This is where researchers can provide valuable assistance.

People perceive urban space differently

Together with the FinEst Centre for Smart Cities team and the City of Narva, we have developed an innovative tool to help bridge the gap between planners and city residents. The Citizen Well-Being Diagnostics Service considers the psychological and physiological characteristics of the test subjects as well as the spatial parameters of the urban environment. The pilot project, in which we tested the tool, involved 68 volunteer Narva residents from four different age groups. We took the test subjects to six residential neighborhoods in Narva and to two public space locations (Peetri square and Joaoru beach area).

Using biosensors, we monitored the volunteers’ stress levels at different measurement points. The results were combined with a psychological study in which we mapped the subjects’ emotions, place attachment and recovery potential at the measurement site. The latter shows the extent to which a person can relax, or recharge their batteries, at a location. The outdoor part of the pilot study looked not only at noise levels, but also at the proportion of tall vegetation, the amount of asphalt, the ease of use of pedestrian space and the presence of various points of interest.

The Narva pilot study is the first attempt of its kind to find a link between the human body’s reactions and the quality of urban space. Based on the results, we can say that the methodology developed does indeed provide additional information on people’s perception of well-being in space. The measured brain signals and cardiovascular physiological responses suggest that people have different physiological perceptions of urban space. This is an important finding, which confirms that in addition to perception studies, physiological well-being should also be considered when making spatial decisions.

Balance is the key to quality

The results of the psychological survey were also found to be very weakly correlated with spatial and physiological indicators. This confirms that people do not respond objectively to questionnaires for various reasons. People may knowingly or unintentionally give inaccurate answers that do not reflect their true well-being. However, the psychological questionnaire is an important part of the well-being score methodology, as it helps to make sense of the results of the other parts of the survey. For example, the questionnaire was important to find out how much the subjects themselves rated their negative and positive emotions at the measurement point.​

In addition, the results of the project allow us to conclude that no one element is more important than another in urban space. Quality is determined by the balance between the different elements. A modern urban space must offer users diversity and take account of all needs.

For example, greenery and landscaping are important in cities, but the link between these alone and physiological outcomes is weak. Residents thrive in an urban space where no one element dominates over others and where everything is adequate for its function.​

The Citizen Well-Being Diagnostics provides urban planners with site-specific recommendations on the spatial parameters to be considered. Based on the recommendations, the expert can assess whether the proportion of some elements should be increased or decreased. A point of equilibrium, where needs are met and opportunities for realizing desires are created, can be considered a starting point for well-being, both in urban space and in personal life.

​Measuring well-being in a science-based way is a further way of taking public involvement in spatial decision-making to a new level. Especially in today’s world of saturated opinion. The tool, developed in partnership between the FinEst Centre for Smart Cities and the City of Narva, allows for the objective well-being of city residents to be considered. Relying on science-based data helps to make planning processes more transparent, thereby creating an urban environment where people feel good.

Citizen Well-Being Diagnostics is now ready for other cities, offering the opportunity to engage citizens in crucial decision-making and planning processes to create modern and appealing cities where people can thrive and enjoy a high quality of life.

See more about the solution and contacts at www.finestcentre.eu

FinEst Centre for Smart Cities, located at Tallinn University of Technology, has finalized six pilot projects where Estonian and Finnish cities developed and tested innovative smart city solutions.

New round of Smart City Challenge 2023 was announced in June where FinEst Centre continues to tackle complex urban challenges. Cities can send- their challenge and FinEst Centre finds the team of researchers and developers, finance and manage the pilot projects. Read more about Smart City Challenge 2023 and join to shape a better future for our cities by contributing to the development of smart city solutions to real urban challenges: https://www.finestcentre.eu/smart-city-challenge-2023

The pilot projects are 100% financed by the European Regional Development Fund and the Estonian Ministry of Education and Research.

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METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

Citizen Well-Being Diagnostics in the City of Narva, Estonia

Sensors on the citizen to measure her stress level in different places

CREDIT

FinEst Centre for Smart Cities

 

The kitchen is key to improving indoor air quality

Reports and Proceedings

UNIVERSITY OF SURREY

Indoor air pollution generated by cooking fuels such as charcoal and wood causes approximately four million premature deaths every year – a tragic statistic that Surrey's renowned Global Centre for Clean Air Research (GCARE) is aiming to address with its Kitchen Pollution Guidance.  

This comprehensive guidance is led by Professor Prashant Kumar and a team of over 50 co-authors from 20 countries. This guidance presents scientific research on practical measures that are easy to implement. It offers helpful tips and actionable advice for individuals while also suggesting actions that housing providers and governing bodies can take. 

To spread the word even further, the GCARE team has produced a short video summarising its kitchen guidance. 

Professor Prashant Kumar, Founding Director of GCARE, said: 

"We all take clean air for granted, particularly when we are in the kitchen – a room that is central in many people's homes across the world. Our guidance is now available in 17 different languages, a fact that demonstrates that we are passionate about passing on this knowledge to as many people as possible." 

The guidance provides several targeted recommendations for ordinary citizens, housebuilders, and policymakers. Key recommendations for ordinary citizens include: 

• Reduce the number of meals you fry in the kitchen. 
• Steer towards shorter cooking sessions. 
• Keep children (and other people who are not preparing a meal) out of the kitchen. 
• Open kitchen windows during cooking to reduce carbon dioxide. 

GCARE's kitchen guidance has recently been adopted and promoted by the Egyptian government. 

Dr Yasmin Fouad from Egypt's Ministry of the Environment said: 

"We are working to support all procedures and good practices to avoid the negative effects of emissions that cause environmental air pollution both indoor and ambient." 

### 

Notes to editors 

• Professor Prashant Kumar is available for interview upon request.  
• For more information, please contact the University of Surrey press office via mediarelations@surrey.ac.uk 
• Find out more about GCARE and its research projects. 

 

Housing unaffordability leads to cascading effects for renters

UC professor contributes to research on rent-burdened households in Los Angeles

Peer-Reviewed Publication

UNIVERSITY OF CINCINNATI

 

IMAGE: GARY PAINTER view more 

CREDIT: UNIVERSITY OF CINCINNATI

Los Angeles residents who pay more than 30% of their income toward rent are forced to make trade-offs in other areas of their lives that can last for years and contribute to many social ills, a University of Cincinnati professor and his colleagues found.

Gary Painter, PhD, the academic director of the Carl H. Lindner College of Business real estate program and a professor of real estate, contributed to a study about the household-level impacts of rent burden in Los Angeles that was published in the Journal of Urban Affairs. The research found a lack of affordable housing in Los Angeles has caused people to cut their budgets in areas including food, health care, education, clothing, transportation and entertainment.

“It's hard to not see the importance of real estate when we are looking at some of the social ills,” said Painter, the inaugural holder of the UC BEARE Chair in Real Estate. “Among people who are struggling to pay their bills, their largest bill is their housing cost.”

An issue affecting millions

The survey, which was conducted in 2019, relied on data from 794 respondents in Central and South Los Angeles. It found people rely on a number of strategies to remain housed when they’re rent burdened, which is when a household spends more than 30% of its income on rent. About 48% of the households reported being severely rent burdened, which is when they spent more than half of their income on rent.

“In California, we know that 1.2 million households, right before the [COVID-19] pandemic, paid more than half of their income in rent,” Painter, a former University of Southern California professor, said. “In [Los Angeles] County, that's 700,000 households. That represents a pretty big group of people.”

Painter worked on the study with Sean Angst, a postdoctoral scholar at the USC, Jovanna Rosen, an assistant professor of public policy at Rutgers University-Camden, and Soledad De Gregorio, an associate researcher at Abt Associates, based in Los Angeles.

They began their research by conducting focus groups in south Los Angeles to better understand the experiences of residents, which helped them develop their survey questions.

“We need to think about human dignity, people's quality of life and their ability to survive and thrive,” said Angst. “When you are making such a wide breadth of sacrifices, your quality of life decreases quite a bit.”

Sacrifices to get by

Almost 85% of respondents, regardless of rent-burdened status, reported consumption cutbacks to make life more affordable in the two years prior to the survey. For rent-burdened households, respondents reported making significantly higher cuts to basic needs that lasted for longer durations.

“What we saw that was especially striking was that in our sample, 25% of families had almost institutionalized these trade-offs,” Painter said. “They’d been cutting back for more than a year, and an important subsection of them had been cutting back for five years. The level of strain and therefore the cascading effects for a good chunk of the families had the potential for pretty long impacts.”

While some trade-offs, such as buying less clothing, might not have severe long-term consequences, some residents reported cutting back on medicine and other health care that could have cascading effects.

A 2022 study published in Housing Policy Debate that Painter contributed to with Angst, Rosen and Victoria Ciudad-Real, a researcher in the USC Price Center for Social Innovation, found the stress of housing affordability strained family dynamics and contributed to worsening mental health for youth in rent-burdened households.

“Once you’re paying more than half your income in rent, you’re having to make really important decisions to maintain housing in whatever way you can, and there are significant consequences of the choices if you are able to maintain housing,” Painter said.

Other consumption trade-offs, such as cuts to transportation spending, can limit what jobs a person can attain, preventing them from gaining higher incomes and further straining their finances.

“In a place like Los Angeles, you often need a car to get to the best jobs,” Painter said. “If you don't have a car because you didn't have the money to buy a car, then the kind of jobs you're able to get are going to be less competitive than the wage you could get if you did have a car.”

Additional strategies

Along with consumption cutbacks, rent-burdened respondents reported taking on additional jobs, having additional people live in a household and taking on additional debt. A quarter of respondents had taken in more people and cut back in three or more consumption categories.

“In many cases, these families had already done a lot of different things to make a budget,” Painter said. “For instance, the people who were paying more than half of their income as rent already had been working extra hours.”

Consumption cutbacks were the first saving strategy that respondents tended to make, Angst said, which was followed by additional strategies such as working additional hours or living with more people.

“If I have more people in my home, that is going to radically change my day to day versus those smaller consumption cutbacks, but it's different than living overcrowded every single day; it's different than working two jobs,” Angst said.

Even when people adjust their spending, work more hours and have more people living together, it’s still not enough for them to get to a more sustainable level of income to housing cost ratio, Painter said. That reinforces the barriers that households face to get to a more stable housing situation.

“It’s not just about people choosing anywhere that they want to live,” Painter said. “Why? Because they have constraints.”

On the brink

The primary driver of homelessness is not being able to afford housing, Painter said, and 23% of rent-burdened respondents said they wouldn’t be able to afford a $400 emergency expense, leaving them at risk of becoming homeless.

“For those folks, one event could cause them to lose their housing,” Painter said.

For many people, savings strategies such as making cutbacks to their consumption, taking on additional work and living with more people didn't help their ability to cover an unexpected expense.

“We didn't see any increased ability to cover that unexpected expense,” Angst said. “That suggests those strategies people are using are no longer helping them increase their savings. Instead the sacrifices and coping strategies that people are using are really just to survive.”

While Los Angeles and other areas of California are economically prosperous overall, the region hasn’t kept up with demand for housing, which has left many people struggling to afford the housing costs.

“These regions of the Bay Area and Southern California continue to be economically overall prosperous regions where there's a lot of innovation happening and a lot that's attractive, especially to highly educated households, to come and live there,” Painter said. “If you don't build housing to match population growth, you end up having this gap, and that gap is associated with more and more people paying a higher percentage of their income as rent.”

Lessons for other communities

Other regions have the same issues as Los Angeles, Painter said, although often not quite to the same extent. To avoid facing some of the same issues, he said, cities need to prioritize real estate to keep up with their growing economies.

“A city like Cincinnati has to keep focused to make sure that the real estate industry is moving as quickly as any economic growth to make sure that you don't end up seeing people who have low- and moderate-income households having to pay a higher and higher percentage of their income as rent,” Painter said.

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JOURNAL

Journal of Urban Affairs

DOI

10.1080/07352166.2023.2235039 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

How do renters survive unaffordability? Household-level impacts of rent burden in Los Angeles

 

Scammers can abuse security flaws in email forwarding to impersonate high-profile domains

Some of the domains vulnerable include Mastercard, The Washington Post and the Department of State

Reports and Proceedings

UNIVERSITY OF CALIFORNIA - SAN DIEGO

 

IMAGE: RESEARCHERS WERE ABLE TO SPOOF A WIDE RANGE OF EMAIL ADDRESSES view more 

CREDIT: UNIVERSITY OF CALIFORNIA SAN DIEGO

Sending an email with a forged address is easier than previously thought, due to flaws in the process that allows email forwarding, according to a research team led by computer scientists at the University of California San Diego. 

The issues researchers uncovered have a broad impact, affecting the integrity of email sent from tens of thousands of domains, including those representing organizations in the U.S. government–such as the majority of U.S. cabinet email domains, including state.gov, as well as security agencies. Key financial service companies, such as Mastercard, and major news organizations, such as The Washington Post and the Associated Press, are also vulnerable. 

It's called forwarding-based spoofing and researchers found that they can send email messages impersonating these organizations, bypassing the safeguards deployed by email providers such as Gmail and Outlook. Once recipients get the spoofed email, they are more likely to open attachments that deploy malware, or to click on links that install spyware on their machine.

Such spoofing is made possible by a number of vulnerabilities centered on forwarding emails, the research team found. The original protocol used to check the authenticity of an email implicitly assumes that each organization operates its own mailing infrastructure, with specific IP addresses not used by other domains. But today, many organizations outsource their email infrastructure to Gmail and Outlook. As a result, thousands of domains have delegated the right to send email on their behalf to the same third party. While these third-party providers validate that their users only send email on behalf of domains that they operate, this protection can be bypassed by email forwarding. 

For example, state.gov, the email domain for the Department of State, allows Outlook to send emails on their behalf. This means emails claiming to be from state.gov would be considered legitimate if they came from Outlook’s email servers. As a result, an attacker can create a spoofed email–an email with a fake identity–pretending, for example, to come from the Department of State--and then forward it through their personal Outlook account. Once they do this, the spoofed email will now be treated as legitimate by the recipient, as it is coming from an Outlook email server.

Versions of this flaw also exist for five other email providers, including iCloud. The researchers also discovered other smaller issues that impact users of Gmail and Zohomail– a popular email provider in India. 

Researchers reported the issue to Microsoft, Apple and Google but to their knowledge, it has not been fully fixed. 

“That is not surprising since doing so would require a major effort, including dismantling and repairing four decades worth of legacy systems,” said Alex Liu, the paper’s first author and a Ph.D. student in the Jacobs School Department of Computer Science and Engineering at UC San Diego. “While there are certain short-term mitigations that will significantly reduce the exposure to the attacks we have described here, ultimately email needs to stand on a more solid security footing if it is to effectively resist spoofing attacks going forward.” 

The team presented their findings at the 8th IEEE European Symposium on Privacy and Security, July 3 to 7, 2023, in Delft, where the work won best paper.  

Different attacks

Researchers developed four different types of attacks using forwarding. 

For the first three, they assumed that an adversary controls both the accounts that send and forward emails. The attacker also needs to have a server capable of sending spoofed email messages and an account with a third party provider that allows open forwarding. 

The attacker starts by creating a personal account for forwarding and then adds the spoofed address to the accounts’s white list–a list of domains that won’t be blocked even if they don’t meet security standards. The attacker configures their account to forward all email to the desired target. The attacker then forges an email to look like it originated from state.gov and sends the email to their personal Outlook account. Then all the attacker has to do is forward the spoofed email to their target. 

More than 12 percent of the Alexa 100K most popular email domains–the most popular domains on the Internet– are vulnerable to this attack. These include a large number of news organizations, such as the Washington Post, the Los Angeles Times and the Associated Press, as well as domain registrars like GoDaddy, financial services, such as Mastercard and Docusign and large law firms. In addition, 32% of .gov domains are vulnerable, including the majority of US cabinet agencies, a range of security agencies, and agencies working in the public health domain, such as CDC. At the state and local level, virtually all primary state government domains are vulnerable and more than 40% of all .gov domains are used by cities. 

In a second version of this attack, an attacker creates a personal Outlook account to forward spoofed email messages to Gmail. In this scenario, the attacker takes on the identity of a domain that is also served by Outlook, then sends the spoofed message from their own malicious server to their personal Outlook account, which in turn forwards it to a series of Gmail accounts. 

Roughly 1.9 billion users worldwide are vulnerable to this attack. 

Researchers also found variations of this attack that work for four popular mailing list services: Google groups, mailman, listserv and Gaggle.

Potential solutions

Researchers disclosed all vulnerabilities and attacks to providers. Zoho patched their issue and awarded the team a bug bounty. Microsoft also awarded a bug bounty and confirmed the vulnerabilities. Mailing list service Gaggle said it would change protocols to resolve the issue. Gmail also fixed the issues the team reported and iCloud is investigating. 

But to truly get to the root of the issue, researchers recommend disabling open forwarding, a process that allows users to configure their account to forward messages to any designated email address without any verification by the destination address. This process is in place for Gmail and Outlook. In addition, providers such as Gmail and Outlook implicity trust high-profile email services, delivering messages forwarded by these emails regardless. 

Providers should also do away with the assumption that emails coming from another major provider are legitimate, a process called relaxed validation policies.

In addition, researchers recommend that mailing lists request confirmation from the true sender address before delivering email. 

“A more fundamental approach would be to standardize various aspects of forwarding,” the researchers write. “However, making such changes would require system-wide cooperation and will likely encounter many operational issues.” 

Methods 

For each service, researchers created multiple test accounts and used them to forward email to recipient accounts they controlled. They then analyzed the resulting email headers to better understand which forwarding protocol the service used. They tested their attacks on 14 email providers, which are used by 46% of the most popular internet domains and government domains. 

They also created mailing lists under existing services provided by UC San Diego, and by mailing list service Gaggle. 

Researchers only sent spoofed email messages to accounts they created themselves. They first tested each attack by spoofing domains they created and controlled. Once they verified that the attacks worked, they ran a small set of experiments that spoofed emails from real domains. Still, the spoofed emails were only sent to test accounts the researchers created. 

“One fundamental issue is that email security protocols are distributed, optional and independently configured components,” the researchers write. This creates a large and complex attack surface with many possible interactions that cannot be easily anticipated or administrated by any single party. “

Forward Pass: On the Security Implications of Email Forwarding Mechanism and Policy

Alex Enze Liu, Ariana Mirian, Grant Ho, Geoffrey M. Voelker and Stefan Savage, UC San Diego Department of Computer Science and Engineering

Gautam Akiwate, Stanford University

Mattijs Jonker, University of Twente, Netherlands

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Forward Pass: On the Security Implications of Email Forwarding Mechanism and Policy

 

Crowdsourcing contests: Understanding what brings high rewards, low risk

Peer-Reviewed Publication

IOWA STATE UNIVERSITY

 

IMAGE: HUI FENG, ASSOCIATE PROFESSOR OF MARKETING. view more 

CREDIT: IVY COLLEGE OF BUSINESS/IOWA STATE UNIVERSITY

AMES, IA – During Frito-Lay's first "Crash the Super Bowl" contest in 2006, thousands of participants submitted 30-second videos promoting Doritos. Entries were winnowed down to five finalists, and a public vote selected the winning commercial, which aired during the most watched American television broadcast of the year.

The ad boosted Doritos sales and pulled in awards, sparking other big brands, like Nestlé, BMW and Fisher-Price, to launch their own crowdsourcing contests.

"Crowdsourcing has become more prevalent over the last decade. It can generate innovative ideas and solutions and engage consumers. The contest itself serves as a promotional event that draws a lot of attention to the product or brand," says Hui Feng, associate professor of marketing at Iowa State University.

Feng studies how certain marketing strategies affect a company’s financial outcomes, including stock prices. In a newly published study, Feng and her co-authors show that crowdsourcing contests are associated with high returns — but also high risks. The team suggests ways companies can strike the right balance and put investors at ease.

Investors in big public firms are forward looking. So, the stock price will reflect how investors view a crowdsourcing contest regarding future cash flow," says Feng.

To collect their data, researchers analyzed more than 500 "marketing ideation crowdsourcing contests" held from 2006 to 2019. They focused specifically on contests that created either promotional content or product development, such as Ben & Jerry’s Do Us a Flavor and Google’s new power inverter design challenge. The researchers also looked at whether contests were open to the general public or professionals, judged by an expert panel or public vote and had a clearly stated purpose and narrow scope.

Feng and her co-authors then collected each firm’s accounting and stock-returns data two days before and after the official announcement of the crowdsourcing contest. If other significant events, like large layoffs or mergers, occurred during this window, the researchers removed the contest from their sample. They didn’t want other factors that could influence stock prices to muddy their dataset.

Big takeaway

The researchers found crowdsourcing contests that limit the entries to professional creators but open the judging to crowd voting have the highest returns and lowest volatility in stock prices.

"When a contest is open everyone to participate,  a lot of submissions are going to be low quality, and  bad or problematic entries can sometimes go viral because people think they’re funny and vote for them to win. The firm can lose control of the content," explains Feng.

Restricting the judging to a panel of experts may help reign it in, but it also reduces transparency. The researchers say letting a crowd vote for professionally-created content strikes the right balance.

"Focusing contests on professionals allows for high-quality ideas to emerge that are more consistent with the firm’s objectives. In addition, consumers enjoy voting on contest submissions," Feng adds.

Other findings

The researchers found the most significant stock return increase occurs on the event announcement day.

Crowdsourcing contests experience higher returns if the purpose is clearly defined and the scope is narrow and specific, rather than broad and general. For example, asking for a 30-second video that will build awareness and excitement around a specific product ensures more focused entries in the submission pool. Asking for a video showing how brand can improve education, health care, economic development and the environment does not, says Feng.

The researchers say new product development crowdsourcing contests also carry higher risks than promotional contests.

"In general, new product development is difficult. There’s a lot of uncertainty about whether it will be commercially successful, if there will be enough demand for it, and it could signal a new direction for the company. Promotions generally take less time and are a less risky investment," says Feng.

Another finding is that large, well-known brands benefit more from crowdsourcing than small or niche brands because they can engage a wider audience and receive more ideas and content.

Feng emphasizes crowdsourcing is a complement to a firm’s own marketing capability, not a substitute. Having a strong marketing team is important for investors to be confident about contests, which need to be designed, promoted and managed.

The black box and ongoing research

The researchers’ latest study shows the effects of crowdsourcing, but Feng says the stock price reaction is still partially “a black box.” She and her co-authors are interested in better understanding why investors react a certain way. Future research could include additional interviews and surveys with investors, along with more experiments and analysis of contest web traffic.

Feng co-authored the paper with Zixia Cao, University of Colorado Denver, and Mike Wiles, Arizona State University.

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JOURNAL

Journal of Marketing

DOI

10.1177/00222429231191446 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

When Do Marketing Ideation Crowdsourcing Contests Create Shareholder Value? The Effect of Contest Design and Marketing Resource Factors

 

Experts propose new global definition of acute respiratory distress syndrome

Peer-Reviewed Publication

AMERICAN THORACIC SOCIETY

Sept. 5, 2023 – In a new report posted online in the  American Journal of Respiratory and Critical Care Medicine, a global consensus conference of 32 critical care experts with broad international representation and from diverse backgrounds has proposed a new definition of acute respiratory distress syndrome (ARDS). In addition to the experts, critical care societies from around the world provided input,  once they received feedback from their members. The report, which builds on the 2012 Berlin Definition of ARDS, will be published Jan. 1, 2024 in the American Thoracic Society’s AJRCCM.

ARDS is a life-threatening illness in which the lungs are severely inflamed. It has a number of possible causes, including sepsis and severe pneumonia.   

Leaders in the field saw the need for an expanded definition due to new research and developments in the diagnosis and treatment of ARDS such as:

• Expanded use of pulse oximetry in place of measurement of arterial blood gases (oxygen and carbon dioxide, which are measured through a blood draw). Recent clinical trials in ARDS have used SpO2/FIO2 (as measured by pulse oximetry) for patient selection and ARDS patients diagnosed using pulse oximetry measurement have similar outcomes to those diagnosed using arterial gas measurement.
• The use of high flow nasal oxygen (HFNO; use of nasal cannula to deliver a large amount of heated and humidified gas). The use of HFNO to manage severe hypoxemic respiratory failure, which occurs when there is not enough oxygen in the blood, has increased dramatically following publication of FLORALI trial results in 2015. In addition, HFNO was widely used at the height of the COVID-19 pandemic, providing further evidence of its usefulness. 

• There has also been increased recognition that chest ultrasound, performed by trained personnel, can substitute for or serve as an adjunct to chest X-rays in settings that have limited resources and do not have access to X-ray equipment.

“One of the major limitations of the Berlin Definition is that its requirement for invasive or non-invasive ventilation cannot be met in settings where mechanical ventilation is not available,” said corresponding author Michael A. Matthay, MD, professor, medicine and anesthesia; associate director, critical care medicine; and senior associate, Cardiovascular Research Institute, University of California, San Francisco. “By expanding the definition of ARDS and the use of pulse oximetry and ultrasound to help diagnose and stage ARDS, and HFNO to treat it, we will be able to help many more patients who are in resource-limited settings. This expanded definition also opens up new avenues of research and will encourage clinical trials to test new treatments that can include more ARDS patients who were not previously included because they were not mechanically ventilated.”

As described in the article, the committee made minor modifications to the Berlin Definition’s conceptual model of ARDS and proposed four main recommendations:

• Include HFNO with a minimum flow rate ³  30 liters a minute. HFNO has already demonstrated its value in critically ill patients and may have value in resource-limited settings throughout the world where mechanical ventilation is not available.
• As an alternative to arterial blood gas measurements, use arterial oxygen tension (SpO2/FIO2), as measured with pulse oximetry, for ARDS diagnosis and assessment of severity if SpO2 is less than or equal to 97 percent.  This measurement will help identify hypoxemia earlier, making trials and early interventions with non-intubated patients more feasible.
• Retain bilateral lung opacities (areas of the lung that appear more opaque) for imaging criteria, but add ultrasound as an imaging modality, especially in resource-limited areas.
• In resource-limited settings, do not require positive end-expiratory pressure (PEEP; the positive pressure that remains in airways at the end of exhalation), oxygen flow rate, or specific respiratory support devices.

“The new definition will likely enhance recognition of ARDS in many patients at an earlier stage of their respiratory failure, when interventions are more likely to succeed,” said Dr. Matthay.

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JOURNAL

American Journal of Respiratory and Critical Care Medicine

METHOD OF RESEARCH

Literature review

SUBJECT OF RESEARCH

People

 

UNF researcher awarded NSF grant to help save coral reefs

Grant and Award Announcement

UNIVERSITY OF NORTH FLORIDA

A team of researchers including Dr. Brian Wingender, University of North Florida Materials Science and Engineering Research Facility (MSERF) assistant director, was recently awarded a research grant from the National Science Foundation’s (NSF) Integrative Biology (IntBIO) program. The project aims to better understand the formation of biomineralized materials and to ultimately result in technology that could lead to stronger and more resilient corals, significantly impacting the oceans and coastal communities.

 

The first focus of the research is to study the functionality of proteins known to be associated with biomineralization, the process by which living organisms produce minerals to harden existing tissues such as teeth, bones, shells and corals. However, the formation mechanisms of these minerals are poorly understood because of the difficulty in replicating natural conditions in a lab.

 

The researchers will manipulate gene expression in a soft coral common sea anemone (Nematostella Vectensis) to observe and understand the biomineralization process. The team’s primary focus is studying how factors like temperature and pH can affect marine biomineralization, by tailoring protein activity through targeted modification, to potentially discover functional characteristics that can help coral resist the harmful effects of climate change that threaten the ecosystems.

 

The research project is composed of three main components:

• Researchers at the University of Florida’s (UF) Whitney Lab, Dr. Mark Martindale, a cellular and developmental biologist, and Dr. Sandra Loesgen, a natural products organic chemist, will develop techniques using high-resolution mass spectrometry.
• Dr. Tommy Angelini, a mechanical engineering professor at UF, will utilize “cellular micromasonry” 3D printing technology.
• Wingender will use the characterization tools at MSERF to analyze the biominerals produced by these genetically modified systems.

 

About University of North Florida

The University of North Florida is a nationally ranked university located on a beautiful 1,381-acre campus in Jacksonville surrounded by nature. Serving nearly 17,000 students, UNF features six colleges of distinction with innovative programs in high-demand fields. UNF students receive individualized attention from faculty and gain valuable real-world experience engaging with community partners. A top public university, UNF prepares students to make a difference in Florida and around the globe. Learn more at www.unf.edu.

 

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