Whistleblower accuses Aledade, largest US independent primary care network, of Medicare fraud

by Fred Schulte, KFF Health News

Credit: Pixabay/CC0 Public Domain

A Maryland firm that oversees the nation's largest independent network of primary care medical practices is facing a whistleblower lawsuit alleging it cheated Medicare out of millions of dollars using billing software "rigged" to make patients appear sicker than they were.

The civil suit alleges that Aledade Inc.'s billing apps and other software and guidance provided to doctors improperly boosted revenues by adding overstated medical diagnoses to patients' electronic medical records.

"Aledade did whatever it took to make patients appear sicker than they were," according to the suit.

For example, the suit alleges that Aledade "conflated" anxiety into depression, which could boost payments by $3,300 a year per patient. And Aledade decided that patients over 65 years old who said they had more than one drink per day had substance use issues, which could bring in $3,680 extra per patient, the suit says.

The whistleblower case was filed by Khushwinder Singh in federal court in Seattle in 2021 but remained under seal until January of this year. Singh, a "senior medical director of risk and wellness product" at Aledade from January 2021 through May 2021, alleges the company fired him after he objected to its "fraudulent course of conduct," according to the suit. He declined to comment on the suit.

The case is pending and Aledade has yet to file a legal response in court. Julie Bataille, Aledade's senior vice president for communications, denied the allegations, saying in an interview that "the whole case is totally baseless and meritless."

Based in Bethesda, Maryland, Aledade helps manage independent primary care clinics and medical offices in more than 40 states, serving some 2 million people.

Aledade is one of hundreds of groups known as accountable care organizations. ACOs enjoy strong support from federal health officials who hope they can keep people healthier and achieve measurable cost savings.

Aledade was co-founded in 2014 by Farzad Mostashari, a former health information technology chief in the Obama administration, and has welcomed other ex-government health figures into its ranks. In June 2023, President Joe Biden appointed Mandy Cohen, then executive vice president at Aledade, to head the Centers for Disease Control and Prevention in Atlanta.

Aledade has grown rapidly behind hundreds of millions of dollars in venture capital financing and was valued at $3.5 billion in 2023.

Mostashari, Aledade's chief executive officer, declined to be interviewed on the record.

"As this is an active legal matter, we will not respond to individual allegations in the complaint," Aledade said in a statement to KFF Health News. "We remain focused on our top priority of delivering high-quality, value-based care with our physician partners and will defend ourselves vigorously if needed in a court of law."

The lawsuit also names as defendants 19 independent physician practices, many in small cities in Delaware, Kansas, Louisiana, North Carolina, Pennsylvania, and West Virginia. According to the suit, the doctors knowingly used Aledade software to trigger illegal billings, a practice known in the medical industry as "upcoding." None has filed an answer in court.

More than two dozen whistleblower lawsuits, some dating back more than a decade, have accused Medicare health plans of overcharging the government by billing for medical conditions not supported by patient medical records. These cases have resulted in hundreds of millions of dollars in penalties. In September 2023, Cigna agreed to pay $37 million to settle one such case, for instance.

But the whistleblower suit filed against Aledade appears to be the first to allege upcoding within accountable care organizations, which describe part of their mission as foiling wasteful spending. ACOs including Aledade made headlines recently for helping to expose an alleged massive Medicare fraud involving urinary catheters, for instance.

Finding the 'gravy'

Singh's suit targets Aledade's use of coding software and guidance to medical practices that joined its network. Some doctors treated patients on standard Medicare through the ACO networks, while others cared for seniors enrolled in Medicare Advantage plans, according to the suit.

Medicare Advantage is a privately run alternative to standard Medicare that has surged in popularity and now cares for more than 30 million people. Aledade has sought to expand its services to Medicare Advantage enrollees.

The lawsuit alleges Aledade encouraged doctors to tack on suspect medical diagnoses that paid extra money. Aledade called it finding "the gravy sitting in the [patient's] chart," according to the suit.

The company "instructed" providers to diagnose diabetes with complications, "even if the patient's diabetes was under control or the complicating factor no longer existed," according to the suit.

Some medical practices in Delaware, North Carolina, and West Virginia billed the inflated code for more than 90% of their Medicare Advantage patients with diabetes, according to the suit.

The lawsuit also alleges that Aledade "rigged" the software to change a diagnosis of overweight to "morbid obesity," which could pay about $2,500 more per patient. Some providers coded morbid obesity for patients on traditional Medicare at 10 times the national average, according to the suit.

"This fraudulent coding guidance was known as 'Aledade gospel,'" according to the suit, and following it "paid dividends in the form of millions of dollars in increased revenue."

These tactics "usurped" the clinical judgment of doctors, according to the suit.

'No diagnosis left behind'

In its statement to KFF Health News, Aledade said its software offers doctors a range of data and guidance that helps them evaluate and treat patients.

"Aledade's independent physicians remain solely responsible for all medical decision-making for their patients," the statement read.

The company said it will "continue to advocate for changes to improve Medicare's risk adjustment process to promote accuracy while also reducing unnecessary administrative burdens."

In a message to employees and partner practices sent on Feb. 29, Mostashari noted that the Justice Department had declined to take over the False Claims Act case.

"We recently learned that the federal government has declined to join the case U.S. ex rel. Khushwinder Singh v. Aledade, Inc. et al. That's good news, and a decision we wholeheartedly applaud given the baseless allegations about improper coding practices and wrongful termination brought by a former Aledade employee three years ago. We do not yet know how the full legal situation will play out but will defend ourselves vigorously if needed in a court of law," the statement said.

The Justice Department advised the Seattle court on Jan. 9 that it would not intervene in the case "at this time," which prompted an order to unseal it, court records show. Under the false claims law, whistleblowers can proceed with the case on their own. The Justice Department does not state a reason for declining a case but has said in other court cases that doing so has no bearing on its merits.

Singh argues in his complaint that many "unsupported" diagnosis codes were added during annual "wellness visits," and that they did not result in the patients receiving any additional medical care.

Aledade maintained Slack channels in which doctors could discuss the financial incentives for adding higher-paying diagnostic codes, according to the suit.

The company also closely monitored how doctors coded as part of an initiative dubbed "no diagnosis left behind," according to the suit.

2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Biden set to name new CDC director

 

Five hotspots where floating plastic litter poses the greatest risk to North Atlantic marine life

by Samantha Garrard, The Conversation

Map of plastic risk to marine megafauna and selected shallow water habitats in the North 

Atlantic, with zero to five designated as lowest to highest risk. The five areas of greatest 

risk have been highlighted.

Plastic has been found in every single part of the ocean, from the surface to the seafloor and from the tropics to the poles. Land-based sources of plastic account for the majority of this pollution, with plastic bags, bottles, wrappers, food containers and cutlery among the most common items found.

These items are often buoyant and float on the sea surface. As they travel long distances, they get pushed by the wind, waves and currents. This means they have the potential to cause harm far beyond the country from which they originated. For example, land-based plastic waste from Indonesia has been shown to travel over 4,000km to the Seychelles.

As it travels, plastic litter can cause harm to wildlife. Megafauna (large marine animals) can eat or become entangled in it. Consuming plastic litter can block or damage the gastrointestinal tract of animals, causing significant health impacts or death.

While ghost fishing gear (lost fishing nets that float freely) is the most common entanglement threat to marine megafauna, they can also become entangled in land-sourced plastics such as plastic bags, frisbees, potato nets, elastic bands and other circular plastics. This can cause severe trauma to the animal, and in some cases entanglement causes death.

If plastic is transported towards the shore, it can get caught or lodged in shallow environments where it can entangle or cover plant or animal habitats, causing damage. Plastic entanglement can cause breakage, and if it covers a habitat it will restrict access to food or light.

At Plymouth Marine Laboratory, our team of marine researchers have developed a risk assessment approach to understand where this plastic litter could cause the most harm in the North Atlantic, and which countries that plastic originated from. Our research highlighted five areas of high risk—the US Atlantic, the US Gulf of Mexico, the UK, French Atlantic and Portuguese Azores.

Reducing risk

In our new study, we assessed the risk of land-sourced plastic litter to marine megafauna. That includes seabirds, whales and dolphins, seals and sea lions, manatees and dugongs, sharks and rays, tuna and billfish. We also assessed the risk to shallow water habitats including coral reefs, mangroves, seagrass beds, saltmarsh and kelp seaweed beds.

Using a particle tracking model, we tracked the flow of buoyant plastic litter released from the rivers of 16 countries bordering the North Atlantic between 2000 and 2015 using the most recent data available. Billions of virtual particles were released at the mouths of the rivers each month, with surface currents and wind used to drive their movement. After 15 years of tracking, our model showed us where plastic was likely to accumulate.

We also assessed the vulnerability of each of the megafauna groups and shallow water habitats to this plastic. For marine megafauna, we developed vulnerability scores by quantifying the amount of scientific evidence of ingestion or entanglement in land-sourced plastic. For habitats, we developed vulnerability scores by quantifying the scientific evidence available for this plastic causing harm by entanglement or smothering.

To assess risk, we mapped the vulnerability and distribution of each megafauna group or habitat against the abundance of plastic. Each point within the map was given a risk score from zero to five. The greatest risk occurred in areas where high numbers of vulnerable megafauna or habitats overlapped with high concentrations of plastic.

Managing the plastic problem

We found that much of the modeled plastic litter causing risk in the UK originated from UK rivers. In other high-risk zones such as the Azores and the US Gulf of Mexico, plastic primarily originated from other regions. More than 99% of plastic litter in the Azores was estimated to come from the other countries, mainly Caribbean islands and the US.

The potential of this plastic to travel vast distances across the ocean makes management of this pollutant particularly difficult. More than 90% of plastic waste in the Dominican Republic and Haiti are estimated to be mismanaged. This waste has the potential to cause ecological harm across both sides of the Atlantic.

UN member nations have agreed to forge an international legally binding agreement to tackle plastic pollution, called the Global Plastics Treaty, with negotiations expected to be completed by the end of this year. This study highlights the importance of the treaty in ensuring international cooperation to reduce plastic consumption and waste, including the provision of financial support to help lower-income nations such as the Caribbean islands implement measures. Identification of high-risk zones will also help prioritize areas where interventions and monitoring should be targeted.

Even if all plastic intervention measures are implemented, it is likely that substantial amounts of plastic will still enter our oceans. The production, sale and distribution of many of single-use items are likely to be phased out under the Global Plastics Treaty, as nations move to restrict avoidable plastic products.

While global measures are hugely important in the fight against plastic, the choices of consumers also play a significant role. Reducing, re-using and recycling plastic are powerful ways to cut your plastic footprint. At both ends of the spectrum, the choices made at international and household level can be good news for marine wildlife.

Provided by The Conversation 

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Plastic litter in oceans overestimated but could persist longer than expected, study suggests

 

Human urine boosts green bean growth on moon and Mars regolith simulants

by Wageningen University

Sample of struvite. Credit: Wieger Wamelink

There is the dream of living and working on the moon or planet Mars. But what are the inhabitants going to eat out there, and how are they going to grow their food? A circular and sustainable agricultural ecosystem for food production will be essential.

A research team at Wageningen University & Research and the B.A.S.E. project investigates how to grow crops in a sustainable circular way, using local resources. Their latest study, published in Open Agriculture, shows that applying human urine in the form of struvite (a mineral) boosts green bean growth on Mars and moon regolith simulants.

Struvite as fertilizer

"The human urine we used in the study was collected from portable toilets at festivals in Amsterdam. You can imagine that there all kinds of substances in urine that we would not like to use in crop fertilizer," says Wieger Wamelink, principal investigator of the study. "So we used struvite instead, a mineral that is extracted from human urine and consists of magnesium ammonium and phosphate and that is almost 100% pure, so it doesn't bring along any contaminations, like medicine remains or drugs. It releases the nutrients slowly during the whole growth period.

"We, as research team, used regolith (the upper layer of 'soil') simulants instead of real Mars and moon regoliths for our experiments."

Mars regolith is not available on Earth, and although there is some moon regolith on Earth, it is not present in the quantities needed for a crop growth experiment. However, both the real regoliths and their simulants lack significant quantities of ammonium, nitrate and phosphate, which are essential for a proper plant growth.

"We have proven that struvite can be an excellent fertilizer. In this way, we can easily process and apply human urine as fertilizer in the regoliths. It boosts plant growth and can increase bean harvest with several factors on the regolith simulants," says Wamelink.

The researchers did not eat the green beans, because at the moment of harvest, struvite was not officially allowed for use as a fertilizer for crops. In addition, regoliths (and their simulants) contain levels of poisonous metals that could end up in the beans. More research on the contamination of the crops with heavy metals from the regolith is needed.

The golden circle of crop growth on Mars or the moon

Because there are only ice and regolith with no organic matter available on Mars and the moon, the soils have to be amended and improved to make crop growth possible. What is needed is a closed sustainable agricultural ecosystem. One of the key factors in this system will be the recycling of human waste.

"By applying struvite extracted from human urine, we can fill in one of the steps in the golden circle of crop growth on Mars and the moon, but also here on Earth," according to Wamelink. Human urine could be (again) applied as fertilizer instead of being wasted.

As a next step, the recently started B.A.S.E. project aims to set up a moon/Mars dome containing all necessities to grow crops at Mars or the moon, indoors. This dome is a research facility to test innovations and make them work together as a circular system. Its blueprint could be applied on Mars or on the moon, but also on planet Earth. For example, in deserts or on the South Pole.

The Food for Mars and Moon project

The Food For Mars and Moon project investigates how to grow crops on both celestial bodies, applying the resources available at hand; regolith and ice. In the past the research team was able to grow a whole series of crops, including potato, carrot, pea, tomato, garden cress and radish on regolith simulants. The project is now in the phase of making crop production fully circular, which includes the application of pollinators, bacteria, fungi and earthworms.

More information: Wieger Wamelink et al, Effect of struvite on the growth of green beans on Mars and Moon regolith simulants, Open Agriculture (2024). DOI: 10.1515/opag-2022-0261

Provided by Wageningen University 

Soil on moon and Mars likely to support crops

 

Reptile roadkill reveals new threat to endangered lizard species

by Lucien Wilkinson, Curtin University

The western spiny-tailed skink. Credit: Holly Bradley

The chance sighting of a dead snake beside a sandy track in remote Western Australia, and the investigation of its stomach contents, has led Curtin University researchers to record the first known instance of a spotted mulga snake consuming a pygmy spiny-tailed skink, raising concerns for a similar-looking, endangered lizard species.

Lead researcher Dr. Holly Bradley from Curtin's School of Molecular and Life Sciences said the discovery of the partially digested pygmy spiny-tailed skink within the snake had implications for the vulnerable western spiny-tailed skink species.

The research paper, "First record of Egernia predation by the range restricted Spotted Mulga Snake (Pseudechis butleri)" was published in the journal Australian Zoologist.

"Found about 300 km east of Geraldton and likely killed by a vehicle, the snake's consumption of the pygmy spiny-tailed skink raises concerns about the susceptibility of similar-sized juvenile western spiny-tailed skinks, which also inhabit the Mid-West region and are classified as endangered," Dr. Bradley said.

"Pygmy spiny-tailed skinks look and act a lot like babies of the endangered western spiny-tailed skink, which live in the same area, so if these snakes are preying on one of them, they are likely also preying on the other.

"Discovering a new potential predator for the western spiny-tailed skink is important for our understanding and management of this rare and threatened species and points to a need for further research to assess and mitigate potential threats to these reptiles."

Dr. Bradley said despite Australia's rich biodiversity of reptiles, there exists a significant gap in understanding their ecology, with the spotted mulga snake and the pygmy and western spiny-tailed skinks prime examples of understudied and quite mysterious reptiles.

"Understanding predator–prey dynamics can be useful for effective conservation, especially for rare and threatened species such as the vulnerable western spiny-tailed skink," Dr. Bradley said.

"Australia is a hotspot for reptile diversity, but with much of our diversity in the remote, dry, and hot areas which are difficult to access, a lot is unknown about our native snakes and lizards.

"Discovering a new potential predator for western spiny-tailed skink represents an improvement in our understanding of Australian reptile ecology and can better inform conservation efforts and ensure the survival of our native reptilian species."

More information: Holly S. Bradley et al, First record of Egernia predation by the range restricted Spotted Mulga Snake Pseudechis butleri, Australian Zoologist (2024). DOI: 10.7882/AZ.2024.003

Provided by Curtin University Light technology recreates 'log castles' to save homeless lizards

Aroma compound found to reduce the effects of drought, improve productivity of tomato plants

by Universitat Politècnica de València

Credit: Pixabay/CC0 Public Domain

Tomato plants emit a scent to resist bacterial attacks. This aroma—or volatile compound—is hexenyl butanoate (HB). A team from the Research Institute for Plant Molecular and Cellular Biology (IBMCP), a joint center of the Universitat Politècnica de Valencia (UPV) and the Spanish National Research Council (CSIC), has discovered that its mode of action is novel, as it works independently of the classic hormone involved in the process of stomatal closure (abscisic acid).

In this way, it is possible to protect plants from threats like drought or pathologies that could threaten crops. The work has been published in Horticulture Research.

"Given the importance of stomatal control in water stress, HB treatments alleviate the symptoms caused by drought and improve the productivity of crops such as tomato. Therefore, in the context of the severe drought we are currently experiencing in Spain, the development of this type of compound is a breakthrough to address this situation," says Purificación Lisón, IBMCP researcher and professor in the Department of Biotechnology at the School of Agricultural Engineering and Environment (ETSIAMN) of the UPV.

Among other advantages, the UPV and CSIC team points out that the HB compound resists diseases that enter the stomata. In the case of tomatoes, its use protects against Pseudomonas syringae. This bacterium causes significant damage, particularly in cold and wet weather, making the fruit unsuitable for marketing.

The IBMCP team has also demonstrated its usefulness in other crops, such as potatoes, where it has increased resistance to Phytophthora infestans. This parasite causes a disease known as late blight or downy mildew, which causes significant losses.

Credit: Universitat Politècnica de València

To study the mode of action of the HB compound, the IBMCP team used different strategies: genetic, using biosynthesis mutants in specific molecules; pharmacological, with exogenous treatments with inhibitors of the possible processes involved; biochemical, through the analysis to detect phosphorylations; and transcriptomic, using the new massive sequencing techniques (RNAseq), which allow understanding the reprogramming mechanisms of the treated plants in terms of mRNAs.

"Our results support the use of HB as a bioactive natural compound for more sustainable agriculture. Currently, there are no alternative products on the market that can induce stomatal closure," adds Mª Pilar López Gresa, also a researcher at the IBMCP (CSIC-UPV) and professor at the Biotechnology Department of the ETSIAMN-UPV.

As stomatal closure is involved in a large number of processes in the plant, the IBMCP team is investigating new uses for HB, such as synchronizing flowering, inducing flowering and fruit set, and promoting ripening, in addition to its use in combating drought and bacteria or parasites.

More information: Celia Payá et al, Signalling mechanisms and agricultural applications of (Z)-3-hexenyl butyrate-mediated stomatal closure, Horticulture Research (2023). DOI: 10.1093/hr/uhad248

Provided by Universitat Politècnica de València

Tomato plant aroma to protect crops

Study shows new habitats affect plants' chemical defenses

by Angela Overmeyer, Max Planck Society

Odor collection. Credit: Sybille Unsicker, Max Planck Institute for Chemical Ecology

An international team of researchers has investigated the question of whether the chemical defenses of plants changes when they have established themselves in new geographical regions.

Greenhouse experiments with populations of ribwort plantain from different countries and continents showed that introduced ribwort plantain populations exhibited higher chemical defenses when climatic factors of their habitat were taken into account, while their growth was not affected.

The results, published in Functional Ecology, refute common theories and demonstrate how difficult it is to formulate generally valid assumptions in ecology.

Ribwort plantain (Plangato lanceolata) is known to many from pharmaceutical use. The medicinal plant of the year 2014 in Germany, which has been used in traditional medicine for centuries, has an antitussive and anti-inflammatory effect and is found in cough syrup or drops.

However, ribwort plantain is also an example of successful colonization of new habitats around the globe and can be described as a plant cosmopolitan. While its original range was limited to Europe and Western Asia, the plant has migrated or been introduced to other areas and has successfully established itself in numerous countries around the world.

Species are exposed to different environmental factors when colonizing new habitats. There are various theories as to how some species succeed in colonizing new regions. One assumption is that alien species may be less exposed to herbivorous insects and pests than in their native range.

This also means that they have to defend themselves less and can invest more resources in growth. As a result, they are better able to compete. Another theory is that introduced species can also form new chemical defenses. There is some evidence for these theories, but overall, only few studies clearly support them.

The research groups led by Sybille Unsicker from Kiel University and former group leader at the Max Planck Institute (MPI) for Chemical Ecology in Jena, and Christiane Roscher, who conducts research at the Environmental Research Center (UFZ) and the German Center for Integrative Biodiversity Research (iDiv), used ribwort plantain to investigate whether the growth and chemical defense of ribwort plantain populations from the original distribution area differ from populations from areas into which ribwort plantain has been introduced.

Ribwort plantain has already been the subject of a number of ecological studies and the main chemical defense compounds have been well characterized. "Supported by scientists from all over the world, we were able to collect ten ribwort plantain populations from Europe, the original distribution area, and a further nine introduced populations from different continents. We grew all populations under the same conditions in the greenhouse and measured growth parameters," says doctoral researcher and first author Pamela Medina van Berkum from the MPI for Chemical Ecology.

In addition, caterpillars were placed on the plants to measure the accumulation of defense metabolites and the release of odors before and after feeding. The caterpillars were of the generalist herbivore Spodoptera littoralis, which is not adapted to ribwort plantain and feeds on many different plants.

"Taking into account the climatic factors of the geographic origin of the seeds, we were able to show that introduced populations were characterized by an increase in chemical defense compounds without producing less biomass under herbivore attack. The concentrations of iridoid glycosides and verbascoside, the most important defense metabolites of ribwort plantain against herbivory, were higher in introduced populations than in native populations," says co-first author Eric Schmöckel from the MPI for Chemical Ecology.

At the same time, however, the introduced populations showed slightly greater feeding damage and the caterpillars consumed more biomass. In addition, the introduced populations showed higher amounts and a greater diversity of odors released after feeding damage. Interestingly, the accumulation of volatile compounds in both introduced and native populations depended on climatic conditions and increased with decreasing temperature.

These results are not entirely consistent with commonly proposed theories that introduced populations should have invested less in defenses than native populations. Christiane Roscher interprets the results as follows, "It may be true that the plants have escaped their natural enemies, but they may also encounter new enemies in their new geographical range. In addition, chemical defenses may be important to cope with climatic conditions and stress factors such as drought and high soil salinity, as several of the traits measured were also influenced by the climate in the populations' countries of origin."

This study provides initial insights into why ribwort plantain is so successful worldwide. However, the role of climatic conditions, in particular, is only partially understood. "In follow-up experiments, we will try to find out how the individual ribwort plantain populations respond to combined stresses. In other words, we want to expose the plants to more realistic environmental conditions like those we are currently observing in the context of climate change," says Sybille Unsicker. "Our research shows that it is difficult, if not impossible, to formulate generalizing hypotheses in an ecological context."


More information: Pamela Medina‐van Berkum et al, Plant geographic distribution influences chemical defences in native and introduced Plantago lanceolata populations, Functional Ecology (2024). DOI: 10.1111/1365-2435.14535


Provided by Max Planck Society


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Why charities focused on the money, not the mission, should listen up

by Greg Bruno, Rutgers University

Credit: Unsplash/CC0 Public Domain

Nonprofit organizations (NPOs) have distinct identities: Some are more motivated by mission, others by money. Now, new research from Rutgers University–New Brunswick finds these preferences can affect an NPO's identity, particularly how receptive it is to feedback.

"For an organization whose utilitarian identity is dominant, in that it emphasizes budgets and the bottom line, leaders might have the intention to listen to ideas but not necessarily to act on them," said J. Sophia Fu, an assistant professor at the Rutgers School of Communication and Information and lead author of the study published in the journal Communication Research.

"By contrast, normative or mission-driven NPOs not only have the intention but often the desire to build a culture to actualize the suggestions they receive," Fu said.

Organizational listening is the practice of soliciting and implementing input from stakeholders—such as employees, donors, board members, and volunteers—when making policies or decisions that shape the direction of a charity. Good listening practices, Fu added, involve both learning stakeholders' needs through dialog and demonstrating a willingness to act on what is learned.

Despite the value of organizational listening, past research has shown that NPOs tend to listen infrequently and poorly.

To help understand why, Fu and colleagues conducted a mixed-method national study drawing on Internal Revenue Service data for medium-sized and large nonprofit organizations in the United States. In the first phase, 122 NPOs from 36 states completed surveys related to their organizational listening practices

Nonprofit sectors included education, arts and culture, environment, human services, and health. Survey questions focused on listening motivation, culture, and information collection, analysis, and integration.

During the second phase, virtual interviews were conducted with leaders from 38 of the NPOs. Questions were designed to understand how participants' views on organizational listening related to NPO identities and shaped organizational changes.

Based on the responses, utilitarian and normative identity scores were calculated for each NPO. These two values were further evaluated to assess how likely an organization was to implement organizational listening results.

Fu and colleagues found that NPOs with a stronger utilitarian identity generally acknowledged the importance of listening, but the recommendations usually weren't implemented because decisions were often made through a top-down process to address bottom-line needs.

By contrast, NPOs with a stronger normative identity made decisions about their programs or services primarily based on stakeholder inputs and interests, even if they knew doing so wouldn't directly contribute to their financial health.

Nonprofit organizations are multidimensional and manage dual identities composed of contradictory elements, said Fu. But these values don't have to be mutually exclusive.

"NPOs are the motors of progress and social change, and organizational innovation is the driver of broader societal progress," said Fu. "For any leader of an NPO, you can't only focus on social impact—you must invest efforts in your financial health. Fortunately, the two identities can be mutually reinforcing and synergistic."

More information: Jiawei Sophia Fu et al, Navigating Multiple Identities for Positive Change Through Organizational Listening, Communication Research (2024). DOI: 10.1177/00936502241227380

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Clownfish avoid the sting of their anemone hosts with sugary slime

As a clownfish spends time with an anemone, its mucus coating begins to change. Chemical tweaks to sugars in the slime may calm stinging cells in anemone tentacles

By Jake Buehler
7 March 2024

Clownfish and anemones have a symbiotic relationship

The secret’s in the snot. Chemical changes in the mucus that coats a clownfish’s body can blunt the sting of its symbiotic anemone partner.

Researchers have long suspected that something special about the mucus of clownfish, also known as anemonefish, protects them from the microscopic venomous barbs of an anemone’s tentacles. But the precise mechanism remained a mystery, says Karen Burke da Silva at Flinders University in Australia.

Neuron-like machinery helps anemones decide when to sting

To investigate, she and her colleagues raised orange clownfish (Amphiprion percula) and bubble-tip anemones (Entacmaea quadricolor) in the lab. Some of the fish and anemones were paired together, while others lived separately. The team took mucus samples from the fish at various times before and after they acclimated to their anemones, then put the mucus on microscope slides and pressed it onto an anemone’s tentacle.

Anemones sting by explosively firing tiny, coiled, venomous harpoons from stinging cells called nematocytes. Using a microscope, the researchers counted and compared how many nematocytes fired between the mucus treatments. They found mucus from clownfish partners – but not from unacquainted fish – reduced nematocyte firing.

To figure out why, the researchers analysed how glycans – chains of sugars that attach to proteins – and fats in the mucus changed as the clownfish acclimated to their host. Three weeks into a symbiotic partnership, the mucus’s chemical profile had shifted substantially. In particular, the concentrations of seven different types of glycans had changed. Getting rid of glycans or otherwise tweaking them may be one way to suppress the nematocytes’ firing, says Burke da Silva.

Alonso Delgado at The Ohio State University wonders if other anemone symbiotes, such as anemone shrimp (Ancylomenes magnificus), use a similar glycan method to stymie stings, or if they have evolved different strategies.

Additional strategies could also be at play in clownfish. The glycan change is slow and reverts within a day of the partners being split up. Instead, the fish may use an unknown chemical strategy in the very beginning to get initial access to the anemone.

Journal reference:
bioRxiv DOI: 10.1101/2024.02.22.581653

 

Eight new deep-sea species of marine sponges discovered

by Uppsala University

Geodia bibilonae, one of the new species identified. Credit: PeerJ (2024). DOI: 10.7717/peerj.16584

Although marine sponges are widespread in the oceans, their biodiversity and distribution is still poorly known. Even though the Mediterranean Sea is the most explored sea on Earth, a study by Julio A. Díaz and colleagues, published in PeerJ, reveals the presence of new sponge species and new records in unexplored habitats such as underwater caves or mountains around the Balearic Islands.

The new discoveries will increase the ecological importance of the Mallorca channel seamounts and the littoral caves, providing compelling arguments for the Spanish government to emphasize the need for protection measures. Regarding the underwater mountains, the data suggests a strong case for their inclusion within the Natura 2000 Network, highlighting their ecological significance and the necessity of conservation efforts.

Sponges are aquatic animals that live attached to the bottom of the sea and feed on bacteria and other microscopic food by constantly filtering large amounts of seawater. We currently know more than 9,600 species worldwide, with still many parts of the world unexplored. The sponge fauna of the Western Mediterranean is one of the most studied in the world and yet, the sampling of new habitats in this region is usually an opportunity to reveal new species.

Díaz, a Ph.D. student of the Balearic Oceanographic Center of the Spanish Institute of Oceanography (CSIC), together with other researchers from the same center, have been collecting sponges in the Balearic Islands, Spain. Collections came from shallow underwater caves to deep-sea fishing grounds and underwater mountains (seamounts), descending to depths of up to 1,000 meters.

With Docent Paco Cárdenas, sponge taxonomist and zoology curator at the Museum of Evolution, Uppsala University, they have focused on one particular large group of sponges, the tetractinellids, for which substantial comparative material is available in the collections of the Museum of Evolution.

Before this study, only 16 of the 83 Mediterranean tetractinellid sponges had been recorded in the Balearic Island region. This study identified a total of 36 tetractinellid species, and, in the process, discovered eight new species for science, such as Stelletta mortarium, which was named after the typical kitchen mortar commonly used in Mediterranean cuisine, because of its cup-shape; or Geodia matrix named after its tendency to accumulate all kind of different elements in its body.

Two new species honor two important sponge scientists: Dr. Maria Antònia Bibiloni, who was key to initiate sponge research in the Balearic Islands in the 1980s, and Dr. Joana R. Xavier for her continuous efforts and leadership to support deep-sea sponge research. In addition, some species were re-discovered since their initial description 40 years ago.

More information: Julio A. Díaz et al, From caves to seamounts: the hidden diversity of tetractinellid sponges from the Balearic Islands, with the description of eight new species, PeerJ (2024). DOI: 10.7717/peerj.16584

Provided by Uppsala University 

Four rare and delicate sponges described

 

Confidence (or its absence) is contagious in the workplace, study finds

by California Institute of Technology

Credit: Pixabay/CC0 Public Domain

New research by Caltech's Kirby Nielsen, assistant professor of economics and William H. Hurt Scholar, shows that the gender gap in confidence that is often held responsible for women's underachievement in the workplace is "contagious"; that is, when evaluating a worker's performance based on self-assessments, reviewers will reward apparent self-confidence—and conversely, penalize a lack of confidence—rather than focusing solely on performance.

Think of it like this: You have been in your current job for three years, and you could really use a pay increase. Your performance reviews are good, and you are well within your rights to ask for a raise. Do you?

Many factors influence a decision like this, but one, unquestionably, is gender. If you are a man, you are statistically more likely to reason that you're doing quite well at your job and deserve more money, and you will approach your boss with just this attitude: "It's time for a raise, and maybe a promotion too."

But if you are a woman? You are statistically more likely to recall the "room for improvement" notes from your last performance review and imagine your colleagues are all performing better. You decide that your boss will offer a raise when you deserve it. Or, you may ask your boss for a raise, but when you do, you are hesitant, apologetic: "I shouldn't bother you, but do you think maybe it's time for me to get a raise?"

One potential consequence of this so-called "confidence gap" is predictable: Even when equally performing, equally trained women and men are present in the workplace, on average men are paid more and have greater upward mobility than women.

For some time, the standard advice given to women to rectify this problem was to "lean in," a slogan made popular by the 2013 book of the same title by Sheryl Sandberg, formerly the chief operating officer of Meta Platforms. Lack confidence in your own worth in the workplace? Lift a page from the careers of more successful men. Value yourself. Tell others they should value you. Nurture your self-confidence and, in the meantime, fake it as best you can, and the rewards will follow.

Some have objected to this advice, believing the onus should be on employers to realize that women and men assess their own performance differently, and that self-reports should be read through this interpretive lens. "Many people know about the confidence gap," Nielsen reasons. "If I, as an employer, think about how people communicate, I might be able to realize that men and women communicate differently about their performance on average. If my male employee is saying he's amazing, maybe I should tone that down a bit in my mind. If my female employee is saying she's OK, maybe I should consider that an understatement."

To shed some light on these questions, Nielsen crafted an experiment. Participants were recruited and assigned randomly to two categories: workers and evaluators.

The workers were given a 10-question math and science quiz. "We incentivized them to do their best by paying them more for each correctly answered question," Nielsen explains. This quiz was followed by 17 self-assessment questions, also incentivized: The closer participants got to their actual test scores in their self-assessments, the more they were paid. False modesty was not rewarded.

One set of questions focused on the participant's absolute performance: Did they answer at least three questions on the test correctly? Another group of questions measured relative performance: Do they think they scored in the top half among everyone who took the test?

Finally, some questions were directed toward subjective beliefs about performance: Do they think another person would describe their performance on this test as evidence of poor skills in math and science?

This first stage of the experiment yielded the expected confidence gap. Male and female participants' actual test scores landed in the same range; there was no difference by gender. But on the 17 measures of confidence, significant differences appeared. "On every single one of the self-assessment questions, women report more pessimistic beliefs about their performance than men," Nielsen notes. "Basically, we replicated the expected finding that there is a gendered confidence gap between equally performing individuals."

Next, in the second part of the experiment, the evaluators stepped in. How would they react to these differences in confidence between the workers whose results they viewed?

Evaluators were first presented with a random worker whose gender was specified but about whom nothing else was known. The evaluators were asked to guess the percentage chance that this worker's performance was poor. Evaluators gave similar guesses about performance for any random person, whether male or female. This eliminated the possibility of what Nielsen calls "taste-based discrimination"; that is, evaluators do not arrive at their task already believing that women are more likely to perform poorly on a math and science quiz.

Then the evaluators were presented with the worker's self-assessments and were again asked to specify a percentage chance that this worker's performance was poor. Here, Nielsen says, "women's relative lack of confidence was shown to be contagious. It causes other people to now conclude that women performed worse."

To test evaluators' prior familiarity with the gender gap in confidence, they were asked to guess workers' likelihood of being overconfident or lacking confidence. The evaluators guessed—accurately—that male workers were more likely to be overconfident and female workers were more likely to be lacking in confidence, indicating that they did know about the confidence gap. However, even being asked these questions did not help the evaluators recognize the influence of confidence in workers' self-reports.

"We thought that maybe if we just asked them about gender and confidence, this would nudge the evaluators to take that into account," Nielsen says. "But that had no effect on their assessments about workers' performance. They continued to guess that women actually performed worse than men after learning about the workers' self-reports."

"What the experiment indicates is that evaluators experienced a type of cognitive bias," Nielsen explains. "They were trying not to discriminate against women but ended up doing so anyway because of the women's pessimistic self-reports, even though they understood that women are typically less confident than men."

There are many real-world implications of this research, Nielsen says, "For example, some people think that having gender-blinded applications or reports could rectify gender imbalances. But this research shows that a gender-blinded process might only make the situation worse. Without knowing applicants' or workers' gender, evaluators would not be able to account for the gender gap in confidence even if they wanted to."

The cognitive bias uncovered in this research could well apply to other groups, for example, people whose cultural codes lead them to project more humility and less confidence. Nelson's experiment tested to see if evaluators would exhibit the same cognitive bias toward non-gendered groups by telling some evaluators that they were looking not at women and men but at members of "group A" and "group B." The results were the same.

Although the findings may be disheartening to people who present with less self-confidence, the good news, Nelson says, is that "we know a lot about cognitive biases, and we know that there are ways we can de-bias people. Evaluators form these biased assessments because they are having a problem incorporating the information they're given, not because they are actively discriminating against women. But this means that interventions to help on this dimension could be very promising."

The paper describing Nielsen's research, titled "The Gender Gap in Confidence: Expected But Not Accounted For," appears in the March 2024 issue of the American Economic Review. Nielsen's co-author is Christine L. Exley of the University of Michigan.

More information: Christine L. Exley et al, The Gender Gap in Confidence: Expected but Not Accounted For, American Economic Review (2024). DOI: 10.1257/aer.20221413

Provided by California Institute of Technology 'Benevolent sexism' in startups widens the gender gap by advantaging men over women