Eye-opener: Pupils enlarge when people focus on tasks

UT Arlington study shows eye sensitivity correlates with improved working memory

UNIVERSITY OF TEXAS AT ARLINGTON

 

IMAGE: 

MATTHEW ROBISON

view more 

CREDIT: PHOTO COURTESY UT ARLINGTON

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

Working memory is one of the brain’s executive functions, a skill that allows humans to process information without losing track of what they’re doing.

In the short term, working memory allows the brain to complete an immediate task, like loading the dishwasher. Long term, it helps the brain decide what to store for future use, such as whether more dishwasher soap will be needed.

University of Texas at Arlington researchers know that working memory varies greatly among individuals, but they aren’t sure exactly why. To better understand, Matthew Robison, assistant professor of psychology, and doctoral student Lauren D. Garner conducted an experiment to see if studying a person’s pupils (the centers of their eyes) was a good indicator of working memory.

Normally, a person’s pupils naturally widen (or dilate) in low-light environments to allow more light into the eye. However, in their new study published in the peer-reviewed journal Attention, Perception & Psychophysics, the researchers reported that a person’s pupils also dilate when they are concentrating on tasks. In particular, they found that the more a person’s eyes dilated during the task, the better they did on tests measuring their working memory.

 “What we found was that the lowest performers on the tasks showed less pupil dilation,” Robison said. “For the highest-performing participants, their pupil dilations were both larger overall and the individuals were more discerning about the information they were asked to recall.”

For the study, he and Garner recruited 179 undergraduate students at UT Arlington. Participants completed several working memory tasks where they were presented with information and then asked to remember it for a few seconds. During the tasks, participants had their pupils continuously measured using an eye-tracker, similar to what optometrists use during eye exams.

“We found that people who more intensely and consistently paid attention, as measured by their pupils being dilated more, performed better on the memory tasks,” said Robison. “Importantly, we found high performers also showed more pupil sensitivity compared to low-performing participants. This is exciting research because it adds another valuable piece of the puzzle to our understanding of why working memory varies between individuals.”

***

This work was supported by funding from the U.S. Naval Research Laboratory (N00173-22-2-C006) and U.S. Army Research Institute (W911NF-23-1-0300).

---

JOURNAL

Attention Perception & Psychophysics

DOI

10.3758/s13414-024-02853-2 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Pupillary correlates of individual differences in n-back task performance

 

Treatment from female doctors leads to lower mortality and hospital readmission rates

UNIVERSITY OF CALIFORNIA - LOS ANGELES HEALTH SCIENCES

Patients have lower rates of mortality and hospital readmissions when treated by female physicians, with female patients benefitting more than their male counterparts, new research suggests.

The mortality rate for female patients was 8.15% when treated by female physicians vs. 8.38% when the physician was male—a clinically significant difference, the researchers found. While the difference for male patients was smaller, female physicians still had the edge with a 10.15% mortality rate compared with male doctors’ 10.23% rate.

The researchers found the same pattern for hospital readmission rates.

The study is published in the peer-reviewed journal Annals of Internal Medicine.

Patient outcomes should not differ between male and female physicians if they practice medicine the same way, said Dr. Yusuke Tsugawa, associate professor-in-residence of medicine in the division of general internal medicine and health services research at the David Geffen School of  Medicine at UCLA  and the study’s senior author.

“What our findings indicate is that female and male physicians practice medicine differently, and these differences have a meaningful impact on patients' health outcomes,” Tsugawa said. “Further research on the underlying mechanisms linking physician gender with patient outcomes, and why the benefit of receiving the treatment from female physicians is larger for female patients, has the potential to improve patient outcomes across the board.”

The researchers examined Medicare claims data from 2016 to 2019 for about 458,100 female and nearly 319,800 male patients. Of those, 142,500 and 97,500, or roughly 31% for both, were treated by female doctors. The primary outcomes were 30-day mortality from the date of hospital admission and 30-day readmission from the date of discharge.

There may be several factors driving these differences, the researchers write. They suggest that male doctors might underestimate the severity of their female patients’ illness – prior research has noted that male doctors underestimate their female patients’ pain levels, gastrointestinal and cardiovascular symptoms, and stroke risk, which could lead to delayed or incomplete care. Also, female doctors may communicate better with their female patients, making it likelier that these patients provide important information leading to better diagnoses and treatment. Finally, female patients may be more comfortable with receiving sensitive examinations and engaging in detailed conversations with female physicians.

But more research is needed into how and why male and female physicians practice medicine differently and its impact on patient care, Tsugawa said. “A better understanding of this topic could lead to the development of interventions that effectively improve patient care,” he said.

In addition, gender gaps in physician pay should be eliminated, he said. “It is important to note that female physicians provide high-quality care, and therefore, having more female physicians benefits patients from a societal point-of-view,” Tsugawa said.

Study co-authors are Dr. Atsushi Miyawaki of the University of Tokyo, Dr. Anupam Jena of Harvard University, and Dr. Lisa Rotenstein of UC San Francisco.

The study was funded by GRoW @ Annenberg.

Article: 10.7326/M23-3163

 

---

JOURNAL

Annals of Internal Medicine

DOI

10.7326/M23-3163 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Comparison of Hospital Mortality and Readmission Rates by Physician and Patient Sex

ARTICLE PUBLICATION DATE

22-Apr-2024

Historically redlined areas see more modern-day gun violence

New research from Boston Children’s Hospital suggests that areas of U.S. cities graded as “hazardous” in the 1930s are nearly six times more likely to have non-suicide firearm fatalities today

BOSTON CHILDREN'S HOSPITAL

In the 1930s, the United States government introduced redlining, a discriminatory practice that categorized neighborhoods based on people’s race or ethnicity and denied financial services to residents in certain areas—redlining disproportionately affected marginalized communities. While redlining was officially outlawed in 1968, new research from Boston Children’s Hospital suggests a relationship between historic redlining and present-day gun violence. 

“We found a significant, dose-dependent correlation between discriminatory designations from the 1930s and the incidence of non-suicide firearm fatalities from 2014-2022. Of note, in areas designated ‘hazardous' 80 years ago, non-suicide firearm fatalities are nearly six times more likely to occur today than in areas designated ‘best,’” said Dr. Eric Fleegler, a pediatric emergency physician and senior author of the paper.

The findings, published online in the Annals of Internal Medicine at 5pm ET on April 22, speak to the lasting detrimental impact of redlining on firearm fatalities today.

The researchers used data from 202 cities across 38 states for nearly 9,000 different areas graded by the Home Owners’ Loan Corporation on a scale from A to D, with A being “best” and D being “hazardous”. They found that 76% of the cities they examined had a higher rate of non-suicide firearm fatalities in D areas compared to A regions. Additionally, the team discovered that there are more than six times the rate of non-suicide firearm fatalities in D areas compared to A regions. 

Despite accounting for other factors associated with firearm fatalities, such as poverty, firearm prevalence, and legislation, the researchers found that the relationship between redlining designation and fatalities today persists. This suggests that there might be other consequences of redlining that impact non-suicide firearm fatalities.

“Firearm fatalities are a leading cause of mortality in the United States, and the epidemic of gun violence continues to affect marginalized communities disproportionately. Our findings warrant further research on and investment in nuanced solutions to the detrimental impacts of historical redlining,” said Dr. Ayesha Dholakia, Chief Resident in Pediatrics at Boston Children’s Hospital  and Boston Medical Center and first author of the paper.

---

JOURNAL

Annals of Internal Medicine

DOI

10.7326/M23-2496 

ARTICLE TITLE

Historical Redlining and Present-Day Firearm Fatalities: a Retrospective Analysis

ARTICLE PUBLICATION DATE

22-Apr-2024

 

Significant global variation in national COVID-19 treatment guidelines

Most countries recommend at least one treatment that definitely doesn’t work. Greatest divergence from gold standard recommendations in under-resourced countries

BMJ

National clinical guidelines for the treatment of COVID-19 vary significantly around the world, with under-resourced countries the most likely to diverge from gold standard (World Health Organization; WHO) treatment recommendations, finds a comparative analysis published in the open access journal BMJ Global Health.

 

And nearly every national guideline recommends at least one treatment proven not to work, the analysis shows.

Significant variations in national COVID-19 treatment recommendations have been suspected since the advent of the pandemic, but these haven’t been formally quantified or studied in depth, note the researchers. 

And despite the fact that COVID-19 is no longer taking the toll on lives and health that it once did, the virus is still evolving and active around the globe, they emphasise. The WHO only rescinded COVID-19’s status as a public health emergency in April 2023.

To assess how well national clinical practice followed the recommendations of the WHO (11th version; July 2022)—regarded as the gold standard—-for the treatment of COVID-19, the researchers analysed the content of all 194 WHO member states’ most recent national guidelines at the end of 2022. 

Each set of guidelines was scored according to how closely they aligned with the WHO recommendations. Extra points were awarded for those that had been updated within the preceding 6 months; those that made recommendations in line with the strength of evidence; and those that included assessments of the effectiveness of treatments and their side effects.

The wealth and resources of each country were then compared using per capita World Bank gross domestic product (GDP) in US dollars for 2021, the Human Development Index  2021, and the Global Health Security Index 2021.

Of the 194 countries contacted, 72 didn’t respond. Of the remaining 122, 9 had no formal guidelines or couldn’t be accessed (1) and a further 4 didn’t recommend any treatments, so these were excluded, leaving a total of 109.

The countries for which guidelines weren’t obtained had, on average, smaller populations, lower GDP per head, and a lower Global Health Security Index, indicative of greater economic challenges and less ability to respond to health emergencies.

The 11th iteration of the WHO guidelines categorises disease severity, but most of the reviewed guidelines (84%; 92) didn’t define COVID-19 severity in the same way, and some didn’t define severity at all (6.5%; 7). Only 10 guidelines (9%) used disease severity definitions that were comparable with those of the WHO.

Most (77%; 84) guidelines didn’t include an assessment of the strength or certainty of the therapeutic recommendation. And the range of recommended drugs, irrespective of severity, varied from 1 to 22. The WHO guidelines recommend a total of 10.

In all, 105 guidelines included at least one treatment recommended by the WHO, but 4 didn’t recommend any.  Countries in the African region had a significantly lower proportion of therapies recommended by the WHO, compared with countries in Europe and SouthEast Asia.

The most commonly recommended drugs were corticosteroids (92%;100), with 80% (88) of guidelines recommending them for the same disease severity as the WHO. But corticosteroids weren’t recommended in severe disease in nearly 1 in 10 guidelines despite overwhelming evidence of their benefit.

Remdesivir was recommended for severe or critical disease in half the guidelines (51%;72). But the WHO guidelines only indicate remdesivir conditionally for mild disease in patients at highest risk of hospital admission.

In late 2022, many guidelines continued to recommend treatments that the WHO had advised against, including chloroquine, lopinavir–ritonavir, azithromycin; vitamins and/or zinc.

One in three guidelines (36; 33%) recommended at least one neutralising monoclonal antibody directed against SARS-CoV-2, the virus responsible for COVID-19.These guidelines were issued by wealthier countries.

But 2 of these monoclonal antibodies—bamlanivimab plus or minus etesivamab and regdanivimab—appeared consistently in clinical guidelines, despite not being recommended by the WHO. 

Doses of the most commonly recommended drugs also varied. And many guidelines hadn’t been updated for more than 6 months.

Guidelines from under-resourced countries diverged the most from the WHO recommendations, when stratified by annual GDP, the Human Development Index, and the Global Health Security Index.

The researchers acknowledge several limitations to their findings, including the scoring used to assess the guidelines, which hasn’t been validated by other studies, and the inability to assess all national guidelines.

But they nevertheless ask: “Why do [national guidelines] differ so much in their treatment guidance for such a widespread and potentially serious infection when all have access to the same information? 

“Apart from the prohibitive cost of some medications for low-resource settings we do not have a satisfactory explanation.” 

They offer some possible explanations, including variations in how the severity of, and therefore the most appropriate treatment for, COVID-19 is defined; the evolution of the evidence; and the research chaos and confusion of the early stages of the pandemic, leading to claims and counterclaims, compounded by intense political and media interest.

 “In this ‘fog of war’ countries clearly felt the need to say something and do something, even if it was based on very little evidence,” explain the researchers. “But why many of these unproven remedies continued to be recommended as evidence of their ineffectiveness accrued is much less clear,” they add.

“There is clearly more variation in national guidelines for COVID-19 therapeutics than there should be to ensure optimum treatment,” which aren’t justified by significant differences between populations or geographic variation in SARS-CoV-2 antiviral susceptibility, they write.

Global health inequalities clearly have a part to play, leading to the recommendation of ineffective, unaffordable and unavailable therapies, they suggest.

“The formalisation of processes in the development of [national guidelines] for COVID-19 and other infectious diseases is essential for ensuring that these guidelines are grounded in the best available evidence,” they conclude. 

“A systematic and structured approach would not only enhance the credibility of the guidelines but could also contribute to their effectiveness in guiding public health interventions, especially in a pandemic setting.”

---

JOURNAL

BMJ Global Health

DOI

10.1136/bmjgh-2023-014188 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Comparison of WHO versus national COVID-19 therapeutic guidelines across the world: not exactly a perfect match

ARTICLE PUBLICATION DATE

22-Apr-2024

 

Cost increasingly important motive for quitting smoking for 1 in 4 adults in England

Making much more of potential savings might encourage more people to stub out for good

BMJ

Health concerns are still the primary motive for more than half of those who say they want to stop smoking in England, but cost is now a key factor for more than 1 in 4, finds an analysis of national survey responses, published in the open access journal BMJ Public Health.

Given this shift in thinking, making much more of the potential savings to be had might encourage more people to stub out for good, suggest the researchers.

Health concerns are generally the primary motive for people trying to stop smoking, with social and financial concerns, plus advice from a health professional, also commonly cited reasons, explain the researchers.

But since 2020, England has undergone a period of substantial societal instability, prompted primarily by the COVID-19 pandemic, which might have triggered changes in the reasons smokers give for wanting to ditch tobacco, they suggest.

To find out, the researchers looked at time trends in motives for trying to stop smoking between March 2018 and May 2023, exploring differences by age, sex, socioeconomic status, presence of children in the household and vaping status.

They drew on responses to the ongoing Smoking Toolkit Study, a monthly survey of a representative sample of around 1700 adults in England.

The responses were limited to those who were either current smokers or who had stopped smoking in the past year and had made at least one serious attempt to quit during that time.

Respondents were asked to name the reason(s) behind their most recent quit attempt from among: advice from a health professional; TV advert for a nicotine replacement product; government TV/radio/press advert; a new stop smoking treatment; cost; smoking restrictions; knowing someone else who was quitting; health warning on a cigarette packet; contact from a local NHS stop smoking service; current or future health problems; attending a local stop smoking activity or event; comments by family, friends, children; significant birthday; pregnancy; simple decision to quit; COVID-19 pandemic.

Out of the 101,919 survey respondents between 2018 and 2023, 17,812 reported smoking in the past year. Of these,17,031 (96%) provided data on quit attempts over the past 12 months, 5777 (34%) of whom reported having made at least one serious attempt to do so.

Health concerns were the most frequently cited motives, reported by more than half the sample (52%) across the entire period—especially concerns about future health, reported by more than 1 in 3 (35.5%) compared with 1 in 5 (19%) who were motivated by current health problems.

Cost was the next most frequently cited motive, reported by nearly 1 in 4 (23%), followed by social factors, reported by around 1 in 5 (19%) and advice from a health professional (12%). 

Around 4% said they were motivated by health warnings on a cigarette packet, while smoking restrictions prompted 3.5% to try and stop; a simple decision to quit was cited by just over 3%. The other reasons attracted only around 1% each.

Up to the start of 2020, 1 in 2 quit attempts was motivated by health concerns; 1 in 5 by current health problems (20%), and 1 in 3 by concerns about future health (34%). One in 5 was motivated by social factors (20%) and cost (20%), and 1 in 6 by health professional advice (16.5%).

While there was little overall change in the proportion of quit attempts motivated by health concerns across the entire study period, the proportion of quit attempts motivated by cost increased significantly, rising from just over 19% in March 2018 to just under 25.5% in May 2023.

But the proportion of quit attempts motivated by health professional advice fell significantly over the entire study period, dropping from just over 14% in March 2018 to 8.5% in May 2023.

The COVID-19 pandemic, which began to affect England in March 2020, is likely to have influenced the proportion of respondents reporting health concerns, social factors, and cost as motives for trying to stop smoking, suggest the researchers. 

The proportion of quit attempts motivated by future health concerns increased during 2020 and 2021.“It is likely the pandemic made health concerns (an already prevalent motive) even more salient, particularly during its first year when the virus was spreading rapidly and vaccinations were not yet available,” they write. 

Once the immediate threat of the virus had subsided thanks to the vaccination programme, the proportion of health-related attempts to quit returned to pre-pandemic levels.

The pandemic probably influenced other motives, suggest the researchers, because it prompted loss of income and jobs for many people.

“These economic pressures probably contributed to the rise in cost-motivated attempts to quit around this time. But while the pandemic’s acute risks to health—and, as a result, attempts to quit motivated by concern for health or social factors—waned over time, its economic impacts have been compounded by a cost-of- living crisis,” they explain.

The pandemic’s impact on access to, and availability of, healthcare services may also have contributed to the decline in the proportion of respondents citing healthcare professional advice as a motivating factor, they add.

The researchers acknowledge various caveats to their findings, including that all the study data were self-reported and relied on personal recall, and may not apply to other countries with different attitudes to smoking, tobacco control policies, and provision of smoking cessation services.

But they conclude: “These findings have implications for smoking cessation interventions and clinical practice. ..They indicate that cost is an increasingly important factor motivating people to try to stop smoking. 

“Communicating the potential savings people can make by stopping smoking (even if they switch to alternative nicotine products) could therefore be an effective means for motivating attempts to quit.” 

Notes for editors
Research: Trends in motives for trying to stop smoking: a population study in England, 2018–2023 Doi: 10.1136/bmjph-2023-000420
Journal: BMJ Public Health

External funding: Cancer Research UK

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

---

JOURNAL

BMJ Public Health

DOI

10.1136/bmjph-2023-000420 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Trends in motives for trying to stop smoking: a population study in England, 2018–2023

ARTICLE PUBLICATION DATE

22-Apr-2024

COI STATEMENT

JB has received unrestricted research funding from Pfizer and J&J, who manufacture smoking cessation medications. All authors declare no financial links with tobacco companies, e-cigarette manufacturers, or their representatives

 

Tropical fish are invading Australian ocean water

UNIVERSITY OF ADELAIDE

 

IMAGE: 

TROPICAL FISH

view more 

CREDIT: COURTESY OF UNIVERSITY OF ADELAIDE

A University of Adelaide study of shallow-water fish communities on rocky reefs in south-eastern Australia has found climate change is helping tropical fish species invade temperate Australian waters.

“The fish are travelling into these Australian ecosystems as larvae caught in the Eastern Australian Current, which is strengthening due to the warming climate,” said the University of Adelaide’s Professor Ivan Nagelkerken, Chief Investigator of the study.

“These larvae would not normally survive in the cooler Australian ocean water, but the warming Eastern Australian Current keeps the baby fish warm and increases their likelihood of survival.”

The novel populations of tropical fish in temperate ecosystems are not having much of an impact now, but may do in the future.

“Because water temperatures in temperate Australia are still a bit cool, these tropical fish do not grow to their maximum size and therefore are not fully competing with temperate Australian fish – yet,” says Professor David Booth of the University of Technology Sydney, a co-Chief Investigator of the study.

“However, under increasing future ocean warming these tropical fish will eventually grow to their full size, and their diets will start to overlap more and more with those of temperate fish.

“It is the expectation that these tropical fish will be permanently established in temperate Australia, where they will become serious competitors with the native temperate fish that have historically lived there.”

While the University of Adelaide study, led by PhD student Minami Sasaki, focused on fish communities off New South Wales, Professor Nagelkerken says similar changes in water temperature are also being seen in south-western Australia and overseas.

He says the fish migration observed in this study is “an ongoing process that has strengthened in the last few decades due to ocean warming”.

The broader impacts on the ecosystems these fish invade are not yet clear.

““Tropical herbivores overgraze temperate kelp, but for the tropical invertebrate eaters, we are not sure yet what it means for the ecosystem itself,” says Professor Nagelkerken.

An earlier study led by University of Adelaide PhD candidates Chloe Hayes and Angus Mitchell, and also involving Okinawa Institute of Science and Technology Graduate University and University of Technology Sydney, showed tropical generalists might fare better than the specialist temperate fish they’re muscling in on.

“We’ve seen that ocean warming physiologically benefits tropical generalists but disadvantages temperate specialists, which may mean the generalists will be more successful in the initial stages of climate change,” says Hayes.

“Generalist tropical species that are less fussed about what they eat or what habitats they use as shelter appear to be the most successful tropical invaders.”

“This could make survival difficult for Australian fish that are native to these rapidly warming temperate environments,” Professor Nagelkerken says.

---

JOURNAL

Journal of Animal Ecology

DOI

10.1111/1365-2656.14079 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Body size mediates trophic interaction strength of novel fish assemblages under climate change

ARTICLE PUBLICATION DATE

21-Apr-2024

 

No bull: How creating less-gassy cows could help fight climate change

A new study has revealed breeding less-flatulent cows and restoring agricultural land could significantly reduce rising methane emission levels, which play a considerable role in climate change.

CURTIN UNIVERSITY

A Curtin University study has revealed breeding less-flatulent cows and restoring agricultural land could significantly reduce rising methane emission levels, which play a considerable role in climate change.

 

The food system, including grazing animals such as cows, generates major sources of methane mainly due to cattle digestion, manure decomposition and land use for grazing.

 

To look for solutions, researchers from the Curtin University Sustainability Policy Institute analysed 27 academic publications and identified dozens of potential strategies to reduce methane emissions from Australia’s beef and dairy sectors.

 

Study lead Merideth Kelliher said the fastest way to lower methane emissions would be to convert farmland into wetlands and forests, however there was a lot of scope for improvement by altering the operations of the dairy and beef sectors.

 

“For example, changing what breeding objectives include can permanently reduce methane production,” Ms Kelliher said.

 

“Studies have found low emission cattle have inheritable genetic traits which can significantly reduce methane production if included in national breeding objectives.

 

“While more research is needed to identify the best traits for low emission cows, consideration should also be given to land use emissions and identifying suitable agricultural land for restoration to natural habitat.”

 

Other strategies to emerge from the study include finding ways for cows to reach maturity faster, improving wastewater management at beef processing plants and providing ozonated water (water treated with ozone gas to remove impurities), feeding cattle more grains than grass and adding certain legumes, seaweeds or other compounds to cattle feed.

 

Co-author and Curtin Professor of Sustainability Dora Marinova said this was the first time such analysis had been conducted and was important given methane emissions are increasing along with global demand for beef and dairy products.

 

“As the world’s second biggest beef exporter, Australia contributes to global methane levels significantly,” Professor Marinova said.

 

“Despite being a signatory of the Paris Agreement to reduce greenhouse emissions and a supporter of the Global Methane Pledge, Australia is yet to commit to methane reduction targets.

 

“Australia needs to explore ways to meet its objectives — this study outlines several potential strategies which are practical, cost-effective and scientifically supported to help inform local and international policy makers’ efforts to reduce the impact of climate change.”

 

Co-author and Curtin Research Fellow Dr Diana Bogueva said this scenario analysis is important also for consumers to better understand the environmental footprint of their food choices.

 

Meta-Analysis and Ranking of the Most Effective Methane Reduction Strategies for Australia’s Beef and Dairy Sector was published in Climate.

---

JOURNAL

Climate

DOI

10.3390/cli12040050 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Meta-Analysis and Ranking of the Most Effective Methane Reduction Strategies for Australia’s Beef and Dairy Sector

 

SharpeRatio@k: novel metric for evaluation of risk-return tradeoff in off-policy evaluation

TOKYO INSTITUTE OF TECHNOLOGY

 

IMAGE: 

SHARPERATIO@K, A NOVEL EVALUATION METRIC FOR OFF-POLICY EVALUATION ESTIMATORS, EFFECTIVELY MEASURES THE RISK-RETURN TRADEOFF OF EVALUATING POLICIES USED IN REINFORCEMENT LEARNING AND CONTEXTUAL BANDITS, WHICH ARE TYPICALLY IGNORED BY CONVENTIONAL METRICS, SHOW SCIENTISTS AT TOKYO TECH. THIS NOVEL METRIC, INSPIRED FROM RISK ASSESSMENT IN FINANCIAL PORTFOLIO MANAGEMENT, PROVIDES A MORE INSIGHTFUL EVALUATION OF OPE, PAVING THE WAY FOR IMPROVED POLICY SELECTION.

view more 

CREDIT: TOKYO INSTITUTE OF TECHNOLOGY

Reinforcement learning (RL) is a machine learning technique that trains software by mimicking the trial-and-error learning process of humans. It has demonstrated considerable success in many areas that involve sequential decision-making. However, training RL models with real-world online tests is often undesirable as it can be risky, time-consuming and, importantly, unethical. Thus, using offline datasets that are naturally collected through past operations is becoming increasingly popular for training and evaluating RL and bandit policies.

In particular, in practical applications, the Off-Policy Evaluation (OPE) method is used to first filter the most promising candidate policies, called “top-k policies,” from an offline logged dataset, and then use more reliable real-world tests, called online A/B tests, to choose the final policy. To evaluate the effectiveness of different OPE estimators, researchers have primarily focused on metrics such as the mean-squared error (MSE), RankCorr and Regret. However, these methods solely focus on the accuracy of OPE methods while failing to evaluate the risk-return tradeoff during online policy deployment. Specifically, MSE and RankCorr fail to differentiate whether near-optimal policies are underestimated or poor-performing policies are overestimated, while Regret focuses only on the best policy and overlooks the possibility of harming the system due to sub-optimal policies in online A/B tests.

Addressing this issue, a team of researchers from Japan, led by Professor Kazuhide Nakata from Tokyo Institute of Technology, developed a new evaluation metric for OPE estimators. “Risk-return measurement is crucial in ensuring safety in risk-sensitive scenarios such as finance. Inspired by the design principle of the financial risk assessment metric, Sharpe ratio, we developed SharpeRatio@k, which measures both potential risk and return in top-k policy selection,” explains Prof. Nakata. The study was published in the Proceedings of the ICLR 2024 Conference.

SharpeRatio@k treats the top-k policies selected by an OPE estimator as a policy portfolio, similar to financial portfolios, and measures the risk, return and efficiency of the estimator based on the statistics of the portfolio. In this method, a policy portfolio is considered efficient when it contains policies that greatly improve performance (high return) without including poorly performing policies that negatively affect learning in online A/B tests (low risk).  This method maximises return and minimises risk, thereby identifying the safest and most efficient estimator.

The researchers demonstrated the capabilities of this novel metric through example scenarios and benchmark tests and compared it with existing metrics.  Testing revealed that SharpeRatio@k effectively measures the risk, return and overall efficiency of different estimators under varying online evaluation budgets, while existing metrics fail to do so. Additionally, it also addresses the overestimation and underestimation of policies. Interestingly, they also found that while in some scenarios it aligns with existing metrics, a better value of these metrics does not always result in a better SharpeRatio@k value.

Through these benchmarks, the researchers also suggested several future research directions for OPE estimators, including the need to use SharpeRatio@k for efficiency assessment of OPE estimators and the need for new estimators and estimator selection methods that account for risk-return tradeoffs. Furthermore, they also implemented their innovative metric in an open-source software for a quick, accurate and insightful evaluation of OPE.

Highlighting the importance of the study, Prof. Nakata concludes, “Our study shows that SharpreRatio@k can identify the appropriate estimator to use in terms of its efficiency under different behaviour policies, providing useful insight for a more appropriate estimator evaluation and selection in both research and practice.”

Overall, this study enhances policy selection through OPE, paving the way for improved reinforcement learning.

###

Related link:

SCOPE-RL document

SCOPE-RL open link

###

About Tokyo Institute of Technology

Tokyo Tech stands at the forefront of research and higher education as the leading university for science and technology in Japan. Tokyo Tech researchers excel in fields ranging from materials science to biology, computer science, and physics. Founded in 1881, Tokyo Tech hosts over 10,000 undergraduate and graduate students per year, who develop into scientific leaders and some of the most sought-after engineers in industry. Embodying the Japanese philosophy of “monotsukuri,” meaning “technical ingenuity and innovation,” the Tokyo Tech community strives to contribute to society through high-impact research.

https://www.titech.ac.jp/english/

---

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Towards Assessing and Benchmarking Risk-Return Tradeoff of Off-Policy Evaluation