WAIT, WHAT?!

COVID-19 pandemic alters view that doctors are obligated to provide care

Previous infectious disease outbreaks such as HIV and SARS showed little impact on how doctors approached their obligation to treat patients

DUKE UNIVERSITY MEDICAL CENTER

DURHAM, N.C. – The unique circumstances arising from the COVID-19 pandemic altered a long-held convention that doctors provide care regardless of personal risk.

In a study assessing doctors’ tolerance for refusing care to COVID-19 patients, Duke Health researchers identified a growing acceptance to withhold care because of safety concerns. 

“All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients,” said the study’s lead author, Braylee Grisel, a fourth-year student at Duke University School of Medicine. 

“We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks,” Grisel said. 

Publishing April 24, in the journal Clinical Infectious Diseases, the researchers analyzed 187 published studies culled from thousands of sources, including academic papers, opinion pieces, policy statements, legal briefings and news stories. Those selected for review met criteria for addressing the ethical dilemma posed by treating a novel infectious disease outbreak over the past 40 years.

Most articles -- about 75% -- advocated for the obligation to treat. But COVID-19 had the highest number of papers suggesting it was ethically acceptable to refuse care, at 60%, while HIV had the least number endorsing refusal of care at 13.3%.

The trendline stayed relatively stable across outbreaks occurring from the 1980s until the COVID-19 pandemic hit – with just 9% to 16% of articles arguing that refusing care was acceptable.

What changed with COVID? The authors found that labor rights and workers' protections were the chief reasons cited in 40% of articles during COVID, compared with only about 17%-19% for other diseases. Labor rights were cited the least often for HIV care, at 6.2%.

Another significant issue cited during the COVID pandemic was the risk of infection posed to doctors and their families, with nearly 27% of papers discussing this risk, compared to 8.3% with influenza and 6.3% for SARS. 

“Some of these results may be because we had the unique opportunity to evaluate changing ethics while the pandemic was actively ongoing, as COVID-19 was the first modern outbreak to put a significant number of frontline providers at personal risk in the United States due to its respiratory transmission,” said senior author Krista Haines, D.O., assistant professor in the departments of Surgery and Population Health Sciences at Duke University School of Medicine. 

The authors noted that the COVID pandemic had several unique characteristics that collectively altered the social contract between doctors and patients, potentially driving changes in treatment expectations. Such factors included:

•    Shortages of resources available to care teams, including personal protective gear, hospital rooms, respirators, treatments and vaccines;
•    Polarizing misinformation about vaccines, effective treatments and how the virus spread;
•    Increased rates of reported mistreatment against staff from patients and their family members.

The authors note the ongoing debate over whether vaccination status should be considered in the decision to treat a patient.

“There was a great deal of discussion among frontline providers and ethicists on how best to allocate scarce resources,” the authors wrote. “Patients who refused vaccination were at a higher risk of complications while also putting other patients and providers at risk. Arguments were made based on reciprocity, medical triage, and personal responsibility to exclude patients who refused vaccines from consideration when ventilators and other resources were limited.”

Grisel said the study’s finding provides insight regarding how care should be provided in future pandemics. What had been a fairly solid expectation that physicians were obligated to provide care despite the risks to themselves now appears to have softened. It is unclear how these results may change in the future when the pandemic is less of an active threat.  

“This study really shows how outside pressures in the sociopolitical sphere influence and affect doctors and care providers,” Grisel said. “In future pandemics, we may need to become more aware of how the risks and outside pressures of an active pandemic influence willingness to provide care. Health care systems can learn how to mitigate these influences to ensure that hospitals are adequately staffed to meet patient needs.”

In addition to Grisel and Haines, study authors include Kavneet Kaur, Sonal Swain, Laura Gorenshtein, Chinecherem Chime, Ellen O’Callaghan, Avani Vasireddy, Lauren Moore, Christina Shin, Michelle Won, Santita Ebangwese, Todd Tripoli, Stephanie Lumpkin, Zachary Ginsberg, Sarah Cantrell, Jennifer Freeman and Suresh Agarwal.

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JOURNAL

Clinical Infectious Diseases

 

Shoreline model predicts long-term future of storm protection and sea-level rise

Climate change pits humans vs. seas on barrier islands

DUKE UNIVERSITY

 

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NORTH END OF THE VILLAGE OF RODANTHE ON NC OUTER BANKS, WHERE LONG-TERM EROSION HAS RESULTED IN HOUSES STANDING ON THE BEACH, WITH ONLY A SLENDER DUNE SEPARATING NC HIGHWAY 12 FROM THE OCEAN.

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CREDIT: KATHERINE ANARDE

DURHAM, NC – Researchers in North Carolina have created a simulation model to analyze how coastal management activities meant to protect barrier islands from sea-level rise can disrupt the natural processes that are keeping barrier islands above water.

“Coastal management strategies intended to protect people, property and infrastructure from storm impacts can, over decades, increase vulnerability, even leading to the loss of barrier islands, especially as sea-level rise rates increase,” said A. Brad Murray, professor of geomorphology and coastal processes at Duke University’s Nicholas School of the Environment.

He and other researchers in North Carolina created a computer model that simulates dynamics of barrier island systems over the next two centuries, showing how natural processes that create and maintain these systems affect communities and infrastructure, and how human efforts to protect communities and infrastructure, in turn, affect those natural processes. They published a pair of studies on the work April 9, 2024 in Earth Futures.

Barrier islands are narrow offshore landforms that run parallel to the mainland coastline. These are dynamic features, naturally gaining elevation and migrating landward as sea level rises or sediment supply dwindles. Barrier islands absorb wave energy before waves hit the mainland, which can lessen coastal storm surge and flooding. The United States has the greatest extent of barriers worldwide, stretching across much of the Southeast and Gulf of Mexico.

Coastal communities on barrier islands, which have long grappled with eroding shorelines and coastal storms, now face substantial sea-level rise due to climate change. They are already encountering increased risks of coastal flooding and threats to critical infrastructure.

Many of these coastal communities rely on federally subsidized “beach nourishment” — the artificial widening of beaches with sand — or engineered solutions, such as the construction of artificially high dunes, to adapt to changing climate threats.

Some of these solutions, however, interrupt natural processes that have kept barriers above sea level.

Sand deposited on these islands when storm waves knock down dunes is essential to maintain barriers’ width and elevation. But on developed barriers, storm fallout — including overwashed sand on roads — are hazards.

“Counterintuitively, the more successful humans are in preventing storm impacts, the less resilient the barrier system becomes in the long term,” said co-author, Laura Moore, professor of coastal geomorphology at the University of North Carolina at Chapel Hill. “Difficult tradeoffs are going to be inevitable when it comes to managing the coast with the hope of preserving coastal living as we know it.”

The researchers’ modelling demonstrates that how long a barrier remains habitable varies with different coastal management strategies and climate scenarios.

For example, the model showed that shifting away from the practices of protecting roads with tall dunes and bulldozing overwashed sand off paved surfaces may allow barriers that would have become uninhabitable to rebound and keep up with sea level rise longer.

Adopting management strategies that allow one segment of the shoreline to evolve naturally — such as building a long bridge to replace part of a highway — can increase the barrier system’s resilience in that area. However, management strategies in one area affect erosion rates in adjacent areas.

Increasing long-term resilience in one area can come at the cost of higher shoreline stabilization costs for neighboring communities. Given these connections along the shore, stakeholders in neighboring coastal areas may benefit from collaborating, the authors noted.

“There’s no perfect solution,” said the study’s lead author, Katherine Anarde, assistant professor of coastal engineering at North Carolina State University. “Understanding an entire barrier system and how it responds to different coastal management decisions is critical to assessing the sustainability of coastal development over the coming decades.  The model helps us consider several factors in managing coastal areas to ensure we’re not unintentionally making things worse in the long run, and to weigh the tradeoffs.”

The National Science Foundation, University of Virginia, and the Gulf Research Program Early-Career Research Fellowship co-funded this study.

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JOURNAL

Earth s Future

DOI

10.1029/2023EF003672 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

The Future of Developed Barrier Systems: 1. Pathways Toward Uninhabitability, Drowning, and Rebound

 

Key to making robots social: Human interaction, not design

CORNELL UNIVERSITY

ITHACA, N.Y. – Researchers who develop social robots – ones that people interact with – focus too much on design features and not enough on sociological factors, according to Cornell and Indiana University scholars.

“If we want to understand what makes a robot social, we have to look at the broader scope of the communities around robots and people’s interactions with each other,” said Malte Jung, co-author and associate professor of information science at Cornell. “Sociality is constructed through interactions people have with each other around the machine. It’s not just about programming a better character for the robot, making it respond better to human social features, making it look cuter or behaving more naturally.”

The research was based on field work by Waki Kamino, a doctoral student in the field of information science and the paper’s lead author, who spent months immersed in Tokyo’s robot-friendly culture.

Her work informed one of the paper’s primary findings: In Japan, manufacturers and robot owners together helped establish new norms for robots as social agents. Companies incorporated familiar designs into their robots and brought owners together by hosting sponsored events, while owners made their robots part of everyday interactions with friends and met up regularly in public spaces, robots in tow.

The research team calls on the field of human-robot interaction (HRI) to consider a broader sociological view when designing and building robot companions.

“Traditionally, HRI research has always looked at just this one interaction between one person and one robot,” Jung said. “We really have to look at the broader scope of the communities around people's interactions with each other and take all of this into consideration.”

“Waki’s research shows that using robots doesn’t mean you’re isolating yourself with the robot,” said Selma Šabanović, professor at Indiana University and a paper co-author. “Interacting with robots is actually a social practice that you do together with others.”

For additional information, see this Cornell Chronicle story. 

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DOI

10.1145/3610977.3634994 

Advancing the safety of AI-driven machinery requires closer collaboration with humans

TAMPERE UNIVERSITY

An ongoing research project at Tampere University aims to create adaptable safety systems for highly automated off-road mobile machinery to meet industry needs. Research has revealed critical gaps in compliance with legislation related to public safety when using mobile working machines controlled by artificial intelligence.

As the adoption of highly automated off-road machinery increases, so does the need for robust safety measures. Conventional safety processes often fail to consider the health and safety risks posed by systems controlled by artificial intelligence (AI).

Marea de Koning, a doctoral researcher specialising in automation at Tampere University, conducts research with the aim of ensuring public safety without compromising technological advancements by developing a safety framework specifically tailored for autonomous mobile machines operating in collaboration with humans. This framework intents to enable original equipment manufacturers (OEM), safety & system engineers, and industry stakeholders to create safety systems that comply with evolving legislation.

Balance between humans and autonomous machines

Anticipating all the possible ways a hazard can emerge and ensuring that the AI can safely manage hazardous scenarios is practically impossible. We need to adjust our approach to safety to focus more on finding ways to successfully manage unforeseen events.

We need robust risk management systems, often incorporating a human-in-the-loop safety option. Here a human supervisor is expected to intervene when necessary. But in autonomous machinery, relying on human intervention is impractical. According to de Koning, there can be measurable degradations in human performance when automation is used due to, for example, boredom, confusion, cognitive capacities, loss of situational awareness, and automation bias. These factors significantly impact safety, and a machine must become capable of safely managing its own behaviour.

“My approach considers hazards with AI-driven decision-making, risk assessment, and adaptability to unforeseen scenarios. I think it is important to actively engage with industry partners to ensure real-world applicability. By collaborating with manufacturers, it is possible to bridge the gap between theoretical frameworks and practical implementation,” she says.

The framework intents to support OEMs in designing and developing compliant safety systems and ensure that their products adhere to evolving regulations.

Integrating framework to existing machinery

Marea de Koning started her research in November 2020 and will finish it by November 2024. The project is funded partly by the Doctoral School of Industry Innovations and partly by a Finnish system supplier.

De Koning’s next research project, starting in April, will focus on integrating a subset of her safety framework and rigorously testing its effectiveness. Regulation 2023/1230 replaces Directive 2006/42/ec as of January 2027, significantly challenging OEMs.

“I’m doing everything I can to ensure that safety remains at the forefront of technological advancements,” she concludes.

The research provides valuable insights for policymakers, engineers and safety professionals. The article presenting the findings titled A Comprehensive Approach to Safety for Highly Automated Off-Road Machinery under Regulation 2023/1230 was published in the prestigious Journal of Safety Science.

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JOURNAL

Safety Science

DOI

10.1016/j.ssci.2024.106517 

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

A comprehensive approach to safety for highly automated off-road machinery under Regulation 2023/1230

SwRI’s Dr. Marc Janssens recognized for role in establishing cone calorimeter fire testing

The National Fire Protection Association® selected fire testing device for 2024 Philip J. DiNenno Prize

Grant and Award Announcement

SOUTHWEST RESEARCH INSTITUTE

 

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SWRI INSTITUTE ENGINEER DR. MARC JANSSENS WAS NAMED “DINENNO PRIZE LAUREATE” FOR HIS ROLE IN THE DEVELOPMENT AND DEPLOYMENT OF THE CONE CALORIMETER IN FIRE RESEARCH SINCE THE MID-1980S. JANSSENS IS PICTURED IN FRONT OF THE GROUNDBREAKING DEVICE THAT EXPOSES A SMALL SAMPLE TO CONTROLLED RADIANT HEAT AND IS USED TO MEASURE HEAT RELEASE AND OTHER FLAMMABILITY CHARACTERISTICS OF VARIOUS MATERIALS.

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CREDIT: SOUTHWEST RESEARCH INSTITUTE

SAN ANTONIO — April 24, 2024 — Southwest Research Institute’s Dr. Marc Janssens was named a “DiNenno Prize Laureate” for his role in the widespread adoption of the cone calorimeter, a fire-testing tool that accurately measures heat release and material flammability. The National Fire Protection Association® recognized the cone calorimeter with the 2024 Philip J. DiNenno Prize for its lasting impact on fire safety. Dr. Vytenis Babrauskas, a co-recipient of the prize, developed the cone calorimeter in the early 1980s.

“It is an immense honor and a shock to be recognized after so many years,” said Janssens, an SwRI Institute engineer who built the first cone calorimeter apparatus outside of the United States at Ghent University in Belgium. Janssens was instrumental in the development, deployment and standardization of the fire test worldwide.

At Ghent, Janssens chaired an ISO working group that surveyed numerous devices and fire-testing methods. Under Janssens’s leadership, the group concluded the cone calorimeter had the unique ability to accurately measure heat release of a small sample of various materials under a wide range of thermal exposure conditions. The team chose to develop the cone calorimeter as the international standard.

“The cone calorimeter has made a difference. It has improved fire safety by supporting the adoption of performance-based fire engineering to design buildings and transportation vehicles around the world,” Janssens said. “It has also led to the development of safer building materials, furnishings and contents.”

Janssens joined Southwest Research Institute in 1996. His early work at the Institute included developing test criteria to evaluate materials used in high-speed ferries for the U.S. Coast Guard.

“Dr. Janssens is recognized as one of the top 10 fire testing experts in the world,” said Dr. Matthew Blais, director of SwRI’s Fire Technology Department. “It is a well-deserved recognition and award that highlights the quality of the work done at the Institute’s Fire Technology Department. Marc is an asset who will help train the next generation of fire scientists and engineers.”

In a career that spans more than four decades, Janssens has evaluated the fire properties of materials used in automobiles and supported fire investigators by improving the accuracy of estimated burn rates of upholstered furniture. He also tested the fire performance of cables, liquid fuels and other combustible materials to ensure fire safety at nuclear power plants.

Janssens is a fellow of the Society of Fire Protection Engineers and authored several chapters in the Society’s handbook on fire protection engineering. He’s also co-authored more than 160 technical publications. He is associate editor of the international journal “Fire and Materials” and serves on the editorial advisory board of the “Journal of Fire Sciences.”

The National Fire Protection Association® will honor Janssens and Babrauskas at the NFPA Conference & Expo® in Orlando June 16.

For more information, visit https://www.swri.org/industries/fire-testing.

Using four inches by four-inch sample, the cone calorimeter can obtain data to determine a material will behave in a real-world fire. The National Fire Protection Association® selected the fire test for the 2024 Philip J. DiNenno Prize.

CREDIT

Southwest Research Institute

 

How evolution has optimized the magnetic sensor in birds

Genetic study supports theory that proteins in the eye are responsible for magnetoreception

UNIVERSITY OF OLDENBURG

 

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THE YELLOW-BELLIED FLYCATCHER (EMPIDONAX FLAVIVENTRIS) IS A SMALL INSECTIVORE OF THE TYRANT FLYCATCHER FAMILY THAT CANNOT PRODUCE THE PROTEIN CRYPTOCHROME 4. THE BIRDS BREED IN NORTH AMERICA AND MIGRATE TO SOUTHERN MEXICO AND CENTRAL AMERICA IN WINTER.

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CREDIT: CORINNA LANGEBRAKE

Migratory birds are able to navigate and orientate with astonishing accuracy using various mechanisms including a magnetic compass. A team led by biologists Dr Corinna Langebrake and Prof. Dr. Miriam Liedvogel from the University of Oldenburg (Germany) and the Institute of Avian Research “Vogelwarte Helgoland” in Wilhelmshaven (Germany) has now compared the genomes of several hundred bird species and found further evidence that a specific protein in the birds’ eyes is the magnetoreceptor which underlies this process. The researchers found that there have been significant evolutionary changes in the gene that encodes the protein cryptochrome 4, and that certain groups of birds have lost it entirely.

These findings are indicative of adaptation to varying environmental conditions and support the theory that cryptochrome 4 functions as a sensor protein, as the team reports in a newly published paper in the British Royal Society research journal Proceedings B.

The study was prompted by research at the Universities of Oldenburg and Oxford (UK) which has shown that magnetoreception is based on a complex quantum mechanical process that takes place in certain cells in the retinas of migratory birds. In a paper published in the science journal Nature in 2021, the German-British team presented findings according to which it was highly likely that cryptochrome 4 was the magnetoreceptor they had been looking for: first, they were able to prove that the protein is present in the birds’ retina, and second, both experiments with bacterially produced proteins and model calculations showed that cryptochrome 4 exhibits the suspected quantum effect in response to magnetic fields.

Robins posess proteins that are significantly more sensitive to magnetic fields than those in chickens

Interestingly, the research also demonstrated that these proteins are significantly more sensitive to magnetic fields in robins, which are migratory birds, than in chickens and pigeons, which are resident species. “Consequently, the reason why cryptochrome 4 is more sensitive in robins than in chickens and pigeons must be found in the protein’s DNA sequence," says Langebrake, who was the lead author. “The sequence was probably optimised by evolutionary processes in these nocturnal migratory birds,” she adds.

In the current study, the team led by Langebrake and Liedvogel therefore investigated magnetoreception from an evolutionary perspective for the first time. The researchers analysed the cryptochrome 4 genes of 363 bird species ranging from the little spotted kiwi to the song sparrow. First, they compared the protein’s evolutionary rate with that of two related cryptochromes, and found that the gene sequences of the cryptochromes used for comparison were very similar across all bird species: They appear to have changed very little over the course of evolution. This is most likely due to their key role in regulating the internal clock – a mechanism that is essential for all birds and in which modifications would have extremely negative effects.

Cryptochrome 4, by contrast, proved to have been highly variable. “This suggests that the protein is important for adaptation to specific environmental conditions,” explains Liedvogel, who is Professor of Ornithology at the University of Oldenburg and director of the Institute of Avian Research. The resulting specialisation could be magnetoreception. “A similar pattern has been observed in other sensory proteins such as light-sensitive pigments in the eye,” she explains.

The researchers then took a closer look at how the gene sequence for chryptochrome 4 has evolved in the evolutionary history of birds. The results led the scientists to conclude that in particular in the case of the passerine (Passeriformes) order the protein has been optimised through rapid selection. “Our results indicate that evolutionary processes could have led to cryptochrome 4 specialising as a magnetoreceptor in songbirds," says Langebrake.

Tyrants have lost the suspicious protein

Another interesting finding was that in three clades of tropical birds – parrots, hummingbirds and Tyranni (Suboscines), also known as tyrants – the information for cryptochrome 4 has been lost in the evolutionary process, meaning that these birds are unable to produce the protein. This indicates that it does not play a vital role in their survival. However, while parrots and hummingbirds are sedentary, some tyrants are long-distance migrants which, like small European songbirds, fly both during the day and at night. “The fact that, unlike robins, they do not have cryptochrome 4 makes them an ideal system for investigating various hypotheses about magnetoreception,” says Langebrake.

An interesting question here is: have the Tyranni developed a magnetic sense that works independently of cryptochrome 4? Or are they able to orientate themselves without a magnetic sense? Another possibility is that their magnetic sense has the same characteristics as that in robins, which is light-dependent and can be disrupted by radio waves, for example. “The first two scenarios would strongly corroborate the cryptochrome 4 hypothesis, while the third would pose a problem for the theory,” the biologist emphasises.

As a next step the research team is therefore planning to investigate magnetic orientation in Tyranni, and clarify whether or not they have a magnetic sense. “The Tyranni clade provides us with a natural tool for understanding the function of cryptochrome 4 and the importance of magnetoreception in migratory birds,” says Liedvogel, outlining a starting point for further research.

This genetic study is a result of the Collaborative Research Centre Magnetoreception and Navigation in Vertebrates: From Biophysics to Brain and Behaviour", which is headed by biologist Prof. Dr. Henrik Mouritsen from the University of Oldenburg and in which the Institute of Avian Research is also involved. Researchers from the Max Planck Institute for Evolutionary Biology in Plön also contributed to the current study.

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JOURNAL

Proceedings of the Royal Society B Biological Sciences

DOI

10.1098/rspb.2023.2308 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Adaptive evolution and loss of a putative magnetoreceptor in passerines

U$A

New survey from MSU and others finds positive perceptions of solar projects

MICHIGAN STATE UNIVERSITY

EAST LANSING, Mich. – As solar energy development accelerates, how do Americans actually feel about those large scale solar, or LSS, farms they see along the highway or near their neighborhood? A new survey has found that for residents living within three miles of a large-scale solar development, positive attitudes outnumbered negative attitudes by almost a 3-to-1 margin.

Researchers at Lawrence Berkeley National Laboratory, Michigan State University and the University of Michigan surveyed almost 1,000 residents living near solar projects — the first time a representative survey of this kind has been deployed nationally.

Among these respondents, 42% support additional development in their community, compared to 18% who would oppose further projects. At the same time, more than 80% of the respondents were unaware of the project prior to construction and a third did not know until completing the survey.

Doug Bessette, associate professor for energy systems in the Department of Community Sustainability at Michigan State University’s College of Agriculture and Natural Resources, was one of the leads on the project.

“The responses from residents were generally positive, which is good to see considering the amount of solar that is likely to be developed in the coming years,” Bessette said. “At the same time, we saw more negative attitudes associated with larger projects and somewhat less support amongst neighbors living really close, within a quarter mile of projects, so there’s a lot of work to be done.”

Positive attitudes were indeed more common among residents living farther from LSS projects than for those living closer to them. The largest projects tend to provoke negative attitudes, while projects under 100 megawatts – those requiring less than roughly 600 acres or one square mile – tend to receive mostly positive responses. Factors like aesthetics, economics and perceptions of fairness in the planning process strongly influence attitudes.

Residents largely oppose increased state-level decision-making on future LSS siting, preferring increased opportunities for community participation and feedback. They also expressed a preference for local hiring, procurement and ownership. For reliable information about what impact a proposed project might have on their community, residents trust existing energy project neighbors, community organizations and university staff.

Jake White, a doctoral student, who contributed to the survey, said, “Our findings show that LSS neighbors want to be engaged more, with respondents strongly supporting increased opportunities for participation in planning processes. This demonstrates a big opportunity for improvement in LSS planning processes – hopefully leading to better outcomes for all.”

When it comes to future LSS projects, respondents favored disturbed sites, such as landfills, as opposed to farmland. There is also a need for communications efforts to increase awareness and engage neighbors when projects come to communities.

So while there is more work to be done, this survey’s results indicate moderate support for solar going forward, with further analysis planned to gauge influencing factors and address equity concerns.

“We were happy to see this last one,” Bessette notes.

Read on MSUToday.

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Michigan State University has been advancing the common good with uncommon will for more than 165 years. One of the world’s leading public research universities, MSU pushes the boundaries of discovery to make a better, safer, healthier world for all while providing life-changing opportunities to a diverse and inclusive academic community through more than 400 programs of study in 17 degree-granting colleges.

For MSU news on the web, go to MSUToday or twitter.com/MSUnews.

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ARTICLE TITLE

Perceptions of Large-Scale Solar Project Neighbors: Results From a National Survey

 

Study shows potential of super grids when hurricanes overshadow solar panels

DOE/OAK RIDGE NATIONAL LABORATORY

 

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ORNL RESEARCHERS MODELED HOW HURRICANE CLOUD COVER WOULD AFFECT SOLAR ENERGY GENERATION AS A STORM FOLLOWED 10 POSSIBLE TRAJECTORIES OVER THE CARIBBEAN AND SOUTHERN U.S. 

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CREDIT: ANDY SPROLES/ ORNL,U.S. DEPT. OF ENERGY

When hurricanes threaten tropical shores, “super grids” could come to the rescue.

Caribbean islands are starting to shift away from importing expensive fossil fuels, using instead their own abundant sun and wind to make electricity. However, their frequent hurricanes can put a damper on solar energy generation. Researchers at the Department of Energy’s Oak Ridge National Laboratory developed a comprehensive modeling method to better predict the drop in electricity generation when these storm clouds overshadow solar panels. The team explored ways to compensate for these energy losses with super grids, a collection of grids connected so electricity can flow across island chains or between continents.

Lead researcher Rodney Itiki said this kind of infrastructure planning is crucial to maintaining equitable access to electricity in the Caribbean’s 12 island countries and the U.S. territories of Puerto Rico and U.S. Virgin Islands. The historically underserved island residents can’t easily evacuate from the path of the many hurricanes that hammer the Caribbean each year. The loss of the sun’s energy during hurricanes is likely to become increasingly important on islands like Puerto Rico, which declared a goal of converting to all-renewable energy by 2050.

Itiki’s model can be used to understand the impact of hurricane clouds on any electric system. In this study, he and his team of experts in grid integration, renewables and advanced computing methods used his algorithm to explore different grid connection approaches, modeling how each would affect the availability of electricity. The model analyzed how a large hurricane would reduce power from known solar installations while traveling 10 possible paths over 10 to 14 days.

“This is one of the major contributions of the research, because when we design the power system, we need to do it considering all possible cases – most of all, the worst-case scenario,” said Itiki, a postdoctoral research associate with ORNL’s Power Systems Resilience group.

Researchers used simulations to understand power availability during hurricanes if electric grids were connected via high-voltage cables on the ocean floor. To learn whether these super grids would balance energy flow among regions, the team modeled four different combinations: a standalone U.S. grid; a standalone Caribbean super grid tying all the islands together; a U.S.-Caribbean super grid; and a super grid connecting the U.S., Caribbean islands and South America.

The largest super grid configuration included 90 photovoltaic plants within the hurricane corridor, plus solar farms in places such as California and Brazil that are unaffected by these hurricanes. The model showed some solar plants losing as much as 88% of their generating capacity for two days while shaded by hurricane clouds.

Researchers found the U.S.-Caribbean super grid increases power reliability the most. The standalone Caribbean super grid proved least helpful, partly because hurricane trajectories typically align with the chain of islands. The South American addition did not significantly reduce power variations because the continent has few solar installations. However, it could provide energy security as an alternate power supply if islands became disconnected from each other or from the U.S. system.

Itiki was intrigued as a graduate student by the successful subsea link between electric grids of the United Kingdom and Germany. He studied the potential benefits of similar connections until a 2017 natural disaster narrowed his geographic focus.

“Soon after Hurricane Maria hit Puerto Rico, I started thinking about interconnecting Puerto Rico with Florida,” Itiki said. Maria left some Puerto Ricans without electricity for almost a year, the longest blackout in U.S. history.

Itiki’s first focus was wind energy during hurricanes. He explored how a U.S.-Caribbean super grid could reduce power slumps caused when hurricanes damage Puerto Rican wind turbines. After improvements to turbine technology made them stronger, he examined how a surge of hurricane wind energy could be shared among the Caribbean, the U.S. and South America.

Next, Itiki intends to fuse his solar and wind algorithms to determine how super grids could broadly enhance energy reliability in both the Caribbean and on the mainland. For example, during a major weather event in the U.S., could the Caribbean grid provide supplementary power to the U.S.?

The research has broad implications for U.S. energy independence from fossil fuels – and for reliably integrating renewable projects. “I don’t think people are planning photovoltaic [solar] plants while taking hurricane shading into account,” Itiki said. “Utilities are choosing locations with the maximum sun exposure, but they need to also consider the normal trajectory of hurricanes. If all the plants are concentrated in Florida, and a hurricane hits there, it will create a maximum power valley.”

Itiki acknowledged that further studies are needed to probe the environmental and economic viability of laying undersea cables. But even without these interconnections, Itiki’s model provides a vital new tool for estimating solar energy during extreme weather and planning transmission systems to compensate. Utilities could use the algorithm to prepare for the solar energy gap during storms, using solutions such as batteries or pumped-storage hydropower.

Other ORNL researchers who contributed to the project include Nils Stenvig and Teja Kuruganti, in addition to Silvio Giuseppe Di Santo at the University of Sao Paulo, Brazil, and Madhav Manjrekar at the University of North Carolina at Charlotte. This research feeds into the North American Energy Resilience Model (NAERM) funded by DOE’s Office of Electricity.

UT-Battelle manages ORNL for the Department of Energy’s Office of Science, the single largest supporter of basic research in the physical sciences in the United States. The Office of Science is working to address some of the most pressing challenges of our time. For more information, please visit energy.gov/science.

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JOURNAL

Energies

DOI

10.3390/en17071545 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Method for Spatiotemporal Solar Power Profile Estimation for a Proposed U.S.–Caribbean–South America Super Grid under Hurricanes

 

Understaffed nursing homes in disadvantaged neighborhoods more likely to overuse antipsychotics

Boosting staffing may help limit use of “chemical restraints,” study finds

NEW YORK UNIVERSITY

Nursing homes in disadvantaged communities are more likely to overmedicate residents with antipsychotics, especially homes that are understaffed, according to a new study published in JAMA Network Open. 

“The neighborhood in which a nursing home is located seems to influence how widely antipsychotics are used, even when they may not be indicated,” said Jasmine Travers, assistant professor at NYU Rory Meyers College of Nursing and the study’s senior author.

Antipsychotic medications are used to treat serious psychiatric disorders such as schizophrenia. These medications have long been given to nursing home residents with and without dementia who are agitated or have behavioral issues. — Sometimes staff rely on their sedating side effects for “chemical restraint” rather than redirecting residents in distress. 

“We know that nursing homes with lower staffing levels use more antipsychotics. These medications may be compensating for understaffing by sedating residents instead of having adequate staff to support their needs,” said Travers. 

Antipsychotic use in older adults can be dangerous, increasing their risk for falls, strokes, and even death. As a result, in recent years, there has been a significant push by the Centers for Medicare and Medicaid Services (CMS) to reduce the use of antipsychotics to manage behaviors such as aggression or wandering in nursing homes. 

However, this may be more challenging in disadvantaged neighborhoods, where residents may be exposed to greater stressors, including higher crime rates, noise pollution, and less green space, all of which can harm their mental and physical health. For older adults, these stressors might translate to poor sleep or agitation, increasing the risk that an antipsychotic medication is used, even without an appropriate diagnosis. 

To better understand the connection between nursing home staffing, neighborhood factors, and antipsychotic use, Travers and her colleagues looked at data from 10,666 nursing homes across the U.S., 1,867 of which were in severely disadvantaged neighborhoods. Neighborhood socioeconomics were measured using data on income, education, employment, and housing for small geographic units called census blocks.

The researchers also looked at what percentage of residents received an antipsychotic drug in the last week but didn’t have a qualifying diagnosis of schizophrenia, Tourette syndrome, or Huntington’s disease. (The study did not take into account residents who are falsely diagnosed with schizophrenia to get around the CMS reporting requirement, a troubling practice documented in a 2022 report by the U.S. Department of Health and Human Services.)

The researchers found that nursing homes that were understaffed—measured as having less than three hours of nurse staffing per resident each day—had greater antipsychotic medication use in severely disadvantaged neighborhoods (19.2%) compared to less disadvantaged neighborhoods (17.1%).

“This means that in a 100-bed nursing home that is understaffed, two additional residents would inappropriately receive an antipsychotic medication if the nursing home was in a disadvantaged neighborhood versus a more well-off area,” said Travers. 

Notably, when nursing homes met or exceeded the federal government’s proposed staffing levels of at least three hours of nursing per resident per day, there was not a significant difference in antipsychotic use based on neighborhood, providing support for having minimum staffing levels. The researchers call for a more focused effort on improving staffing in nursing homes in lower income areas, which could include additional funding—similar to funds provided to federally qualified health centers—or other tailored interventions to address gaps in staffing.

“Addressing staffing deficiencies, particularly in nursing homes in disadvantaged neighborhoods, will be critical for reducing the overuse of antipsychotics,” said Travers. “Understanding this vulnerability can help inform policy solutions to support, not penalize, nursing homes in disinvested communities.”

In addition to Travers, study authors include Erinn Hade and Steven Friedman of NYU Grossman School of Medicine, Aasha Raval and Kimberly Hadson of NYU Meyers, and Jason Falvey of the University of Maryland School of Medicine. The research was supported by the National Institute on Aging (K76AG074922, K76AG074926, P30AG028747) and the Patrick and Catherine Weldon Donaghue Medical Research Foundation.

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JOURNAL

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.8322 

ARTICLE TITLE

Staffing and Antipsychotic Medication Use in Nursing Homes and Neighborhood Deprivation

ARTICLE PUBLICATION DATE

24-Apr-2024