Tobacco corporation attempts to gain public trust in its science are having success – new research

Philip Morris International gains trust in industry-funded science by posing as a generous supporter and concealing its involvement through third parties

UNIVERSITY OF BATH

A new study suggests that the tobacco company Philip Morris International (PMI), is successfully increasing public trust in industry-funded science by portraying itself as a generous supporter of scientific research while simultaneously concealing its involvement through third parties.

The paper, published in Frontiers in Communication, was co-authored by researchers in the Tobacco Control Research Group (TCRG) at the University of Bath, University of Colorado and University of Bristol.

In 2017, whilst publicly proclaiming itself to have transformed into a transparent organisation funding robust science, tobacco producer Philip Morris International (PMI) launched a new scientific organisation: the Foundation for a Smoke-Free World (FSFW). On 13th May 2024, FSFW rebranded itself Global Action to End Smoking.

The new study aimed to understand the extent to which the public trusts PMI’s involvement in science, and whether channelling funds through the third-party organisation, FSFW, affected levels of trust in its science. 1,580 UK residents were asked to rate their level of trust in: PMI, FSFW, or Cancer Research UK (CRUK), on a scale from 1 (no trust) to 7 (complete trust). CRUK was selected as a control group as a highly trusted scientific organisation, wholly independent from the tobacco industry.

Key Findings:

• Overall trust in PMI was 4.66 on a scale from 1 (no trust) to 7 (complete trust), compared to 5.79 out of 7 in Cancer Research UK, indicating moderate trust in PMI's scientific endeavours.

• Overall trust for FSFW was 5.04 out of 7. After participants were informed that FSFW is funded by the tobacco industry, the overall trust rating dropped to 4.77 out of 7. This suggests that when research is funded through a third-party scientific group such as FSFW, people are more likely to trust the science that emanates.

Dr Tess Legg, Research Associate from the University of Bath’s Department for Health and lead author of the paper, said:

“This work is important because tobacco companies use their involvement in science as ‘proof’ that they are credible research organisations. They also funnel research funds through third-party companies and historically this has involved attempts to obscure their involvement in the resulting science.”

Up until now, there has been no clear understanding of whether – and to what extent – these two strategies work to build trust in the industry and its science. This study is the first in the UK to try to gain quantitative evidence of how effective these tactics are at making people trust the tobacco industry and its science.

The study's authors warn against the ongoing acceptance of tobacco industry funding and dissemination of scientific findings. They call for increased efforts to educate the public about the subtle yet harmful tactics employed by these industries. Dr Legg notes:

“As it stands, FSFW still has an immense amount of money from PMI at its disposal and so the risk of it continuing to further the industry’s interests is high. Our findings suggest that more needs to be done by the tobacco control and public health communities to help the UK public understand how underhand the tobacco industry’s attempts to rebrand really are, and to stop scientific front groups from muddying the water by lending the industry an air of credibility.

While the findings don’t make particularly happy reading for those of us working to counter the tactics used by the tobacco industry, it’s important to build up a quantitative picture of the effects the strategies used by industries to influence science are having.

Beyond this, at a time when the tobacco industry continues its abhorrent attempts to infiltrate science as part of its ‘pseudo-transformation’, we need to focus efforts on reforming science to ensure it works in the public interest.”

This work builds on TCRG’s previous work mapping the tactics that the tobacco industry (and other industries) use to influence science. It also builds on the group’s work on the FSFW which has demonstrated that the tobacco industry continues its attempts to influence the evidence base on its products and paint itself as a credible partner in science.

---

JOURNAL

Frontiers in Communication

ARTICLE TITLE

The UK public’s trust in tobacco industry involvement in science – an experimental survey

 

Study reveals consumers value animal welfare more than environmental sustainability when buying meat and dairy products

Peer-Reviewed Publication

UNIVERSITY OF PORTSMOUTH

The treatment of animals rates higher than green issues when consumers choose meat and dairy products.  

That’s according to a new study, which suggests that while consumers consider sustainability important, other factors such as taste, quality, and animal welfare take precedence in their purchasing decisions.

On product labels, consumers valued information regarding animal welfare, food safety, and health and nutrition. The results can help producers to market particularly sustainably produced food products in a more targeted way and make them more attractive to consumers.

The study was conducted across five European countries—Czechia, Spain, Sweden, Switzerland and the UK to identify the attributes that are most important to consumers buying meat or dairy products.

Taking part in an online survey, 3,192 participants were asked to rate the importance of 18 different factors when shopping for meat and dairy products on a scale from 1 (not at all important) to 5 (extremely important):

·       Attributes - freshness, quality/taste, healthy eating, nutrition, price, processing, special offers, convenience of use/preparation, and familiarity of brand.

·       Animal welfare attributes - animal welfare, outdoor-reared/free range, and pasture-fed.

·       Attributes related to environmental sustainability - locally produced, sustainable packaging, food miles, carbon footprint, and organic.

·       Social sustainability - Fair trade or producer/farmer fairly paid.

Across all surveyed countries, consumers consistently prioritised freshness, quality/taste, and animal welfare as the most important attributes. In contrast, environmental factors such as food miles, carbon footprint, and organic production were deemed less important in influencing purchasing decisions. However, sustainability labels were perceived as helpful among consumers.

Study co-author Dr Andy Jin, Senior Lecturer in Risk Management in the Faculty of Business and Law at the University of Portsmouth, said: “Our study highlights the complex interplay of factors that influence consumer behaviour when buying meat and dairy products. Consumers indicated that information related to animal welfare, food safety, and health and nutrition was considered more important than environmental sustainability when making food choices.

“The findings demonstrate the importance of labelling strategies that encompass multiple aspects of product attributes, beyond environmental considerations alone.”

The implications of the research extend further than consumers to policymakers, producers, and retailers in the food industry who are striving to meet evolving consumer demands for more sustainable products.

Dr Jin added: “Labels on their own are not enough to change behaviour, especially for consumers who have low or no behavioural intention to buy sustainable meat or dairy products.

“These results should be translated into additional policy measures, such as nudges or behavioural interventions, helping individuals translate their attitudes into behaviour and facilitating the choice of sustainably produced products.”

The research, published in the journal Food Quality and Preference, was conducted by the universities of Portsmouth and Newcastle in the UK, Swedish University of Agricultural Sciences, University of Córdoba in Spain, Mendel University in Czech Republic and Agroscope from Switzerland.

---

JOURNAL

Food Quality and Preference

DOI

10.1016/j.foodqual.2024.105179 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Consumers across five European countries prioritise animal welfare above environmental sustainability when buying meat and dairy products

ARTICLE PUBLICATION DATE

1-Aug-2024

 

Macaque Brainnetome Atlas: A multifaced brain map of rhesus monkey

SCIENCE CHINA PRESS

 

IMAGE: 

(A) 248 CORTICAL SUBREGIONS AND (B) 56 SUBCORTICAL SUBREGIONS OF MACAQUE BRAINNETOME ATLAS

view more 

CREDIT: ©SCIENCE CHINA PRESS

This study is led by Prof. Tianzi Jiang (Brainnetome center of the Institute of Automation, Chinese Academy of Sciences), Prof. Lingzhong Fan (Brainnetome center of the Institute of Automation, Chinese Academy of Sciences), and Prof. Zhengyi Yang (Brainnetome center of the Institute of Automation, Chinese Academy of Sciences).

As an ideal model for studying human cognitive function and brain diseases, macaques are highly similar to humans in genetics, physiology, and brain structure. Currently, non-human primates are considered as a core source for exploring cognitive neural mechanisms and promoting translational medicine. Therefore, a multifaced brain atlas elucidating the architecture of the macaque brain is of great significance for translating research findings from macaques to humans. Such an atlas can characterize profiles of whole-brain regions, including connectivity, anatomy, and geometric topology, aiding in our understanding of brain function, development, and evolution. However, existing atlas have primarily focused on fragmented regions and single-modal data, while comprehensive macaque brain atlases have been challenging to achieve.

Recently, the research team led by Dr. Tianzi Jiang at the Brainnetome center of the Institute of Automation, Chinese Academy of Sciences delineated a multifaced macaque brain atlas, Macaque Brainnetome Atlas (MacBNA). MacBNA not only provides fine-grained parcellation of brain regions but also describes the macroscopic connections between subregions. Serving as a reliable reference system, it can effectively integrate multi-scale brain images and multi-omics data, thus delineating a multi-modal, cross-scale atlas of the macaque brain. Macaque Brainnetome Atlas, as a multifaced brain atlas depicting the architecture of the macaque brain, will overcome many limitations of existing atlases, including focusing solely on specific anatomical regions or single-modal information. Additionally, brainnetome atlases of both humans and macaques constructed using the same method will play a crucial role in effectively transferring information and knowledge acquired from monkey brains to human brains.

In addition, the multi-modal multi-scale dataset in this study will also provide an open-access platform for addressing computational issues, such as establishing macaque digital twin brains and cross-scale image registration. Researchers are currently continuing to collect data to further enrich MacBNA. Furthermore, the principles and methods of brain network atlas construction have the potential to extend to comparative studies in other species. Therefore, they anticipate that MacBNA and its related multimodal multi-scale resources will play a crucial role in cross-species comparisons, translational medicine, and computational modeling. The development of brainnetome atlases will evolve towards cross-species brain atlases and multimodal multi-scale brain atlases, providing a solid foundation for diagnosis, treatment, cross-species research, and inspiration for neuromorphic intelligence.

---

JOURNAL

Science Bulletin

DOI

10.1016/j.scib.2024.03.031 

 

What is "time" for quantum particles?

Publication by TU Darmstadt researchers in renowned journal "Science Advances"

TECHNISCHE UNIVERSITAT DARMSTADT

What is "time" for quantum particles?

Publication by TU Darmstadt researchers in renowned journal "Science Advances"

In an amazing phenomenon of quantum physics known as tunneling, particles appear to move faster than the speed of light. However, physicists from Darmstadt believe that the time it takes for particles to tunnel has been measured incorrectly until now. They propose a new method to stop the speed of quantum particles.

In classical physics, there are hard rules that cannot be circumvented. For example, if a rolling ball does not have enough energy, it will not get over a hill, but will turn around before reaching the top and reverse its direction. In quantum physics, this principle is not quite so strict: a particle may pass a barrier, even if it does not have enough energy to go over it. It acts as if it is slipping through a tunnel, which is why the phenomenon is also known as “quantum tunneling”. What sounds magical has tangible technical applications, for example in flash memory drives.

In the past, experiments in which particles tunneled faster than light drew some attention. After all, Einstein’s theory of relativity prohibits faster-than-light velocities. The question is therefore whether the time required for tunneling was “stopped” correctly in these experiments. Physicists Patrik Schach and Enno Giese from TU Darmstadt follow a new approach to define “time” for a tunneling particle. They have now proposed a new method of measuring this time. In their experiment, they measure it in a way that they believe is better suited to the quantum nature of tunneling. They have published the design of their experiment in the renowned journal “Science Advances.”

According to quantum physics, small particles such as atoms or light particles have a dual nature.

Depending on the experiment, they behave like particles or like waves. Quantum tunneling highlights the wave nature of particles. A “wave packet” rolls towards the barrier, comparable to a surge of water. The height of the wave indicates the probability with which the particle would materialize at this location if its position were measured. If the wave packet hits an energy barrier, part of it is reflected. However, a small portion penetrates the barrier and there is a small probability that the particle will appear on the other side of the barrier.

Previous experiments observed that a light particle has traveled a longer distance after tunneling than one that had a free path. It would therefore have traveled faster than the light. However, the researchers had to define the location of the particle after its passage. They chose the highest point of its wave packet.

“But the particle does not follow a path in the classical sense,” objects Enno Giese. It is impossible to say exactly where the particle is at a particular time. This makes it difficult to make statements about the time required to get from A to B.

Schach and Giese, on the other hand, are guided by a quote from Albert Einstein: “Time is what you read off a clock”. They suggest using the tunneling particle itself as a clock. A second particle that does not tunnel serves as a reference. By comparing these two natural clocks, it is possible to determine whether time elapses slower, faster or equally fast during quantum tunneling.

The wave nature of particles facilitates this approach. The oscillation of waves is similar to the oscillation of a clock. Specifically, Schach and Giese propose using atoms as clocks. The energy levels of atoms oscillate at certain frequencies. After addressing an atom with a laser pulse, its levels initially oscillate synchronized – the atomic clock is started. During tunneling, however, the rhythm shifts slightly. A second laser pulse causes the two internal waves of the atom to interfere. Detecting the interference makes it possible to measure how far apart the two waves of the energy levels are, which in turn is a precise measure of the elapsed time.

A second atom, which does not tunnel, serves as a reference to measure the time difference between tunneling and non-tunneling. Calculations by the two physicists suggest that the tunneling particle will show a slightly delayed time. “The clock that is tunneled is slightly older than the other,” says Patrik Schach. This seems to contradict experiments that attributed superluminal speed to tunneling.

In principle, the test can be carried out with today’s technology, says Schach, but it is a major challenge for experimenters. This is because the time difference to be measured is only around 10-26 seconds – an extremely short time. It helps to use clouds of atoms as clocks instead of individual atoms, explains the physicist. It is also possible to amplify the effect, for example by artificially increasing the clock frequencies. “We are currently discussing this idea with experimental colleagues and are in contact with our project partners”, adds Giese. It is quite possible that a team will soon decide to carry out this exciting experiment.

Publication: Patrik Schach, Enno Giese: „A unified theory of tunneling times promoted by Ramsey clocks“, https://doi.org/10.1126/sciadv.adl6078

---

JOURNAL

Science Advances

DOI

10.1126/sciadv.adl6078 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

„A unified theory of tunneling times promoted by Ramsey clocks“

 

Using solar energy to generate heat at high temperatures

ETH ZURICH

 

IMAGE: 

ILLUSTRATION OF THE EXPERIMENTAL THERMAL TRAP. IT CONSISTS OF A QUARTZ ROD (INSIDE) AND A CERAMIC ABSORBER (OUTSIDE). SOLAR RADIATION ENTERS AT THE FRONT, HEAT IS GENERATED IN THE REAR AREA.

view more 

CREDIT: VISUALIZATIONS: CASATI E ET AL. DEVICE 2024, EDITED

The production of cement, metals and many chemical commodities requires extremely high temperatures of over a thousand degrees Celsius. At present, this heat is usually obtained by combusting fossil fuels: coal or natural gas, which emit large amounts of greenhouse gases. Heating with renewable electricity is not an alternative, as this would be inefficient at these high temperatures. Although much of our economy and society will need to become carbon neutral in the coming decades, these industrial processes are likely to continue to be powered by fossil fuels for the near future. They are considered difficult to decarbonise.

Researchers at ETH Zurich have now demonstrated, in the lab, a way to make these industries independent of fossil fuels. Using solar radiation, they have engineered a device that can deliver heat at the high temperatures needed for the production processes. The team led by Emiliano Casati, a scientist in the Energy and Process Systems Engineering Group, and Aldo Steinfeld, Professor of Renewable Energy Carriers, has developed a thermal trap. It consists of a quartz rod coupled to a ceramic absorber which, thanks to its optical properties, can efficiently absorb sunlight and convert it into heat.

In their lab-​scale experiments, the team used a quartz rod measuring 7.5 centimetres in diameter and 30 centimetres in length. They exposed it to artificial light with an intensity equivalent to 135 times that of sunlight, reaching temperatures of up to 1050 degrees Celsius. Previous studies by other researchers have achieved a maximum of 170 degrees with such thermal traps.

Large-​scale solar concentrating technologies are already established at an industrial scale for solar power generation, for example in Spain, the US and in China. These plants typically operate at up to 600 degrees. At higher temperatures, heat loss by radiation increases and reduces the efficiency of the plants. A major advantage of the thermal trap developed by ETH Zurich researchers is that it minimises radiative heat losses.

High-​temperature solar plants

Our approach significantly improves the efficiency of solar absorption,” says Casati. “We are, therefore, confident that this technology supports the deployment of high-​temperature solar plants.” However, detailed technical and economic analyses are still pending, he says. Such analysis is beyond the scope of the current experimental study, which the researchers have published in the scientific journal Device.

Casati is continuing his research to optimise the process. The technology could one day make it possible to use solar energy not only to generate electricity, but also to decarbonise energy-​intensive industries on a large scale. “To combat climate change, we need to decarbonise energy in general," says Casati. “People often think of energy in terms of electricity, but we actually use about half of our energy in the form of heat.”

---

JOURNAL

Device

DOI

10.1016/j.device.2024.100399 

ARTICLE TITLE

Solar thermal trapping at 1,000°C and above

 

Wind farms can offset their emissions within two years, new study shows

TAYLOR & FRANCIS GROUP

After spinning for under two years, a wind farm can offset the carbon emissions generated across its entire 30-year lifespan, when compared to thermal power plants.

That’s according to a new peer-reviewed study published in the Journal of the Royal Society of New Zealand – which also shows within six months a turbine can generate all the energy consumed across its life-cycle.

The research uses data from the Harapaki onshore wind farm in Hawke’s Bay, New Zealand – however the authors of the paper explain that their findings would be replicated across most, if not all, wind farms internationally.

“The wind turbine technology employed in New Zealand is consistent with that used internationally,” explains lead author Isabella Pimentel Pincelli from the Sustainable Energy Systems research group, Wellington Faculty of Engineering, at Te Herenga Waka Victoria University of Wellington.

“Although the carbon offset depends on the exact older technology the wind turbines are replacing, we would expect a similar offset internationally. In New Zealand it is gas turbines, but many countries will be displacing fossil fuel generators.

“The outcomes of our study underscore the environmental efficiency of onshore wind farms and their important role in the energy transition. Notably, the manufacturing of wind turbines is the primary contributor to the carbon and energy footprints, highlighting a critical area for targeted environmental mitigation strategies.”

The study reviewed current literature on wind farms, as well as using real construction data to take into account everything from the manufacturing of individual turbine parts, to transporting them into place, to decommissioning the entire wind farm at Harapaki – which comprises 41 turbines.

The results indicate that this particular farm will leave a carbon footprint of 10.8 gCO2eq/kWh, which equates to a greenhouse gas payback time of 1.5–1.7 years for avoided combined cycle gas turbines, and an energy payback time of 0.4–0.5 years.

Co-author Professor Alan Brent, Chair in Sustainable Energy Systems at Wellington, explains while the results underscore how onshore wind plants are aligned with the principles of sustainable development, more can still be explored with making the manufacturing process more eco-friendly.

“The environmental impacts of the installation and transportation phases are important. Together they accounted for nearly 10% of the overall emissions,” states Brent, a Professor of Sustainable Energy Systems.

“It therefore remains crucial to continue implementing improvements aimed at limiting negative environmental impacts while maximizing positive contributions throughout the supply chain of onshore wind plants.

“Notably, the manufacturing of wind turbines is the primary contributor to the carbon and energy footprints, highlighting a critical area for targeted environmental mitigation strategies.”

To address the carbon outlay of the process of developing such wind farms, the expert team recommend developing a recycling process for end-of-life blades.

Currently blades are disposed of in landfill due to commercial feasibility, but by recycling the blades – either mechanically or chemically – could drop the emissions from the current 10.8 gCO2eq to a potential 9.7.

Additionally, the team recommend that research is carried out regularly in this area as with the “rapid advancements of technologies” it will be “necessary to ensure research remains reflective of current practices to accurately inform decision-making processes”.

This study has some methodological limitations. First, it focuses only on the energy intensity and emissions throughout the life cycle of the wind farm, even though there are other environmental impacts, such as ozone depletion, human toxicity, acidification, eutrophication, and resource depletion. Social, wildlife, or economic impacts were also not considered.

---

JOURNAL

Journal of the Royal Society of New Zealand

DOI

10.1080/03036758.2024.2344785 

ARTICLE TITLE

Developing Onshore Wind Farms in Aotearoa New Zealand: Carbon and Energy Footprints

Antimicrobial Resistance

Call for actionable steps in response to the

 rising threat of antimicrobial resistance

 (AMR)

GERMAN CENTER FOR INFECTION RESEARCH

Antimicrobial resistance (AMR) is one of the top global public health and development threats. According to the World Health Organisation (WHO), an estimated 4.95 million deaths were associated with AMR in 2019, including 1.27 million deaths attributable to bacterial AMR. Limiting the emergence and spread of resistant pathogens is critical to preserving the world’s ability to treat human, animal and plant diseases, reduce food safety and security risks and maintain progress on the WHO's sustainable development goals. The AMR Multi-Stakeholder Partnership Platform has developed key recommendations for action on antimicrobial resistance for consideration by United Nations (UN) Member States in the UN General Assembly High-Level Meeting on AMR, which will take place on 26 September 2024 at the UN Headquarters in New York. As a member of the AMR Multi-Stakeholder Partnership Platform and active participant of the platform's Action Group, the German Center for Infection Research (DZIF) has contributed to the development of the key recommendations.

The following key recommendations are based on discussions facilitated by the Action Group of the AMR Multi-Stakeholder Partnership Platform on the UN High-Level Meeting on AMR. The stakeholders of the platform, representing diverse sectors (human, animal, agrifood, plant, environment), disciplines and backgrounds, call upon the UN Member States to agree upon actionable, measurable steps applying a One Health approach to ensure a healthier, more sustainable and resilient present and future where antimicrobials are preserved as critical life-saving medicines, equally accessible to everyone, everywhere.

1. Enhance One Health collaboration on AMR through effective cross-sectoral, transparent, inclusive, multilateral, multidisciplinary, multi-stakeholder coordination, communication and follow-through.

2. Accelerate the implementation of AMR National Action Plans (NAPs), building on country context, capacity and capabilities.

3. Strengthen capacity for AMR efforts by mobilising sustainable financing for research, infrastructure and AMR NAPs implementation.

4. Strengthen health systems through comprehensive primary and secondary prevention strategies, such as infection prevention and control (IPC), stewardship programmes, water, sanitation and hygiene (WASH), vaccination, early diagnosis and prompt treatment and environmental management of air, water, soil, food and vectors for better human, animal and environmental health.

5. Better leverage preventive measures such as vaccination by expanding the evidence base on their impact against AMR, developing mechanisms to increase access and utilisation of existing vaccines, improving regulatory pathways, facilitating market authorisation and distributing products across sectors and countries.

6. Strengthen sector-specific AMR and antimicrobial use (AMU) surveillance, building towards integrated surveillance for evidence-based action to reduce the risk and impact of AMR.

7. Transform agrifood systems to significantly reduce AMU while optimising animal health and welfare.

8. Ensure universal, equitable, affordable and sustainable access, including in rural areas, to quality essential medicines, vaccines and diagnostics for humans and animals.

9. Encourage high-income countries and other stakeholders to commit to taking an end-to-end approach to sustainable antimicrobial research and development (R&D), including by increasing public investment in push and pull incentives to catalyse the global R&D efforts necessary to deliver new treatments and tools that target global priority pathogens.

10. Prevent and address the drivers, sources and challenges of the environmental dimensions of AMR.

The AMR Multi-Stakeholder Partnership Platform was established in November 2022 by the Quadripartite organisations—the Food and Agriculture Organisation of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organisation (WHO) and the World Organisation for Animal Health (WOAH)—as one of the global governance structures recommended by the United Nations Inter-Agency Coordination Group on AMR. It brings together relevant stakeholders across the human, animal, plant and environment sectors to assist in preserving antimicrobials and ensuring their responsible use through a One Health approach. It promotes a shared global vision, helps build consensus and takes action to contribute to the implementation of the Global Action Plan on AMR (GAP). Since its inaugural meeting in November 2023, the platform has grown to more than 200 members (organisations, networks and federations). The German Center for Infection Research (DZIF) is one of them.

Read the full recommendations (and their brief version), watch the public release event and join the AMR Multi-Stakeholder Partnership Platform's global movement for action against AMR.

Better medical record-keeping needed to

 fight antibiotic overuse, studies suggest

Many who get antibiotics in clinics & emergency departments have no diagnosis or symptoms that might explain a prescription; improved diagnosis coding could help target efforts to optimize use & reduce risk

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

A lack of detailed record-keeping in clinics and emergency departments may be getting in the way of reducing the inappropriate use of antibiotics, a pair of new studies by a pair of University of Michigan physicians and their colleagues suggests.

In one of the studies, about 10% of children and 35% of adults who got an antibiotic prescription during an office visit had no specific reason for the antibiotic in their record.

The rate of this type of prescribing is especially high in adults treated seen in emergency departments and in adults seen in clinics who have Medicaid coverage or no insurance, the studies show. But the issue also occurs in children.

Without information about what drove these inappropriate prescriptions, it will be even harder for clinics, hospitals and health insurers to take steps to ensure that antibiotics are prescribed only when they’re really needed, the researchers say.

Overuse and misuse of antibiotics raise the risk that bacteria will evolve to resist the drugs and make them less useful for everyone. Inappropriately prescribed antibiotics may also end up doing more harm than good to patients.

“When clinicians don’t record why they are prescribing antibiotics, it makes it difficult to estimate how many of those prescriptions are truly inappropriate, and to focus on reducing inappropriate prescribing,” said Joseph Ladines-Lim, M.D., Ph.D., first author of both of the new studies and a combined internal medicine/pediatrics resident at Michigan Medicine, U-M’s academic medical center.

“Our studies help contextualize the estimates of inappropriate prescribing that have been published previously,” he added. “Those estimates don’t distinguish between antibiotic prescriptions that are considered inappropriate due to inadequate coding and antibiotic prescriptions truly prescribed for a condition that they can’t treat.”

Ladines-Lim worked with U-M pediatrician and health care researcher Kao-Ping Chua, M.D., Ph.D., on the new studies. The one on outpatient prescribing by insurance status is in the Journal of General Internal Medicine and the one on trends in emergency department prescribing is in Antimicrobial Stewardship and Healthcare Epidemiology.

Building on previous research

Chua and colleagues recently published findings about trends in inappropriate antibiotic prescribing in outpatients under age 65, suggesting about 25% were inappropriate. But that number includes antibiotic prescriptions written for infectious conditions that antibiotics don’t help, such as colds, and antibiotic prescriptions that aren’t associated with any diagnoses that could be a plausible antibiotic indication.

The new studies add more nuance to that finding, by looking more closely at these two different types of inappropriate prescriptions. 

Most antibiotic stewardship efforts to date have focused on reducing the use of the first type of inappropriate prescription – those written for infectious but antibiotic-inappropriate conditions like colds. The new studies show such patients still account for 9% to 22% of all antibiotic prescriptions, depending on the setting and age group.

But since doctors and other prescribers aren’t required to run a test for a bacterial infection or list a specific diagnosis in order to prescribe antibiotics, symptoms provide potential clues to why they might have written a prescription anyway.

So some of those 9% to 22% of all people receiving antibiotics may have also had a secondary bacterial infection that the clinician suspected based on symptoms.

However, it’s impossible to know.

As for those with no infection-related diagnoses or symptoms in their records who got antibiotics, the researchers suggest that clinicians may not have bothered to add these diagnoses or symptoms to the patient record inadvertently – or even deliberately, to try to avoid the scrutiny of antibiotic watchdogs.

But the researchers also speculate that the lower rate of diagnosis documentation in patients in the healthcare safety net may also have to do with the way healthcare organizations are reimbursed.

Often, clinics and hospitals receive a fixed amount from Medicaid to care for all their patients with that type of coverage. So they aren’t incentivized to create records that are as detailed as for privately insured patients, whose care traditionally is reimbursed under a fee-for-service model.

“This could actually be a matter of health equity if people with low incomes or no insurance are being treated differently when it comes to antibiotics,” says Ladines-Lim, who has also studied antibiotic use related to immigrant and asylum-seeker health and will soon begin a fellowship in infectious diseases.

He said that private and public insurers, and health systems, may need to incentivize accurate diagnosis coding for antibiotic prescriptions – or at least make it easier for providers to document why they’re giving them.

That might even include steps such as requiring providers to record the reason for antibiotic prescribing before prescriptions can be sent to pharmacies through electronic health record systems.

After all, Ladines-Lim said, physicians often have to list a diagnosis that justifies tests they order, such as CT scans or x-rays. With antibiotic resistance posing an international threat to patients who have antibiotic-susceptible conditions, similar steps to justify prescriptions of antibiotics might be advisable.

In addition to Ladines-Lim and Chua, the other authors of the two articles are Michael A. Fischer, M.D., M.S. of Boston Medical Center and Boston University, and Jeffrey A. Linder, M.D., M.P.H. of Northwestern University Feinberg School of Medicine.

Chua is a member of the Susan B. Meister Child Health Evaluation and Research Center, and the U-M Institute for Healthcare Policy and Innovation.

The research was funded by a Resident Research Grant from the American Academy of Pediatrics, a Physician Investigator Award from Blue Cross Blue Shield Foundation of Michigan, and a Research Grant from the National Med-Peds Residents’ Association.

Prevalence of Inappropriate Antibiotic Prescribing with or without a Plausible Antibiotic Indication among Safety-Net and Non-Safety Net Populations, Journal of General Internal Medicine - https://link.springer.com/article/10.1007/s11606-024-08757-z

Appropriateness of Antibiotic Prescribing in US Emergency Department Visits, 2016–2021; Antimicrobial Stewardship and Healthcare Epidemiology https://doi.org/10.1017/ash.2024.79

---

JOURNAL

Antimicrobial Stewardship & Healthcare Epidemiology

DOI

10.1017/ash.2024.79 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Appropriateness of Antibiotic Prescribing in US Emergency Department Visits, 2016–2021

ARTICLE PUBLICATION DATE

17-May-2024

 

AI reveals critical gaps in global Antimicrobial Resistance research

NEWCASTLE UNIVERSITY

Artificial Intelligence (AI) has helped identify knowledge, methodological and communication gaps in global Antimicrobial Resistance (AMR) research.

In a new study carried out by the Chinese Academy of Sciences and Newcastle University under the co-leadership of Professor Yong-Guan Zhu and Professor David W Graham, respectively, experts compiled a comprehensive database of 254,738 articles spanning two decades, shedding light on patterns of AMR research worldwide.

They found that the terminology and methods used in AMR research significantly differ across the medical, veterinary, food safety, plant agriculture, and environmental sectors. The semantic and methodological differences result in limited valuation work between sectors and limited cross-sectoral communication, resulting in inconsistent messages to decision-makers.

Through sophisticated AI-based analysis, the team developed global maps showcasing regional, methodological, and sectoral AMR research activities. The findings confirm a stark lack of interdisciplinary collaboration, particularly in low-income countries, where the burden of increasing AMR is most acute.

Published in the journal Environment International, the findings explain why solutions to AMR based on One Health are not developing as needed. The results could play a critical role in providing guidance on how and where to better integrate AMR surveillance across sectors and regions worldwide.

Professor David W Graham, Emeritus Professor of Engineering at Newcastle University, said: “The findings highlight the urgent need for greater coordination in research methods across sectors and regions. For instance, the medical and veterinary communities need information about living AMR infectious pathogens to prioritise decisions, whereas environmental researchers often focus on genetic targets. Our work shows that culturing microbiology and isolate sequencing, and metagenomics must be performed in tandem in all future work, and more context data must be collected to relate results from different sectors.

“Our paper's findings support key messages from UN Environment Programme and World Health Organization that emphasise the best way to mitigate AMR is through prevention and integrated surveillance, which is key to prioritising solutions.”

This is being addressed by the United Nations Quadripartite Technical Group on Integrated Surveillance on Antimicrobial Use and Resistance on which both Prof Zhu and Graham are members.

Graham further said, “this work was only possible due its novel use of Artificial Intelligence and Natural Language Processing to intelligently search an extensive and living database, an archive we make openly available for public use and contributions. This paper represents the first in a series of joint manuscripts leveraging AI to guide future AMR and other research agenda.”

Professor Yong-Guan Zhu, Professor of Environmental Sciences, Chinese Academy of Sciences, added: “the framework of One Health is of critical importance in safeguarding human and ecosystem health, but it needs roadmaps to implement, this study timely identifies path forward. The study also demonstrates that multidisciplinary and international collaboration is essential in solving global challenges, and we should embrace emerging technologies, such as AI”.  

Both scientists recommend future research and increased investment in capacity development, especially in low-income countries, to address the pressing AMR challenges in these regions.

Funding: This work is financially supported by the National Natural Science Foundation of China and the Ningbo Municipality.

Reference

Chen, C., Li, S.-L., Xu, Y.-Y., Liu, J., Graham, D. W., & Zhu, Y.-G. (2024). Characterising global antimicrobial resistance research explains why one health solutions are slow in development: An application of AI-based Gap Analysis. Environment International, 187, 108680. doi:10.1016/j.envint.2024.108680    

---

JOURNAL

Environment International

DOI

10.1016/j.envint.2024.108680 

METHOD OF RESEARCH

Computational simulation/modeling

ARTICLE TITLE

Characterising global antimicrobial resistance research explains why One Health solutions are slow in development: An application of AI-based gap analysis