More CO₂ in the atmosphere during El Niño

New study analyses how the carbon cycle responds to temperatures in the tropics

Universität Leipzig

A recent study challenges previous assumptions about the connection between CO₂ in the atmosphere and temperatures in the tropics. Between 1959 and 2011, the CO₂ content in the atmosphere responded twice as strongly to temperatures in the tropics than before. This has often been attributed to increasing droughts in the tropics and to changes in carbon cycle responses caused by climate change. However, the current study conducted by researchers from the Max Planck Institute for Biogeochemistry and Leipzig University suggests that a small number of particularly strong El Niño events could be responsible for this.

Both tropical and non-tropical ecosystems absorb large amounts of carbon that were previously released into the atmosphere through human CO₂ emissions. Globally, land surface ecosystems act as a carbon sink and absorb on average around a third of human CO₂ emissions. These ecosystems are therefore a natural buffer for climate change. In the 1980s and 1990s, however, researchers observed an increased fluctuation in global carbon storage on land, and it appeared that the CO₂ growth rate was particularly sensitive to temperatures in the tropics. In a recent study, researchers from Jena and Leipzig found that this “doubling” of sensitivity was caused by the increased occurrence of El Niño events in the 1980s and 1990s compared to 1960–1979. This also includes the extreme El Niño events of 1982/83 and 1997/98. El Niño events cause severe droughts and heat waves in the tropics, which affect plant growth and thus reduce carbon uptake. In times of El Niño, vegetation even releases large amounts of carbon that would otherwise be sequestered in the soil or forests. This causes the CO₂ content in the atmosphere to increase. 

Internal climate variability as the main factor for changes in the carbon cycle
The authors of the study emphasise that this CO₂ increase is due to internal climate variability rather than a systematic change in the carbon cycle caused by climate change. “Our results show that this doubling of sensitivity is not necessarily a sign of a fundamental change in the response of the carbon cycle to climate change,” says Na Li from the Max Planck Institute for Biogeochemistry, first author of the study. Instead, it is caused by the combination of extreme El Niño events and their global impact.

“Slow-in, fast-out”: dynamics of the carbon cycle during extreme weather events 
“Through our work, we were also able to show that this phenomenon is related to the ‘slow-in, fast-out’ dynamics of the carbon cycle. This means that carbon is only slowly absorbed by ecosystems, but can be suddenly and quickly released again during extreme weather events such as strong El Niños,” explains Professor Ana Bastos from Leipzig University, senior author of the study.

New findings on reducing uncertainties in climate projections
The results of this study are important because they highlight uncertainties in future climate projections. To date, it was assumed that a heightened sensitivity of the CO₂ increase to temperatures in the tropics is caused by long-term climate-related changes in the carbon cycle, and thus in the global climate system. However, the study shows that extreme events can cause short-term fluctuations that do not necessarily indicate permanent changes in the carbon cycle. “These new findings could help to develop more precise climate models and reduce the uncertainties in predicting future climate scenarios,” says junior professor Dr Sebastian Sippel from Leipzig University. He also stated that we need to better understand how extreme climate phenomena such as El Niño affect carbon dynamics in order to make more reliable forecasts for the future.

Research is an important building block in the Cluster of Excellence
Professor Ana Bastos and junior professor Dr Sebastian Sippel as well as Professor Miguel Mahecha and Professor Markus Reichstein are also part of Leipzig University’s Cluster of Excellence Breathing Nature. In this context, researchers are investigating the complex links between climate change and biodiversity, and how they interact with human activity. They use innovative methods to understand patterns and dynamics of ecosystems and the atmosphere.

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Journal

Advances

DOI

10.1126/sciadv.adl6155 

Method of Research

Data/statistical analysis

Article Title

Enhanced global carbon cycle sensitivity to tropical temperature linked to internal climate variability

 

Unlocking ocean power: $3.6 million for community-centric wave energy converters

Wave energy could power millions of homes, but to make a splash in the industry, the tech must balance engineering, socio-economic and environmental trade-offs

University of Michigan

 

 

Images

Coastal communities are partnering with a multidisciplinary research team to determine the best way to harvest wave energy at Beaver Island, Michigan, and Nags Head, North Carolina.

 

The project is led by the University of Michigan, supported with $3.6 million from the National Science Foundation. It brings together researchers from five different institutions to help provide renewable energy that addresses the needs and concerns of coastal and island communities and identifies paths to make wave energy technology competitive with solar and wind power.

 

Waves are a vast source of untapped renewable energy. They could completely cover Alaska and Hawaii's electricity needs and generate enough power along mainland U.S. coasts to keep the lights on in 130 million homes, or meet 35% of the country's electricity demand, without any direct greenhouse gas emissions, according to the National Renewable Energy Laboratory.

 

Despite its promise, wave energy still can't compete with wind and solar energy in today's market because engineers haven't settled on the best way to harvest it or assess the technology. 

 

"Everybody knows what a wind turbine looks like because the research community has rallied behind a single idea," said Jeff Scruggs, U-M professor of civil and environmental engineering and the project's co-principal investigator. "For wave energy converters, that's not the case. When you look at the devices that companies are deploying for their trials, they are nothing like each other. Everybody's got their own idea about the best way to harvest wave energy."

 

Companies and laboratories have tested a wide host of concepts: bobbing buoys, submersed devices, hinged rafts, paddles and more. Each comes with its own pros and cons. A device optimized for generating energy could be more prone to damage from storms or have more environmental risks than other devices, and there are no guidelines to determine which trade-offs are acceptable or economical. 

 

"We need to develop a method to holistically assess wave energy devices, and that's something that can't be done by one person with one area of expertise working individually," said Lei Zuo, the Herbert C. Sadler Collegiate Professor of Engineering at U-M, a professor of naval architecture and marine engineering and the project's lead principal investigator.

 

The team will develop that assessment framework by getting community input from the start. For Beaver Island, wave energy might be a pathway to increased energy security and independence from expensive diesel for the island's back-up generators. At Nags Head, wave power could provide emergency electricity after catastrophic events—like hurricanes—or power devices that remove salt from seawater during emergency scenarios when freshwater may have been compromised. But the researchers need the communities' feedback to decide the best approach at each location.

 

"As researchers, we often think that communities are only recipients of our research. But coastal communities often know more about what is happening locally on the coast and about what is likely to work for their communities," said Eric Wade, assistant professor of coastal studies at East Carolina University who will assess the project's sociological impacts and co-lead community engagement.

 

Without that community-centric design, renewable energy projects are likely to face terminal pushback. In a recent example, an offshore wind energy project off the coast of Cleveland, Ohio, recently ended due to challenges from residents and environmental groups who feared damage to wildlife and treasured views.

 

"All of the research to date indicates that wave energy isn't likely a high risk to marine life compared to climate change, but because we don't have enough deployments to really know what the risks are, it’s hard to make that case to regulators," said Lindsay Dubbs, research associate professor at the University of North Carolina's Institute for the Environment, who will lead the project's environmental risk assessments. "That has certainly prevented some marine energy devices from being permitted and deployed in a timely manner."

 

Additional team members include: Danesh Tafti, professor of mechanical engineering at Virginia Tech; Daniel Deng, U-M adjunct professor of naval architecture and marine engineering and laboratory fellow at the Pacific Northwest National Laboratory; Gail Gruenwald, a member of the Beaver Island Association; and Bill Staby, founder of Blue Water Network LLC.

 

Zuo is also a professor of mechanical engineering, and Scruggs is also a professor of electrical and computer engineering. Wade and Dubbs are both affiliated with the Coastal Studies Institute.

 

 

Model projects energy storage needs for fossil fuel-free energy system

North Carolina State University

Researchers have developed a model that can be used to project what a nation’s energy storage needs would be if it were to shift entirely to renewable energy sources, moving away from fossil fuels for electric power generation. The model offers policymakers critical information for use when making near-term decisions and engaging in long-term energy system planning.

“We focused this study on Italy’s energy system because it has suffered significantly in recent years, due to difficulties obtaining affordable natural gas due to Russia’s invasion of Ukraine,” says Anderson de Queiroz, co-author of a paper on the work and an associate professor of civil, construction and environmental engineering at North Carolina State University. “That has raised questions about how Italy can make its energy system more robust. Our goal here was to develop a model that would allow us to determine what Italy’s energy storage needs would be if it moved completely away from fossil fuels and met its electricity demands with renewable resources.”

Energy storage is a critical piece of this puzzle because renewable energy sources, such as solar or wind, don’t produce energy at the same rate all the time. For example, you need to be able to store energy generated by solar power so that you can use that energy at night, when the sun is not shining.

To better understand an energy system’s energy storage needs, the researchers modified an existing optimization model called Temoa.

Specifically, the researchers modified the model to account for how renewable energy production would change during different times of day and different times of the year. For example, there would be greater solar power production during summer when days are longer, but solar power would still drop overnight. The researchers also accounted for changes in energy consumption at different times of day and during different seasons. For example, energy consumption may go up during hot summer afternoons if people are using air conditioners.

Capturing these daily and seasonal fluctuations in renewable energy production and energy consumption allowed the researchers to create a more detailed model of the energy system, which allowed them to better answer questions about the system’s energy storage needs. How much renewable energy could be redirected to storage? How much energy storage would be needed to meet demands?

“Our modified model makes clear that increasing energy storage capacity is critical for decarbonizing Italy’s power sector, but it also offers some detailed insights,” de Queiroz says. “For example, the model suggests that Italy needs to be able to store about 10% of its electricity generation in short-term energy storage devices.”

The term “short-term energy storage” is somewhat confusing. It does not refer to how long a storage device can store energy. Rather, it refers to how long the device can sustain its maximum power output. For example, a one-hour 2-kilowatt device could release two kilowatts of power for one hour, whereas a three-hour 2-kilowatt device could release two kilowatts of power for three hours. Energy storage systems that can release the maximum power output for four hours or less are typically considered short-term energy storage devices.

“Our projection related to short-term energy storage devices is driven both by the energy system’s energy storage needs and the fact that these devices are the most cost-effective way to meet those needs, based on recent cost projections and estimates,” de Queiroz says.

But while this paper focuses on Italy, the modified model the researchers developed for this work can be used to project energy storage needs for any energy system.

“As the world moves toward renewable power sources, we need to find ways to account for their variability,” says de Queiroz. “Energy storage devices give us the flexibility to adjust to fluctuations in energy production while also giving us the reliability we need to meet energy demands. And models like the one we’ve demonstrated here provide critical insights for policymakers regarding their long-term energy storage needs.”

The paper, “Modeling energy storage in long-term capacity expansion energy planning: an analysis of the Italian system,” is published open access in the Journal of Energy Storage. First author of the paper is Matteo Nicoli, a Ph.D. student at Politecnico di Torino. The paper was co-authored by Victor Faria, a recent Ph.D. graduate from NC State; and by Laura Savoldi of the Politecnico di Torino.

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Journal

Journal of Energy Storage

DOI

10.1016/j.est.2024.113814 

Method of Research

Computational simulation/modeling

Subject of Research

Not applicable

Article Title

Modeling energy storage in long-term capacity expansion energy planning: an analysis of the Italian system

 

Study: Conflicting goals, focus on economic development lead to underperforming streetcar systems

Streetcars meant to spur development instead of taking people to highly desired spots predicted lack of streetcar success

University of Kansas

LAWRENCE — A city’s streetcar system can be many things. But it can’t be everything. New research from the University of Kansas has found that cities with underperforming streetcar systems often get there by setting too many, sometimes conflicting, goals for what they want the transit systems to accomplish.

Joel Mendez, assistant professor of public affairs & administration at KU, conducted a study in which he analyzed streetcar systems from around the United States. He then focused on two cities with high-performing systems and two with poor-performing streetcars to see what differences caused the disparities. Results showed it is a case of placemaking vs. place taking, or focusing on a streetcar as an economic developmental tool versus a system that takes passengers where they want to go.

Over the past decade, more than $1 billion has been invested in streetcar systems across the nation.

“The reality is most systems are not doing great in terms of attracting passengers,” Mendez said. “This research was geared toward understanding what’s driving performance outcomes in these streetcar systems. I explored the role which goal tension plays in this situation as past research has found that transit projects can pursue as many as 25 distinct and often conflicting goals.”

Such goals commonly include improving air quality, reducing car traffic, increasing mobility for low-income residents and economic development. While all the goals have merit, Mendez said they can often contradict each other.

For the study, Mendez selected two cities with high-performing streetcar systems: Kansas City, Missouri, and Tucson, Arizona. Two underperforming cities — Atlanta and Cincinnati — were selected as well. He examined performance metrics, system policies, location characteristics and planning documents and interviewed 40 people involved in the planning and development of the four systems. Interviewees were asked what influenced decisions that shaped the streetcar systems in their respective city. Mendez found that systems that prioritized economic development in decision making tended to perform poorly. The most successful systems were in cities that emphasized system performance and placed streetcar systems in areas where people lived, worked and wanted to go for entertainment, recreational and personal reasons.

“In cities that prioritized economic development, decisions reflected that focus,” Mendez said. “For example, if you look at corridors where poor performing systems were placed, you will find twice the number of vacant parcels and properties. Such placement can maximize the economic development impact of the streetcar, but it limits its ability to serve the immediate needs of the public.”

Riders of such systems often indicated that they did not use the streetcar as it did not take them to where they wanted to go. Such placement often reflected where decision makers wanted development to go. Anticipated development, if it does come to fruition, can take time and result in the presence of empty streetcars in the meantime.

“This can sour people on the idea of streetcars and affect both political and public perceptions. Plans for expansion won’t happen if employers, workers and leaders think it’s a waste. I think it’s important for cities to focus on passenger attraction,” Mendez said.

Kansas City and Tucson, the cities with high-performing systems, focused more so on place taking, or transporting people to highly desired locations, such as downtown areas with high densities of jobs, entertainment, dining and other features.

The study, published in the Journal of Planning Education and Research, also found that fare policy played a role in ridership numbers. In systems where the fares were not coordinated with other modes of transit, ridership suffered.

Portland, Oregon, installed a streetcar system about two decades ago and saw immediate success. That, coupled with an ongoing availability of federal funds for such systems, spurred many other cities to follow suit in the past decade. Other cities continue to plan streetcar systems, and Mendez said the findings could help planners, developers, policymakers and the public set goals that give such transit systems a chance for success. His larger body of research examines transit planning and policy and how it intersects with equity and future work will examine how private actors influence streetcar development, and if they are doing so in ways that benefit themselves over public interests.

Meanwhile, cities with high-performing streetcar systems are showing that taking people where they want to go is the surest indicator of a successful plan.

“You have to make it easy to get to if you want people to use it,” Mendez said.

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Journal

Journal of Planning Education and Research

DOI

10.1177/0739456X241268516 

Method of Research

Observational study

Subject of Research

Not applicable

Article Title

Place-Making or Place-Taking? The Relationship between Goal Tension and System Performance of U.S. Modern-Era Streetcar Systems

AMERIKA

Heart transplant patients from socioeconomically deprived areas face higher risk for postoperative complications, earlier death than others

The disparity persisted even when they were transplanted at high-volume, high-quality hospitals

University of California - Los Angeles Health Sciences

Heart transplant patients who live in socioeconomically disadvantaged areas are more likely to experience post-surgical complications and die within five years than patients who live in more advantaged areas, even when those patients were transplanted at topnotch high-volume hospitals, new UCLA research suggests.

The findings, to be published September 30 in the peer-reviewed Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, suggest that a lack of access to follow-up care, likely stemming from neighborhood deprivation, are at the root of this disparity, said lead author Sara Sakowitz MS MPH, a medical student at the David Geffen School of Medicine at UCLA.

The paper was originally highlighted at the 2024 Society of Thoracic Surgeons National Meeting, where it was named the J. Maxwell Chamberlain Memorial Paper, representing the top paper in perioperative care.

“Our study demonstrates that access to high quality centers for cardiac transplantation does not mitigate persistent neighborhood deprivation-based disparities in patient and allograft survival,” Sakowitz said. “Rather, factors outside the immediate post-transplantation period that stem from access to longitudinal care or crucial immunosuppressive medications, appear to be implicated.”

“Altogether, this means that improving access to care is not wholly sufficient to address persistent disparities in post-transplant outcomes. We must shift our focus to addressing inequities in access to and engagement with longitudinal care, over the months and years following transplant,” she added.

The researchers examined data from the Organ Procurement and Transplantation Network (OPTN) for adults who received heart transplants between January 2005 and December 2022, with data from follow-ups through June 2023. They used a metric called the Area Deprivation Index (ADI), a composite of a neighborhood’s financial strength, economic hardship, inequality, and educational attainment to rank regions from 1 for highest socioeconomic status or “least deprived,” to 100, representing lowest socioeconomic status, or “most deprived.”

Death at years one, three and five post-transplant was the primary outcome the researchers measured, followed by outcomes during transplant hospitalization and organ failure at three and five years.

Of the 38,000 heart transplant recipients’ data examined, about 20% (7,600) were from the most deprived areas.

The researchers found that people in the most deprived areas had a 14% higher risk of dying at three years and 13% higher chance of dying at five years. In addition, they faced a 14% higher risk of organ failure after three years and 13% increased risk after five years.

Even when they received care at high quality hospitals, heart transplant recipients stood a 10% higher chance of dying at both three and five years compared to their counterparts living in less deprived areas, suggesting that treatment at the better hospital did not translate into statistically better outcomes.

Patients from deprived communities more frequently had diabetes, higher body mass index, and coronary disease compared with those from higher income areas, the researchers noted. But the disparity persisted even after adjusting for factors such as race, insurance, and comorbidities.

“Therefore, community-level socioeconomic disadvantage appears to act as a higher-level, compounding structural factor that independently shapes post-transplant outcomes,” they write.

Study limitations include a potentially insufficient granularity in OPTN data, a lack of surgeon experience information, and the possibility that the ADI scores may not completely represent patients’ socioeconomic characteristics due to how they are calculated, indicating a need for more research.

In the meantime, the researchers are further exploring the factors possibly contributing to the disparity, such as access and adherence to post-transplant medication and the impact of residential and environmental forces on health.

“Our goal is to fully characterize the complex, non-linear, and multi-faceted associations of social determinants with cardiac care and outcomes, so that we can design appropriately targeted solutions at both the local and national scale,” Sakowitz said. “To address the systemic, root causes underlying disparities in transplantation, we have to break down these large scale problems into inflection points where we can make meaningful change.”

The research was performed in the Cardiovascular Outcomes Research Laboratories (CORELAB) in the Department of Surgery under the direction of Dr.Peyman Benharash, the senior author of the report. Additional co-authors are Dr. Syed Shahyan Bakhtiyar, Dr. Saad Mallick, Amulya Vadlakonda, Dr. Nikhil Chervu, and Dr. Richard Shemin of UCLA. Bakhtiyar is also affiliated with the University of Colorado.

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Journal

The Journal of Heart and Lung Transplantation

DOI

10.1016/j.healun.2024.08.012 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Hospital volume does not mitigate the impact of area socioeconomic deprivation on heart transplantation outcomes

Article Publication Date

30-Sep-2024

 

Cause-specific mortality rates among the US Black population

JAMA Network

The Study:

 This study highlights that progress in reducing excess mortality rates among Black individuals was made primarily in reducing deaths from cancer and cardiovascular diseases among males and from cardiovascular diseases and diabetes among females. However, this progress was stalled or reversed by an increase in mortality from external causes, such as assaults and accidents, as well as a stagnation in advancements against cardiovascular diseases during periods without decrease.

Corresponding Author: To contact the corresponding author, Harlan M. Krumholz, MD, SM, email harlan.krumholz@yale.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2024.36402)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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Journal

JAMA Network Open

Spiritual themes, distrust may factor into Black patients’ reluctance to participate in cancer clinical trials

Surveys from two Baltimore medical centers shed light on what may be fueling enrollment declines

American Society for Radiation Oncology

WASHINGTON, September 30, 2024 — Spiritual beliefs and a historically-based distrust of clinical research may factor into Black patients’ decisions about whether to participate in cancer trials, according to surveys of patients treated at two Baltimore medical centers. Findings will be presented today at the American Society for Radiation Oncology (ASTRO) Annual Meeting. 

This cross-sectional, descriptive study found lingering distrust in clinical research among Black patients, despite their self-reported trust in their cancer medical teams. The surveys sought to shed light on what might be contributing to the growing underrepresentation of Black people in cancer trials and identify ways in which researchers might improve recruitment efforts so their findings can be generalizable to more diverse populations.

“When you offer someone participation in a clinical trial, the conversation has to go beyond the consent form,” said Charlyn Gomez, lead author of the study and a medical student at the University of Maryland School of Medicine in Baltimore. “If we want to improve recruitment of underrepresented people in clinical research, we cannot just talk about trial goals. We have to look beyond that to understand where the patient is coming from and what their priorities are.”

“Our research has identified some really important themes that should be discussed with patients as part of the recruitment process, such as spirituality or faith, as well as recognizing the elephant in the room that is a justifiable mistrust stemming from structural racism and historical practices in clinical trial programs,” she said. “But on the positive side, we also found there is trust in the medical care team and perhaps we can build from there.”

Clinical trials in the U.S. historically have been populated almost exclusively by white, male participants. In 1993, Congress directed the National Institutes of Health (NIH) to establish guidelines for the inclusion of women and minority populations in all government-funded clinical research so that study populations would more accurately reflect real-world populations. Despite these mandates, however, inclusion of racial and ethnic minority populations in cancer trials has remained low; one study found that among the cancer clinical trials reporting race, only 7.2% of participants were Black, even though Black people make up 14% of new cancer diagnoses. More recently, research shows that the gap in participation between Black and white patients grew even wider among people diagnosed with cancer during the COVID-19 pandemic.

Underrepresentation of diverse populations in clinical research can have serious consequences, Gomez said. Seeking to identify key psychosocial factors that may be playing a role, she and her colleagues developed a questionnaire from two previously validated surveys and gave it to patients who completed definitive radiation treatment for curative gastrointestinal, thoracic, gynecological, and head and neck malignancies. Between October 2023 and February 2024, 97 patients – 30% of whom were Black – were asked if they would participate in a clinical trial and to fill out surveys describing the factors they might consider when making this decision. They were asked to complete the surveys while waiting to see their cancer physicians.

There were no differences in insurance coverage, education, employment status, cancer stage or cancer treatments between Black and non-Black participants. And within both groups, at least 90% of participants said they trusted their cancer doctors.

Black patients were more than five times as likely to agree with statements that death or illnesses were determined by God’s will (55.5% vs.10%; p=0.001) and that God, not research, determined wellness (59.1% vs.11.6%; p<0.001), compared to patients who were not Black. Twenty percent of Black people said they agreed that research harmed minority populations, compared to zero non-Black patients (p<0.001).

One-third of Black patients said they felt research would provide information about their health they would rather not know about, compared to 4% of non-Black participants (p=0.037). Black people were 10 times more likely than their non-Black peers to say they felt they individually (20% vs. 2%; p=0.038) and their community (40% vs. 6%; p=0.031) had nothing to gain from participating in clinical research.

At least some of that distrust stems from historically unethical research practices that harmed Black people, Gomez said. From 1932 to 1972, the U.S. Public Health Service failed to obtain informed consent or explain the risks of a study of untreated syphilis among Black men in Tuskegee, Alabama. Researchers also withheld penicillin treatment from the 399 study participants with syphilis when it became available in 1945, causing preventable illness and death among study participants and their family members. This led to the creation of the Belmont report, establishing ethical principles and guidelines for the protection of human research subjects.

Overcoming that justifiable and deeply embedded distrust is imperative to developing cancer treatments that can benefit Black patients, Gomez said.

“Physicians need to be more intentional in their efforts to gain the trust of Black patients so they may be better represented in clinical trials. Unfortunately, due to a host of issues such as systemic racism and fewer access points into the healthcare system, we are seeing that Black patients tend to experience poor outcomes with certain cancers. This reality should raise a lot of alarms, because if we're trying to develop new treatments and the patients who need them the most aren't part of the clinical trials testing them, then we're missing a big group of important people.”

Gomez said the findings might guide the development of training programs for researchers and physicians to help with recruitment efforts. “I think it would be well-received if physicians were trained to address these issues and perhaps incorporate these discussions into their protocols,” she said.

In light of the weight given to religious and spiritual beliefs, she said it may also be important to include family and community members in discussions about the potential benefit and importance of participating in clinical trials. “Sometimes, patients seek out guidance to help them make that choice, alongside their family and other community members, and it becomes a shared decision-making process.”

Gomez also said more studies like this one are needed to further explore the factors that may impede participation in clinical research for underrepresented groups. “It's crucial for us to improve the recruitment of Black patients into cancer clinical trials,” she said. “But to do that, we have to understand the values and priorities of patients in this underserved population.”

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Attribution to the American Society for Radiation Oncology (ASTRO) Annual Meeting is requested in all coverage.

Study/Presentation Details

• Abstract 215: Centering Black voices: Factors influencing a cancer patient’s decision to join a clinical trial
• News Briefing: Tuesday, October 1, 9:00 a.m. Eastern time. Details here. Register here.
• Scientific Presentation: Monday, September 30, 10:55 a.m. Eastern time, Walter E. Washington Convention Center. Email press@astro.org to access the livestream or recording.

ABOUT ASTRO

The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. Radiation therapy contributes to 40% of global cancer cures, and more than a million Americans receive radiation treatments for cancer each year. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and follow us on social media.

 

New tool can assess elderly dogs’ frailty

North Carolina State University

Researchers from North Carolina State University have developed a tool that can aid owners and veterinarians in assessing an elderly dog’s frailty. The tool – when coupled with simple assessments of body and muscle condition by the veterinarian – can predict likelihood of short-term (within six months) mortality and provide important data to owners faced with treatment and quality-of-life decisions for their aging dogs.

“In humans, we classify frailty as a physical or physiological state associated with loss of strength, slow walking speed, weight loss, exhaustion and reduced activity – which is what happens as your body starts winding down,” says Natasha Olby, Dr. Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology at NC State.

“In humans, frailty correlates with disability and mortality, and we have tools for assessing frailty in humans. However, this is an emerging field in dogs and there is a need for screening tools that can be applied easily.”

Olby is the primary investigator for NC State’s canine neuro-aging program, which seeks to understand the mechanisms involved in the canine aging process.

“We were motivated to develop a frailty phenotype, or set of common characteristics, in part because we think frailty may be altering outcomes for some of the dogs in our clinical trials,” Olby says. “The other motivation is that we see frail dogs every day – and the condition is not well-described.

“One of the most common questions veterinarians receive from owners trying to decide on treatments for elder dogs is, ‘How long will my dog live?’” Olby says. “If we could develop a phenotype that is reasonably predictive of short-term mortality, it could be helpful for owners who are faced with treatment decisions.”

The researchers developed a frailty screening questionnaire that asked owners questions about their dog’s nutrition status (which included overall body condition and appetite), exhaustion/energy level, mobility, muscle condition and social activity. These five “domains” are also used in human frailty assessments.

They then validated the tool against two dog populations: 39 dogs that were current participants in Olby’s neuro-aging study, and 198 dogs aged 10 years and older who were not enrolled in the neuro-aging study.

Dogs that were classified as impaired in three of the five domains were considered frail and were twice as likely to die within six months as dogs that were not frail.

“Of course, the reality is that you never really know how long a dog will live, but this questionnaire coupled with body and muscle condition scores is good at predicting six-month mortality,” Olby says. “And it is an easily deployable screening tool that doesn’t require any lab work – a veterinarian can assess body and muscle condition with simple palpation.”

The researchers are hopeful that this screening tool will lead to more complete phenotypes for canine frailty.

“It is definitely still a work in progress, but this screen is a simple tool that owners and veterinarians can use as a starting place for discussing care options for elderly dogs,” Olby says.

The work appears in Frontiers in Veterinary Science and was supported by the Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology. Olby is the corresponding author. Former NC State postdoctoral researcher Katharine Russell is the first author. Former resident Gilad Fefer, current resident Alejandra Mondino and NC State professors Emily Griffith, Korinn Saker and Margaret Gruen also contributed to the work.

-peake-

Note to editors: An abstract follows.

“Establishing a clinically applicable frailty phenotype screening tool for aging dogs”

DOI: 10.3389/fvets.2024.1335463

Authors: Katharine J. Russell, Alejandra Mondino, Gilad Fefer, Emily Griffith, Korinn Saker, Margaret E. Gruen and Natasha J. Olby, North Carolina State University
Published: Sept. 24, 2024 in Frontiers in Veterinary Science

Abstract:
Introduction: Frailty is a well-defined clinical syndrome in humans caused by accumulation of impairments which result in loss of reserve capacity and increased vulnerability to disability, dependence, and death. Dogs are of particular interest in studies of frailty due to the similarities they share with people in their environment, lifestyles, and age-related diseases.
Materials and methods: The aim of this study was to develop a frailty phenotype, based on previously validated measures in dogs, which could be easily applied in the clinical setting, and which was predictive of all-cause, short term (6-month) mortality. The study was conducted in two phases. In phase 1, a retrospective cohort of 51 dogs was used to identify and evaluate potential measures for the five domains of frailty. This information was then used to develop a simple frailty phenotype based on examination findings and owner directed questions. In phase 2 of the study, this phenotype was evaluated in a prospective cohort of 198 dogs aged 9years or older from multiple different specialty and primary care services to determine how the phenotype performed across a diverse canine population.
Results: The developed frailty phenotype was predictive of all-cause, short-term mortality independent of age, sex, or weight (hazard ratio = 4.71; 95% CI, 2.66–8.8). Of the covariates evaluated only breed was significant, with purebred dogs having 1.85 times higher mortality than mixed breed dogs (95% CI, 1.04– 3.31). The frailty phenotype performed similarly across all hospital services from which patients were enrolled.
Conclusion: Based on these findings, the defined frailty phenotype represents a valuable screening tool for early risk identification and intervention and can aid in clinical decision making for owners and veterinarians. Additionally, it will promote further research into the understanding and treatment of frailty in dogs.

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Journal

Frontiers in Veterinary Science

DOI

10.3389/fvets.2024.1335463 

Method of Research

Observational study

Subject of Research

Animals

Article Title

Establishing a clinically applicable frailty phenotype screening tool for aging dogs

Article Publication Date

24-Sep-2024

COI Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

 

NIH awards ADA Forsyth over $6 million to design AI-driven amalgam replacement for dental restoratives

Forsyth Institute

 

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SEM images of self-healing dental composites: before and after heal. Self-healing composites may autonomously repair microcracks that is hard to detect and almost impossible to repair manually.

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Credit: Image courtesy of Jirun Sun, PhD, ADA Forsyth Institute

The ADA Forsyth Institute (AFI) has been awarded a $6.2 million grant from the National Institute of Oral and Craniofacial Research (NIDCR). Funded under the highly competitive RM1 mechanism, this five-year award will support a groundbreaking project to develop next-generation smart materials for dental fillings using physics-based artificial intelligence (AI). This innovation marks one of the first applications of AI for basic research in oral health, aimed at accelerating the testing and development process.

Next-Generation Smart Material

The new dental composite will feature self-healing and antimicrobial properties, incorporating nanofillers that react to biological signals. “Imagine you have a crack developing in the filling,” said biomaterials expert Jirun Sun, PhD, the contact principal investigator (PI) leading the multi-PI team.

“The material will detect that change and repair the crack. Or if your mouth has a lot of acid that lowers the pH, which is known to break down traditional composites and tooth structure, the material will counteract the acid. The smart material will automatically respond to changing conditions in each individual patient’s mouth.”

Transdisciplinary Effort Maximizing AI Capabilities

The transdisciplinary team of scientists will integrate experiments with a physics-based model of testing and data-driven simulations as part of the material design and evaluation of these complex and dynamic materials. The AFI team has partnered with Optimuos, a digital engineering firm specializing in digital twin technologies, to build the AI driven solution.

“Without this approach, the number of parameters that we must test would have taken decades to complete,” said Dr. Sun. “Incorporating artificial intelligence and virtual lab simulations into the physical material development process, based on well-defined laws of physics and chemistry, will accelerate our goal of transforming personalized dental care.”

Ben Wu, DDS, PhD, the Chief Scientific Officer and Chief Operating Officer of AFI, emphasized the project’s broader implications. “This grant is the first step to leveraging AI and deep learning to facilitate and accelerate research. This approach can be applied to the other cutting edge innovative research at AFI, from managing drug-resistant biofilm to aberrant immunological host response, and much more.  Our institute is well positioned to leverage the new tools of bioengineering, AI and data science to accelerate discovery and impact oral health.”

Applications in Dentistry

The new material will be optimized to provide a viable replacement for amalgam, a cost effective and durable solution that is slowly being phased down around the world. Although alternative restorative filling materials currently exist, they may need to be replaced more often and can be more expensive to use. The scientists are designing these new materials to be easy to use and accessible to everyone.

“AFI scientists aren’t just creating something more durable, they’re creating a completely different generation of dental composite,” said Dr. Raymond Cohlmia, Executive Director of the American Dental Association (ADA) and the Chair of AFI’s board of directors. “This smart material could revolutionize dental care and drastically improve patient outcomes. The future of dental restorations – and so much more – is happening now. I’m so proud that AFI is at the forefront.”

Joining Dr. Sun on this exciting, multiple PI award are Drs. Felicitas Bidlack, Yulong Zhang, Xuesong He, and Ben Wu from AFI; Dr. Leyla Mirmomen, Chief Executive Officer at Optimuos; and Dr. Pirouz Kavehpour, Professor at University of California, Los Angeles, and Chief Scientist at Optimuos. 

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About the ADA Forsyth Institute

The ADA Forsyth Institute was founded in 1910 as the Forsyth Dental Infirmary for Children (later, the Forsyth Institute), to provide dental care to the disadvantaged children of Boston. While continuing to serve children in need, yet recognizing the ultimate goal is to prevent dental disease, the Institute in 1915 began to focus on scientific research and is today the world’s leader in oral health research. In October of 2023, the Institute joined with the American Dental Association to form the ADA Forsyth Institute, a 501(c)(3) entity dedicated to improving people’s oral and overall health and powering the profession of dentistry through cutting-edge basic research, creative translational science, innovative clinical technologies, and global public health outreach. Consistent with the Institute’s founding mission, the ADA ForsythKids mobile dental program continues to serve children in need.