Monday, August 29, 2022

How do land sparing vs. land sharing interventions influence human wellbeing?

Q&A with the researchers

Peer-Reviewed Publication

THE ALLIANCE OF BIOVERSITY INTERNATIONAL AND THE INTERNATIONAL CENTER FOR TROPICAL AGRICULTURE

Land interventions and human wellbeing (1) 

IMAGE: INSIDE SUSTAINABLE USE RESERVES (BRAZIL): PEOPLE PRACTICE SMALL-SCALE AGRICULTURE AND LIVE PREDOMINANTLY IN HOMES MADE OF WOOD AND PALM THATCHING. THESE SUBSISTENCE LIVELIHOODS ARE DIRECTLY CONNECTED TO THE SURROUNDING LANDSCAPE. view more 

CREDIT: RACHEL CARMENTA

A recent study published in People and Nature focuses on how land use approaches impact human wellbeing. 

Q: Before we get into the details of the research, can you explain the terms “Land sparing” vs. “Land sharing”, and how these relate to your research?

RC: Land sharing and land sparing is a framework often used to assess how different land management strategies impact biodiversity and agricultural yields.

Specifically, it looks at the relationship between agricultural yield and species response curves, asking: do species do better in landscapes where agriculture is intensively concentrated and managed in certain patches, sparing land for nature elsewhere (ie, land sparing)? Or do species do better in landscapes that are composed of a mosaic distribution of low-intensity agriculture peppered through a ‘natural’ landscape that provides a biodiversity-friendly matrix (land sharing)?

One of the invisible factors in the spare debate is how those strategies impact people living in the landscapes. Some have argued that a more ethical and just approach should focus on the people – and that perhaps doing so can move the scientific community beyond the ‘false dichotomy’ of Sharing vs. Sparing. With this in mind, we put people at the center of our research and assessed the impact of contrasting interventions across the sharing vs. sparing spectrum on locals’ human wellbeing.


Q: Your new paper discusses the importance of “integrated interventions” in conservation of tropical landscapes. Can you explain what are integrated interventions, with an example?

RC: Integrated forms of conservation recognize that people and nature can co-exist in the same landscape, with more respect for cultural and agricultural traditions and an emphasis on collaborative, cross-sectoral efforts.

These approaches try to integrate different needs within a landscape (conservation, agriculture, climate change mitigation), rather than pursue single-sector, or ‘siloed’ goals. For instance, sustainable use reserves attempt to do this with clear rules about resource use for conservation purposes, land rights granted, small-scale diversified and sustainable agriculture allowed, etc.

However, we know little about how these interventions perform on multi-dimensional wellbeing, partly because the sharing-sparing focus measures different things (ie, yield and species responses), and partly because usually social impact, when included, involves only the material dimensions of peoples' wellbeing.


Q: What is an example of the opposite, a single-sector intervention?

NEC: The clearest examples of this are high-input conventional agriculture and strict protected areas. High-input conventional agriculture aims to maximize yields for commodities (often one crop only) and theoretically squeeze more units of yield out of a given area. With “less” land allocated to agriculture, more land would be spared for nature through strict protection, where people (often indigenous peoples) are banned from resource use or residing within the area, and land is ‘protected’ for nature alone.

More evidence is contesting the assumptions behind these types of interventions, and more robust performance assessments are also contesting the often-assumed outstanding performance. When other aspects are considered, such as the impact on human health and ecosystems in the short and long term, changes in yield over time, species mobility, and the production from other companion crops, conventional agriculture does not necessarily outperform integrated  / diversified / low-input systems, particularly in the long-term.


Q: So the finding, if I understand correctly, is that human wellbeing does better integrated interventions? 

RC: Yes, that's right. We looked at how these interventions impact locally salient human wellbeing. The key findings are threefold, and each relates to people more than the conservation status, agriculture performance or biodiversity in the landscape (which have been measured elsewhere).

  1. First, by asking what matters to people, we demonstrate that the longstanding focus of impact appraisal on material things in peoples’ lives (e.g. income) is at odds with what people care most about. Material aspects of human wellbeing are of less or equal importance as the relational (“family”, “friends”, “connection with nature”) and quality of life (“good food”, “good land”) aspects of human wellbeing.
  2. Second, by asking how the interventions affected what matters the most to people, we demonstrate that integrated interventions have more impact, and what’s more – more of that impact is positive. Meanwhile, single sector – or land sparing interventions - have less impact, and more of that is actually negative.
  3. Third, we find a dominance of null impact across all interventions, meaning thatinterventions can be better co-designed with local communities to be locally relevant and bring significant benefits. This finding also suggests that interventions are one drop in a sea of influences - for example, political economy - that impact peoples' lives.

Overall, our research joins previous evidence showing the flaws of the land-sparing debate, particularly on how these rather simplistic interventions can negatively impact people. Our research also calls for decolonial conservation and development interventions by co-designing, co-implementation, and co-assessing impact. This will require asking people who are impacted: how have they been impacted, and which types of impacts are most salient, and what types of futures do they want to see in their landscapes and territories?


Q: What do these findings mean for other researchers, especially across international organizations working on conservation and agriculture for development?

RC: The findings support the growing recognition of the need for integrated, systems- and multidisciplinary- approaches that can sustainably and equitably govern natural resources and landscapes for society, climate and conservation outcomes. It also supports the ecological economists and other rogue economists who have been arguing that material metrics of wellbeing are insufficient, and finally, it finds traction with the many voices calling for a decolonial approach to conservation and development challenges.


Q: How do you think sustainable development organizations and other conservation actors can apply this research for better impact?

RC: Our research can support initiatives by generating the evidence that will help navigation towards positive impact on people and nature. Also, it can help to adopt bottom-up impact assessments that include the relational and subjective dimensions of peoples’ wellbeing, not only the material. Similarly,  it can support holistic and systems-oriented research, combining agricultural and ecological assessments with wellbeing ones to understand trade-offs and synergies. Last but not least, this can motivate other researchers to improve, test, expand and apply our methods in other regions.  

CAPTION

Intensive agriculture dominating the landscape. Communities that formally held small-scale agriculture plots are no longer farming the region, and community assembly houses and graveyards are now surrounded by a sea of soy.

CREDIT

Rachel Carmenta

Reactive comment: White House announces new policy to drop paywalls around publicly funded research

Business Announcement

FRONTIERS

On 25 August 2022, the White House unveiled new policy to end the paywalls surrounding federally funded scientific research in the United States.

The Office of Science and Technology Policy announced ground-breaking new guidance to remove any “delay or barrier between the American public and the returns on their investments in research.” When implemented, it will make the results of taxpayer-supported research immediately available to the public at no cost.

Citing the need to realize and access the ground-breaking possibilities created by taxpayer-funded research, Dr Alondra Nelson said the “American people fund tens of billions of dollars of cutting-edge research annually” and that this research, when widely available, “can drive more equitable outcomes across every sector of society.”

Kamila Markram, co-founder and chief executive officer of Frontiers, the open access research publisher, said: “Enormous progress has been made in our collective efforts to extend the benefits of publicly funded research to all of society, and this announcement ought to be a tipping point. The Covid emergency taught us that open science drives innovation and saves lives.

“As we face down global, existential threats, not least climate change, open science without paywalls will accelerate collaboration and improve our chances of success. We stand ready to work with partners in the vanguard of this transition.”

What are the seven virtues of a healthy democracy?

A new book outlines how the average citizen can defend democracy in the U.S.

Book Announcement

PENN STATE

UNIVERSITY PARK, Pa. — People can become involved in politics in a number of ways. They can vote, volunteer in campaigns, or even run for office themselves. But when it comes to improving the state of the U.S. democracy, what can the average citizen do?

Christopher Beem, managing director of the McCourtney Institute for Democracy at Penn State, attempted to answer that question in his upcoming book, "The Seven Democratic Virtues: What You Can Do to Overcome Tribalism and Save Our Democracy."

The book describes the characteristics and practices — such as humility, courage, and charity — that Beem said can help people become better democratic citizens. According to Beem, the book was inspired by a question he was often asked when people learned about his area of study.

“Many people would ask me what the average citizen can do to defend our democracy, and it’s a good question that deserves a serious answer,” Beem said. “People might not be able to change the way the news is reported or overcome the power of lobbyists and campaign donations. But we can step up and analyze our own behavior and make small changes to the way we think and act to help stand up for our democracy.”

According to Beem, one of the greatest current threats to democracy in the U.S. is tribalism, the tendency for people to form groups, cooperate within them, and distrust and disparage those outside the group. He argued that tribalism is a basic neurological tendency for people to be drawn to others similar to themselves, and that it affects almost everyone.

Beem said that while democracies are generally vulnerable to tribalism — for example, the two-party system in the U.S. tends to split people into one team or the other — the problem has reached new heights in the U.S. in recent years.

“It has swamped the banks of our democratic life and turned us into two ever-more-hostile camps,” Beem wrote in the book’s introduction. “In this moment, the ‘other side’ is no longer an opponent but an existential threat; norms of behaviors are for suckers; politics has become a zero-sum game. As more partisans — politicians and citizens alike — reflect this attitude, the rhetoric ratchets up, leading to ever more distrust, antagonism, and even enmity.”

However, Beem said there is still opportunity for people to step up and be part of the solution: changing the way they think about democratic citizenship. 

To organize the list of virtues that would help citizens live together and thrive within a democracy, Beem broke them down into three categories: democratic thinking, democratic acting, and democratic belief.

According to Beem, intellectual or “thinking” virtues help us understand what is good and just, and the three thinking democratic virtues are humility, honesty and consistency. While humility is about understanding that everyone has biases that are hard to overcome, honesty is about recognizing that those biases can lead us to believe falsehoods.

“Consistency is how we can try to overcome those biases,” Beem said. “For example, if you think a certain behavior is acceptable when it’s done by someone on your side, would you feel the same way if it was somebody on the other side? Of course, every circumstance is different and there could be exceptions. But at minimum, having that kind of discussion helps move us beyond our biases. That’s democratic thinking.”

Next, Beem described the moral or “acting” virtues, which help us improve our actions —  courage and temperance. Courage is the ability to challenge the beliefs and actions of members of your own group, not just those of other groups. Temperance, meanwhile, is the ability to keep anger toward others from morphing into hate.

Finally, Beem listed the final virtues of charity and faith. While charity is the process of giving each other the benefit of the doubt and trusting that everyone has a common, shared commitment to democracy, faith is the belief that democracy can ultimately prevail.

“Faith is the idea that you can be a witness for what you understand to be true, and you can have faith that your fellow citizens will respect your voice and actions, listen to what you have to say, and actually be moved,” Beem said. “That’s not to say that happens all the time, or even the majority of the time, but that it can and has happened.”

Ultimately, Beem said he hopes people walk away from reading the book feeling more empowered than when they started.

“If you’re unhappy with the state of the country, it can be easy to feel overwhelmed or even despair,” Beem said. “I hope people can find things they can do to feel like they’re making a difference. In President [Joe] Biden’s inaugural address, he talked about times that America has been in crisis before, and that it took enough people standing up and doing the right thing to find a solution. And I think that's right, that if you have enough people, you can change the culture. And by doing that, you can change our politics.”

"The Seven Democratic Virtues: What You Can Do to Overcome Tribalism and Save Our Democracy" will be published Aug. 30, by Penn State University Press. Beem will be teaching a one-credit class organized around the book in Spring 2023.

Reveal the fate of microplastics in a coastal wastewater treatment plant by the integrated membrane system

Peer-Reviewed Publication

HIGHER EDUCATION PRESS

Reveal the fate of microplastics in a coastal wastewater treatment plant by the integrated membrane system 

IMAGE: NONE view more 

CREDIT: YING CAI, JUN WU, JIAN LU, JIANHUA WANG , CUI ZHANG

Microplastic (defined to be less than 5 nm) is growing environmental pollution problem. The increase of plastics waste from the plastic industry or personal care products could cause the accumulation of microplastics in various ecosystem and environments. Microplastics are ubiquitous and have been detected in more than 2,000 marine organisms. The large amount of chemicals released by microplastics can affect living organisms and threaten their health. In addition, hydrophobic microplastics could adsorb on endocrine disruptors, antibiotics and other organic pollutants in water, which is undoubtedly aggravated the aquatic environment pollution. Therefore, how to prevent microplastics from entering the environment is still a challenge. 

Various studies have shown that waste treatment plant is the most important way for the discharge of various emerging contaminants including microplastics into the environment. Among them, the rapidly growing membrane technology is a prospective treatment method for various pollutants removal in wastewater treatment process. Membrane technology has an excellent removal rate for COD, NH4+-N, bacteria, organic pollutants and antibiotic resistance genes. With the shortage of water resources and water pollution, the integrated membrane system (IMS) technology for reclaimed water reuse has attracted more and more attention. Can the wastewater treatment plant prevent the microplastics from entering the marine environment? And what is the fate of microplastics in the IMS system used for water reclamation?

To answer these questions, Prof. Jian Lu and Dr. Ying Cai from Chinese Academy of Sciences and their team members have worked jointly and investigated systematically the fate of microplastics in conventional activated sludge system (CAS) and IMS system in a coastal reclaimed water plant. Their work identified IMS system could prevent the re-entry of most of the microplastics into the marine environment and convert the wastewater into renewable water, which can subsequently reduce pollution to the ocean and solve the shortage of water resources. This study entitled “Fate of microplastics in a coastal wastewater treatment plant: Microfibers could partially break through the integrated membrane system” is published online in Frontiers of Environmental Science & Engineering in 2022.

In this study, the fate of microplastics in IMS in a coastal reclaimed water plant was investigated. The removal rate of microplastics in the IMS system reached 93.2% after membrane bioreactor (MBR) treatment while that further increased to 98.0% after the reverse osmosis (RO) membrane process. The flux of microplastics in MBR effluent was reduced from 1.5×1013 MPs/d to 10.2 ×1011 MPs/d while that of the RO treatment decreased to 2.7×1011 MPs/d. The application of the IMS system in the reclaimed water plant could prevent most of the microplastics from being discharged into coastal water. These findings suggested that the IMS system was more efficient than CAS in removing of microplastics. However, small scale fiber plastics (< 200 μm) could break through RO system, which is not ignored.

This study investigated comprehensively and systematically the fate of microplastics in traditional water treatment process and in the membrane technology of typical reclaimed water plant in coastal zone. The results show that the removal rate of microplastics by IMS is much higher than that by traditional wastewater treatment process. The introduction of IMS into coastal wastewater treatment plants could prevent the re-entry of most of the microplastics into the marine environment and convert the wastewater into renewable water, which can subsequently reduce pollution to the ocean and solve the shortage of water resources.

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About Higher Education Press

Founded in May 1954, Higher Education Press Limited Company (HEP), affiliated with the Ministry of Education, is one of the earliest institutions committed to educational publishing after the establishment of P. R. China in 1949. After striving for six decades, HEP has developed into a major comprehensive publisher, with products in various forms and at different levels. Both for import and export, HEP has been striving to fill in the gap of domestic and foreign markets and meet the demand of global customers by collaborating with more than 200 partners throughout the world and selling products and services in 32 languages globally. Now, HEP ranks among China's top publishers in terms of copyright export volume and the world's top 50 largest publishing enterprises in terms of comprehensive strength.

The Frontiers Journals series published by HEP includes 28 English academic journals, covering the largest academic fields in China at present. Among the series, 13 have been indexed by SCI, 6 by EI, 2 by MEDLINE, 1 by A&HCI. HEP's academic monographs have won about 300 different kinds of publishing funds and awards both at home and abroad.

About Frontiers of Environmental Science & Engineering

Frontiers of Environmental Science & Engineering (FESE) is the leading edge forum for peer-reviewed original submissions in English on all main branches of environmental disciplines. FESE welcomes original research papers, review articles, short communications, and views & comments. All the papers will be published within 6 months since they are submitted. The Editors-in-Chief are Prof. Jiuhui Qu from Tsinghua University, and Prof. John C. Crittenden from Georgia Institute of Technology, USA. The journal has been indexed by almost all the authoritative databases such as SCI, Ei, INSPEC, SCOPUS, CSCD, etc.

Efficacy, cash and more will increase booster shot acceptance

Peer-Reviewed Publication

CORNELL UNIVERSITY

ITHACA, N.Y. -- The more effective the COVID-19 booster, the more likely people are to get it, according to new Cornell research. And they are more likely to accept the booster shot with cash incentives and if it is made by Moderna or Pfizer.

As the Omicron variant of COVID-19 emerged, Cornell researchers conducted the public opinion survey – thought to be one of the first to assess the factors that affect people’s willingness to receive a vaccine booster.

“We know little about why individuals would receive a booster compared to the initial willingness to vaccinate,” said lead author Shyam Raman, a Ph.D. candidate in the Cornell Jeb E. Brooks School of Public Policy. “Because more variants will likely emerge and fewer than half of all eligible Americans have received even one booster shot, it’s important to understand what goes into that crucial decision.”

The paper, “COVID-19 Booster Uptake among U.S. Adults: Assessing the Impact of Vaccine Attributes, Incentives, and Context in a Choice-Based Experiment” – was published on Aug. 15 in Social Science & Medicine.

The paper was written by Raman and three other Cornell researchers: Douglas Kriner, Clinton Rossiter Professor in American Institutions in the Department of Government in the College of Arts and Sciences (A&S) and a professor in the Brooks School; Nicholas Ziebarth, associate professor in the Department of Economics and in the Brooks School; and Sarah Kreps, John L. Wetherill Professor in the Department of Government (A&S) and a professor in the Brooks School; as well as Kosali Simon of Indiana University.

As of August, the Centers for Disease Control and Prevention estimates just over 48% of fully vaccinated Americans have received a booster. Understanding the basis of attitudes toward boosters is critical to accelerate lagging public health campaigns, according to the researchers.

The researchers conducted a survey of 548 fully vaccinated but not yet boosted participants in December 2021 as the vaccination rate was plateauing, evidence was mounting that initial vaccine immunity was waning, and the new variant – omicron – was emerging amid considerable scientific uncertainty about its scope and lethality.

Against that backdrop, the researchers found:

  • The booster’s efficacy, its manufacturer and cash incentives all contribute to a positive decision. Moderna and Pfizer boosters were more desirable than those manufactured by Johnson & Johnson.
  • Information that the omicron variant may be less lethal but more contagious also upped acceptance.
  • Protection duration and protection against future variants proved to be less persuasive.

Participants in the survey said they would be most swayed by evidence of a booster shot’s effectiveness. If a booster shot were 50% effective, about half the participants would receive it. That climbed to 59% for a 70% effective booster and to 73% for a booster that was 90% effective.

A significant partisan political divide persists in the booster shot decision, the researchers found. When compared to participants identifying as politically independent, Democrats were more willing to receive a booster and Republicans were significantly less willing. Republican participants remain skeptical of vaccination and hesitant about booster shots. The researchers call for continued targeted outreach to that group, they said.

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Spring forward: Changing climate’s early winter wakeup call is a buzz kill for bumblebees

Ottawa Biology study finds climate change is waking bumblebees earlier from winter hibernation, putting the species at risk with impact on human agricultural crops

Peer-Reviewed Publication

UNIVERSITY OF OTTAWA

Spring forward: Changing climate’s early winter wakeup call is a buzz kill for bumblebees 

IMAGE: CONCEPTUAL REPRESENTATION OF HOW CLIMATE CHANGE EFFECTS CAN BE MITIGATED VIA A RANGE SHIFT view more 

CREDIT: BIOLOGICAL CONSERVATION / UNIVERSITY OF OTTAWA

New research from the University of Ottawa has found the earlier arrival of spring in parts of North America negatively impacts bumblebee survival, which could potentially threaten bee-pollinated agricultural crops and other plant sources.

Published in Biological Conservation, this paper is among the first to study climate change’s influence on seasonal weather changes in relation to bumblebees. Researchers from the Faculty of Science found the bees are not correspondingly shifting their activity timing earlier in the year, threatening their ability to find food sources or causing bees to miss out on them altogether.

“This study represents crucial groundwork for understanding that climate can impact the seasonal timing of biological events,” says lead author Olga Koppel, a PhD student in the Faculty of Science’s Department of Biology.

“Bumblebee survival is strongly in our best interest, as we rely heavily on bee-pollinated agricultural crops, including vegetables, fruits, and even clothing fibres such as cotton. The over 40 bumblebee species that are native to North America provide this invaluable economic service.”

Climate change is being linked to global biodiversity decline and its impact on species is a quickly growing field of research. Climate change increases the likelihood of earlier spring onset and flowering in many areas including spring plants, wild plants and trees. These are a necessary food source for winter hibernating bumblebee queens, who search for pollen and nectar after waking up hungry in need of energy.

Being able to match the timing of floral resources gives bumblebee species an edge. Survival, however, for those emerging from hibernation before the arrival of spring flowers – their main food source –is unlikely and leads to smaller colonies with lower odds of persisting in that area the following year. Bumblebees who sync with the changing timing of spring take full advantage of the season’s floral resources and are more likely to persist over time.

Lead authors Koppel and Jeremy Kerr, a Full Professor and Chair in the Department of Biology, examined the relationship between climate and bumblebee spring emergence in a database of specimens from museum collections across North America, comprising 21 species and 17,000 individuals. The authors found climate strongly explained variation in spring emergence timing in 15 of the 21 bumblebee species.

“This research has demonstrated that bumblebee emergence timing can be biased heavily in the direction of climate changes, which has implications for similar research on other species, as well as for the urgent conservation of these valuable pollinator species,” says Koppel. “This study provides a roadmap for evaluating large-scale temporal responses to climate change for many insects and other animals.”

Strong phenological shifts among bumblebee species in North America can help predict extinction risk’ by Olga Koppel and Jeremy Kerr, Department of Biology, Faculty of Science, is published in August’s Biological Conservation. DOI: 10.1016/j.biocon.2022.109675

CAPTION

Climate change climate change is waking bumblebees earlier from winter hibernation, putting the species at risk with impact on human agricultural crops.

CREDIT

Olga Koppel, University of Ottawa

CAPTION

Phenology-Climate Correlation

CREDIT

Biological Conservation / University of Ottawa

There's finally (peer reviewed) chemistry in wine and food pairings (video)

Business Announcement

AMERICAN CHEMICAL SOCIETY

There's finally (peer reviewed) chemistry in wine and food pairings (video) 

IMAGE: RED WINE GOES WITH MEAT; WHITE WINE GOES WITH FISH. PORT GOES WITH STILTON. NEVER DRINK WINE AFTER EATING ARTICHOKES. THESE RULES ABOUT HOW TO PAIR WINE WITH FOOD HAVE SOLID CHEMICAL UNDERPINNINGS — BUT MANY OTHERS DON’T. THE HOLY GRAIL OF FOOD AND WINE PAIRING SCIENCE WOULD BE A FRAMEWORK FOR UNDERSTANDING WHY SOME PAIRINGS WORK AND PREDICTING THE RESULTS OF NEW ONES. FIND OUT HOW CLOSE WE ARE TO DISCOVERING THAT FRAMEWORK AND LEARN ABOUT SOME HIGHLY UNEXPECTED PAIRINGS (COFFEE, CHOCOLATE AND … GARLIC!?): HTTPS://YOUTU.BE/PITGSXIDFXS. view more 

CREDIT: THE AMERICAN CHEMICAL SOCIETY

WASHINGTON, Aug. 29, 2022 — Red wine goes with meat; white wine goes with fish. Port goes with Stilton. Never drink wine after eating artichokes. These rules about how to pair wine with food have solid chemical underpinnings — but many others don’t. The holy grail of food and wine pairing science would be a framework for understanding why some pairings work and predicting the results of new ones. Find out how close we are to discovering that framework and learn about some highly unexpected pairings (coffee, chocolate and … garlic!?): https://youtu.be/pITgSxidfXs.

Reactions is a video series produced by the American Chemical Society and PBS Digital Studios. Subscribe to Reactions at http://bit.ly/ACSReactions and follow us on Twitter @ACSReactions.

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS’ mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the world’s scientific knowledge. ACS’ main offices are in Washington, D.C., and Columbus, Ohio.

A new type of defibrillator met safety, effectiveness goals in global clinical study

Peer-Reviewed Publication

MAYO CLINIC

 A new type of extravascular implantable cardioverter-defibrillator (ICD) using a lead (thin wire) placed behind the sternum met safety and effectiveness goals for participants in a premarket global clinical study. The device effectively terminated acute and chronic life-threatening ventricular arrhythmias. The findings were presented during a late-breaking session at the European Society of Cardiology Congress and were simultaneously published in The New England Journal of Medicine.

Arrhythmias such as ventricular fibrillation and ventricular tachycardia happen in the lower heart chambers, or ventricles. They are dangerous because they interfere with the normal coordinated filling and pumping of blood through the heart. These arrhythmias can cause collapse and death if not rapidly treated. The ability of ICDs to accurately detect and terminate ventricular arrhythmias in high-risk patients saves lives.

For study participants, the lead of the extravascular ICD was inserted under the sternum, compared to transvenous ICD leads that are inserted through the veins into the heart, or subcutaneous ICDs that have a lead placed beneath the skin above the sternum. Patients with prior open-heart surgery, or who required pacing for a slow heart rate or had a pacemaker, were not candidates for this study.

This study is encouraging. By placing the lead in this new position behind the sternum, the uncommon but serious risks associated with transvenous ICDs, such as lung collapse, damage to heart valves and heart perforation, can be avoided. Limitations of the subcutaneous ICD are also overcome. Since the lead is behind the sternum and close to the heart, pacing can be delivered, and defibrillation requires less energy with a longer battery life than with the subcutaneous ICD, says Paul Friedman, M.D., a cardiac electrophysiologist, and principal global investigator and first author of the study. Dr. Friedman chairs the Department of Cardiology at Mayo Clinic in Rochester.

The new extravascular ICD delivered anti-tachycardia pacing — rapid pacing — to painlessly terminate 70% of ventricular tachycardia episodes for which it was applied, (which is) at least as good as transvenous ICDs and not available in the subcutaneous ICD," says Dr. Friedman. "The extravascular ICD was also able to provide backup pacing to prevent pauses and was able to effectively defibrillate using a device half the size of the subcutaneous ICD."

Researchers from 17 countries participated in the study. Of the 316 patient participants with an attempted implant, 299 were discharged with a working extravascular ICD system. The defibrillation success rate was 98.7%. At six months, 92.6% of participants had no major system or procedure-related complications.

"It is important to note that electrophysiologists do not routinely place device leads behind the sternum. However, we found that with a robust training program, we could safely do so in the electrophysiology lab. Initial implantations at each site included a cardiologist and a cardiac surgeon. The average procedure time was 74 minutes, similar to that of the early subcutaneous ICD experience," says Yong-Mei Cha, M.D., director of the Implantable Device Lab at Mayo Clinic and site principal investigator of the study.

"While encouraging, these results reflect an early experience, and there is more to be learned with longer follow-up and greater usage," says Dr. Friedman. "The rates of inappropriate shock are higher than with current devices but similar or lower than the early experience with other types of defibrillators, and steps have already been taken to lower it. Additionally, this new device is not for everyone. Patients with previous open-heart surgery were excluded from the study and would not be candidates for this treatment at present."

The study was sponsored by Medtronic Inc., which also developed the device. The extravascular ICD is premarket and has not been approved by the Food and Drug Administration. But it can be available, pending review, through a continued access study.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

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How the brain’s housekeeper malfunctions during bacterial meningitis

Peer-Reviewed Publication

KAROLINSKA INSTITUTET

Bacterial meningitis is a life-threatening infectious disease of the brain that leaves many survivors with long-lasting neurological impairments. Now, researchers at Karolinska Institutet in Sweden show in a study on rats that the brain’s tool for waste clearance, the glymphatic system, malfunctions during bacterial meningitis, causing a buildup of toxic garbage that damages brain cells. The findings are published in the journal mBio.

“Our study shows that the glymphatic system loses its functionality when an infection occurs in the brain,” says Federico Iovino, associate professor (docent) and group leader at the Department of Neuroscience, Karolinska Institutet and leading author of the study. “Even though we’ve only studied rats so far, we believe it’s possible that the same mechanisms are at play in humans and that the glymphatic system could be a new avenue to explore in the hopes of finding treatments to prevent neurological disabilities caused by bacterial meningitis.”

The glymphatic system was first described in 2013 as a sort of washing-machine that clears waste from the central nervous system, which comprises the brain and the spinal cord. Several neurological diseases, including Alzheimer’s and Parkinson’s disease, have since been associated with its dysfunction.

In this study, the research group of Dr. Federico Iovino and collaborators at the University of Texas Health Science Center at Houston in the U.S. and the University of Southern Santa Catarina in Brazil examined the glymphatic system in rats infected with the bacteria Streptococcus pneumoniae. S. pneumoniae is the leading pathogen causing bacterial meningitis, a potentially deadly infection that in many cases leads to permanent disabilities.

The researchers found higher amounts of bacterial waste products in the brains of rats with meningitis than in a control group. The concentrations were highest in the brain’s cerebrospinal fluid compartments. In contrast, blood tests revealed low levels of bacterial components, indicating the glymphatic system had failed to drain the brain from bacteria and associated rest products. Over time, increased signs of neuroinflammation and neuronal damage were observed, with a corresponding loss of cognitive abilities.

“About half of pneumococcal meningitis survivors suffer from neurological impairments, such as hearing loss, motor and cognitive delay and psychiatric disorders, because of neurons damaged by the infection,” Federico Iovino says. “Since damaged neurons often cannot be repaired or replaced, it is important to find ways to prevent the injury, and the first step in that direction is to understand the molecular mechanisms.”

To further their understanding, the researchers examined brain tissues and cells in detail. They zeroed in on a key fluid transporter, the aquaporin-4 (AQP4)-water channel located at the end-feet of the strings of astrocytes, which are star-shaped cells that act as housekeepers of the glymphatic system.

This water channel normally regulates fluid exchanges between the cerebrospinal fluid compartments and other areas of the brain. But what the researchers found was that during pneumococcal meningitis, the AQP4-water channel lost its natural place and connection with the blood-brain barrier vessel wall. The astrocytic end-feet had detached from the vessel walls after the astrocytes swelled in response to the neuroinflammation caused by the bacterial infection.

“It’s like a snowball effect,” Federico Iovino says. “The infection causes a buildup of toxic bacterial products which activates an immune response that leads to neuroinflammation. The inflammation triggers cellular processes that lead to a detachment of astrocytic end-feet from the blood-brain barrier walls with consequent misplacement and loss of function of the important AQP4-water channel. Combined these events result in a malfunctioning glymphatic system and consequent neuronal damage.”

The study was funded by the Karolinska Institutet Committee for Research, the Karolinska Institutet Research Foundation Grants, the Swedish Research Council, the Bjarne Ahlström Foundation for research in Clinical Neurology, the Clas Groschinsky Foundation, the HKH Crown Princess Lovisa Association for Child Care, the Magnus Bergvall Foundation, the Tore Nilson Foundation, the McGovern Medical School, The University of Texas Health Science Center at Houston, the University of Southern Santa Catarina in Brazil, the Alzheimer's Association and the National Institutes of Health/National Institute on Aging.

Publication: “Dysfunctional glymphatic system with disrupted aquaporin-4 expression pattern on astrocytes causes bacterial product accumulation in the CSF during pneumococcal meningitis.” Jaqueline S. Generoso*, Sigrun Thorsdottir*, Allan Collodel, Diogo Dominguini, Roberta R. E. Santo, Fabricia Petronilho, Tatiana Barichello, Federico Iovino, mBio, online Aug. 29, 2022, doi: 10.1128/mbio.01886-22
* Equal contribution

THIRD WORLD U$A

Older homeless people are at great risk of dying


Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN FRANCISCO

Research Describes a “Health Shock” from Losing Housing Later in Life 

A quarter of the participants in a long-term study of older people experiencing homelessness in Oakland died within a few years of being enrolled, UC San Francisco researchers found. 

The study, funded by the National Institute on Aging, recruited people who were 50 and older and homeless, and followed them for a median of 4.5 years. By interviewing people every six months about their health and housing status, researchers were able to examine how things like regaining housing, using drugs, and having various chronic conditions, such as diabetes, affected their risk of dying.  

They found that people who first became homeless at age 50 or later were about 60 percent more likely to die than those who had become homeless earlier in life. But homelessness was a risk for everyone, and those who remained homeless were about 80 percent more likely to die than those who were able to return to housing. 

The median age of death was 64.6 years old, and the most common causes of death for people in the study were heart disease (14.5 percent), cancer (14.5 percent), and drug overdose (12 percent). 

“Becoming homeless late in life is a major shock to the system,” said Margot Kushel, MD, who directs the Benioff Housing and Homelessness Initiative and is a professor of medicine at UCSF and senior author of the study published August 29, 2022 in JAMA Internal Medicine

 “These untimely deaths highlight the critical need to prevent older adults from becoming homeless — and of intervening and rehousing those that do, quickly,” she said.

The study is unique for its prospective design. Previous studies of mortality in homeless populations were retrospective and drew information from medical records. By contrast, the current study — Health Outcomes of People Experiencing Homelessness in Older Middle agE (HOPE HOME) — followed a group of people, whether or not they received health care.

Many study participants had serious conditions that went untreated.

“We looked at how frequently people reported diagnosis of heart disease or cancer before dying of these diseases. It was really low,” said Rebecca Brown, MD, affiliated assistant professor of medicine in the Division of Geriatrics at UCSF. “We think this represents a lack of access to care and delayed diagnosis. Often, we didn’t even know people were ill because they didn’t report it in their six-month interviews. But we found it on their death certificates.”

Researchers went to great lengths to track down what happened to the people in the study when they missed check-ins and couldn’t otherwise be accounted for, including looking at photos of unidentified deaths at the coroner’s office, reviewing California state death records to match their participants’ names and dates of birth, querying emergency contacts, searching social media, and reading online obituaries.

They found that as of Dec. 31, 2021, 117 of the 450 people had died since the study began enrolling in 2013. Nearly 40 percent (45) occurred after the pandemic started in March of 2020, but just three of those deaths were from COVID-19. Participants entered the study in two waves, with 350 enrolled in 2013-14 and another 100 enrolled in 2017-18; 101 of the deaths were from the first wave, and 16 were from the second.

Mortality rates were high compared to the general Oakland population. The risk of dying was 3 times higher for men and 5 times higher for women, compared to people of the same age and sex in Oakland. The median age for participants entering the study was 58, and 80 percent were black; 76 percent were male, and 24 percent were female.

The study also contained detailed information about people’s use of drugs and alcohol, as well as their mental health. But drug and alcohol use itself was not independently associated with death. 

“The streets are just no place to live,” said Johná Wilcoxen, 72, who spent more than a decade living in his car when he lost Section 8 housing because his children moved out. Through his ordeal he continued working as a plumber, which gave him a place to go during the day and money for food. “The more people as we can get off the street, the better,” he said.

Authors: In addition to Kushel and Brown, the study authors include Jennifer L. Evans, MS; Karen Valle, MS; and David Guzman, MSPH, of the Benioff Homelessness and Housing Initiative at UCSF; and Yea-Hung Chen, PhD, of the UCSF Department of Epidemiology and Biostatistics.

Funding: National Institute on Aging at the National Institutes of Health grants R01AG041860 and K24AG046372, and the UCSF Benioff Homelessness and Housing Initiative.

Disclosures: None
 

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at https://ucsf.edu, or see our Fact Sheet.

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