Community health workers identify health-related social needs in patients

Implementation of health-related social needs screening at Michigan health centers: A qualitative study

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Research News

 

Community Health Workers Can Play a Role in Identifying Health-Related Social Needs in Patients

Addressing patients' health-related social needs, like housing and food security, is integral to patient care. Federally Qualified Health Centers are leaders in screening for and addressing patients' health-related social needs. However, screening practices vary. This variation is relatively unexplored, particularly with regards to organizational and state policy influences. Study authors conducted in-person, qualitative interviews at Michigan FQHCs to examine how screening approaches vary in the context of statewide social needs screening initiatives and structural factors. They identified four themes:

1) Statewide initiatives and local leadership drove variation in screening practices.

2) Community health workers played an integral role in identifying patients' needs and their roles often shifted from "screener" to "implementer."

3) Social needs screening data was variably integrated into electronic health records and infrequently used for population health management and

4) Sites experienced barriers to social needs screening that limited their perceived impact and sustainability.

FQHCs placed value on the role of community health workers, on sustainable initiatives and on funding to support continued social needs screening in primary care settings, according to the study. Determining the optimal approaches to screening is important to advancing community health.

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Implementation of Health-Related Social Needs Screening at Michigan Health Centers: A Qualitative Study Margaret Greenwood-Ericksen, MD, MSc, et al Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico https://www.annfammed.org/content/19/4/310

Behavioral health integration helps practices address patients' socioeconomic needs

Applying lessons from behavioral health integration to social care integration in primary care

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Research News

 

Lessons from Primary Care and Behavioral Health Integration Should Inform Health Care Practices to Identify and Address Patients' Social, Economic Needs

Although interest is accelerating around addressing patients' social and economic needs, effective and sustainable strategies for integrating social care practices into health care delivery have not yet been identified. This paper synthesizes learnings from primary care and behavioral health care integration and translates them into organizing principles with the goal of advancing social care integration practices to improve the health of patients and communities.

Applying Lessons From Behavioral Health Integration to Social Care Integration in Primary Care Theresa J. Hoeft, PhD, et al Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle https://www.annfammed.org/content/19/4/356

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Integration of social care into health care: Our collective path ahead

Researchers, policy makers, health care systems and payers all play a part in meeting patient social care needs

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Research News

 

Drs. Alicia Cohen and Emilia De Marchis provide commentary on three articles in this issue of Annals of Family Medicine, specifically Greenwood-Ericksen et al's research on Michigan's Federally Qualified Health Centers; Hoeft et al's special report about translating lessons learned from behavioral health integration into the social care realm; and Fessler et al's narrative about how they as medical students stepped away from their medical clerkships to act as community volunteers for people experiencing homelessness during the COVID-19 pandemic. All three articles serve as a timely call to action, reminding those in health care that work remains to meet the needs of patients, particularly in screening for and intervening on identified social risks. The urgency of this work has only been heightened by the pandemic as patients face new or intensified socio-economic hardships. Cohen and De Marchis write that collaboration is needed among researchers, policy makers, payers and health care systems to assist in identifying evidence-based practices for social needs integration. This includes improved training and education for all clinical care team members about social risk and social care activities, best practice guidelines, evidence-based interventions, and sustainable funding streams. Social risk data can also more broadly aid advocacy and policy efforts to expand community-based resources, efforts to address health inequities, and population health-level interventions. Cohen and De Marchis note that greater flexibility in using Center for Medicare & Medicaid dollars and the new 2021 Evaluation and Management coding guidelines for social determinants may help with more consistent funding for social care activities. "The path ahead requires working together and sharing learnings to advance our common goal of achieving health equity and wellness--for patients and the health care workforce alike," they write.

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Building an Evidence Base for Integration of Social Care Into Health Care: Our Collective Path Ahead Alicia J. Cohen, MD, MSc, FAAFP, Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System; Departments of Family Medicine and Health Services, Policy, and Practice, Brown University, Providence, Rhode Island. Department of Family Medicine, University of Michigan, Ann Arbor, Michigan.

Emilia H. De Marchis, MD, MAS, Department of Family & Community Medicine, University of California, San Francisco https://www.annfammed.org/content/19/4/290

 

Scientists created several samples of glasses for protection against nuclear radiation

Bismuth borate glasses were shown outperformance while compared with the commercial ones

URAL FEDERAL UNIVERSITY

Research News

 

IMAGE: PHYSICISTS ENGINEERED SEVERAL SAMPLES OF GLASSES. ALL OF THEM CLARITY, BUT WITH DIFFERENT ADDITIVE. view more 

CREDIT: IMAGE: URFU / ANASTASIA FARAFONTOVA.

An international research team, including physics from Russia, has created new glasses for protection against X-ray and gamma radiation. Scientists could select new components that improved the characteristics of the samples and allowed to reduce the amount of lead in the glass composition. Physicists engineered several samples of glasses. One of the latest results - glasses based on barium fluoride - was described by the team in the Optic magazine. But the best results have bismuth borate glasses. Its radiation protection characteristics (mean-free-path, half-value layer) are better than commercial analogs. The features of these samples are described in the Scientific Reports.

"Gamma-ray is using in many fields like industrial (to detect defects in metal casting), medical (to treat malignant and cancerous tumors), agriculture (to control the degree of ripeness and extend the shelf life of fruits and vegetables) and space applications, etc," says Karem Abdelazim Gaber Mahmud, co-author of the research articles, research engineer at the Ural Federal University (Russia), an employee of the Nuclear Material Authority (Egypt). "Gamma radiation has significant penetrating depths, so we are faced with the task of creating a material that could provide maximum protection and the necessary safety for workers."

Commercial radiation shielded glasses contain predominantly lead and phosphate. Due to its high density, lead is one of the most effective protection against gamma-ra?. But this is a heavy toxic metal. Lead glass can weigh up to several hundred kilograms. Therefore, scientists worldwide try to find the optimal composition, components that would help lighten the weight of the glass, reduce the thickness, and lower cost price. Another problem is that after exceeding a certain percentage of additive materials, the glasses lose their clarity, just as after absorbing a certain dose of radiation. Therefore, on the one hand, it is necessary to minimize the amount of lead in the glass composition, while maintaining the protective properties, and on the other hand, it is necessary to extend the shelf life of the end-product, its clarity. Scientists from Jordan, Saudi Arabia, Turkey, Malaysia, China, Egypt are working most actively in this direction.

"Scientists began to create protective glasses in the late 1940s, in the early 1950s, during the formation of nuclear power," says Oleg Tashlykov, research co-author, associate professor at Ural Federal University. "That time in England, America, Russia they were solving the problem of monitoring radiation-hazardous work. They came up with several options for glasses with different additives, but everywhere the basic components are lead and phosphate. The current trend is to choose such a composition to minimize the volume of lead, or better to replace it with another metal."

Note that the protective properties of glass researchers have experimentally tested at the Institute of Reactor Materials of the Russian state corporation "Rosatom" (Sverdlovsk region, Russia). The next step is further research of parameters, improvement, and optimization of the composition, commercialization of technology.

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When corals meet algae: First stages of symbiosis seen for the first time

First observations of coral cells and free-living algae physically interacting provide a deeper understanding of their symbiosis and improve conservation of reefs

FRONTIERS

 VIDEO: FIRST STAGE IN THE FORMATION OF THE MUTUALISM ( "SYMBIOSIS ") BETWEEN CELLS OF THE CORAL ACROPORA TENUIS (CNIDARIA: ACROPORIDAE) [TRANSPARENT] AND FREE-LIVING ALGAE OF ITS POTENTIAL "ZOOXANTHELLA " PARTNER, THE SINGLE-CELLED PHOTOSYNTHETIC... view more 

CREDIT: KAWAMURA, SEKIDA, NISHITSUJI, SHOGUCHI, HISATA, FUJIWARA, AND SATOH

The physical interactions between coral and algal cells as they combine to form a symbiotic relationship have been observed for the first time. Within minutes of being introduced, coral cells had started to engulf the algae, where they were either digested or moved to a protective 'bubble' within the cell. This new study, published in Frontiers in Marine Science, will form the basis of further research to understand what drives their symbiosis at a cellular and molecular level, including the eviction of algae, which is the cause of coral bleaching.

"We watched coral cells develop pseudopodia - temporary arm-like structures - that were used to engulf the algae as early as 5 minutes after the two cells were mixed," explains Professor Nori Satoh, co-lead author of the study and head of the Marine Genomics Unit at the Okinawa Institute of Science and Technology Graduate University, Japan. "Once inside the coral cell, some algae were moved to a vacuole, a protective membrane-bound bubble, while others were broken up and digested."

Eviction notice

Coral and algae have had a cooperative relationship for over 200 million years. Coral cells provide algae with shelter and the building blocks for photosynthesis. In return, the algae provide the coral with nutrients. When corals are stressed, the algae can be evicted, which turns the coral white. Linked to climate change and pollution, this coral bleaching can be devastating, with negative impacts on wildlife, tourism, fisheries, and coastal flood protection.

Experiments to understand the detailed mechanisms of algal symbiosis with stony reef-building corals have proved difficult in the past, but Satoh and Kawamura recently succeeded in growing stable cell cultures of Acropora tenuis, a coral species widespread across Asia. The researchers introduced dinoflagellate algae to these laboratory-cultured coral cells to understand what happens in the initial stages of coral and algal symbiosis.

"Our study was designed to understand at the single cell level what occurs in the process of symbiosis and what may cause this symbiosis to cease," says co-lead author Prof Kaz Kawamura from Kochi University, Japan.

Swallowed up

Several minutes after they were introduced, the corals cells started to move faster and actively incorporate the dinoflagellate algae within their cells.

"We were able to directly observe the interactions and symbiosis with video and confirmed what we saw by preserving the cells in plastic resin and taking semi-thin sections to show the engulfment of dinoflagellates inside the coral cells," explains Kamamura. "We also noted that the coral cells that had incorporated algae gradually became round and less mobile and that their symbiosis lasted for at least a month."

Future research will build on this study to help us understand how corals recognize, take up and maintain their algal endosymbionts.

"Our laboratory-based system of coral cells and algae may ultimately provide methods that we can use for the preservation and conservation of coral reefs," says Satoh.

Satoh adds, "We have already prepared comprehensive gene information of both the coral Acropora tenuis and dinoflagellate algae. This will be especially useful for future studies of cellular and molecular mechanisms involved in their symbiosis."

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Deep discounts: The nemesis of bargain hunters

ST. EDWARD'S UNIVERSITY

Research News

AUSTIN, Texas -- Researchers at St. Edward's University have found that frugal individuals are more likely than their spendthrift counterparts to give in to the allure of deep discounts, whether it is Tax-free weekend, Amazon Prime Day, a Groupon Deal or some other offer.

In order to reconcile making unplanned purchases that may be at odds with their highly disciplined approach to spending, frugal shoppers will categorize the purchase as a necessity versus a luxury, according to the research published recently in the Journal of Business Research.

"Essentially, frugal consumers convince themselves they "really" need the product to justify getting the deep discount and call it a "win" in the smart shopper category. It seems that deep discounts truly are the folly of frugal shoppers," said Sarah Mittal, an assistant professor of Marketing at St. Edward's University.

Mittal and her co-authors Sommer Kapitan, Jill M. Sundie and Daniel J. Beal (of the Auckland University of Technology, Washington and Lee University and Virginia Tech, respectively) conducted a set of three studies to better understand the process by which frugal consumers justify these impulsive responses to deep discounts.

"Frugality is a trait that balances spending restraint and exuberant exploitation of bargain opportunities," Mittal said. "With our studies, we set out to offer insight into the manner in which this balance is kept and the conditions under which it can be tilted toward increased expenditures."

According to the researchers, the buying tendencies of frugal shoppers is one of the less studied aspects of consumer behavior. And yet in times of recession or economic downturns, such as the downturn brought on by the ongoing pandemic, consumers tend to turn into more price-conscious and conservation minded consumers.

In the first qualitative study, focused on interviews with self-identified frugal consumers, the researchers found that these shoppers make a "clear distinction between necessities and luxuries" and that it is a guiding principle that helps frugal consumers determine when to spend money.

In a second experimental study, the researchers offered frugal shoppers a deeply discounted and minimally discounted offering, and found that frugal consumers (but not less frugal consumers) reported a higher need for a desirable product when it was deeply discounted (60% off), compared to when it was only minimally discounted (10% off).

Lastly, in a third longitudinal study designed to look more closely at the process of updating a perceived need, the researchers looked at how shoppers viewed their need for a more practical service -- a car wash -- and a less practical good -- a selfie stick -- before and after a discount offer.

They found that frugal individuals -- but not those low in frugality -- increased their perceptions of need for the car wash in response to a good deal and correspondingly increased their purchase intentions as well. But frugal consumers did not change their perceived need for any product just because it was a good deal.

"If a moderate need for a good/service already exists, deep discounts and good deals, then, tend to push product need from a "maybe I need that" to an "I really need that" perception for frugal consumers. This positive change in need then enhances purchase intentions," Mittal said.

What could these insights mean for marketers?

"Marketers who partake in deep discounting should stick to moderate- to high-need items," Mittal said. "What we found is that frugal individuals justify the splurge by adjusting up their perceived "need" for a product. The effect did not hold for low need items (e.g. a selfie stick or a banana holder --- too frivolous to justify even for the frugal). Marketers can also emphasize the practical utility of a product to help nudge frugals to buy the deal."

In the future, research could delve further into the consequences for frugal consumers of making such impulse purchases, such as having feelings of guilt, shame or pride after getting the "good deal," which could provide additional insights into psychological mechanisms that may help facilitate their overall spending restraint.

Key Findings

When confronted with an unexpected deep discount on an (at least moderately needed) offering, the necessity vs. luxury distinction that keeps frugal people in check is flexibly adjusted to justify a purchase.

Frugal individuals -- like their less frugal counterparts -- can be triggered to make unplanned or impulse purchases.

Spendthrifts are not motivated by deals in the same way. It's like a switch that goes off in frugal individuals ---it allows them to let go of restraint and convince themselves they are meeting frugal goals by getting a "good" deal for an item they would have "needed" anyway.

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Experts advocate for 'employment first, employment for all' for workers with disabilities

Inclusionary values are emphasized in this special issue of the Journal of Vocational Rehabilitation, which presents contributions from the 2020 Conference of the Association of People Supporting Employment First (APSE)

IOS PRESS

Research News

Amsterdam, July 14, 2021 - The Journal of Vocational Rehabilitation (JVR) announces publication of an openly available special issue that provides free access to key presentations from the 2020 Virtual Conference of the Association of People Supporting Employment First (APSE). These contributions advocate for and help facilitate the full inclusion of people with disabilities in the workplace and community.

APSE Conferences are the only national conferences focused solely on the advancement of Employment First, Employment for All. They bring together more than 1,000 key influencers and stakeholders representing individuals with disabilities, communities, agencies, and services to network and discuss state-of-the-art strategies to ensure equitable employment for all citizens with disabilities receiving assistance from publicly funded systems.

"This special issue highlights just a few of the incredible topics covered during the 45 sessions comprising the 2020 event," explains Guest Editor Julie J. Christensen, MSW, PhD, Executive Director, APSE, Rockville, MD, USA. "It represents the resilience of a community that remains dedicated to making a contribution in research, practice, and policy. All three are integral and necessary to create lasting change, perhaps more now than ever as we continue to work for Employment First, Employment for All. I'm just incredibly excited to be focusing more attention on the resource that JVR provides to the APSE Community."

Highlights from the conference include coverage of:

• Importance of developing multicultural competency to ensure equity in rehabilitation services
• Moving beyond "what gets measured, gets done" to leveraging data to scale up and track outcomes and quality improvement
• Empowering coalitions of self-advocates to hold state laws accountable for Statewide Employment First efforts
• Importance of family input and taking the socioeconomic and cultural context of the family unit into consideration
• Need to update information tools to remain current with the times (such as using social media in talent recruitment)

Rehabilitation professionals are required to be competent in serving multiculturally diverse individuals in a manner that promotes empowerment and full engagement. Tammy Jorgensen Smith, PhD, CRC, University of South Florida, College of Behavioral and Community Sciences, Department of Rehabilitation and Mental Health Counseling, Tampa, Florida, USA, writes that "Multicultural competency is critical for accurate clinical assessment and diagnosis and for effectively serving a diverse population of clients." In her paper, Dr. Smith discusses diagnostic tools and ethical decision-making models that integrate multicultural considerations and recommendations for building multicultural competency.

Families bring their own set of values and assumptions based on their socioeconomic and cultural background. In the article "Good fences make good neighbors," Bethany Chase, DSW, Rutgers University, The Boggs Center on Developmental Disabilities, New Brunswick, NJ, USA, provides context for why parents/guardians may be distrustful of the employment process, as well as why employment specialists may struggle to build strong partnerships with them. She discusses how to implement practices that not only welcome the critical input of families, but also maintain healthy and well-defined boundaries that affirm the autonomy, professionalism, and competence of the worker.

"By setting proactive, positive, welcoming, and compassionate guidelines and boundaries, employment specialists can reap the benefits of an engaged family while continuing to affirm the professionalism, autonomy, and competence of the worker," Dr. Chase concludes.

The issue features a postschool follow-up study of the integrated vocational functioning of 50 workers with significant intellectual disabilities over a 35-year period - the longest follow-up of its kind - contributed by Lou Brown, PhD, Professor Emeritus, University of Wisconsin-Madison, and co-investigators.

Dr. Brown, widely regarded one of the most influential scholars and advocates for students with disabilities, passed away in May 2021. In a tribute honoring Dr. Brown JVR's Editor-in-Chief Paul Wehman writes, "Lou was a great man, an incredible pioneer, and an irreplaceable voice for persons with all disabilities, but especially those with the greatest challenges. When he wrote, he talked to the reader, he made the reader believe in what true inclusionary values were, and why all people with disabilities should be a normal part of our local communities."

The conference took place during the early months of the COVID-19 pandemic and takes into account the dramatic shift in the workplace. "We struggled to adapt to a virtual-only environment at the start of the pandemic," notes Dr. Christensen. "In many states, the flow of funding was temporarily interrupted and resulted in layoffs of the Disability Students Program (DSP) workforce. Some industries have disappeared. Others have grown exponentially. We're going to need to adjust accordingly.

"On the positive side, 'Work from Home' is now normalized. While we don't want this 'new normal' to be interpreted as letting the business community off the hook for complying with the ADA and ensuring that workplaces are fully accessible, 'Work from Home' has opened up new opportunities for employment for people with disabilities," she concludes.

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Brain organoid study highlights potential role of genetic and environmental interaction in autism spectrum disorder

Study illustrates a quicker and less expensive way to explore gene-plus-environment causes of autism spectrum disorder and other conditions

JOHNS HOPKINS UNIVERSITY BLOOMBERG SCHOOL OF PUBLIC HEALTH

Research News

Researchers at Johns Hopkins Bloomberg School of Public Health have shown in a brain organoid study that exposure to a common pesticide synergizes with a frequent autism-linked gene mutation.

The results represent one of the clearest pieces of evidence yet that genetic and environmental factors may be able to combine to disturb neurodevelopment. Researchers suspect that genetic and environmental factors might contribute to the increased prevalence of autism spectrum disorder, a developmental disorder characterized by cognitive function, social, and communication impairments.

The study's use of brain organoids also points the way towards quicker, less expensive, and more human-relevant experimentation in this field when compared to traditional animal studies.

The brain organoid model, developed by the Bloomberg School researchers, consists of balls of cells that are differentiated from human stem cell cultures and mimic the developing human brain. The researchers found in the study that chlorpyrifos, a common pesticide alleged to contribute to developmental neurotoxicity and autism risk, dramatically reduces levels of the protein CHD8 in the organoids. CHD8 is a regulator of gene activity important in brain development. Mutations in its gene, which reduce CHD8 activity, are among the strongest of the 100-plus genetic risk factors for autism that have so far been identified.

The study, which appears online July 14 in Environmental Health Perspectives, is the first to show in a human model that an environmental risk factor can amplify the effect of genetic risk factor for autism.

"This is a step forward in showing an interplay between genetics and environment and its potential role for autism spectrum disorder," says study lead Lena Smirnova, PhD, a research associate in the Department of Environmental Health and Engineering at the Bloomberg School.

Clinically rare as recently as 40 years ago, autism spectrum disorder now occurs in roughly two percent of live births, according to the Centers for Disease Control and Prevention.

"The increase in autism diagnoses in recent decades is hard to explain--there couldn't have been a population-wide genetic change in such a short time, but we also haven't been able to find an environmental exposure that sufficiently accounts for it," says study co-author Thomas Hartung, MD, PhD, professor and Doerenkamp-Zbinden Chair in the Bloomberg School's Department of Environmental Health and Engineering. Hartung is also director of the Center for Alternatives to Animal Testing at the Bloomberg School. "To me, the best explanation involves a combination of genetic and environment factors," says Hartung.

How environmental factors and genetic susceptibilities interact to increase risk for autism spectrum disorder remains mostly unknown, in part because these interactions have been difficult to study. Traditional experiments with laboratory animals are expensive and, especially for disorders involving the brain and cognition, of limited relevance to humans.

Advances in stem cell methods in the past decades have allowed researchers to use human skin cells that can be transformed first into stem cells and then into almost any cell type and studied in the lab. In recent years, scientists have expanded beyond simple lab-dish cell cultures to make cultures of three-dimensional organoids that better represent the complexity of human organs.

For their study, the researchers used brain organoids to model the effects of a CHD8 gene disruption combined with exposure to chlorpyrifos. A group led by co-author Herbert Lachman, MD, professor at Albert Einstein College of Medicine, engineered the cells that make up the organoids to lack one of the two normal copies of the CHD8 gene. This modeled a substantial, but less-than-total, weakening of the CHD8 gene's activity, similar to that seen in people who have CHD8 mutations and autism. The researchers then examined the additional effect of exposure to chlorpyrifos, which is still widely used on agricultural produce in the U.S. and abroad.

"High-dose, short-term experimental exposures do not reflect the real-life situation, but they give us a starting point to identify genetic variants that might make individuals more susceptible to toxicants," says Smirnova. "Now we can explore how other genes and potentially toxic substances interact."

The researchers found that the brain organoids with just one copy of the CHD8 gene had only two-thirds the normal level of CHD8 protein in their cells, but that chlorpyrifos exposure drove CHD8 levels much lower, turning a moderate scarcity into a severe one. The exposure demonstrated clearly how an environmental factor can worsen the effect of a genetic one, likely worsening disease progression and symptoms.

As part of their study, the researchers compiled a list of molecules in blood, urine, and brain tissue that prior studies have shown to be different in autism spectrum patients. They found that levels of several of these apparent autism biomarkers were also significantly altered in the organoids by CHD8 deficiency or chlorpyrifos exposure, and moreso by both.

"In this sense, we showed that changes in these organoids reflect changes seen in autism patients," Smirnova says.

The findings, according to the researchers, pave the way for further studies of gene-environment interactions in disease using human-derived organoids.

"The use of three-dimensional, human-derived, brain-like models like the one in this study is a good way forward for studying the interplay of genetic and environmental factors in autism and other neurodevelopmental disorders," Hartung says.

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"Gene-Environment Interactions in Developmental Neurotoxicity: A Case Study of Synergy between Chlorpyrifos and CHD8 Knockout in Human BrainSpheres" was written by Sergio Modafferi, Xiali Zhong, Andre Kleensang, Yohei Murata, Francesca Fagiani, David Pamies, Helena Hogberg, Vittorio Calabrese, Herbert Lachman, Thomas Hartung, and Lena Smirnova.

The study was funded in part by the Alternatives Research and Development Foundation and the Environmental Protection Agency (R839505).

Disclosures:

Thomas Hartung, Helena Hogberg, and David Pamies are named inventors on a patent by Johns Hopkins University on the production of mini-brains (also called BrainSpheres), which is licensed to AxoSim, New Orleans, Louisiana, USA. Thomas Hartung, Lena Smirnova, David Pamies, and Helena Hogberg are consultants for AxoSim, New Orleans, and Thomas Hartung is also a consultant for AstraZeneca and American Type Culture Collection (ATCC) on advanced cell culture methods. All other authors declare they have no actual or potential competing financial interests.

 

Antidepressants may improve outcomes in people with diabetes and depression

THE ENDOCRINE SOCIETY

Research News

WASHINGTON--People with diabetes and depression who take antidepressants may have a lower risk of death and of serious diabetes complications, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

People with diabetes face a higher risk of depression, which makes them more likely to die or develop diabetes complications including heart and kidney disease, stroke, eye, and foot problems. Depression makes diabetes complications worse due to stress, body weight changes, and lack of exercise.

"People with depression and diabetes have poorer health outcomes than those with diabetes alone, and regular antidepressant treatment could lower their risk of complications," said study author Shi-Heng Wang, Ph.D., of the China Medical University in Taichung, Taiwan.

"People who adhere to their antidepressants have better diabetes outcomes and quality of life than those with poor adherence," said study author Chi-Shin Wu, M.D., Ph.D., of the National Taiwan University Hospital in Taipei, Taiwan.

The researchers conducted a nationwide retrospective cohort study of 36,276 patients with depression and diabetes to determine if antidepressants could improve diabetes outcomes. They found regular antidepressant treatment was associated with a lower risk of death and heart disease.

Other authors of the study include: Le-Yin Hsu of the National Taiwan University in Taipei, Taiwan; and Yi-Jiun Pan of the China Medical University in Taichung, Taiwan.

The manuscript received funding from the Ministry of Science and Technology, the China Medical University, and the Ministry of Health and Welfare.

The manuscript, "Associations Between Antidepressant Use and Advanced Diabetes Outcomes in Patients with Depression and Diabetes Mellitus," was published online, ahead of print.

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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world's oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

 

Study: Idea sharing increases online learner engagement

UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN, NEWS BUREAU

Research News

IMAGE: ONLINE LEARNING ENGAGEMENT CAN BE INCREASED BY NEARLY ONE-THIRD BY SIMPLY PROMPTING STUDENTS TO SHARE COURSE IDEAS RATHER THAN PERSONAL DETAILS IN THE FORM OF ICEBREAKERS AND SOCIAL INTRODUCTIONS, SAID... view more 

CREDIT: PHOTO BY GIES COLLEGE OF BUSINESS

CHAMPAIGN, Ill. -- Sharing ideas in an online learning environment has a distinct advantage over sharing personal details in driving learner engagement in massive open online courses, more commonly known as MOOCs, says new research co-written by a University of Illinois Urbana-Champaign expert who studies the intersection of marketing and digital environments.

Online learning engagement can be increased by nearly one-third by simply prompting students to share course ideas in a discussion forum rather than having them share information about their identity or personal motivations for enrolling, said Unnati Narang, a professor of business administration at the Gies College of Business.

With less than 10% of online learners completing courses, and less than 5% participating in course discussions, there's a stark need for online learning platforms to identify and employ strategies that can enhance student engagement, Narang said.

"Engagement levels have tended to be really low in online classrooms simply because students may not ever get the chance to get to know each other in the way they do in an in-person, face-to-face classroom," she said. "A lot of those elements are, quite obviously, lacking in the online learning environment."

Initially, online platforms placed a lot of emphasis on having discussion forums to engage students. But over time, those efforts tended to fizzle out, Narang said.

"Even if a student is posting something, it may never be read by a classmate or by the instructor, which can really demotivate students who are trying to engage in the material," she said.

To determine how to increase learner engagement, Narang and her co-authors analyzed more than 12,000 discussion forum postings during an 18-month period and conducted a field experiment involving more than 2,000 learners in a popular online course offered by a large U.S. university.

"We randomly nudged students to either share something personal about themselves or ideas related to the course," she said. "We thought we were going to see an increase in engagement thanks to the social aspects of identity sharing because there's so much emphasis on it in face-to-face classes for icebreakers and social introductions."

The results indicated that asking learners to share ideas related to the course had a stronger effect on their video consumption and assessment completion, according to the paper.

"We found that the idea of sharing knowledge outperforms identity sharing as well as the control condition of not sharing anything," Narang said. "Across diverse metrics of learner engagement and performance, we found that what learners share plays a big role in enhancing the online learning environment, and they tended to perform 30% better in terms of how many videos they consumed, how many assessments they completed and how they scored on assessments. So there's a distinct advantage to idea sharing in online pedagogy."

For educators, the implications of what the researchers dubbed the "idea advantage" in an era of increased online learning due to the COVID-19 pandemic suggests that identity sharing tends to be superficial and brief, so it's better to push students to engage more on the course content and their ideas about what they're studying, Narang said.

"Just very basic getting-to-know-you introductions that instructors make in a physical classroom - who are you, where you're from, etc. - doesn't really translate into the online learning environment," she said. "There's just too much anonymity to successfully do that when you're in a virtual classroom. The idea posts, on the other hand, tend to be much more elaborate and well-articulated. Students put more time and effort into crafting their answers. On average, an idea-sharing post was 66 words long. But an identity-sharing post tended to be roughly half as long. Students were clearly more invested in ideas than trying to make friends in the online learning environment, thus why the idea advantage is so strong."

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Narang's co-authors are Aric Rindfleisch, the John M. Jones Professor of Marketing at the University of Illinois Urbana-Champaign, and Manjit S. Yadav, the JC Penney Chair in Marketing and Retailing Studies at Texas A&M University.

The paper was published in the Journal of Marketing Research.

 

How climate change and fires are shaping the forests of the future

Tracking future forest fires with AI

TECHNICAL UNIVERSITY OF MUNICH (TUM)

Research News

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IMAGE: THE ICONIC LANDSCAPE OF YELLOWSTONE NATIONAL PARK IS CHARACTERIZED BY VAST FORESTS THAT HAVE BEEN UNTOUCHED BY MAN BUT ARE THREATENED BY INCREASING NUMBERS OF FOREST FIRES DUE TO CLIMATE... view more 

CREDIT: R. SEIDL / TUM

Forest fires are already a global threat. "But considering how climate change is progressing, we are probably only at the beginning of a future that will see more and bigger forest fires," explains Rupert Seidl, Professor of Ecosystem Dynamics and Forest Management in Mountain Landscapes at TUM.

In many places, fire is part of the natural environment, and many tree species have become naturally adapted to recurrent fires. These adaptations range from particularly thick bark, which protects the sensitive cambium in the trunk from the fire, to the cones of certain types of pine, which open only due to the heat of fire, allowing a quick regeneration and recovery of affected woodland .

AI is accelerating ecosystem models

"The interaction between climate, forest fires, and other processes in the forest ecosystem is very complex, and sophisticated process-based simulation models are required to take account of the different interactions appropriately," explains Prof. Seidl. A method that has been developed at TUM is using artificial intelligence to significantly expand the field of use of these complex models.

This method involves the training of a deep neural network in order to imitate the behavior of a complex simulation model as effectively as possible. The neural network learns on the basis of how the ecosystem responds to differing environmental influences, but does so using only a fraction of the computing power that would otherwise be necessary for large-scale simulation models. "This allows us to carry out spatially high-resolution simulations of areas of forest that stretch across several million hectares," explains scientist Dr. Werner Rammer.

Forecast for the forests in Yellowstone National Park

The simulations completed by the team of scientists include simulations for the "Greater Yellowstone Ecosystem", which has the world-famous Yellowstone National Park at its heart. This area, which is approximately 8 million hectares in size, is situated in the Rocky Mountains and is largely untouched. The researchers at the TUM have worked with American colleagues to determine how different climate scenarios could affect the frequency of forest fires in this region in the 21st century, and which areas of forest cannot regenerate successfully following a forest fire.

Depending on the climate change scenario, the study has found that by the end of the century, the current forest coverage will have disappeared in 28 to 59 percent of the region. Particularly affected were the forests in the sub-alpine zone near the tree line, where the species of tree are naturally less adapted to fire, and the areas on the Yellowstone Plateau, where the relatively flat topography is mostly unable to stop the fire from spreading.

Climate change is causing significant changes to forest ecosystems

The regeneration of the forest in the region under investigation is at threat for several reasons: If the fires get bigger and the distances between the surviving trees also increase, too few seeds will make their way onto the ground. If the climate gets hotter and drier in the future, the vulnerable young trees won't survive, and if there are too many fires, the trees won't reach the age at which they themselves yield seeds.

"By 2100, the Greater Yellowstone Ecosystem is expected to have changed more than it has in the last 10,000 years, and will therefore look significantly different than it does today," explains Rammer. "The loss of today's forest vegetation is leading to a reduction in the carbon which is stored in the ecosystem, and will also have a profound impact on the biodiversity and recreational value of this iconic landscape."

The potential developmental trends identified in the study are also intended to help visitors to the national park understand the consequences of climate change and the urgency of the climate protection measures. In the next step, the research team will be using AI to estimate the long-term impact of the problems caused by climate change in the forests of Europe.

CAPTION

The way in which increasing numbers of forest fires are changing the landscape over the long term is being studied with the use of AI.

CREDIT

R. Seidl / TUM

 

Chemistry discovery could remove micropollutants from environment

U.S. ARMY RESEARCH LABORATORY

Research News

IMAGE: DR. RONG YE (LEFT), DR. MING ZHAO (CENTER), AND DR. PENG CHENG (RIGHT) AT CORNELL DISCUSS THEIR ARMY-FUNDED RESEARCH THAT IDENTIFIES A NEW CHEMISTRY APPROACH THAT COULD REMOVE MICROPOLLUTANTS FROM... view more 

CREDIT: CORNELL UNIVERSITY

RESEARCH TRIANGLE PARK, N.C. -- Army-funded research identified a new chemistry approach that could remove micropollutants from the environment.

Micropollutants are biological or chemical contaminants that make their way into ground and surface waters in trace quantities.

Using a pioneering imaging technique, Cornell University researchers obtained a high-resolution snapshot of how ligands, molecules that bind to other molecules or metals, interact with the surface of nanoparticles. In doing so, they made an unexpected breakthrough discovery. They determined that by varying the concentration of an individual ligand they could control the shape of the particle it attached too.

This approach could result in an array of daily applications, including developing chemical sensors that are sensitive at a very low level to a specific chemical in the environment.

"Professor Peng Chen's work allows for deep insights into molecular adsorption processes, which is important to understand for designing molecular sensors, catalysts, and schemes to clean up micro-pollutants in the environment," said Dr. James Parker, program manager, U.S. Army Combat Capabilities Development Command, known as DEVCOM, Army Research Laboratory. "This research is also important for designing and engineering stimuli-responsive materials with specialized function that could not be found in regular, bulk materials."

The research, published in Nature Communications, studied interactions of ligands and gained new understanding of the strength, or affinity of ligand adsorption as well as how multiple ligands cooperate, or don't, with each other.

"When the molecule adsorbs on the surface of a nanoscale material, it also actually protects the surface and makes it more stable," said Dr. Peng Chen, the Peter J.W. Debye Professor of Chemistry in the College of Arts and Sciences at Cornell University, who led the research. "This can be utilized to control how nanoscale particles grow and become their eventual shape. And we found we can do this with just one ligand. You don't do any other trick. You just decrease the concentration or increase the concentration, and you can change the shape."

Understanding how ligands interact with the surface of nanoparticles has been a challenge to study. Adsorbed ligands are difficult to identify because there are other molecules in the mix, and nanoparticle surfaces are uneven and multifaceted, which means they require incredibly high spatial resolution to be scrutinized.

A nanoparticle's size and surface structures, or facets, are intrinsically tied to the particle's potential applications. The larger the particle, the more atoms fit inside it, while smaller particles have less available space internally but a greater surface volume ratio for atoms to sit atop, where they can be utilized for processes such as catalysis and adsorption. The different types of structures the atoms and molecules form on these surface facets are directly correlated with the particle's shape.

Army-funded research identifies a new chemistry approach that could remove micropollutants from the environment.

Scientists have used several imaging methods to survey these particles, but until now, they haven't been able to obtain nanometer resolution to really explore the nooks and crannies of the multiple surface facets and quantify the affinity, or strength, of a ligand's adsorption. The research team was able to do just that by employing a method of their own devising called COMPetition Enabled Imaging Technique with Super-Resolution or COMPEITS.

The process works by introducing a molecule that reacts with the particle surface and generates a fluorescent reaction. A nonfluorescent molecule is then sent to bind to the surface, where its reaction competes with the fluorescent signal. The resulting decrease in fluorescence, essentially creating a negative image, can then be measured and mapped with super high resolution.

Using COMPEITS on a gold nanoparticle, the team was able to quantify the strength of ligand adsorption, and they discovered ligand behavior can be very diverse. Ligands, it turns out, are fair-weather friends of a sort, at some sites they cooperate to help each other adsorb, but at other sites they can impair each other's efforts. The researchers also discovered that sometimes this positive and negative cooperativity exists at the same site.

In addition, the researchers learned that the surface density of adsorbed ligands can determine which facet is dominant. This crossover inspired the team to vary the concentrations of individual ligands as a way to tune the shape of the particle itself.

"For us, this has opened more possibilities," Chen said. "For example, one way to remove micropollutants, such as pesticides, from the environment is to adsorb micro-portions on the surface of some adsorbent particle. After it is adsorbed on the surface of the particle, if the particle is a catalyst, it can catalyze the destruction of the micropollutants."

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In addition to ARL, the Center for Alkaline-Based Energy Solutions, an Energy Frontier Research Center of U.S. Department of Energy supported the research.

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As the Army's national research laboratory, ARL is operationalizing science to achieve transformational overmatch. Through collaboration across the command's core technical competencies, DEVCOM leads in the discovery, development and delivery of the technology-based capabilities required to make Soldiers more successful at winning the nation's wars and come home safely. DEVCOM Army Research Laboratory is an element of the U.S. Army Combat Capabilities Development Command. DEVCOM is a major subordinate command of the Army Futures Command.