Monday, August 29, 2022

Consortium to develop fully implantable brain-computer interface to enable communication for people with paralysis

Project will push the boundaries of real-time brain-to-speech decoding with artificial intelligence algorithms and a miniaturized, wireless device.

Grant and Award Announcement

WYSS CENTER FOR BIO AND NEUROENGINEERING

The fully implantable wireless ABILITY brain computer interface system — IMAGE: BUILDING ON THE WYSS CENTER'S PREVIOUS CLINICAL STUDY ENABLING BCI COMMUNICATION, THE PROJECT WILL USE THE FULLY IMPLANTABLE WIRELESS ABILITY SYSTEM (PICTURED) CONNECTED TO CUSTOMIZED ELECTRODE GRIDS TO RECORD FROM A LARGER AREA OF THE BRAIN. IT WILL ALSO EXPLORE NEW DECODING ALGORITHMS THAT HAVE THE POTENTIAL TO TACKLE IMPORTANT CLINICAL AND SOCIAL NEEDS FOR PEOPLE WITH PARALYSIS. view more
CREDIT: WYSS CENTER FOR BIO AND NEUROENGINEERING

Geneva, Switzerland - A research consortium led by the UMC Utrecht Brain Center (the Netherlands) in collaboration with Graz University of Technology (Austria), the Wyss Center for Bio and Neuroengineering (Switzerland) and CorTec (Germany) is to receive a grant through the EIC Pathfinder Challenge mechanism.

The researchers aim to develop a unique fully implantable Brain-Computer Interface (BCI) system for people with locked-in syndrome (LIS) - a condition in which paralysis severely limits communication. The BCI will be unprecedented in its small size, wireless and powered via induction so will not require batteries. Suitable for use at home, it will be capable of decoding speech in real-time to enable people with LIS to communicate with family and caregivers.

The project will further develop the Wyss Center’s fully implantable wireless ABILITY system to connect to customized electrocorticography (ECoG) electrode grids, developed by CorTec, that detect brain signals from the surface of the brain. The ambitious timeline aims for full implant development and verification in the first two years of the project, with the second two years focusing on clinical studies and algorithm improvements to restore communication in locked-in patients with amyotrophic lateral sclerosis (ALS) or brainstem stroke. ALS is a progressive neurodegenerative disease in which people gradually lose the ability to move and talk, eventually all means of communication are lost, leaving patients isolated. Brainstem stroke can render people unable to speak or move, without recovery.

“As a first step to enable the patients to interact with the system, we will set up the decoding for mouse clicks and cursor control from intended movements, which we have shown to be feasible in previous research,” explains Prof. Dr. Gernot Müller-Putz, Head of the Institute of Neural Engineering and its associated Laboratory of Brain-Computer Interfaces at the Graz University of Technology.

“Our BCI system will go far beyond current technology,” says Prof. Nick Ramsey from the UMC Utrecht Brain Center, the Netherlands, who coordinates the project. “We want to create a sustainable, high-resolution BCI by combining state-of-the-art hardware and software based on artificial intelligence (AI).”

“This new project builds on the promising preliminary data from our clinical study enabling communication with a completely locked-in participant, and our pre-clinical study currently underway with the wireless, implantable ABILITY device.” said Dr. Jonas Zimmermann, Senior Neuroscientist at the Wyss Center. “In this project we will record from a larger area of the brain and explore new decoding algorithms that have the potential to tackle important clinical and social needs for people with ALS but also for those with other neurological conditions that impair movement and communication.”

Dr. Tracy Laabs, Chief Development Officer at the Wyss Center, is excited: “After several years of prototype developments, this project will allow us to make the crucial final steps that will bring our system to the patient”.

The BCI system will be trialed in two people with locked-in syndrome in the home environment. The brain surface-lining electrode grids will collect high resolution neural data that will be decoded using AI algorithms to translate the brain signals to computer speech in real-time. The research project

‘Intracranial Neurotelemetry to Restore Communication’ (INTRECOM) is part of the EIC Pathfinder Challenge program in which the European Innovation Council supports visionary, entrepreneurial researchers who have bold ideas for radically new technologies. The Swiss participants receive support from the Swiss State Secretariat for Education, Research and Innovation (SERI).

ENDS

Caption: Building on the Wyss Center's previous clinical study enabling BCI communication, the project will use the fully implantable wireless ABILITY system connected to customized electrode grids to record from a larger area of the brain. It will also explore new decoding algorithms that have the potential to tackle important clinical and social needs for people with paralysis.

Credit: Wyss Center for Bio and Neuroengineering, Geneva

About the Wyss Center for Bio and Neuroengineering, Geneva, Switzerland

The Wyss Center is an independent, non-profit, research and development organization that advances our understanding of the brain to realize therapies and improve lives.

The Wyss Center staff, together with the Center’s academic, clinical and industrial collaborators, pursue innovations and new approaches in neurobiology, neuroimaging and neurotechnology.

Wyss Center advances reveal unique insights into the mechanisms underlying the dynamics of the brain and the treatment of disease to accelerate the development of devices and therapies for unmet medical needs.

The Wyss Center was established by a generous donation from the Swiss entrepreneur and philanthropist Hansjörg Wyss in 2014. Additional resources from funding agencies and other sources help the Wyss Center accelerate its mission.

www.wysscenter.ch/

REDLINING

Climate change exacerbated hurricane Harvey’s flood damage, hitting low-income and Latinx neighborhoods disproportionately harder

Peer-Reviewed Publication

LOUISIANA STATE UNIVERSITY

New research published today shows that if it were not for the impact of climate change, up to 50 percent of residences in Houston’s Harris County would not have been flooded by Hurricane Harvey five years ago. The study, published in Nature Communications, coincides with the fifth anniversary of Hurricane Harvey, a Category 4 hurricane that made landfall in Texas and Louisiana in 2017, causing massive flooding in Houston.

“We already know that climate change is increasing the severity and frequency of extreme weather events,” said Kevin Smiley, the study’s lead author and LSU Department of Sociology assistant professor. “But now researchers are able to pinpoint the extent of damage from a specific extreme weather event such as Hurricane Harvey and the resulting floods.”

Fifty percent less residences impacted equates to about 50,000 fewer homes damaged and billions of dollars saved in residential damage.

“This means that we have quantified the contribution of climate change to the suffering of people who live there,” said Michael Wehner, the study’s co-author and senior scientist at Lawrence Berkeley National Laboratory.

The research, a first of its kind investigation into potential disparities between those impacted by the climate change-induced flooding, finds patterns of racial and economic disparities.

“Part of the reason why low-income neighborhoods flooded has to do with the historical development of Houston along its waterways and surrounding petrochemical corridor,” Smiley said. “There’s a clear climate and environmental justice story as to where these neighborhoods are located.”

How do researchers study the impacts of climate change?

Climate change attribution, which ascertains the connection between climate change and extreme weather events, involves running computational models to estimate how much these changes in climate make extreme weather events, like hurricanes, more severe. Scientists can compare these estimates without climate change to what actually happened to see the difference.

“This is the first end-to-end impact attribution study of a specific weather event following on our previous studies showing a significant increase in Harvey’s precipitation and the resulting flooding increase because of climate change,” Wehner said.

Although popular discussion tends to center around climate change forecasts for the future, the study underscores the fact that climate change is impacting life now.

“Climate change is happening right now with real and substantial costs,” Smiley said. “Three to five extra inches of rainfall from climate change can make the difference between your lawn getting soaked and your house getting flooded leaving it uninhabitable.”

JOURNAL

Nature Communications

DOI

10.1038/s41467-022-31056-2

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Social inequalities in climate change-attributed impacts of Hurricane Harvey

ARTICLE PUBLICATION DATE

25-Aug-2022

Citizen science: Empowering citizens to address global challenges

Peer-Reviewed Publication

INTERNATIONAL INSTITUTE FOR APPLIED SYSTEMS ANALYSIS

Citizen science is increasingly recognized as an important vehicle for democratizing science and promoting the goal of universal and equitable access to scientific data and information. IIASA researchers actively contribute to the development of this scientific approach and have recently published a primer aimed at both established and aspiring practitioners of citizen science to highlight key issues and how to address them.

Citizen science has a long history and interested volunteers have participated in scientific inquiry for centuries, leading to some of the most extensive datasets and sources of information on among others, public health, pollution monitoring, and ecology and biodiversity tracking. Today, it offers unique opportunities to join science and research across the globe, empowering people to participate in the scientific process, to gather and share data and information, and to be equipped to contribute to collective action to address important challenges that we face locally and globally today.

IIASA is well known for developing innovative research methods to address global problems and citizen science is no exception. A new IIASA-led article just published in Nature Methods Reviews Primers, highlights how citizens can contribute meaningfully to scientific research, thereby becoming an integral part of integrated and evidence-based knowledge creation needed to address some of today’s most pressing challenges, including environmental pollution, food security, biodiversity loss, or the climate crisis. The authors also call attention to the impacts and great potential of citizen science for monitoring progress on ambitious global efforts like the UN Sustainable Development Goals (SDGs), large-scale data collection, and as a viable means to close data gaps and support inclusive decision-making.

“Nature Methods Reviews Primers articles are high-quality, introductory review articles describing the current state-of-the-art for applying a specific scientific method. Being invited to write a primer on citizen science is important in two main ways. First, it underlines that the field is earning recognition within the scientific establishment as a valid and valuable approach. Secondly, it offers the opportunity to showcase the breadth and depth of citizen science possibilities to a wide range of scientists and researchers who are not yet familiar with it,” explains co-lead author Gerid Hager, a researcher in the Novel Data Ecosystems for Sustainability Research Group of the IIASA Advancing Systems Analysis Program.

One of the big advantages of citizen science is the fact that it promotes open data practices. In this way, the approach contributes to science innovation by opening science up to society and advancing collaborations between various actors, including citizens, which helps to make science more participatory and inclusive.

“When designed optimally, beyond addressing the data gaps to create effective policies and achieve sustainable development, citizen science can help establish more inclusive data ecosystems that empower individuals and communities, especially those that are hard-to-reach and marginalized,” notes co-lead author Dilek Fraisl, a researcher in the same group at IIASA.

In conclusion, the authors point out that the fields of application for citizen science methods and approaches continue to broaden in terms of subject matter and deepen in terms of the advancement of methodologies as more examples of citizen science research enter the mainstream scientific literature. The principles described in their primer have been successfully applied to a wide range of research domains, particularly in biodiversity research, earth observation and geography, climate change research, or environmental monitoring, which in turn contribute further to the development of both best practice and novel approaches within the ecological and environmental sciences.

Reference

Fraisl, D., Hager, G., Bedessem, B., Gold, M., Hsing, P-Y., Danielsen, F., Hitchcock, C.B., Hulbert, J.M., Piera, J., Spiers, H., Thiel, M., Haklay, M. (2022). Citizen science in environmental and ecological sciences. Nature Methods Reviews Primers DOI: 10.1038/s43586-022-00144-4

JOURNAL

Nature Methods

DOI

10.1038/s43586-022-00144-4

ARTICLE TITLE

Citizen science in environmental and ecological sciences

ARTICLE PUBLICATION DATE

25-Aug-2022

Significant increase in freshwater entering Arctic Ocean through Bering Strait

Peer-Reviewed Publication

UNIVERSITY OF MARYLAND CENTER FOR ENVIRONMENTAL SCIENCE

SOLOMONS, MD (August 25, 2022)—A new study has confirmed that over the past 30 years the volume of freshwater flowing through Bering Strait into the Arctic Ocean has increased by 40-50%, which means that the Arctic Ocean is becoming less salty. This could impact sea ice formation, regional and global ocean circulation, and ecosystems.

“Our analysis indicates that the Arctic Ocean is becoming less salty in part because the water flowing north through the Bering Strait is becoming less salty,” said lead author Lee Cooper of the University of Maryland Center for Environmental Science. “This could have a lot of downstream implications for how the Arctic Ocean works and connects with climate and related processes, including the intensity of mixing in the North Atlantic.”

Researchers used a new tracer approach to look at the oxygen isotope composition of water samples collected throughout the Bering and Chukchi shelves to assess the change in saltiness. The study evaluated more than one thousand water samples collected over the extensive continental shelf and the results provide a strong confirmation of increasing freshwater. The significance of the Bering Strait for freshwater is that it is the single largest point source of freshwater to the Arctic Ocean.

Less saline water is quicker to freeze and less likely to mix with deep water, resulting in less nutrient-rich deeper water being upwelled, ultimately decreasing biological productivity. Ultimately it also may interfere with deep water mixing in the North Atlantic that is climate-sensitive.

The study, “Changes in the oxygen isotope composition of the Bering Sea contribution to the Arctic Ocean are an independent measure of increasing freshwater fluxes through the Bering Strait”, authored by Lee Cooper and Jacqueline Grebmeier of the University of Maryland Center for Environmental Science and Cédric Magen of the University of Maryland, is part of a group of papers published as a special issue in PLOS One focused on the internationally coordinated Distributed Biological Observatory, supported by the US National Science Foundation, the US National Oceanic and Atmospheric Administration, NASA and other agencies, as well as science agencies in Korea, China, Japan, and Canada.

THE UNIVERSITY OF MARYLAND CENTER FOR ENVIRONMENTAL SCIENCE

The University of Maryland Center for Environmental Science leads the way toward better management of Maryland’s natural resources and the protection and restoration of the Chesapeake Bay. From a network of laboratories located across the state, UMCES scientists provide sound evidence and advice to help state and national leaders manage the environment, and prepare future scientists to meet the global challenges of the 21st century. www.umces.edu

# # #

JOURNAL

PLoS ONE

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Changes in the oxygen isotope composition of the Bering Sea contribution to the Arctic Ocean are an independent measure of increasing freshwater fluxes through the Bering Strait

Smoking is even more damaging to the heart than previously thought

Reports and Proceedings

EUROPEAN SOCIETY OF CARDIOLOGY

Barcelona, Spain – 25 Aug 2022: Smokers have weaker hearts than non-smokers, according to research presented at ESC Congress 2022.1 The study found that the more people smoked, the worse their heart function became. Some function was restored when people kicked the habit.

“It is well known that smoking causes blocked arteries, leading to coronary heart disease and stroke,” said study author Dr. Eva Holt of Herlev and Gentofte Hospital, Copenhagen, Denmark. “Our study shows that smoking also leads to thicker, weaker hearts. It means that smokers have a smaller volume of blood in the left heart chamber and less power to pump it out to the rest of the body. The more you smoke, the worse your heart function becomes. The heart can recuperate to some degree with smoking cessation, so it is never too late to quit.”

According to the World Health Organization, tobacco kills more than eight million people each year.2 Cigarette smoking is responsible for 50% of all avoidable deaths in smokers, with half of these due to atherosclerotic cardiovascular diseases such as heart attack and stroke.3 The detrimental effects of smoking on the arteries and arterial diseases such as heart attack and stroke are well established.4

Studies have also shown that smoking is associated with a higher risk of heart failure, where the heart muscle does not pump blood around the body as well as it should, usually because it is too weak or stiff. This means that the body does not receive the oxygen and nutrients it needs to work normally. The link between smoking and heart structure and function has not been fully examined. This study therefore explored whether smoking was related to changes in the structure and function of the heart in people without cardiovascular disease, and the effect of changing smoking habits.

The study used data from the 5th Copenhagen City Heart Study which investigated cardiovascular risk factors and diseases in the general population. A total of 3,874 participants aged 20 to 99 years without heart disease were enrolled. A self-administered questionnaire was used to obtain information on smoking history and to estimate pack-years, which is the number of cigarettes smoked through life. One pack-year is defined as 20 cigarettes smoked every day for one year.

Participants had an ultrasound of the heart, called echocardiography, which provides information about its structure and how well it is working. The researchers compared the echocardiography measures of current smokers versus never smokers after adjusting for age, sex, body mass index, hypertension, high cholesterol, diabetes and lung function.

The average age of participants was 56 years and 43% were women. Nearly one in five participants were current smokers (18.6%), while 40.9% were former smokers and 40.5% had never smoked. Compared to never smokers, current smokers had thicker, weaker and heavier hearts. Increasing pack-years were associated with pumping less blood. Dr. Holt explained: “We found that current smoking and accumulated pack-years were associated with worsening of the structure and function of the left heart chamber – the most important part of the heart. Furthermore, we found that over a 10-year period, those who continued smoking developed thicker, heavier and weaker hearts that were less able to pump blood compared to never smokers and those who quit during that time.”

She concluded: “Our study indicates that smoking not only damages the blood vessels but also directly harms the heart. The good news is that some of the damage is reversible by giving up.”

ENDS

Notes to editors

Email: press@escardio.org

The hashtag for ESC Congress 2022 is #ESCCongress.

Funding: The Copenhagen City Heart Study is funded by The Danish Heart Foundation and The Metropolitan Region of Denmark.

Disclosures: Tor Biering-Sørensen reports: Steering Committee member of the Amgen financed GALACTIC-HF trial. Chief investigator and steering committee chair of the Sanofi Pasteur financed “NUDGE- FLU” trial. Chief investigator and steering committee chair of the Sanofi Pasteur financed “DANFLU-1” trial. Chief investigator and steering committee chair of the Sanofi Pasteur financed “DANFLU-2” trial. Steering Committee member of “LUX-Dx TRENDS Evaluates Diagnostics Sensors in Heart Failure Patients Receiving Boston Scientific's Investigational ICM System” trial. Advisory Board: Sanofi Pasteur, Amgen and GSK. Speaker Honorarium: Novartis, Sanofi Pasteur and GSK. Research grants: GE Healthcare and Sanofi Pasteur. The remaining authors have nothing to disclose.

References and notes

1The abstract “The effects of smoking on cardiac structure and function in a general population” will be presented during the session Risk stratification with echocardiographic parameters on Friday 26 August at 10:15 to 11:00 CEST at Station 1.

2World Health Organization tobacco fact sheet: https://www.who.int/news-room/fact-sheets/detail/tobacco.

3Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227–3337.

4Centers for Disease Control and Prevention smoking and cardiovascular disease fact sheet: https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_CVD_508.pdf.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2022

It is the world’s largest gathering of cardiovascular professionals, disseminating ground-breaking science both onsite in Barcelona and online – from 26 to 29 August. Explore the scientific programme. More information is available from the ESC Press Office at press@escardio.org.

Public call for tougher restrictions on buying tobacco in Britain

Peer-Reviewed Publication

UNIVERSITY COLLEGE LONDON

People in Britain strongly support restricting the sale of tobacco near schools and raising the legal age of sale to 21, finds a new UCL-led study.

In collaboration with The University of Edinburgh and Cardiff University, the research, published in Tobacco Control, examined data from the Cancer Research UK and SPECTRUM*-funded Smoking Toolkit Study, which has surveyed approximately 1,700 adults each month from England since 2006, and 2,200 adults each month from England, Scotland and Wales, since 2020.

The researchers examined data from September 2021, which asked participants about their views on potential policies targeting the availability of tobacco and cigarettes.

The results indicated that most of those surveyed supported retailers having their license revoked if they sold tobacco products to those under-age (89.6%) and for restrictions on the sale of cigarettes and tobacco near schools (69.9%).

Meanwhile, half (49.2%) thought that the legal age of sale for cigarettes and tobacco should be raised to 21, compared with just under a third who were opposed to the idea (30.7%).

Participants were also in favour of reducing the number of retailers selling tobacco in neighbourhoods that already had a high density of tobacco retailers – with almost half (46.5%) showing their support, compared with less than a quarter (23.3%) who disagreed.

Lead author Dr Loren Kock (UCL Institute of Epidemiology & Health) said: “Our findings indicate that policies to restrict tobacco retail near schools, and for tobacco retailer licences would receive strong majority support from the British public if legislated.

“Raising the age of sale to 21 and reducing the number of tobacco retailers also received greater support than opposition.

“However, a substantial proportion of respondents report having no opinion either way on these policies, suggesting there is potential to grow public support through clearer communication on the evidence and benefits of these policies.

“Moreover, support for tobacco availability policy may grow, and opposition diminish, if policies are demonstrated to be effective, and as future generations grow up without cigarettes.”

There are around 6.9million adult cigarette smokers in the UK, who spend approximately £15.6billion a year on legal and illicit tobacco.

Currently the law prohibits the sale of tobacco products to those under the age of 18. And previous studies have shown that a ban on the sale of tobacco products near schools could stop children from taking up the habit.

In 2019, the UK Government set an objective for England to be smokefree by 2030, meaning only 5% of the population would smoke by then. However, a recent report by Dr Javed Khan OBE, highlighted that particularly poorer areas may struggle to reach this target unless the rate of decline of people who smoke is accelerated by 40% **.

Niamh Shortt, Personal Chair of Health Geographies, School of GeoSciences, University of Edinburgh, said: “Across the UK nations targets have been set to radically reduce the proportion of people that smoke over the next decade.

“This new research shows that the public strongly support the introduction of new measures needed to meet these ambitious targets, including reducing the local availability of tobacco products.

“Having wide scale public support to introduce restrictions on the sales of tobacco should embolden the UK and devolved governments to introduce new policies restricting access to tobacco, particularly amongst children, and ensure future generations are tobacco free.”

Study limitations

The use of cross-sectional observational data and potentially unmeasured covariates limits the ability to infer causality between included variables (namely sociodemographic and smoking and quitting characteristics) and support for policies. The sample sizes for the sub-group analyses in Scotland and Wales analyses may also be underpowered.

Data on support for tobacco availability were collected during one survey wave, and if further data were collected the results may change.

* SPECTRUM is a UK Prevention Research Partnership (UKPRP) consortium.

** https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete/making-smoking-obsolete-summary

JOURNAL

Tobacco Control

DOI

10.1136/tc-2022-057508

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Assessing the profile of support for potential tobacco control policies targeting availability in Great Britain: a cross-sectional population survey

ARTICLE PUBLICATION DATE

26-Aug-2022

Sales professionals know how to look after their customers – Everything can be talked about

Peer-Reviewed Publication

UNIVERSITY OF EASTERN FINLAND

Ensuring long-term and productive customer relationships is very important for the continuity of business. Interestingly, customer relationships are always forged between people, even in the context of doing business. Especially in relationship selling, where the aim is to maintain productive and long-term customer relationships, it is extremely important to understand how customer relationships develop between people. So far, earlier studies have not been able to explain why and by which mechanism some customer relationships deepen, while others don’t.

Published in European Journal of Marketing, a study conducted by the University of Eastern Finland researchers explores long-term business-to-business (B2B) customer relationships, and how and to what end such relationships are forged in B2B sales. Applying the social penetration theory, the researchers were particularly interested in how self-disclosure, and weighing the benefits and disadvantages of the customer relationship, either deepened the relationship or didn’t. For the study, the researchers interviewed 47 professionals working in B2B sales.

From being business partners to being collaborative and personal partners

The study showed that long-term and productive customer relationships develop in three phases: first, business partners became collaborative partners and, ultimately, collaborative and personal partners. Sales professionals and customers disclosed things about their personal life and about their company. Both of these domains of self-disclosure deepened as the customer relationship deepened: the things disclosed initially were rather superficial, but became deeper as the relationship deepened, and included topics such as divorce, bankruptcy, personal values, and future business plans.

Some sales professionals, however, felt that they did not wish to share anything about their personal life with the customer. This could have been due to a lack of trust, a desire to maintain strict personal boundaries, or the fact that the customer did not come off as the type of person they’d want to socialise with outside work.

Deepest customer relationships increased trust and commitment to common goals

The benefits of a customer relationship in its deepest level were manifold compared to the initial phase. Trust grew deeper, communication became effortless, it was easier to decide and commit to common goals, and to manage conflicts. Sales professionals felt that they had gained benefits in the form of time savings, cost benefits, increased self-confidence, and more efficient work.

JOURNAL

European Journal of Marketing

DOI

10.1108/EJM-07-2020-0492

ARTICLE TITLE

Development of long-term B2B customer relationships: the role of self-disclosure and relational cost/benefit evaluation

New study demonstrates clinical and financial impact of patient exposure to ill healthcare worker in long-term care facility

Peer-Reviewed Publication

ASSOCIATION FOR PROFESSIONALS IN INFECTION CONTROL

Arlington, Va., August 25, 2022 – A study conducted by researchers in Japan shows that the presence of one ill healthcare worker in a long-term care facility led to respiratory infections among 17 patients and more than $12,000 in total medical costs. Findings from the study, published today in the American Journal of Infection Control (AJIC), suggest that addressing the causative factors for such exposures is critical to help prevent infectious disease outbreaks in similar facilities.

“To our knowledge, this is the first study that used statistical analysis to confirm the source of a respiratory infection in a long-term care ward for patients with severe motor and intellectual disabilities, as well as the first to calculate the corresponding medical costs,” said Naoki Takayama, MSN, RN, of the National Hospital Organization Tenryuu Hospital in Japan, and a study author. “It sheds light on the significant clinical and financial implications of healthcare workers coming to work while ill, a phenomenon known as presenteeism that is detrimental and challenging for many healthcare facilities.”

Respiratory tract infections account for more than 40% of deaths among patients with severe motor and intellectual disabilities (SMID). While many SMID facilities, including the one involved in the current study, follow standard employee health-surveillance protocols to prevent such infections, consistent adherence to these protocols can be difficult. Additionally, multiple issues may contribute to employees’ presenteeism, including concerns about lost income, lack of days off, burdening colleagues, and maintaining professionalism.

In the current study, researchers sought to identify the source and resulting costs of respiratory infections among 18 individuals (one healthcare worker and 17 patients) in the 55-bed SMID ward of a single public hospital in Japan. All individuals in the study cohort had a fever of 99.5o F or higher with respiratory symptoms such as cough and nasal discharge. Researchers first conducted an outbreak investigation, which identified a healthcare worker as the single, initial cause of the outbreak. Researchers confirmed the healthcare worker as the outbreak cause through univariate statistical analysis (odds ratio, 17.5; 95% CI, 3.0-101.8). In this case, the worker was a part-time employee with 10 years of experience who came to work despite having a cough, nasal discharge, sore throat, and headache. She completed a health screening checklist upon arrival for her shift and practiced standard precautionary measures such as wearing a surgical mask.

While the healthcare worker and all 17 patients recovered from their infections, the median time to recovery was 10 days. Based on medical records for all 17 individuals, researchers determined that the total cost for additional treatment and laboratory tests associated with the respiratory infections was $12,324.

“The findings from this study suggest that identifying and eliminating the factors that contribute to employee presenteeism should be a priority for healthcare facilities and providers to better protect their patients and employees from infectious illness,” said Linda Dickey, RN, MPH, CIC, FAPIC, 2022 APIC president.

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org.

About AJIC

As the official peer-reviewed journal of APIC, The American Journal of Infection Control (AJIC) is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. Published by Elsevier, AJIC also publishes infection control guidelines from APIC and the CDC. AJIC is included in Index Medicus and CINAHL. Visit AJIC at ajicjournal.org.

NOTES FOR EDITORS

“Healthcare workers’ presenteeism causing an outbreak of respiratory infections in a facility for patients with severe motor and intellectual disabilities,” by Naoki Takayama, MSN, RN; Haruyo Sakaki, PhD; Masahiro Shirai, PhD, MD; Atsushi Toyoda, MD; Hiroko Takayanagi, RN; Kazuya Takagi, RN; Kaoru Fujita, MD; Eiko Endo, PhD, RN, was published online in AJIC on August 25, 2022. The article may be found online at: https://doi.org/10.1016/j.ajic.2022.07.016

AUTHORS

Naoki Takayama, MSN, RN (corresponding author: takayama.naoki.vw@mail.hosp.go.jp)