Thursday, October 19, 2023

Electrons are quick-change artists in molten salts, chemists show

 

New study finds racial and ethnic disparities persist in access to chiropractic care and physical rehabilitation for adults with low back pain


Peer-Reviewed Publication

BOSTON MEDICAL CENTER




BOSTON - Low back pain is the leading cause of disability worldwide and a major driver of healthcare costs in the United States, according to the World Health Organization. Over the last 20 years, recommended treatment of low back pain has shifted from use of pain medications including opioids to early use of nonpharmacologic treatments such as spinal manipulation and therapeutic exercise which are commonly provided by chiropractors and physical therapists. However, while nearly all Americans will experience back pain at some point in their lives, most Americans have never tried chiropractic care or physical therapy.

New research published in the Journal of General Internal Medicine from Boston Medical Center discovered that the use of chiropractic care or physical rehabilitation, including occupational therapy or physical therapy, increased modestly for adults from 2002 to 2018, with only one third of Americans with low back pain seeking these common non-pharmacological treatments in 2018.

Researchers also found chiropractic care or physical rehabilitation use was less likely among Hispanic versus non-Hispanic adults with low back pain. Black Americans were as likely as White Americans to access occupational therapy or physical therapy but half as likely to access chiropractic care. Furthermore, while access to occupational therapy or physical therapy was generally similar among Americans with various incomes and insurance providers, use of chiropractic care was low among low-income adults and those with public health insurance. There remains a need to understand the causes of racial and ethnic disparities in access to chiropractic care, occupational therapy, or physical therapy.

The authors found that there are gaps in access that are strongly associated with income, insurance status and other factors that could be addressed with policy changes to improve access in Medicaid populations and low-income communities.

“Chiropractic care and physical therapy are among the best options we have for treating low back pain, and can help reduce reliance on treating pain with opioids and other pain medications,” said lead author Eric J. Roseen, DC, PhD, Director of the Program for Integrative Medicine and Health Disparities at Boston Medical Center, and Assistant Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine. “Guidelines released during the study period went from recommending these approaches as second line treatment, after other treatments fail, to first line treatment to be used before traditional pain medications. While the modest increases in use of these treatments we observed may be a sign of guideline adoption, most Americans with back pain are not receiving this type of care.”

Chiropractic care and physical rehabilitation are evidence-based approaches for managing low back pain, a very common and disabling health condition. The strength of evidence for these treatments has increased over the past 20 years, and guidelines from the American College of Physicians now strongly recommend these as initial treatment for acute or chronic low back pain.

Researchers used data from the CDC’s National Health Interview study from 2002 to 2018 involving 146,087 Americans who experienced low back pain in the prior three months to see if they had accessed chiropractic care or physical rehabilitation in the prior year, and to understand whether access to these services is equitable and how this has changed over time.

Between 2002 and 2018, only one third of adults with lower back pain reported use of either chiropractic care or physical rehabilitation, including occupational and physical therapy. Rates did not change until 2016 when uptake among adults modestly increased with the introduction of new clinical guidelines, but disparities by race and ethnicity remained despite the stronger recommendations.

Researchers believe that health insurance and policy changes are needed to increase access to non-pharmacological care for low back pain, particularly in underserved communities. Researchers pointed to stigma around pain treatment and specific guideline-recommended treatments that may also limit use of chiropractic care, physical therapy or occupational therapy.

“Understanding and addressing the causes of racial and ethnic inequities in access to chiropractic care and physical therapy in underserved communities is an important part of improving pain outcomes for all Americans,” Roseen said.

 

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About Boston Medical Center

Boston Medical Center models a new kind of excellence in healthcare, where innovative and equitable care empowers all patients to thrive. We combine world-class clinicians, cutting-edge treatments, and advanced technology with compassionate, quality care, that extends beyond our walls. As an award-winning health equity leader, our diverse clinicians and staff interrogate racial disparities in care and partner with our community to dismantle systemic inequities. And as a national leader in research and the teaching affiliate for Boston University Chobanian & Avedisian School of Medicine, we’re driving the future of care.

 

Nail salon and other small beauty service workers face significant daily health challenges


Peer-Reviewed Publication

TEXAS A&M UNIVERSITY



The beauty service microbusiness industry in the United States — such as the small, independently-owned nail salons found across the country — is huge, with more than $62 billion in annual sales.

However, most of the workers who provide these highly sought services are Asian female immigrants who earn very low wages. These workers face numerous workplace health challenges stemming from the chemicals they use, repetitive movements with handheld tools and awkward body posturing.

They also are reluctant to bring attention to these conditions due to factors such as possible immigration-related trauma, lack of English proficiency, fear of losing their jobs and unfamiliarity with American culture and business practices.

new commentary led by Dr. Aurora Le, associate professor with the Texas A&M University School of Public Health, offers multi-layered insight into the complex challenges these beauty service workers face, as well as suggestions for interventions and policy measures to address them.

For this assessment, which was funded through the National Institute for Occupational Safety and Health, Le and a colleague from the University of Minnesota used a research framework that depicts how behavior, the physical/built environment, sociocultural environment, and health care system interact with factors at the individual, interpersonal, community and society level to influence the health of individuals and populations.

“This structure not only helps us understand how these multilayered issues affect each other, but also helps us shape and prioritize strategies to address health issues and disparities through organizations, communities and policies,” Le said.

For example, where the behavioral domain intersects with the interpersonal level of influence for Asian and Asian American beauty service workers, the researchers identified a lack of occupational health services and training, of employment-related benefits and low wages, and of other workplace health promotion benefits.

“This means that outreach and education at the individual level about occupational safety and health would require cultural competency and communication that includes materials not only in their language, but also at their literacy level,” Le said. “The same would be true at the interpersonal level, which includes social interactions in the home and work environment, as well as larger social networks.”

At the community level, the resources available for these workers vary significantly by geographic location, with cities that have more immigrants from a particular country having more in-language resources.

“Still, it’s the case that most of these resources pertain to services such as how to enroll in and access health care, how to get legal help, and so on,” Le said. “Materials about occupational safety and health are extremely limited, especially for microbusinesses.”

Within the larger society level, which includes state-specific licensure and health department regulations, many beauty service microbusiness owners may lack a thorough understanding of the regulations and so might not be in compliance.

“It’s also the case that most of these businesses have fewer than 10 employees and thus are subject to fewer regulations, but also operate under razor-thin profit margins and struggle to survive,” Le said. “In addition, immigrant employees with little job security are much less likely to report unsafe practices.”

Making Change

How can these findings inform future occupational safety and health policies and practices?

“For one thing, it’s clear that little could be accomplished at the individual level for these beauty service workers,” Le said. “Instead, change will require collaboration by stakeholders who are invested in the community’s health and experts in areas such as business development who understand the context in which these workers operate. That means that training at the very minimum must be available in the workers’ preferred language, and that these employers need to gain buy-in on the importance of workplace health and safety.”

At the community level, Le said community-based organizations for Asians and Asian Americans were at the forefront for these workers during the COVID-19 years, and now offer more resources on occupational safety and health issues. One example is the Vietnamese American nonprofit Boat People SOS, which has added programming on chemical exposures for nail salon workers to its training.

At the larger society/policy level, the federal government has provided funding to some community-based organizations for safety outreach efforts to Asian and Asian American beauty service microbusinesses. Le said this has led some states to adopt safer practices and advocate for workplace standards for nail salons, including better wages and training and paid time off.

Finally, at the level of the occupational safety and health practitioner and researcher, Le said the best approach would be community-based participatory research, in which all parties have equal input and decision making and build on existing assets to empower participants to have greater control over their lives. Le said that bringing more Asians and Asian Americans into the field of occupational safety and health as researchers at universities and government agencies also would help greatly, as would increased collaboration between scientists, other subject matter experts and policy makers.

“These workers and employers have come to this country and made new lives for themselves,” Le said. “And now, a new, multi-level focus on occupational safety and health could help them thrive.”

By Ann Kellett, Texas A&M University School of Public Health

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Startup workers flee for bigger, more established companies during pandemic


Findings reveal vulnerability of early-stage firms in downturns


Peer-Reviewed Publication

UNIVERSITY OF TORONTO, ROTMAN SCHOOL OF MANAGEMENT

Prof. Ting Xu 

IMAGE: 

TING XU IS AN ASSISTANT PROFESSOR OF FINANCE AT THE UNIVERSITY OF TORONTO'S ROTMAN SCHOOL OF MANAGEMENT. HIS RESEARCH FOCUSES ON ENTREPRENEURIAL FINANCE, INNOVATION, LABOR AND PRODUCTIVITY. HIS WORK HAS EXPLORED ANGEL FINANCING, CROWDFUNDING, INNOVATION DIFFUSION, STARTUP LABOR MARKET, AND THE BOUNDARY OF PUBLIC AND PRIVATE FIRMS. HIS WORK HAS BEEN PUBLISHED IN LEADING ACADEMIC JOURNALS, INCLUDING THE JOURNAL OF FINANCE, THE REVIEW OF FINANCIAL STUDIES, THE REVIEW OF ECONOMICS AND STATISTICS, AND THE JOURNAL OF FINANCIAL AND QUANTITATIVE ANALYSIS. HIS RESEARCH HAS BEEN COVERED IN NEWS OUTLETS SUCH AS BLOOMBERG, NPR, BBC, SLATE, AND POLITICO, AND HAS BEEN PRESENTED TO REGULATORS SUCH AS THE SEC AND THE US HHS. HIS RESEARCH HAS RECEIVED FUNDING FROM THE SOCIAL SCIENCES AND HUMANITIES RESEARCH COUNCIL OF CANADA, THE CANADIAN SECURITIES INSTITUTE RESEARCH FOUNDATION, AND THE CANADIAN FOUNDATION FOR GOVERNANCE RESEARCH.

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CREDIT: UNIVERSITY OF TORONTO



October 19, 2023

Startup workers flee for bigger, more established companies during pandemic
Findings reveal vulnerability of early-stage firms in downturns

Toronto - The world may have felt like it had stopped in the pandemic’s first weeks. But a “flight to safety” was underway at a popular digital job platform catering to the startup sector.

Digging into the data for nearly 180,000 users from AngelList Talent (now called Wellfound), the biggest online recruitment platform for private and entrepreneurial companies, researchers have found that U.S. job hunters turned away from smaller, early-stage companies in favour of positions at bigger, more established firms.

Just as research has shown investors rush to safer places for their money during downturns, the labour market shows similar behaviour – and this is the first study to document it, points out researcher Ting Xu, an assistant professor of finance at the University of Toronto’s Rotman School of Management.

“Our results explain why startups struggled in the COVID-19 downturn despite a robust financing market,” said Prof. Xu, who conducted the study with fellow researchers Shai Bernstein of Harvard Business School and Richard R. Townsend of the University of California San Diego.

They found that, compared to the period before, job hunters were 20 per cent more likely to search for work at companies with more than 500 employees after March 13, 2020 when the U.S. declared a state of national emergency over the pandemic. The companies were concentrated in sectors such as IT, media, e-commerce, healthcare and business services.

The average size of companies that job seekers searched also grew by 29 per cent after March 13, continuing until mid-May, the end of the examined data period. Job seekers were also more likely to  search companies that were bigger than their employment at the time.

The general trends didn’t change in the application phase. The average size of companies where workers applied increased by eight per cent and the firms were 16 per cent more likely to be in a later stage of fundraising.

The overall trend was driven by highly-skilled, better-educated job seekers, which is no small thing, Prof. Xu said. “It’s not only the quantity of talent that matters for firm success, but also its quality,” he said. “If the shift is concentrated among high-quality candidates, it means that the startups are not just losing access to any talent, but to the best talent that are critical to their success.”

Not only did applications to smaller, early-stage startups dropped by 20 per cent, the researchers found these companies became less responsive to the applications they did get and were less likely to hire – a signal, said Prof. Xu, that the quality of applications dropped.

The research helps to explain why startups, theorized to be well-positioned to seed new growth during an economic recovery, tend instead to suffer: “Startups struggle to hire during downturns,” said Prof. Xu.

The pandemic was an ideal period to study this behaviour because it was not as complicated by other potential contributing factors as in other economic downturns. People’s economic expectations dropped off much more sharply and quicker, and startup financing remained relatively healthy.

The paper has been accepted for publication in The Review of Financial Studies

Bringing together high-impact faculty research and thought leadership on one searchable platform, the new Rotman Insights Hub offers articles, podcasts, opinions, books and videos representing the latest in management thinking and providing insights into the key issues facing business and society.  Visit www.rotman.utoronto.ca/insightshub.

The Rotman School of Management is part of the University of Toronto, a global centre of research and teaching excellence at the heart of Canada’s commercial capital. Rotman is a catalyst for transformative learning, insights and public engagement, bringing together diverse views and initiatives around a defining purpose: to create value for business and society. For more information, visit www.rotman.utoronto.ca

 

Current bird flu epidemic found to have originated in Europe and Africa

Current bird flu epidemic found to have originated in Europe and Africa
Evolution of clade 2.3.4.4b HA genes and early migration patterns of resurgent HPAI. a, 
Maximum clade credibility tree with branches colored by discrete geographic region. 
Color bars indicate host and subtype. The posterior distribution of the tMRCA is shown as
 bar charts on specific nodes. b, Continuous phylogeographic reconstruction of the spread 
of H5N8 from mid-2014 to 2017. c, Early spread of H5N8 from 2017 to mid-2020 before
 the 2020–2021 resurgence. d, Early spread of H5N1 from mid-2020 to 2021 before the 
2021–2022 resurgence. Circles represent nodes in the maximum clade credibility 
phylogeny, colored by the inferred time of occurrence. Arcs indicate direction of dispersion
 (counterclockwise) between nodes. An interval of 80% HPD is depicted by shaded areas, 
illustrating the uncertainty of the phylogeographic estimates.
 Credit: Nature (2023). DOI: 10.1038/s41586-023-06631-2

An international team of biologists, public health specialists and infectious disease experts reports that the current near-global bird flu epidemic has its roots in Europe and Africa. In their study, published in the journal Nature, the group analyzed bird flu data from multiple animal health databases.

Going back to 2020, infectious disease experts have found a new strain of the H5N1  in both wild and domestic birds. Since that time, infections have spread to every place on Earth except Oceania and Antarctica. Thus far, it is the worst  outbreak in Europe's history and has killed record numbers of birds in many other countries. It has also been found to jump to other animals, including humans—to date, it has killed 458 people.

Fortunately, while the virus can leap from birds to humans, it has not yet evolved the ability to jump between people. In this new effort, the research team sought to find the origins of the new outbreak by analyzing information in databases of statistics about animals, including bird deaths, around the globe.

The data came from two massive databases, one maintained by the World Organization for Animal Health and another by the United Nation's Food and Agriculture Organization. The team also obtained  from several entities that have been tracking bird deaths due to bird flu from multiple sites around the world.

The researchers found that a major shift has occurred with bird flu—where once new strains almost always originated in Asia, the new variant came from Africa and Europe. They found that it was a new variant of H5N1, the strain that originated in China back in mid-1990s. Genetic analysis showed that the new version of the variant had originated in north Africa as H5N8. As it moved to Europe, it evolved to H5N1, where it become more virulent, resulting in massive bird losses. Since that time, it has spread to most of the rest of the world.

The researchers suggest that the evolutionary path of the virus represents a major shift in bird flu evolution—one that will require a new approach by officials and health experts hoping to quash the  before the virus adapts to jump between humans, and before the next new strain arrives.

More information: Ruopeng Xie et al, The episodic resurgence of highly pathogenic avian influenza H5 virus, Nature (2023). DOI: 10.1038/s41586-023-06631-2

Journal information: Nature 

© 2023 Science X Network

Cambodian man dies from bird flu

 

In an ancient hot spring haunt of Inca rulers, scientists discover a new freshwater shrimp-like species

In an ancient hot spring haunt of Inca rulers, scientists discover a new freshwater shrimp species
Experiments showed H. yashmara can survive temperatures of up to 52.1°C (125.78°F), 
the hottest recorded for amphipods. Credit: Dr. Nilton Deza Arroyo

In an ancient hot spring haunt of Incan rulers, researchers discovered a new species of tiny, shrimp-like scavengers known as amphipods thriving at record temperatures that can cook other crustaceans to death.

Although called freshwater shrimps, amphipods are not true shrimps. Typically, they dwell in cool aquatic and semi-aquatic habitats. So Japanese and Peruvian researchers were stunned when unidentified Hyalella  showed up during a hot spring biota survey of Baños del Inca (Baths of the Inca) near the ancient Inca city of Cajamarca.

"Though the amphipod is a taxon with a great diversity of habitats, the discovery of a  from a previously unexpected high-temperature environment is most surprising," said study corresponding author Ko Tomikawa, professor at Hiroshima University's (HU) Graduate School of Humanities and Social Sciences.

"This is an important finding because it indicates that the diversity of habitats for amphipods is much greater than previously thought."

The new species was given the scientific name Hyalella yashmara after the two daughters of one of the researchers. Hyalella is a genus of amphipods endemic to the Americas.

Shared similarities, distinct differences

Researchers noted that H. yashmara is most similar to another Peruvian amphipod species called H. meinerti. Among the similarities they share are having a head with eyes and an upper dorsal antenna shorter than the lower ventral antenna.

But it also differs from its counterparts when it comes to its gnathopods 1 and 2, claw-bearing limbs used for feeding, grasping mates, and moving; respiratory structures called sternal gills; uropod 3, a part of the tail fan; and telson, or tail plate, shape. A detailed description of the new species was published in the journal Invertebrate Systematics.

Clues to adapting to climate change

Like its cold-dwelling counterparts, experiments showed H. yashmara can swim around cooler waters of 19.8°C (67.64°F). Although it can't survive habitats colder than that for more than 24 hours.

Temperatures at Baños del Inca hit around 78°C (172.4°F) closest to the thermal spring's origin. Field surveys revealed that these amphipods hang around pools simmering at 50°C (122°F) not far off the hot spring's source and in channels cooled down to 35°C (95°F).

But they do seem to like it hot. Researchers noticed that these creatures are virtually inert early in the morning when temperatures are between 35–40°C (95–104°F) and bustling with activity as it grows warmer during the day.

Tests revealed they can survive temperatures of up to 52.1°C (125.78°F), the hottest recorded for amphipods. Such a temperature is enough to cook other crustaceans, including some of its shrimp cousins to death.

"Many animals cannot tolerate high-temperature environments because proteins are thermally denatured at high temperatures. We guess the new species found in the hot spring of Peru has acquired a protein that is highly active at high temperatures during the course of evolution," Tomikawa explained.

Unraveling its unique adaptations can give clues on bolstering the heat tolerance of freshwater animals threatened by our warming climate.

"Rising water temperatures due to recent global warming pose a threat to the survival of freshwater organisms that prefer cold water environments. Detailed studies on the ecology and physiology of Hyalella yashmara may reveal the mechanism of high-temperature tolerance in crustaceans," Tomikawa said.

"This information is of great importance as a basis for the conservation of cold-water freshwater organisms."

Untangling its Gondwana origin story

Results of their molecular phylogenetic analyses, a method of studying  based on genetic material, revealed a common Gondwanan ancestor for amphipods in the families Hyalellidae, where Hyalella species belong, and Chiltoniidae, which are abundant in Australia and New Zealand. Gondwana is the ancient supercontinent that clumped together the present-day continents of South America, Africa, and Australia.

That ancestor abandoned the sea to colonize new freshwater habitats during the Mesozoic age (about 252–66 million years ago)—the period when Earth's single landmass known as Pangaea started drifting apart to form the continents we know today.

The analyses also suggested that the species of Hyallela in South America originated from different ancestors. Meanwhile, the species in North America likely share a most recent common ancestor with H. yashmara.

"The discovery of this new species proposes a new story of the distributional expansion of the genus Hyalella. Molecular phylogenetic analyses have revealed that the distribution of Hyalella likely expanded from South America to North America as a result of the introduction of a South American clade closely related to Hyalella yashmara into North America," Tomikawa said.

Their molecular phylogenetic analyses covered 34 species of the nine families in the superfamily Hyaloidea and four of the two families in the superfamily Talitroidea.

More information: Ko Tomikawa et al, Description of a new thermal species of the genus Hyalella from Peru with molecular phylogeny of the family Hyalellidae (Crustacea, Amphipoda), Invertebrate Systematics (2023). DOI: 10.1071/IS22060


Provided by Hiroshima University 

Aquatic animals living closer to the edge when it comes to heat stress: Study