Implicit bias prevents women from obtaining prompt treatment for health problems

Many struggle for years to obtain validation from providers, family members

Peer-Reviewed Publication

UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN, NEWS BUREAU

 

IMAGE: COMMUNICATION PROFESSOR CHAREE THOMPSON, RIGHT, AND GRADUATE STUDENT SARA BABU CO-WROTE A STUDY ABOUT WOMEN’S STRUGGLES TO OBTAIN MEDICAL TREATMENT AND EMOTIONAL SUPPORT FOR CHRONIC HEALTH CONDITIONS, WHICH THEY SAY REPRESENTS A FORM OF IMPLICIT BIAS AND DISEMPOWERMENT THAT DENIES WOMEN’S KNOWLEDGE OF THEIR BODIES AND HEALTH. view more 

CREDIT: PHOTO BY FRED ZWICKY

CHAMPAIGN, Ill. — For some women who experience serious and chronic physical or mental health conditions, one of their most daunting challenges is obtaining the belief and validation of health care providers, family members and friends, researchers found in a recent study.

Those in the study described prolonged struggles to obtain emotional support, diagnosis and treatment for a variety of serious, often-painful health conditions – including cancer, endometriosis, multiple sclerosis and Crohn’s disease, as well as mental illnesses such as depression and anxiety that were exacerbated by others’ negative reactions, said Charee Thompson, the first author of the study and a professor of communication at the University of Illinois Urbana-Champaign.

“Most women we talked to had lived with their health issues and pain for years,” said Thompson. She and her co-authors – U. of I. graduate students Sara Babu and Shana Makos – interviewed 36 women from across the U.S. about their experiences with providers not taking their health concerns seriously and regarding the mental and physical toll it took.

“Most of them were in their 20s, 30s or older, and oftentimes their mental or reproductive health issues started when they were adolescents. We’re talking decades of neglect or undertreatment,” Thompson said. “One thing that was surprising and frankly heartbreaking was the personal rejection and sometimes the abuse that women experienced because of their health problems.”

Although the study population of 36 was small, the researchers said the women’s experiences reflect a form of implicit bias, discrimination and disempowerment that women have faced for centuries.

The team called these negative responses to participants’ health disclosures “communicative disenfranchisement” – a process that denies individuals’ knowledge of their health and bodies, and treats their symptoms, experiences and intersecting identities such as race and sexual orientation as nonexistent, imaginary or worthless.

Also known as medical gaslighting, communicative disenfranchisement “is an isolating, painful and humiliating experience that is sustained by talk from physicians and others that’s often intertwined with economic factors such as insurance status and transportation,” Thompson said.

University of Connecticut communication professor Elizabeth Hintz developed the theory of communicative disenfranchisement while studying the experiences of patients with multiple pain syndromes.

Ranging in age from 21-70, the majority of the participants in the current study were white. Six of the women were Black and the remaining three were Filipina, Hispanic or Middle Eastern. However, eight of the participants said they were multiracial.

When these women’s concerns were invalidated by their health care providers, they attributed their clinicians’ discrediting them to their race and economic or insurance status, according to the study.

Those whose mental health or reproductive health problems began during childhood or adolescence said their parents’ skepticism about their health problems, their family’s conservative values or lack of economic resources prevented them from obtaining the health care they needed until they became adults or entered college.

Study participants recounted experiences with clinicians who shamed or scolded them for their physical and mental health issues, made humiliating remarks about their bodies and weight, and attributed their health issues to “poor self-management and a personal failure to be doctorable – to present problems in ways that are worthy of medical care and attention,” the team wrote.

Many patients’ stories resembled “chaos narratives” where their well-being was negatively affected rather than improved by their interactions with providers. Each patient in the study told the team she saw several physicians before locating someone who listened to her concerns, engaged in mutual decision-making and helped her search for answers.

“Reeling from dismissal, women often disengaged from health care while simultaneously questioning themselves and trying to self-manage their symptoms,” the researchers wrote. “Isolated, women wondered if their symptoms were real, worthy of attention and care, and whether receiving this kind of treatment from providers was normal.”

Feeling dehumanized and traumatized, these patients grieved for the years and life experiences such as motherhood and careers lost to poor health, the team found. However, as they developed confidence in their self-knowledge and found their voices, many women were motivated by these injustices to advocate for others in their families or their community.

“I really admired these women for their strength and resilience,” Thompson said.

During the 18th and 19th centuries, women’s health complaints were often diagnosed as “hysteria” – a controversial mental health disorder and catchall diagnosis that physicians attributed to females’ supposed fragile, highly emotional nature, according to various researchers who explored the topic.

While hysteria was removed from the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders in 1980, Thompson said “we now have coded, gendered language such as psychosomatic and somatoform disorders – where emotional distress triggers physical issues – that’s used when there’s no medical explanation for patients’ symptoms.”

Mitigating these biases requires that providers have cultural knowledge – including an understanding of patients’ intersectional gender and sexual identities as well as race – along with an awareness of their values and beliefs, Thompson said.

“The automatic response should be to believe women – before landing on a diagnosis or having confirmation bias, where you make a diagnosis and there’s nothing that moves you from it,” Thompson said. “To really listen to women means you do more listening than talking.”

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JOURNAL

Health Communication

DOI

10.1080/10410236.2022.2137772 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Women’s experiences of health-related communicative disenfranchisement

 SUCCESS IN ADVERTISING

Later brand reveal in advertisements leads to better sales

Peer-Reviewed Publication

UNIVERSITY OF OTAGO

 

IMAGE: DR JOHN WILLIAMS view more 

CREDIT: UNIVERSITY OF OTAGO

When it comes to product advertisements, consumers like a bit of mystery.

A University of Otago-led study, in partnership with researchers from the Ehrenberg-Bass Institute for Marketing Science, in Australia, has found television advertisements are more successful if they show the product first and the brand later.

Lead author Dr John Williams, of the Department of Marketing, says researchers examined creative variables in television advertisements and monitored consumers’ supermarket purchases after they viewed the ads.

The results contradict standard marketing theory and practice, but retrospectively make sense, Dr Williams says.

Part of the reason for this novel finding is that most advertising research evaluates “effectiveness” by asking consumers whether they would buy the product or even if they merely like the ad.

In contrast, researchers used a commercially-relevant and industry-validated measure of sales success, eliminating the so-called “intention-behaviour gap” that plagues much marketing research.

“Usually, television advertisements will start by showing the brand and then repeating it throughout,” Dr Williams says.

“But we discovered marketers should consider showing the product first and revealing the brand later.”

Research into consumer psychology suggests there are a few reasons for this.

“If you see an ad that’s relevant to you but you’re not sure what brand it’s for, that creates unresolved tension and attention – the critical first step in advertising effectiveness – which is then resolved, giving a little trickle of dopamine,” he says.

“This makes an ad memorable due to the prolonged attention and processing, and also creates positive associations.”

Secondly, people usually already have opinions on brands before seeing their advertisements.

“If the brand is shown first, people either already buy it or buy some other brand that does the same job.

“In each case, they are more likely to direct their attention elsewhere because they’ve already made up their mind – there is no unresolved mystery that is then resolved.”

The study, published in the International Journal of Market Research, also highlights the importance of using multiple methods to analyse data.

“All statistical methods of analysing data have strengths, weaknesses and caveats, and therefore if you only use one method, you can never be sure whether your results are due to patterns in the data, or some aspect of the method you applied.

“This risk can be mitigated if you use multiple methods and see if they all tell the same story.”

The results have practical implications for brand marketers and people who work in brand agencies, as consumers are not as concerned about brands as they might think.

“Most people want products and services that satisfy their wants and needs, rather than particular brands. Although, there are a lot of exceptions to this general rule.”

 

For more information please contact:

Dr John Williams

Department of Marketing

University of Otago

Email: john.williams@otago.ac.nz

 

Jessica Wilson

Adviser Media Engagement

University of Otago

Mobile: 021 279 5016

Email: jessica.wilson@otago.ac.nz

 

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JOURNAL

International Journal of Market Research

DOI

10.1177/14707853221134258 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Finding creative drivers of advertising effectiveness with modern data analysis

New study finds animals play key role in restoring forests

The world’s wildlife populations have declined by almost 70% in the last 50 years as their habitats have been polluted and cleared by humans. Yet, animals play a crucial role in reforestation, a new study has found.

Peer-Reviewed Publication

YALE UNIVERSITY

As nations meet this week in Montreal on efforts to address an unprecedented loss of biodiversity — more than a million species are threatened with extinction — a new study published in The Royal Society journal Philosophical Transactions of the Royal Society B points to the unique and vital role animals play in reforestation.

An aerial view of regenerating secondary tropical forest in the Barro Colorado Nature Monument, Panama. Credit: Christian Ziegler, Max Planck Institute of Animal Behavior. 

Efforts to restore forests have often focused on trees, but the study found that animals play a key role in the recovery of tree species by carrying a wide variety of seeds into previously deforested areas.

The study was conducted by an international team led by Sergio Estrada-Villegas, a postdoctoral associate at the Yale School of the Environment, working with Professor of Tropical Forest Ecology Liza Comita. The project, which examined a series of regenerating forests in central Panama spanning 20 to 100 years post-abandonment, was completed by Estrada-Villegas during his time as a Cullman Fellow in the joint program between YSE and the New York Botanical Garden. The study was published in a special theme issue of the journal that focused on forest landscape restoration as part of the U.N. Decade of Ecosystem Restoration.

“When we talk about forest restoration, people typically think about going out and digging holes and planting seedlings,” Comita says. “That's actually not a very cost-effective or efficient way to restore natural forests. If you have a nearby preserved intact forest, plus you have your animal seed dispersers around, you can get natural regeneration, which is a less costly and labor-intensive approach.”

The research team analyzed a unique, long-term data set from the forest in Barro Colorado Nature Monument in Panama, which is overseen by the Smithsonian Tropical Research Institute, to compare what proportion of tree species in forests were dispersed by animals or other methods, like wind or gravity, and how that changes over time as the forest ages. The team focused on the proportion of plants dispersed by four groups of animals: flightless mammals, large birds, small birds, and bats.

Because the area has been intensely studied by biologists at the Smithsonian for about a century, the research team was able to delve into data stemming back decades, including aerial photographs taken in the 1940s-1950s. The area also presents a unique view into forests where there is very little hunting or logging. The results offer the most detailed data of animal seed dispersal across the longest time frame of natural restoration, according to the study.

The role of flightless animals in seed dispersal across all forest ages, from 20 years to old growth, and the variety of animal species involved were among the most important findings of the study and point to the importance of natural regeneration of forests, Comita and Estrada-Villegas say. In tropical forests, more than 80% of tree species can be dispersed by animals.

The researchers say the findings can serve as a road map for natural regeneration of forests that preserve biodiversity and capture and store carbon at a time when the U.N. Decade of Restoration is highlighting the need for land conservation, and world leaders are working to mitigate climate change stemming from fossil fuel emissions. Forests soak up carbon dioxide from the atmosphere and store it in biomass and soils. Tropical forests, in particular, play an important role in regulating global climate and supporting high plant and animal diversity, the researchers note.

Estrada-Villegas, an ecologist who studies both bats and plants, says the study highlights how crucial animals are to healthy forests.

“In these tropical environments, animals are paramount to a speedy recovery of forests,” says Estrada-Villegas, who has recently joined the faculty of Universidad del Rosario in Bogotá, Colombia.

The study was co-authored by Daisy H. Dent, a tropical ecologist from the Max Planck Institute for Animal Behavior; Pablo Stevenson, of the Universidad de los Andes in Bogota, Columbia; Omar López, of the Smithsonian Tropical Research Institute in Balboa, Panama; and Saara J. DeWalt, chair of the Department of Biological Sciences at Clemson University.

 

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JOURNAL

Philosophical Transactions of the Royal Society B Biological Sciences

DOI

10.1098/rstb.2021.0076 

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Animal seed dispersal recovery during passive restoration in a forested landscape

REPLACE IT WITH ASPHALT

Santa should phase out coal as punishment in Christmas stockings

Coal for 'naughty' children damages children's health and the environment, argue experts

Peer-Reviewed Publication

BMJ

Father Christmas has long been doling out coal to children on the 'naughty list’, but with the climate emergency in mind, isn't it time to phase out this festive punishment? 

In the Christmas issue of The BMJ, paediatrician Tamsin Holland Brown, and her daughters Lilac and Marigold, make the environmental—and compassionate—case for ending this "outdated and potentially harmful" tradition.

The traditional practice of rewarding well-behaved children with gifts but leaving miscreant ones with coal in the festive season persists; lumps of coal are widely available from major online retailers, and the #coalforchristmas hashtag crops up on social media.

However, the authors point out that not only does the burning of this non-renewable fossil fuel exacerbate the climate crisis, but its impact on air quality can also be bad for children's health. "It would be good for goodness' sake if coal was left in the ground", they argue.

Receiving a lump of coal might also have a negative impact on kids' mental health, they suggest. 

As the covid-19 pandemic, war, cost of living crisis, and the climate emergency have already added to anxieties, the authors suggest fostering friendships, and connections between generations, "might combat anxiety" better than a lump of coal.

The authors also make the case for rewarding 'naughtiness', citing Greta Thunberg, the eco-activist who inspired millions of children to go on school strikes for climate. As Thunberg says, children "can't save the world by playing by the rules," so these children deserve to be on the nice—not naughty—list, suggest the authors.

So as alternatives to punitive coal, the authors suggest recycled/upcycled gifts, plant-based foods, walks and bike rides in nature, inspiring novels, or even a stick insect. 

While the co-authors Lilac and Marigold have admitted that they missed school to attend a climate march in 2019, they point out that "[coal] is a fossil fuel and so giving children [coal means] the adults are being the naughty ones." 

We need to "Be kind to the world," they conclude.

 

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JOURNAL

The BMJ

DOI

10.1136/bmj.o2970 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The gift that won’t keep on giving: ban coal as punishment at Christmas

ARTICLE PUBLICATION DATE

19-Dec-2022

SHOULD HAVE DONE THIS BEFORE THE STRIKE

How many free hot drinks and biscuits are excessive?

Free hot drinks and biscuits would boost staff morale and cost less than 0.1% of the NHS budget, say researchers

Peer-Reviewed Publication

BMJ

When free hot drinks and biscuits are on offer to healthcare staff, how much is reasonable to take before it’s deemed “excessive” consumption, ask researchers in the Christmas issue of The BMJ?

Might some staff be “taking the biscuit” while others end up getting the short end of the teaspoon? 

And could imposing limits on free refreshments for staff achieve nothing other than fostering resentment and even counterintuitively increasing consumption?

To find out, they surveyed 1,874 healthcare workers and academics, asking how many free hot drinks and packets of biscuits they would take during a single visit to a hospital library before considering their consumption "excessive."

Having collected data over a four-week period, they found that respondents would take an average of 3.32 drinks before considering it excessive.

This is slightly higher than the average number of hot drinks respondents consume over a typical day when left to supply their own refreshments (3.04). Coffee is the drink of choice for just over half of respondents. 

The highest number of acceptable free hot drinks varied by choice of drink. For example, respondents who preferred to drink free coffee would consume more cups in a visit than those who preferred to drink free tea (average 3.44 v 3.29). 

Department of work or clinical specialty also appeared to have an impact on the number of free drinks deemed excessive. General practitioners, for example, would consume more free hot drinks than staff working in emergency departments (average 3.67 v 3.22).

Regardless of beverage choice, respondents considered taking more than an average of 2.25 packets of free biscuits to be excessive.

This varied by role, with doctors having a slightly higher threshold for acceptable number of packets taken than non-doctors (average 2.35 v 2.14).

The number of packets perceived to be excessive also varied by time in role (average 2.89 for those less than two years in role compared with 2.16 for those more than eight years in role).

Although no formal cost effectiveness evaluation was carried out, the researchers estimate that a centrally funded initiative to provide all NHS staff with three hot drinks daily (excluding milk) would cost about £32,692,935 (€37,987,556; $39,570,875) per year.

The additional daily provision of two snack sized biscuit packets for every NHS employee at a cost of 25p each would cost £128,188,286 annually; this equates to a total refreshment cost of £160,881,221 per year, or a not excessive 0.084% of the NHS budget.

The researchers point out that office workers have previously identified free hot drinks as a more important workplace benefit than free support for mental health, and free coffee is associated with improved morale and productivity.

“Given the current concerns over the morale, recruitment, and retention of NHS staff, the estimated £21.7bn cost of a potential staff exodus, and the well documented challenges facing providers of healthcare and social care, the provision of free hot drinks and biscuits could be a worthy and cost effective expense,” they write.

They note that limiting the availability of biscuits and hot drinks is certainly not in the holiday spirit, and they suggest that healthcare employers “should allow biscuits and hot drinks to be freely available to staff, and they should leave these grateful recipients to judge for themselves what constitutes reasonable consumption.”

 

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JOURNAL

The BMJ

DOI

10.1136/bmj-2022-072846 

METHOD OF RESEARCH

News article

ARTICLE TITLE

Taking the biscuit: defining excessive quantities of free refreshments in a healthcare library

ARTICLE PUBLICATION DATE

19-Dec-2022

Oat biscuit best for busy NHS staff tea breaks, finds study

Oaty treat ranked top in tests for energy content and dunk break point

Peer-Reviewed Publication

BMJ

Busy healthcare workers can safely enjoy a cup of tea within less than 10 minutes, and the best accompanying biscuit for nutritional content, crunchiness, and dunking is oat based, finds a study in the Christmas issue of The BMJ.

After witnessing how NHS staff avoid breaks because of constraints on their time, researchers set out to identify the time taken to prepare a safe, palatable cup of tea. 

In keeping with the tradition of tea paired with a biscuit, and because dunking may help tea cool faster, they also assessed four biscuit varieties for nutritional content and durability after dunking.

Their findings are based on six tests carried out with resources that could be commonly found in a staff room in the surgery department of the University Hospital of Wales.

After agreeing on the process of preparing a standard cup of tea, they collected data on the rate the tea temperature dropped and the overall time required for a comfortable, and therefore potentially safe, drinking temperature to be achieved (known as time to drinkable tea or TTDT).

They then selected four different types of round non-chocolate biscuit - oat, digestive, rich tea, and shortie - to find the best biscuit to pair with tea on the basis of nutritional content, absorptive ability, crunchiness, and integrity after dunking.

The researchers recorded tea cooling and TTDT data for each biscuit variety and repeated the tests three times with freshly prepared cups of tea. Biscuits were ranked first to last (scores 1 to 4), with penalty points given for adverse events such as scalds and breakability.

Although the results varied, important findings were that it takes around 420 seconds for a cup of tea to reach optimal palatability (61ºC) with 30 mL of semi-skimmed cow's milk, and just 370 seconds with 40 mL.

The oat biscuit ranked first overall after all six tests. For instance, it had the highest energy content (70 kcal per biscuit) and highest mean dunk time of 34.3 seconds to dunk break point.

The digestive ranked second. Although it had the lowest crunch reduction volume (15%) of all four biscuits, it crumbled in three tests of absorptive capability and structural integrity (saturation, dunk break point, and pragmatic dunk break point).

The shortie was ranked third, only absorbing an average 4 mL of tea during the three saturation tests, whereas the rich tea (the only biscuit given penalty points for breaking during the dunk break point test) was ranked fourth, although the penalty points did not directly influence the rich tea’s ranking.

Based on these results, the researchers suggest that NHS staff can easily enjoy the pairing of a cup of tea with a biscuit in less than 10 minutes.

Biscuit dunking also has a beneficial effect on tea cooling and should be encouraged, and the oat biscuit was the best at achieving this when compared with the digestive, rich tea, and shortie, they add. 

The authors acknowledge some study limitations, such as differing opinions on how to brew a palatable cup of tea and limited biscuit choice, but say they are confident that their methods reflect a real world approach to tea making in NHS staff rooms.

What’s more, they say the joy of dunking a biscuit enhanced the tea break experience and could have an important place in teambuilding and connectedness between different hierarchies and disciplines.

Though changes in staff morale and performance were not evaluated in this study, they say: “Making time for a cup of tea is an important daily ritual, and it should be encouraged to help improve the mood and performance of healthcare workers.”

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JOURNAL

The BMJ

DOI

10.1136/bmj-2022-072839 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Direct Uptake of Nutrition and Caffeine Study (DUNCS): biscuit based comparative study

ARTICLE PUBLICATION DATE

19-Dec-2022

Harnessing artificial intelligence technology for IVF embryo selection

Peer-Reviewed Publication

WEILL CORNELL MEDICINE

 

IMAGE: EXAMPLES OF EMBRYOS EVALUATED BY THE STORK-A ALGORITHM. FROM LEFT TO RIGHT, AN EMBRYO PREDICTED TO HAVE A NORMAL CHROMOSOME COUNT OR A SINGLE CHROMOSOMAL ABNORMALITY; AN EMBRYO PREDICTED TO HAVE A NORMAL CHROMOSOME COUNT; AN EMBRYO PREDICTED TO HAVE MORE THAN ONE CHROMOSOMAL ABNORMALITY. view more 

CREDIT: WEILL CORNELL MEDICINE

An artificial intelligence algorithm can determine non-invasively, with about 70 percent accuracy, if an in vitro fertilized embryo has a normal or abnormal number of chromosomes, according to a new study from researchers at Weill Cornell Medicine.

Having an abnormal number of chromosomes, a condition called aneuploidy, is a major reason embryos derived from in vitro fertilization (IVF) fail to implant or result in a healthy pregnancy. One of the current methods for detecting aneuploidy involves the biopsy-like sampling and genetic testing of cells from an embryo—an approach that adds cost to the IVF process and is invasive to the embryo. The new algorithm, STORK-A, described in a paper published Dec. 19 in Lancet Digital Health, can help predict aneuploidy without the disadvantages of biopsy.  It operates by analyzing microscope images of the embryo and incorporates information about maternal age and the IVF clinic’s scoring of the embryo’s appearance.

“Our hope is that we’ll ultimately be able to predict aneuploidy in a completely non-invasive way, using artificial intelligence and computer vision techniques,” said study senior author Dr. Iman Hajirasouliha, associate professor of computational genomics and of physiology and biophysics at Weill Cornell Medicine and a member of the Englander Institute for Precision Medicine.

The study’s first author is Josue Barnes, a doctoral student in the Weill Cornell Graduate School of Medical Sciences who studies in the Hajirasouliha Laboratory. Dr. Nikica Zaninovic, associate professor of embryology in clinical obstetrics and gynecology and director of the Embryology Laboratory at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center led the embryology work for the study.

According to the U.S. Centers for Disease Control and Prevention, there were more than 300,000 IVF cycles performed in the United States in 2020, resulting in about 80,000 live births. IVF experts are always looking for ways to boost that success rate, to achieve more successful pregnancies with fewer embryo transfers—which means developing better methods for identifying viable embryos.

Fertility clinic staff currently use microscopy to assess embryos for large-scale abnormalities that correlate with poor viability. To obtain information about the chromosomes, clinic staff may also use a biopsy method called preimplantation genetic testing for aneuploidy (PGT-A), predominantly in women over the age of 37.

To develop a computational approach to embryo assessment that capitalized on the Embryology Laboratory’s pioneering use of time lapse photography, investigators from the Center for Reproductive Medicine teamed up with colleagues in the Englander Institute.

In a 2019 study, the teams developed an artificial intelligence (AI) algorithm, STORK, that could assess embryo quality about as well as IVF clinic staff. For the new study, they developed STORK-A as a potential replacement for PGT-A—or as a more selective way of deciding which embryos should have PGT-A testing.

The new STORK-A algorithm uses microscope images of embryos taken at five days past fertilization, clinic staff’s scoring of embryo quality, maternal age, and other information that is normally gathered as part of the IVF process. Because it uses AI, the algorithm automatically “learns” to correlate certain features of the data, often too subtle for the human eye, with the chance of aneuploidy. The team trained STORK-A on a dataset of 10,378 blastocysts for which ploidy status was already known.

From its performance, they assessed the algorithm’s accuracy in predicting aneuploid versus normal-chromosome “euploid” embryos at nearly 70 percent (69.3%). In predicting aneuploidy involving more than one chromosome—complex aneuploidy—versus euploidy, STORK-A was 77.6 percent accurate. They later tested the algorithm on independent datasets, including one from an IVF clinic in Spain, and found comparable accuracy results, demonstrating the generalizability of STORK-A.

The study provides a proof of concept for an approach that is currently experimental. Standardizing the use of STORK-A in clinics would require clinical trials comparing it to PGT-A, and Food and Drug Administration approval—all years in the future. But the new algorithm represents progress on the way to making IVF embryo selection less risky, less subjective, less costly and more accurate.

“This is another great example of how AI can potentially transform medicine. The algorithm turns tens of thousands of embryo images into AI models that may ultimately be used to help improve IVF efficacy and further democratize access by reducing costs,” said co-author Dr. Olivier Elemento, director of the Englander Institute for Precision Medicine and a professor of physiology and biophysics and of computational genomics in computational biomedicine at Weill Cornell Medicine.

“We believe that ultimately by using this technology we can reduce the number of embryos to be biopsied, reduce the costs, and provide a very good tool for consultation with the patient when they need to make decision whether to do PGT-A or not,” said Dr. Zaninovic.

The team now plans to build on this success with algorithms trained on videos of embryo development.

“By using video classification, we can leverage both temporal and spatial information about the embryo’s development, and hopefully that will allow the detection of trends in development that distinguish aneuploidy from euploidy with even higher accuracy,” Barnes said.

“This technology is being optimized with the hope that at some point its accuracy will be close to genetic testing, which is the gold standard and is more than 90 percent accurate,” said co-author Dr. Zev Rosenwaks, director and physician-in-chief of the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine, and the Revlon Distinguished Professor of Reproductive Medicine in Obstetrics and Gynecology at Weill Cornell Medicine. “But we realize that this goal is aspirational.”

Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. For this information, see profiles for Dr. Iman Hajirasouliha, Dr. Nikica Zaninovic, Dr. Olivier Elemento and Dr. Zev Rosenwaks.

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JOURNAL

The Lancet Digital Health

Research reveals which animals perceive time the fastest

Reports and Proceedings

BRITISH ECOLOGICAL SOCI

New research reveals that the animals that perceive time the fastest are those that are small, can fly, or are marine predators.

These preliminary results will be presented at the British Ecological Society’s annual meeting in Edinburgh on Tuesday 20th December by Dr Kevin Healy at the University of Galway.

The study, which is the largest of its kind to date, analysed the rate at which over 100 animals  perceive changes in the world – known as temporal perception. The researchers found that animals with fast paced lifestyles have visual systems that can detect changes at higher rates.

Species such as blow flies and Dragon flies were able to detect changes at the highest rate, with vision that could handle 300hz (able to see changes 300 times a second), significantly faster than humans which can see at 65hz. In vertebrates, the fastest eyes belonged to the pied fly catchers which could see at 146hz. Salmon clocked in at 96hz and Dogs at 75hz. The slowest eyes belonged to crown-of-thorns starfish at 0.7hz.

“Having fast vision helps a species perceive rapid changes in the environment. Such detailed perception of changes is very useful if you move quickly or need to pinpoint the trajectory of  moving prey.” Explained Dr Kevin Healy.

“By looking at such a wide range of animals, from dragonflies to starfish, our findings show that a species’ perception of time itself is linked to how fast its environment can change. This can help our understanding of predator-prey interactions or even how aspects such as light pollution may affect some species more than others.”

One unexpected finding from the research is that many terrestrial predators have relatively slow time perception compared to aquatic predators. Dr Kevin Healy said: “We think this difference may be because in aquatic environments predators can continuously adjust their position when lunging for prey, while in terrestrial environments, predators that lunge at prey, such as a jumping spider, are not able to make adjustments once they’ve launched.”

Not all animals have fast temporal perception as it’s energetically costly and limited by how quickly neurons linked to retinal cells in the eye can recharge. Animals that don’t require rapid vision use this energy for other requirements, such as growth or reproduction.

Variation in time perception also occurs within species, including in humans, with some studies suggesting that in football, goalkeepers see changes at a higher rate and that coffee can temporarily boost this by a small amount.

The analysis in this research used data collected from numerous studies which measured time perception using flickering light experiments. Each experiment flickered a light and recorded the rate the optic nerve sent information, using special devices called electroretinograms, which in turn measured how fast an animal could detect the rate of a light flashing. This is known as critical flicker fusion frequency.

Dr Kevin Healy will present the work at the British Ecological Society annual meeting. This work is currently unpublished. This conference will bring together over 1200 ecologists to discuss the latest breakthroughs in ecology.

-ENDS-

 Lonely heart-failure patients face worse outcomes than sociable peers

A perceived loss of social role, such as caring for family and friends, has been linked to worse outcomes for heart failure patients, which suggests social engagement should form part of their care

Peer-Reviewed Publication

FRONTIERS

Older heart failure patients who feel that they have lost their social role amongst friends and family are more likely to suffer poor clinical outcomes. This is the finding of a new study in Frontiers in Cardiovascular Medicine that has examined the specific aspects of social interaction that can lead to a poor prognosis for these patients.

“We are the first to show a close association between the loss of perceived social role and long-term poor clinical outcomes in older heart failure patients,” said Dr Satoshi Katano, first author of this research, based at Sapporo Medical University Hospital, Sapporo, Japan. “Our study highlights the real need to develop a management program that includes a social approach to the care of these patients.”

Healthy aging

Social frailty has been widely identified as a risk to healthy aging. Social frailty covers areas such as the loss of social roles, social networks, and social activities.

“Recent research has shown that social frailty is present in two thirds of older people that suffer heart failure, and it has been linked to worse outcomes for these patients. However, it hasn’t been clear exactly why social frailty makes the prognosis worse,” explained Katano. “To examine the aspects of social frailty that may contribute to poor outcomes, we measured social frailty using the Makizako questionnaire in over 300 heart failure patients over the age of 65 that were admitted to our hospital for care.”

The Makizako questionnaire is a trusted method of assessing social frailty. It asks participants five questions that evaluate the patient’s social support, social activities, living situation, and perceived social role. A negative response to two or more of the five questions is an indicator of social frailty.

“We found that a patient’s perceived social role, as well as their social frailty as a whole, was associated with long-term adverse clinical outcomes in older heart failure patients. In addition, both of these factors added to the likelihood of a negative prognosis,” reported Katano.

He continues, “Our study followed patients for three years after their admission to hospital, which is much longer than previous studies that have only followed patients up to a year. This enabled us to examine the long-term impact of social frailty on adverse clinical outcomes in older heart failure patients.”

Social aspect to aftercare

The study was conducted in Japan, and while the researchers highlighted that social interactions may vary across different cultures, it is likely that social frailty will adversely impact health in older heart failure patients in all societies. Therefore, Katano believes that including a social aspect to aftercare is essential.

“The next important step is to develop programs to help older heart failure patients who have social frailty. Participation in domestic tasks and social activities such as engagement in meaningful volunteer activities that serve to help others, can all help to improve the perception of social role in older heart failure patients. These lifestyle changes will help older heart failure patients live longer, healthier, and more productive lives.”

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JOURNAL

Frontiers in Cardiovascular Medicine

DOI

10.3389/fcvm.2022.1051570 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Loss of perceived social role, an index of social frailty, is an independent predictor of future adverse events in hospitalized patients with heart failure

ARTICLE PUBLICATION DATE

20-Dec-2022

 

Paying farmers to create woodland and wetland is the most cost-effective way to hit UK environment targets, study suggests

Study of farmer preferences shows that turning whole areas of farmland into habitats comes with half the price tag of integrating nature into productive farmland , whilst delivering the same, biodiversity and carbon targets

Peer-Reviewed Publication

BRITISH ECOLOGICAL SOCIETY

Incentivising farmers to restore some land as habitats for nature could deliver UK climate and biodiversity targets at half the taxpayer cost of integrating nature into land managed for food production, according to a new study published today in the British Ecological Society journal People and Nature.

This research is also being presented today at the British Ecological Society’s annual meeting in Edinburgh by Professor Nicholas Hanley, an environmental ecologist based at the University of Glasgow.

The research, led by the universities of Cambridge, Leeds and Glasgow, provides the first evidence for the taxpayer savings offered by focusing food production in certain areas to allow the creation of new woods, wetland and scrub habitats on some of the land currently used for farming.

The study suggests that this “land sparing” approach would cost just 48% of the funds required to achieve the same outcomes for biodiversity and the climate through an approach known as “land sharing”, where conservation measures get mixed into farming by adding hedgerows to fields, reducing pesticides, and so on – all of which lowers food yield.

Additionally, the researchers say that trying to share land with nature through making farming more wildlife-friendly would see the UK lose 30% more of its food production capacity than if farmers are encouraged to spare portions of land entirely for creating semi-natural habitats.

The UK government has legally binding commitments to reverse nature declines by 2030 and reach net zero carbon by 2050. Sparing land for habitats could hit these targets at half the cost of trying to farm on land shared with nature, say researchers.

“Currently, only a fraction of the £3.2 billion of public money annually paid to farmers goes on biodiversity and climate mitigation, some £600m a year,” said Lydia Collas, who led the study as part of her PhD at Cambridge’s Department of Zoology.

“Almost all this fraction of funding supports land-sharing approaches that may do little to benefit species or sequester carbon, but do typically reduce food yields. Until now there has been no research on whether this is the most cost-effective solution to delivering environmental targets.”

Cambridge’s Prof Andrew Balmford, senior author of the study, said: “Greater incentives for farmers to create woodlands and wetlands will deliver for wild species and climate mitigation at half the cost to the taxpayer of the land-sharing approach that currently receives ten times more public funding.”

The researchers say their findings – presented at the British Ecological Society’s annual meeting by study co-author Prof Nick Hanley, an environmental economist from the University of Glasgow – should inform the current Brexit-prompted rethink of England’s new Environmental Land Management Scheme (ELMs).

The researchers conducted a choice experiment study with 118 farmers responsible for 1.7% of all England’s arable land, asking them to estimate the payments they would require to implement land-sharing practices or habitat-creating “sparing” approaches on their land.

Farmers chose from a variety of agricultural approaches, nature interventions and, crucially, payment rates. The study also considered the government's costs of administering and monitoring these schemes.

The team used three bird species – yellowhammers, bullfinches and lapwings – as a proxy for effects on biodiversity, as well a range of ways farmers could help slow climate change, such as woodland and hedgerow creation.

On average, farmers in the experiment accepted lower payments per hectare for land sharing practices. However, habitat creation schemes deliver far greater environmental outcomes per hectare, so creating woodlands, wetlands and scrublands would deliver the same overall biodiversity and climate mitigation benefits at half the cost to the taxpayer.

“We found that enough farmers are willing to substantially change their business to benefit from payments for public goods in the form of habitats, provided the government rewards them properly for doing so,” said Balmford.

Collas, now a now a Policy Analyst at Green Alliance, added: “Existing evidence already shows that semi-natural habitats deliver far more biodiversity and climate mitigation per unit area, and creating them has far less impact on food production than meeting targets through land sharing.

“This evidence is dismissed when thinking about agricultural policy in the UK because of an untested assumption that farmers are unwilling to create natural habitat. We now have evidence showing this assumption is wrong.”

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JOURNAL

People and Nature

DOI

10.1002/pan3.10422 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Paying farmers to create woodland and wetland is the most cost-effective way to hit UK environment targets, study suggests

ARTICLE PUBLICATION DATE

20-Dec-2022

UK woodlands could store almost twice as much carbon as previously estimated

Peer-Reviewed Publication

UNIVERSITY COLLEGE LONDON

UK forests could store almost double the amount of carbon than previous calculations suggest, with consequences for our understanding of carbon stocks and humanity’s response to climate change, according to a new study involving UCL researchers.

For the study, published today in the journal Ecological Solutions and Evidence, the international team of scientists used a novel 3D scanning technique and analysis to assess the amount of aboveground biomass (AGB) - used to derive carbon storage - of 815 trees in a UK woodland. The team found that their results were 77% higher than previous estimates (410 t ha-1 of biomass vs 232 t ha-1). 

The authors say that their study could have implications for the role of forests in tackling climate change, with the potential underestimation of forest carbon stocks having both positive and negative consequences for climate policy.

Study co-author Professor Mat Disney (UCL Geography and the National Centre for Earth Observation) said: “Forests currently act as a carbon sink in the UK. However, whilst our finding that the carbon storage capacity of typical UK woodland could be nearly double what we previously thought might seem like a purely positive outcome, in practice this means that for every ha of woodland lost, we’re potentially losing almost twice the carbon sink capacity we thought.

“This has serious implications for our understanding of the benefits of protecting trees in terms of climate mitigation - and deforestation and afforestation targets more broadly.”

The study was a collaboration between researchers from UCL, UK’s National Centre for Earth Observation (NCEO), the Universities of Ghent, Oxford and Tampere, The National Physical Laboratory, and Sylvera. To establish their findings, the team undertook 3D terrestrial laser scanning (TLS) analysis in a 1.4 ha section of Wytham Woods in Oxfordshire. TLS is a remote sensing technique whereby millions of laser pulses are emitted to capture the environment and structures of trees in the woodland in 3D.

They then used statistical modelling to calculate the mass and volume of the trees, and subsequently the carbon storage capacity of the area, and compared this to the findings of previous models.

The authors say that their study brings into question the certainty of estimates of forest carbon storage across the UK, particularly for the largest and most carbon-heavy trees, which are currently based on widely used models that estimate tree mass from the trunk diameter. It is likely that previous studies have been greatly underestimating forest biomass across the UK.

Study lead author Professor Kim Calders (Ghent University) said: “Currently, most estimates of forest carbon stocks are based on simple allometric models that assume that a tree’s size and mass increase at a steady rate. Our findings show that relying on these models is problematic, as they are not representative of UK forests. While the models work well for trees smaller than around 50 cm in diameter, which are fairly uniform in terms of their size and volume, this isn’t what we see for larger, heavier trees. These are far more complex when it comes to structure - and they vary hugely across place and species.

“It’s vital that we’re able to reduce uncertainty in forest carbon estimates, given that land use, and forest protection and restoration in particular, constitute a quarter of countries’ current commitments to their Paris Agreement targets.”

Currently, the UK’s biomass stock reporting to the Food and Agriculture Organization of the UN is based on these allometric models, which the authors say have very likely resulted in significant under-reporting.

Study co-author Yadvinder Malhi (Oxford University) added: “Wytham Woods belongs to the University of Oxford and has witnessed over 70 years of detailed scientific research. This research shows how new approaches can yield surprises in even well-studied forests, with profound consequences for our understanding of forests and their role in tackling climate change that apply across the UK and beyond.”

Notes to Editors

For more information or to speak to the researchers involved, please contact

Evie Calder, UCL Media Relations. T: +44 (0)7858 152 143 / +44 20 7679 8557 E: e.calder@ucl.ac.uk

Prof. Disney’s mobile number is 07788 577401 (m.disney@ucl.ac.uk).

Calders, K., Verbeeck, H., Burt, A., Origo, N., Nightingale, J., Malhi, Y., Wilkes, P., Raumonen, P., Bunce, R. G. and Disney, M. I. (2022), ‘Laser scanning reveals potential underestimation of biomass carbon in temperate forest’ will be published in Ecological Solutions and Evidence on Tuesday 20 December 2022, 05:01 UK time / 00:01 US EST and is under a strict embargo until this time.
The DOI for this paper will be: 10.1002/2688-8319.12197

The URL is https://besjournals.onlinelibrary.wiley.com/doi/10.1002/2688-8319.12197.

This work was funded in part by European Metrology Programme for Innovation and Research (EMPIR) through the Metrology for Earth Observation and Climate (MetEOC) program led by NPL, as well as the UK Natural Environment Research Council and NERC National Centre for Earth Observation.

Additional material

Paper figures/images: https://www.dropbox.com/sh/d8kd7y9krlud8vp/AAAtV2jmmbO7ITNOIMBCftRFa?dl=0

A walk through a laser scanned Wytham Woods: https://vimeo.com/manage/videos/233204068

Dataset - Terrestrial laser scanning data Wytham Woods: individual trees and quantitative structure models (QSMs): https://doi.org/10.5281/zenodo.7307956

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JOURNAL

Ecological Solutions and Evidence

DOI

10.1002/2688-8319.12197 

ARTICLE TITLE

Laser scanning reveals potential underestimation of biomass carbon in temperate forest

ARTICLE PUBLICATION DATE

20-Dec-2022