Breathing is going to get tougher

Hotter temps = more air pollution from natural sources

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - RIVERSIDE

 

IMAGE: CHANGE IN PM2.5 SURFACE CONCENTRATION AFTER 4 DEGREES C OF WARMING. BLACK DOTS SYMBOLIZE STATISTICALLY SIGNIFICANT CHANGES. view more 

CREDIT: JAMES GOMEZ/UCR

Not all pollution comes from people. When global temperatures increase by 4 degrees Celsius, harmful plant emissions and dust will also increase by as much as 14 percent, according to new UC Riverside research.

The research does not account for a simultaneous increase in human-made sources of air pollution, which has already been predicted by other studies. 

“We are not looking at human emissions of air pollution, because we can change what we emit,” said James Gomez, UCR doctoral student and lead author of the study. “We can switch to electric cars. But that may not change air pollution from plants or dust.”

Details of the degradation in future air quality from these natural sources have now been published in the journal Communications Earth & Environment. About two-thirds of the future pollution is predicted to come from plants.

All plants produce chemicals called biogenic volatile organic compounds, or BVOCs. “The smell of a just-mowed lawn, or the sweetness of a ripe strawberry, those are BVOCs. Plants are constantly emitting them,” Gomez said.

On their own, BVOCs are benign. However, once they react with oxygen, they produce organic aerosols. As they’re inhaled, these aerosols can cause infant mortality and childhood asthma, as well as heart disease and lung cancer in adults.

There are two reasons plants increase BVOC production: increases in atmospheric carbon dioxide and increases in temperatures. Both of these factors are projected to continue increasing.

To be clear, growing plants is a net positive for the environment. They reduce the amount of carbon dioxide in the atmosphere, which helps control global warming. BVOCs from small gardens will not harm people. 

“Your lawn, for example, won’t produce enough BVOCs to make you sick,” Gomez explained. “It’s the large-scale increase in carbon dioxide that contributes to the biosphere increasing BVOCs, and then organic aerosols.”

The second-largest contributor to future air pollution is likely to be dust from the Saharan desert. “In our models, an increase in winds is projected to loft more dust into the atmosphere,” said Robert Allen, associate professor of Earth and Planetary Sciences at UCR and co-author of the study. 

As the climate warms, increased Saharan dust is likely to get blown around the globe, with higher levels of dust in Africa, the eastern U.S., and the Caribbean. Dust over Northern Africa, including the Sahel and the Sahara, is likely to increase due to more intense West African monsoons.

Both organic aerosols and dust, as well as sea salt, black carbon, and sulfate, fall into a category of airborne pollutants known as PM2.5, because they have a diameter of 2.5 micrometers or less. The increase in naturally sourced PM2.5 pollution increased, in this study, in direct proportion to CO2 levels.

“The more we increase CO2, the more PM2.5 we see being put into the atmosphere, and the inverse is also true. The more we reduce, the better the air quality gets,” Gomez said. 

For example, if the climate warms only 2 degrees Celsius, the study found only a 7% increase in PM2.5. All of these results only apply to changes found in air quality over land, as the study is focused on human health impacts. 

The researchers hope the potential to improve air quality will inspire swift and decisive action to decrease CO2 emissions. Without it, temperatures may increase 4 degrees C by the end of this century, though it’s possible for the increase to happen sooner. 

Gomez warns that CO2 emissions will have to decrease sharply to have a positive effect on future air quality.

“The results of this experiment may even be a bit conservative because we did not include climate-dependent changes in wildfire emissions as a factor,” Gomez said. “In the future, make sure you get an air purifier.”
 

Coughing 

Air pollution from natural sources is expected to increase alongside an increase in average global temperatures.

CREDIT

GabboT

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JOURNAL

Communications Earth & Environment

DOI

10.1038/s43247-023-00688-7 

ARTICLE TITLE

The projected future degradation in air quality is caused by more abundant natural aerosols in a warmer world

New study to examine link between air

quality, climate change, and birth

outcomes

PSE Healthy Energy and the University of California, Berkeley partner to develop targeted solutions to climate and public health impacts throughout California’s Contra Costa County

Business Announcement

PSE HEALTHY ENERGY

OAKLAND, CA – On Monday February 27, the U.S. Environmental Protection Agency (EPA) announced that nonprofit research institute PSE Healthy Energy has been awarded $1,350,000 to study local disparities in exposure to air pollution, heat, and humidity throughout Contra Costa County. The Contra Costa Climate, Air Pollution, and Pregnancy Study will be conducted in partnership with the University of California, Berkeley and will analyze birth outcomes and develop targeted solutions to protect the region’s most vulnerable populations.

“We know that climate change is already increasing exposure to air pollution, extreme heat, and humidity and that these events increase health risks, particularly for vulnerable populations,” said Elena Krieger, director of research at PSE Healthy Energy and principal investigator for the study. “Our aim is to better understand how these exposures relate to birth outcomes and to work with communities and policy makers to develop targeted, community-led, and effective interventions.”

The study will leverage PSE Healthy Energy’s Richmond Air Monitoring Network (RAMN) in combination with additional low-cost air monitors in place throughout Contra Costa County, enabling the team to study local variations in exposure across the region. Over the course of three years, the study will assess disparities in exposure to air pollution, heat, and humidity and their relationship with birth outcomes. The researchers will also assess areas and populations facing the greatest increase in risk from climate change impacts, such as increased heat, humidity, and wildfire smoke.

“Low-cost air pollution sensors can help us understand microscale variations in exposure to air pollution, temperature, and humidity. This more granular understanding can help us uncover how local climate impacts may compound socioeconomic risk factors, such as poverty, low educational attainment, and linguistic isolation, and lead to greater exposure and health disparities,” said Ajay Pillarisetti, assistant professor of Environmental Health Sciences at UC Berkeley and the study’s co-principal investigator.

In the final phase of the project, researchers will work with the identified populations and communities to co-develop a suite of interventions to mitigate exposures, ranging from house-level retrofits to community planning measures such as tree planting. The team will use a mix of cost-benefit and distributional analyses, incorporating community-identified priorities and strategies, to identify policy solutions.

The research grant is part of the EPA’s Science to Achieve Results (STAR) program and was part of $21M in research grant funding announced to investigate cumulative health impacts of climate change on underserved communities.

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About PSE Healthy Energy
PSE Healthy Energy is a nonprofit research institute dedicated to supplying evidence-based scientific and technical information on the public health, environmental, and climate dimensions of energy production and use. We are the only interdisciplinary collaboration focused specifically on health and sustainability at the intersection of energy science and policy. Visit us at psehealthyenergy.org and follow us on Twitter @PhySciEng.

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METHOD OF RESEARCH

Observational study

Japanese scientists with a novel research approach to study populations of deep-sea brittle stars

Peer-Reviewed Publication

PENSOFT PUBLISHERS

 

IMAGE: BRITTLE STARS COLLECTED FROM SAGAMI SEA, JAPAN view more 

CREDIT: HISANORI KOHTSUKA (THE UNIVERSITY OF TOKYO)

For the first time, researchers develop a metabarcoding technology for brittle stars. Japanese scientists, led by Dr Masanori Okanishi of the Hiroshima Shudo University and the University of Tokyo, analyzed environmental DNA (eDNA) released from marine invertebrates in the water, and successfully identified the species they were looking for. The study is published in the open-access journal Metabarcoding and Metagenomics.

Metabarcoding allows researchers to easily and quickly identify species and determine their number in a given location on the basis of environmental DNA (that is DNA released into, for example, the water in a particular lake). 

In Japan, this method has been used successfully to detect the number of species in specific locations in the sea by sampling as little as a bucket of water. Monitoring species is part of the effort for conservation of biological resources and maintenance of their economic value, and metabarcoding can be utilized as a less labor-intensive and more cost-effective tool for marine surveys of biodiversity.

The new study reports on the research team’s development of the first DNA primers for metabarcoding of brittle stars. Brittle stars are the most abundant species in the phylum Echinodermata (approximately 2,100 species), making them promising indicator organisms for environmental DNA metabarcoding. These marine invertebrates are thought to release abundant environmental DNA due to their size, large populations, and habitats in a variety of seafloor environments.

To determine the origin of DNA sequences obtained from samples and used for metabarcoding, Okanishi’s team constructed a database of reference DNA sequences based on specimens identified to 60 brittle star species from Sagami Bay. 

Up until now, metabarcoding had not been used for organisms with little mobility such as brittle stars, because many reference DNA sequences had been misidentified or unidentified. The new database will aid further research and application of the technology.

“If metabarcoding becomes possible through the development of additional primers and richer databases of reference DNA sequences, it will be possible to monitor the marine environment with a precision never before thought possible,” say the authors in conclusion.

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JOURNAL

Metabarcoding and Metagenomics

DOI

10.3897/mbmg.7.94298 

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Development of two new sets of PCR primers for eDNA metabarcoding of brittle stars (Echinodermata, Ophiuroidea)

ARTICLE PUBLICATION DATE

28-Feb-2023

COI STATEMENT

TM is an inventor of the patent for the use of BAC for eDNA preservation. The other authors have declared that no competing interests exist.

Mahogany trees shape the right-forewing shape and size of the Mahogany shoot borer

Peer-Reviewed Publication

UNIVERSITY OF EASTERN FINLAND

 

IMAGE: CAOBA (SWIETENIA MACROPHYLLA) TREE ATTACKED BY THE LARVAE, SHOWING THE TREE DEFORMATIONS CAUSED BY THE INSECT PEST ATTACK. view more 

CREDIT: ALEXANDER PULGARÍN DÍAZ

The Mahogany trees Cedro and Caoba (Cedrela odorata and Swietenia macrophylla) affect the right-forewing of their unwelcome guest, the Mahogany shoot borer, which could later influence its flying abilities and pest management, a new study shows.

Hypsipyla grandella, or the Mahogany shoot borer, has a heavy impact on Cedro and Caoba trees, restricting their plantations. But at the same time, these trees affect the right-forewing of the moth-pest in size and form.

The Mahogany shoot borer is one of the most important forest insect-pests in the South and Central America, where it devastates Cedro and Caoba forest plantations. It destroys the trees’ leading shoots and could affect all plants in a forest stand, resulting in forked trees without commercial value. Although both Cedro and Caoba are highly appreciated for the beauty and workability of their wood, the biology of the Mahogany shoot borer is poorly known.

Research shows that the Mahogany shoot borer prefers Cedro over Caoba. Meanwhile, other research indicates that the form and size of moths and butterflies are affected by their host. In the new study, researchers wanted to study if the form and size of the Mahogany shoot borer is affected by whether its host is Cedro or Caoba. To study this, they focused on the right-forewing of the moth and used a technique called geometric morphometry to evaluate changes in the wing form and size. The wing was chosen for analysis, since in moths and butterflies, wings are very important for migration, territorialism and courtship, and to escape from enemies.

The researchers found that the wing form differs between males and females, and when the host was Cedro, the wing was larger. These findings are common in moths and butterflies, but what is uncommon is that only the male wing form differed between the hosts.

An important question is if the observed differences in wing form and size could influence the species’ flying system, as reported in other butterflies and moths. For example, for long-distance flights it is important to have a long forewing with a narrow tip, and for controlled flights, a small and broad forewing is important. According to the researchers, the host could affect the systems for controlling damages caused by the Mahogany shoot borer, as when the host is Cedro, the moth could fly longer distances, and when the host is Caoba, the moth could have more controlled flights. These findings could help to guide future plantings of Cedro and Caoba, taking into account that moths with larger right-forewings could be more frequent in Cedro, having better capabilities for long-distance flights, which is not ideal in integrated pest management systems.

The study was funded by Corporación Colombiana de Investigación Agropecuaria – AGROSAVIA under the project “Strategies for planning and management of forest plantations and agroecosystems in Colombia”, led by Jhon Jairo Zuluaga Pelaéz.

Caoba (Swietenia macrophylla) tree attacked by the larvae, showing the tree deformations caused by the insect pest attack.

Hypsipyla grandella larvae.

CREDIT

Alexander Pulgarín Díaz

JOURNAL

Zoologischer Anzeiger

DOI

10.1016/j.jcz.2022.12.005 

ARTICLE TITLE

Size and shape variation of Hypsipyla grandella Zeller (Lepidoptera: Pyralidae) in two hosts: A morphometric approach.

In the end, it’s the individual advantage that counts

Bacteria rely on cooperation and evolution in order to defend themselves against predatory protists

Peer-Reviewed Publication

HELMHOLTZ CENTRE FOR ENVIRONMENTAL RESEARCH - UFZ

 

IMAGE: (1) PREDATION ON THE UNPROTECTED BACTERIA BY PREDATORS, (2) TOXIN FORMATION AS COOPERATIVE DEFENCE AND RECOVERY OF THE BACTERIAL POPULATION, (3) FILAMENT FORMATION AS INDIVIDUAL DEFENCE THROUGH EVOLUTION AND STABILISATION OF DENSITIES. view more 

CREDIT: DAVID KNEIS / TU DRESDEN

In a lake or river, between one and 10 million bacteria live in just 1 ml of water. Such a high density is necessary because bacteria permanently break down organic compounds and pollutants and thus purify the water. However, if there are too many bacteria, this can lead to the spread of pathogens. Preventing this requires predators: microscopic protists of which there are usually between a few hundred and a few thousand individuals in 1 ml of water. They constantly eat bacteria and thus ensure that the bacteria fulfil their cleaning function but do not become too abundant. Using the bacterium Pseudomonas putida and the bacterivorous protist Poteriospumella lacustris, the research team investigated the role of the various defence strategies of the bacteria and how the formation of feeding resistance is related to the dynamics of ecological systems.

Cooperative behaviour helps – but only in the short term

In the five-week laboratory experiment, the scientists found that, as expected, the predatory protists first multiplied in the bacterial culture for a week and reduced the number of bacteria. However, the population of protists quickly collapsed in the second week because the bacteria produced a toxin that strongly inhibits the reproduction of these predators.  “Such a chemical defence is successful only if a relatively large number of bacteria join in and release a corresponding amount of toxin into the water”, says Dr Magali de la Cruz Barron, lead author and hydrobiologist at the UFZ and TU Dresden. This cooperative behaviour protects the entire population – at least for a short time. But after a few days, the bacteria no longer secreted toxin, and the predators recovered by the end of the third week. It is not possible to say exactly why this is. One common explanation for such a phenomenon is that too many “cheaters” form. These are in this case bacteria that do not form toxins themselves but which benefit from them in the group because they do not have to expend any effort of their own to protect themselves. “But we could show with the help of mathematical simulations that cheaters are not necessary to explain such patterns if alternative defence strategies evolve” explains Magali de la Cruz Barron.

Individual defence lasts a long time and stabilises the population densities

And indeed, the research team discovered a second defence mechanism that the bacteria developed from the third week onwards. Most bacteria formed filaments (i.e. threads with cells arranged in chains). These made the bacteria 10 to 100 times larger and much bulkier so that many of them could no longer be eaten by the protists. This individual behaviour was successful. The bacterial density stabilised by the end of the fifth week. However, there were still sufficient numbers of bacteria that could be eaten because in order to reproduce, the bacteria had to keep forming small units that served as food for the predators. This also allowed the protists to establish a stable population density. Unlike toxin formation, the individual defence of the bacteria was not reversible. “By sequencing the bacterial genome, we have proven that the formation of the filaments was indeed accompanied by a change in the genetic material. Evolution has thus taken place. Not over millions of years but rather within only a few days”, says Prof. Dr Markus Weitere, co-author and head of the UFZ Department of River Ecology. This observation is not entirely new. It is known that evolution can take place in relatively short periods of time, especially in fast-growing organisms such as bacteria. “But what is remarkable is that this mutation did not happen just once. The experiments were often repeated, and these adjustments were always made”, says Weitere. Even though the change in the genome probably occurs by chance, it leads to a reproducible adaptation pattern in the bacteria.

With this experiment, the research team showed how the formation of defence strategies affects the dynamics of predator–prey systems and how important this defence is for stabilising populations. It also became clear that it makes sense for the prey species not to rely on just one strategy. “Depending on the situation, one of several strategies can be successful. In our experiment, it was the quick cooperative behaviour that led to the initial success. In the end, it was the more cumbersome individual defence through evolution that led to a permanent defence”, says Weitere. Thus, individual protection prevails – even if the initial cooperative defence was definitely beneficial for the community.

The research work took place within the framework of the Priority Programme “Flexibility matters: interplay between trait diversity and ecological dynamics using aquatic communities as model systems (DynaTrait)” funded by the German Research Foundation (DFG). 

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JOURNAL

The ISME Journal

DOI

10.1038/s41396-023-01381-5 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Shifts from cooperative to individual-based predation defence determine microbial predator–prey dynamics

ARTICLE PUBLICATION DATE

28-Feb-2023

Millet and sorghum cultivation may provide an answer to rising levels of aridity linked to climate change

A study published in PLOS ONE by members of the CaSEs research group of the UPF Department of Humanities demonstrates how traditional small-scale rainfed agriculture provides information on sustainable agricultural practices.

Peer-Reviewed Publication

UNIVERSITAT POMPEU FABRA - BARCELONA

 

IMAGE: CLASSIFICATION OF THE WORLD’S REGIONS CLASSIFICATION ACCORDING TO ARIDITY INDEX VALUES, TERRITORIAL DISTRIBUTION OF ETHNOGRAPHIC GROUPS (EHRAF) ACCORDING TO GREG POLYGONS (GEO-REFERENCING OF ETHNIC GROUPS DATASET) view more 

CREDIT: AUTHORS

Astudy by researchers from the UPF Culture, Archaeology and Socio-Ecological Dynamics Research Group (CaSEs), recently published in the journal PLOS ONE, provides a global assessment of traditional small-scale farming practices for three of the world’s most important drought-tolerant species: finger millet, pearl millet and sorghum.

The research, which combines already published ethnographic data and new information collected in the field, demonstrates how traditional small-scale rainfed agriculture provides novel information on sustainable agricultural practices, at the intersection between traditional ecological knowledge and academic knowledge.

Abel Ruiz Giralt: “Our work advances our understanding of how human communities developed sustainable and resilient agricultural strategies over time. This is especially significant in the current context of climate instability and population growth, which requires immediate action”

Finger millet, pearl millet and sorghum are primary staple crops in drylands, and their production dates back more than 5,000 years. However, compared to other crops, the production of millet and sorghum has progressively decreased in the last 50 years.

In the current context of climate change and rising levels of aridity around the world, research into local practices and traditional crops is critical. Traditional ecological knowledge provides a very important source of information, since it encompasses the exploitation of locally available resources, and is the result of processes of long-term adaptation to the environment.

“Our work advances our understanding of how human communities developed sustainable and resilient agricultural strategies over time. This is especially significant in the current context of climate instability and population growth, which requires immediate action”, says Abel Ruiz-Giralt, first author of the article, together with Marco Madella, Stefano Biagetti and Carla Lancelotti, all researchers at the UPF Department of Humanities and members of the CaSEs Research Group.

The authors note that traditional practices to increase crop yields are based on renewable resources, contrary to the widespread and short-term solutions often used by supranational institutions, which cause significant damage to both crop biodiversity and soil conservation.

These traditional practices enable increasing productivity and minimizing crop failure, without sacrificing long-term sustainability and resilience. “Our study offers an alternative view on possible ways to integrate traditional knowledge into scientific and political programmes, with the aim of providing solutions for food security in low and middle-income arid areas”, the researchers assure.

Creating new models to explain traditional farming practices

In their research, the authors build and test models that show the interaction of ecological and geographic variables, which serve to explain traditional agricultural practices and the variability of existing systems in this field, as well as mapping the possible cultivation areas of finger millet, pearl millet and sorghum on a global level.

They state: “We have found that the relationship between total annual precipitation and the viability and variability of agricultural systems in drylands around the world is not as strong as was previously thought”. And they add: “Other factors such as the length of growth cycles, the availability of soil nutrients and water retention capacity seem to be far more determinant in the configuration of traditional agro-ecosystems”, they assert.

The researchers have chosen to use a comparative global approach, which allows simplifying complex ethnographic data, since they have reduced intracultural variability through generalizations based on the most common practices. For this reason, they have used the ethnographic data available in the eHRAF World Cultures database as the main source of information.

“We have found that the relationship between total annual precipitation and the viability and variability of agricultural systems in drylands around the world is not as strong as was previously thought”

The eHRAF World Cultures database contains a large number of documents that describe activities derived from traditional ecological knowledge (TEK) from around the world, data that come from ethnographic studies carried out unevenly during the last two centuries. “Despite the inevitable distortion generated by the use of data collected under different theoretical and methodological perspectives over more than 150 years of ethnographic research, the eHRAF database continues to be one of the most effective tools for conducting global comparative research, due to the wealth of information it supplies”, Abel Ruiz-Giralt states.

The models presented in the study, which include various environmental predictors in their design, simplify the relationships and interactions between humans and the environment, and can therefore be useful to understand the underlying general dynamics involved in the study and development of traditional agricultural systems. “We believe our paper is a timely and valuable contribution to this debate, as it provides new data on smallholder practices at the intersection of traditional ecological and academic knowledge”.

This work is part of the research project RAINDROPS-Resilience and Adaptation in Drylands, funded with a European Research Council Starting Grant (ERC-Stg 759800), with Carla Lancelotti as its principal investigator.

Reference work: Abel Ruiz-Giralt, Stefano Biagetti, Marc Madella, Carla Lancelotti (February 2023). “Small-scale farming in drylands: New models for resilient practices of millet and sorghum cultivation”, PLOS ONE

https://doi.org/10.1371/journal.pone.0268120

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0268120 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Small-scale farming in drylands: New models for resilient practices of millet and sorghum cultivation

FOR PROFIT MEDICINE

Family Heart Foundation real-world analysis reveals that majority of Americans at high risk of stroke and heart attack remain under-treated

Findings to be presented at ACC Scientific Sessions highlight life-threatening gaps in treatment

Reports and Proceedings

FAMILY HEART FOUNDATION

NEW ORLEANS, Feb. 28, 2023 – According to a new study from the Family Heart Foundation, a leading research and advocacy organization, 72.2% of high-risk hypercholesterolemia patients never achieve the low-density lipoprotein-cholesterol (LDL-C) thresholds recommended in the 2018 American College of Cardiology/American Heart Association Guideline on the Management of Blood Cholesterol. This may be due to a lack of physician prescribing, insurance coverage and patient follow through, despite the known risk of cardiovascular disease. Based on real-world data from an analysis of the Family Heart DatabaseTM of more than 300 million Americans, the findings will be highlighted in a poster presentation at the American College of Cardiology 2023 conference on March 4, 2023 at 12:45 pm at the Ernest N. Morial Convention Center in New Orleans.

“This study provides us with a clear view of the poor state of LDL cholesterol management for high-risk individuals in the United States,” said Mary P. McGowan, M.D., chief medical officer, Family Heart Foundation, and co-author of the study. “Despite the availability of safe and effective lipid-lowering therapies, only 28% of high-risk patients ever reach below guideline LDL-C thresholds, which further elevates these patients’ risks for atherosclerotic cardiovascular disease (ASCVD) events, such as heart attacks and stroke.”

Titled “72% of High-Risk Hypercholesterolemia Patients Never Reach Below ACC/AHA Guideline LDL-C Thresholds,” the observational study assessed achievement of LDL-C below thresholds in 38,110,734 high-risk patients.

Additional key findings from the study show:

• Only 27.8% of all high-risk patients ever reached below-guideline LDL-C thresholds.
• For those with episodes below LDL-C thresholds, mean duration of each episode was 158.8 days.
• 79.5% of clinicians never prescribed combination cholesterol-lowering medications though the guideline provides direction and rational for doing so.
• Only 2.2% of high-risk patients received combination cholesterol-lowering medications.

The Family Heart Database is comprised of real-world diagnostic, procedural, and prescription data from claims and/or laboratory information in the U.S. from 2012 to 2021.

The poster will be available for viewing throughout the Congress in the Poster Hall – Hall F. In addition, the Family Heart Foundation will be discussing the implications of this research for the American public at a multistakeholder roundtable in New Orleans with key opinion leaders in cardiology and public health.

 

About the Family Heart Foundation

The Family Heart Foundation is a nonprofit research and advocacy organization. The Foundation is a pioneer in the application of real-world evidence, patient-driven advocacy, and multi-stakeholder education to help prevent heart attacks and strokes caused by familial hypercholesterolemia (FH) and elevated Lipoprotein(a), or Lp(a), two common genetic disorders that have an impact across generations. The Family Heart Foundation conducts innovative research to break down barriers to diagnosis and management of inherited lipid disorders; educates patients, providers, and policy makers; advocates for change; and provides hope and support for families impacted by heart disease and stroke caused by FH, HoFH, and high Lp(a). The organization was founded in 2011 as the FH Foundation. For more information, visit FamilyHeart.org and follow us on Twitter, Facebook, Instagram and LinkedIn.

Less than one in ten Phase III clinical trials are ever cited at the point-of-care

A decade-long analysis reveals potential bottlenecks in the pathway of clinical research into medical practice.

Peer-Reviewed Publication

ELIFE

A study has characterised the factors that influence the adoption of clinical research into practice by comparing the citation rates of medical research papers between 18 different specialities, article type, geography and time. The results are published today in eLife.

The work reveals that most clinical trials are never cited by the time they reach the point-of-care – where clinical trials are embedded into regular medical practice. Furthermore, less than one in two Phase III clinical trials are ever cited across 9 out of 18 medical specialities. Phase III clinical trials typically involve a large number of participants and are designed to evaluate the safety and effectiveness of a new medical intervention across the general population. 

The results represent a preliminary step to understanding why increased research funding in the US has not yielded equivalent results in health outcomes. The findings could be used to monitor the efficiency of research investments and evaluate health policies influencing the translation of biomedical studies to clinical practice.

The lack of evidence to assess the effectiveness and efficiency of treatments is a contributing factor that underpins the unsustainable expenditure of the US healthcare system. This is made worse by a limited understanding of the factors that influence the translation of clinical research into practice. 

“This may partially explain why, in the US healthcare systems, many patients do not receive the recommended services and many receive treatment that is not necessary or appropriate for them,” says co-author Moustafa Abdalla, resident  in the Department of Surgery, at  Massachusetts General Hospital, and fellow at Harvard Medical School, both in Boston, Massachusetts, US. 

The team used the resource tool UpToDate, which provides current evidence-based clinical information at the point of medical practice, to assess what clinical research makes it into practice. By leveraging a dataset of more than 10,000 UpToDate articles, sampled every three months between 2011–2020, they were able to trace the path of research from initial publication to medical practice, compared to the 2.4 million uncited studies published during the same time window across 18 medical specialties. 

The analysis revealed substantial variation in how different medical specialities adopt research with regards to frequency of literature citations and the quality-of-evidence incorporated. Across all specialities, only 0.4% to 2.4% of published clinical research is ever cited in UpToDate. Amongst the 18 specialities included in the analysis, neurology had the highest citation rate at 2.4% (2,057 of 85,843 research articles), and pathology had the lowest rate at 0.4% (317 of 69,343 research articles). 

The proportion of citations varied substantially by the type of article the research was presented in. Practice guidelines represented the most likely article type to be cited, with 9 of the 18 specialties receiving citations at a rate of over 13%. Clinical trials were the second most likely to be cited, but were also the most variable. In 9 of the 18 specialties, the team observed that less than one in ten Phase III clinical trials were ever cited at the point-of-care. 

The team next sought to characterise the effects of National Institutes of Health (NIH) funding on the number of citations a paper receives, primarily focusing on the US. They found that, across all specialties in the past decade, average annual NIH funding correlated strongly with the total number of citations. Given this strong correlation, the team then calculated the effective cost per new citation at the point-of-care. This was used to represent the approximate indirect cost of bringing clinical research to medical practice in NIH funding dollars. In urology – a branch of medicine that focuses on diseases of the urinary track – and nephrology – a specialty of medicine concerning the kidneys – the cost of bringing a new citation to the point-of-care was estimated   at $48,086.18 per article (not including the intercept of the model which reflects set up and startup costs). On the other side of the spectrum,    in pathology, it cost  $874.85 for every additional citation. 

Whilst UpToDate represents the largest point-of-care resource, its relevance varies by specialty and training status. Therefore, whilst the study uses UpToDate as a metric of translation of research, the authors say a citation does not necessarily indicate actual changes in practice. Instead, citations represent adoption of knowledge to support current approaches, inform new changes in practice, or highlight points of controversy. 

“While the findings of our study are largely descriptive and explanatory, we have provided a baseline for monitoring the efficiency of research investments. This may eventually lead to the development of strategies to quantify the effectiveness of proposed reforms to the biomedical scientific process,” concludes co-author Mohamed Abdalla, Scientist, Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.

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About eLife

eLife transforms research communication to create a future where a diverse, global community of scientists and researchers produces open and trusted results for the benefit of all. Independent, not-for-profit and supported by funders, we improve the way science is practised and shared. From the research we publish, to the tools we build, to the people we work with, we’ve earned a reputation for quality, integrity and the flexibility to bring about real change. eLife receives financial support and strategic guidance from the Howard Hughes Medical Institute, Knut and Alice Wallenberg Foundation, the Max Planck Society and Wellcome. Learn more at https://elifesciences.org/about.

To read the latest Medicine research published in eLife, visit https://elifesciences.org/subjects/medicine.

 

About the Institute for Better Health

As Trillium Health Partner’s (THP) research and innovation engine, the Institute for Better Health (IBH) is a core enabler of THP’s mission of a new kind of health care for a healthier community through the application of scientific expertise, innovative thinking and partnerships. Focused on generating cutting-edge science and innovation in health service delivery and population health, IBH leads practical research and innovation that shapes how we engage, design, deliver, and sustain health care to solve problems stretching from the bedside to the system.

 

For more information, please visit instituteforbetterhealth.com.

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JOURNAL

eLife

DOI

10.7554/eLife.82498 

ARTICLE TITLE

Tracing the path of 37,050 studies into practice across 18 specialties of the 2.4 million published between 2011-2020

ARTICLE PUBLICATION DATE

28-Feb-2023