It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Saturday, April 27, 2024
Homelessness a major issue for many patients in the emergency department
VANDERBILT UNIVERSITY MEDICAL CENTER
Housing insecurity is an issue for 1 in 20 patients who go to emergency departments at major medical centers in the Southeast, according to a Vanderbilt University Medical Center (VUMC) study published in JAMA Network Open.
These patients were more likely to present with a chief complaint of suicide, to be uninsured, and to have multiple visits during the study period from Jan. 5 to May 16, 2023.
“This points to the importance of prioritizing mental health care and homeless health teams in hospital settings,” said lead author Madeleine Ball, a class of 2024 student in the Vanderbilt University School of Medicine and 2023-2024 Research Committee Lead for VUMC’s Homeless Health Service.
“Directing resources toward patients who come to the emergency department regularly could have significant impact for patients. Our study emphasizes the utility of screening for homelessness in all acute care centers to best tailor and optimize care for this susceptible patient population.”
uthors examined a total of 23,795 emergency department visits, using the Veterans Health Administration’s Homelessness Screening Clinical Reminder to screen for homelessness.
Information from the questionnaire was combined with demographics, method of arrival, diagnoses, acuity, timing of presentation, disposition, and insurance status.
A total of 5% (1,185) screened positive for housing insecurity.
Unstable housing and homelessness can exacerbate adverse health outcomes, leading to increased risk of chronic disease, injury, and disability, the authors said, but emergency departments currently do not have a universal method to identify those at risk of, or currently experiencing, homelessness.
“Now that our team has made screening for housing insecurity common practice in the VUMC ED, we have several research questions to explore,” Ball said.
“We plan to present a qualitative analysis of the implementation of this new screening process with a goal of answering a wide variety of research questions to optimize care for this patient population.”
Senior author Jennifer Hess, MD, assistant professor of Emergency Medicine in the Department of Emergency Medicine at VUMC, said she hopes the analysis provides a call for other institutions to introduce screening and create tailored care plans for patients experiencing housing insecurity
“This project contributed a vital first step in advancing health equity by identifying who may benefit from resources and additional assistance,” Hess said.
“We are grateful for the diverse, multidisciplinary team that allowed this project to happen and look forward to where it may lead. As homelessness and housing insecurity continue to rise throughout the country, we need to make it a priority to improve care for this susceptible and often overlooked patient population.”
JOURNAL
JAMA Network Open
ARTICLE TITLE
Characteristics and Healthcare Utilization of Patients with Housing Insecurity in the Emergency Department
ARTICLE PUBLICATION DATE
26-Apr-2024
Undocumented Latinx patients got COVID-19 vaccine at same rate as US citizens
UNIVERSITY OF CALIFORNIA - LOS ANGELES HEALTH SCIENCES
For undocumented Latinx patients who sought care in the emergency room during the pandemic, the reported rate of having received the COVID-19 vaccine was found to be the same as U.S. citizens, a new UCLA Health study found. These findings surprised researchers, given that COVID-19 disproportionately affected the Latinx community in infections, hospitalizations, and death.
Dr. Jesus R. Torres, lead study author and emergency medicine physician at UCLA Health, aimed to study undocumented people because they tend not to be identified in existing research even though they comprise approximately 3% of the population in the U.S., according to the Pew Research Center. Torres noted that the emergency room is one of the very few places where undocumented immigrants can get access to medical care.
From September 2, 2021, to March 31, 2022, the researchers surveyed 306 emergency room patients about their citizenship status and whether they received a COVID-19 vaccine or not. The group was comprised of adult men, women, and Latinx, Black, White, and other races.
The researchers found that undocumented Latinx patients were more likely to have a prior COVID-19 infection. They also found that the group had the same rate of vaccine uptake compared to other groups in the study.
“We would have expected Latinx patients to have lower rates of vaccination, considering higher rates of infection, hospitalizations, and death,” Torres said.
Torres said that from a public health perspective, it’s imperative to identify disadvantaged groups for research, policy advising, resource allocation, and targeted vaccine uptake campaigns.
Article: COVID-19 Vaccine Uptake in the Undocumented Latinx Population Presenting to the Emergency Department JAMA Network Open. 2024;7(4):e248578. doi:10.1001/jamanetworkopen.2024.8578
COVID-19 Vaccine Uptake in Undocumented Latinx Patients Presenting to the Emergency Department
ARTICLE PUBLICATION DATE
26-Apr-2024
April research news from the Ecological Society of America
ECOLOGICAL SOCIETY OF AMERICA
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A RECENT STUDY PUBLISHED IN FRONTIERS IN ECOLOGY AND THE ENVIRONMENT CALLS FOR COLLABORATIVE MANAGEMENT OF ALTERED LANDSCAPES LEFT BEHIND AFTER WILDFIRE.
The Ecological Society of America (ESA) presents a roundup of four research articles recently published across its six esteemed journals. Widely recognized for fostering innovation and advancing ecological knowledge, ESA’s journals consistently feature illuminating and impactful studies. This compilation of papers explores fire hazards in Mediterranean cork oak woodlands, putting theory to work predicting where cold-blooded organisms will occur under climate change, barriers to going high-tech in rangeland management and more, showcasing the Society’s commitment to promoting cutting-edge research that furthers our understanding of the natural world.
From Ecological Applications:
Browsers put a cork in Mediterranean woodland fire risk Author contact: Miguel N. Bugalho (migbugalho@isa.ulisboa.pt)
Mediterranean oak woodlands are the original home of the world’s cork trees, but they are increasingly threatened by shrub encroachment and intense fires. At the same time, deer numbers have been on the rise throughout the Iberian Peninsula primarily due to land abandonment and an absence of predators. Focusing on the ways in which interactions among drought, shrub encroachment and deer impact Portuguese woodlands, the authors found that deer can reduce the risk of fire in these unique ecosystems. By browsing on encroaching shrubs, deer kept shrub expansion in check, which reduced fuel loads and lessened fire hazards. After 18 years, woodland plots that were fenced to keep deer out had denser thickets of shrubs—more fuel for fire—than neighboring unfenced plots where deer were free to browse. Based on these results, the authors conclude that control of understory vegetation by deer and other browsers can play an important role in shielding Mediterranean woodlands from intensifying fire conditions as the world warms.
Novel framework predicts where species will occur under climate change Author contact: Margaret W. Simon (mwsimon@ku.edu)
Move over, birds and mammals—most animals on Earth, including nearly all pests and pathogens, are cold-blooded and unable to internally regulate their body temperature. Climate change is expected to directly impact where these species live, how many there are, and which new pests or diseases invade. To predict these impacts, this study examines how temperature affects different traits of cold-blooded animals and how these traits, in turn, influence their populations. By creating a model that considers how traits like growth rate and reproduction respond to temperature changes, the research team can predict where species can survive as temperatures shift. The model is general enough to work for many types of cold-blooded animals, from insects to fish to reptiles, and can even apply to conditions other than temperature, like humidity or salinity. By understanding these temperature effects, we can better anticipate how climate change will affect ecosystems, including which species might thrive or struggle in new conditions.
Wider use of technology would aid rangeland management Author contact: Brandon T. Bestelmeyer (brandon.bestelmeyer@usda.gov)
With accelerating development of new digital tools like monitoring databases, online maps, virtual fencing, mobile applications and more, land management is going high-tech—or, at least, it has the potential to do so. For managers of the world’s rangelands, numerous web-based instruments have been introduced in recent years that could significantly improve, if not revolutionize, development of effective management and response strategies. But what good are these marvels of the modern age if rangeland managers can’t access, are unfamiliar with or have little confidence in such tools? The authors of this article contend that social networks of managers, scientists and technology experts will be crucial if rangeland management is to keep pace with technological innovation and adapt to a changing world.
Tips for managing landscapes reshaped by wildfire Author contact: Kimberley T. Davis (kimberley.davis@usda.gov)
Natural landscapes have historically been shaped by wildfire, but changing climate conditions are driving rapid shifts in how often and how intensely fires burn. These changing fire regimes can trigger large-scale changes in many ecosystems. Post-fire transitions from forest to scrubland, or from native sagebrush to invasive grasslands, have been well documented throughout the western U.S. However, the authors of this study argue that too little of this research has focused on whether conventional management approaches can meet the complex challenges posed by these altered ecosystems. They advocate for greater collaboration among managers, scientists and Indigenous communities, along with additional pre- and post-fire research, expanded monitoring and greater exchange of information among stakeholders.
The Ecological Society of America, founded in 1915, is the world’s largest community of professional ecologists and a trusted source of ecological knowledge, committed to advancing the understanding of life on Earth. The 8,000 member Society publishes six journals and a membership bulletin and broadly shares ecological information through policy, media outreach and education initiatives. The Society’s Annual Meeting attracts 4,000 attendees and features the most recent advances in ecological science. Visit the ESA website at https://www.esa.org
Antimicrobial resistance crisis: “Antibiotics are not magic bullets”
Dr James Gill, a Clinical Lecturer at the University of Warwick and a practising GP, will attend a pivotal event hosted at the House of Lords on Monday (April 29) focused on combating the global crisis of antimicrobial resistance (AMR)
UNIVERSITY OF WARWICK
Dr James Gill, a Clinical Lecturer at the University of Warwick and a practising GP, will attend a pivotal event hosted at the House of Lords on Monday (April 29) focused on combating the global crisis of antimicrobial resistance (AMR).
Antimicrobial resistance poses a formidable threat to communities worldwide, with projections indicating that by 2050, over 10 million deaths annually could be attributed to AMR, surpassing even the toll of cancer. In the face of this escalating emergency, effective communication is paramount. Health professionals and organisations play a crucial role in disseminating accurate, accessible information to raise awareness about critical health issues such as AMR.
Reflecting on the significance of the event, Dr James Gill said, "Antibiotics have been perceived as magic bullets, capable of swiftly addressing various ailments. However, their indiscriminate use poses significant risks, both in terms of adverse effects and the development of resistance."
Partnering with The Fleming Initiative, YouTube Health will collaborate to amplify awareness of this pressing global concern across social media platforms. Under the patronage of HRH Prince William and the leadership of Lord Ara Darzi, The Fleming Initiative represents a transformative alliance of policymakers, scientists, and behavioural change experts committed to combating AMR.
Dr Gill continued, "A fundamental shift in patient perception is imperative. Rather than viewing antibiotics as a panacea, patients must understand the potential harm associated with their misuse. Empowering patients to question the necessity of antibiotics and fostering a dialogue on appropriate usage is paramount in addressing the challenge of AMR."
While physicians are well-informed, there exists a pressing necessity to re-educate patients on the nuanced impact of antibiotics. Rather than viewing these medications as mere symptom alleviators, patients must understand the potential long-term harm, including disruptions to their gut microbiome and the development of antibiotic resistance. Dr Gill underscores the importance of fostering a shift in patient mindset, wherein individuals actively engage in discussions with their doctors, questioning the necessity of antibiotic prescriptions and considering alternative approaches.
By enhancing patient awareness, Dr Gill envisions a transformative outcome wherein patients adopt a more discerning approach towards antibiotic use, ultimately contributing to the collective effort in combating antimicrobial resistance.Dr James Gill, a Clinical Lecturer at the University of Warwick and a practising GP, will attend a pivotal event hosted at the House of Lords on Monday (April 29) focused on combating the global crisis of antimicrobial resistance (AMR).
Antimicrobial resistance poses a formidable threat to communities worldwide, with projections indicating that by 2050, over 10 million deaths annually could be attributed to AMR, surpassing even the toll of cancer. In the face of this escalating emergency, effective communication is paramount. Health professionals and organisations play a crucial role in disseminating accurate, accessible information to raise awareness about critical health issues such as AMR.
Reflecting on the significance of the event, Dr James Gill said, "Antibiotics have been perceived as magic bullets, capable of swiftly addressing various ailments. However, their indiscriminate use poses significant risks, both in terms of adverse effects and the development of resistance."
Partnering with The Fleming Initiative, YouTube Health will collaborate to amplify awareness of this pressing global concern across social media platforms. Under the patronage of HRH Prince William and the leadership of Lord Ara Darzi, The Fleming Initiative represents a transformative alliance of policymakers, scientists, and behavioural change experts committed to combating AMR.
Dr Gill continued, "A fundamental shift in patient perception is imperative. Rather than viewing antibiotics as a panacea, patients must understand the potential harm associated with their misuse. Empowering patients to question the necessity of antibiotics and fostering a dialogue on appropriate usage is paramount in addressing the challenge of AMR."
While physicians are well-informed, there exists a pressing necessity to re-educate patients on the nuanced impact of antibiotics. Rather than viewing these medications as mere symptom alleviators, patients must understand the potential long-term harm, including disruptions to their gut microbiome and the development of antibiotic resistance. Dr Gill underscores the importance of fostering a shift in patient mindset, wherein individuals actively engage in discussions with their doctors, questioning the necessity of antibiotic prescriptions and considering alternative approaches.
By enhancing patient awareness, Dr Gill envisions a transformative outcome wherein patients adopt a more discerning approach towards antibiotic use, ultimately contributing to the collective effort in combating antimicrobial resistance.
Research expo highlights student and faculty creativity
Event helped connect UTA inventors and entrepreneurs to leading business minds
UNIVERSITY OF TEXAS AT ARLINGTON
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EXHIBITORS AT THE UT ARLINGTON RESEARCH AND INNOVATION EXPO
Hundreds of faculty, students and business leaders flocked to The University of Texas at Arlington for its second annual Research and Innovation Expo, an event designed to showcase the University’s research efforts.
“This is an event where we can showcase our research achievements and encourage everyone to learn about and engage with other investigators outside their own fields,” said Eileen Clements, interim executive director of the UT Arlington Research Institute and an organizer of the event.
Researchers learned how to find external funding for their projects from such varied sources as federally funded government organizations like the National Science Foundation and National Institutes of Health, private foundations, or industry leaders who need technology solutions to advance their companies.
“This expo was a way for researchers who have been successful in securing extramural funding to offer advice to others,” said Jeff Campbell, director of the Shimadzu Institute for Research Technology at UTA and an event organizer. “We put together a cross-section of faculty from around campus to share their success stories and offer tips for future collaborations.”
“It’s all about the mindset,” Corson said. “Anyone on campus has it within them to embrace their entrepreneurial aspirations and get engaged, whether it’s an artist who is going out for their first gig or someone curing cancer.”
In addition to showcasing the talented faculty on campus in Arlington, the expo also featured business and entrepreneurial leaders from the community who offered their wisdom and words of motivation to the next generation of leaders.
“We need to be able to stay ahead of the curve by utilizing technology and innovation,” said attendee and speaker Troy Alley Jr., chief operating officer and president of real estate at Con-Real LP, the largest Black-owned construction and real estate company of its kind in the southern United States. “This is what helps you stay competitive.”
Panel at the UT Arlington Research and Innovation Expo
CREDIT
Photo courtesy UT Arlington
The expo was a platform for top private-sector, philanthropic and academic leaders from across the county to share lessons learned from their entrepreneurial experiences and advise UTA faculty. Additional guest speakers included:
Kirk Ririe, co-founder of Idaho Technology
Azad Madni, professor at the University of Southern California, member of the National Academy of Engineering and recipient of the Gordon Prize for Innovation in Engineering and Technology Education
Thom Ruhe, president and CEO of NC IDEA
Brian Kelsey, manager for economic development advisory services at EY
New circuit boards can be repeatedly recycled
UNIVERSITY OF WASHINGTON
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A TEAM LED BY RESEARCHERS AT THE UNIVERSITY OF WASHINGTON DEVELOPED A NEW PCB THAT PERFORMS ON PAR WITH TRADITIONAL MATERIALS AND CAN BE RECYCLED REPEATEDLY WITH NEGLIGIBLE MATERIAL LOSS. RESEARCHERS USED A SOLVENT THAT TRANSFORMS A TYPE OF VITRIMER — A CUTTING-EDGE CLASS OF POLYMER — INTO A JELLY-LIKE SUBSTANCE WITHOUT DAMAGE, ALLOWING SOLID COMPONENTS TO BE PLUCKED OUT FOR REUSE OR RECYCLING. HERE, FROM LEFT TO RIGHT IS A VITRIMER-BASED CIRCUIT BOARD, A SHEET OF GLASS FIBERS, VITRIMER THAT’S BEEN SWOLLEN AND REMOVED FROM A BOARD, AND ELECTRICAL COMPONENTS SUCH AS A COMPUTER CHIP.
A recent United Nations report found that the world generated 137 billion pounds of electronic waste in 2022, an 82% increase from 2010. Yet less than a quarter of 2022’s e-waste was recycled. While many things impede a sustainable afterlife for electronics, one is that we don’t have systems at scale to recycle the printed circuit boards (PCBs) found in nearly all electronic devices.
PCBs — which house and interconnect chips, transistors and other components — typically consist of layers of thin glass fiber sheets coated in hard plastic and laminated together with copper. That plastic can’t easily be separated from the glass, so PCBs often pile up in landfills, where their chemicals can seep into the environment. Or they’re burned to extract their electronics’ valuable metals like gold and copper. This burning, often undertaken in developing nations, is wasteful and can be toxic — especially for those doing the work without proper protections.
A team led by researchers at the University of Washington developed a new PCB that performs on par with traditional materials and can be recycled repeatedly with negligible material loss. Researchers used a solvent that transforms a type of vitrimer — a cutting-edge class of sustainable polymers — to a jelly-like substance without damaging it, allowing the solid components to be plucked out for reuse or recycling.
The vitrimer jelly can then be repeatedly used to make new, high-quality PCBs, unlike conventional plastics that degrade significantly with each recycling. With these “vPCBs” (vitrimer printed circuit boards), researchers recovered 98% of the vitrimer and 100% of the glass fiber, as well as 91% of the solvent used for recycling.
The researchers published their findings April 26 in Nature Sustainability.
“PCBs make up a pretty large fraction of the mass and volume of electronic waste,” said co-senior author Vikram Iyer, a UW assistant professor in the Paul G. Allen School of Computer Science & Engineering. “They’re constructed to be fireproof and chemical-proof, which is great in terms of making them very robust. But that also makes them basically impossible to recycle. Here, we created a new material formulation that has the electrical properties comparable to conventional PCBs as well as a process to recycle them repeatedly.”
Vitrimers are a class of polymers first developed in 2015. When exposed to certain conditions, such as heat above a specific temperature, their molecules can rearrange and form new bonds. This makes them both “healable” (a bent PCB could be straightened, for instance) and highly recyclable.
“On a molecular level, polymers are kind of like spaghetti noodles, which wrap and get compacted,” said co-senior author Aniruddh Vashisth, a UW assistant professor in the mechanical engineering department. “But vitrimers are distinct because the molecules that make up each noodle can unlink and relink. It’s almost like each piece of spaghetti is made of small Legos.”
The team’s process to create the vPCB deviated only slightly from those used for PCBs. Conventionally, semi-cured PCB layers are held in cool, dry conditions where they have a limited shelf life before they’re laminated in a heat press. Because vitrimers can form new bonds, researchers laminated fully cured vPCB layers. The researchers found that to recycle the vPCBs they could immerse the material in an organic solvent that has a relatively low boiling point. This swelled the vPCB’s plastic without damaging the glass sheets and electronic components, letting the researchers extract these for reuse.
This process allows for several paths to more sustainable, circular PCB lifecycles. Damaged circuit boards, such those with cracks or warping, can in some cases be repaired. If they aren’t repaired, they can be separated from their electronic components. Those components can then be recycled or reused, while the vitrimer and glass fibers can get recycled into new vPCBs.
The team tested its vPCB for strength and electrical properties, and found that it performed comparable to the most common PCB material (FR-4). Vashisth and co-author Bichlien H. Nguyen, a principal researcher at Microsoft Research and an affiliate assistant professor in the Allen School, are now using artificial intelligence to explore new vitrimer formulations for different uses.
Producing vPCBs wouldn’t entail major changes to manufacturing processes.
“The nice thing is that a lot of industries — such as aerospace, automotive and even electronics — already have processing set up for the sorts of two-part epoxies that we use here,” said lead author Zhihan Zhang, a UW doctoral student in the Allen School.
The team analyzed the environmental impact and found recycled vPCBs could entail a 48% reduction in global warming potential and an 81% reduction in carcinogenic emissions compared to traditional PCBs. While this work presents a technology solution, the team notes that a significant hurdle to recycling vPCBs at scale would be creating systems and incentives to gather e-waste so it can be recycled.
“For real implementation of these systems, there needs to be cost parity and strong governmental regulations in place,” said Nguyen. “Moving forward, we need to design and optimize materials with sustainability metrics as a first principle.”
Additional co-authors include Agni K. Biswal, a UW postdoctoral scholar in the mechanical engineering department; Ankush Nandi, a UW doctoral student in the mechanical engineering department; Kali Frost, a senior applied scientist at Microsoft Research; Jake A. Smith, a senior researcher at Microsoft Research and an affiliate researcher in the Allen School; and Shwetak Patel, a UW professor in the Allen School and the electrical and computer engineering department. This research is funded by the Microsoft Climate Research Initiative, an Amazon Research Award and the Google Research Scholar Program. Zhang was supported by the UW Clean Energy Institute Graduate Fellowship.
The number of health care professionals able to write a prescription for a key medication to treat addiction quadrupled at community health clinics from 2016 to 2021, according to a new study by researchers at Oregon Health & Science University.
The findings, published online today in the journal JAMA Health Forum, provides a glimmer of hope amid a national overdose epidemic that has claimed more than 100,000 lives in the United States in each of the past few years.
The study examined community health centers serving low-income people primarily in West Coast states. Researchers found the number of health care professionals prescribing buprenorphine increased from 8.9% to 37.5% from 2016 to 2021 — a substantial increase that researchers attribute to increased state and federal efforts to ease the ability of clinicians to prescribe medication to treat addiction.
Buprenorphine, approved by the Food and Drug Administration in 2002, relieves withdrawal symptoms, cravings and pain. It normalizes brain function by acting on the same target in the brain as opioids or heroin. It’s one of three medicines approved by the FDA for treatment of opioid dependence, along with methadone and naltrexone.
“It’s heartening,” said lead author Daniel Hartung, Pharm.D., M.P.H., associate professor in the OHSU-Oregon State University College of Pharmacy. “Over a third of the providers in these community health centers are writing prescriptions for buprenorphine.”
Researchers examined data from 166 clinics in the network supported by Portland-based OCHIN, Inc. The study included more than 1,300 health care professionals that provided care for some 570,000 people in 2021.
In clinics in rural areas, the proportion of health care professionals able to prescribe buprenorphine was even greater, growing from 20.3% to 52.7% in five years.
“There’s still a lot of work to be done,” Hartung said. “But it’s a step in the right direction when more providers have the capacity to write prescriptions to treat patients who want to be treated.”
In addition to Hartung, co-authors included Robert W. Voss, M.S., of OCHIN, Inc.; Steffani R. Bailey, Ph.D., and Nathalie Huguet, Ph.D., associate professors of family medicine in the OHSU School of Medicine; and John Muench, M.D., M.P.H., professor emeritus of family medicine in the OHSU School of Medicine.
The research was supported by the grant R01DA046468 from the National Institute on Drug Abuse of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the officials views of the NIH. It was conducted with the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network, which is led by OCHIN in partnership with Health Choice Network, Fenway Health and OHSU, funded through contract R1-OCHIN-01-MC from the Patient-Centered Outcomes Research Institute.
Changes in Buprenorphine Prescribing in Community Health Centers
ARTICLE PUBLICATION DATE
26-Apr-2024
Blood test finds knee osteoarthritis up to eight years before it appears on x-rays
Early detection could lead to therapies that slow progression and restore joint health
DUKE UNIVERSITY MEDICAL CENTER
DURHAM, N.C. – A blood test successfully predicted knee osteoarthritis at least eight years before tell-tale signs of the disease appeared on x-rays, Duke Health researchers report.
In a study appearing April 26 in the journal Science Advances, the researchers validated the accuracy of the blood test that identifies key biomarkers of osteoarthritis. They showed that it predicted development of the disease, as well as its progression, which was demonstrated in their earlier work.
The research advances the utility of a blood test that would be superior to current diagnostic tools that often don’t identify the disease until it has caused structural damage to the joint.
“Currently, you’ve got to have an abnormal x-ray to show clear evidence of knee osteoarthritis, and by the time it shows up on x-ray, your disease has been progressing for some time,” said senior author Virginia Byers Kraus, M.D., Ph.D., a professor in the departments of Medicine, Pathology, and Orthopedic Surgeryat Duke University School of Medicine. “What our blood test demonstrates is that it’s possible to detect this disease much earlier than our current diagnostics permit.”
Osteoarthritis (OA) is the most common form of arthritis, afflicting an estimated 35 million adults in the U.S. and causing significant economic and societal impacts. While there are currently no cures, the success of potential new therapies could hinge on identifying the disease early and slowing its progression before it becomes debilitating.
Kraus and colleagues have focused on developing molecular biomarkers that can be used for both clinical diagnostic purposes and as a research tool to aid in the development of effective drugs. In previous studies, the blood biomarker test demonstrated 74% accuracy in predicting knee OA progression and 85% accuracy in diagnosing knee OA.
The current study further honed the test’s predictive capabilities. Using a large United Kingdom database, the researchers analyzed serum of 200 white women, half diagnosed with OA and the other half without the disease, matched by body mass index and age.
They found that a small number of biomarkers in the blood test successfully distinguished the women with knee OA from those without it, catching molecular signals of OA eight years before many of the women were diagnosed with the disease by x-ray.
“This is important because it provides more evidence that there are abnormalities in the joint that can be detected by blood biomarkers well before x-rays can detect OA,” Kraus said. “Early-stage osteoarthritis could provide a ‘window of opportunity’ in which to arrest the disease process and restore joint health.”
In addition to Kraus, study authors include Shuming Sun, Alexander Reed, Erik J. Soderblom, M Arthur Moseley, Kaile Zhou, Vaibhav Jain, Nigel Arden, and Yi-Ju Li.
The study received funding support from National Institutes of Health (R01-AR071450 and P30-AG028716).
JOURNAL
Science Advances
Location, location, location
How geography acts as a structural determinant of health
Riverside, Calif. -- In unincorporated communities in the United States-Mexico borderlands, historically and socially marginalized populations become invisible to the healthcare system, showing that geography acts as a structural determinant of health for low-income populations. So concludes a study by a University of California, Riverside, team that focused its attention on the borderland in Southern California, specifically, eastern Coachella Valley.
From September to December 2020, the team, led by Ann Cheney, an associate professor of social medicine, population, and public health in the School of Medicine, conducted interviews in collaboration with MarÃa Pozar, a community investigator and CEO of Conchita Servicios de la Comunidad, with 36 Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. The researchers found communities in the “colonias” (unincorporated areas in the borderlands) lack basic critical infrastructure including healthcare access.
The U.S.-Mexico borderland is home to nearly 2.7 million Hispanic or Latinx individuals. The immigrant population in the colonias has limited English proficiency, health literacy levels, and income, and lower levels of formal education. Many are undocumented.
The study, published in the journal Social Science & Medicine, found the caregivers perceive U.S.-based physicians as not providing them with sufficient information since most physicians do not speak their language and do not adequately listen to or are dismissive of their concerns about their children’s respiratory health. The caregivers perceive Mexican-based physicians as providing them with a diagnosis and treatment plan, whereas U.S.-based physicians often prescribe medications and provide no concrete diagnosis.
“Further, only those with legal documentation status can cross the border, which contributes to disparities in children’s respiratory health,” Cheney said. “Thus, caregivers without legal status in the U.S. must access healthcare services in the U.S. for their children and receive, what these caregivers perceive, as suboptimal care.”
Cheney added she was surprised to learn that caregivers who did not have legal documentation status in the U.S. asked trusted family and friends to take their children across the border to receive healthcare services for childhood asthma and related conditions.
“Geography, meaning living in unincorporated communities, harms health,” she said. “Geography and the politics of place determines who can and cannot cross borders.”
Study participants discussed the distance they needed to travel to pediatric specialty care for the care and management of their children’s respiratory health problems. Some commented on the lack of interaction and communication with physicians during medical visits. Some participants commented on the lack of physicians’ knowledge about the connections between their children’s exposure to environmental hazards and poor respiratory health and allergic symptoms.
The research took place in four unincorporated rural communities — Mecca, Oasis, Thermal, and North Shore — in eastern Coachella Valley, along the northern section of the Salton Sea. People living in the colonias here are subject to the health effects of environmental hazards. Many are farmworkers living and working in the nearby agricultural fields. Most of the workforce lives in mobile parks and below the federal poverty line.
“In addition to toxic water and dust from the Salton Sea, other environmental health hazards, such as agriculture pesticide exposure, waste processing facilities, and unauthorized waste dumps, also contribute to this community’s high incidence of poor respiratory health,” said Gabriela Ortiz, the first author of the research paper and a graduate student in anthropology who works with Cheney. “These communities are vulnerable to the policies and governing decisions around exposure to environmental hazards and infrastructure development. The absence of infrastructure and lack of healthcare infrastructure limits their access to primary care and specialty care services.”
Ortiz explained that anthropologists and social scientists have long argued that environmental injustices are a product of structural violence.
“This is indirect violence caused by social structures and institutions that prevent individuals from meeting their basic needs because of political economic domination and class-based exploitation,” she said. “Understanding the complex interplay between geography, borderlands, and health is essential for coming up with effective public health policy and interventions.”
The title of the research paper is “Seeking care across the US-Mexico border: The experiences of Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress.”
Cheney, Ortiz, and Pozar were joined in the study by Ashley Moran and Sophia Rodriquez of UCR.
The study was funded by the National Institutes of Health/National Institute of Minority Health and Health Disparities.
The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment is more than 26,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual impact of more than $2.7 billion on the U.S. economy. To learn more, visit www.ucr.edu.
