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Published12 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Owen Pinnell and Sarah IbrahimBBC ArabicToxic pollutants released during gas flaring are endangering millions more people than previously feared, a BBC investigation suggests.Flaring – the burning of waste gas during oil drilling – is taking place across the Gulf, including by COP28 hosts the United Arab Emirates.New research suggests pollution is spreading hundreds of miles, worsening air quality across the entire region. It comes as the UAE hosts the UN’s COP28 climate summit on Thursday.The UAE banned flaring 20 years ago, but images show it is continuing, despite the potential health consequences for its inhabitants and those in neighbouring countries. Analysis for BBC Arabic shows gasses are now spreading hundreds of kilometres across the region.Pollution from wells in Iraq, Iran and Kuwait were also analysed as part of the study. All of the countries involved either declined to comment or did not respond. Oil companies managing the sites, including BP and Shell, where flaring took place said they were working to reduce the practice.On Monday, BBC News revealed leaked documents showed how the UAE had planned to use its role as the host of UN climate talks as an opportunity to strike oil and gas deals. David R. Boyd, the UN Special Rapporteur on human rights and the environment said the BBC’s findings were: “Very disturbing. Big oil companies and states in the Middle East are violating the human rights of millions of people by failing to tackle air pollution from fossil fuels. “Despite the massive human suffering, Big Oil and petrostates carry on with business as usual with total impunity and zero accountability.”Oil field where ‘cancer is rife’Gas flaring: What is it and why is it a problem?BreathlessHow the hidden toxic air pollution of the oil giants is spreading hundreds of kilometres, putting the health of millions of people at risk in Dubai, Abu Dhabi, Kuwait, Iran and Iraq.The documentary is available to watch now on BBC iPlayer (UK only) and is also being broadcast on BBC World News at 09:30 GMT on Saturday 9 December.Flaring is avoidable and the gas can be captured and used to generate electricity or heat homes – yet it continues to take place across the world.Pollutants from this type of flaring include PM2.5, Ozone, NO2, and benzo(a)pyrene (BaP) which at high levels or continued exposure have been linked to strokes, cancer, asthma and heart disease according to international experts including the World Health Organisation (WHO). Global flaring is also a major source of the planet-warming greenhouse gases CO2 and methane.Two decades ago, the UAE national oil company, Adnoc – run by the president of this year’s COP28 climate summit, Sultan al-Jaber – committed to ending “routine flaring”. Yet assessment of satellite images by the BBC shows it is taking place on a daily basis at offshore sites. The UAE is one of the biggest sources of oil for the UK market.More on the COP28 climate summitWhat is COP28 and why is it so important?UAE planned to use climate talks to make oil dealsFour ways climate change worsens extreme weatherReally simple guide to climate changeReliably measuring air pollution from the flares on the ground is challenging and there is little official data.Each time gas is flared it is known to release a certain amount of pollution. Working with BBC Arabic, environmental scientists combined this information with the volumes of gas flared – which the World Bank publishes – to work out total pollution. A simulation based on current weather conditions then estimated how gases moved across the region. The model suggested, for example, that three offshore fields in the UAE were adding to air pollution in Dubai and Abu Dhabi, hundreds of kilometres away. Studies have shown that children exposed to elevated levels of PM2.5 are more likely to develop asthma and persistent wheezing than those who are not exposed. Respiratory disease is one of the leading causes of death in the region, with the rates of asthma in UAE amongst the highest in the world. Pollution from IraqThe BBC analysis indicates that in the case of Kuwait, some of this man-made pollution is coming from flares 140km away in Iraq. Iraq has the second highest volume of flaring in the world, according to World Bank data, after Russia – burning nearly 18 billion cubic metres of gas a year. This could power nearly 20 million European homes annually. The biggest single source of flaring in the world is from a giant Iraqi oil field called Rumaila, managed by BP and Petrochina. It is in southern Iraq, just over 30km (20 miles) from the border with Kuwait.The BBC research suggests one cancer-causing pollutant called benzoapyrene was ten times higher in northern Kuwait than European safety standards. In villages close to the flares in Iraq itself, levels of PM2.5 were also extremely high, reaching hourly peaks of 100 micrograms per cubic metre. The WHO’s recommended safe limit is 5 micrograms per cubic metre. Even 100km away in Kuwait City, levels still reached 5 to 10 micrograms per cubic metre. Dirty air in parts of the Gulf is often blamed on the region’s regular dust storms, but Dr Barak al-Ahmad, research fellow at Harvard T.H. Chan School of Public Health, found that wasn’t necessarily the case. He and his team spent two years analysing Kuwait’s air and dust to find out where the pollution was coming from. “Actually, what we found out is that only 40% comes from the desert.”Forty-two percent comes from sources that involve power plants, and involve the oil industry, and involves all the industry that is in Kuwait and outside of Kuwait.” According to his team’s study the remaining pollution comes from high levels of traffic in the country. “This is man-made air pollution that we can regulate, we can reduce, we can in fact eliminate,” he told the BBC. Dr Ahmad said PM2.5 particles get into the bloodstream of those who breathe it in and can then quickly get into their organs. “Your kidneys, your brain, your heart, everywhere. This can lead to an acute asthmatic attack. At some point, it could be very life threatening,” he said. Abdulrahman Alameeri, a 39 year-old engineer, lives with his family in Kuwait City and his two sons struggle with asthma. Particularly his six year-old Jassem, who has been hospitalised on multiple occasions. He told the BBC: “The first time [Jassem] had an asthma attack, he was unable to breathe. He turned blue.” Dr Akshaya Bhagavathula, associate professor of epidemiology at North Dakota State University, who was not involved in the BBC study, reviewed the results of our research. “This preliminary modelling study highlights potentially substantial impacts of flaring on air quality in the Gulf region, but additional measurements and analysis are needed to comprehensively quantify health burdens.” The oil fields in Iraq and Kuwait have complex ownership structures, allowing international oil companies like Eni, Lukoil and BP who work here to not declare all emissions from their activities. BP is a major player in the region. It is a leading contractor working at Rumaila oil field and for Kuwait Oil Company which is responsible for 82% of flaring in the country. BP reported that it made £53m in profit last year from its operations in Kuwait. In response BP told the BBC: “As we have stated before, BP is not and has never been the operator of the Rumaila field. Nevertheless, we continue to actively support the lead contractor in its work to help the operator of the field to reduce its flaring and emissions.” Rumaila is operated by Rumaila Operating Organisation which is a consortium of organisations including Basra Energy Company – a partnership between BP and PetroChina. Undercover in the world’s dirtiest oil fieldInstead of burning the gas, it could be captured and used to power people’s homes, according to the World Bank. The initial cost of installing the technology to do so is high – the World Bank estimates globally it would cost $100bn. But if captured and sold the gas could fetch $16bn annually. In 2013, the Iraqi government and oil and gas giant Shell set up the Basrah Gas Company to capture gas at the three biggest fields, Rumaila, Qurna and Zubair. But since then, overall levels of flaring have remained steady – and actually increased at two of the fields, according to World Bank data. Shell told the BBC: “Basrah Gas Company’s sole purpose is to capture gas that would otherwise be flared from three giant oilfields, which are operated by other companies. It captures more than 63% of the gas from those fields, but does not have the capacity to capture all of it.” Lukoil told the BBC it operates “in accordance with Iraqi law”. And ENI said it “collaborates to reduce and minimize gas flaring”. PetroChina told the BBC that they are working with BP to support the rehabilitation of Rumaila. And expressed that they are extremely concerned by the issues raised by the BBC.Although the UAE did not respond, its national oil company, Adnoc said: “Across all our operations, we are focussed on our goal of eliminating routine flaring by 2030. We flare at a lower rate than the global industry average.”Methodology The contribution of flaring to the regional burden of air pollution is estimated through regional chemical-transport model (CTM) simulations. The air quality over the region has been reconstructed with and without the flare’s emissions. The use of CTM simulations allows for an estimation of how the pollutants emitted from the flares are dispersed, and their interaction with background atmospheric composition, the production of secondary pollutants and their contribution to local air quality. The pollutant emissions from the flares were estimated from the flared gas volumes reported by the World Bank Gas Flaring Tracker and emission factors available in peer-reviewed publications and reference emission inventories guidebooks. The simulation was limited to two monthly periods. A full year would be desirable to thoroughly describe the impact of weather variability on the atmospheric composition and air quality, but we believe that the simulation of two full months is an acceptable option to obtain a first reliable estimate of the flare’s impact under different seasonal conditions. The atmospheric composition over the area has then been reconstructed using a three-dimensional modelling system obtained by the coupling of WRF meteorological model, and FARM CTM. Environmental modelling: AriaNet. Methodology review from Barak Al Ahmad, Dr Aidan Farrow, Dr Eric Kort, Dr Karn Vohra, Dr Akshaya Bhagavathula, Dr Ravi Ravishankara. What questions do you have about COP28?In some cases your question will be published, displaying your name, age and location as you provide it, unless you state otherwise. Your contact details will never be published. Please ensure you have read our terms & conditions and privacy policy.Use this form to ask your question:

If you are reading this page and can’t see the form you will need to visit the mobile version of the BBC website to submit your question or send them via email to YourQuestions@bbc.co.uk. Please include your name, age and location with any question you send in. More on this storyWhat is gas flaring and why is it a problem?Published29 September 2022BP in oil field where ‘cancer is rife’Published30 September 2022

Published33 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, EPA-EFE/REX/ShutterstockBy Hannah RitchieBBC News, SydneyAustralia will ban imports of disposable vapes from January, in an effort to curb nicotine addiction in children. New laws to stop single-use vapes from being made, advertised, and supplied in the country will also be introduced. It comes amid a broader push to phase out recreational vaping completely. Vaping has been marketed as a way to quit smoking, but Australia’s health minister says it has created a “new generation of nicotine dependency”. Vapes, or e-cigarettes, are lithium battery-powered devices that have cartridges filled with liquids containing nicotine, artificial flavourings, and a range of other chemicals.It has been illegal for any Australian to purchase or import e-cigarettes or nicotine vapes without a doctor’s prescription since 2021, but despite those restrictions rates of addiction have continued to skyrocket.A study from the University of Sydney earlier this year found that over a quarter of teenagers aged 14-17 had vaped, while research from Australia’s Cancer Council charity found that nine out of 10 teenagers in the same age group found it easy to access nicotine vapes. “All Australian governments are committed to working together to stop the disturbing growth in vaping among our young people,” said Mark Butler, the federal health minister who is leading the ban.In May, the Australian government signalled its intention to phase out the use of single-use vapes, but until now it had provided no concrete timeline. Mr Butler says that the import ban on disposable vapes will start on 1 January, and that by March refillable non-therapeutic vapes will also be banned from entering the country.Importers and manufacturers supplying therapeutic vapes will also have to comply with tighter government regulation concerning the flavours, nicotine levels, and packaging of their products. Experts have warned that not enough is known yet about the long-term impacts of vaping. Research from Johns Hopkins University has linked the practice to chronic lung disease and asthma.And in Australia, scientists who have studied the liquids used in vapes have warned that they contain “a suite of chemicals” known to impact lung health. Australia’s announcement comes just days after New Zealand’s government scrapped its world-leading smoking ban to pay for tax cuts. More on this storyWhy Australia decided to quit its vaping habitPublished28 MayTobacco firm calls for tougher rules on vapesPublished1 day agoShock as New Zealand axes world-first smoking banPublished12 hours ago

Trying something new is a risk every child undertakes as they explore and learn about the world. While risk can be costly, it can also pay off in rewards or knowledge. But new research suggests children without predictable support from the adults in their lives are less willing to take those risks — and reap those rewards.
“If you’re in a resource-rich environment — meaning for a child that you’re safe, your meals are coming, someone is at home for you, you’re surrounded by adults that are protecting you — you’ll try new things,” says Seth Pollak, a University of Wisconsin-Madison professor of psychology who studies childhood adversity. “And that’s how you discover and learn about the world.”
But not every exploration will be rewarding and, according to a new study of childhood exploration and parental predictability that Pollak and collaborators today published in the Proceedings of the National Academy of Sciences, kids who don’t believe they have the support of reliable parents are less willing to risk the unknown.
“What’s unseen around that corner could be golden, but you could also end up in some bad situations,” Pollak says. “You could end up ordering a bad meal or touching something that hurts you. You could end up in a bad relationship or with an empty wallet. And so, we thought, in order to have the confidence to try something new, you have to feel like you’re supported and relatively safe — like you can afford to make a bad call.”
The researchers studied decisions that more than 150 children ages 10 to 13 made while playing games designed by C. Shawn Green, a UW-Madison psychology professor. The games offered the children opportunities to risk a little and explore for potential gains.
One game, fashioned after a pair of casino slot machines, gave players a history of payouts on just one of the machines — information that helped them understand their expected winnings if they kept pulling that machine’s handle. The other machine’s history was a mystery, and investing a pull there was more of a risk, but also potentially a bigger return.
The other game, in which the kids collected apples in virtual orchards, featured diminishing returns as players continued to pick from an individual tree. With limited time, would the players move to new trees, with unknown bounties? Or would they plug away at the tree they knew best?

The kids and their parents also participated in a battery of surveys and assessments. The researchers gauged the stress the children experience and the predictability of their lives — based on factors like parental job loss, divorce, death or illness in the family, and changing schools and homes — as well as children’s own views about whether or not their parents were reliable and predictable.
Yuyan Xu, a UW-Madison graduate student and first author of the study, asked children to respond to questions about how they’ve experienced their relationships, such as: When my parents say they’re going to pick me up, can I count on them to be there? When my parent makes a promise, do they follow through on it? Do I typically know how my parents are going to react to different kinds of situations?
The less reliable and predictable the kids felt their parents were, the less likely they were to take exploratory risks in the games they played. They were less likely to give the mysterious slot machine a chance or choose to move to a different apple tree.
“The children from more stable backgrounds, they play around and experiment in our games. They use that to get a sense of how things work, maybe earning them more money or more points,” Pollak says. “Kids from unstable backgrounds just don’t play that way. They stay within a narrower range of possibilities. They prefer to stick with what they already know, even if it’s limited, rather than taking a chance at a higher possible reward.”
The researchers found those self-imposed limits on risk were not related to the more objective measures of stress and unpredictability on the kids’ lives or even on parental reports that didn’t necessarily agree with their child’s perceptions of their relationships. There wasn’t a correlation between lack of risk-taking and levels of anxiety or neuroses, or of the kids’ feelings about the rest of the world outside their family. If they felt their parents were unreliable and unpredictable, they were less willing to explore.
“I think it makes sense,” Pollak says. “Their brains are doing exactly what we want our brains to do, right? If you really feel things are not predictable and you don’t know how things are going to land, you’d stick to what works and what’s familiar. You wouldn’t waste your resources on something that could all fall apart.”
The researchers ran their experiments first with a group of nearly 80 kids, then repeated it with a second group of just over 80 more to confirm their results.

“The interesting thing here is that there seems to be a way in which our early childhood experiences are calibrating how we decide to make these decisions years and years down the line and in these really different kinds of situations,” says Xu.
Openness to exploration wouldn’t be the only important aspect of childhood enhanced by stability. Language development, sleep quality, stress regulation and other subjects of childhood development research have been tied to predictability in children’s lives. Pollak plans to delve further into the relationship between predictability and exploration to see how rifts might be healed.
“What can we do for kids who view their history of interpersonal relationships as unstable?” he says. “We might not be able to change the relationships by the time we understand them to be unpredictable. But could we change the way kids think about them, how they act on them? If that is flexible, maybe we can tune those kids into the benefits and rewards of exploration to help foster kids’ learning.”
This research was supported by grants from the National Institutes of Health (R01MH61285 and P50HD105353).

Experiences of discrimination and acculturation are known to have a detrimental effect on a person’s health. For pregnant women, these painful experiences can also affect the brain circuitry of their children, a new study from Yale and Columbia University finds. These effects, the researchers say, are separate from those caused by general stress and depression.
The study was published in the journal Neuropsychopharmacology.
Previous research has shown that not only are high levels of stress and depression harmful to the person experiencing them, but they can also have long-lasting effects on their children if experienced during pregnancy. In recent years, studies have also revealed that discrimination and acculturation — or the changes that occur due to migration and the subsequent balancing of multiple, different cultures — can affect the adult brain. What’s less clear is how children might be affected by their parents’ experiences of discrimination and acculturation.
For the new study, the researchers assessed the degree of discrimination, acculturation, and distress experienced by 165 people while pregnant using established questionnaires. The participants were 14 to 19 years old, mostly Hispanic (88%), and lived in or near the Washington Heights neighborhood of New York City. The researchers then performed magnetic resonance imaging (MRI) to evaluate brain connectivity in 38 of the participants’ infants after birth.
The first step, researchers said, was to determine whether discrimination and acculturation are distinct from other types of stress or depression.
“We thought that some of these experiences might go hand-in-hand or overlap, in which case it would be difficult to measure the effects of discrimination or acculturation on their own,” said Dustin Scheinost, associate professor of radiology and biomedical imaging at Yale School of Medicine and senior author of the study.
Scheinost and his colleagues from Columbia and Children’s Hospital of Los Angeles used a data analysis program that assessed all of their separate questionnaire measures of acculturation, discrimination, stress, depression, childhood trauma, and socioeconomic status, and organized them into groups by how similar the data anlaysis program determined them to be. Doing this, researchers say, helped them understand the degree to which different measures might be used to evaluate similar experiences.

“That analysis clustered measures of stress and depression and separately pulled out discrimination and acculturation measures as their own distinct variables,” said Scheinost. “That told us that while these experiences of discrimination are related to stress and depression, they are separate enough that we can look at their unique effects.”
When the research team analyzed the MRI images of the infants’ brains, they found differences in the children whose parents reported experiencing discrimination while pregnant.
The amygdala is an area of the brain associated with emotional processing and it’s very vulnerable to prenatal stress, said the researchers. Prior research has found that early experiences of adversity can have measurable impacts on amygdala connectivity in infants, children, adolescents, and adults. A growing body of evidence also suggests the amygdala is involved in ethnic and racial processing, such as differentiating faces of people from different races or ethnicities, for example.
When the researchers assessed connectivity between the amygdala and another region of the brain called the prefrontal cortex, which is associated with higher-order functioning, they found that children of people who experienced more discrimination while pregnant had weaker connectivity between the two brain regions.
“Our finding was consistent with what you expect to see in the brain of those affected by early life adversity either pre- or postnatally,” said Scheinost.
The takeaway, said Scheinost, is that while discrimination and acculturation affect the brain in ways other types of stress do, there is something unique and important about these particular experiences that should be better understood. Future research, he said, should focus on whether other populations are affected in similar ways and what underlies the effects.
“We don’t fully know why this happens,” said Scheinost. “So we need to investigate the biological mechanisms that carry these experiences of adversity from parent to offspring.”

Stronger quadriceps muscles, relative to the hamstrings, may lower the risk of total knee replacement, according to research being presented today at the annual meeting of the Radiological Society of North America (RSNA). Researchers said the findings could inform strength-training programs for people with advanced arthritis in the knee.
Advanced knee osteoarthritis is a major cause of pain and disability worldwide. In the U.S. alone, 14 million adults have symptomatic knee osteoarthritis, and more than half of those diagnosed are projected to eventually undergo total knee replacement surgery.
While stronger muscle groups are generally understood to be associated with a lower rate of total knee replacement, their relative importance is not well established. Of particular interest is the relationship between the extensors and the hamstrings, the two most important muscle groups in the knee.
The extensors, the muscles on the front of the thigh commonly referred to as the quadriceps, are the strongest muscle group in the body and have essential influence on gait, other activities and biomechanics. The muscles around the back of the thigh known as the hamstrings are responsible for extension of the hip and flexion of the knee, making them equally essential for physical activity.
“The two muscle groups act as counter forces, and the balance between them enables a wide range of activities while protecting the knee joint,” said study lead author Upasana Upadhyay Bharadwaj, M.D., from the University of California, San Francisco (UCSF). “An imbalance, in addition to other factors, leads to a change in the biomechanics resulting in the progression of osteoarthritis.”
Dr. Upadhyay Bharadwaj and colleagues evaluated thigh muscle volume in 134 participants from the Osteoarthritis Initiative, a nationwide study sponsored by the National Institutes of Health. They compared 67 patients who underwent total knee replacement of a single knee with 67 control participants who had not undergone knee replacement. The cases and controls were matched for variables including age and gender.
The researchers obtained 3T MRI of the thigh at the time of surgery. They also evaluated MRI findings from two years and four years before the surgery. They used a previously trained deep-learning model to segment and compute volumes of the muscles of the thigh — measures that are tedious to compute manually.

Comparing patients who had total knee replacement with the control group, a higher ratio of quadriceps to hamstring volume was significantly associated with lower odds of total knee replacement. Higher volumes of hamstrings and gracilis, a long, thin muscle on the inside of the thigh, were also linked with lower odds of total knee replacement.
“Our study shows that in addition to strong muscles individually, larger extensor muscle groups — relative to hamstring muscle groups — are significantly associated with lower odds of total knee replacement surgery in two to four years,” Dr. Upadhyay Bharadwaj said.
The study findings have implications for both the interpretation of imaging exams and clinical management. The results suggest that training programs that strengthen the quadriceps in relation to the hamstrings may be beneficial.
“Although we presume that overall muscle volume is important as a surrogate marker for muscle strength, the ratio, hence the balance, between extensor and hamstring muscles may be more important and significantly associated with lower odds of total knee replacement,” Dr. Upadhyay Bharadwaj said.
Although the study focused on people with arthritis, the findings may also help inform strength training for a wider segment of the population.
“While these results are essential for targeted therapy in a population at risk for osteoarthritis, even the general public can benefit from our results to preventively incorporate appropriate strengthening exercises,” Dr. Upadhyay Bharadwaj said.
Co-authors are John A. Lynch, Ph.D., Gabby B. Joseph, Ph.D., and Thomas M. Link, M.D., Ph.D.

Health care organizations are looking to artificial intelligence (AI) tools to improve patient care, but their translation into clinical settings has been inconsistent, in part because evaluating AI in health care remains challenging. In a new article, researchers propose a framework for using AI that includes practical guidance for applying values and that incorporates not just the tool’s properties but the systems surrounding its use.
The article was written by researchers at Carnegie Mellon University, The Hospital for Sick Children, the Dalla Lana School of Public Health, Columbia University, and the University of Toronto. It is published in Patterns.
“Regulatory guidelines and institutional approaches have focused narrowly on the performance of AI tools, neglecting knowledge, practices, and procedures necessary to integrate the model within the larger social systems of medical practice,” explains Alex John London, K&L Gates Professor of Ethics and Computational Technologies at Carnegie Mellon, who coauthored the article. “Tools are not neutral — they reflect our values — so how they work reflects the people, processes, and environments in which they are put to work.”
London is also Director of Carnegie Mellon’s Center for Ethics and Policy and Chief Ethicist at Carnegie Mellon’s Block Center for Technology and Society as well as a faculty member in CMU’s Department of Philosophy.
London and his coauthors advocate for a conceptual shift in which AI tools are viewed as parts of a larger “intervention ensemble,” a set of knowledge, practices, and procedures that are necessary to deliver care to patients. In previous work with other colleagues, London has applied this concept to pharmaceuticals and to autonomous vehicles. The approach treats AI tools as “sociotechnical systems,” and the authors’ proposed framework seeks to advance the responsible integration of AI systems into health care.
Previous work in this area has been largely descriptive, explaining how AI systems interact with human systems. The framework proposed by London and his colleagues is proactive, providing guidance to designers, funders, and users about how to ensure that AI systems can be integrated into workflows with the greatest potential to help patients. Their approach can also be used for regulation and institutional insights, as well as for appraising, evaluating, and using AI tools responsibly and ethically. To illustrate their framework, the authors apply it to the development of AI systems developed for diagnosing more than mild diabetic retinopathy.
“Only a small majority of models evaluated through clinical trials have shown a net benefit,” says Melissa McCradden, a Bioethicist at the Hospital for Sick Children and Assistant Professor of Clinical and Public Health at the Dalla Lana School of Public Health, who coauthored the article. “We hope our proposed framework lends precision to evaluation and interests regulatory bodies exploring the kinds of evidence needed to support the oversight of AI systems.”

COVID-19 caused an alarming surge in premature births, but vaccines were key to returning the early birth rate to pre-pandemic levels, according to a new analysis of California birth records.
“The effect of maternal COVID infection from the onset of the pandemic into 2023 is large, increasing the risk of preterm births over that time by 1.2 percentage points,” says Jenna Nobles, a University of Wisconsin-Madison sociology professor. “To move the needle on preterm birth that much is akin to a disastrous environmental exposure, like weeks of breathing intense wildfire smoke.”
But the first two years of the pandemic alone were far worse for many pregnancies, according to findings Nobles and co-author Florencia Torche, a Stanford University sociology professor, published today in the Proceedings of the National Academy of Sciences.
The virus that causes COVID-19 endangers pregnancies by causing immune and inflammation responses, and via deterioration of the placenta. One consequence is early interruption of the pregnancy and birth well in advance of the end of the expected 39- to 40-week gestation.
As the virus spread from July to November of 2020, the likelihood that a mother with COVID-19 in California would give birth more than three weeks before the due date was 5.4 percentage points higher than anticipated — 12.3% instead of 6.9% — according to the new study.
The researchers measured the impact of the pandemic with the help of birth records for California’s nearly 40 million people, using information on birth timing and the comparison of sibling births to help control for the pandemic’s disparate impacts on different demographic groups. They found the excess risk of preterm birth fell slightly in early 2021 before dropping steeply in 2022, at which point maternal COVID-19 infection in pregnancy caused no excess risk of preterm birth for infants.
Vaccines contributed to that decrease, the researchers say, an effect that jumps out when the birth records are divided up geographically.

“In ZIP codes with the highest vaccination rates, the excess risk of preterm birth declines much faster. By summer 2021, having COVID-19 in pregnancy had no effect on preterm birth risk in these communities. It takes almost a year longer for that to happen in the ZIP codes with the lowest vaccine uptake,” Nobles says. “That highlights how protective COVID vaccines have been. By increasing immunity faster, early vaccination uptake likely prevented thousands of preterm births in the U.S.”
Preterm birth is associated with a host of short- and long-term health problems and deficiencies for the children and their families. It’s the leading contributor to infant mortality, and cutting short development in the womb can require additional medical attention that costs, on average, more than $80,000 per child. Preterm birth by even just a few weeks reduces expected educational attainment, health and earnings as an adult.
“And we found similar increases, of about 38%, in the risk of very preterm birth — that is pre-32 weeks — when a child is likely to need neonatal intensive care, with the possibility of developmental delays and serious implications for their families as well,” Nobles said.
The evidence showing the positive effects of vaccination in preventing premature births could help allay some of the most prominent concerns voiced as COVID-19 vaccines became available to pregnant patients.
“One big contributor to vaccine hesitancy is that people are worried about safety for the fetus and about the ability to get pregnant,” Nobles says. “We already know there is very little evidence of adverse effects of vaccination on fetal development. The results here are compelling evidence that what will actually harm the fetus is not getting vaccinated. That’s a message practitioners can share with concerned patients.”
The results should be a compelling argument in favor of getting vaccinations and boosters, according to the researchers, even after COVID-related premature birth risk ebbed in California.
“This is still an evolving epidemic, and the rate of vaccine boosters among pregnant people right now is very low,” Nobles says. “The question is, how many more iterations of viral evolution does this need to escape the immunity that we have? It’s miraculous and incredible that we’re now down to essentially zero additional preterm births, but it does not indicate that it’s going to be that way in perpetuity.”
This research was supported in part by grants from the National Science Foundation (NSF2049529) and the National Institutes of Health (R21 HD105361-01).

All animals start out as a single-celled organism and then start growing. At some point, of course, they need to stop getting bigger, but the process by which this happens is poorly understood.
New research from Alexander Shingleton at the University of Illinois Chicago and colleagues identifies a potential trigger that makes fruit flies stop growing, which has implications for understanding human development. The research is published in the Proceedings of the National Academy of Sciences.
In humans, the body’s signal to stop growing happens around puberty, though it takes several more years before growth actually ceases.It is important to better understand this process in part because of recent changes in how children experience puberty.
“We know that the onset of puberty is getting younger and younger. But in order to understand why something is changing, you need to understand how it works,” said Shingleton, a professor of biological sciences.
So the researchers looked at fruit flies, which undergo the equivalent of puberty when they metamorphosize from larvae into adults. The theory among many biologists has been that a larva stops growing when it reaches a certain body size, which triggers it to start the process of becoming an adult. Other insects do this, such as the kissing bug, which uses a “stretch receptor” in its abdomen to monitor its size, Shingleton explained.
But Shingleton and his coauthors weren’t convinced that fruit flies were using such a mechanism. They hypothesized that it had something to do with a steroid hormone involved in fruit fly growth called ecdysone, which is similar to estrogen and testosterone in humans.
The researchers used a mathematical model to explore their idea. The model showed that body size is not the trigger that causes a fruit fly to stop growing. Instead, a “stop growing” switch is triggered by the gland that makes ecdysone. In the larval stage, that gland receives lots of nutritional information that helps it decide how to regulate ecdysone production. But once ecdysone reaches a certain level, the gland no longer needs that nutritional information to make decisions and starts regulating itself.
The researchers believe this switch from needing nutritional information is what triggers the fruit fly to stop growing. “It’s not that the fly is measuring itself in a direct way,” Shingleton said.
He’d like to see similar studies done on mammals, which could shed more light on the growth-stopping process in humans. But Shingleton suspects that the fruit fly experience is related to ours, given that both involve similar steroid hormones and both fruit flies and humans convey nutritional information via insulin.
The other researchers on the project are UIC undergraduate student Amirali Monshizadeh, John Tyson at Virginia Tech and Stanislav Shvartsman at Princeton.

Parents who send their children to child care can breathe a little easier — research published in JAMA Network Open from experts at Michigan Medicine, the University of Pittsburgh School of Medicine, and UPMC Children’s Hospital of Pittsburgh shows that children in daycare were not significant spreaders of COVID-19.
The study found that transmission rates of SARS-CoV-2 within child care centers was only about 2% to 3%, suggesting that children and caregivers were not spreading COVID at significant rates to others in the centers.
The study also found low rates of infection among households that had kids attending child care centers, as only 17% of household infections resulted from children who caught COVID at their centers.
Overall, the study found that only 1 in 20 symptomatic children attending child care centers tested positive for the virus.
In contrast, once someone in a household tested positive for the coronavirus, transmission to other household members was high, at 50% for children and 67% for adults.
Young children frequently contracted COVID-19 from individuals outside their child care center.
Additional safety measures
Despite the low rates of transmission in child care centers, experts still highly recommend that families get themselves and their children vaccinated against COVID-19, as additional research shows that vaccines are a safe and effective way of preventing against serious infection.

“We strongly recommend the COVID-19 vaccine for young children to disrupt the high rates of transmission that we saw occur in households that can lead to missed work and school,” said Andrew Hashikawa, M.D., clinical professor of emergency medicine.
The Centers for Disease Control and Prevention currently advises that kids with congestion, runny noses or other respiratory symptoms get tested for COVID and stay home if positive.
The findings suggest that these recommendations could be revised to align with those of other serious respiratory viruses, like influenza and respiratory syncytial virus, commonly known as RSV.
“While it’s crucial to remain vigilant in our efforts to manage the spread of SARS-CoV-2, it seems that prioritizing testing and extended exclusion periods for children in child care centers may not be the most practical approach, as it can place undue financial burden on families from frequent testing, result in missed work, and hinder children’s critical access to quality care and education,” said Hashikawa.
This study was supported by Merck Investigator Studies Program grant 60418, the Henry L. Hillman Foundation and Flu Lab.

Biomedical engineers at Duke University have developed a method using data from wearable devices such as smartwatches to digitally mimic an entire week’s worth of an individual’s heartbeats. The previous record covered only a few minutes.
Called the Longitudinal Hemodynamic Mapping Framework (LHMF), the approach creates “digital twins” of a specific patient’s blood flow to assess its 3D characteristics. The advance is an important step toward improving on the current gold standard in evaluating the risks of heart disease or heart attack, which uses snapshots of a single moment in time — a challenging approach for a disease that progresses over months to years.
The research was conducted in collaboration with computational scientists at Lawrence Livermore National Laboratory and was published on November 15, 2023, at the International Conference for High Performance Computing, Networking, Storage, and Analysis (SC23). The conference is the leading global conference in the field of high-performance computing.
“Modeling a patient’s 3D blood flow for even a single day would take a century’s worth of compute time on today’s best supercomputers,” said Cyrus Tanade, a PhD candidate in the laboratory of Amanda Randles, the Alfred Winborne and Victoria Stover Mordecai Associate Professor of Biomedical Sciences at Duke. “If we want to capture blood flow dynamics over long periods of time, we need a paradigm-shifting solution in how we approach 3D personalized simulations.”
Over the past decade, researchers have steadily made progress toward accurately modeling the pressures and forces created by blood flowing through an individual’s specific vascular geometry. Randles, one of the leaders in the field, has developed a software package called HARVEY to tackle this challenge using the world’s fastest supercomputers.
One of the most commonly accepted uses of such coronary digital twins is to determine whether or not a patient should receive a stent to treat a plaque or lesion. This computational method is much less invasive than the traditional approach of threading a probe on a guide wire into the artery itself.
While this application requires only a handful of heartbeat simulations and works for a single snapshot in time, the field’s goal is to track pressure dynamics over weeks or months after a patient leaves a hospital. To get even 10 minutes of simulated data on the Duke group’s computer cluster, however, they had to lock it down for four months.

“Obviously, that’s not a workable solution to help patients because of the computing costs and time requirements,” Randles said. “Think of it as taking three weeks to simulate what the weather will be like tomorrow. By the time you predict a rainstorm, the water would have already dried up.”
To ever apply this technology to real-world people over the long term, researchers must find a way to reduce the computational load. The new paper introduces the Longitudinal Hemodynamic Mapping Framework, which cuts what used to take nearly a century of simulation time down to just 24 hours.
“The solution is to simulate the heartbeats in parallel rather than sequentially by breaking the task up amongst many different nodes,” Tanade said. “Conventionally, the tasks are broken up spatially with parallel computing. But here, they’re broken up in time as well.”
For example, one could reasonably assume that the specifics of a coronary flow at 10:00 am on a Monday will likely have little impact on the flow at 2:00 pm on a Wednesday. This allowed the team to develop a method to accurately simulate different chunks of time simultaneously and piece them back together. This breakdown made the pieces small enough to be simulated using cloud computing systems like Amazon Web Services rather than requiring large-scale supercomputers.
To put the mapping framework to the test, researchers used tried and true methods to simulate 750 heartbeats — about 10 minutes of biological time — with the lab’s allotment of computing time on Duke’s computer cluster. Using continuous data on heart rate and electrocardiography from a smartwatch, it produced a complete set of 3D blood flow biomarkers that could correlate with disease progression and adverse events. It took four months to complete and exceeded the existing record by an order of magnitude.
They then compared these results to those produced by LHMF running on Amazon World Services and Summit, an Oak Ridge National Laboratory system, in just a few hours. The errors were negligible, proving that LHMF could work on a useful time scale.

The team then further refined LHMF by introducing a clustering method, further reducing the computational costs and allowing them to track the frictional force of blood on vessel walls — a well-known biomarker of cardiovascular disease — for over 700,000 heartbeats, or one week of continuous activity. These results allowed the group to create a personalized, longitudinal hemodynamic map, showing how the forces vary over time and the percentage of time spent in various vulnerable states.
“The results significantly differed from those obtained over a single heartbeat,” Tanade said. “This demonstrates that capturing longitudinal blood flow metrics provides nuances and information that is otherwise not perceptible with the previous gold standard approach.”
“If we can create a temporal map of wall stress in critical areas like the coronary artery, we could predict the risk of a patient developing atherosclerosis or the progression of such diseases,” Randles added. “This method could allow us to identify cases of heart disease much earlier than is currently possible.”
This work was supported by the National Science Foundation (ACI-1548562, DGE164486), the Department of Energy (DE-AC52-07NA27344, DE-AC05-00OR22725), Amazon Web Services, the National Insitutes of Health (DP1AG082343) and the Coulter Foundation.