scientificamerican--2020-10-14--I Can't Breathe: Asthma, Black Men and the Police

In late September , a New York Supreme Court judge ordered a judicial inquiry into the death of Eric Garner .
In 2014 , Garner 's last words , `` I ca n't breathe , '' caught on tape , became a national rally cry for criminal justice reform in the United States .
Those same words have been spoken by many Black men during their last moments of life while interacting with the police .
It has been known for centuries that black men are more likely to die in police custody than men of other races .
Could @ @ @ @ @ @ @ color of their skin that puts these men at risk ?
Because “ I can ’ t breathe ” is so frequently uttered , one such factor could be asthma .
Asthma , also known as bronchial asthma , is a chronic disease of the airway characterized by intermittent inflammation of the airways , which over time leads to irreversible changes .
An estimated 339 million people globally had asthma in 2016 .
Asthma is a common disease in both children and adults .
People living with asthma frequently have difficulty breathing and @ @ @ @ @ @ @ , and irritants in the air .
Most mortality from asthma occurs in low- and middle-income countries .
Usually , it has a low fatality rate compared to other chronic diseases .
However , in 2014 , African Americans were about three times more likely to die from asthma-related causes than the white population .
Black children are over four times more likely to be admitted to hospital for asthma compared to white children .
African Americans do not only have a higher prevalence of asthma than whites ; they are also plagued @ @ @ @ @ @ @ death .
Multiple factors contribute to this disparity in prevalence rates including socioeconomic status , environmental factors and , plausibly , genetics .
While it is well established that genetic factors strongly affect susceptibility to asthma , it is uncertain the extent to which genetic variations contribute to the disparity in asthma prevalence , morbidity and mortality in different races .
African Americans living in low-income areas have a higher prevalence of asthma and are at a greater risk of asthma-related death .
Evidence suggests that both the African American race and lower @ @ @ @ @ @ @ asthma prevalence , morbidity , and mortality affect the rate of asthma diagnosis in African Americans .
Patients who lack sufficient financial support or health insurance are at greater risk of asthma-related mortality .
The quality of air breathed , which depends on the degree of environmental pollution , contributes to the asthma morbidity of urban residents in the United States like African Americans .
Obesity , which is now pandemic , is another risk factor for bronchial asthma .
These are two issues that particularly plague the Black people of American inner @ @ @ @ @ @ @ care system has many inequalities that negatively impact people of color .
These inequalities lead to gaps in health insurance coverage , poor access to health care with higher mortalities , poor health maintenance behavior due to lack of follow up , and poor provider-patient communication .
The result is poorer outcomes for Black people living with asthma .
Police brutality is inordinately a cause of mortality amongst the people of color .
In the United States , African Americans disproportionately bear the brunt of these brutalities .
Many of them , unfortunately @ @ @ @ @ @ @ health challenges like asthma .
Incidents of police brutality involving all races tend to be targeted at lower-income people who often do not have the financial resources to effectively publicize their complaints of police brutality or to seek redress .
There are no large studies on the knowledge , attitudes and practices of police officers concerning asthma .
It is uncertain that police officers are aware of the symptoms , signs and immediate care that can be given to asthmatic patients in custody until help arrives .
In 2014 there was a case @ @ @ @ @ @ @ kept saying he was asthmatic and could not breathe in Los Angeles .
The police officers could not recognize the warning signs .
That inmate died .
If the officers knew how to recognize the clinical tale-tell signs , he might have been alive today .
The doctor who performed an autopsy on Eric Garner testified that a police officer choked him with enough force that it triggered a `` lethal cascade '' of events , ending in a fatal asthma attack .
How many more Black men have died in the hands @ @ @ @ @ @ @ ?
How many more must die before we make the needed changes ?
There is a need to put an end to racism in the United States and the world at large .
Given that asthma is prevalent in communities of color , the police must embrace better tactics in apprehending , restraining and keeping custody of suspects .
We must de-emphasize the use of force and firearms while we work to improve the health and health care of all communities .

In late September, a New York Supreme Court judge ordered a judicial inquiry into the death of Eric Garner. In 2014, Garner's last words, "I can't breathe," caught on tape, became a national rally cry for criminal justice reform in the United States. Those same words have been spoken by many Black men during their last moments of life while interacting with the police.
It has been known for centuries that black men are more likely to die in police custody than men of other races. Could there be other factors aside from the color of their skin that puts these men at risk? Because “I can’t breathe” is so frequently uttered, one such factor could be asthma.
Asthma, also known as bronchial asthma, is a chronic disease of the airway characterized by intermittent inflammation of the airways, which over time leads to irreversible changes. An estimated 339 million people globally had asthma in 2016.
Asthma is a common disease in both children and adults. People living with asthma frequently have difficulty breathing and wheezing brought on by stress, exertion, and irritants in the air. Most mortality from asthma occurs in low- and middle-income countries. Usually, it has a low fatality rate compared to other chronic diseases.
However, in 2014, African-Americans were about three times more likely to die from asthma-related causes than the white population. Black children are over four times more likely to be admitted to hospital for asthma compared to white children. African-Americans do not only have a higher prevalence of asthma than whites; they are also plagued with higher rates of asthma-related morbidity and death. Multiple factors contribute to this disparity in prevalence rates including socioeconomic status, environmental factors and, plausibly, genetics.
While it is well established that genetic factors strongly affect susceptibility to asthma, it is uncertain the extent to which genetic variations contribute to the disparity in asthma prevalence, morbidity and mortality in different races.
African-Americans living in low-income areas have a higher prevalence of asthma and are at a greater risk of asthma-related death. Evidence suggests that both the African American race and lower socioeconomic status are independent risk factors for asthma prevalence, morbidity, and mortality affect the rate of asthma diagnosis in African-Americans. Patients who lack sufficient financial support or health insurance are at greater risk of asthma-related mortality.
The quality of air breathed, which depends on the degree of environmental pollution, contributes to the asthma morbidity of urban residents in the United States like African-Americans. Obesity, which is now pandemic, is another risk factor for bronchial asthma. These are two issues that particularly plague the Black people of American inner cities.
Unfortunately, the American health care system has many inequalities that negatively impact people of color. These inequalities lead to gaps in health insurance coverage, poor access to health care with higher mortalities, poor health maintenance behavior due to lack of follow up, and poor provider-patient communication. The result is poorer outcomes for Black people living with asthma.
Police brutality is inordinately a cause of mortality amongst the people of color. In the United States, African-Americans disproportionately bear the brunt of these brutalities. Many of them, unfortunately, MAY have some underlying or undiagnosed health challenges like asthma. Incidents of police brutality involving all races tend to be targeted at lower-income people who often do not have the financial resources to effectively publicize their complaints of police brutality or to seek redress.
There are no large studies on the knowledge, attitudes and practices of police officers concerning asthma. It is uncertain that police officers are aware of the symptoms, signs and immediate care that can be given to asthmatic patients in custody until help arrives.
In 2014 there was a case of an asthmatic in police custody who kept saying he was asthmatic and could not breathe in Los Angeles. The police officers could not recognize the warning signs. That inmate died. If the officers knew how to recognize the clinical tale-tell signs, he might have been alive today.
The doctor who performed an autopsy on Eric Garner testified that a police officer choked him with enough force that it triggered a "lethal cascade" of events, ending in a fatal asthma attack. How many more Black men have died in the hands of the police because of their asthma? How many more must die before we make the needed changes?
There is a need to put an end to racism in the United States and the world at large. Given that asthma is prevalent in communities of color, the police must embrace better tactics in apprehending, restraining and keeping custody of suspects. We must de-emphasize the use of force and firearms while we work to improve the health and health care of all communities.


scientificamerican--2020-10-14--Curtain Falls on History's Biggest Arctic Expedition

The largest Arctic science expedition in history came to a close yesterday , as the German research vessel Polarstern sailed into the port at Bremerhaven , Germany .
The Polarstern spent the past year drifting across the Arctic Ocean , frozen into the sea ice at the top of the world .
As it floated across the central Arctic , scientists on board collected myriad data on the Arctic climate system—its clouds , atmosphere , ocean physics and biology , to name a few .
Spearheaded by the Alfred Wegener Institute in Germany and known as the MOSAiC Expedition—short for @ @ @ @ @ @ @ Arctic Climate—the mission involved collaborations from hundreds of scientists at research institutions around the world .
The mission sought to provide an unprecedented opportunity to study the rapidly melting Arctic , currently one of the fastest warming parts of the globe , for a full year from the inside out .
“ I can honestly say it has been a historic milestone for Arctic research , ” Markus Rex , a scientist at the Wegener Institute and the leader of the MOSAiC Expedition , said at a press conference .
“ And we @ @ @ @ @ @ @ and samples that will change Arctic research for a long time.
” The mission wasn ’ t without its challenges .
First , the Polarstern had to find a suitable ice floe to use as its primary research base—a chunk of ice sturdy enough to anchor the ship and to support all the research equipment the scientists needed to use .
Finding the right floe proved easier said than done .
Once the ship was frozen in place , scientists on the Polarstern had to contend with roving polar bears ; dangerous shifts @ @ @ @ @ @ @ cold ; and the long , dark monotony of polar night , a period during winter when the sun doesn ’ t rise at all in the central Arctic .
The expedition also has contended with reports of sexism and sexual harassment on board a support vessel that assisted the Polarstern during the first six weeks of the mission .
Travel restrictions and mandatory quarantines interrupted a personnel exchange originally planned to take place by aircraft .
The exchange ultimately took place by sea , with the Polarstern forced to temporarily leave its @ @ @ @ @ @ @ The pandemic also interrupted a series of research flights scheduled for earlier in the spring after a member of the flight team tested positive for the virus .
Despite the trouble , the mission was able to continue as planned .
The expedition ’ s conclusion comes at the end of a historic season for the melting Arctic .
This summer was marked by unusually high temperatures and low sea ice extent , particularly along the Russian coastline .
In September , as the Polarstern was cruising home , Arctic sea ice cover @ @ @ @ @ @ @ .
The record-breaker was in 2012 .
Scientists hope MOSAiC data will help researchers better understand the ways the Arctic is changing and the reasons it ’ s shifting so rapidly .
The expedition also observed , firsthand , the thinning and melting of the Arctic sea ice .
“ You just need your eyes to see that the Arctic ice is dying , ” Rex noted .
“ It ’ s a region of unique beauty , ” he added .
“ And we should do everything we can to preserve this @ @ @ @ @ @ @ still have to preserve it.
” Reprinted from Climatewire with permission from E & E News .
E & E provides daily coverage of essential energy and environmental news at www.eenews.net .

The largest Arctic science expedition in history came to a close yesterday, as the German research vessel Polarstern sailed into the port at Bremerhaven, Germany.
The Polarstern spent the past year drifting across the Arctic Ocean, frozen into the sea ice at the top of the world. As it floated across the central Arctic, scientists on board collected myriad data on the Arctic climate system—its clouds, atmosphere, ocean physics and biology, to name a few.
Spearheaded by the Alfred Wegener Institute in Germany and known as the MOSAiC Expedition—short for Multidisciplinary Drifting Observatory for the Study of Arctic Climate—the mission involved collaborations from hundreds of scientists at research institutions around the world.
The mission sought to provide an unprecedented opportunity to study the rapidly melting Arctic, currently one of the fastest warming parts of the globe, for a full year from the inside out.
“I can honestly say it has been a historic milestone for Arctic research,” Markus Rex, a scientist at the Wegener Institute and the leader of the MOSAiC Expedition, said at a press conference. “And we come back with a pool of data and samples that will change Arctic research for a long time.”
The mission wasn’t without its challenges.
First, the Polarstern had to find a suitable ice floe to use as its primary research base—a chunk of ice sturdy enough to anchor the ship and to support all the research equipment the scientists needed to use. Finding the right floe proved easier said than done.
Once the ship was frozen in place, scientists on the Polarstern had to contend with roving polar bears; dangerous shifts and cracks in the ice; extreme cold; and the long, dark monotony of polar night, a period during winter when the sun doesn’t rise at all in the central Arctic.
The expedition also has contended with reports of sexism and sexual harassment on board a support vessel that assisted the Polarstern during the first six weeks of the mission.
The coronavirus pandemic brought unexpected logistical challenges this spring.
Travel restrictions and mandatory quarantines interrupted a personnel exchange originally planned to take place by aircraft. The exchange ultimately took place by sea, with the Polarstern forced to temporarily leave its home floe to conduct the swap.
The pandemic also interrupted a series of research flights scheduled for earlier in the spring after a member of the flight team tested positive for the virus.
Despite the trouble, the mission was able to continue as planned.
The expedition’s conclusion comes at the end of a historic season for the melting Arctic. This summer was marked by unusually high temperatures and low sea ice extent, particularly along the Russian coastline.
In September, as the Polarstern was cruising home, Arctic sea ice cover hit its second-lowest extent in recorded history. The record-breaker was in 2012.
Scientists hope MOSAiC data will help researchers better understand the ways the Arctic is changing and the reasons it’s shifting so rapidly.
The expedition also observed, firsthand, the thinning and melting of the Arctic sea ice.
“You just need your eyes to see that the Arctic ice is dying,” Rex noted.
“It’s a region of unique beauty,” he added. “And we should do everything we can to preserve this region and use the small chance we still have to preserve it.”
Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news at www.eenews.net.


scientificamerican--2020-10-14--First Room-Temperature Superconductor Excites and Baffles Scientists

Scientists have created a mystery material that seems to conduct electricity without any resistance at temperatures of up to about 15 °C .
That ’ s a new record for superconductivity , a phenomenon usually associated with very cold temperatures .
The material itself is poorly understood , but it shows the potential of a class of superconductors discovered in 2015 .
The superconductor has one serious limitation , however : it survives only under extremely high pressures , approaching those at the centre of Earth , meaning that it will not have any immediate practical applications .
Still , @ @ @ @ @ @ @ for the development of zero-resistance materials that can function at lower pressures .
Superconductors have a number of technological applications , from magnetic resonance imaging machines to mobile-phone towers , and researchers are beginning to experiment with them in high-performance generators for wind turbines .
But their usefulness is still limited by the need for bulky cryogenics .
Common superconductors work at atmospheric pressures , but only if they are kept very cold .
Even the most sophisticated ones—copper oxide-based ceramic materials—work only below 133 kelvin ( −140 °C ) .
Superconductors that @ @ @ @ @ @ @ big technological impact , for example in electronics that run faster without overheating .
The latest study , published in Nature on 14 October , seems to provide convincing evidence of high-temperature conductivity , says physicist Mikhail Eremets at the Max Planck Institute for Chemistry in Mainz , Germany—although he adds that he would like to see more “ raw data ” from the experiment .
He adds that it vindicates a line of work that he started in 2015 , when his group reported the first high-pressure , high-temperature superconductor—a compound of @ @ @ @ @ @ @ up to −70 °C .
In 2018 , a high-pressure compound of hydrogen and lanthanum was shown to be superconductive at −13 °C .
But the latest result marks the first time this kind of superconductivity has been seen in a compound of three elements rather than two—the material is made of carbon , sulfur and hydrogen .
Adding a third element greatly broadens the combinations that can be included in future experiments searching for new superconductors , says study co-author Ashkan Salamat , a physicist at the University of Nevada , Las @ @ @ @ @ @ @ a whole new region ” of exploration , he says .
Materials that superconduct at high but not extreme pressures could already be put to use , says Maddury Somayazulu , a high-pressure-materials scientist at Argonne National Laboratory in Lemont , Illinois .
The study shows that by “ judiciously choosing the third and fourth element ” in a superconductor , he says , you could in principle bring down its operational pressure .
The work also validates decades-old predictions by theoretical physicist Neil Ashcroft at Cornell University in Ithaca , New York @ @ @ @ @ @ @ temperatures much higher than was thought possible .
“ I think there were very few people outside of the high-pressure community who took him seriously , ” Somayazulu says .
Physicist Ranga Dias at the University of Rochester in New York , along with Salamat and other collaborators , placed a mixture of carbon , hydrogen and sulfur in a microscopic niche they had carved between the tips of two diamonds .
They then triggered chemical reactions in the sample with laser light , and watched as a crystal formed .
As they @ @ @ @ @ @ @ a current passed through the material dropped to zero , indicating that the sample had become superconductive .
Then they increased the pressure , and found that this transition occurred at higher and higher temperatures .
Their best result was a transition temperature of 287.7 kelvin at 267 gigapascals—2.6 million times atmospheric pressure at sea level .
The researchers also found some evidence that the crystal expelled its magnetic field at the transition temperature , a crucial test of superconductivity .
But much about the material remains unknown , researchers warn .
“ @ @ @ @ @ @ @ do , ” says Eremets .
Even the crystal ’ s exact structure and chemical formula are not yet understood .
“ As you go to higher pressures , the sample size gets smaller , ” says Salamat .
“ That ’ s what makes these types of measurements really challenging.
” High-pressure superconductors made of hydrogen and one other element are well understood .
And researchers have made computer simulations of high-pressure mixtures of carbon , hydrogen and sulfur , says Eva Zurek , a computational chemist at the State University of @ @ @ @ @ @ @ says those studies can not explain the exceptionally high superconducting temperatures seen by Dias ’ s group .
“ I am sure , after this manuscript is published , many theoretical and experimental groups will jump on this problem , ” she says .
This article is reproduced with permission and was first published on October 14 2020 .

Scientists have created a mystery material that seems to conduct electricity without any resistance at temperatures of up to about 15 °C. That’s a new record for superconductivity, a phenomenon usually associated with very cold temperatures. The material itself is poorly understood, but it shows the potential of a class of superconductors discovered in 2015.
The superconductor has one serious limitation, however: it survives only under extremely high pressures, approaching those at the centre of Earth, meaning that it will not have any immediate practical applications. Still, physicists hope it could pave the way for the development of zero-resistance materials that can function at lower pressures.
Superconductors have a number of technological applications, from magnetic resonance imaging machines to mobile-phone towers, and researchers are beginning to experiment with them in high-performance generators for wind turbines. But their usefulness is still limited by the need for bulky cryogenics. Common superconductors work at atmospheric pressures, but only if they are kept very cold. Even the most sophisticated ones—copper oxide-based ceramic materials—work only below 133 kelvin (−140 °C). Superconductors that work at room temperature could have a big technological impact, for example in electronics that run faster without overheating.
The latest study, published in Nature on 14 October, seems to provide convincing evidence of high-temperature conductivity, says physicist Mikhail Eremets at the Max Planck Institute for Chemistry in Mainz, Germany—although he adds that he would like to see more “raw data” from the experiment. He adds that it vindicates a line of work that he started in 2015, when his group reported the first high-pressure, high-temperature superconductor—a compound of hydrogen and sulfur that had zero resistance up to −70 °C.
In 2018, a high-pressure compound of hydrogen and lanthanum was shown to be superconductive at −13 °C. But the latest result marks the first time this kind of superconductivity has been seen in a compound of three elements rather than two—the material is made of carbon, sulfur and hydrogen. Adding a third element greatly broadens the combinations that can be included in future experiments searching for new superconductors, says study co-author Ashkan Salamat, a physicist at the University of Nevada, Las Vegas. “We’ve opened a whole new region” of exploration, he says.
Materials that superconduct at high but not extreme pressures could already be put to use, says Maddury Somayazulu, a high-pressure-materials scientist at Argonne National Laboratory in Lemont, Illinois. The study shows that by “judiciously choosing the third and fourth element” in a superconductor, he says, you could in principle bring down its operational pressure.
The work also validates decades-old predictions by theoretical physicist Neil Ashcroft at Cornell University in Ithaca, New York, that hydrogen-rich materials might superconduct at temperatures much higher than was thought possible. “I think there were very few people outside of the high-pressure community who took him seriously,” Somayazulu says.
Mystery material
Physicist Ranga Dias at the University of Rochester in New York, along with Salamat and other collaborators, placed a mixture of carbon, hydrogen and sulfur in a microscopic niche they had carved between the tips of two diamonds. They then triggered chemical reactions in the sample with laser light, and watched as a crystal formed. As they lowered the experimental temperature, resistance to a current passed through the material dropped to zero, indicating that the sample had become superconductive. Then they increased the pressure, and found that this transition occurred at higher and higher temperatures. Their best result was a transition temperature of 287.7 kelvin at 267 gigapascals—2.6 million times atmospheric pressure at sea level.
The researchers also found some evidence that the crystal expelled its magnetic field at the transition temperature, a crucial test of superconductivity. But much about the material remains unknown, researchers warn. “There are a lot of things to do,” says Eremets. Even the crystal’s exact structure and chemical formula are not yet understood. “As you go to higher pressures, the sample size gets smaller,” says Salamat. “That’s what makes these types of measurements really challenging.”
High-pressure superconductors made of hydrogen and one other element are well understood. And researchers have made computer simulations of high-pressure mixtures of carbon, hydrogen and sulfur, says Eva Zurek, a computational chemist at the State University of New York at Buffalo. But she says those studies cannot explain the exceptionally high superconducting temperatures seen by Dias’s group. “I am sure, after this manuscript is published, many theoretical and experimental groups will jump on this problem,” she says.
This article is reproduced with permission and was first published on October 14 2020.


scientificamerican--2020-10-14--How to Avoid COVID while Voting

How to Avoid COVID while Voting

Zeke Dunn of Brooklyn has worked at polling places in nearly every primary and general election since 2017 .
The 39-year-old television producer says doing so provides a way for him to connect with his neighbors and fulfill his civic duty .
But this past June he skipped working in New York State ’ s primary : his partner is pregnant , and he could not risk bringing the novel coronavirus home from a polling place .
As infection rates in New York City declined to low levels over the summer , Dunn decided to work the polls this November @ @ @ @ @ @ @ .
“ I ’ m not crazy about the risks , ” he says .
“ If it ’ s the same as it normally is , it ’ s exactly what they tell you not to do ” to avoid COVID-19 : spending 12- to 14-hour shifts in close proximity to other poll workers , as well as interacting with hundreds of voters , in an old and poorly ventilated building .
Dunn says he is determined to show up despite the risks—and this was not a decision he came to lightly @ @ @ @ @ @ @ older people work these jobs , ” he says .
“ If my being willing to work in a high-contact role means they can be put in a job that has less contact with other people because I came to work that day , I ’ d be happy to make that concession.
” He plans on bringing a face shield and several KN95 masks , which block 95 percent of particles larger than 0.3 micron , on Election Day .
* In June the U.S. Centers for Disease Control and Prevention issued @ @ @ @ @ @ @ COVID-19 at polling places .
The recommendations advise poll workers and voters to adopt many of the same measures public health experts have encouraged in other settings : wearing masks , maintaining social distancing , and disinfecting surfaces and voting equipment .
And people who feel unwell or have recently been exposed to someone with the virus should stay home .
“ It ’ s incumbent upon all election officials at every level to advocate for the recommendations by the CDC for social distancing and mask wearing , ” says C. Perry Brown @ @ @ @ @ @ @ M University ’ s Institute of Public Health .
“ The only way to cut down on transmission is to adhere to the recommendations.
” Brown says he thinks officials should even go so far as to mandate wearing a mask in public .
( Some states already have such mandates , but others do not . )
Brown recommends that voters look for a voting booth that is next to an empty one and bring disinfecting wipes to quickly clean the booth before touching anything in it .
Voters should also pay @ @ @ @ @ @ @ following proper infection control protocols—and speak up if it is not—says Lenora Campbell , dean of the College of Health and Human Sciences at North Carolina Agricultural and Technical State University .
She says poll workers should have a plan for how to deal with any voters who might refuse to wear a mask .
“ It is everyone ’ s responsibility to ensure a safe voting experience , ” Campbell says .
Michael Kohanski , a rhinology fellow at the University of Pennsylvania ’ s Perelman School of Medicine , recommends that @ @ @ @ @ @ @ that are less likely to be crowded and take advantage of early voting options if available .
“ Also , plan a backup time to vote in case you are not comfortable with the wait time at a polling location , ” he says .
“ Take the time to know all the up- and down-ballot candidates and any referendum items that are on your ballot , so you can reduce your indoor time while voting.
” The polling places themselves need to be prepared , too .
In July Lidia Morawska , @ @ @ @ @ @ @ Laboratory for Air Quality and Health at Queensland University of Technology in Australia , co-authored an open letter in Clinical Infectious Diseases urging public health agencies such as the World Health Organization to recognize the possibility of airborne transmission of coronavirus .
That week the WHO updated its guidelines to acknowledge the risk of such transmission .
The CDC made a similar update on October 5 .
Morawska says election officials should maximize airflow at polling places by opening windows or running ventilation systems on high and without recirculation in order to bring @ @ @ @ @ @ @ risk of airborne spread .
“ Local building ventilation engineers should be consulted to identify the best measures , ” Morawska says .
“ If it is not possible to provide adequate ventilation , air purifiers may be installed—and everybody should be wearing masks , particularly the [ polling ] staff , as they may be potentially exposed in these environments for a long time.
” President Donald Trump—who trails his opponent , former vice president Joe Biden , in national polls—has frequently distorted the facts about mail-in voting and has made unfounded @ @ @ @ @ @ @ ballots are safe and secure , but Trump ’ s falsehoods may persuade some Americans to vote in person instead .
Ben Hovland , chairman of the U.S. Election Assistance Commission , says it is important for voters to know they have options .
“ [ Voters should ] think about how they ’ re going to engage and know what their options are , ” he says .
“ Every state has an option to vote by mail or absentee ballot , ” although a handful of states still require an excuse @ @ @ @ @ @ @ People who either want or need to vote in person should go during off hours or take advantage of early voting wherever it is available .
“ Election Day is the last day to vote , ” Hovland says .
“ As we spread out the number of Americans participating over a broader election period , rather than just on Election Day , that helps reduce congestion and helps make a safer voting experience for all Americans.
” Read more about the coronavirus outbreak from Scientific American here .
And read coverage from @ @ @ @ @ @ @ *Editor ’ s Note ( 10/14/20 ) : This sentence has been edited after posting to correct the description of KN95 masks .

Zeke Dunn of Brooklyn has worked at polling places in nearly every primary and general election since 2017. The 39-year-old television producer says doing so provides a way for him to connect with his neighbors and fulfill his civic duty. But this past June he skipped working in New York State’s primary: his partner is pregnant, and he could not risk bringing the novel coronavirus home from a polling place. As infection rates in New York City declined to low levels over the summer, Dunn decided to work the polls this November. But he worries about getting COVID-19.
“I’m not crazy about the risks,” he says. “If it’s the same as it normally is, it’s exactly what they tell you not to do” to avoid COVID-19: spending 12- to 14-hour shifts in close proximity to other poll workers, as well as interacting with hundreds of voters, in an old and poorly ventilated building.
Dunn says he is determined to show up despite the risks—and this was not a decision he came to lightly. “I thought about how many older people work these jobs,” he says. “If my being willing to work in a high-contact role means they can be put in a job that has less contact with other people because I came to work that day, I’d be happy to make that concession.” He plans on bringing a face shield and several KN95 masks, which block 95 percent of particles larger than 0.3 micron, on Election Day.*
In June the U.S. Centers for Disease Control and Prevention issued guidelines to help prevent the spread of COVID-19 at polling places. The recommendations advise poll workers and voters to adopt many of the same measures public health experts have encouraged in other settings: wearing masks, maintaining social distancing, and disinfecting surfaces and voting equipment. And people who feel unwell or have recently been exposed to someone with the virus should stay home.
“It’s incumbent upon all election officials at every level to advocate for the recommendations by the CDC for social distancing and mask wearing,” says C. Perry Brown, an epidemiologist at Florida A&M University’s Institute of Public Health. “The only way to cut down on transmission is to adhere to the recommendations.” Brown says he thinks officials should even go so far as to mandate wearing a mask in public. (Some states already have such mandates, but others do not.) Brown recommends that voters look for a voting booth that is next to an empty one and bring disinfecting wipes to quickly clean the booth before touching anything in it.
Voters should also pay attention to whether their polling place is following proper infection control protocols—and speak up if it is not—says Lenora Campbell, dean of the College of Health and Human Sciences at North Carolina Agricultural and Technical State University. She says poll workers should have a plan for how to deal with any voters who might refuse to wear a mask. “It is everyone’s responsibility to ensure a safe voting experience,” Campbell says.
Michael Kohanski, a rhinologist at the University of Pennsylvania’s Perelman School of Medicine, recommends that voters go to the polls at times that are less likely to be crowded and take advantage of early voting options if available. “Also, plan a backup time to vote in case you are not comfortable with the wait time at a polling location,” he says. “Take the time to know all the up- and down-ballot candidates and any referendum items that are on your ballot, so you can reduce your indoor time while voting.”
The polling places themselves need to be prepared, too. In July Lidia Morawska, an aerosol scientist who directs the International Laboratory for Air Quality and Health at Queensland University of Technology in Australia, co-authored an open letter in Clinical Infectious Diseases urging public health agencies such as the World Health Organization to recognize the possibility of airborne transmission of coronavirus. That week the WHO updated its guidelines to acknowledge the risk of such transmission. The CDC made a similar update on October 5. Morawska says election officials should maximize airflow at polling places by opening windows or running ventilation systems on high and without recirculation in order to bring in fresh outside air and reduce the risk of airborne spread.
“Local building ventilation engineers should be consulted to identify the best measures,” Morawska says. “If it is not possible to provide adequate ventilation, air purifiers may be installed—and everybody should be wearing masks, particularly the [polling] staff, as they may be potentially exposed in these environments for a long time.”
President Donald Trump—who trails his opponent, former vice president Joe Biden, in national polls—has frequently distorted the facts about mail-in voting and has made unfounded claims about potential ballot fraud. Mail-in ballots are safe and secure, but Trump’s falsehoods may persuade some Americans to vote in person instead. Ben Hovland, chairman of the U.S. Election Assistance Commission, says it is important for voters to know they have options. “[Voters should] think about how they’re going to engage and know what their options are,” he says. “Every state has an option to vote by mail or absentee ballot,” although a handful of states still require an excuse, such as age or disability. People who either want or need to vote in person should go during off hours or take advantage of early voting wherever it is available.
“Election Day is the last day to vote,” Hovland says. “As we spread out the number of Americans participating over a broader election period, rather than just on Election Day, that helps reduce congestion and helps make a safer voting experience for all Americans.”
Read more about the coronavirus outbreak from Scientific American here. And read coverage from our international network of magazines here.
*Editor’s Note (10/14/20): This sentence has been edited after posting to correct the description of KN95 masks.


scientificamerican--2020-10-14--Science Pinpoints Global Metal Deposit Locations

Copper , lead and zinc are essential for modern technology 's electronics and batteries .
Demand has skyrocketed , and mining companies are depleting known deposits faster than prospectors can find more .
Now an international team of scientists has discovered a relationship between deposits of these metals and the thickness of the lithosphere ( the earth 's crust and upper mantle ) , providing a reliable way to locate these crucial resources .
The project began by chance , says Mark Hoggard , first author of the new study and a geologist at Harvard University and Columbia University 's @ @ @ @ @ @ @ Czarnota , a researcher at Geoscience Australia , was visiting Harvard and mentioned noticing—and wondering why—metal deposits in northern Australia seemed to align with areas where the lithosphere 's thickness varies .
The research team found that this connection applies globally , hinting at more places to search for the hidden ores .
The study , published in July in Nature Geoscience , comprehensively maps the correlation between known metal deposits and lithosphere thickness and proposes a potential mechanism for that correlation .
The lithosphere can reach up to 300 kilometers below the @ @ @ @ @ @ @ really hard for geophysicists to measure , ” says Maureen Long , a Yale University geophysicist , who was not involved in the study .
To calculate the lithosphere 's thickness , seismometer readings are typically used to record how fast earthquake vibrations travel through the planet .
Long notes , however , that the world 's limited number of earthquakes and seismometers means “ our ability to resolve the earth 's structure is not perfect.
” To create a high-resolution world map of lithosphere thickness , Hoggard and his colleagues combined and @ @ @ @ @ @ @ adding temperature and pressure data from lithospheric rocks carried to the surface in volcanic eruptions .
They found that metal deposits tend to appear where the lithosphere is around 170 kilometers thick .
Theorizing about why , they note that metal 's building blocks are commonly found near the earth 's surface , where they accumulate in basins .
If these basins sit above a part of the lithosphere with the right thickness , the amount of heat that rises from the deeper mantle could set the perfect temperature for the constituents to @ @ @ @ @ @ @ metals has traditionally involved “ boots on the ground , ” Hoggard says , with people widely sampling mineral content in soil or measuring the earth 's magnetic field to find anomalies .
The team 's discovery provides an opportunity to find promising sites remotely ; in fact , mining companies have already begun using this information to inform their searches , Hoggard says .
“ What these authors have done that 's really novel is ... connecting these deeper structures in the upper mantle to something that we can see [ near @ @ @ @ @ @ @ distribution of these metal deposits , ” Long says .
“ It 's a really exciting piece of work .
”

Copper, lead and zinc are essential for modern technology's electronics and batteries. Demand has skyrocketed, and mining companies are depleting known deposits faster than prospectors can find more. Now an international team of scientists has discovered a relationship between deposits of these metals and the thickness of the lithosphere (the earth's crust and upper mantle), providing a reliable way to locate these crucial resources.
The project began by chance, says Mark Hoggard, first author of the new study and a geologist at Harvard University and Columbia University's Lamont-Doherty Earth Observatory. His co-author Karol Czarnota, a researcher at Geoscience Australia, was visiting Harvard and mentioned noticing—and wondering why—metal deposits in northern Australia seemed to align with areas where the lithosphere's thickness varies. The research team found that this connection applies globally, hinting at more places to search for the hidden ores. The study, published in July in Nature Geoscience, comprehensively maps the correlation between known metal deposits and lithosphere thickness and proposes a potential mechanism for that correlation.
The lithosphere can reach up to 300 kilometers below the surface, making its thickness “actually really hard for geophysicists to measure,” says Maureen Long, a Yale University geophysicist, who was not involved in the study. To calculate the lithosphere's thickness, seismometer readings are typically used to record how fast earthquake vibrations travel through the planet. Long notes, however, that the world's limited number of earthquakes and seismometers means “our ability to resolve the earth's structure is not perfect.”
To create a high-resolution world map of lithosphere thickness, Hoggard and his colleagues combined and calibrated existing regional and global models, adding temperature and pressure data from lithospheric rocks carried to the surface in volcanic eruptions. They found that metal deposits tend to appear where the lithosphere is around 170 kilometers thick. Theorizing about why, they note that metal's building blocks are commonly found near the earth's surface, where they accumulate in basins. If these basins sit above a part of the lithosphere with the right thickness, the amount of heat that rises from the deeper mantle could set the perfect temperature for the constituents to concentrate into metal deposits.
Finding these metals has traditionally involved “boots on the ground,” Hoggard says, with people widely sampling mineral content in soil or measuring the earth's magnetic field to find anomalies. The team's discovery provides an opportunity to find promising sites remotely; in fact, mining companies have already begun using this information to inform their searches, Hoggard says.
“What these authors have done that's really novel is ... connecting these deeper structures in the upper mantle to something that we can see [near] the surface, which is the distribution of these metal deposits,” Long says. “It's a really exciting piece of work.”


scientificamerican--2020-10-15--How Speech-Recognition Software Discriminates against Minority Voices

“ Clow-dia , ” I say once .
Twice .
A third time .
Defeated , I say the Americanized version of my name : “ Claw-dee-ah.
” Finally , Siri recognizes it .
Having to adapt our way of speaking to interact with speech-recognition technologies is a familiar experience for people whose first language is not English or who do not have conventionally American-sounding names .
I have now stopped using Siri , Apple 's voice-based virtual assistant , because of it .
The growth of this tech in the past decade—not just Siri but Alexa and Cortana and @ @ @ @ @ @ @ racial bias .
One recent study , published in the Proceedings of the National Academy of Sciences USA , showed that speech-recognition programs are biased against Black speakers .
On average , the authors found , all five programs from leading technology companies , including Apple and Microsoft , showed significant race disparities ; they were roughly twice as likely to incorrectly transcribe audio from Black speakers compared with white speakers .
This effectively censors voices that are not part of the “ standard ” languages or accents used to create these technologies @ @ @ @ @ @ @ negotiate with these devices unless I adapt my language patterns , ” says Halcyon Lawrence , an assistant professor of technical communication and information design at Towson University , who was not part of the study .
“ That is problematic.
” For Lawrence , who has a Trinidad and Tobagonian accent , or for me as a Puerto Rican , part of our identity comes from speaking a particular language , having an accent or using a set of speech forms such as African American Vernacular English ( AAVE ) .
Having @ @ @ @ @ @ @ an identity to be able to be recognized is inherently cruel .
The inability to be understood impacts other marginalized communities , such as people with visual or movement disabilities who rely on voice recognition and speech-to-text tools , says Allison Koenecke , a computational graduate student and first author of the PNAS study .
For someone with a disability who is dependent on these technologies , being misunderstood could have serious consequences .
There are probably many culprits for these disparities , but Koenecke points to the most likely : the data @ @ @ @ @ @ @ from white , native speakers of American English .
By using databases that are narrow both in the words that are used and how they are said , training systems exclude accents and other ways of speaking that have unique linguistic features .
Humans , presumably including those who create these technologies , have accent and language biases .
For example , research shows that the presence of an accent affects whether jurors find people guilty and whether patients find their doctors competent .
Recognizing these biases would be an important way to @ @ @ @ @ @ @ developing more inclusive technology takes time , effort and money , and often the decision to invest these are market-driven .
( In response to several queries , only a Google spokesperson responded in time for publication , saying , in part , “ We 've been working on the challenge of accurately recognizing variations of speech for several years and will continue to do so.
” ) Safiya Noble , an associate professor of information studies at the University of California , Los Angeles , admits that it 's a tricky challenge @ @ @ @ @ @ @ says Noble , who was not involved in the study .
“ But that does n't mean that companies should n't strive to decrease bias and disparities.
” To do this , they need the input of humanists and social scientists who understand how language actually works .
From the tech side , feeding more diverse training data into the programs could close this gap , Koenecke says .
Noble adds that tech companies should also test their products more widely and have more diverse workforces so people from different backgrounds and perspectives @ @ @ @ @ @ @ technologies .
Koenecke suggests that automated speech-recognition companies use the PNAS study as a preliminary benchmark and keep using it to assess their systems over time .
In the meantime , many of us will continue to struggle between identity and being understood when interacting with Alexa , Cortana or Siri .
But Lawrence chooses identity every time : “ I 'm not switching , ” she says .
“ I 'm not doing it .
”

“Clow-dia,” I say once. Twice. A third time. Defeated, I say the Americanized version of my name: “Claw-dee-ah.” Finally, Siri recognizes it. Having to adapt our way of speaking to interact with speech-recognition technologies is a familiar experience for people whose first language is not English or who do not have conventionally American-sounding names. I have now stopped using Siri, Apple's voice-based virtual assistant, because of it.
The growth of this tech in the past decade—not just Siri but Alexa and Cortana and others—has unveiled a problem in it: racial bias. One recent study, published in the Proceedings of the National Academy of Sciences USA, showed that speech-recognition programs are biased against Black speakers. On average, the authors found, all five programs from leading technology companies, including Apple and Microsoft, showed significant race disparities; they were roughly twice as likely to incorrectly transcribe audio from Black speakers compared with white speakers.
This effectively censors voices that are not part of the “standard” languages or accents used to create these technologies. “I don't get to negotiate with these devices unless I adapt my language patterns,” says Halcyon Lawrence, an assistant professor of technical communication and information design at Towson University, who was not part of the study. “That is problematic.” For Lawrence, who has a Trinidad and Tobagonian accent, or for me as a Puerto Rican, part of our identity comes from speaking a particular language, having an accent or using a set of speech forms such as African American Vernacular English (AAVE). Having to change such an integral part of an identity to be able to be recognized is inherently cruel.
The inability to be understood impacts other marginalized communities, such as people with visual or movement disabilities who rely on voice recognition and speech-to-text tools, says Allison Koenecke, a computational graduate student and first author of the PNAS study. For someone with a disability who is dependent on these technologies, being misunderstood could have serious consequences. There are probably many culprits for these disparities, but Koenecke points to the most likely: the data used for training, which are predominantly from white, native speakers of American English. By using databases that are narrow both in the words that are used and how they are said, training systems exclude accents and other ways of speaking that have unique linguistic features. Humans, presumably including those who create these technologies, have accent and language biases. For example, research shows that the presence of an accent affects whether jurors find people guilty and whether patients find their doctors competent.
Recognizing these biases would be an important way to avoid implementing them in technologies. But developing more inclusive technology takes time, effort and money, and often the decision to invest these are market-driven. (In response to several queries, only a Google spokesperson responded in time for publication, saying, in part, “We've been working on the challenge of accurately recognizing variations of speech for several years and will continue to do so.”)
Safiya Noble, an associate professor of information studies at the University of California, Los Angeles, admits that it's a tricky challenge. “Language is contextual,” says Noble, who was not involved in the study. “But that doesn't mean that companies shouldn't strive to decrease bias and disparities.” To do this, they need the input of humanists and social scientists who understand how language actually works.
From the tech side, feeding more diverse training data into the programs could close this gap, Koenecke says. Noble adds that tech companies should also test their products more widely and have more diverse workforces so people from different backgrounds and perspectives can directly influence the design of speech technologies. Koenecke suggests that automated speech-recognition companies use the PNAS study as a preliminary benchmark and keep using it to assess their systems over time.
In the meantime, many of us will continue to struggle between identity and being understood when interacting with Alexa, Cortana or Siri. But Lawrence chooses identity every time: “I'm not switching,” she says. “I'm not doing it.”


scientificamerican--2020-10-15--Physician-Politicians Tout Medical Credentials in Key U.S. Congressional Races

Hiral Tipirneni spent nearly a decade working in emergency medicine in Arizona .
She started out 23 years ago at Banner Good Samaritan Hospital in downtown Phoenix , treating patients with broken bones , failing hearts and a lot of other problems .
Then some health tragedies hit home .
“ Our family suffered a great loss to cancer : my mom and nephew , ” she says .
Tipirneni felt she should do something to combat the illness that took her loved ones .
In 2010 she accepted a position as a scientific review officer for the Society of @ @ @ @ @ @ @ management group overseeing cancer studies .
But when Donald Trump was elected U.S. president in 2016 , “ I was terrified of the threats of ‘ repeal and replace ’ of the Affordable Care Act , ” she recalls .
“ After years spent in the ER seeing thousands of families come through with no access to health care ... , it was too much to stand by .
That prompted me to throw my hat into the ring.
” Following a failed bid for a seat in the House of Representatives during @ @ @ @ @ @ @ a Democrat , is running for the state ’ s sixth congressional district in the November 3 election .
The district includes part of Maricopa county and some Phoenix suburbs .
She is challenging Republican incumbent David Schweikert , a former businessman now serving his fourth consecutive term in that seat and his fifth overall in the House .
Republicans have held this seat since 1995 .
But in the middle of a pandemic that has killed more than 5,700 Arizonans—more than 3,400 of them in Maricopa County—Tipirneni is hoping her medical background @ @ @ @ @ @ @ We see decision after decision being made not based on data , not based on science , but rather on political expediency , partisanship—or based on the election calendar , ” she says .
“ That ’ s blasphemy for a scientist or physician.
” Tipirneni is one of several candidates with a scientific background running for federal office this fall .
The election will serve as the political climax to a year that saw raging wildfires fueled by climate change , devastating hurricanes and the COVID pandemic , which has claimed the @ @ @ @ @ @ @ toll medical experts say has been driven high by politicians who have ignored public health guidelines .
Given these catastrophic outcomes , Tipirneni and another physician-politician , Barbara Bollier , who is running for an open U.S. Senate seat in Kansas , hope voters will be swayed by candidates who tout respect for science when making policy decisions .
Both races are incredibly close , with recent polls showing Tipirneni and Bollier either ahead or behind their opponents by only a few percentage points .
The stakes are high .
If Democrats manage @ @ @ @ @ @ @ , along with achieving a few other wins , they will gain control of the Senate .
And Tipirneni winning in Arizona could help them hold onto their majority in the House .
Both outcomes would put Democrats in charge of the two houses of Congress , ending the current split with Republicans .
“ After a big military conflict , you often see a surge in military veterans running for office , ” says Eitan Hersh , a political scientist at Tufts University .
“ Following the 2016 election , more women @ @ @ @ @ @ @ midterms . ]
And after COVID-19 , it ’ s not surprising that some physicians would run for office , feeling like their voices need to be heard .
If there ’ s a big surge in doctors running , some will get in.
” In Arizona , Tipirneni has raised more than $ 1 million more in campaign funding than Schweikert .
Generally , a September poll by the Arizona Policy Lab found that science-based approaches to fighting COVID , including mask mandates , were popular among Arizonan voters in both parties @ @ @ @ @ @ @ for how Donald Trump and how Republican governor Doug Ducey have handled COVID-19 , ” says Samara Klar , a political scientist at the University of Arizona .
Ducey , for instance , pushed hard for the resumption of activities with few restrictions in the spring , only to see a surge in COVID cases that forced another shutdown .
Klar adds that polls show that “ at the same time , there ’ s been strong support for how local mayors have dealt with it.
” This , she says , could @ @ @ @ @ @ @ .
Schweikert did not respond to requests for comment from Scientific American .
He has been a vocal supporter of the use of masks , however .
In a July tweet , he encouraged his constituents to “ continue wearing our face coverings when out in public , or when in close proximity to others.
” He also advocated for increased access to federal resources to purchase items such as personal protective equipment ( PPE ) .
“ We ... ask the U.S. Department of Health and Human Resources ( HHS ) and @ @ @ @ @ @ @ ) for an immediate influx of federal resources to combat the virus , through increased testing , contact tracing , personal protective equipment ( PPE ) , staffing support , and emergency funding for local initiatives to respond to and mitigate further spread , ” he and four other Arizonan congresspeople wrote in a letter in August .
But despite Schweikert ’ s support for public health practices , his messages may be tainted by the president ’ s handling of the pandemic .
Recent polls show that Republicans have begun to drift @ @ @ @ @ @ @ Trump , 49 percent to 41 percent , in Arizona .
On energy policy , Schweikert and Tipirneni ’ s messaging diverges .
“ Arizona should be leading the charge on a renewable energy economy , ” Tipirneni says , adding that those energy sources are key to reducing the impacts of climate change .
“ But we have leaders like my opponent , who has stood at every opportunity to block those kinds of initiatives because he is someone who still takes money from fossil fuels and is driven by party leadership @ @ @ @ @ @ @ ” Schweikert ’ s platform promotes an “ ‘ all of the above ’ energy solution , ” tapping into “ traditional energy reserves ” but also expanding renewable energy resources .
In his time in the House , however , he has taken dozens of antienvironmental positions , including voting against protecting Chaco Canyon from oil and gas drilling , banning offshore drilling in the Atlantic and Pacific Ocean , and implementing methane pollution safeguards .
Democrats have not cornered the market on physician candidates .
In Kansas , Roger Marshall , @ @ @ @ @ @ @ an ob-gyn , is running against Bollier , a Democratic former anesthesiologist , creating a rare doctor-doctor duel .
But despite sharing a medical background , the two appear diametrically opposed on issues pertaining to science .
Bollier had been a Republican until she switched parties in 2018 , and has served in the state ’ s legislature for a decade .
She acknowledges that climate change is caused by people and has committed to greatly expand wind energy in the state .
In contrast , Marshall has rejected the scientific consensus on @ @ @ @ @ @ @ m not sure that there is even climate change ” in 2017 .
His campaign Web site makes no mention of the issue .
Bollier “ is a scientist and data nerd at heart , ” says her communications director Alexandra De Luca .
“ Barbara follows science .
She always listens to the experts .
Roger Marshall does not .
If Roger Marshall followed science , he wouldn ’ t be holding events indoors , shaking hands with vulnerable Kansans.
” Bollier ’ s campaign , De Luca says , held more @ @ @ @ @ @ @ this summer .
And Bollier only began in-person campaigning in late August—always outdoors and physically distanced .
Marshall did push for additional coronavirus testing kits for Kansas in April , saying that more testing could keep workers at large meat processing plants on the job—processors in Kansas had already had big outbreaks of the virus .
But Marshall differed from much medical research in May , when he told the Wall Street Journal he was taking the antimalarial drug hydroxychloroquine as a preventive measure against COVID-19 .
Though touted by President Trump as @ @ @ @ @ @ @ the medication was always sparse , and emergency authorization for it was revoked by the U.S. Food and Drug Administration in June .
In the May article , Marshall added that he “ would encourage any person over the age of 65 or with an underlying medical condition to talk to their own physician about taking hydroxychloroquine.
” In September , Marshall wrote a Facebook post suggesting that most COVID-19 deaths were from other ailments ; Facebook deleted the post .
His campaign did not respond to Scientific American ’ s requests for @ @ @ @ @ @ @ his medical credentials : he has given himself the nickname “ Doc , ” and his Twitter username is @ RogerMarshallMD .
He also has used his medical skills to help in the pandemic , he says .
In late April , Marshall tweeted , “ Today , I began treating COVID-19 patients on a volunteer basis in Wyandotte County , KS .
I began the process of onboarding several days ago , and have started in the clinic today.
” Thus far , polls show the race between Bollier and Marshall “ @ @ @ @ @ @ @ , ” with all of them falling within the margin of error , says Don Haider-Markel , a political scientist at the University of Kansas .
Despite electing a Democratic governor in 2018 , he says , the state still leans conservative , and to have a competitive Democrat in the running is “ not typical , to say the least.
” After the economy and jobs , Haider-Markel observes , Kansans care most about the handling of the pandemic in this election cycle—ranking that issue ahead of education and civil unrest .
@ @ @ @ @ @ @ Democrats are trying to focus attention on health care , he adds , but “ it ’ s not clear that voters are prioritizing that more than last month.
” Bollier is likely succeeding at picking up moderate Republican and independent voters , Haider-Markel says .
Trump ’ s election alienated many Republican women in the suburbs in eastern Kansas and around Wichita who have likely switched to supporting the Democratic candidate , he explains .
“ I think Bollier ’ s messaging on evidence-based policy will resonate with them—but they were already @ @ @ @ @ @ @ to begin with.
” Patti Doll , a 67-year-old former social worker who lives in Wichita , has been following the Senate race closely .
She is a Democrat and says the pandemic has made her pay greater attention to candidates ’ adherence to scientific guidelines .
Marshall , she notes with dissatisfaction , is still campaigning without a mask in October .
“ It ’ s his job to lead and show people that this is important , ” she says .
“ If it was switched , and it was Bollier @ @ @ @ @ @ @ was a Democrat , I would vote across party lines in this situation .
It doesn ’ t matter to me .
Follow the science .
”

Hiral Tipirneni spent nearly a decade working in emergency medicine in Arizona. She started out 23 years ago at Banner Good Samaritan Hospital in downtown Phoenix, treating patients with broken bones, failing hearts and a lot of other problems. Then some health tragedies hit home. “Our family suffered a great loss to cancer: my mom and nephew,” she says. Tipirneni felt she should do something to combat the illness that took her loved ones. In 2010 she accepted a position as a scientific review officer for the Society of Research Administrators International, a global research management group overseeing cancer studies.
But when Donald Trump was elected U.S. president in 2016, “I was terrified of the threats of ‘repeal and replace’ of the Affordable Care Act,” she recalls. “After years spent in the ER seeing thousands of families come through with no access to health care..., it was too much to stand by. That prompted me to throw my hat into the ring.”
Following a failed bid for a seat in the House of Representatives during a 2018 special election, Tipirneni, a Democrat, is running for the state’s sixth congressional district in the November 3 election. The district includes part of Maricopa county and some Phoenix suburbs. She is challenging Republican incumbent David Schweikert, a former businessman now serving his fourth consecutive term in that seat and his fifth overall in the House.
Republicans have held this seat since 1995. But in the middle of a pandemic that has killed more than 5,700 Arizonans—more than 3,400 of them in Maricopa County—Tipirneni is hoping her medical background will carry weight with voters. “We see decision after decision being made not based on data, not based on science, but rather on political expediency, partisanship—or based on the election calendar,” she says. “That’s blasphemy for a scientist or physician.”
Tipirneni is one of several candidates with a scientific background running for federal office this fall. The election will serve as the political climax to a year that saw raging wildfires fueled by climate change, devastating hurricanes and the COVID pandemic, which has claimed the lives of more than 216,000 Americans—a death toll medical experts say has been driven high by politicians who have ignored public health guidelines. Given these catastrophic outcomes, Tipirneni and another physician-politician, Barbara Bollier, who is running for an open U.S. Senate seat in Kansas, hope voters will be swayed by candidates who tout respect for science when making policy decisions.
Both races are incredibly close, with recent polls showing Tipirneni and Bollier either ahead or behind their opponents by only a few percentage points. The stakes are high. If Democrats manage to flip a Senate seat in Kansas, along with achieving a few other wins, they will gain control of the Senate. And Tipirneni winning in Arizona could help them hold onto their majority in the House. Both outcomes would put Democrats in charge of the two houses of Congress, ending the current split with Republicans.
“After a big military conflict, you often see a surge in military veterans running for office,” says Eitan Hersh, a political scientist at Tufts University. “Following the 2016 election, more women ran than ever before [in the midterms.] And after COVID-19, it’s not surprising that some physicians would run for office, feeling like their voices need to be heard. If there’s a big surge in doctors running, some will get in.”
Grand Battle in the Grand Canyon State
In Arizona, Tipirneni has raised more than $1 million more in campaign funding than Schweikert. Generally, a September poll by the Arizona Policy Lab found that science-based approaches to fighting COVID, including mask mandates, were popular among Arizonan voters in both parties. “There is really strong disapproval for how Donald Trump and how Republican governor Doug Ducey have handled COVID-19,” says Samara Klar, a political scientist at the University of Arizona. Ducey, for instance, pushed hard for the resumption of activities with few restrictions in the spring, only to see a surge in COVID cases that forced another shutdown. Klar adds that polls show that “at the same time, there’s been strong support for how local mayors have dealt with it.” This, she says, could hurt the Republicans’ chances in Arizona.
Schweikert did not respond to requests for comment from Scientific American. He has been a vocal supporter of the use of masks, however. In a July tweet, he encouraged his constituents to “continue wearing our face coverings when out in public, or when in close proximity to others.” He also advocated for increased access to federal resources to purchase items such as personal protective equipment (PPE). “We ... ask the U.S. Department of Health and Human Resources (HHS) and the Federal Emergency Management Agency (FEMA) for an immediate influx of federal resources to combat the virus, through increased testing, contact tracing, personal protective equipment (PPE), staffing support, and emergency funding for local initiatives to respond to and mitigate further spread,” he and four other Arizonan congresspeople wrote in a letter in August. But despite Schweikert’s support for public health practices, his messages may be tainted by the president’s handling of the pandemic. Recent polls show that Republicans have begun to drift away from Trump. Biden currently leads Trump, 49 percent to 41 percent, in Arizona.
On energy policy, Schweikert and Tipirneni’s messaging diverges. “Arizona should be leading the charge on a renewable energy economy,” Tipirneni says, adding that those energy sources are key to reducing the impacts of climate change. “But we have leaders like my opponent, who has stood at every opportunity to block those kinds of initiatives because he is someone who still takes money from fossil fuels and is driven by party leadership to invest in other forms of energy.”
Schweikert’s platform promotes an “‘all of the above’ energy solution,” tapping into “traditional energy reserves” but also expanding renewable energy resources. In his time in the House, however, he has taken dozens of antienvironmental positions, including voting against protecting Chaco Canyon from oil and gas drilling, banning offshore drilling in the Atlantic and Pacific Ocean, and implementing methane pollution safeguards.
The Kansas Contest
Democrats have not cornered the market on physician candidates. In Kansas, Roger Marshall, a Republican representative in the House and an ob-gyn, is running against Bollier, a Democratic former anesthesiologist, creating a rare doctor-doctor duel. But despite sharing a medical background, the two appear diametrically opposed on issues pertaining to science.
Bollier had been a Republican until she switched parties in 2018 and has served in the state’s legislature for a decade. She acknowledges that climate change is caused by people and has committed to greatly expand wind energy in the state. In contrast, Marshall has rejected the scientific consensus on climate, stating, “I’m not sure that there is even climate change” in 2017. His campaign Web site makes no mention of the issue.
Bollier “is a scientist and data nerd at heart,” says her communications director Alexandra De Luca. “Barbara follows science. She always listens to the experts. Roger Marshall does not. If Roger Marshall followed science, he wouldn’t be holding events indoors, shaking hands with vulnerable Kansans.” Bollier’s campaign, De Luca says, held more than 40 virtual town halls on Zoom this summer. And Bollier only began in-person campaigning in late August—always outdoors and physically distanced.
Marshall did push for additional coronavirus testing kits for Kansas in April, saying that more testing could keep workers at large meat processing plants on the job—processors in Kansas had already had big outbreaks of the virus. But Marshall differed from much medical research in May, when he told the Wall Street Journal he was taking the antimalarial drug hydroxychloroquine as a preventive measure against COVID-19. Though touted by President Trump as a possible cure, the data supporting the medication was always sparse, and emergency authorization for it was revoked by the U.S. Food and Drug Administration in June. In the May article, Marshall added that he “would encourage any person over the age of 65 or with an underlying medical condition to talk to their own physician about taking hydroxychloroquine.” In September Marshall wrote a Facebook post suggesting that most COVID-19 deaths were from other ailments; Facebook deleted the post. His campaign did not respond to Scientific American’s requests for an interview.
Marshall regularly plays up his medical credentials: he has given himself the nickname “Doc,” and his Twitter username is @RogerMarshallMD. He also has used his medical skills to help in the pandemic, he says. In late April, Marshall tweeted, “Today, I began treating COVID-19 patients on a volunteer basis in Wyandotte County, KS. I began the process of onboarding several days ago, and have started in the clinic today.”
Thus far, polls show the race between Bollier and Marshall “as surprisingly close for a Republican state,” with all of them falling within the margin of error, says Don Haider-Markel, a political scientist at the University of Kansas. Despite electing a Democratic governor in 2018, he says, the state still leans conservative, and to have a competitive Democrat in the running is “not typical, to say the least.” After the economy and jobs, Haider-Markel observes, Kansans care most about the handling of the pandemic in this election cycle—ranking that issue ahead of education and civil unrest. In the final days of campaigning, Democrats are trying to focus attention on health care, he adds, but “it’s not clear that voters are prioritizing that more than last month.”
Bollier is likely succeeding at picking up moderate Republican and independent voters, Haider-Markel says. Trump’s election alienated many Republican women in the suburbs in eastern Kansas and around Wichita who have likely switched to supporting the Democratic candidate, he explains. “I think Bollier’s messaging on evidence-based policy will resonate with them—but they were already going to be more attracted to her to begin with.”
Patti Doll, a 67-year-old former social worker who lives in Wichita, has been following the Senate race closely. She is a Democrat and says the pandemic has made her pay greater attention to candidates’ adherence to scientific guidelines. Marshall, she notes with dissatisfaction, is still campaigning without a mask in October. “It’s his job to lead and show people that this is important,” she says. “If it was switched, and it was Bollier who was a Republican, and Marshall was a Democrat, I would vote across party lines in this situation. It doesn’t matter to me. Follow the science.”


scientificamerican--2020-10-15--Why Social Media Make Us More Polarized, and How to Fix It

Every time I log onto Facebook , I brace myself .
My newsfeed—like everyone else ’ s I know—is filled with friends , relatives and acquaintances arguing about COVID-19 , masks and Trump .
Facebook has become a battleground among partisan “ echo chambers.
” But what is it about social media that makes people so polarized ?
To find out , my colleagues and I ran a social media experiment in which we divided Democrats and Republicans into “ echo chambers , ” or small groups whose members affiliate with just one political party .
Next , we picked @ @ @ @ @ @ @ of : immigration , gun control and unemployment .
We asked each participant what they thought of those issues , then let people talk to each other and revise their opinions .
After several rounds of discussion and revision , we evaluated each group ’ s viewpoint .
To our surprise , the echo chambers did not make people more polarized , but less .
After interacting in social networks with likeminded peers , each echo chamber—Republican and Democrat—had adopted a more moderate opinion .
All groups independently moved toward opinions that were @ @ @ @ @ @ @ opposite ” side of the political spectrum .
As a scientist who studies networks , I ’ m used to being surprised by the results of my experiments .
Technology has allowed us to access more information and data about people ’ s social networks , debunking many of our assumptions about human behavior .
But even my team at the Network Dynamics Group was surprised : Why did our social media experiment find the opposite of what happens all the time in the real world of social media ?
The answer lies @ @ @ @ @ @ @ “ influencers.
” By now , most of us have a fairly specific understanding of what an “ influencer ” is .
The word conjures up a young , wealthy person whose lifestyle is sponsored by brands like Instagram , TikTok or YouTube .
But the word has a very specific network science meaning .
In social media , networks tend to be centralized : a small number of people , or perhaps just one person , at the “ center ” of the network is connected to lots of other people in @ @ @ @ @ @ @ the periphery of the social network have only a modest number of connections , while the few—the so-called “ influencers ” —at the center of the network are connected to nearly everyone .
This puts these people into the powerful position of being able to exert a disproportionate level of “ influence ” over the group .
By contrast , the networks used in our study were “ egalitarian ” —the opposite of centralized .
In an egalitarian network , everyone has an equal number of contacts , and therefore influence , throughout @ @ @ @ @ @ @ an egalitarian network is that new ideas and opinions can emerge from anywhere in the community and spread to everyone .
But in centralized networks—like many social media sites—ideas are filtered through , or sometimes even blocked , by a powerful social influencer .
As I show in my upcoming book Change : The Power in the Periphery to Make Big Things Happen , centralized and egalitarian networks have very different effects on partisan bias and the acceptance of new ideas .
In a centralized echo chamber , if the influencer at the @ @ @ @ @ @ @ partisan bias , it can become amplified throughout the entire group .
But in egalitarian networks , ideas spread based on their quality , and not the person touting them .
There is a lot of wisdom in network peripheries , in regular people with good ideas .
When the social network enables those people to talk with each other , new thinking that challenge a group ’ s biases can take hold and spread .
To see how egalitarian networks might affect other kinds of contentious issues , we conducted another experiment @ @ @ @ @ @ @ of cigarette smoking .
The effects were the same as with the partisan study .
Both groups moved toward a more accurate understanding of smoking risks .
Moreover , when participants were interviewed after the study , they reported having developed higher opinions of the other .
Both smokers and nonsmokers had come to view the other group as more reasonable and trustworthy about the risks of smoking .
But the exchange of ideas and eradication of bias only works when networks are egalitarian .
The problem of partisan bias is exacerbated on @ @ @ @ @ @ @ organized around a few key influencers .
This feature of social media is one of the main reasons why misinformation and fake news has become so pervasive .
In centralized networks , biased influencers have a disproportionate impact on their community—enabling small rumors and suppositions to become amplified into widespread misconceptions and false beliefs .
Our country has been struggling with bias and polarization a long time .
But the issue is about to get much more urgent .
As the debate over COVID-19 vaccination heats up , biased viewpoints will undoubtedly become @ @ @ @ @ @ @ their center .
If we want to eradicate , or at least lessen the impacts of the coronavirus , we should rethink how our online communities operate .
The solution to the problem of vaccine hesitancy is not to eliminate echo chambers .
Rather , it is to be intentional about the social networks in those echo chambers .
The more equity in people ’ s social networks , the less biased and more informed groups will become—even when those groups start off with highly partisan opinions .

Every time I log onto Facebook, I brace myself. My newsfeed—like everyone else’s I know—is filled with friends, relatives and acquaintances arguing about COVID-19, masks and Trump. Facebook has become a battleground among partisan “echo chambers.” But what is it about social media that makes people so polarized?
To find out, my colleagues and I ran a social media experiment in which we divided Democrats and Republicans into “echo chambers,” or small groups whose members affiliate with just one political party. Next, we picked the most polarizing issues we could think of: immigration, gun control and unemployment. We asked each participant what they thought of those issues, then let people talk to each other and revise their opinions. After several rounds of discussion and revision, we evaluated each group’s viewpoint.
To our surprise, the echo chambers did not make people more polarized, but less. After interacting in social networks with likeminded peers, each echo chamber—Republican and Democrat—had adopted a more moderate opinion. All groups independently moved toward opinions that were closer to the opinions on the “opposite” side of the political spectrum.
As a scientist who studies networks, I’m used to being surprised by the results of my experiments. Technology has allowed us to access more information and data about people’s social networks, debunking many of our assumptions about human behavior. But even my team at the Network Dynamics Group was surprised: Why did our social media experiment find the opposite of what happens all the time in the real world of social media?
The answer lies in something social media has amplified: “influencers.”
By now, most of us have a fairly specific understanding of what an “influencer” is. The word conjures up a young, wealthy person whose lifestyle is sponsored by brands like Instagram, TikTok or YouTube. But the word has a very specific network science meaning. In social media, networks tend to be centralized: a small number of people, or perhaps just one person, at the “center” of the network is connected to lots of other people in the “periphery.” The multitudes in the periphery of the social network have only a modest number of connections, while the few—the so-called “influencers”—at the center of the network are connected to nearly everyone. This puts these people into the powerful position of being able to exert a disproportionate level of “influence” over the group.
By contrast, the networks used in our study were “egalitarian”—the opposite of centralized. In an egalitarian network, everyone has an equal number of contacts, and therefore influence, throughout the network.
The key feature of an egalitarian network is that new ideas and opinions can emerge from anywhere in the community and spread to everyone. But in centralized networks—like many social media sites—ideas are filtered through, or sometimes even blocked, by a powerful social influencer. As I show in my upcoming book Change: The Power in the Periphery to Make Big Things Happen, centralized and egalitarian networks have very different effects on partisan bias and the acceptance of new ideas.
In a centralized echo chamber, if the influencer at the middle shows even a small amount of partisan bias, it can become amplified throughout the entire group. But in egalitarian networks, ideas spread based on their quality, and not the person touting them. There is a lot of wisdom in network peripheries, in regular people with good ideas. When the social network enables those people to talk with each other, new thinking that challenge a group’s biases can take hold and spread.
To see how egalitarian networks might affect other kinds of contentious issues, we conducted another experiment with smokers and nonsmokers discussing the risks of cigarette smoking. The effects were the same as with the partisan study. Both groups moved toward a more accurate understanding of smoking risks. Moreover, when participants were interviewed after the study, they reported having developed higher opinions of the other. Both smokers and nonsmokers had come to view the other group as more reasonable and trustworthy about the risks of smoking. But the exchange of ideas and eradication of bias only works when networks are egalitarian.
The problem of partisan bias is exacerbated on social media because online networks are often organized around a few key influencers. This feature of social media is one of the main reasons why misinformation and fake news has become so pervasive. In centralized networks, biased influencers have a disproportionate impact on their community—enabling small rumors and suppositions to become amplified into widespread misconceptions and false beliefs.
Our country has been struggling with bias and polarization a long time. But the issue is about to get much more urgent. As the debate over COVID-19 vaccination heats up, biased viewpoints will undoubtedly become entrenched in communities with powerful influencers at their center. If we want to eradicate, or at least lessen the impacts of the coronavirus, we should rethink how our online communities operate. The solution to the problem of vaccine hesitancy is not to eliminate echo chambers. Rather, it is to be intentional about the social networks in those echo chambers. The more equity in people’s social networks, the less biased and more informed groups will become—even when those groups start off with highly partisan opinions.


scientificamerican--2020-10-15--How to Take Racial Bias Out of Kidney Tests

Medicine has a long history of erroneous beliefs about biological differences between races .
Today this ideology continues in diagnostic algorithms and practice guidelines that are adjusted based on patients ’ race—and often lead to further inequities in the health care of nonwhite patients .
Now students are working to change these practices , with some successful results .
This summer the University of Washington School of Medicine announced that its medical centers would no longer use race in a measure of kidney function called the estimated glomerular filtration rate , or eGFR .
To determine kidney health , doctors @ @ @ @ @ @ @ of creatinine , a by-product of muscle breakdown , in the blood .
( Because failing kidneys have a harder time filtering out creatinine , a high level indicates that the renal system is having problems . )
Physicians use an equation to combine this information into an eGFR score .
Perfectly healthy kidneys get a score above 60 , while failing ones have scores below 15 .
The first equation to easily calculate eGFR ( without the extra step of collecting and analyzing patients ’ urine ) , was developed through a @ @ @ @ @ @ @ noticed that Black participants had , on average , higher creatinine than white ones .
This could be explained by the fact that a higher proportion of Black study participants may have already had end-stage kidney disease .
But instead the study assumed that Black individuals had higher muscle mass , and thus higher creatinine , than white ones .
To prevent these supposedly elevated creatinine levels from skewing test results , researchers multiplied Black people ’ s eGFR scores by a factor of 1.2 .
Ten years later , a larger study @ @ @ @ @ @ @ accurate eGFR equation called the chronic kidney disease epidemiology collaboration , or CKD-EPI—but it still contains a correction factor for Black patients .
This could have fatal consequences .
In order to qualify for a kidney transplant , a patient ’ s eGFR score has to be low enough to be considered end-stage kidney disease .
Because a Black person ’ s score is bumped up by the correction factor , they might have to wait until their kidney disease reaches a later , more severe stage before they qualify for treatment .
@ @ @ @ @ @ @ , a student of medicine and public health at UW , fought for two years to take race out of the equation—and won .
Now the University of Washington system will calculate eGFR using the CKD-EPI equation , but without any race correction .
The university also recently established a UW Medicine Office of Healthcare Equity , which it says “ provides an opportunity to define short-term and long-term goals.
” In the announcement of its new policy , UW Medicine stated , “ This change was made because the use of race @ @ @ @ @ @ @ variable and does not meet the scientific rigor that we expect of our diagnostic tools.
” Scientific American spoke with Nkinsi about why this change was necessary , and how she worked to make it happen .
[ An edited transcript of the interview follows . ]
What was the goal of removing race as a factor in eGFR scores ?
One of the bigger issues that we ’ re trying to bring to light is that Black people in this country are more likely to get diagnosed with kidney disease later and @ @ @ @ @ @ @ treatments like transplants .
And one of the reasons for that is because the eGFR measurements are kind of masking disease until the disease becomes later stage .
We ’ re not saying that we want people to practice colorblind medicine ; we want them to practice anti-racist medicine .
And the reason that having the race variable [ in the eGFR ] is problematic is because it ’ s being used as a proxy for muscle mass .
This test is taught in medical schools all over the U.S. How did you @ @ @ @ @ @ @ really a team effort that started with being outspoken .
By this point , I ’ d already seen so many instances where race , particularly Black race , is brought up as a risk factor—somehow the color of your skin is linked to all of your physiology .
I ’ m sitting there in class [ as ] one of five Black people , and I remember thinking that this is not just a theoretical discussion : every single person that has kidney function measured is going to have race built into @ @ @ @ @ @ @ I started asking more questions .
The conversation got pretty heated , and they couldn ’ t really explain the logic behind using race in these equations .
From there , I met with the director of this [ course ] unit … about why I felt that this was an important topic to review further … within the context of health disparities and race-based medicine .
And then all of these different departments came together … and studied whether or not [ removing race from the test ] could be feasible in @ @ @ @ @ @ @ be .
They specifically credited students for being the ones who actually made this change possible .
I was in complete shock [ when I heard ] , because I went into this fully expecting that nothing would happen .
These past two years , that at times felt terrible , it was worth something—and it ’ s something that could change how we practice medicine forever .
The National Kidney Foundation is having a whole task force to discuss whether or not national recommendations should be changed .
It ’ s causing @ @ @ @ @ @ @ hopefully causing people to reconsider different algorithms where race is considered .
What made you decide to fight for change ?
It ’ s important because it impacts so many patients .
It ’ s [ also ] very personal—you ’ re talking about my body , you ’ re talking about my family ’ s bodies .
How can I trust that … [ we ’ re ] getting the best care , when I know that the way [ doctors ] treat Black people is so much different than the way @ @ @ @ @ @ @ If you speak up , you ’ re an angry Black person who ’ s unprofessional .
If you don ’ t speak up , you feel like you ’ re failing the community .
What advice would you give medical students seeking to do what you did at their own schools ?
We have to remember that a lot of our educators have been in medicine for so long , and they learned things a certain way , and it gets ingrained over time .
Having students come in , you ’ @ @ @ @ @ @ @ different perspective , especially now that we ’ re so much more aware of health inequities .
You should learn about why these disparities exist and about the history of medicine and why we use race in a lot of these algorithms .

Medicine has a long history of erroneous beliefs about biological differences between races. Today this ideology continues in diagnostic algorithms and practice guidelines that are adjusted based on patients’ race—and often lead to further inequities in the health care of nonwhite patients. Now students are working to change these practices, with some successful results. This summer the University of Washington School of Medicine announced that its medical centers would no longer use race in a measure of kidney function called the estimated glomerular filtration rate, or eGFR.
To determine kidney health, doctors first measure factors such as the level of creatinine, a by-product of muscle breakdown, in the blood. (Because failing kidneys have a harder time filtering out creatinine, a high level indicates that the renal system is having problems.) Physicians use an equation to combine this information into an eGFR score. Perfectly healthy kidneys get a score above 60, while failing ones have scores below 15. The first equation to easily calculate eGFR (without the extra step of collecting and analyzing patients’ urine), was developed through a 1999 study with 1,628 participants. Researchers noticed that Black participants had, on average, higher creatinine than white ones. This could be explained by the fact that a higher proportion of Black study participants may have already had end-stage kidney disease. But instead the study assumed that Black individuals had higher muscle mass, and thus higher creatinine, than white ones. To prevent these supposedly elevated creatinine levels from skewing test results, researchers multiplied Black people’s eGFR scores by a factor of 1.2. Ten years later, a larger study led to the development of a more accurate eGFR equation called the chronic kidney disease epidemiology collaboration, or CKD-EPI—but it still contains a correction factor for Black patients.
This could have fatal consequences. In order to qualify for a kidney transplant, a patient’s eGFR score has to be low enough to be considered end-stage kidney disease. Because a Black person’s score is bumped up by the correction factor, they might have to wait until their kidney disease reaches a later, more severe stage before they qualify for treatment.
Aware of this disparity, Naomi Nkinsi, a student of medicine and public health at UW, fought for two years to take race out of the equation—and won. Now the University of Washington system will calculate eGFR using the CKD-EPI equation, but without any race correction. The university also recently established a UW Medicine Office of Healthcare Equity, which it says “provides an opportunity to define short-term and long-term goals.”
In the announcement of its new policy, UW Medicine stated, “This change was made because the use of race in the biomedical environment is an ineffective variable and does not meet the scientific rigor that we expect of our diagnostic tools.” Scientific American spoke with Nkinsi about why this change was necessary, and how she worked to make it happen.
[An edited transcript of the interview follows.]
What was the goal of removing race as a factor in eGFR scores?
One of the bigger issues that we’re trying to bring to light is that Black people in this country are more likely to get diagnosed with kidney disease later and are less likely to have access to treatments like transplants. And one of the reasons for that is because the eGFR measurements are kind of masking disease until the disease becomes later stage. We’re not saying that we want people to practice colorblind medicine; we want them to practice anti-racist medicine. And the reason that having the race variable [in the eGFR] is problematic is because it’s being used as a proxy for muscle mass.
This test is taught in medical schools all over the U.S. How did you end up changing it?
It was really a team effort that started with being outspoken. By this point, I’d already seen so many instances where race, particularly Black race, is brought up as a risk factor—somehow the color of your skin is linked to all of your physiology. I’m sitting there in class [as] one of five Black people, and I remember thinking that this is not just a theoretical discussion: every single person that has kidney function measured is going to have race built into that algorithm. That’s when I started asking more questions. The conversation got pretty heated, and they couldn’t really explain the logic behind using race in these equations. From there, I met with the director of this [course] unit … about why I felt that this was an important topic to review further … within the context of health disparities and race-based medicine. And then all of these different departments came together … and studied whether or not [removing race from the test] could be feasible in our healthcare system—and found that it would be. They specifically credited students for being the ones who actually made this change possible.
I was in complete shock [when I heard], because I went into this fully expecting that nothing would happen. These past two years, that at times felt terrible, it was worth something—and it’s something that could change how we practice medicine forever. The National Kidney Foundation is having a whole task force to discuss whether or not national recommendations should be changed. It’s causing a lot of really good discussions and hopefully causing people to reconsider different algorithms where race is considered.
What made you decide to fight for change?
It’s important because it impacts so many patients. It’s [also] very personal—you’re talking about my body, you’re talking about my family’s bodies. How can I trust that … [we’re] getting the best care, when I know that the way [doctors] treat Black people is so much different than the way we see other people in medicine? If you speak up, you’re an angry Black person who’s unprofessional. If you don’t speak up, you feel like you’re failing the community.
What advice would you give medical students seeking to do what you did at their own schools?
We have to remember that a lot of our educators have been in medicine for so long, and they learned things a certain way, and it gets ingrained over time. Having students come in, you’re able to see things from a different perspective, especially now that we’re so much more aware of health inequities. You should learn about why these disparities exist and about the history of medicine and why we use race in a lot of these algorithms.