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This Is a Critical Moment: Delaware Must Not Go Backward in Health Equity

The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way. By LeRoi S. Hicks, M.D., MPH, FACP As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals. While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time. A tale of two cities To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter. Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive. The key to lowering health care costs is to improve quality, access and equity Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments. The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care. Let’s do more—not less—of what we already know works Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone. One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition. The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas. These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy. The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department. When we work together, we succeed We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state. Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems. By narrowly focusing on cost, we risk losing the progress we have made Delaware House Bill 350, as it’s proposed, would cause harm in two ways: First, it would compromise our ability to invest in these kinds of interventions that work. Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware. In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable. These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish. At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them. LeRoi Hicks, M.D., is the campus executive director for ChristianaCare, Wilmington Campus.

#Experts in the Media: CMU's Rayid Ghani Weighs in on the Role of AI

The topic of Artificial Intelligence (AI) is beginning to dominate a lot of conversations and even conferences across the planet. And recently, Rayid Ghani, a Distinguished Career Professor in the Machine Learning Department and the Heinz College of Information Systems and Public Policy at Carnegie Mellon University was part of an in-depth article that explored if AI could be expected to play a positive role in the future of humankind.  In fact, it asked if we could soon expect AI to do the heavy lifting with regards to major problems like global warming that we're all trying to solve. The answers experts offered were varied and some a bit surprising but for the most part AI can help ... but we humans need to do a lot of the work. Today, AI is already proving itself in prediction and warning systems in the event of tornadoes or forest fires, for example. It is then necessary to evacuate populations, or for humans to agree to be vaccinated in the event of a pandemic, underlines Rayid Ghani, of Carnegie Mellon University. “We created this problem, not AI. Technology can help us… A little,” he clarified. “And only if humans decide to use it to tackle problems.” March 17 - The Archide  It is a fascinating article and well worth the read. And if you are a journalist looking to know more about Artificial Intelligence and what we can expect in the future - let us help with your coverage. Rayid Ghani is a reformed computer scientist who wants to increase the use of large-scale Machine Learning in solving large public policy. Rayid Ghani  is available to speak with media - simply click on his icon now to arrange an interview today.

CMU To Send Group of Satellites Into Orbit To Test Low-Cost Autonomous Swarming

Satellites designed by Carnegie Mellon University researchers to orbit in a swarm and maintain communication with each other while zipping around the Earth will test the latest in low-cost, CubeSat technology. The CMU team is monitoring four small satellites as they communicate with each other, determining where they are relative to one another and autonomously maneuvering to stay within communication range. The satellites have no propulsion systems but can change their orbital positions by adjusting their orientation in flight to increase or decrease drag. These maneuvers will allow the satellites to stay within a few hundred miles of each other and orbit in a loose formation relative to members of the swarm. “We’re trying to do really complicated, multiagent autonomy in a very small box,” said Zac Manchester, an assistant professor in the Robotics Institute at CMU’s School of Computer Science. “Our goal is to have these satellites act autonomously in a coordinated way. We want them to talk to each other, find out where their buddies are and stay close enough to maintain communication.” The goal of PY4 is to demonstrate low size, weight, power, and cost (SWaP-C) spacecraft-to-spacecraft ranging, in-orbit relative navigation, and coordinated simultaneous multi-point radiation measurements. Manchester’s Robotic Exploration Lab leads the project, known as PY4. The experiment is funded through a NASA Small Spacecraft Technology program grant, led by the agency’s Space Technology Mission Directorate, and managed by NASA’s Ames Research Center in Silicon Valley. The four CubeSats, each measuring 4 inches by 4 inches by 6.5 inches — about the size of a cracker box — launched Monday, March 4, aboard a SpaceX Falcon 9 rocket from Vandenberg Space Force Base in California. Max Holliday, middle, installs one of the four PyCubed-Based CubeSat (PY4) spacecraft into the Small Satellites Dispenser. The PY4 mission intends to demonstrate a low-cost approach to multiple-satellite missions. Advancing autonomy and proving that relatively small and inexpensive satellites can succeed could reduce mission and operational costs dramatically for subsequent missions. This technology demonstration aims to show that a group of low-cost small satellites provide the same functionality as larger, more costly spacecraft. Multiple satellites are needed for multipoint science data collection and for applications like positioning and tracking, stereo and 3D imaging of the Earth, and taking measurements to study the atmosphere and weather. Lowering the cost of these missions seeks to broaden the applications of multisatellite technology. “The big one that has been motivating us in the lab has been global wildlife tracking,” Manchester said. “We could have a number of low-cost satellites monitoring animals across the world to better understand the global impacts of poaching, illegal fishing, deforestation and climate change.” The satellites operate in low-Earth orbit at an altitude of about 342 miles (550 kilometers), slightly higher than the International Space Station. Solar panels snapped open once the satellites were in orbit to charge the batteries. The satellites orbit the Earth, passing over the poles at about 15,660 miles per hour (7 kilometers per second). The CMU team is monitoring the satellites but can only communicate directly with them using their own ground station during a five-minute window a few times per day. For the rest of the time, they rely on the Iridium constellation for communication with the satellites. A rendering of the satellites in orbit. In orbit, the satellites act autonomously. They periodically measure their relative distance to establish their positions in relation to each other. Combining this information with other sensor data available from the satellites allows them to control the configuration of the swarm. A maneuver such as changing the configuration of the swarm from a line to a box could take weeks. Manchester expects his team to gather all the data needed for their research in a few months. Zachary Manchester is a researcher and aerospace engineer with broad interests in dynamics, control, estimation and optimization.  If you're looking to know more about this project - simply click on his icon now to arrange an interview today.

AI Tool Lets New Managers Practice Performance Reviews and Job Interviews

A new artificial intelligence tool developed at Carnegie Mellon University’s Tepper School of Business lets students practice conducting performance reviews and job interviews with AI agents based on large language models (LLMs) that behave like employees. The tool could help prospective managers level up their experience before they hit the job market.

Innovative EEG Brain Monitoring Program Provides Optimal Care for Critically Ill Patients

ChristianaCare has launched an innovative electroencephalogram (EEG) brain monitoring program that represents a significant leap forward in the diagnosis and management of neurological conditions. The easy-to-use EEG program is the first of its kind that can be performed at the bedside to measure the electrical activity of the brain, providing a vital sign for brain function to help diagnose seizures more quickly. ChristianaCare is the first hospital system in Delaware to use the Ceribell point-of-care EEG monitoring system, which can reduce the time it takes to diagnose certain neurological conditions from hours to mere minutes. Using the system, clinicians have immediate access to EEG information so they can triage at-risk patients in just five minutes and monitor patients for treatment optimization. “With this new program, our team of expert clinicians will have the diagnostic information they need to provide high-risk patients with the right care at the right time, ensuring the best outcomes for our patients and their families,” said Kim Gannon, M.D., Ph.D., service line leader for Neurosciences at ChristianaCare. New technology detects ‘silent seizures’ Critically ill patients are at high risk of harmful brain electrical discharges called seizures. Some of these patients experience a type of “silent seizure” with no noticeable symptoms (non-convulsive) that can only be detected using EEG. If prolonged, non-convulsive seizures can lead to permanent brain injury and higher risk of morbidity and mortality. Demonstration of EEG device on patient at ChristianaCare Newark Campus. As a result, guidelines from the Neurocritical Care Society recommend EEG should be initiated within 15-60 minutes when these seizures are suspected. Meeting these guidelines has proven difficult due to the limitations of conventional EEG systems, which were not designed for use in emergency situations. Even top academic centers that have 24/7 EEG capabilities may experience wait times of four hours or more for conventional equipment. When relying on clinical judgement alone while waiting for these conventional EEG systems, diagnostic accuracy has been shown to be only slightly better than chance (65%). The value of this new technology for patients is that it provides accurate results quickly so that the care team can intervene early. “The neuroscience and critical care teams at ChristianaCare believe that ‘time is brain’ not only applies to stroke but also when dealing with seizure,” Gannon said. Gannon is referring to the fact that for every minute that passes when someone is having a stroke, 1.9 million brain cells are lost, increasing the chance of disability or death. That same kind of speed and urgency can now more easily be brought to bear for patients when a seizure is suspected. “This monitoring system is easy to use and can be set up in about five minutes,” said Richard Choi, D.O., medical director of the Neurocritical Care Unit at Christiana Hospital. “It consists of a simple headband, pocket-sized recorder with intuitive software and an on-line portal for remote viewing. Using the system, we can review EEG data, assess response to treatment and optimize care, all in real-time.” Neurosciences at ChristianaCare ChristianaCare’s multidisciplinary neurosciences team provides comprehensive and advanced care for neurologic illnesses across the acute and ambulatory settings. As the largest and most comprehensive neurology practice in Delaware with more than 55,000 patient visits last year, ambulatory subspecialties include stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular disorders, headaches/migraines, pediatric neurology and Botox specialists. The inpatient team of experts includes neurosurgeons, neurointerventional surgeons, neurocritical care physicians and vascular neurologists. The Newark Campus serves as the only comprehensive stroke center in the state and includes the only Epilepsy Monitoring Unit in Delaware.

Sunday is Cinco de Mayo. Do you know the history behind the day?

Celebrated annually on May 5th, Cinco de Mayo commemorates the Mexican army's victory over French forces at the Battle of Puebla in 1862. While often associated with festive gatherings and cultural celebrations, Cinco de Mayo also holds significant relevance beyond its historical origins, offering various story angles that appeal to a broad audience. Cultural significance and heritage preservation: Explore the historical context of Cinco de Mayo and its importance in Mexican culture, highlighting the traditions, food, music, and art associated with the holiday. Immigration and identity: Examine how Cinco de Mayo is celebrated in different parts of the world, particularly in the United States, and its role in shaping the Mexican-American identity and fostering cross-cultural understanding. Political implications and national pride: Investigate the political undertones of Cinco de Mayo, considering its significance in Mexican nationalism and its portrayal in international relations. Economic impact and tourism: Analyze the economic implications of Cinco de Mayo festivities, including the boost in tourism, sales of Mexican-themed products, and the commercialization of cultural heritage. Education and historical awareness: Discuss the educational value of Cinco de Mayo in schools and communities, examining how it promotes historical awareness, tolerance, and multiculturalism. Social justice and activism: Explore how Cinco de Mayo intersects with social justice movements, addressing issues such as immigration reform, cultural appropriation, and representation in media and politics. By covering these angles, journalists can provide their audiences with a deeper understanding of Cinco de Mayo beyond its surface-level festivities, fostering meaningful dialogue and engagement with the holiday's historical, cultural, and societal significance. Connect with an Expert about Cinco de Mayo: Margarita R. Ochoa Associate Professor and Associate Chair of History · Loyola Marymount University Timothy Matovina Chair, Department of Theology · University of Notre Dame Rodrigo Vargas Professor, Ecosystem Ecology and Environmental Change · University of Delaware Heather Chiero, PhD Associate Professor of History, Anthropology and Philosophy · Augusta University To search our full list of experts visit www.expertfile.com Photo Credit: Daniel Lloyd Blunk-Fernández

Researcher develops microrobots to battle cancer with unique precision

Magnetic robots that can target cancer cells are nothing new. But the patented microrobots developed by the University of Delaware's Sambeeta Das can be guided with a magnetic field to deliver medication to cells – or to destroy infectious cells, such as cancer – inside the body. To mark the launch of National Inventors Month, Das, assistant professor of mechanical engineering, shared her journey toward invention. Q: Tell us about your patented invention on microrobots for cancer research. What problem were you trying to solve? Das: One of the biggest issues with cancer research is the ability to target cancer cells without harming healthy cells. Cancer cells are sneaky, and they have evolved ways of hiding from the body’s immune cells. A big part of our research focuses on targeting, specifically precision targeting. We want to be able to target a single cell in a mass of cells, whether that is a single cell in a mass of cancer cells or whether it is a single abnormal cell surrounded by healthy cells. To do this, we use magnetic microrobots that can be driven inside the body by magnetic fields to a particular cell location. Magnetic fields are biocompatible, meaning they are not harmful to biological tissues, and our microrobots are very small, around 20 microns, which is about the size of a single bacteria cell. We can load our microrobots with various drugs and modify their surface in such a way that when the robots come in contact with the cells we are targeting, they can kill the target cell or perform some other function. Q: How is this solution unique? Das: Other people have made magnetic microrobots, but our system is unique since it allows us to do automatic targeting with a lot of precision. For example, a person operating our microrobots can just point to a cell and our system will drive the microrobot there. Additionally, the instrument we have made and patented is an all-in-one portable device that can be used anywhere. We don’t need a separate microscope, camera or software, it is all built in and very user friendly. Anyone can use it. This makes it super portable, which means quick solutions for health practitioners. In addition, poor and resource challenged areas can also be accessed with this portable solution. Q: What drives you toward invention? Das: I like to solve problems, and I like seeing something come together from nothing. I am very interested in problems that affect human health and longevity, particularly those that affect the common person. Q: How do you approach solving a problem, and whose support has been critical along the way? Das: One thing I have realized is that it is imperative to ask the right question to solve a problem. You must really get to the core of the issue. The second thing is to always keep the end user in mind. So, it’s kind of a two-pronged approach—looking from both ends of the problem. For support, I would say my team members and my collaborators. Their support has been invaluable in helping me solve the problems that I want to solve. In fact, my graduate students keep a running list of crazy ideas that they have come up with. It helps us look at problems in a unique way and come up with innovative solutions. Q: Not every invention makes it. How do you deal with failure? Das: The way that I start working on a problem is to assume that whatever we do, we are going to fail. I always tell my students that their first couple of experiments or designs will always fail. But failure is essential because it will teach you what not to do. And knowing what not to do is sometimes the critical part of the invention process. The failures inform us about the ways of not doing something which means now there is another way of doing something. Q: What is the best advice you’ve ever received? Das: The best career advice I’ve ever received is that there is always another way. If you run into roadblocks there is always another answer, there is always another opportunity. So we just need to keep going and trying new and crazy ideas. Q: How are inventive minds created – is it innate or can it be developed? How do you encourage innovation among your students? Das: That’s an interesting question and honestly, I am not sure. I do believe in what Edison said, “Genius is 1% inspiration and 99% perspiration.” He is a known inventor, so I would go with his interpretation on this. As for my students, I give them lots of freedom. I think freedom is essential in encouraging innovation. The freedom to come up with crazy ideas without anyone saying that won't work and the freedom to fail—multiple times. Das is available for interviews to talk about her microrobots and other projects at UD. To reach her, visit her profile and click the "contact" button.

Today is the anniversary of the 1931 opening of the Empire State Building in New York City. Covering? Our experts can help!

A monumental anniversary approaches as we commemorate the 1931 opening of the Empire State Building, an architectural marvel that has stood as an emblem of innovation and human achievement for nearly a century. Beyond its towering presence on the New York City skyline, this anniversary is a poignant moment to reflect on the enduring legacy of this iconic structure and its resonance with the public, encapsulating themes of perseverance, ingenuity, and urban development. Here are several compelling story angles that journalists may find ripe for exploration: Historical significance and architectural marvel: Delve into the fascinating backstory of the Empire State Building, exploring the engineering feats and human endeavor that brought this skyscraper to life. Evolving skyline and urban identity: Examine how the Empire State Building has shaped the cultural and visual landscape of New York City, and its enduring significance in an ever-changing metropolis. Sustainable initiatives and environmental impact: Explore the building's initiatives toward sustainability and energy efficiency, offering insights into its role as a model for sustainable urban development. Economic impact and tourism: Investigate the economic impact of the Empire State Building on local communities, tourism, and its enduring appeal as a global tourist destination. Cultural resonance and popular culture: Uncover the building's rich cultural legacy, from its appearances in film, literature, and art, to its symbolic significance in popular imagination. Preservation efforts and historical conservation: Shed light on ongoing efforts to preserve and maintain the architectural integrity and historical significance of this iconic landmark for future generations. Connect with an Expert about Architecture and the Empire State Building: Dana Cupkova Associate Professor · Carnegie Mellon University Richard Campanella Associate Dean for Research, Senior Professor of Practice - Architecture and Geography · Tulane University Eric Corey Freed Founding Principal · OrganicARCHITECT Peter Christensen Arthur Satz Professor of the Humanities and Professor of Art History · University of Rochester Dennis Shelden Director, Center for Architecture Science and Ecology (CASE) · Rensselaer Polytechnic Institute To search our full list of experts visit www.expertfile.com Photo Credit: Ben Dumond