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3D-printed lung model helps researchers study aerosol deposition in the lungs
Treating respiratory diseases is challenging. Inhalable medicines depend on delivering particles to the right lung areas, which is complicated by factors like the drug, delivery method and patient variability, or even exposure to smoke or asbestos particles. University of Delaware researchers have developed an adaptable 3D lung model to address this issue by replicating realistic breathing maneuvers and offering personalized evaluation of aerosol therapeutics. “If it's something environmental and toxic that we're worried about, knowing how far and how deep in the lung it goes is important,” said Catherine Fromen, University of Delaware Centennial Associate Professor for Excellence in Research and Education in the Department of Chemical and Biomolecular Engineering. “If it's designing a better pharmaceutical drug for asthma or a respiratory disease, knowing exactly where the inhaled aerosol lands and how deep the medicine can penetrate will predict how well that works.”that can replicate realistic breathing maneuvers and offer personalized evaluation of aerosol therapeutics under various breathing conditions. Fromen and two UD alumni have submitted a patent application on the 3D lung model invention through UD’s Office of Economic Innovation and Partnerships (OEIP), the unit responsible for managing intellectual property at UD. In a paper published in the journal Device, Fromen and her team demonstrate how their new 3D lung model can advance understanding of how inhalable medications behave in the upper airways and deeper areas of the lung. This can provide a broader picture on how to predict the effectiveness of inhalable medications in models and computer simulations for different people or age groups. The researchers detail in the paper how they built the 3D structure and what they’ve learned so far. Valuable research tool The purpose of the lung is gas exchange. In practice, the lung is often approximated as the size of a tennis court that is exchanging oxygen and carbon dioxide with the bloodstream in our bodies. This is a huge surface area, and that function is critical — if your lungs go down, you're in trouble. Fromen described this branching lung architecture like a tree that starts with a trunk and branches out into smaller and smaller limbs, ranging in size from a few centimeters in the trachea to about 100 microns (roughly the combined width of two hairs on your head) in the lung’s farthest regions. These branches create a complex network that filters aerosols as they travel through the lung. Just as tree branches end in leaves, the lung’s branches culminate in delicate, leaf-like structures called alveoli, where gases are exchanged. “Those alveoli in the deeper airways make the surface area that provides this necessary gas exchange, so you don't want environmental things getting in there where they can damage these sensitive, finer structures,” said Fromen, who has a joint appointment in biomedical engineering. Mimicking the complex structure and function of the lung in a lab setting is inherently challenging. The UD-developed 3D lung model is unique in several ways. First, the model breathes in the same cyclic motion as an actual lung. That’s key, Fromen said. The model also contains lattice structures to represent the entire volume and surface area of a lung. These lattices, made possible through 3D printing, are a critical innovation, enabling precise design to mimic the lung's filtering processes without needing to recreate its full biological complexity. “There's nothing currently out there that has both of these features,” she explained. “This means that we can look at the entire dosage of an inhaled medicine. We can look at exposure over time, and we can capture what happens when you inhale the medication and where the medicine deposits, as well as what gets exhaled as you breathe.” The testing process Testing how far an aerosol or environmental particle travels inside the 3D lung model is a multi-step process. The exposure of the model to the aerosol only takes about five minutes, but the analysis is time-consuming. The researchers add fluorescent molecules to the solution being tested to track where the particles deposit inside the model’s 150 different parts. “We wash each part and rinse away everything that deposits. The fluorescence is just a molecule in the solution. When it deposits, we know the concentration of that, so, when we rinse it out, we can measure how much fluorescence was recovered,” Fromen said. This data allows them to create a heat map of where the aerosols deposit throughout the lung model’s airways, which then can be validated against benchmarked clinical data for where such aerosols would be expected to go in a human under similar conditions. The team’s current model matches a healthy person under sitting/breathing conditions for a single aerosol size, but Fromen’s team is working to ensure the model is versatile across a much broader range of conditions. “An asthma attack, exercise, cystic fibrosis, chronic obstructive pulmonary disorder (COPD) — all those things are going to really affect where aerosols deposit. We want to make sure our model can capture those differences,” Fromen said. The ability to examine disease features like airway narrowing or mucus buildup could lead to more personalized care, such as tailored medication doses or redesigned inhalers. Currently, inhaled medicines follow a one-size-fits-all approach, but the UD-developed model offers a tool to address these issues and understand why many inhaled medicines fail clinical trials.
ChristianaCare is enhancing care options in Milford, Delaware, with the addition of two highly skilled physicians to better serve the community's growing health needs. Chinwe Ike-Chinwo, M.D., is a board-certified primary care physician with a special interest in preventive medicine. Thinesh Sivapatham, M.D., is a fellowship-trained neurointerventional surgeon and member of ChristianaCare's Neurointerventional Surgery team, specializing in minimally invasive techniques to treat conditions affecting the blood vessels of the head, neck and spine, including strokes and aneurysms. The practice is located at Halpern Plaza, 701 N. DuPont Blvd. To schedule an appointment, patients can call 302-725-3420. Convenient and Accessible Primary Care At the new ChristianaCare Primary Care at Milford practice, Ike-Chinwo is passionate about building long-term relationships with her patients, helping them achieve optimal health through personalized care. “I am excited to serve the Milford community and help individuals achieve their best health,” she said. “Through prevention, chronic disease management and wellness care, we aim to support our patients in leading healthier, more fulfilling lives.” Ike-Chinwo introduces herself in this video. The primary care practice offers a comprehensive range of services to adult patients, including sick visits, immunizations, physical exams, preventive screenings and treatment for both acute and chronic conditions and women’s health. The practice is open Monday through Friday, from 8 a.m. to 4:30 p.m. In March 2025, the practice will welcome a second provider. In April 2025, the Milford site will also offer ChristianaCare’s My65+ program, which focuses on preventive care and chronic disease management for patients 65 and older. The providers at ChristianaCare’s new Milford location will play a crucial role in addressing the growing health care needs of Sussex County, which is experiencing rapid population growth, particularly among older adults. Sussex County has been designated as a Medically Underserved Area by the federal government, with projections showing that the population will increase from 237,378 in 2022 to over 361,000 by 2050, further intensifying the demand for primary care services. As the demand for primary and specialty care in Sussex County grows, especially among older adults, ChristianaCare is committed to meeting the health care needs of the community with personalized, patient-centered care. “Our mission is to make high-quality, compassionate care accessible to every resident of the communities we serve,” said Priya Dixit-Patel, M.D., physician executive for Core and Advanced Primary Care at ChristianaCare. “As primary care providers remain in short supply in many areas like Milford, we are focused on delivering care that can prevent disease, manage chronic conditions, and improve overall well-being, particularly for older adults.” Specialized Neurointerventional Consults Close to Home Sivapatham is excited to bring neurointerventional care to the Milford community and surrounding areas. “Neurointerventional Surgery is a highly specialized field that is often only found in larger metropolitan areas,” said Sivapatham, who speaks about treatment for stroke in this video. “I look forward to working closely with patients to ensure they receive the same high-quality care right here in Sussex County.” Kim Gannon, M.D., Ph.D., medical director of the Comprehensive Stroke Program and physician executive of the Neuroscience Service Line at ChristianaCare, highlighted the importance of improving access to physician consults for patients in Sussex County. “Providing neurointerventional care closer to home significantly improves access to specialized services for stroke patients who might otherwise need to travel to Newark,” said Gannon. “We want to ensure that patients receive the ongoing care and support essential for their recovery and long-term health at a location close to where they live.”
In another milestone commitment to community health, ChristianaCare today announced a $1.6 million investment in 25 local nonprofits, unveiling the recipients of its Community Investment Fund during a special celebration at The Ministry of Caring in Wilmington. Since 2019, ChristianaCare’s Community Investment Fund has provided more than $5.6 million to 64 organizations, addressing social, behavioral and environmental health factors. ”ChristianaCare is empowering and supporting our nonprofit partners so they can help meet the many needs of the people they serve, and work with us to improve patient health and create healthy communities and a healthy Delaware,” said Bettina Tweardy Riveros, chief health equity officer at ChristianaCare. This year’s recipients received funding to support health improvement initiatives in neighboring communities and address critical issues and community needs. “Each of these recipients is making a significant and positive impact by addressing critical health challenges throughout our communities, including food insecurity, housing insecurity and environmental health. At ChristianaCare, we are honored to be joining forces with these 25 organizations to provide them with more resources so that they do more for those in need. It is another way we care for our community,” she said. The funded initiatives will be implemented throughout the upcoming year and were selected based on the quality of applicants’ proposals and implementation plans, and on the alignment of their proposals with the critical issues prioritized by the community in ChristianaCare’s Community Health Needs Assessment and Community Health Implementation Plan. Recipient Spotlight: Healthy Food for Healthy Kids "The impact of ChristianaCare’s 2024 Community Investment Awards funds on Healthy Foods for Healthy Kids will be felt not only in 2025 but for years to come. This funding will expand our program to an additional school, serving over 600 more students, and support data and research for future growth." Healthy Food for Healthy Kids, Lydia Sarson, Executive Director. Recipient Spotlight: Project New Start “Approximately 85% of the justice-involved individuals served by Project New Start are housing and food insecure. With ChristianaCare’s 2024 Community Investment Fund Award to Project New Start, which began 11/01/24, we have already been able to assist 23 individuals with clothing and household goods; 20 individuals with transportation assistance; 17 individuals with food support; and 7 individuals with housing as of 12/31/24. The impact of these funds cannot be overstated as this investment by ChristianaCare provides Project New Start the means to provide the critical basic needs an individual requires to live with dignity without the trauma of worrying about where they will sleep, how they will eat and how they can sustain employment. We are so grateful to ChristianaCare for their ongoing support.” Priscilla Turgon, Founder and Executive Director of Project New Start, Inc. Recipient Spotlight: YMCA of Delaware - Central YMCA Supportive Housing Program “The Central YMCA Supportive Housing Program, in partnership with Christiana Care, serves low-income men at risk of homelessness who often face trauma, addiction, disabilities or lack of family support. Through stable housing, nutritious meals, welcome packages, rental assistance and supportive activities, the program fosters community wellbeing, improves health outcomes, prevents homelessness and empowers residents to achieve self-sufficiency.” Jimia Redden, Executive Director of Housing. This year’s Community Investment Fund recipients are: • AIDS Delaware: AIDS Delaware’s mission is to eliminate the spread and stigma of HIV/AIDS, improve the lives of those living with HIV/AIDS and promote community health through comprehensive and culturally sensitive services, education programs and advocacy. • Black Mothers in Power: Black Mothers in Power seeks to eradicate racial health disparities for Black birthing people and Black babies throughout Delaware. • Boys & Girls Club of DE: Boys & Girls Clubs of Delaware inspires and enables young people, especially those most in need, to reach their full potential as productive, responsible, caring citizens. • Children and Families First DE: Children & Families First is one of Delaware's oldest and most trusted non-profit leaders in providing the supports and services children and their families need to thrive. • Claymont Community Center - Brandywine Resource Council: Claymont Community Center is a base for a variety of community organizations supporting educational, social, recreational, cultural, personal development, financial and wellness needs. • Delaware Center for Horticulture: The Delaware Center for Horticulture cultivates greener communities by inspiring appreciation and improvement of the environment through horticulture, education and conservation. • Delaware Futures, Inc: Delaware Futures empowers at-promise high school and middle school youth across the state of Delaware by providing year-round, trauma-informed curricula tailored to students at each grade level. • Delaware Nature Society: Delaware Nature Society connects people and nature to create a healthy environment for all through education, conservation and advocacy. • Do Care Doula: Do Care Doula provides grant-funded Doula training and development, subsidized Doula support and a variety of community outreach programs. • Healthy Food for Healthy Kids: Healthy Food for Healthy Kids supports educators in Delaware, bringing life-lasting benefits of gardening and good nutrition to kids. • Jefferson Street Center: The mission of JSC is to advance community-driven priorities in Northwest Wilmington that promote the conditions necessary for all residents to thrive. • Latin American Community Center: LACC seeks to empower members to become contributing members of society through advocacy and offers programs and services to anyone ages of one to 101. • Milford Housing Development Corporation: Milford Housing Development Corporation is a value-driven, nonprofit, affordable housing developer, providing services throughout Delaware. Its mission is to provide decent, safe, affordable housing solutions to people of modest means. • Ministry of Caring: Since Brother Ronald began the ministry in 1977 with the first shelter for homeless women on the Delmarva Peninsula, the Ministry has worked ceaselessly to ease the needs and struggles of our neighbors. • ONCOR Coalition: ONCOR’s vision is to build and promote spaces that connect people to the city and each other. It promotes positive relationships through community-based educational programs and recreational opportunities. • Our Daily Bread Dining Room of MOT: ODB is the only soup kitchen in the Middletown, Odessa and Townsend region. ODB is a volunteer run organization with over 300 volunteers. Volunteers help purchase and pick up food and ingredients, prepare and serve meals and clean and maintain the facility. • Project New Start: Project New Start provides a comprehensive cognitive behavioral change/workforce development initiative for individuals transitioning out of state and federal institutions. • Ray of Hope Mission Center: Ray of Hope’s mission is to recognize and address the needs of those who are struggling within our community and assist them in their efforts to provide for themselves and their families, both physically and spiritually. • St. Patrick's Center: Serving people in Wilmington’s East Side neighborhood since 1971, St. Patrick’s Center is a nonprofit organization that operates a Senior Center, and provides meals, groceries, clothing, paratransit and social service support to the public. • The Resurrection Center: The purpose of the Resurrection Center is to spread the gospel of Jesus Christ and create a spirit-filled environment that hungers for the Gospel and to serve as liberating agents in the midst of the world. • Voices of Hope: Voices of Hope’s mission is to empower lives and foster recovery. The nonprofit is dedicated to supporting individuals and families facing substance use disorder. Through compassion, education and community engagement, Voices of Hope strives to break the chains of addiction, promoting a healthier, brighter future for all. • West End Neighborhood House: At West End Neighborhood House, staff, clients, volunteers and donors work together to resolve complex social challenges throughout Delaware. Through outcomes-driven programming, the West End Neighborhood House provide support that meets community needs in finances, housing, education, employment and family services. • Westside Family Healthcare: Westside Family Healthcare is a community-minded, non-partisan health center located in Delaware. Westside opened its doors in 1988 and has maintained status as a Federally Qualified Health Center since 1994. • Wilmington HOPE Commission Inc.: The Hope Commission is a reentry program that helps formerly incarcerated men return to their community. It offers support services that address factors known to lead to repeat offenses. • YMCA of Delaware: The Central YMCA Supportive Housing Program offers housing for men aged 18 and older. Residents benefit from dorm-style accommodations, discounted access to the fitness center and connections to a range of health and human service providers in partnership with the YMCA.
The ethics of using AI in academic writing: Opportunities and challenges in education
A major topic buzzing around educational circles right now is the use of AI in academic writing. With AI tools becoming more sophisticated, students and educators find themselves navigating a new academic landscape. It’s both exciting and daunting. Joshua Wilson, an associate professor of education at the University of Delaware, can discuss this landscape. Drawing on his research in automated writing evaluation (AWE), Wilson explores how AI tools – particularly generative AI – can transform the teaching and learning of writing by supporting critical thinking and knowledge transformation. He emphasizes that AI can help writers overcome lower-level constraints, such as grammar and organization, enabling deeper reflection and metacognitive engagement. Additionally, AI tools hold promise for helping students structure their thoughts and ideas, serving as valuable aids in organizing ideas before they begin writing. Thus, making writing more accessible and less intimidating for learners at all levels. However, he cautions that the value of AI depends on its thoughtful integration into educational practices, alignment with learning theories, and addressing challenges such as equity, feedback accuracy, and ethical use. He provides actionable insights for educators, researchers, and policymakers on how AI can enhance writing instruction, critical thinking and accessibility while avoiding potential pitfalls. Wilson has appeared in publications including The Washington Post, The Baltimore Sun and The Philadelphia Inquirer. To speak with Wilson further about AI and writing, click on his profile.
Education specialist tips: How to support displaced families
The California wildfires have devastated the Los Angeles region as families have lost their homes, places of work and schools. With expertise in housing insecurity and social work, University of Delaware faculty in the College of Education and Human Development (CEHD) explain how community members can support these families. Ann Aviles and Ohiro Oni-Eseleh, both CEHD faculty, share resources for displaced families and guidance for parents, educators and other community members who want to support them. Aviles, an associate professor, said an unexpected displacement can be unsettling for anyone, but they can have greater impacts on certain populations. "Populations that are especially vulnerable include those from low-income families, families of color (in particular, Black and Latiné communities), unaccompanied youth and undocumented families," she said. "These families often have less access to economic resources for temporary housing such as hotels or short-term rentals." She notes that the main way educators and community members can assist these populations is to first and foremost treat them with respect and dignity. "Priority should be given to short-term solutions that are informed directly by the people most impacted. Educators, community leaders and others wanting to provide families support should ask them what is most important and needed, and then respond accordingly," she said. Oni-Eseleh, an assistant professor and director of the master of social work program at UD, notes that there are multiple hotlines and community groups dedicated to assisting families that are displaced. "Many communities have emergency hotlines that provide immediate support and connect individuals to social workers or mental health professionals. These hotlines often operate 24/7 and can be a valuable resource during a crisis," he said. For more tips from both of these experts, please reach out to mediarelations@udel.edu.
Nona’s Story: HomeHealth Nurse Visit Leads to Life-Saving Care
Elena Gomez, RN, wears the dark blue scrubs of a ChristianaCare nurse, but Nona Lerza sees her as even more. “I call you an angel,” said Lerza, who credits Gomez with saving her life. Gomez, a ChristianaCare HomeHealth case manager, regularly visited Lerza, at her home in Middletown, Delaware, to check her blood pressure after a hospitalization. One day in February, with bad weather on the horizon, Gomez phoned Lerza to see if she could stop by for a check-in. That call – and Gomez’s persistence – turned out to be lifesaving. During her visit, Gomez found Lerza’s blood pressure was high – high enough to warrant emergency care. Lerza wasn’t eager to return to the hospital. But she trusted Gomez, and the strength of that connection convinced Lerza to heed Gomez’s advice and head to the emergency department. After arriving by ambulance, Lerza underwent quadruple bypass surgery at Christiana Hospital. Her cardiology team agreed – Gomez saved her life. Fully recovered, Lerza is now back to living independently in her home. “There aren’t enough words in the dictionary to say all she did for me,” Lerza said. “She closed my house up. She did everything for me that night and I can’t thank her enough. It seems very hollow to say thank you. But if she hadn’t come, I don’t know where I’d be today.” For Gomez – a second generation nurse – working as a HomeHealth nurse gives her the chance to build lasting relationships with patients. “We are here for the community; we are here for our patients; we are here for the families,” she said, “and we will do everything in our power to help them get better.”
ChristianaCare Reduces Health Care Costs by $6.2 Million While Improving Care for Medicaid Patients
ChristianaCare’s Delaware Medicaid Partners Accountable Care Organization (ACO) has set the standard for innovative, high-quality care at lower cost for the State of Delaware’s Medicaid population. According to the most recent data available, ChristianaCare’s ACO reduced health care spending by $6.2 million in 2023 while improving care for nearly 30,000 Medicaid beneficiaries in Delaware, including approximately 8,000 children. “We’re demonstrating that population health works,” said Christine Donohue-Henry, M.D., MBA, chief population health officer, ChristianaCare. “Our neighbors count on us to take care of them — and we can improve their health while also helping the state reduce health care costs. We do this by delivering high-quality care that emphasizes preventive care and proactive management of health conditions, and by investing in our population health infrastructure. “In this way, we can keep people healthier and reduce the need for them to access the most expensive kinds of care, such as emergency care and hospitalization.” ChristianaCare’s Medicaid ACO includes more than 1,900 primary and specialty care clinicians who partner with patients and families to prevent illness, manage chronic diseases and help them achieve their health goals. The ACO makes it easy for adults and children to get the screenings and treatments they need, improving overall health. ChristianaCare’s Medicaid ACO is one of four authorized by the State of Delaware and the only one to voluntarily accept downside financial risk at its launch in 2021, which means that if ChristianaCare’s Medicaid ACO is not successful in reducing cost and improving care for a particular year, the ChristianaCare ACO is required to make a payment to the state. By sharing in both savings and losses, the ACO controls state health care costs while maintaining high-quality care. Bending the Cost Curve by Focusing on High-Quality Preventive Care Alongside financial savings, ChristianaCare’s Medicaid ACO has improved care quality and worked to reduce health disparities. By focusing on preventive care, the ACO has helped adults and children get the screenings and treatment they need, leading to better health outcomes and fewer unmet needs. Since launching in 2021, ChristianaCare’s ACO has met all required quality standards and consistently improved its performance each year on key measures like diabetes management, blood pressure control and breast cancer prevention. Year over year, breast cancer screenings have increased by 4%, while patients with high blood pressure (hypertension) have shown improvement in blood pressure control. Notably, healthy blood sugar levels (HbA1c less than 8%) have also improved in patients with diabetes by 7%. In collaboration with its Medicaid health plan partners, ChristianaCare primary care and imaging teams host patient-centered health and wellness day events to increase access to care, close quality gaps and improve the overall health of the communities they serve. These events help patients get preventive screenings and services, supporting the ACO’s goals of better care and health equity. The ACO’s success is driven by its focus on caring for entire families, including addressing the needs of pregnant mothers and supporting children and adults throughout their lives, according to Rose Kakoza, M.D., MPH, senior clinical network director, ChristianaCare Clinical Alliance. Key programs include enhanced maternity care to support mothers and infants, expanded mental health services and social support programs that address food and housing needs. By integrating clinical care with social support — such as help with food and housing — the ACO is working to break cycles of poor health across generations. This approach also has practical benefits. For example, the improved mental health of a parent strengthens the family environment, supporting children’s well-being and development. “By making significant investments in population health and addressing both medical needs and the social drivers of health, we’ve not only improved health outcomes but also more effectively managed costs for Delaware’s most vulnerable residents, helping to reduce state spending,” Kakoza said. About Delaware Medicaid Partners Delaware Medicaid Partners ACO, led by ChristianaCare, uses a family-centered approach to save money and improve care for Medicaid patients. By combining medical care with social support, the ACO addresses the unique needs of Medicaid patients, improving health and promoting equity. Care coordination is provided by ChristianaCare’s CareVio®, whose team of nurses, social workers, and pharmacists help patients with serious health conditions get the care they need. CareVio uses real-time data to prevent complications that could lead to unnecessary hospital stays or emergency visits. Through ongoing collaboration and innovation, Delaware Medicaid Partners ACO aims to set an example for other states working to improve care while managing costs.
More than half of U.S. states allow the sale of raw milk directly from farms to consumers, a number that would likely increase if Robert F. Kennedy Jr. – a raw milk advocate – is confirmed to lead the Department of Health and Human Services (DHHS). Kali Kniel, a professor of microbial food safety at the University of Delaware, can discuss the dangers and potential benefits of drinking raw milk. Some have celebrated the legalization of raw milk around the country, claiming it tastes better and has some nutritional benefits. Meanwhile, the U.S. Food and Drug Administration, one of the DHHS agencies Kennedy would lead, cautions against drinking raw milk, which comes directly from cows, sheep or goats and has been banned from being sold across state lines since the 1980s. Concerns regarding raw milk have been elevated as a deadly strain of bird flu is infecting dairy farms around the country. In the following Q&A, Kniel talks about the pathogens that may be present in raw milk, ways to communicate food safety to the public and other topics. Milk and other dairy products that sit on shelves at the grocery store are pasteurized. What does this process involve and why is it important for dairy products? Pasteurization of milk is a process of heating milk and passing it between heated stainless steel plates until it reaches 161 degrees Fahrenheit. It is held at that temperature for around 15 seconds before it is quickly cooled to 39 degrees Fahrenheit. This process is intended to kill the pathogenic bacteria that could make a person sick. How does this process affect milk’s quality and nutritional value? Scientific studies have shown that pasteurization does not significantly change the nutritional value of milk. Unpasteurized milk may have more vitamin C, which does not survive the pasteurization process, but milk is not considered a good source of vitamin C, as it contains less than 10% of the Recommended Dietary Allowance (RDA), the average amount of nutrients it takes to meet a healthy person’s needs. There are no beneficial bacteria in raw milk. Milk (pasteurized or raw) is not a good source of probiotic or potentially beneficial bacteria, so for that consumers should choose yogurt and other fermented dairy products as well as other fermented products. Scientific studies using animal models have shown no difference in how calcium in raw milk and pasteurized milk is absorbed by the human body. Popularity in drinking raw milk is increasing, despite the U.S. Food and Drug Administration advising that it’s not safe to drink. What are the health risks that come with drinking raw milk? Raw milk may contain pathogenic bacteria, including Campylobacter, Salmonella, pathogenic types of E. coli, Listeria and Brucella, as well as the protozoan parasite Cryptosporidium. These are all zoonotic microbes, which means they can be transmitted from animals to humans. Often the animal does not appear ill, so it is not possible to determine if an ill animal is shedding these pathogens in its feces that can contaminate milk. Microbial testing of the finished product and environmental monitoring programs may be helpful, but do not guarantee that the raw milk is absent of these pathogens. Milk can be contaminated with these pathogens from direct contamination with feces or from environmental conditions. Cross-contamination from dairy workers can also happen, even when people are trying their best to reduce the risk of cross-contamination. The likelihood of a disease outbreak occurring associated with a person consuming raw milk is relatively high given that others may also be exposed. Unpasteurized milk will have a relatively short shelf life and may not be available for testing. Following good hygiene practices on the farm and during milking such as biosecurity around the farm, appropriately sanitizing equipment and monitoring the health of animals can reduce the chance of milk contamination, but not eliminate it. There have been numerous outbreaks of illness associated with raw milk as well as cheese made from raw milk. Persons most at risk of illness associated with drinking raw milk include children, in particular 5 years of age and under, individuals aged 65 and over, pregnant women and immunocompromised individuals. It should be noted that all outbreaks of illness associated with raw milk have included individuals under 19 years of age. Children may be most vulnerable, as they cannot voice an opinion on consumption and risk of raw milk if it is in their household. The Center for Disease Control and Prevention (CDC) collects data on foodborne disease outbreaks voluntarily reported by state, local or territorial health departments. According to the CDC from 2013 to 2018 there were 75 outbreaks of illness linked to raw milk consumption. These outbreaks include 675 illnesses and 98 hospitalizations. Most of these illnesses were caused by Campylobacter, shiga-toxigenic E. coli, or Salmonella. An increase in outbreaks has been correlated with changes in the availability of raw milk. For example, between 2009 and 2023, there were 25 documented outbreaks in the state of Utah, which has 16 raw milk retailers licensed by the Utah Department of Agriculture and Food. In all of these outbreaks, the raw milk was contaminated with the bacteria Campylobacter, which typically causes gastroenteritis symptoms like diarrhea and nausea, but may also cause chronic illness, including Guillain-Barré syndrome which can cause paralysis. How likely are these illnesses to happen from drinking raw milk? It is difficult to say. Foodborne illness is often underreported, depending on how severe people’s symptoms are. According to one study, only about 3.2% of the U.S. population drinks raw milk, while about 1.6% eats cheese made from raw milk. But compared with consumers of pasteurized dairy products, they are 840 times more likely to experience an illness and 45 times more likely to be hospitalized. The authors of this work used the CDC’s national reporting system to analyze data from 2009 to 2014. Despite health risks, why do some people still drink raw milk? Some people feel a nostalgic connection to raw milk, and others may feel that foods that are not treated with heat retain certain nutrients and enzymatic activity. I am not aware of any peer-reviewed rigorous scientific studies that indicate the nutritional benefits of consuming raw milk over time, given the risks of potential for illness, combined with a well balanced diet full of healthful food choices. It remains that raw milk is particularly risky for children to consume, as children can get sick from consuming fewer bacterial cells compared to adults. More than 900 cases of highly pathogenic avian influenza — the disease commonly known as bird flu — have been detected in dairy cattle across 16 states, and at least 40 people have been infected with the disease from close contact with dairy cows. Raw milk is being tested for the virus. With raw milk gaining interest among consumers, what are the possible consequences? Does it elevate the risk of bird flu spreading further to people? There remain clear risks of transmission of pathogenic bacteria through consumption of raw milk, and now with the potential for contamination of raw milk with avian influenza, it is even more important that consumers protect themselves by drinking pasteurized milk. The people most at risk right now are those involved with the milking process and in the handling of dairy cattle. So it is important that those individuals be aware of the risks and take appropriate precautions, including hand washing and wearing appropriate personal protective equipment like protective clothing, gloves, face shields and eye protection. As of December, the U.S. Department of Agriculture is requiring 13 states to share raw milk samples so the agency can test for bird flu viruses. How could this testing better help us understand the virus? I think it is very smart that USDA is leading the National Milk Testing Strategy, which will help us understand the extent of infected herds. Surveillance of microorganisms is an important way to assess risk so we can develop appropriate strategies to reduce and control these risks.
New Year's Resolutions: Why they fail and how we can stick to them
By now, most people have already made their New Year's resolutions and (hopefully) put them into practice. But most people — about 90% — give up on them within the first few weeks of the year. University of Delaware experts dig into the psychology behind why resolutions fail and offer a recipe for success. The timing of New Year’s resolutions also isn’t always ideal. According to Philip Gable, professor in the Department of Psychological and Brain Sciences, a lack of commitment is one reason why many people fail to achieve their goals. “New Year's resolutions sometimes lack in commitment,” he said. “It's just this time of year when people feel like they should make a resolution, as opposed to other times in the year when it's less common but maybe more meaningful, like if you get a doctor's report and realize you need to change that aspect of your life.” In order to be part of the 10% of people who keep their New Year’s resolutions, Gable said to break down big goals into small, achievable steps. “I think a lot of times with goals, people will commit to a very big goal and not realize the smaller steps they need to take to achieve that goal,” Gable said. “If we have too big of a goal, we get emotionally distressed when we can't do it, or we fail because we set too big of a goal. Or maybe we couldn't think through all of the elements required to meet that really big goal. So starting small gives us something achievable, and then that gives you a platform to go to the next thing.” Naomi Sadeh, associate professor in the Department of Psychological and Brain Sciences at the University of Delaware, said that part of the reason it’s so hard to make long-term changes is that humans are wired to prioritize instant gratification over delayed rewards. In other words, when posed with an option, we tend to pick the easy choice with an immediate outcome to satisfy a need today instead of delaying gratification for a bigger reward — we splurge on items we don’t really need instead of saving money, order takeout instead of cooking a healthy meal, or binge-watch a TV show instead of going to the gym. “With impulsivity and with breaking New Year's resolutions, often it's when people tend to opt for that sooner, smaller reward over the longer, bigger reward,” Sadeh said. “The sooner reward is really tempting, even if it's not as satisfying in the long run as the longer goal or bigger goal that you had.” When people set goals, they tend to feel very motivated for a few days and falsely assume they’re committed to their goal. But as soon as that motivation wears off, they give up. “There's potentially a mismatch in the timing of your goals,” said Rob West, interim chair and professor in the Department of Psychological and Brain Sciences. “Your goals are immediate, they're conscious, they're volitional. You have those in the moment, and they can be developed and abandoned quickly. But habits take a considerable amount of time and repetition.” To connect directly with Gable, visit his profile and click on the connect button. Interviews with other researchers can be arranged by contacting UD's Media Relations department.
AI Everywhere: Where Artificial Intelligence and Health Care Intersect
Imagine a world where AI doesn’t just support health care providers, but anticipates their next move — detecting diseases faster than human eyes, analyzing patterns and patient data that humans might overlook and revolutionizing health care decision making at every level. Driven by data, AI can identify which patients are most likely to have repeated emergency department visits or thrive from personalized medicine. With the power of robotics enhanced by AI, people with medical needs can gain more independence, managing daily tasks such as taking medication, monitoring their health and receiving personalized care, all from the comfort of their own homes. And this is just the beginning. “AI is transforming – and is going to continue transforming – every industry, especially health care,” said Bharat Rao, a notable figure in the fields of health care, technology and AI. Rao himself has made significant contributions to artificial intelligence, machine learning and data analytics, particularly in health care innovation. His current start-up, CareNostics, uses AI technology to identify patients at increased risk for chronic disease. “We take this for granted,” he said, “but it’s like what I used to see on Star Trek as a kid. The opportunities are limitless.” Rao was a keynote speaker at ChristianaCare’s inaugural Innovation Summit, a two-day conference at ChristianaCare’s Newark campus in Delaware, in fall 2024. During panel discussions and keynotes, more than 200 attendees heard about current and future health tech from national innovators and thought leaders, as well as technical advice for inventors who want to patent ideas and protect intellectual property in a world where “AI Is Everywhere,” the conference’s theme. Speakers emphasized that it’s not just technologists, but also researchers, clinicians and other health care professionals who play an essential role in implementing AI-based health care solutions. “There’s no AI without HI, which is human intelligence,” said Catherine Burch, MS, CXA, CUA, vice president of innovation at ChristianaCare. “You want to help shape the future, not wait for it to shape you.” How AI helps improve patient care “AI is incredibly good at reducing noise in images,” said speaker David Lloyd, a technical leader at Amazon, who discussed the use of AI in radiology. “It can detect anomalies, and it can automate radiologist reports, which saves time for radiologists.” Data informatics is another example of the power of AI to help health professionals determine which patients are at an increased risk for falls, malnutrition or recurrent asthma attacks, enabling them to optimize patient health and prevent hospitalizations. “Some patients with asthma go to the ER repeatedly because their treatment plan isn’t working,” said speaker Vikram Anand, head of data at CareNostics. When patients have uncontrolled asthma, data-rich platforms like CareNostics can provide treating physicians with guidelines and other support to improve patient care, which may lead to evidence-based medication changes or other therapies, he said. Using robots as part of the health care team in patient homes may sound like science fiction, but speakers discussed the current evolution of consumer robotics, like Amazon’s Astro. Astro follows patients around their home, interacts with them and supports their care. When ChristianaCare tested Astro’s impact on HomeHealth patients, they found that it reduced feelings of isolation by 60%. “Astro is like Alexa on wheels,” said speaker Pam Szczerba, PT, MPT, CPHQ, director of ChristianaCare’s HomeHealth quality, education and risk management, who studied patients’ experiences with Astro. “People like interacting with Alexa, but they can only interact in the room they’re in. Astro’s mobility lets it go to the patient.” Based on early successes, health professionals are assessing robots as an extension of clinicians in the home. Early results show that patients with robots show improved activation with their care plans. This may lead to more widespread distribution of household robots to newly diagnosed patients to help prevent disease complications, avoidable emergency department visits and re-hospitalizations. How AI helps ease provider burden Speakers also discussed the potential of AI to improve health care delivery and patient outcomes by handling more administrative work for health professionals. “We can reduce some of the redundancy of work to free up time for people to be creative,” said speaker Terrance Bowman, managing director at Code Differently, a company that educates and prepares people to work in technology-driven workplaces. “AI should be taking the ‘administrivia’ – administrative trivial tasks – out of your life,” said speaker Nate Gach, director of innovation at Independence Blue Cross. “When you want folks to do the creative part of the job that takes brain power, have ChatGPT respond to easy emails.” Other examples shared included the power of AI to record meetings, create summaries and send participants automated meeting minutes. Benefits can be seen across industries. Specific to health care, eliminating the need for note-taking during visits enables more personalized and attentive provider-patient interaction. With the evolution of ambient speech apps, clinicians are no longer just dictating notes into the electronic health record. Now AI is listening to the conversation and creating the notes and associated recommendations. “The physician is no longer spending ‘pajama time’ doing catch-up work, at home late into the evening,” said speaker Tyler Flatt, a director and leading expert in AI and digital transformation at Microsoft. “Especially as we’re dealing with burnout, it’s better for patient and physician satisfaction.” AI may also help caregivers uncover details that they hadn’t noticed, helping them diagnosis patients with subtle symptoms. “We feed a large quantity of data and have it suggest commonalities about patients,” said speaker Matthew Mauriello, assistant professor of computer and information sciences at the University of Delaware. “Some things are very insightful, but humans miss them.” AI has also been used for patient engagement, including chatbots that can assist with tasks like scheduling clinical appointments or acknowledging patient questions. “One of the things AI is great at is natural language understanding,” said David Lloyd. “You can alleviate a lot of the burden if you have something that can talk to your patients, especially if it’s an administrative task.” Creating new health innovations “The key is to think of something you’ve done that’s original and non-obvious,” said Rao, who holds more than 60 patents in AI. “The process of writing about it will help you flesh it out.” Turning breakthrough ideas into game changers is just the start — protecting these innovations is what ensures they shape the future, rather than fade into the past. “Keeping it secret and internal to your organization until you know what you want to do with it is important,” Greg Bernabeo, partner at FisherBroyles, LLP, said. “Otherwise, the opportunity is lost, and you can’t get the genie back in the bottle.” Benefits of non-obvious thinking People who pursue “non-obvious” ideas are often on the cutting edge of technology in and out of health care, said keynote speaker, Ben DuPont, while discussing innovative ideas with Randy Gaboriault, MS, MBA, senior vice president and chief digital and information officer at ChristianaCare. “Amazon was not founded by a book retailer; Airbnb was not founded by somebody who was in hospitality,” said DuPont, author, entrepreneur, and co-founder and partner at Chartline Capital Partners venture capital fund. “Before Uber, the founders were running around Paris and they couldn’t get a taxi.” Innovative ideas often arise when people consider non-obvious points of view while thinking about solutions, DuPont said. Non-experts have the ability to cut through the clutter and find the frustration, which can lead to innovative solutions, which DuPont explores in his book “Non-Obvious Thinking: How to See What Others Miss.” Health providers, for example, may discover ideas when they move out of their comfort zones. “If you want to be a better doctor, go do something that has nothing to do with medicine,” he said. “Innovation happens at the collision of seemingly unrelated disciplines.” Diversity in the workplace is necessary, “but it’s not just diversity in the way people look: It’s diversity in how people think,” DuPont said. “There are people that think in dramatic and different ways. We need those people around the table. They might say: ‘If we just move this little thing over here’ … and it starts an avalanche that changes the world.” Involving the future generation During the Innovation Summit, students with an interest in STEM (science, technology, engineering, and mathematics) from St. Mark’s High School in Wilmington, Delaware, competed against one another at ChristianaCare’s inaugural HealthSpark ChallengeTM. Twenty-six high school juniors and seniors were divided into five teams, then challenged to brainstorm ideas for solutions to address the negative mental health effects of social media on teenagers. Each team created a concept poster and pitched their ideas to Summit attendees. The attendees then voted for their favorite solution. The winning solution, Editing Identifiers, is designed to help minimize negative feelings about body image among teens. The solution would use AI technology to identify altered photos on social media. The goal would be to show teens that photos of “perfect” people aren’t real and alleviate the feelings of body dysmorphia. Looking forward Summit speakers highlighted many ways that AI is already incorporated into health care, as well as ways that health tech, AI, and robotics may improve care for patients in the coming years. “We are just scratching the surface,” Rao said. “It’s like laparoscopic surgery – years ago, it was considered experimental or dangerous. Today, surgery is commonly done laparoscopically, with better outcomes and less infection. AI can help identify care gaps and get the right treatment to the right patient. It’s going to be good for the patient.” In a rapidly evolving landscape, the integration of AI into health care not only enhances patient care but also creates opportunities for innovation and collaboration, said ChristianaCare’s Gaboriault. “As AI continues to advance, the health care industry stands on the brink of a revolution, one where the possibilities are as vast as the data that fuels them.”
