Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community.

Background: Smoke exposure from wildfires or residential wood burning for heat is a public health problem for many communities. Do-It-Yourself (DIY) portable air cleaners (PACs) are promoted as affordable alternatives to commercial PACs, but evidence of their effect on health outcomes is limited. Objective: Pilot test an evaluation of the effect of DIY PAC usage on self-reported symptoms, and investigate barriers and facilitators of PAC use, among members of a tribal community that routinely experiences elevated concentrations of fine particulate matter (PM2.5) from smoke. Methods: We conducted studies in Fall 2021 ("wildfire study"; N = 10) and Winter 2022 ("wood stove study"; N = 17). Each study included four sequential one-to-two-week phases: 1) initial, 2) DIY PAC usage ≥8 h/day, 3) commercial PAC usage ≥8 h/day, and 4) air sensor with visual display and optional PAC use. We continuously monitored PAC usage and indoor/outdoor PM2.5 concentrations in homes. Concluding each phase, we conducted phone surveys about participants' symptoms, perceptions, and behaviors. We analyzed symptoms associated with PAC usage and conducted an analysis of indoor PM2.5 concentrations as a mediating pathway using mixed effects multivariate linear regression. We categorized perceptions related to PACs into barriers and facilitators of use. Results: No association was observed between PAC usage and symptoms, and the mediation analysis did not indicate that small observed trends were attributable to changes in indoor PM2.5 concentrations. Small sample sizes hindered the ability to draw conclusions regarding the presence or absence of causal associations. DIY PAC usage was low; loud operating noise was a barrier to use. Discussion: This research is novel in studying health effects of DIY PACs during wildfire and wood smoke exposures. Such research is needed to inform public health guidance. Recommendations for future studies on PAC use during smoke exposure include building flexibility of intervention timing into the study design.

Long-term exposure to ambient O3 and PM2.5 is associated with reduced cognitive performance in young adults: A retrospective longitudinal repeated measures study in adults aged 18-90 years.

A growing body of evidence indicates that exposure to air pollution affects cognitive performance; however, few studies have assessed this in the context of repeated measures within a large group of individuals or in a population with a large age range. In this study, we evaluated the associations between long-term exposure to fine particulate matter (PM2.5) and ozone (O3) in large cohort of adults aged 18-90 years. The study cohort included 29,091 Lumosity users in the contiguous US who completed 20 repetitions of the Lost in Migration game between 2017 and 2018. Game scores reflect the ability to filter information and avoid distracting information. Long-term air pollution data included ambient PM2.5 and O3 averaged for the 365-day period before each gameplay date. Generalized linear models were used to examine the associations between long-term PM2.5 and O3 and game score percentile. Co-pollutant models were adjusted for meteorology, time trend, age, gender, device, education, local socioeconomic factors, and urbanicity. Results represent the change in attention game score percentile per 1 µg/m3 increase in PM2.5 or 0.01 ppm increase in O3. In the entire cohort, a -0.10 (95% CI: -0.16, -0.04) change in score percentile was associated with PM2.5, while no significant association was observed with O3. Modification of these associations by age was observed for both PM2.5 and O3, with stronger associations observed in younger users. In users aged 18-29, a -0.25 (-0.45, -0.05) change in score percentile was associated with PM2.5, while no associations were observed in other age groups. With O3, there was a -2.92 (-4.63, -1.19) and -2.81 (-4.29, -1.25) change in score percentile for users aged 18-29 and 30-39, respectively. We observed that elevated long-term PM2.5 and O3 were associated with decreased focus scores in young adults, but follow-up research is necessary to further illuminate these associations.

Short-Term Exposure to Wildfire Smoke and PM2.5 and Cognitive Performance in a Brain-Training Game: A Longitudinal Study of U.S. Adults.

BACKGROUND: There is increasing evidence that long-term exposure to fine particulate matter [PM ≤2.5µm in aerodynamic diameter (PM2.5)] may adversely impact cognitive performance. Wildfire smoke is one of the biggest sources of PM2.5 and concentrations are likely to increase under climate change. However, little is known about how short-term exposure impacts cognitive function. OBJECTIVES: We aimed to evaluate the associations between daily and subdaily (hourly) PM2.5 and wildfire smoke exposure and cognitive performance in adults. METHODS: Scores from 20 plays of an attention-oriented brain-training game were obtained for 10,228 adults in the United States (U.S.). We estimated daily and hourly PM2.5 exposure through a data fusion of observations from multiple monitoring networks. Daily smoke exposure in the western U.S. was obtained from satellite-derived estimates of smoke plume density. We used a longitudinal repeated measures design with linear mixed effects models to test for associations between short-term exposure and attention score. Results were also stratified by age, gender, user behavior, and region. RESULTS: Daily and subdaily PM2.5 were negatively associated with attention score. A 10 µg/m3 increase in PM2.5 in the 3 h prior to gameplay was associated with a 21.0 [95% confidence interval (CI): 3.3, 38.7]-point decrease in score. PM2.5 exposure over 20 plays accounted for an estimated average 3.7% (95% CI: 0.7%, 6.7%) reduction in final score. Associations were more pronounced in the wildfire-impacted western U.S. Medium and heavy smoke density were also negatively associated with score. Heavy smoke density the day prior to gameplay was associated with a 117.0 (95% CI: 1.7, 232.3)-point decrease in score relative to no smoke. Although differences between subgroups were not statistically significant, associations were most pronounced for younger (18-29 y), older (≥70y), habitual, and male users. DISCUSSION: Our results indicate that PM2.5 and wildfire smoke were associated with reduced attention in adults within hours and days of exposure, but further research is needed to elucidate these relationships. https://doi.org/10.1289/EHP10498.

Scaling Up: Citizen Science Engagement and Impacts Beyond the Individual.

As the application of citizen science expands to address increasingly complex social problems (e.g., community health), there is opportunity to consider higher-order engagement beyond that of individual members of a community. The US Environmental Protection Agency (EPA) is working to foster public engagement in science through Smoke Sense, which is a citizen science research project that aims to reduce the public health burden of wildland fire smoke. Smoke Sense is facilitated by a mobile app that shares information on air quality, smoke, and health, and collects individual reports of smoke exposure and concurrent health symptoms. However, Smoke Sense is also generating interest among organizations that are working in this problem domain at the local, state, national, and tribal levels. The interest in the citizen science project at the organizational level led us to ask: What would motivate members of organizations to engage in a citizen science project like Smoke Sense, and how do they envision that engagement could improve public health? To explore these questions, we collected data through interviews with individuals who were engaged in Smoke Sense through their work at local, state, and tribal environmental and health agencies in the western US. An inductive, thematic analysis suggests that individuals' motivations stem from their experiences and challenges with smoke in their different roles (e.g., personal, professional, and community member). Respondents envisioned leveraging both the app itself and the data generated by individuals in their region to enhance and support their existing outreach and communication efforts related to smoke. Citizen science projects that aim to address issues in complex problem domains should be designed to complement the work of partner organizations.

Knowing Your Audience: A Typology of Smoke Sense Participants to Inform Wildfire Smoke Health Risk Communication.

Central to public health risk communication is understanding the perspectives and shared values among individuals who need the information. Using the responses from a Smoke Sense citizen science project, we examined perspectives on the issue of wildfire smoke as a health risk in relation to an individual's preparedness to adopt recommended health behaviors. The Smoke Sense smartphone application provides wildfire-related health risk resources and invites participants to record their perspectives on the issue of wildfire smoke. Within the app, participants can explore current and forecasted daily air quality, maps of fire locations, satellite images of smoke plumes, and learn about health consequences of wildfire smoke. We used cluster analysis to identify perspective trait-clusters based on health status, experience with fire smoke, risk perception, self-efficacy, access to exposure-reducing resources, health information needs, and openness to health risk messaging. Differences between traits were examined based on demographics, health status, activity level and engagement with the app. We mapped these traits to the Precaution Adoption Process Model (PAPM) to indicate where each trait lies in adopting recommended health behaviors. Finally, we suggest messaging strategies that may be suitable for each trait. We determined five distinct perspective traits which included individuals who were Protectors and have decided to engage on the issue by adopting new behaviors to protect their health; Cautious, Proactive, and Susceptible individuals who were at a Deciding stage but differed based on risk perceptions and information needs; and the Unengaged who did not perceive smoke as a health issue and were unlikely to change behavior in response to messaging. Across all five traits, the level of engagement and information needs differed substantially, but were not defined by demographics. Individuals in the Susceptible trait had the highest level of engagement and the highest information needs. Messaging that emphasizes self-efficacy and benefits of reducing exposure may be effective in motivating individuals from the deciding stage to taking health protective action. Shared perspectives define an individual's propensity for acting on recommended health behaviors, therefore, health risk message content should be tailored based on these perspectives.

De novo protein design by citizen scientists.

Online citizen science projects such as GalaxyZoo1, Eyewire2 and Phylo3 have proven very successful for data collection, annotation and processing, but for the most part have harnessed human pattern-recognition skills rather than human creativity. An exception is the game EteRNA4, in which game players learn to build new RNA structures by exploring the discrete two-dimensional space of Watson-Crick base pairing possibilities. Building new proteins, however, is a more challenging task to present in a game, as both the representation and evaluation of a protein structure are intrinsically three-dimensional. We posed the challenge of de novo protein design in the online protein-folding game Foldit5. Players were presented with a fully extended peptide chain and challenged to craft a folded protein structure and an amino acid sequence encoding that structure. After many iterations of player design, analysis of the top-scoring solutions and subsequent game improvement, Foldit players can now-starting from an extended polypeptide chain-generate a diversity of protein structures and sequences that encode them in silico. One hundred forty-six Foldit player designs with sequences unrelated to naturally occurring proteins were encoded in synthetic genes; 56 were found to be expressed and soluble in Escherichia coli, and to adopt stable monomeric folded structures in solution. The diversity of these structures is unprecedented in de novo protein design, representing 20 different folds-including a new fold not observed in natural proteins. High-resolution structures were determined for four of the designs, and are nearly identical to the player models. This work makes explicit the considerable implicit knowledge that contributes to success in de novo protein design, and shows that citizen scientists can discover creative new solutions to outstanding scientific challenges such as the protein design problem.

A strategy of Day14 bone marrows and early intervention is not superior to a strategy of noDay14 bone marrows and delayed intervention in patients with acute myeloid leukemia.

We conducted a retrospective study of 364 acute myeloid leukemia patients treated using a Day14 or a noDay14 strategy. Under the Day14 strategy, patients received an interim marrow at 7-10 days following chemotherapy and, in case of residual disease, received immediate reinduction chemotherapy. Under the noDay14 strategy patients were only evaluated at end-of-induction (EOI). Overall induction mortality was higher in the Day14 cohort (8.3 vs. 3.6%, p = .12) but rates of remission (75.4 vs. 83%, p = .13) and refractory disease (14.3 vs. 13.4%, p = .87) at EOI were similar in the Day14 and noDay14 cohorts as were relapse rates (37.9% vs. 34.3%, p = .616), median relapse-free survival (14.8 vs. 15 months, p = .658) and median overall survival (25.3 vs. 37.2 months, p = .264). In multivariate analysis, the use of a Day14 strategy did not impact outcomes suggesting that a Day14 strategy is not superior to a noDay14 strategy.

Investigating the influence of 'losses disguised as wins' on decision making and motivation in rats.

Multiline slot machines encourage continued play through 'losses disguised as wins' (LDWs), outcomes in which the money returned is less than that wagered. Individuals with gambling problems may be susceptible to this game feature. The cognitive and neurobiological mechanisms through which LDWs act are unknown. In a novel rat operant task, animals chose between a 'certain' lever, which always delivered two sugar pellets, or an 'uncertain' lever, resulting in four sugar pellets on 50% of trials. LDWs were then introduced as a return of three sugar pellets on 30-40% of uncertain rewarded trials. For half the rats, winning outcomes were paired with audiovisual feedback (cues). In a second study, the basolateral amygdala (BLA) was inactivated during initial presentation of LDWs. While LDWs shifted most rats' choice toward the certain lever, a subgroup of LDW vulnerable rats continued to choose the uncertain option, when the reward rate diminished. This profile of LDW vulnerability was reproduced after inactivating the BLA. Persistent choice of uncertain outcomes despite lower reward rates may reflect impaired functioning within the BLA. Future work using this model may provide insight into the neurobiological mechanisms contributing to the motivational properties of LDWs and their contribution to problematic gambling.