PROVIDENCE, R.I. [Brown University] — A team of researchers from Brown University’s School of Public Health, Brown’s School of Engineering and Silent Spring Institute found that simple air filtration devices called Corsi-Rosenthal boxes are effective at reducing indoor air pollutants.
Credit: Photo: Ken Zirkel
PROVIDENCE, R.I. [Brown University] — A team of researchers from Brown University’s School of Public Health, Brown’s School of Engineering and Silent Spring Institute found that simple air filtration devices called Corsi-Rosenthal boxes are effective at reducing indoor air pollutants.
The study, which analyzed the effectiveness of Corsi-Rosenthal boxes installed at the School of Public Health to help prevent the spread of COVID-19, is the first peer-reviewed study of the efficacy of the boxes on indoor pollutants, according to the authors.
Lowering indoor air concentrations of commonly-found chemicals known to pose a risk to human health is a way to improve occupant health, according to lead author Joseph Braun, an associate professor of epidemiology at Brown.
“The findings show that an inexpensive, easy-to-construct air filter can protect against illness caused not only by viruses but also by chemical pollutants,” Braun said. “This type of highly-accessible public health intervention can empower community groups to take steps to improve their air quality and therefore, their health.”
Corsi-Rosenthal boxes, or cubes, can be constructed from materials found at hardware stores: four MERV-13 filters, duct tape, a 20-inch box fan and a cardboard box. As part of a school-wide project, boxes were assembled by students and campus community members and installed in the School of Public Health as well as other buildings on the Brown University campus.
To assess the cubes’ efficacy at removing chemicals from the air, Braun and his team compared a room’s concentrations of semi-volatile organic compounds before and during the box’s operation.
The results, published in Environmental Science & Technology, showed that Corsi-Rosenthal boxes significantly decreased the concentrations of several PFAS and phthalates in 17 rooms at the School of Public Health during the period they were used (February to March 2022). PFAS, a type of synthetic chemical found in a range of products including cleaners, textiles and wire insulation, decreased by 40% to 60%; phthalates, commonly found in building materials and personal care products, were reduced by 30% to 60%.
PFAS and phthalates have been linked to various health problems, including asthma, reduced vaccine response, decreased birth weight, altered brain development in children, altered metabolism and some cancers, said Braun, who studies the effect of these chemicals on human health. They are also considered to be endocrine-disrupting chemicals that may mimic or interfere with the body’s hormones. What’s more, PFAS have been associated with reduced vaccine response in children and also may increase the severity of and susceptibility to COVID-19 in adults.
“The reduction of PFAS and phthalate levels is a wonderful co-benefit to the Corsi-Rosenthal boxes,” said study co-author Robin Dodson, a research scientist at Silent Spring Institute and expert in chemical exposures in the indoor environment.. “These boxes are accessible, easy to make and relatively inexpensive, and they’re currently being used in universities and homes across the country.”
“The Corsi-Rosenthal box was designed to be a simple, cost-effective tool to promote accessible and effective air cleaning during the COVID-19 pandemic; the fact that the boxes are also effective at filtering out air pollutants is a fantastic discovery,” said Richard Corsi, one of the inventors of the boxes and dean of the College of Engineering at the University of California, Davis. “I am thrilled that researchers at Brown University and Silent Spring Institute have identified a significant co-benefit of the boxes with respect to reduced exposure to two harmful classes of indoor pollutants: PFAS and phthalates.
The sentiment was echoed by Jim Rosenthal, Corsi’s collaborator and CEO of Air Relief Technologies, the company that manufactures the MERV-13 filters used in Corsi-Rosenthal Boxes.
“This interesting research showing that the air filters not only reduce particles carrying the SARS-CoV-2 virus but also reduce other indoor air pollutants could be very significant as we continue to work to create cleaner and safer indoor air,” Rosenthal said.
The researchers also found that the Corsi-Rosenthal boxes increase sound levels by an average of 5 decibels during the day and 10 decibels at night, which could be considered distracting in certain settings, such as classrooms. However, Braun said, the health benefits of the box likely outweigh the audio side effects.
“The box filters do make some noise,” Braun said. “But you can construct them quickly for about $100 per unit, with materials from the hardware store. They are not only highly effective but also scalable.”
Brown study authors include Kate Manz and Kurt Pennell from the School of Engineering, and Jamie Liu, Shaunessey Burks and Richa Gairola from the School of Public Health. This research was supported by the National Science Foundation and the National Institute of Environmental Health Sciences.
Journal
Environmental Science & Technology
DOI
10.1021/acs.est.2c05169
Method of Research
Observational study
Subject of Research
Not applicable
Article Title
Using Corsi-Rosenthal Boxes to Mitigate COVID-19 Transmission Also Reduce Indoor Air Concentrations of PFAS and Phthalates?
Article Publication Date
23-Dec-2022
COI Statement
Competing financial interests: Joseph Braun was financially compensated for his services as an expert witness for plaintiffs in litigation related to PFAS-contaminated drinking water.
The Research Brief is a short take about interesting academic work.
The big idea
One third of families who relied on formula to feed their babies during the COVID-19 pandemic were forced by severe infant formula shortages to resort to suboptimal feeding practices that can harm infant health, according to our research published in the journal Maternal and Child Nutrition.
As psychologyresearchers who study breastfeeding, this situation left us concerned for the safety of infant nutrition. With two colleagues who focuson public health, we conducted an online survey of over 300 infant caregivers in the U.S. to understand how many families had trouble obtaining infant formula and what they fed their babies when they did.
Considering the scope of the formula shortages, we were not surprised that 31% of the formula-feeding families we surveyed reported challenges obtaining infant formula, the most common being that it was sold out and they had to travel to more than one store.
But their babies still needed to eat. Being unable to get their hands on infant formula pushed caregivers to potentially unhealthy or even dangerous stopgaps. For example, 11% of the formula-feeding families surveyed said they practiced “formula-stretching” – diluting infant formula with extra water to make formula supplies last longer, which provides a baby with less nutrition in each bottle.
Furthermore, 10% of formula-feeding families reported substituting cereal for infant formula in bottles, 8% prepared smaller bottles and 6% skipped formula feedings for their infants, which all provide infants with less nutritious meals.
Exclusively breastfeeding families were insulated against these supply disruptions. Almost half of breastfeeding families surveyed reported that COVID-19 lockdowns actually allowed them time to increase their milk supply.
Why it matters
Our study suggests that the waves of formula shortages from 2020 to 2022 in the U.S. were more than just an inconvenience for parents. Instead, this study is the first to document that formula shortages likely had real and widespread adverse impacts on infant nutrition, given that a large proportion of parents surveyed resorted to feeding their baby in ways that can harm infant health.
Given that approximately 75% of infants in the U.S. are fed with infant formula in the first six months of life, formula shortages could put roughly 2.7 million babies each year at risk for suboptimal feeding practices.
President Biden met with baby formula manufacturers in June 2022 to discuss shortages.Kevin Dietsch/Getty Images
The best way to protect infant nutrition from supply chain issues is to promote and support breastfeeding, which provides optimal infant nutrition and insulates infants from those disruptions. Since not all babies can be breastfed, though, governmental policies could help prevent and address acute formula shortages and ensure equitable formula access for all.
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
Post-bariatric surgery exercise modulates brain regions associated with regulation of food intake
Physical exercise practiced by patients submitted to bariatric surgery acts on brain regions involved in food intake, reducing hunger or accelerating satiety,…
Physical exercise practiced by patients submitted to bariatric surgery acts on brain regions involved in food intake, reducing hunger or accelerating satiety, for example. This was the result observed in a clinical trial conducted at Hospital das Clínicas (HC), the hospital complex run by the University of São Paulo’s Medical School (FM-USP) in Brazil. An article on the study, pointing to positive effects of exercise on obesity-related conditions in post-bariatric patients, is published in the International Journal of Obesity.
Credit: Carlos Merege Filho
Physical exercise practiced by patients submitted to bariatric surgery acts on brain regions involved in food intake, reducing hunger or accelerating satiety, for example. This was the result observed in a clinical trial conducted at Hospital das Clínicas (HC), the hospital complex run by the University of São Paulo’s Medical School (FM-USP) in Brazil. An article on the study, pointing to positive effects of exercise on obesity-related conditions in post-bariatric patients, is published in the International Journal of Obesity.
The study showed that an exercise training program starting three months after bariatric surgery produced functional alterations in brain networks associated with food intake and modified by obesity. The findings confirm the hypothesis that exercise and bariatric surgery act synergistically on the connectivity among brain regions associated with cognition, reward and emotional regulation, potentially moderating hunger and enhancing satiety.
According to the article, exercise increased the connectivity between the hypothalamus (the brain region that controls homeostasis, including regulation of appetite and energy expenditure) and the brain’s sensory areas. At the same time, it apparently decreased the link between the default mode network, which is more active during a resting state, and the salience network, the brain region involved in decision-making.
The researchers also found that exercise after bariatric surgery appeared to modulate the medial hypothalamic nucleus involved in appetite suppression and increased energy expenditure.
“The regulation of energy expenditure is governed by multiple internal and external signals. People with obesity display major dysregulation of brain regions associated with appetite and satiety. Our study showed that exercise by post-bariatric patients helped ‘normalize’ these complex networks so as to improve the central control of food intake. For example, some of these regions are activated and connect more intensely in people with obesity when they eat fatty or sugary food, increasing their desire to consume such food. We found that exercise counteracts this effect, at least in part,” Bruno Gualano, last author of the article, told Agência FAPESP. Gualano is a professor at FM-USP.
The study was supported by FAPESP via a research grant for the project “Effects of exercise training in patients undergoing bariatric surgery: a randomized clinical trial” and was part of the PhD research of Carlos Merege Filho, first author of the article, with a scholarship from FAPESP. The co-authors included Hamilton Roschel, Marco Aurélio Santo, Sônia Brucki, Claudia da Costa Leite, Maria Concepción García Otaduy and Mariana Nucci (all of whom are affiliated with HC-FM-USP); and John Kirwan of Pennington Biomedical Center (USA).
Considered one of the world’s main public health problems, obesity is a chronic disease characterized by excessive body fat accumulation and a major risk factor for cardiovascular and musculoskeletal disorders, as well as severe COVID-19. The parameter used for diagnosis in adults is body mass index (BMI), defined as weight in kilograms divided by height squared in meters. A BMI between 25 and 29.9 indicates overweight, while 30 or more signals obesity, according to the World Health Organization (WHO).
Brazil has one of the highest rates of overweight and obesity in the world. According to projections, almost 30% of the adult population will be obese in 2030. A billion people, or 17.5% of the world’s adult population, will be obese by then, according to the World Obesity Atlas 2022 published by the World Obesity Federation.
Importance
From the clinical standpoint, Gualano believes, the findings suggest that exercise should be considered an important complementary therapy to improve brain functions and enhance the known benefits of bariatric surgery, such as a reduction in cardiometabolic risk factors, as well as preservation of muscle mass and bone health.
He and his group have been conducting research in this field since 2018, as evidenced by other publications, one of which showed that exercise attenuated and reversed loss of muscle mass, improving muscle strength and function in post-bariatric patients. Genotypic and phenotypic analysis evidenced metabolic and structural remodeling of skeletal muscle.
In another study, exercise reduced risk factors for diseases associated with obesity, such as diabetes, high blood pressure and atherosclerosis (hardening of the arteries), by increasing sensitivity to insulin, combating inflammation and improving the health of blood vessels.
Methods
The randomized clinical trial reported in the International Journal of Obesity involved 30 women aged between 18 and 60 who had been submitted at HC-FM-USP’s bariatric surgery unit to a Roux-en-Y gastric bypass, which creates a small stomach pouch to restrict food intake and bypasses a large portion of the small intestine to limit calorie absorption. A majority of patients admitted to the unit are women.
Half the study sample were randomly assigned to a six-month exercise program of resistance and aerobic training three times a week, starting three months after the operation and supervised by a team of physical education professionals.
Clinical, laboratory and brain functional connectivity parameters were assessed at the start of the trial, as a baseline, and again three and nine months after the operation. Functional magnetic resonance imaging (fMRI) was used to detect connectivity between anatomically distinct brain areas organized as networks, and to analyze the combined effects of the surgical procedure and exercise training. Data collection began in June 2018 and ended in August 2021.
“The literature has already shown that post-bariatric patients have many brain alterations compatible with improved control of appetite, satiety and hunger in neural circuits that govern food intake. Our study found that exercise training bolstered this response,” Gualano said, noting the importance of lifestyle changes to maintain the benefits of weight loss for people with obesity.
Bariatric surgery can currently be performed on patients with a BMI of between 30 and 35 and type 2 diabetes that has not been controlled for more than two years, and patients with a BMI over 35 who have other diseases associated with overweight, such as high blood pressure, sleep apnea or hepatic steatosis (fatty liver disease). For people with comorbidities, the recommended BMI is over 40.
In the past five years, 311,850 bariatric surgeries have been performed in Brazil; 14.1% were paid for by the SUS (Sistema Único de Saúde), the national health service. The rest were covered by insurance policies or paid for privately, according to the Brazilian Bariatric and Metabolic Surgery Society (SBCBM).
“Regular exercise is known to induce several physiological adaptations that translate into health benefits. These benefits are reversed if the patient stops exercising regularly. Our study didn’t measure the duration of the brain changes induced by exercise, however. They’re highly likely to diminish and possibly even go into reverse as the amount and intensity of exercise decrease. It’s crucial to adopt a healthy lifestyle in order for the responses to bariatric surgery to be long-lasting,” Gualano said.
Next steps for the research group will include studying the effects in people with obesity of exercise and diet combined with other weight loss strategies, including new drugs such as peptide analogs or incretin mimetics, a class of medications commonly used to treat type 2 diabetes. Incretins are gut hormones that aid digestion and blood sugar control by signaling to the brain to stop eating after a meal.
In early January, the National Health Surveillance Agency (ANVISA) approved semaglutide as an anti-obesity drug for long-term weight management. The drug had previously been approved only for patients with type 2 diabetes. It is the first injectable anti-obesity medication available in Brazil and is supposed to be administered once a week. It is said to enhance satiety, modulate appetite and control blood sugar.
About São Paulo Research Foundation (FAPESP)
The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe
Journal
International Journal of Obesity
DOI
10.1038/s41366-022-01251-8
Article Title
Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial
It's the Washington, D.C. power couple that cost taxpayers nearly $1 million per year.
While Dr. Anthony Fauci gave the nation its pandemic public policy prescriptions, his wife, Dr. Christine Grady, the Chief Bioethicist at Fauci’s employer, the National Institutes of Health (NIH) provided the moral framework.
The Faucis are important to the center-left, because they represent the pinnacle moment of the administrative state – top-down public policy run by an elite group of government scientists.
Conversely, to the center-right, the Faucis represent “the fatal conceit of the elites.” As Noble Laureate economist Friedrich Hayek theorized, the elites are no match for billions of free people acting in their own best interests.
MEET THE FAUCIS
While Tony Fauci was the top paid federal bureaucrat and out-earned the U.S. President at $480,654 per year, Christine Grady, as the chief bioethicist at NIH out-earned the U.S. Vice President ($243,749). When adding 35-percent in benefits, the couple cost taxpayers an estimated nearly $1 million per year.
“I've benefited greatly from this partnership of overlapping interest and common interest. So, a lot of the things that I do with regard to the development of vaccines, the development of therapies, being involved with outbreaks and pandemics, have ethical overtones to them. I can say that I am very blessed to be living with someone who is very likely, most people think, one of the most outstanding ethicists in the world. To have her in the house -- you know, as a consultant on ethical issues—is pretty advantageous.”
So, the Faucis lived a conflict of interest at the breakfast table, the office, and back home around the dinner table. However, NIH has never acknowledged this.
In fact, NIH forced our organization to file two federal lawsuits with the public-interest law firm Judicial Watch as our lawyers to finally bring transparency to the Fauci/Grady job descriptions, conflict of interest documents, financial and ethics disclosures, contracts, and other documents.
Then, NIH slow-walked thousands of pages of production. Yet, no nepotism waivers were produced, no acknowledgement of conflicting interests, and no records documenting violations of federal ethics policy.
While Grady’s work during the pandemic was described as “invaluable” by then-NIH director Francis Collins, the general public knows little about her day-to-day responsibilities.
Dr. Fauci knew that his “draconian policies” on social isolation and economic lockdowns would have “collateral negative consequences,” and admitted Christine Grady was a driving force behind his hardline approach.
In a November 2021 interview with the couple, Fauci said that he gained strength from his wife’s support saying, “background and her experience in really core ethical principles [helped] me to really feel much more comfortable in what I was saying.”
In the interview, Christine Grady described how she mind-mapped national policy with her husband:
"But we've had conversations about the sort of consequences of telling people to stay home and what it would do for the economy. And there were a lot of people in those days that, and still who said, it's ruining the economy. It's much more important to just keep things going and not worry about transmitting virus…I said, that one of the messages should be, how many lives are you willing to sacrifice? And that message would be pretty stark and pretty brutal, but that's really what the trade-off was…And so we've had that kind of conversation over dinner more than once, actually.”
Fauci replied that these conversations “sharpened [his] resolve” to move forward with lockdown policies.
Social isolation was one of the individual sacrifices Grady and Fauci thought were necessary to make on behalf of “public health.”
Vaccine Development & Public Safety
Like her husband, Grady exclusively focused her attention and remarks on vaccine development rather than other potential ways to treat and combat the spread of COVID-19.
In this paper, Grady’s advocacy for vaccines came with a troubling acknowledgement:
“even with mandated safety monitoring after EUA distribution, it would be difficult or impossible to ascertain vaccine-induced adverse events.”
However, during most of her public presentations, she asserted that vaccines were developed in a fast, but “safe and rigorous” manner. Just one of many examples can be found here.
By November 2021, she said the risk of unknown long-term effects were “not zero” but that “there is a balance between benefiting the public health now versus waiting for all the information we might get.”
Grady’s stance on vaccine mandates changed radically throughout the pandemic.
In June 2020, a presentation she gave suggested “immunity passports” could cause “discrimination without much overall gain.” A passport system would allow businesses to limit or deny access to those who remained unvaccinated.
Six months later, in January 2021, Grady said, “I do believe that healthcare providers, like everyone else, should have the choice” whether to take the vaccine or not.
Later that month, she also flipped her position on vaccine passports. What once was a potential source of discrimination was recast as a way to access “social benefits” like restaurants and movie theaters.
It’s a disturbing way to describe Americans free association of movement.
Grady went on to co-author a March 2022 report approving of social ostracization for the vaccine-hesitant and encouraging employers to pressure their workers:
“While some employers might understandably feel hesitant to pressure employees to get vaccinated, our analysis suggests that it is often ethically acceptable to inform, encourage, strongly encourage, incentivize, and subtly pressure unvaccinated people to benefit them, the organization, and other employees.”
In fewer than two years, Grady had completely altered her assessment of vaccine mandates and widespread restrictions on the behavior of unvaccinated Americans. Gone were concerns about discrimination and freedom of choice.
As Dr. Fauci pushed and pressured the public to get vaccinated for the sake of their neighbors and family members, Grady began considering it ethical to fire workers who did not comply.
Likewise, it became a “social benefit” to get a vaccine passport that would allow people to avoid government restrictions on their free movements.
Interviewer: Let me ask you, Chris, as a bioethicist, what do you make of this moment we're in, when even a mask has become more of a divisive issue?
Grady: Well, I would say that masks shouldn't be divisive. It's a relatively easy way to protect one's self and others. And so for public health reasons, I think everybody should do it. From an ethical perspective there is always this tension between what you ask people to do that feels like a restriction of their liberty and what is required for public health. And in this case, it seems like a slam dunk. It's not restricting liberty much, and it's very helpful for public health.
“There's a classic tension between public health, and individual interests and freedoms. Where there seems to be this conflict to the things that we do to protect the public health, and to protect the population for the common good. Sometimes they are perceived to be, and sometimes they do in small ways, infringe on people's freedoms. There are principles of public health ethics that help you sort out the kinds of interventions that we should use: Things that are effective, that are proportional, where the benefits outweigh the risks that are necessary, that are least infringement possible, that are transparent, that we can publicly justify.
…What's striking to me is that, the kinds of burdens that we've asked people to undertake, like putting on a mask, don't really infringe on one's freedoms very much. They're low burden and they have an effect. They do protect the person who's wearing the mask, as well as the people that are around them.”
A recent credible study on mask wearing during the pandemic argued there is no clear impact of masking on Covid-19 infection rates.
Patients Dying in Isolation
During the pandemic, Grady revealed a default preference for government control over individual rights and responsibilities. Grady was an early proponent of one of the most heinous pandemic polices: patients dying in isolation.
For example, while uncritically accepting dying in isolation as a fact of the pandemic, Grady’s primary solution was to expand funding for health care workers to have access to therapy and other resources to heal from their “moral distress.”
“Because of visiting policies and fear of contagion sometimes when somebody is really sick their family cannot visit them, they can't see them…the stress and the sadness and the isolation on families is and is going to be great.”
"It’s a lonely kind of death, many institutions, understandably have visitor policies which either restrict the number of visitors to one or zero so sometimes people are dying without having their family nearby and that puts an additional burden on the healthcare staff.”
In one co-authored paper urging healthcare workers to “temper these potentially dehumanizing scenarios with imaginative solutions that do not sacrifice compassion and equal respect on the altars of safety and efficiency.”
She interrogates the tension between individual freedom and community safety in a book published April 26, 2022, as a co-author proposing a radical “solidarity model” for ethics in healthcare, stating that rather than emphasizing a respect for individuals to make decisions in their own interest:
“We should recognize that there are times when solidarity takes precedence over individual liberties, and broadening our concept of “respect for persons” means uniting as a profession to protect all those who expect to receive care from nurses in whatever healthcare setting they find themselves.”
She co-edited a section in the same book arguing this extends to dying in insolation:
“The solidarity model may apply to restricted family visitation, which generated moral distress for nurses, particularly when patients died without loved ones present…”
CONCLUSION – GRADY AND THE NEXT PANDEMIC
As demonstrated by her own words, Grady’s record evinces an understanding of ethics that begs fundamental moral questions, regularly subordinates individuals beneath an amorphous “public health,” and relies on subtle but unacknowledged shifts to retain an alleged moral high ground.
While some of her observations early in the pandemic did show an interest in providing nuance to policymaking—questioning the usefulness of immunity passports and highlighting issues with long-term vaccine effects under a EUA rollout—this quickly gave way to conformity to broader political zeitgeist, painting pushback as ignorant, uncaring, and simply wrong.
By 2021 her public statements never suggested a limit to sacrifices the individual should ethically make on behalf of “public health,” from masking, to taking vaccines, to foregoing family gatherings even at the point of one’s own death.
Both Fauci and Grady made clear that they wish for ethicists like Grady to have more power and more influence over political decision-making.
As Grady remains the chief NIH bioethicist, Americans should ponder: does Grady’s philosophy advance what is “fair” and “just” in public health policy? What does her continued leadership mean for the future of American policy.
Taxpayers compensate Grady generously, and they’re owed full transparency about her role, responsibilities and influence – during the pandemic and into the future.
Note: We reached out to Dr. Christine Grady and NIH for comment. While acknowledging our requests, no statement or comment was received before publication.
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