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MOUNTAIN VIEW, Calif. — Internet-of-things startup Sateliot announced an agreement Feb. 7 with Sentrisense, an Argentine company focused on power line maintenance, to offer satellite connectivity for electric grid sensors.

The new service will allow Sentrisense to monitor sensors attached to electric towers or power lines, modify the amperage and quickly identify broken wires, fires or other dangerous conditions.

“The massive connectivity between 5G satellites and the sensors will allow far more accurate predictions on wear and tear analysis, and alert to the presence of fallen trees or ice on the lines,” Sateliot CEO Jaume Sanpera said in a statement. In addition, data from the sensors will help Sentrisense determine wire inclination and each wire’s distance from the ground “with an affordable connection of just $1 per month per device,” he added.

Traditionally, Sentrisense devices have relayed data through cellphone towers. Under the new agreement, Sateliot will offer Sentrisense service beyond the reach of cell towers. Sentrisense monitors electric wires in the United States, Australia, Belgium, Chile, Spain and Sweden.

“This connectivity agreement will allow Sentrisense Line guard sensors to connect anywhere in the world, even in remote locations,” Sentrisense CEO Sebastán Cerone said in a statement. “The electric grid, the largest engineering feat of humankind right now, is by definition is an analog asset, and we are fully digitizing it. We want to turn the grid … into a smart tool, able to predict fires and other weather and environmental hazards.”

In addition to relaying data on the condition of the wires, Sentrisense devices report ambient weather conditions like humidity, temperature, wind direction and speed. These reports will help increase the resilience of the electric grid by informing operators of heat waves or blizzard conditions, according to the news release.

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The mortality rate for pregnant people with sickle cell disease is 26 times higher than the national average, research finds. That figure hasn’t improved since the last time assessment.

Researchers have further documented an association between a substantially higher risk of maternal morbidity and mortality among those with the inherited blood disorder sickle cell disease, compared to those without it.

Their analysis, completed using a large national administrative database with records for pregnant people with sickle cell disease, appears in JAMA Network Open.

A double research disparity

The study findings highlight a need for increased disease-specific interventions for pregnant people with sickle cell disease, or SCD, as well as health disparities long known to affect people with the disorder.

In the United States, the condition is most prevalent in the Black community, according to the US Centers for Disease Control and Prevention. From 2000 to 2003, the maternal mortality rate for people with sickle cell disease was 7.2 deaths per 10,000. In this study looking at data collected 15 years later, the mortality rate among pregnant people with SCD was 13.3 deaths per 10,000.

“People with sickle cell disease are already lacking profoundly needed research and clinical care. Pregnant people with sickle cell disease are at an even greater disadvantage,” says Lydia Pecker, assistant professor of medicine specializing in hematology at the Johns Hopkins University School of Medicine.

Pregnancy with SCD

In the new study, researchers applied the US Centers for Disease Control and Prevention Severe Maternal Morbidity index to the National Inpatient Sample—a nationally representative sample of hospital admissions in the United States. Their analysis covered information collected from 2012 to 2018, which included 5,401,899 deliveries. This figure comprised 3,901 deliveries among pregnant people with SCD and 742,164 deliveries among Black people. 84% of those with sickle cell disease who delivered were Black pregnant people.

Maternal mortality—defined as death during pregnancy, at delivery, or soon after delivery—was highest among those with SCD, at 13.3 per 10,000, compared to 1.2 per 10,000 among pregnant Black people and without SCD and 0.5 per 10,000 among non-Black, non-SCD patients during the study period.

“Pregnancy can bring out negative side effects of any pre-existing condition, and sickle cell disease is no exception,” says Ahizechukwu Eke, associate professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine. “Sickle cell patients require more interventions, including increased blood transfusions, and more frequent ultrasounds to assess the condition of the fetus.”

The researchers note that despite improvements in the care of people with SCD and improvements in the care of high-risk pregnancies, maternal mortality and morbidity rates of people with SCD have not improved. These findings suggest that advancements in SCD and high-risk OB care are not reaching enough pregnant people with SCD, the researchers say.

In the United States, 90% of people with SCD are Black, so pregnancies among people with SCD are often exposed to the harms of systemic and interpersonal racism. These factors contribute to high rates of maternal morbidity and mortality among pregnant Black Americans and, the investigators show, this also affects people with SCD.

“Our work demonstrates that people with sickle cell disease face risk over and above other pregnant people with Black race. Among the risks that are specific to people with sickle cell disease are a highly morbid pre-existing condition and a lack of treatment options, in part due to the insufficient research focused on pregnant people with sickle cell disease and in part to the absence of high-quality specialty care in many regions of the country,” says Macy Early, a fourth-year medical student at Johns Hopkins University School of Medicine, and lead author of this study.

Sickle cell disease

SCD is an inherited blood disorder that is estimated to affect 70,000 to 100,000 Americans. The genetic alteration at the root of the disease affects red blood cells that contain hemoglobin, the protein responsible for transporting and delivering oxygen to the body, to become “sickled” in appearance. The disease not only causes anemia, strokes, organ damage, and shortened life spans, but also repeated and frequent episodes of severe pain when the misshapen red blood cells get stuck in small blood vessels.

Although SCD is a lifelong debilitating illness, advances in treatment have led to nearly all affected people in the United States reaching their reproductive years. As such, there is a growing population of people affected by the effects of SCD in pregnancy and study of possible treatments is needed.

For the pregnant person, SCD is linked to heightened risks of blood clots, chronic pain, anemia, and preeclampsia (high blood pressure during pregnancy). The researchers confirmed that babies born to people with SCD tend to be smaller than average, delivered early, and show damage to the placenta. Data from this study also affirm that SCD is associated with an increased risk of fetal death.

Researchers say they next plan to study data at the individual clinic level to analyze how outcomes for patients differ when high-quality OB care is accessible. They hope to accelerate research on risk and treatment during pregnancy, as well as continue to advocate for funding to ensure that all people in the United States receive high-quality care.

A companion paper to this study comparing outcomes in pregnant people with sickle cell disease and those with nutritional anemia also appears in JAMA Network Open.

Source: Johns Hopkins University

Night staff at nursing homes had lower rates of COVID-19 testing and vaccination than day-shift staff, according to a new study.

Throughout the COVID-19 pandemic, regular testing and vaccinations of nursing home staff have been critical strategies for containing virus outbreaks in nursing homes.

In order to assess how various structural factors affected the differences in testing rates and vaccinations, researchers analyzed data from nursing homes across the country, looking specifically at work shifts.

They found that day-shift staff had the highest testing rates and odds of primary vaccination, while night-shift staff had the lowest.

Work shift has not been recognized as a significant factor contributing to implementation of testing and vaccination programs at nursing homes, says lead author Elizabeth White, an assistant professor of health services, policy, and practice at Brown University’s School of Public Health.

“Testing and vaccination programs have been so critical to mitigating the effects of COVID-19 in nursing homes,” White says. “Our findings suggest that any future booster campaigns or testing campaigns need to consider equitable distribution of resources across shifts to reduce the variation we saw in our study.”

She emphasizes that the study findings have broader relevance beyond nursing homes as well as beyond the pandemic.

“Our findings highlight that work shift is an important structural factor to consider when implementing public health initiatives—from COVID vaccination and testing to flu vaccine—in organizations with shift-based workforces,” White says.

For the study in Health Affairs, the researchers had access to a large and unique data set, White says, due to Brown’s involvement with an initiative by the National Institute on Aging called the Imbedded Pragmatic Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias Clinical Trials (IMPACT) Collaboratory, co-led by Vincent Mor, a professor at Brown who is a senior author of the study.

They analyzed nursing home data, including staff COVID-19 testing and immunization records, from 294 facilities for the period from April 2020 to March 2021.

The researchers found significant differences in testing rates and odds of primary vaccination by work shift: Night-shift staff testing rates were 0.71 times those of the day-shift staff, and evening-shift testing rates were 0.91 times those of the day shift. Controlling for staff and facility characteristics, adjusted vaccination rates were 67% among day shift staff, 62% among evening-shift staff, and 50% among night-shift staff.

The authors note that differences in staffing levels and resources, work demands and the presence of senior and mid-level leadership across nursing home shifts may influence the implementation of organization-wide processes such as COVID-19 testing and vaccination.

Compared to staff who work during the day, staff who work the evening and night shift have less exposure to senior leaders, in particular the directors of nursing, medical directors, and nursing home administrators, White explains.

Other research throughout the pandemic has shown that those leaders, in particular, are important in building trust around vaccines and for helping to successfully implement changes in workplace health protocols.

Another important study finding, White says, was that the lower rates of COVID-19 testing among Black employees was almost entirely attributed to a disproportionate number of Black employees working on evening and night shifts.

“That tells us that shift is a structural factor contributing to a racial disparity in testing among staff,” White says.

The authors conclude that their findings highlight the need to coordinate resources and communication evenly across shifts when implementing large-scaled public health initiatives in nursing homes and other organizations with shift-based workforces.

“These results apply not only to nursing homes, but also to hospitals or even Amazon and other organizations with shift-based workforces,” White says.

This study was funded under an IMPACT Collaboratory supplement through an initiative of the National Institutes of Health called Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP), aimed at reducing disparities in underserved populations who are disproportionately affected by COVID-19.

The residents of nursing homes have been disproportionately affected by COVID, White says, as have the staff, who are often from underserved populations.

Additional coauthors are from the University of Michigan at Ann Arbor, Harvard University, RAF Healthcare Solutions, Hebrew Senior, and Brown.

The National Institute on Aging funded the work.

Source: Brown University