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Northwell Health is using insights from website traffic to forecast COVID-19 hospitalizations two weeks in the future.
- The machine-learning algorithm works by analyzing the online behavior of visitors to the Northwell Health website and comparing that data to future COVID-19 hospitalizations.
- The tool, which uses anonymized data, has so far predicted hospitalizations with an accuracy rate of 80 percent.
- Machine-learning tools are helping health-care professionals worldwide better constrain and treat COVID-19.
The value of forecasting<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTA0Njk2OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMzM2NDQzOH0.rid9regiDaKczCCKBsu7wrHkNQ64Vz_XcOEZIzAhzgM/img.jpg?width=980" id="2bb93" class="rm-shortcode" data-rm-shortcode-id="31345afbdf2bd408fd3e9f31520c445a" data-rm-shortcode-name="rebelmouse-image" data-width="1546" data-height="1056" />
Northwell emergency departments use the dashboard to monitor in real time.
Credit: Northwell Health<p>One unique benefit of forecasting COVID-19 hospitalizations is that it allows health systems to better prepare, manage and allocate resources. For example, if the tool forecasted a surge in COVID-19 hospitalizations in two weeks, Northwell Health could begin:</p><ul><li>Making space for an influx of patients</li><li>Moving personal protective equipment to where it's most needed</li><li>Strategically allocating staff during the predicted surge</li><li>Increasing the number of tests offered to asymptomatic patients</li></ul><p>The health-care field is increasingly using machine learning. It's already helping doctors develop <a href="https://care.diabetesjournals.org/content/early/2020/06/09/dc19-1870" target="_blank">personalized care plans for diabetes patients</a>, improving cancer screening techniques, and enabling mental health professionals to better predict which patients are at <a href="https://healthitanalytics.com/news/ehr-data-fuels-accurate-predictive-analytics-for-suicide-risk" target="_blank" rel="noopener noreferrer">elevated risk of suicide</a>, to name a few applications.</p><p>Health systems around the world have already begun exploring how <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315944/" target="_blank" rel="noopener noreferrer">machine learning can help battle the pandemic</a>, including better COVID-19 screening, diagnosis, contact tracing, and drug and vaccine development.</p><p>Cruzen said these kinds of tools represent a shift in how health systems can tackle a wide variety of problems.</p><p>"Health care has always used the past to predict the future, but not in this mathematical way," Cruzen said. "I think [Northwell Health's new predictive tool] really is a great first example of how we should be attacking a lot of things as we go forward."</p>
Making machine-learning tools openly accessible<p>Northwell Health has made its predictive tool <a href="https://github.com/northwell-health/covid-web-data-predictor" target="_blank">available for free</a> to any health system that wishes to utilize it.</p><p>"COVID is everybody's problem, and I think developing tools that can be used to help others is sort of why people go into health care," Dr. Cruzen said. "It was really consistent with our mission."</p><p>Open collaboration is something the world's governments and health systems should be striving for during the pandemic, said Michael Dowling, Northwell Health's president and CEO.</p><p>"Whenever you develop anything and somebody else gets it, they improve it and they continue to make it better," Dowling said. "As a country, we lack data. I believe very, very strongly that we should have been and should be now working with other countries, including China, including the European Union, including England and others to figure out how to develop a health surveillance system so you can anticipate way in advance when these things are going to occur."</p><p>In all, Northwell Health has treated more than 112,000 COVID patients. During the pandemic, Dowling said he's seen an outpouring of goodwill, collaboration, and sacrifice from the community and the tens of thousands of staff who work across Northwell.</p><p>"COVID has changed our perspective on everything—and not just those of us in health care, because it has disrupted everybody's life," Dowling said. "It has demonstrated the value of community, how we help one another."</p>
New anthropological research suggests our ancestors enjoyed long slumbers.
- Neanderthal bone fragments discovered in northern Spain mimic hibernating animals like cave bears.
- Thousands of bone fragments, dating back 400,000 years, were discovered in this "pit of bones" 30 years ago.
- The researchers speculate that this physiological function, if true, could prepare us for extended space travel.
Evidence of ancient human hibernation / human hibernation for space travel | Dr Antonis Bartsiokas<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c18723ed15c9b3ed88a24552f681711e"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/ba72UrBWsc4?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>While the fragments have been well studied in the intervening decades, Arsuaga (who led an early excavation in Atapuerca) and Bartsiokas noticed something odd about the bones: they displayed signs of seasonal variations. These proto-humans appear to have experienced annual bone growth disruption, which is indicative of hibernating species.</p><p>In fact, the remains of cave bears were also found in this pit, increasing the likelihood that the burial site was reserved for species that shared common features. This could be the result of a dearth of food for bears and Neanderthals alike. The researchers write that modern northerners don't need to sleep for months at a time; an abundance of fish and reindeer didn't exist in Spain, as they do in the Arctic. They write, </p><p style="margin-left: 20px;">"The aridification of Iberia then could not have provided enough fat-rich food for the people of Sima during the harsh winter—making them resort to cave hibernation."</p><p>The notion of hibernating humans is appealing, especially to those in cold climates, but some experts <a href="https://www.theguardian.com/science/2020/dec/20/early-humans-may-have-survived-the-harsh-winters-by-hibernating" target="_blank">don't want to put the cart before the horse</a>. Large mammals don't engage in textbook hibernation; their deep sleep is known as a "torpor." Even then, the demands of human-sized brains could have been too large for extended periods of slumber.</p><p>Still, as we continually discover our animalistic origins to better understand how we evolved, the researchers note the potential value of this research.</p><p style="margin-left: 20px;">"The present work provides an innovative approach to the physiological mechanisms of metabolism in early humans that could help determine the life cycle and physiology of extinct human species."</p><p>Bartsiokas <a href="https://www.youtube.com/watch?v=ba72UrBWsc4" target="_blank" rel="noopener noreferrer">speculates</a> that this ancient mechanism could be coopted for space travel in the future. If the notion of hibernating humans sounds far-fetched, the <a href="https://www.theatlantic.com/health/archive/2020/01/human-hibernation-real-possibility/605071/" target="_blank" rel="noopener noreferrer">idea has been contemplated for years</a>, as NASA began funding research on this topic in 2014. As the saying goes, everything old is new again. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His new book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>
Take a journey through the maze of interpretations of one of the most famous paintings in history.
A tale of silence, an icon of human solitude in the face of the forces of nature, or perhaps a memento of the great artist?
The author of "Auroville: The City Made of Dreams" talks about the difficulties of establishing (and writing about) utopian societies.
Research from MIT's School Effectiveness & Inequality Initiative found making college more affordable cut dropout rates and boosted degree attainment.
The study groups<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDk1OTU2OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1NzYyMjgyMH0.HoOUfA4eXLgFltk-M_Mu3E3qORUh2shzeYoVa3wk86E/img.jpg?width=1245&coordinates=0%2C237%2C0%2C237&height=700" id="861dd" class="rm-shortcode" data-rm-shortcode-id="cfef9e15abee21ae82c46b76199c4436" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
An aerial view of MIT and Harvard Bridge. The university's School Effectiveness & Inequality Initiative partnered with the Susan Thompson Buffett Foundation for the study.
Credit: Adobe Stock<p>The study comes from <a href="https://seii.mit.edu/" target="_blank">MIT's School Effectiveness & Inequality Initiative</a>. Its researchers wanted to determine the effect scholarships had on degree attainment. As they put it, </p><p style="margin-left: 20px;">"Financial aid is typically motivated by a desire to increase postsecondary attainment by making college more affordable. This raises the question of whether aid meets this test by boosting educational attainment. As with any sort of award or subsidy, it's worth considering the extent to which financial aid changes behavior. The fact that aid is motivated by the desire to increase schooling does not mean aid programs accomplish this."</p><p>To test this question, they partnered with <a href="https://buffettscholarships.org/" target="_blank">the Susan Thompson Buffett Foundation</a>, an organization that offers scholarships to first-time freshman attending public colleges in Nebraska. The researchers designed a partially randomized study around the Foundation's 2012–2016 scholarship applicants, a cohort of roughly 16,500 students seeking aid. </p><p>Because low-scoring applicants were unlikely to complete college, they were not provided a scholarship and were removed from the study. Similarly, while high-scoring applicants were awarded a scholarship, they too were removed from the study as their degree completion was likely with or without the financial abetment. This left a middle pool of applicants, each sporting a comparable level of need and college-readiness.</p><p>The Foundation awarded scholarships randomly to this middle group of applicants; those who did not receive scholarships served as the controls. Because the number of applicants far exceeded the available aid, no student was artificially denied a scholarship for the study's sake. All told, the study included 3,699 scholarship-awarded participants and 4,491 controls. Most sought degrees at four-year colleges though some matriculated into two-year schools.</p><p>As this group was comparable in areas such as GPA, colleges attended, and expected family contributions, any statistically significant difference between the recipients and the controls would provide some evidence of a causal connection between financial aid and degree attainment.</p>
Easing the six-year itch<p>The researchers followed the students' college careers, from freshman year to spring 2019, and found that the scholarships did change behavior. Enrollment was only slightly higher for the aid recipients than the controls—98.7 percent compared to 96.1—but as the two groups' college careers continued, a noticeable difference emerged in dropout rates. By the end of their fourth year, only 71.6 percent of the control group remained, a dropout rate of 24.5 percent; meanwhile, the scholarship group only declined by 18 percent.</p><p>The scholarships also bolstered degree completion. Though bachelor degree completion was roughly even by the end of the fourth year, the aid recipients began to pull ahead after that. By the end of their sixth year, 71 percent of the award recipients received their degree, 8.4 percentage points more than the control. This suggests that as degree completion began to drag on longer, the infusion of extra financial resources made the final push more manageable.</p><p>The researchers not only found that aid promotes full-time enrollment, but that it benefitted historically underrepresented groups most, including non-white and first-generation applicants. These findings support a <a href="https://vtechworks.lib.vt.edu/handle/10919/100548" target="_blank">growing</a> <a href="https://files.eric.ed.gov/fulltext/ED545465.pdf" target="_blank" rel="noopener noreferrer">body</a> of <a href="https://kuscholarworks.ku.edu/bitstream/handle/1808/12507/Shulenburger_University.pdf;sequence=1" target="_blank" rel="noopener noreferrer">research</a> that suggests college affordability directly impacts student decision-making and degree attainment.</p><p>The study, titled "<a href="https://seii.mit.edu/wp-content/uploads/2020/10/SEII-Discussion-Paper-2020.06-Angrist-Autor-Pallais.pdf" target="_blank" rel="noopener noreferrer">Marginal Effects of Merit Aid for Low-Income Students</a>," is part of an ongoing research study. Additional reports will be released as the study continues.</p>
What does college affordability mean?<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="2f032882b6038c7d6734ac69f95fbb69"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/qZTnmMxnU0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Scholarships are one way of making college more affordable, but they are part of a much larger conversation as to what affordability means.</p><p>The <a href="https://www.cnbc.com/2019/10/24/why-college-tuition-keeps-rising.html" target="_blank">ballooning cost of tuition</a> in recent decades is another concern. Factors for this surge include a massive increase in demand, cuts in state funding, new student services, and <a href="https://www.chronicle.com/article/executive-compensation-at-public-and-private-colleges/#id=table_public_2019" target="_blank" rel="noopener noreferrer">bloated administrative compensation</a>. While colleges could certainly rein in some of their more extravagant expenses, and legislators agree to fund more, <a href="https://www.luminafoundation.org/files/publications/ideas_summit/College_Affordability-What_Is_It_and_How_Can_We_Measure_It.pdf" target="_blank" rel="noopener noreferrer">the question of affordability</a> goes further still. </p><p>It concerns the quality of education, whether students are dependent or independent, their resources before matriculating, what they can expect from the investment after graduation, and how much of their future income they are willing (or able) to pay. The calculus must also consider <a href="https://bigthink.com/kenzie-academy/software-engineering-school" target="_self">available alternatives</a>, their costs, and their potential outcomes. It's a multifaceted balancing act between what's available, what students can afford, and what schools can offer with the resources they have available—which, of course, ties directly to the funds that schools have available. </p><p>In <a href="https://www.higheredtoday.org/2017/05/16/think-college-affordability/" target="_blank" rel="noopener noreferrer">an op-ed for Higher Education Today</a><em>, </em>Susan Baum, a senior fellow in the Education Policy Program at the Urban Institute, correctly points out that a "low-cost program designed purely to train people for an occupation that is unlikely to exist in 10 years, while appearing 'affordable,' is not affordable at all."</p><p>So then, how should we think about college affordability?</p><p>Baum recommends we start the conversation with need-based considerations at the forefront. "The financial resources available to a student at the time of enrollment are critical. Students have very different starting points for measuring outcomes and value depending on their circumstances," Baum writes. But it also requires us to think beyond funding; we need to consider the resources colleges need to provide a valuable education as well as the types of experiences that students want. </p><p>If we want more students to graduate, we need to discover the right balance between moderate spending, need-based aid, and program quality, a balance that will make college accessible to all who desire to attend.</p>
For the Iroquois, it was a type of military training and a way to honor the gods.
George Catlin, Wikimedia Commons<h3>Power of muscles, power of ritual</h3><p>The Shawnee let women play, but only with their hands. Only the men used sticks. The Dakota didn't have any such prohibitions. They even allowed mixed matches, but for each male player there had to be five females (the women also competed among themselves). But these were exceptions; in most tribes, women were prohibited from coming near the pitch. Men whose wives were pregnant weren't considered for the team, as it was believed that they had transferred all their strength to the child and were greatly weakened. For three days before the match, the players were required to refrain from sex. Before the team left the village, the shamans sent scouts to make sure the way was clear – enemies could leave something along the path that would weaken the players.</p><p>Before the match began, the players marked their bodies with charcoal; they believed this gave them strength. In clouds of sacred tobacco thrown onto a fire, they asked for supernatural strength to give them the eyesight of the hawk, the agility of the deer, the strength of the bear. But the most important were the sticks. The players paid them the same respect as they did to weapons. Before entering the pitch they smeared them with magical ointments, festooning them with amulets prepared by the shamans. The sticks were also placed in players' coffins so that they'd have equipment to play with in the afterlife. The reasons for playing a match were legion. It could be about maintaining relations with neighbours (after a game ended, a rematch was immediately agreed); rendering honour to the heavens, e.g. on behalf of an ill person (whose fate depended on the result); commemorating the dead. Matches could also be part of a funerary rite.</p><p>Lacrosse was also used to solve conflicts; the game was seen as a great method of keeping warriors in shape. Sometimes, during a match, the players stopped worrying about the ball and focused on each other. Confrontations switched instantly into wrestling or fistfights. Hence the Mohawk-speaking tribes called their version of lacrosse <em>begadwe</em>, or the 'little brother of war', and those who spoke Onondaga, <em>dehuntshigwa'es</em>: 'small war'.</p><p>The most spectacular example of using lacrosse during a battle was a manoeuvre by Ojibwa chief Minweweh in 1763. At that time, several tribes rose up against British rule, starting what became known as Pontiac's Rebellion. Since the springtime, the Sauks and Ojibwas had been passing through the Mackinac straits to Fort Michilimackinac, one of the strongest fortresses in the region, and one of the most difficult to capture. On 2nd June, unexpectedly for the British, a lacrosse match began. The tribes played outside the fort for several hours, when suddenly the play turned into an attack, and the players into warriors. The fort fell; 35 British soldiers perished. The capture of Michilimackinac turned out to be one of the most effective victories of the rebellion; the Europeans retook the fort only a year later.</p>