Carolina Discoveries: recent research and why it matters

Recent Carolina research has focused on unseen coastal flooding, curbing unnecessary surgical instrument costs, early autism evidence and tick-borne pathogens.

Grid of images: Close-up of surgical instrument tray, flooded town street, close-up of tick, portrait of baby
Top right: High tide flooding via the stormwater network on Front Street in Beaufort, North Carolina, on Nov. 8, 2021 (image by Sunny Day Flooding Project). Bottom right, baby prior to MRI at the Carolina Institute of Developmental Disabilities (courtesy of CIDD).

Carolina’s research enterprise is vast and productive. Here’s a look at some recent research findings — and why the research matters to the people of North Carolina, the nation and the world. Look for more Carolina Discoveries roundups in the coming months.

Autism and infants

Finding crucial differences in baby brains helps with early diagnosis.

When parents and babies bond, when they lock eyes and experience their world together day after day, it’s not just cute; it’s how babies learn to interpret subtle cues about their environment. It’s the way babies learn to relate a caregiver’s behaviors to their own. This visual rhythm through the first years of life is crucial to cognitive, emotional and social development. In babies who go on to develop autism, recent Carolina research suggests that something goes awry in the brain’s visual system that impacts this visual interplay.

For the first time, scientists have found that brain differences in the visual brain systems of infants who later are diagnosed with autism are associated with inherited genetic factors.

A study led by Jessica Girault, assistant professor of psychiatry at the UNC School of Medicine and published in the American Journal of Psychiatry shows that these brain changes in 6-month-olds are evident well before they show symptoms of autism as toddlers. Moreover, the presence of brain changes in the visual system is associated with the severity of autism traits in their older siblings.

Adapted from a story by UNC Health and UNC School of Medicine. Learn more.

High-tide flooding

Shining a light on the unseen, underground risks.

A study led by Adam Gold, a postdoctoral research associate at the Institute for the Environment, looks at the relationship between the inundation of urban stormwater infrastructure and high tide flooding in East Coast communities. The study found that it is a widespread problem affecting up to 2 million people.

“Even though you might not be seeing flooding on your roadway very frequently, it’s very likely that a lot of these coastal areas are having flooding, only underground. So let’s say you have a high tide flood that floods the road a couple of times a year. It’s very likely that the stormwater network underneath the road is being flooded maybe 20 to 30 times a year, so you’re having decreased capacity to drain from these areas,” said Gold.

Adapted from a story by the UNC Institute for the Environment. Learn more.

Tick-borne illnesses

Better understanding North Carolina’s most prevalent tick-borne dangers.

North Carolina experiences some of the highest rates of spotted fever group rickettsiosis
and ehrlichiosis — two dangerous tick-borne illnesses — in the United States, often accounting for more than of 10% and 5% of cases reported to the CDC, respectively. Yet timely and accurate surveillance is limited by both the nature of reporting and the limitations of existing diagnostic methods.

A cross-sectional study by a team from Carolina highlights important issues in vector-borne disease at the intersection of public health, diagnostics and clinical practice.

“Anecdotally, we see that a lot of patients suspected of having tick-borne disease are tested for Lyme, which is not particularly common in central North Carolina, but are not tested for other, less well-known diseases like ehrlichiosis, which is endemic to the region and may well be the most frequent cause of tick-borne disease here,” said Gillings School of Global Public Health’s Dr. Ross Boyce, a corresponding author on the paper.

Adapted from a story by the School of Medicine’s Institute for Global Health and Infectious Diseases. Learn more.

High hospital costs

Saving money by reducing unnecessary instruments in operating rooms.

In a typical surgery, 70-80% of the instruments that enter the operating room aren’t used. But every re-usable instrument that enters an operating room must be sterilized again, even if it wasn’t used. The more instruments that go into an operating room, the higher the costs.

Surgical procedures account for more than 60% of the operating costs of a hospital and about 15% of those costs — or roughly 9% of total hospital operating costs — are spent on surgical instruments. For a medium-sized hospital, that’s $4 million to $7 million per year in total surgical instrument spending. Across the 6,000-plus hospitals in the U.S., the costs soar into the billions.

Researchers from UNC Kenan-Flagler Business School developed an algorithm that enables software to automate most of the complex task of reducing unnecessary instruments in operating rooms, which they detail in a recent paper, “Data-Driven Surgical Tray Optimization to Improve Operating Room Efficiency.”

Adapted from a story by UNC Kenan-Flagler Business School. Learn more.