Culture

New insights into how the human brain solves complex decision-making problems

image: (modified from the figures of the original paper doi:10.1038/s41467-019-13632-1). Computations implemented in the inferior prefrontal cortex during meta reinforcement learning. (A) Computational model of human prefrontal meta reinforcement learning (left) and the brain areas where the neural activity patterns are explained by the latent variables of the model. (B) Examples of behavioral profiles. Shown on the left is choice bias for different goal types and on the right is choice optimality for task complexity and uncertainty. (C) Parameter recoverability analysis. Compared are the effects of task uncertainty (left) and task complexity (right) on choice optimality.

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KAIST

A new study on meta reinforcement learning algorithms helps us understand how the human brain learns to adapt to complexity and uncertainty when learning and making decisions. A research team, led by Professor Sang Wan Lee at KAIST jointly with John O'Doherty at Caltech, succeeded in discovering both a computational and neural mechanism for human meta reinforcement learning, opening up the possibility of porting key elements of human intelligence into artificial intelligence algorithms. This study provides a glimpse into how it might ultimately use computational models to reverse engineer human reinforcement learning.

This work was published on Dec 16, 2019 in the journal Nature Communications. The title of the paper is "Task complexity interacts with state-space uncertainty in the arbitration between model-based and model-free learning."

Human reinforcement learning is an inherently complex and dynamic process, involving goal setting, strategy choice, action selection, strategy modification, cognitive resource allocation etc. This a very challenging problem for humans to solve owing to the rapidly changing and multifaced environment in which humans have to operate. To make matters worse, humans often need to often rapidly make important decisions even before getting the opportunity to collect a lot of information, unlike the case when using deep learning methods to model learning and decision-making in artificial intelligence applications.

In order to solve this problem, the research team used a technique called 'reinforcement learning theory-based experiment design' to optimize the three variables of the two-stage Markov decision task - goal, task complexity, and task uncertainty. This experimental design technique allowed the team not only to control confounding factors, but also to create a situation similar to that which occurs in actual human problem solving.

Secondly, the team used a technique called 'model-based neuroimaging analysis.' Based on the acquired behavior and fMRI data, more than 100 different types of meta reinforcement learning algorithms were pitted against each other to find a computational model that can explain both behavioral and neural data. Thirdly, for the sake of a more rigorous verification, the team applied an analytical method called 'parameter recovery analysis,' which involves high-precision behavioral profiling of both human subjects and computational models.

In this way, the team was able to accurately identify a computational model of meta reinforcement learning, ensuring not only that the model's apparent behavior is similar to that of humans, but also that the model solves the problem in the same way as humans do.

The team found that people tended to increase planning-based reinforcement learning (called model-based control), in response to increasing task complexity. However, they resorted to a simpler, more resource efficient strategy called model-free control, when both uncertainty and task complexity were high. This suggests that both the task uncertainty and the task complexity interact during the meta control of reinforcement learning. Computational fMRI analyses revealed that task complexity interacts with neural representations of the reliability of the learning strategies in the inferior prefrontal cortex.

These findings significantly advance understanding of the nature of the computations being implemented in the inferior prefrontal cortex during meta reinforcement learning as well as providing insight into the more general question of how the brain resolves uncertainty and complexity in a dynamically changing environment. Identifying the key computational variables that drive prefrontal meta reinforcement learning, can also inform understanding of how this process might be vulnerable to break down in certain psychiatric disorders such as depression and OCD. Furthermore, gaining a computational understanding of how this process can sometimes lead to increased model-free control, can provide insights into how under some situations task performance might break down under conditions of high cognitive load.

Professor Lee said, "This study will be of enormous interest to researchers in both the artificial intelligence and human/computer interaction fields since this holds significant potential for applying core insights gleaned into how human intelligence works with AI algorithms."

Credit: 
The Korea Advanced Institute of Science and Technology (KAIST)

On the menu: Study says dining out is a recipe for unhealthy eating for most Americans

video: Dariush Mozaffarian, senior author and dean of the Friedman School of Nutrition Science and Policy at Tufts University, discusses the goals of a study, published on January 29, 2020 in The Journal of Nutrition. The study found that most of what Americans ate while dining out over a 14-year period was of poor nutritional quality.

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Tufts University

BOSTON (Jan. 29, 2020, 9:00 a.m. EST)--The typical American adult gets one of every five calories from a restaurant, but eating out is a recipe for meals of poor nutritional quality in most cases, according to a new study by researchers at the Friedman School of Nutrition Science and Policy at Tufts University.

Published today in The Journal of Nutrition, the study analyzed the dietary selections of more than 35,000 U.S. adults from 2003-2016 in the National Health and Nutrition Examination Survey (NHANES) who dined at full-service (those with wait staff) or fast-food restaurants, which included pizza shops and what has become known as fast-casual. The researchers assessed nutritional quality by evaluating specific foods and nutrients in the meals, based on the American Heart Association 2020 diet score.

At fast-food restaurants, 70 percent of the meals Americans consumed were of poor dietary quality in 2015-16, down from 75 percent in 2003-04. At full-service restaurants, about 50 percent were of poor nutritional quality, an amount that remained stable over the study period. The remainder were of intermediate nutritional quality.

Notably, the authors found that less than 0.1 percent - almost none - of all the restaurant meals consumed over the study period were of ideal quality.

"Our findings show dining out is a recipe for unhealthy eating most of the time," said Dariush Mozaffarian, senior author and dean of the Friedman School. "It should be a priority to improve the nutritional quality of both full-service and fast-food restaurant meals, while reducing disparities so that all Americans can enjoy the pleasure and convenience of a meal out that is also good for them."

The disparities documented by the study authors show some groups ate more healthfully than others while dining out. For example, the average quality of fast-food meals consumed by non-Hispanic whites and Mexican-Americans improved, but there was no change in the average quality of fast-food meals consumed by non-Hispanic blacks. Also, the proportion of poor-quality fast-food meals decreased from 74 percent to 60 percent over this period for people with college degrees, but remained high at 76 percent for people without a high school diploma.

The researchers also looked at the extent to which Americans relied on restaurants during the study period and found:

Restaurant meals accounted for 21 percent of Americans' total calorie intake.

Full-service restaurant meals represented 9 percent of total calories consumed.

Fast-food meals represented 12 percent of total calories consumed.

Fast-food breakfasts increased from just over 4 percent to nearly 8 percent of all breakfasts eaten in America.

The researchers assessed specific foods and nutrients in restaurant meals and identified priorities for improvement. "We found the largest opportunities for enhancing nutritional quality would be adding more whole grains, nuts and legumes, fish, and fruits and vegetables to meals while reducing salt," said first author Junxiu Liu, a postdoctoral scholar at the Friedman School. She noted the study findings showed no improvement in sodium levels in fast-food meals and worsening levels in full-service dishes consumed.

"Our food is the number one cause of poor health in the country, representing a tremendous opportunity to reduce diet-related illness and associated healthcare spending," Mozaffarian said. "At restaurants, two forces are at play: what's available on the menu, and what Americans are actually selecting. Efforts from the restaurant industry, consumers, advocacy groups, and governments should focus on both these areas."

NHANES participants are representative of the national population and completed at least one valid 24-hour dietary recall questionnaire from nine consecutive cycles of NHANES between 2003-2016, including types of foods and beverages consumed and the source.

The study authors used the American Heart Association (AHA) diet score to assess meal quality, which is based on the AHA 2020 Strategic Impact Goals and is a validated risk factor for cardiovascular and metabolic outcomes. The AHA diet score includes both a primary and secondary score. The primary score assesses the consumption of fruits and vegetables, fish/shellfish, whole grains, sodium, and sugar-sweetened beverages, and the secondary score assesses intake of nuts/seeds/legumes, processed meat, and saturated fat.

Researchers also evaluated individual food groups and nutrients based on the USDA Food Patterns Equivalents Database (FPED) and MyPyramid Equivalents Database (MPED) associated with chronic illnesses.

Limitations of the study include the fact that self-reported food recall data is subject to measurement error due to daily variations in food intake. Participants may also overreport or underreport healthy or unhealthy foods due to social desirability perceptions.

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Tufts University, Health Sciences Campus

Color-changing bandages sense and treat bacterial infections

image: A bandage changed color from green to yellow, and from green to red, in the presence of increasing concentrations of drug-sensitive (DS) and drug-resistant (DR) E.coli, respectively.

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Adapted from <i>ACS Central Science</i> <b>2020</b>, DOI: 10.1021/acscentsci.9b01104

According to the World Health Organization, antibiotic resistance is one of the biggest threats to global health. Sensing and treating bacterial infections earlier could help improve patients' recovery, as well curb the spread of antibiotic-resistant microbes. Now, researchers reporting in ACS Central Science have developed color-changing bandages that can sense drug-resistant and drug-sensitive bacteria in wounds and treat them accordingly.

Xiaogang Qu and colleagues developed a material that changes color from green to yellow when it contacts the acidic microenvironment of a bacterial infection. In response, the material, which is incorporated into a bandage, releases an antibiotic that kills drug-sensitive bacteria. If drug-resistant bacteria are present, the bandage turns red in color through the action of an enzyme produced by the resistant microbes. When this happens, the researchers can shine light on the bandage, causing the material to release reactive oxygen species that kill or weaken the bacteria, making them more susceptible to the antibiotic. The team showed that the bandage could speed the healing of wounds in mice that were infected with drug-sensitive or drug-resistant bacteria.

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American Chemical Society

Finer particulate matter (PM1) could increase cardiovascular disease risk

In addition to harmful gases such as carbon monoxide, air pollution contains tiny particles that have been linked to health problems, including cardiovascular disease and asthma. Most studies have analyzed the potential health effects of larger-sized particulate matter (PM), such as particles less than 2.5 μm in diameter (PM2.5). Now, researchers report in Environmental Science & Technology Letters that particles with diameters less than 1 μm (PM1) are even more strongly correlated with cardiovascular disease.

To better understand air pollution, a nationwide PM1 monitoring campaign was recently performed in China. Zhaomin Dong, Maigeng Zhou and colleagues analyzed the data, which came from 65 Chinese cities, to determine if PM1 exposure correlated with the number of non-accidental deaths in each city during the same time period. They found that for every 10 μg/m3 increase in PM1, there was a 0.29% increased risk of cardiovascular disease, which was 21% higher than the risk related to PM2.5 (0.24%). The finer PM1 could more easily deposit in the lungs and circulation than larger particles, which might explain the increased health risks, the researchers say.

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American Chemical Society

Living longer is important, but those years need to be healthy ones

DALLAS, Jan. 29, 2020 -- Data reported in the just published American Heart Association's Heart & Stroke Statistics - 2020 Update, show heart disease and stroke deaths continue to decline, but that trend has slowed significantly in recent years. Further discouraging is that more people are living in poor health, beginning at a younger age, as a direct result of risk factors that contribute to these leading causes of death worldwide.

To build on its mission to be a relentless force for a world of longer, healthier lives, the American Heart Association, the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke, has published a presidential advisory in the journal, Circulation, outlining new national and global 2030 Impact Goals to help all people live healthier for more years of their life.

Across the US: Together, we will equitably increase healthy life expectancy from 66 to at least 68 years by 2030.

Around the world: Together with global and local collaborators, we will equitably increase worldwide healthy life expectancy from 64 to at least 67 years by 2030.

"We know people are living longer thanks in part to nearly a century of dedicated efforts from volunteers, staff and many invaluable supporters joining the American Heart Association in our fight again heart disease and stroke, leading to improvements in disease control and prevention, advancements in medical treatments and improved lifestyle behaviors," said American Heart Association president Robert A. Harrington, M.D., FAHA. "Unfortunately, not all those years are healthy ones as the effects of chronic illnesses are increasingly impacting the quality of life of people at a much younger age than in the past."

Goal progress will be tracked by the Health-Adjusted Life Expectancy (HALE) metric, commonly referred to as Healthy Life Expectancy, which anticipates the number of years a person can expect to live in good health. It's a comprehensive single metric that provides an estimate of overall health across a person's lifetime and captures both physical and mental health conditions. That is especially relevant to the broader focus on overall health and well-being emphasized in the new goals.

Over the past decade, key factors that support ideal cardiovascular health have seen some positive movement across the U.S. Reports show adults are getting more active and, overall, people are eating healthier, smoking cigarettes less and better controlling their cholesterol. But that good news is offset by major setbacks in other critical areas, especially among youth, a trend that puts upcoming generations at even higher risk for facing major health issues at younger ages.

According to the Association's Heart & Stroke Statistics - 2020 Update:

Obesity rates are on the rise in children and adults -- nearly 40% of U.S. adults and 18.5% of youth are now obese.

Physical activity rates are abysmally low among youth -- less than a third of U.S. students take part in a daily physical education class and only 26% meet national recommendations of an hour a day of moderate to vigorous physical activity.

Rates for uncontrolled high blood sugar are leading more people toward diabetic and pre-diabetic conditions -- diabetes prevalence in the U.S. increased 129.7% for males and 120.9% for females between 1990 and 2017.

While cigarette smoking in the U.S. is down among adults and at all-time lows for teens, the growing youth vaping epidemic is making daily headlines and the global use of tobacco continues to climb -- in 2015, there were more than 933 million smokers, globally.

The trends are even more devastating among certain races, ethnicities, genders and geographic locations -- at least 80% of the world's smokers, most of whom are male, live in low- and middle-income countries.

"We believe every person should enjoy health and well-being no matter their age, gender, race or even the zip code in which they live. And, we know disparities exist even to that level -- from one block of a city to another," said John Warner, M.D., FAHA, 2017-18 president of the American Heart Association, lead author of the presidential advisory and Executive Vice President for Health System Affairs at the University of Texas Southwestern Medical Center in Dallas. "To improve individual health, we must make the environments where we live, work, learn and play equitably supportive of healthy behaviors. We also need to help people better understand the impact their communities have in driving choices for health and well-being."

In a Harris Poll recently conducted for the American Heart Association, most respondents (93%) agreed that living a long, healthy life is important to them and believe everyone deserves the longest, healthiest life possible (92%). However, there appears to be a disconnect between their desires and their understanding of how those intentions connect back to their behaviors, as less than half of the respondents (49%) strongly agreed their behavior influences their health and well-being and only a third (34%) strongly agreed that their environment influences or supports their health choices.

"We need to make healthy choices the easy ones, make healthcare accessible and affordable and we need to get better at stopping preventable diseases before they start," said Harrington, the Arthur L. Bloomfield Professor of Medicine and Chairman of the Department of Medicine at Stanford University. "Sometimes parents are more worried about whether they can feed their children anything, much less whether it's healthy or not. If you're living with high blood pressure, you shouldn't have to worry about choosing between whether to pay rent or buy your medicine."

Harrington said what will drive the success of the goals is working collaboratively with many diverse groups from local neighborhoods to global governments. Additional improvements will need to come through increased efforts for primary and secondary prevention, public health policies that impact populations, the establishment of effective, comprehensible and affordable healthcare systems and modifications to individual lifestyle behaviors.

"Much of this will be an expansion of efforts already underway with many committed collaborators, but it will be critical to bring in new ideas and resources to connect the collective vision with the creativity and innovation needed to make real change," he said. "We'll be inviting more people to the table, but even more importantly, we're asking likeminded stakeholders to invite us in -- let us help be a catalyst bringing together elements that can create a healthier world for everyone."

While the basic metric of healthy life expectancy is well established, tracking progress and understanding trends to meet the 2030 goals will also require improvements in capturing the way health information is reported and analyzed. An accompanying publication to the 2030 goals is an American Heart Association policy statement outlining major recommendations for enhancing cardiovascular health and disease surveillance worldwide.

"In every country, in every city and village, we want everyone of all ages and backgrounds to be healthy and experience every simple joy, make every heartfelt memory, celebrate every special occasion they need and want to do," said Harrington. "This is so much more than just wanting people to live to a ripe old age, we want them to live healthier, longer. And we're dedicating ourselves to doing just that over the next decade."

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American Heart Association

Pollination is better in cities than in the countryside

image: In cities, the dominant pollinators are bumble bees.

Image: 
Henryk Niestrój /Pixabay

Flowering plants are better pollinated in urban than in rural areas. This has now been demonstrated experimentally by a team of scientists led by the German Centre for Integrative Biodiversity Research (iDiv), the Martin Luther University Halle-Wittenberg (MLU) and the Helmholtz Centre for Environmental Research (UFZ). Although the scientists found a greater diversity of flying insects in the countryside, more bees in cities resulted in more pollinated flowers of test plants. By far the most industrious pollinators were bumble bees, most likely benefitting from the abundant habitats available in the city. To promote pollination, the researchers recommend to take into greater account the needs of bees when landscape planning - both in cities and in the countryside. Their results have been published in the journal Nature Communications.

Cities all over the world are expanding. A number of studies have already shown that the conversion of natural areas into built land affects insects and, while the diversity and abundance of insects often decreases, some insect species or species groups may benefit. However, little is known about the effects of urbanisation on the ecosystem services insects provide, such as plant pollination.

A team of scientists led by the German Centre for Integrative Biodiversity Research (iDiv), the Martin Luther University Halle-Wittenberg (MLU) and the Helmholtz Centre for Environmental Research (UFZ) have now investigated the effect of the urban environment on insect pollinators and pollination. For this purpose, flower-rich, inner city locations such as parks and botanical gardens were compared with similarly flower-rich sites in rural areas surrounding nine large German cities; Berlin, Braunschweig, Chemnitz, Dresden, Göttingen, Halle, Jena, Leipzig and Potsdam. The scientists sampled flying insects using pan-traps and potted red clover plants as reference for pollination in all locations. Furthermore, they also recorded all insect visits to red clover flowers 20 times a day for 15 minutes. The seeds produced were also counted, thus determining the rate of pollination success.

The most successfully pollinated plants were in the cities; here the flowers were visited more often than in the rural areas. Although the researchers found a greater biodiversity and biomass of flying insects in the rural areas - especially flies and butterflies - these did little to pollinate the red clover. This job was done predominantly by bees, which showed higher species richness and flower visitation rates in cities. Indeed, three out of four of the recorded flower-visitors were bumble bees. At a frequency of 8.7 percent, the honey bee was the second most important pollinator.

The researchers believe the great diversity and numbers of bees in cities is due to the availability of suitable habitats available for wild bees and bumblebees. Good nesting opportunities are found in exposed soils, dead wood and wall cavities, and the large variety of flowering plants in parks and gardens ensures a reliable food supply. Also, bees probably cope better with the challenge of highly dynamic city life than other groups of insects. "Urban people are constantly changing their environment. Finding your way around is a challenge that bees are particularly well-equipped to deal with due to their highly developed orientation and learning skills," says the head of the study, Prof Robert Paxton, scientist from Martin Luther University Halle-Wittenberg (MLU) and the German Centre for Integrative Biodiversity Research (iDiv). "Flies and butterflies obviously find this more difficult."

Invariably, almost all the insect species assessed benefit from diverse habitat structures which reliably provide food, nesting sites and orientation. In agricultural land these are flower strips, grassland, forest and hedges, and in inner city locations, gardens, wastelands and parks. These are often missing in an extensively cleared agricultural landscape. "I was really shocked at how consistently poor the pollination performance in agricultural land was," says Paxton. "Other studies have shown that wild bees and bumble bees are particularly susceptible to pesticides. This could also help explain why their diversity is greater in the city, where pesticides play a lesser role."

The figures show just how important pollination is, both for ecosystems and humankind. An estimated 90 percent of all flowering plant species rely on pollination by animals; insect pollinators are essential for maintaining plant diversity. But the food we eat also depends on pollination; the value of pollinators' services to global agriculture in 2015 was calculated at between $235 and $557 billion.

Flowering plants and their pollinators also play an important role in cities. "What would our urban green spaces be without flowers?" says lead author Dr Panagiotis Theodorou, scientist from the German Centre for Integrative Biodiversity Research (iDiv), Martin Luther University Halle-Wittenberg (MLU) and the Helmholtz Centre for Environmental Research (UFZ). "The number of urban vegetable gardens and orchards is also growing, but without pollinators, no fruit will ripen there."

In the medium term, however, cities could also help to maintain rural pollination. "If agricultural land degrades further, cities could serve as a source of pollinators for the farmland surrounding them," says Theodorou. The researchers therefore recommend that cities should be made more attractive to pollinators, and that the needs of the hardworking bumble bee should be especially taken into account when planning green spaces. But of course, more flower-rich areas and suitable nesting sites also need to be created in the countryside and linked to city habitats so as to boost pollination in commercial orchards.

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German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig

Does lung damage speed pancreatic cancer?

(PHILADELPHIA) -Chronic obstructive pulmonary disease or COPD is associated with higher rates of many cancers, including lung, esophagus, colon, bladder and breast cancer. Often a result of many years of smoking, the disease makes it hard to breathe, leaving patients with lower levels of oxygen and higher levels of carbon dioxide in their blood. Low oxygen, called hypoxia, is a known feature of the pancreatic cancer microenvironment and a contributor to tumor aggressiveness and resistance to therapy. However, the impact of high CO2 levels on pancreatic cancer has been considerably less studied.

Recent work from the Division of Surgical Research in the Jefferson Pancreas, Biliary, and Related Cancer Center demonstrates that CO2 drives both the aggressiveness of pancreatic tumor cells and their resistance to treatment. The research findings were published as an "article in press" on the website of the Journal of the American College of Surgeons on January 29th, ahead of print, and offers the possibility of correcting these levels prior to treatment.

"Patients with these respiratory diseases usually start to accumulate excess CO2 in their bodies before they develop symptomatic lack of oxygen," says first author Avinoam Nevler, MD, a researcher with the Sidney Kimmel Cancer Center (SKCC) - Jefferson Health, and at the department of surgery. "If carbon dioxide indeed contributes to disease progression, we may have an opportunity to improve treatment response not only by focusing on oxygen, but by normalizing carbon dioxide levels in patients as well."

Dr. Nevler, together with PhD candidate Samantha Brown and senior authors Jonathan Brody, PhD, co-leader of the SKCC GI Cancer Program, and Charles Yeo, MD, Chair of the Department of Surgery and others looked at both pancreatic tumor cell lines in the lab and historical patient data for associations between obstructive pulmonary diseases and pancreatic cancer.

Earlier research had shown that the pancreatic tumor microenvironment harbors increased levels of CO2. Here, the team showed that increasing the CO2 in cell cultures to levels observed in pulmonary patients was enough to increase their growth and aggressiveness. When these high-CO2-cultured cells were then treated with common chemotherapeutic agents and radiation therapy, they showed increased resistance compared to cells cultured in normal CO2 conditions.

The researchers also looked at whether they could see the same relationship in people. Dr. Nevler and colleagues queried pancreatic-cancer patient surgical records for those who also had a diagnosis of asthma or COPD. Although it was impossible to separate the contribution of CO2 and oxygen levels in these patients, the researchers did see that of the 578 patients they examined, cases with chronic lung disease patients had a 60% increased risk of cancer recurrence.

"Although there's more work to do in order to solidify the association we're seeing," says Dr. Nevler, "what's really exciting is that carbon dioxide levels can be reduced in patients through smoking cessation, using a tailored exercise and respiratory therapy regimen and even changing the diet. We are currently in the process of designing a clinical trial to test these modalities and hopefully extend patients' lives by normalizing CO2 levels and re-sensitizing the cancers to standard pancreatic chemotherapy," says Dr. Nevler.

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Thomas Jefferson University

NYUAD researchers develop new approach to more efficiently store and preserve human cells

image: The paper-based cryopreservation platform can be rolled or folded during storage to save space, and can be cut into small pieces during the retrieval of cells.

Image: 
Mohammad A. Qasaimeh/NYU Abu Dhabi

Fast facts:

Scientists at NYU Abu Dhabi have developed a new technique that allows a type of filter paper (comparable to coffee filter paper) to store cells for long periods of time, more efficiently

This new method, featured in Advanced Biosystems, requires less storage space than traditional methods of using vials, and provides advantages over management and distribution of cells

The papers can be rolled or folded during storage and cut into small pieces during the retrieval of cells without the need to thaw the entire platform

The new technique could have huge benefits for industrial cell banks and fields that rely on long-term, successful preservation of cells

Abu Dhabi, UAE - 29 January 2020: Researchers from the Division of Engineering at NYU Abu Dhabi (NYUAD) have developed a new technique that utilizes filter paper to cryopreserve human cells, offering scientists an efficient alternative to conventional, long-term cryopreservation methods.

This new approach produces comparable results but requires significantly less storage space and greatly offers advantages over storing, managing, and distributing vials of cryopreserved cells. These findings provide a promising prospect for industrial cell banks and researchers engaged in tissue engineering, drug testing, and other fields that rely on long-term, successful preservation of cells. The new technique may potentially find applications in the field of biobanks, a repository that stores biological samples for research purposes.

The conventional preservation approach places cells in small vials where their metabolic activities are "frozen" at extremely low temperatures (-80 ºC or below, typically -196 ºC for long-term storage). Although effective for cell retrieval, these approaches require large spaces to store a vast number of vials, which makes the management and distribution of cells highly challenging, time-consuming, and expensive.

As NYUAD Assistant Professor of Mechanical and Biomedical Engineering Mohammad A. Qasaimeh and colleagues explain in the study, "Paper-based Cell Cryopreservation," published in the journal Advanced Biosystems, a conventional filter paper made of cellulose fibers offers a simple and robust alternative, allowing for easy loading and efficient freezing of cells. The method is space-saving and simple to manage since large sheets of papers can be rolled or folded during their storage, and later cut into small pieces during the retrieval of cells without a need to thaw the entire platform. "The paper platform, working as a 3D shield and carrier for cells during cryopreservation, greatly simplifies the storage, management, and logistics of cell banking," said lead researcher and corresponding author Qasaimeh.

The researchers report that the paper's porosity and 3D cellulose fiber network offer a highly protective environment for the cells to retain their viability and content during preservation. As a result, after their freeze, thawed cells are efficiently released from paper with viability rates comparable to conventional methods. The paper additionally favors the cryopreservation of 3D cell cultures; and after the thaw, it provides a versatile environment for the remaining cells within the paper to form 3D cell constructs (spheroids).

"Unlike other scaffold-based cryopreservation strategies such as fiber meshes and nanofiber sheets, where the substrates must be repeatedly engineered for their use in cell cryopreservation, this paper-based method is solely based on the ready-to-use papers where cells are preserved with no significant effect on their viability and metabolic activity," said Roaa Alnemari, a former Research Assistant with Qasaimeh's lab.

"In addition to its practical advantages, the method also enables investigations of the in situ-formed spheroids in multiple dimensions and over time, and it opens the door for high-throughput, cost-effective biological assays," said Research Assistant at NYUAD Pavithra Sukumar. "We can localize spheroids on multiple microspots within the paper to expand the applicability of the method to wider applications, such as stacking the paper sheets on top of each other to mimic different forms of in vivo 3D tumor masses," said Research Scientist at NYUAD Muhammedin Deliorman.

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New York University

Branding in a hyperconnected world

Researchers from the University of Pittsburgh, Texas A&M, UNC-Chapel Hill, University of Wisconsin, and Columbia University published a new paper in the Journal of Marketing that examines the changing role and management of brands in a hyperconnected world.

The study forthcoming in the March issue of the Journal of Marketing is titled "Branding in a Hyperconnected World: Refocusing Theories and Rethinking Boundaries" is authored by Vanitha Swaminathan, Alina Sorescu, Jan-Benedict Steenkamp, Thomas O'Guinn, and Bernd Schmitt.

Nike's valuation increased by approximately $30 billion between the launch of the Colin Kaepernick ad and the end of 2019 in large part due to the viral publicity generated by this action and the way consumers responded to it. This story captured the attention of marketers everywhere and reshaped Nike's brand associations. It also seems to defy one of the traditional principles of branding where brands were encouraged to remain "above the fray" and not be involved in controversial issues that may potentially turn away certain customer segments.

A new article in the Journal of Marketing begins with the premise that a hyperconnected environment is changing the role and management of brands such that new theories and models are needed to account for these changes. This article sets the stage for new branding research in a hyperconnected world in which the boundaries of branding have been blurred and broadened. To encourage future research, a research agenda on branding from the perspectives of consumers, firms, and society is presented.

Considering both the broadening and blurring of brand boundaries, the research team poses three questions: (1) What are the roles and functions of brands? (2) How is brand value (co)created? and (3) How should brands be managed?

The article re-examines traditional roles of brands (e.g., brands as signals of quality or as mental cues) and notes how those roles are changing in a hyperconnected environment. It also describes how hyperconnectivity contributes to several new roles in which brands are containers of socially constructed meaning, architects of value in networks, catalysts of communities, arbiters of controversy, and stewards of data privacy among others. Many of these new roles can be the focus of research from multiple disciplinary perspectives and a variety of research questions that can draw from different theoretical perspectives are highlighted. As brand boundaries are blurring, the article discusses the shift towards cocreated brand meanings and experiences, enacted via digital platforms which facilitate such cocreation.

Given the complex nature of brands today and in the future, the article encourages researchers to engage in future boundary-breaking research. One implication of hyperconnectivity for branding research is that brands will need to be conceptualized more broadly within each of the theoretical perspectives in the extant brand literature. The consumer and the firm perspectives should focus more on consumers and firms as part of networks rather than on their roles as individual buyers or managers of brands. The society perspective should go beyond the role of brands as cultural symbols and examine them as agents of social change. Moreover, brands are becoming more than symbols attached to products that are owned by individual firms; brands can also be ideas, persons, and places.

There is also an opportunity to examine topics that cut across these theoretical perspectives. Brands need to fulfill a broader mission and purpose. For example, the firm perspective will need to embrace societal questions as organizations or corporate brands will be asked to address broader issues including social responsibility, sustainability, and human-resource practices that go beyond profit maximization. The consumer perspective will also have to be more rooted in the society perspective as consumers form networks that are becoming distinct and occasionally vociferous entities that can shape both managerial practice and societal trends. The impact of networks on brands, like that of communities, requires additional sociological, psychological, and cultural insight. Such work would benefit from increased collaboration among branding researchers of different backgrounds, including teams of marketing strategists, economists, modelers, psychologists, sociologists, and consumer culture researchers.

Credit: 
American Marketing Association

Bluestar Genomics’ breakthrough study highlights promising data for multi-cancer detection from a single blood draw

SAN FRANCISCO, January 29, 2020 -- Bluestar Genomics, a company developing innovative, data-driven, epigenomic approaches to comprehensive disease analysis and diagnostics, today announced the publication of a new study demonstrating the efficacy of their 5-hydroxymethylcytosine (5hmC) signal detection technology for its use in breast, lung, pancreatic, and prostate cancer. The study was published online in medRxiv. Results from the study provide further evidence that, using a single blood draw, Bluestar Genomics' technology can non-invasively detect cancers and help identify the underlying biology of the disease using epigenetic markers.

Breast, lung, pancreatic, and prostate cancer make up 41% of the cancer incidence in the United States. Early detection and a deep understanding of each cancer remain critical for implementing the highest quality of care. Tissue biopsy is invasive, and screening methods are limited for many forms of cancer and often fall short of capturing the complete genomic landscape. Bluestar Genomics uses liquid biopsy combined with 5hmC profiling to provide a detailed picture of the genomic landscape and identify potential biologic pathways that may be driving tumor progression.

"We have taken significant strides to strengthen our understanding of the underlying biology related to multiple forms of cancer and the tumor microenvironment," said Samuel Levy, Chief Executive Officer and Chief Scientific Officer, Bluestar Genomics. "In addition to early-stage cancer detection capabilities, our knowledge of 5hmC distribution across the genome can potentially yield new candidate biomarkers. With this information, we will create clinical tools that can revolutionize oncology screening and have a significant impact on patient outcomes."

Bluestar Genomics executed the study using multiple cell-free DNA samples to measure 5hmC profiles from patients with breast, lung, pancreatic, and prostate cancer. When used in conjunction with machine learning-based classification methods, their novel enrichment technology exhibited high performance in classifying these samples with Area Under the Curve (AUC) measures of 0.89, 0.84, 0.95 and 0.83, respectively. The majority of the breast and pancreatic cancer samples were stage 1 or stage 2, validating Bluestar Genomics' potential to aid clinical decision making and detect cancer when treatment is most effective.

"There are significant limitations in screening for various cancers," said Kelly Bethel, MD, Chief Medical Officer, Bluestar Genomics. "Our research data outperforms screening PSA testing, the current standard of care screening blood test for prostate cancer. Detection of small early malignancies is challenging by usual imaging methods, and our platform technology also demonstrates the ability to detect the presence of malignant tumors smaller than 2cm. Overall, these findings suggest a clinical path toward early detection as part of a multi-cancer screening test."

These results were presented by Anna Bergamaschi, Ph.D., Principal Scientist, Bluestar Genomics at the PMWC 2020 Silicon Valley conference on January 23 at the Liquid Biopsy Showcase.

Credit: 
CG Life

ASHG survey finds Americans strongly support human genetics research and potential

ROCKVILLE, Md. - As genetics and genomics knowledge expands rapidly throughout research, medicine, and society, Americans are excited and optimistic about this area of research and its emerging health applications, according to a new survey released today by the American Society of Human Genetics (ASHG) in partnership with Research!America.

The survey found the large majority of Americans agree genetic knowledge will be important to their own health and their families' health. Americans agree that more research is needed in human genetics, and that increased federal funding for that research is important. The survey also confirms the importance placed on confidentiality and security of research data, addressing Americans' views regarding genetic testing coverage, and highlighting opposition to the use of genetics for insurance coverage or rate-setting. Moreover, Americans express great curiosity about genetics, as well as interest in what it tells us about human history and our common heritage as a species, even as knowledge gaps persist.

The nationwide survey, conducted by Zogby Analytics, December 2019, consisted of an online survey of 1,100 American adults, plus 775 additional adults for minority population oversampling. The margin of error was +/- 3.1 percent. The margin of error was higher for subgroups.

ASHG undertook the survey following a broad review of existing recent public opinion polls and academic research findings that covered a wide array of genetics and medical research topics. That review is also being released as a companion resource, providing additional insights and raising important questions regarding public opinion on a broader set of questions than possible to be covered in the ASHG/Research!America survey.

Additional highlights from the ASHG/Research!America survey include:

- Asked to select adjectives expressing their views on genetics research, respondents' top five selections were "Curious" (59 percent), "Hopeful" (53 percent), "Amazed" (42 percent), and "Optimistic" (42 percent), followed by "Cautious" (38 percent).

- Americans believe it is positive that researchers will use genetics to find cures for key diseases like cancer or Alzheimer's (78 percent); that physicians will be able to use genetic information to inform their health care (71 percent); that people will learn "surprising information" about their heritage or backgrounds (69 percent); and that it will be possible to change genes in embryos to prevent severe diseases like sickle cell disease, cystic fibrosis, or muscular dystrophy (60 percent).

- Thirteen percent report having taken a direct-to-consumer genetic test; 8 percent had a genetic test through a hospital or research center; 5 percent had received genetic counseling; and 5 percent had participated in research requiring a blood or saliva sample.

- Eighty-four percent agree that more research is needed in human genetics, and 74 percent reported that increased federal funding for that research is important.

- More than 60 percent report that assurances of data confidentiality and privacy would be the key decision factor in their participation in research, along with the ability to help a loved one's health or their own.

- Thirty percent report having heard of "precision medicine," a fast-paced area of research that is creating new diagnostic and treatment options based on an individual's genetic composition.

"When it comes to human genetics, the U.S. public is supportive of research, believes more research is needed, and believes it's important to national health and their families' health," said ASHG President Anthony Wynshaw-Boris, MD, PhD. "It's exciting how curious and hopeful Americans are about this fast-paced area of research. That said, the survey shows there is still important work to do in educating the public on some genetics basics and how it might benefit them through applications like personalized medicine. It is rewarding to know they would participate in research that could help themselves or a loved one, but they also want assurances about privacy and confidentiality of that research data."

Wynshaw-Boris said the Society is also committed to realizing a world in which people everywhere realize the benefits of genetics and genomics research. "Lower awareness and higher skepticism among underserved populations reflect legitimate historic experience with research that we need to understand and the need to improve engagement and education with diverse populations," he said. "Overall, the poll confirms that more can be done to reinforce the progress and potential of genetics research, while also educating the public about rigorous privacy practices and laws already in place for U.S. federal research, and our growing ability to evaluate risks or resilience for common conditions such as heart disease, dementia, diabetes, or mental illness."

"Time and again, the public tells us they value medical research," said Research!America President & CEO Mary Woolley. "Americans believe in the hope research presents to improve the health and well-being of individuals, families, and communities. As a nation, we must step up and invest robustly in research to find the solutions to what ails us."

In coming months, ASHG will increase communication about the value of human genetics to the public, including webinars, papers, and public information and engagement on topics related to current advances and issues in human genetics. This is part of the organization's goal in the next three to five years to serve as a reliable source for public information on the topic of human genetics.

"It is an exciting time for human genetics and genomics, and emerging knowledge is speeding discovery and applications in research, medicine, and society," Wynshaw-Boris said. "With these advances, we seek to build a future where people everywhere benefit from human genetics and genomics research."

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American Society of Human Genetics

Study reveals new way to treat stroke using an already FDA-approved drug

image: Jang-Yen (John) Wu, Ph.D., holds a bottle containing granulocyte colony-stimulating factor (GCSF). Data from the study support the hypothesis that GCSF is one of the few growth factors that can reduce infarction by decreasing endoplasmic reticulum (ER) and mitochondrial stress while improving behavioral performance in a mouse model.

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Florida Atlantic University

Stroke is the third leading cause of death and disability in the United States. More than 87 percent are ischemic strokes, caused by obstruction of one or more cerebral arteries. With limited progress in developing treatments, there is a critical need for neuroprotective agents to effectively treat stroke.

A study from Florida Atlantic University's Schmidt College of Medicine holds promise for a new way to treat stroke using an already FDA-approved drug - granulocyte colony-stimulating factor (GCSF). GCSF enhances blood cellular development and is currently used to treat neutropenia (low white blood cells) caused by chemotherapy and has successfully been used with very few side effects for patients who require bone marrow transplants to stimulate blood cell formation.

The study, published in the Journal of Biomedical Science, is the first to report on the neuroprotective effect of GCSF against autophagy and mitochondrial stress in vivo. The data support the hypothesis that GCSF is one of the few growth factors that can reduce infarction by decreasing endoplasmic reticulum (ER) and mitochondrial stress while improving behavioral performance.

Results showed that GCSF improved neurological deficits that occur in the first few days following cerebral ischemia and improved long-term behavioral outcomes while also stimulating a neural progenitor recovery response. Researchers tested behavioral performance on corner and locomotor tests, used as an indicator of brain injury.

Using a mouse model, researchers investigated the efficacy of GCSF beyond the typical four-hour thrombolytic therapy (tPA) clot-busting drug - the gold standard to treat stroke for global ischemia. They examined the pro-survival mechanisms of GCSF against apoptosis resulting from autophagy, mitochondrial stress and ER stress.

"In recent years, many studies including ours have shown that as an endogenous growth factor and immune system modulator factor, GCSF is beneficial in models of neurological disorders such as stroke and traumatic brain injury," said Jang-Yen (John) Wu, Ph.D., corresponding author, distinguished professor of biomedical science in FAU's Schmidt College of Medicine, and a member of the FAU Brain Institute (I-BRAIN). "Although the anti-apoptotic activity of GCSF is reported in global cerebral ischemia, this mechanism has not been fully explored."

Researchers used a mechanism-based therapeutic approach for stroke first to examine the connection of mitochondrial, autophagy and ER stress inhibition in the protective action of GCSF and then to analyze relevant ER stress pathways in the bilateral common carotid artery occlusion (BCAO) model of stroke. They confirmed the neuroprotection of GCSF gene therapy in the BCAO mouse stroke model by a decrease of dynamin-related protein (DRP1), a marker of mitochondrial stress, in the frontal and middle brain of the GCSF treated group.

The initial dose of GCSF was administered 24 hours post-BCAO and then followed by a single application of the same dose for another three days for a total of four days of administration. Researchers examined behavior and used immunoblotting to analyze key proteins in ER stress, autophagy and mitochondrial stress-induced apoptosis. BCAO mice receiving GCSF protein showed significantly less asymmetric turning in the corner test than BCAO mice without GCSF. In the behavioral assays, GCSF elicited increased locomotor sensitization verified by greater activity in the locomotor activity test, demonstrating the neuroprotective properties of the drug.

"More than 15 million people worldwide suffer from stroke and our study provides new and important insights into GCSF induced protection as it relates to ER stress and mitochondrial stress activated apoptosis, " said Howard Prentice, Ph.D., corresponding author, a professor of biomedical sciences in FAU's Schmidt College of Medicine, and a member of FAU's I-BRAIN. "Future research will need to focus on uncovering the complete mechanisms by which GCSF retains the ER and mitochondrial homeostasis."

Wu and Prentice have been developing GCSF as a therapeutic method to replenish new brain cells because of its ability to preserve the central nervous system, suppress cell death and at the same time elicit neurogenesis as well as angiogenesis. GCSF works the same way for other neurological diseases such as Parkinson's disease due to its neuroprotective properties.

Wu and Prentice have received a patent with the U.S. Patent Office (USPTO) for the neuroprotective properties of GCSF in stroke. Wu and Dipnarine Maharaj, M.D., Maharaj Institute of Immune Regenerative Medicine, also received a patent from the USPTO for use of GCSF for treatment of Parkinson's disease. A patent application with the USPTO also has been filed by WU for the neuroprotective and neurogenesis properties of GCSF gene therapy for treatment of stroke and Alzheimer's disease.

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Florida Atlantic University

Yale-NUS research shows airborne microbes link Great Barrier Reef and Australian continent

A team of researchers led by Yale-NUS College Professor of Science (Environmental Studies) Stephen Pointing has discovered a link between two different ecosystems, continental Australia and the Great Barrier Reef, due to airborne microbes that travel from the former to the latter. The finding showed that the health of these two ecosystems are more interconnected than previously believed, hence holistic conservation efforts need to span different ecosystems.

Microbes are fundamental to the health of ecosystems, playing roles such as providing energy, oxygen and carbon to other organisms and recycling nutrients from other organisms' waste products. Prof Pointing's team recently published two papers in established scientific journals Nature Microbiology and The ISME Journal (a Nature partner journal) on the role of microbes in connecting ecosystems, specifically how microbes from one ecosystem can have significant effects on the well-being of a completely different ecosystem.

The team's success has grown from development of a new apparatus and methodology to accurately study microbes in air - something that has never been previously done due to the low abundance of airborne microbes and how quickly they degrade once captured for sampling. The team's first paper, published in the June 2019 issue of the peer-reviewed journal Nature Microbiology, revealed this method and highlighted how some microbes survive better than others during transport in the air over the Southern Ocean.

Their second paper, published in The ISME Journal in November 2019, focused on the interconnectedness between earth, sea, and sky. Prof Pointing and his team observed that vital microbes essential for the flourishing of the Great Barrier Reef are present in the air, and are in fact transported through the air from other ecosystems like the Australian continental landmass.

While there has long been speculation that airborne microbes are absorbed into the Reef, this was the first study that confirmed the existence of such a link. Genetic testing highlighted that the most abundant shared species in the air and coral played important functional roles in both coral and soil ecosystems, suggesting that the atmosphere acts to connect these ecosystems by transporting microbes essential to the health of each between them.

Prof Pointing, who is also Director of the Division of Science at Yale-NUS, said, "In order to make effective policy decisions to protect our natural environment, it is vital to have reliable data on the level of connectivity between different ecosystems. The role that the air plays in ecosystem connectivity has not been appreciated until now. Our research provides empirical evidence that distant ecosystems on land and at sea are connected by the multitude of microorganisms such as bacteria and fungi that are transported in air currents between these ecosystems. Because microorganisms are so important to ecosystem health, any change to their transport patterns can have potentially catastrophic environmental impacts."

The team's third paper, specially commissioned by Nature Microbiology and published on 28 January 2020, is a position paper setting the direction of research in the field for the next five to 10 years. It explores ways in which human activity affects how microbes are transported in air, such as how pollution particles in the atmosphere can kill microbes, or disrupt or alter their transport patterns. It also explores the potential of some microbes to detoxify toxic polycyclic aromatic hydrocarbons (PAH) compounds in the air, which are known to cause cancer in humans, although further research is required to determine the feasibility of such an endeavour.

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Yale-NUS College

How to head off a Red Bull habit -- study

image: Flinders University Professor of Psychology Eva Kemps researches mind, body and cognition.

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Flinders University

Regular consumers of popular caffeinated energy drinks may need help kicking the habit.

New research at Flinders University in Australia, published in the international journal PLOS One, put a form of cognitive incentive retraining - a form of computer-based training aimed at reducing decision-making biases in purchasing energy drinks - to the test on more than 200 regular consumers of energy drinks aged between 18 and 25.

With the powerful marketing by brands such as Red Bull, V, Mother and Monster, the Australian Research Council-funded research is focusing on finding ways to reduce or combat the rising levels of energy and soft drink consumption.

The training aimed to reduce energy drink consumption by either reducing the extent to which energy drink cans capture the attention of regular energy drink consumers (attentional bias) or reducing the tendency for these consumers to approach energy drinks (approach bias).

"We are keen to expand these trial methods on consumers to combat through their attentional and approach bias towards energy drinks," says Mind, Body and Cognition research leader Professor of Psychology Eva Kemps.

"By giving participants some simple techniques, we examined whether they were prepared to moderate their bias toward choosing energy drinks over soft drinks and more healthy options, and perhaps reduce consumption before they become addicted."

While an occasional energy drink is not problematic, it has been reported that some individuals consume four or more energy drinks a day. Excessive intake can lead to the development of intolerance and serious withdrawal symptoms upon cessation.

Energy drink consumption is rising, with one estimate of it doubling in the past 10-15 years to more than 11.5 billion litres a year globally, with a majority of consumers young adults.

Side-effects of excessive intake of the high caffeine drinks, with other stimulants taurine, guarana and ginseng, can lead to a range of negative physical and mental health consequences, including anxiety, depression, or even stress PTSD and substance abuse.

Reported adverse effects range in severity from headaches to heart palpitations, renal failure, seizures, and in rare cases death.

The 226 volunteers in the study - many of them university students - said they consumed 1 or more cans a fortnight, for an energy boost, to relieve fatigue, improve sporting or academic performance, or as a party mixer with alcohol.

The training aimed to reduce energy drink consumption by tackling either the extent to which the products capture the attention of regular energy drink consumers (attentional bias) or the tendency for these consumers to approach energy drinks (approach bias).

Attentional and approach biases have been demonstrated for a range of appetitive substances, including alcohol, tobacco, drugs and chocolate.

The research is part of an ARC Discovery Project (2018-21) looking at the role of automatic processing in the (over)consumption of soft drinks, and follows previous attentional retraining research to reduce food cravings and promote healthier eating and weight loss.

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Flinders University

Hope for enhanced UTI treatments to minimize bladder pain

video: The fight against Urinary Tract Infection pain, discomfort and a constant urge to urinate has taken a step forward with scientists identifying how the immune systems defence against bladder infection causes nerves to magnify sensations felt by patients.

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Dr Luke Grundy, Flinders University & SAHMRI

Urinary tract infections (UTI's) are painful and usually short lived - but for millions of people this is simply not the case.

Low levels of infection can be found long after it's thought to have cleared, and research suggests this could be an unknown, but leading cause of chronic bladder dysfunction.

But the fight against pain, discomfort and a constant urge to urinate has taken a step forward with scientists identifying how the immune systems defence against bladder infection causes nerves to magnify the sensations felt by patients.

Flinders University researchers at SAHMRI in collaboration with Griffith University on the Gold Coast, have analysed how the immune system responds to urinary tract infections and the direct link this response has to magnifying bladder pain.

Clinical Pharmacology Research Fellow & Head of Bladder Research, Dr Luke Grundy, says understanding how nerves in the bladder transmit different sensations to the brain could potentially help limit bladder dysfunction in overactive bladder patients.

"We believe that chronic pain and bladder dysfunction are a failure of these nerves to reset after inflammation, so by understanding how these nerves function with a UTI and what causes them to become more sensitive over time, we can develop effective treatments."

"This is important, as many people diagnosed with an overactive bladder, a disorder that is currently considered to have no specific cause, have a history of urinary tract infections, and have been shown to have persistent low levels of UTI. This may lead to enhanced patient diagnosis and alternative treatment options for those suffering with an overactive bladder."

With the number of antibiotic resistant UTI's growing globally each year, many can no longer be treated with common antibiotics despite the fact one in every two women will develop a UTI in their lifetime.

Dr Grundy says this study provides new information into how UTI causes hypersensitivity of the nerves that carry sensation from the bladder to the brain, resulting in the symptoms of urinary frequency, urgency, and pelvic or suprapubic pain.

"Our study provides a new understanding of why some overactive bladder patients do not respond to traditional medications and continue to suffer in silence, and opens the door for the development of more specific and effective treatments in the future".

Chaired by two of Flinders University's renowned gut researchers, Professor Nick Spencer and Professor Stuart Brierley, a week long conference will delve into the latest gut / brain breakthroughs at the annual meeting of the Federation of Neurogastroenterology and Motility, from 24 to 28 March 2020.

The 4th Meeting of the Federation of NeuroGastroenterology and Motility is hosted by the Australasian NeuroGastro­enterology and Motility Association Inc, the American NeuroGastro­enterology and Motility Society, the Asian NeuroGastro­enterology and Motility Association, the European Society of Neurogastro­enterology and Motility, and the Latin-American Society of Neurogastroenterology.

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Flinders University