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Farmed carnivores may become ‘disease reservoirs’ posing human health risk

Latest Research in Cambridge - Tue, 24/08/2021 - 16:03

Farming large numbers of carnivores, like mink, could allow the formation of undetected ‘disease reservoirs’, in which a pathogen could spread to many animals and mutate to become a risk to human health.

Research led by the University of Cambridge has discovered that carnivores have a defective immune system, which makes them likely to be asymptomatic carriers of disease-causing pathogens.

Three key genes in carnivores that are critical for gut health were found to have lost their function. If these genes were working, they would produce protein complexes called inflammasomes to activate inflammatory responses and fight off pathogens. The study is published today in the journal Cell Reports.

The researchers say that the carnivorous diet, which is high in protein, is thought to have antimicrobial properties that could compensate for the loss of these immune pathways in carnivores – any gut infection is expelled by the production of diarrhoea. But the immune deficiency means that other pathogens can reside undetected elsewhere in these animals.

“We’ve found that a whole cohort of inflammatory genes is missing in carnivores - we didn’t expect this at all,” said Professor Clare Bryant in the University of Cambridge’s Department of Veterinary Medicine, senior author of the paper. 

She added: “We think that the lack of these functioning genes contributes to the ability of pathogens to hide undetected in carnivores, to potentially mutate and be transmitted becoming a human health risk.”

Zoonotic pathogens are those that live in animal hosts before jumping to infect humans. The COVID-19 pandemic, thought to originate in a wild animal, has shown the enormous damage that can be wrought by a novel human disease. Carnivores include mink, dogs, and cats, and are the biggest carriers of zoonotic pathogens. 

Three genes appear to be in the process of being lost entirely in carnivores: the DNA is still present but it is not expressed, meaning they have become ‘pseudogenes’ and are not functioning. A third gene important for gut health has developed a unique mutation, causing two proteins called caspases to be fused together to change their function so they can no longer respond to some pathogens in the animal’s body.

“When you have a large population of farmed carnivorous animals, like mink, they can harbour a pathogen - like SARS-CoV-2 and others - and it can mutate because the immune system of the mink isn’t being activated. This could potentially spread into humans,” said Bryant.

The researchers say that the results are not a reason to be concerned about COVID-19 being spread by dogs and cats. There is no evidence that these domestic pets carry or transmit COVID-19. It is when large numbers of carnivores are kept together in close proximity that a large reservoir of the pathogen can build up amongst them, and potentially mutate.

This research was funded by Wellcome.

Reference
Digby, Z. et al: ‘Evolutionary loss of inflammasomes in the Carnivora and implications for the carriage of zoonotic infections.’ Cell Reports, August 2021. DOI: 10.1016/j.celrep.2021.109614

 

Carnivorous animals lack key genes needed to detect and respond to infection by pathogens, a study has found.

Infectious diseasesCOVID-19Clare BryantDepartment of Veterinary MedicineCambridge Infectious DiseasesDepartment of MedicineQueens' CollegeSchool of the Biological SciencesSchool of Clinical MedicineWe’ve found that a whole cohort of inflammatory genes is missing in carnivores Clare Bryant Oikeutta elaimille on FlickrFarmed mink


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

Farmed carnivores may become ‘disease reservoirs’ posing human health risk

Research in Medicine - Tue, 24/08/2021 - 16:03

Farming large numbers of carnivores, like mink, could allow the formation of undetected ‘disease reservoirs’, in which a pathogen could spread to many animals and mutate to become a risk to human health.

Research led by the University of Cambridge has discovered that carnivores have a defective immune system, which makes them likely to be asymptomatic carriers of disease-causing pathogens.

Three key genes in carnivores that are critical for gut health were found to have lost their function. If these genes were working, they would produce protein complexes called inflammasomes to activate inflammatory responses and fight off pathogens. The study is published today in the journal Cell Reports.

The researchers say that the carnivorous diet, which is high in protein, is thought to have antimicrobial properties that could compensate for the loss of these immune pathways in carnivores – any gut infection is expelled by the production of diarrhoea. But the immune deficiency means that other pathogens can reside undetected elsewhere in these animals.

“We’ve found that a whole cohort of inflammatory genes is missing in carnivores - we didn’t expect this at all,” said Professor Clare Bryant in the University of Cambridge’s Department of Veterinary Medicine, senior author of the paper. 

She added: “We think that the lack of these functioning genes contributes to the ability of pathogens to hide undetected in carnivores, to potentially mutate and be transmitted becoming a human health risk.”

Zoonotic pathogens are those that live in animal hosts before jumping to infect humans. The COVID-19 pandemic, thought to originate in a wild animal, has shown the enormous damage that can be wrought by a novel human disease. Carnivores include mink, dogs, and cats, and are the biggest carriers of zoonotic pathogens. 

Three genes appear to be in the process of being lost entirely in carnivores: the DNA is still present but it is not expressed, meaning they have become ‘pseudogenes’ and are not functioning. A third gene important for gut health has developed a unique mutation, causing two proteins called caspases to be fused together to change their function so they can no longer respond to some pathogens in the animal’s body.

“When you have a large population of farmed carnivorous animals, like mink, they can harbour a pathogen - like SARS-CoV-2 and others - and it can mutate because the immune system of the mink isn’t being activated. This could potentially spread into humans,” said Bryant.

The researchers say that the results are not a reason to be concerned about COVID-19 being spread by dogs and cats. There is no evidence that these domestic pets carry or transmit COVID-19. It is when large numbers of carnivores are kept together in close proximity that a large reservoir of the pathogen can build up amongst them, and potentially mutate.

This research was funded by Wellcome.

Reference
Digby, Z. et al: ‘Evolutionary loss of inflammasomes in the Carnivora and implications for the carriage of zoonotic infections.’ Cell Reports, August 2021. DOI: 10.1016/j.celrep.2021.109614

 

Carnivorous animals lack key genes needed to detect and respond to infection by pathogens, a study has found.

Infectious diseasesCOVID-19Clare BryantDepartment of Veterinary MedicineCambridge Infectious DiseasesDepartment of MedicineQueens' CollegeSchool of the Biological SciencesSchool of Clinical MedicineWe’ve found that a whole cohort of inflammatory genes is missing in carnivores Clare Bryant Oikeutta elaimille on FlickrFarmed mink


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

Female scientists lead Cambridge success in Royal Society awards

Latest Research in Cambridge - Tue, 24/08/2021 - 13:00

Burnell is one of twelve former and current Cambridge researchers, including six women, to be recognised in 2021 for their exceptional research and outstanding contributions to science.

Dame Jocelyn has been honoured for her work on the discovery of pulsars in the 1960s while she was a postgraduate student at New Hall (now Murray Edwards College) carrying out research at Cambridge's Cavendish Laboratory.

Past winners of the Copley Medal have included Charles Darwin, Albert Einstein and Dorothy Crowfoot Hodgkin. Dame Jocelyn said: “I am delighted to be the recipient of this year’s Copley Medal, a prize which has been awarded to so many incredible scientists.

“With many more women having successful careers in science, and gaining recognition for their transformational work, I hope there will be many more female Copley winners in the near future.

“My career has not fitted a conventional – male – pattern. Being the first person to identify pulsars would be the highlight of any career; but I have also swung sledgehammers and built radio telescopes; set up a successful group of my own studying binary stars; and was the first female president of the Institute of Physics and of the Royal Society of Edinburgh.

“I hope that my work and presence as a senior woman in science continues to encourage more women to pursue scientific careers”.

The Copley Medal award includes a £25,000 gift which Dame Jocelyn will add to the Institute of Physics' Bell Burnell Graduate Scholarship Fund, which provides grants to graduate students from under-represented groups in physics.

Three female scientists currently working at Cambridge have been recognised in 2021. Professor Sadaf Farooqi from the MRC Metabolic Diseases Unit receives the Croonian Medal and Lecture, together with Sir Stephen O'Rahilly, for their seminal discoveries regarding the control of human body weight, resulting in novel diagnostics and therapies, which improve human health. 

Dr Serena Nik-Zainal from the MRC Cancer Unit has been awarded the Francis Crick Medal and Lecture, for her contributions to understanding the aetiology of cancers by her analyses of mutation signatures in cancer genomes, which is now being applied to cancer therapy.

Professor Anne Ferguson-Smith from the Department of Genetics and currently the University’s Pro-Vice-Chancellor for Research receives the Buchanan Medal, for her pioneering work in epigenetics, her interdisciplinary work on genomic imprinting, the interplay between the genome and epigenome, and how genetic and environmental influences affect development and human diseases.

Former Cavendish Laboratory Research Fellow, Professor Michelle Simmons, has won the Bakerian Medal and Lecture, for her seminal contributions to our understanding of nature at the atomic-scale by creating a sequence of world-first quantum electronic devices in which individual atoms control device behaviour. 

Professor Frances Kirwan, alumna and Honorary Fellow of Clare College, received the Sylvester Medal, for her research on quotients in algebraic geometry, including links with symplectic geometry and topology, which has had many applications.

Other current Cambridge researchers honoured include Dr Sjors Scheres from the MRC Laboratory of Molecular Biology. Scheres has been awarded the Leeuwenhoek Medal and Lecture for his ground-breaking contributions and innovations in image analysis and reconstruction methods in electron cryo-microscopy, enabling the structure determination of complex macromolecules of fundamental biological and medical importance to atomic resolution.

Emeritus Professor Michael Green from the Department of Applied Mathematics and Theoretical Physics has been awarded Royal Medal A for crucial and influential contributions to the development of string theory over a long period, including the discovery of anomaly cancellation.

The Royal Society’s President, Sir Adrian Smith, said: “Through its medals and awards the Royal Society recognises those researchers and science communicators who have played a critical part in expanding our understanding of the world around us.”

“From advancing vaccine development to catching the first glimpses of distant pulsars, these discoveries shape our societies, answer fundamental questions and open new avenues for exploration.”

Find the full list of 2021 Royal Society medal, award and prize winners here.

Professor Dame Jocelyn Bell Burnell has become only the second woman to be awarded the Royal Society’s prestigious Copley Medal, the world’s oldest scientific prize.

Royal SocietyWomen in STEMMJocelyn Bell BurnellAnne Ferguson-SmithStephen O’RahillySadaf FarooqiMichael GreenSerena Nik-ZainalSjors ScheresRoyal SocietyCavendish LaboratoryMRC Cancer UnitMRC Laboratory of Molecular BiologyDepartment of Applied Mathematics and Theoretical PhysicsMRC Metabolic Diseases UnitDepartment of GeneticsMurray Edwards CollegeChurchill CollegeSchool of the Physical SciencesSchool of the Biological SciencesI hope there will be many more female Copley winners in the near futureJocelyn Bell Burnellhttps://www.youtube.com/watchProfessor Dame Jocelyn Bell Burnell


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

Female scientists lead Cambridge success in Royal Society awards

Research in Medicine - Tue, 24/08/2021 - 13:00

Burnell is one of twelve former and current Cambridge researchers, including six women, to be recognised in 2021 for their exceptional research and outstanding contributions to science.

Dame Jocelyn has been honoured for her work on the discovery of pulsars in the 1960s while she was a postgraduate student at New Hall (now Murray Edwards College) carrying out research at Cambridge's Cavendish Laboratory.

Past winners of the Copley Medal have included Charles Darwin, Albert Einstein and Dorothy Crowfoot Hodgkin. Dame Jocelyn said: “I am delighted to be the recipient of this year’s Copley Medal, a prize which has been awarded to so many incredible scientists.

“With many more women having successful careers in science, and gaining recognition for their transformational work, I hope there will be many more female Copley winners in the near future.

“My career has not fitted a conventional – male – pattern. Being the first person to identify pulsars would be the highlight of any career; but I have also swung sledgehammers and built radio telescopes; set up a successful group of my own studying binary stars; and was the first female president of the Institute of Physics and of the Royal Society of Edinburgh.

“I hope that my work and presence as a senior woman in science continues to encourage more women to pursue scientific careers”.

The Copley Medal award includes a £25,000 gift which Dame Jocelyn will add to the Institute of Physics' Bell Burnell Graduate Scholarship Fund, which provides grants to graduate students from under-represented groups in physics.

Three female scientists currently working at Cambridge have been recognised in 2021. Professor Sadaf Farooqi from the MRC Metabolic Diseases Unit receives the Croonian Medal and Lecture, together with Sir Stephen O'Rahilly, for their seminal discoveries regarding the control of human body weight, resulting in novel diagnostics and therapies, which improve human health. 

Dr Serena Nik-Zainal from the MRC Cancer Unit has been awarded the Francis Crick Medal and Lecture, for her contributions to understanding the aetiology of cancers by her analyses of mutation signatures in cancer genomes, which is now being applied to cancer therapy.

Professor Anne Ferguson-Smith from the Department of Genetics and currently the University’s Pro-Vice-Chancellor for Research receives the Buchanan Medal, for her pioneering work in epigenetics, her interdisciplinary work on genomic imprinting, the interplay between the genome and epigenome, and how genetic and environmental influences affect development and human diseases.

Former Cavendish Laboratory Research Fellow, Professor Michelle Simmons, has won the Bakerian Medal and Lecture, for her seminal contributions to our understanding of nature at the atomic-scale by creating a sequence of world-first quantum electronic devices in which individual atoms control device behaviour. 

Professor Frances Kirwan, alumna and Honorary Fellow of Clare College, received the Sylvester Medal, for her research on quotients in algebraic geometry, including links with symplectic geometry and topology, which has had many applications.

Other current Cambridge researchers honoured include Dr Sjors Scheres from the MRC Laboratory of Molecular Biology. Scheres has been awarded the Leeuwenhoek Medal and Lecture for his ground-breaking contributions and innovations in image analysis and reconstruction methods in electron cryo-microscopy, enabling the structure determination of complex macromolecules of fundamental biological and medical importance to atomic resolution.

Emeritus Professor Michael Green from the Department of Applied Mathematics and Theoretical Physics has been awarded Royal Medal A for crucial and influential contributions to the development of string theory over a long period, including the discovery of anomaly cancellation.

The Royal Society’s President, Sir Adrian Smith, said: “Through its medals and awards the Royal Society recognises those researchers and science communicators who have played a critical part in expanding our understanding of the world around us.”

“From advancing vaccine development to catching the first glimpses of distant pulsars, these discoveries shape our societies, answer fundamental questions and open new avenues for exploration.”

Find the full list of 2021 Royal Society medal, award and prize winners here.

Professor Dame Jocelyn Bell Burnell has become only the second woman to be awarded the Royal Society’s prestigious Copley Medal, the world’s oldest scientific prize.

Royal SocietyWomen in STEMMJocelyn Bell BurnellAnne Ferguson-SmithStephen O’RahillySadaf FarooqiMichael GreenSerena Nik-ZainalSjors ScheresRoyal SocietyCavendish LaboratoryMRC Cancer UnitMRC Laboratory of Molecular BiologyDepartment of Applied Mathematics and Theoretical PhysicsMRC Metabolic Diseases UnitDepartment of GeneticsMurray Edwards CollegeChurchill CollegeSchool of the Physical SciencesSchool of the Biological SciencesI hope there will be many more female Copley winners in the near futureJocelyn Bell Burnellhttps://www.youtube.com/watchProfessor Dame Jocelyn Bell Burnell


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

Hospital-acquired COVID-19 tends to be picked up from other patients, not from healthcare workers

Latest Research in Cambridge - Tue, 24/08/2021 - 08:00

The study provides previously unprecedented detail on how infections might spread in a hospital context, showing that a minority of individuals can cause most of the transmission.

The researchers analysed data from the first wave of the pandemic, between March and June 2020.  While a great deal of effort is made to prevent the spread of viruses within hospital by keeping infected and non-infected individuals apart, this task is made more difficult during times when the number of infections is high. The high level of transmissibility of the virus and the potential for infected individuals to be asymptomatic both make this task particularly challenging.

Looking back at data from the first wave, researchers identified five wards at Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, where multiple individuals, including patients and healthcare workers, tested positive for COVID-19 within a short space of time, suggesting that a local outbreak might have occurred.

Using new statistical methods that combine viral genome sequence data with clinical information about the locations of individuals, the researchers identified cases where the data were consistent with transmission occurring between individuals in the hospital. Looking in detail at these transmission events highlighted patterns in the data.

The results of the study, published today in eLife, showed that patients who were infected in the hospital were mostly infected by other patients, rather than by hospital staff. Out of 22 cases where patients were infected in hospital, 20 of these were the result of the virus spreading from patients to other patients

Dr Chris Illingworth, a lead author on the study, who carried out his research while at Cambridge’s MRC Biostatistics Unit, said: “The fact that the vast majority of infections were between patients suggests that measures taken by hospital staff to prevent staff transmitting the virus to patients, such as the wearing of masks, were likely to have been effective.

“But it also highlights why it is important that patients themselves are screened for COVID-19 regularly, even if asymptomatic, and wear face masks where possible.”

The study found contrasting results among healthcare workers, who were almost as likely to be infected by patients as they were by other healthcare workers. This was one piece of evidence that motivated the decision to upgrade the respiratory protection worn by healthcare workers in COVID-19 wards at CUH. A recent Cambridge study indicated that this resulted in staff being better protected against catching COVID-19.

The researchers also found a trend towards individuals either infecting no one else, or infecting multiple other people – just over a fifth of patients (21%) caused 80% of the infections. This phenomenon is sometimes called ‘superspreading’ and can make infection control very challenging. Whether or not an individual can be identified in advance as being more or less likely to pass on the virus is an ongoing topic of research.

Dr William Hamilton, an infectious diseases clinician at CUH and co-lead author on the study said: “Preventing new cases of hospital-based infection is a critical part of our work.  Here we have shown that analysing clinical and viral genome sequence data can produce insights that inform infection control measures, which are so important for protecting patients and healthcare workers alike.”

The research was funded by COG-UK, Wellcome, the Academy of Medical Sciences, the Health Foundation and the NIHR Cambridge Biomedical Research Centre.

Reference
Illingworth, CJR & Hamilton, WL et al. Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections. eLife; 24 Aug 2021; DOI: 10.7554/eLife.67308

The majority of patients who contracted COVID-19 while in hospital did so from other patients rather than from healthcare workers, concludes a new study from researchers at the University of Cambridge and Addenbrooke’s Hospital.

COVID-19CoronavirusGenomicshealthcareChris IllingworthWilliam HamiltonWellcomeThe Academy of Medical SciencesHealth FoundationNIHR Cambridge Biomedical Research CentreSchool of Clinical MedicineCOVID-19 Genomics UK (COG-UK) ConsortiumAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustDepartment of MedicineThe fact that the vast majority of infections were between patients suggests that measures taken by hospital staff to prevent staff transmitting the virus to patients, such as the wearing of masks, were likely to have been effectiveChris Illingworth Preventing hospital acquired Covid-19 infection | Estée Torok outsideclickCoronavirus


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News

Hospital-acquired COVID-19 tends to be picked up from other patients, not from healthcare workers

Research in Medicine - Tue, 24/08/2021 - 08:00

The study provides previously unprecedented detail on how infections might spread in a hospital context, showing that a minority of individuals can cause most of the transmission.

The researchers analysed data from the first wave of the pandemic, between March and June 2020.  While a great deal of effort is made to prevent the spread of viruses within hospital by keeping infected and non-infected individuals apart, this task is made more difficult during times when the number of infections is high. The high level of transmissibility of the virus and the potential for infected individuals to be asymptomatic both make this task particularly challenging.

Looking back at data from the first wave, researchers identified five wards at Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, where multiple individuals, including patients and healthcare workers, tested positive for COVID-19 within a short space of time, suggesting that a local outbreak might have occurred.

Using new statistical methods that combine viral genome sequence data with clinical information about the locations of individuals, the researchers identified cases where the data were consistent with transmission occurring between individuals in the hospital. Looking in detail at these transmission events highlighted patterns in the data.

The results of the study, published today in eLife, showed that patients who were infected in the hospital were mostly infected by other patients, rather than by hospital staff. Out of 22 cases where patients were infected in hospital, 20 of these were the result of the virus spreading from patients to other patients

Dr Chris Illingworth, a lead author on the study, who carried out his research while at Cambridge’s MRC Biostatistics Unit, said: “The fact that the vast majority of infections were between patients suggests that measures taken by hospital staff to prevent staff transmitting the virus to patients, such as the wearing of masks, were likely to have been effective.

“But it also highlights why it is important that patients themselves are screened for COVID-19 regularly, even if asymptomatic, and wear face masks where possible.”

The study found contrasting results among healthcare workers, who were almost as likely to be infected by patients as they were by other healthcare workers. This was one piece of evidence that motivated the decision to upgrade the respiratory protection worn by healthcare workers in COVID-19 wards at CUH. A recent Cambridge study indicated that this resulted in staff being better protected against catching COVID-19.

The researchers also found a trend towards individuals either infecting no one else, or infecting multiple other people – just over a fifth of patients (21%) caused 80% of the infections. This phenomenon is sometimes called ‘superspreading’ and can make infection control very challenging. Whether or not an individual can be identified in advance as being more or less likely to pass on the virus is an ongoing topic of research.

Dr William Hamilton, an infectious diseases clinician at CUH and co-lead author on the study said: “Preventing new cases of hospital-based infection is a critical part of our work.  Here we have shown that analysing clinical and viral genome sequence data can produce insights that inform infection control measures, which are so important for protecting patients and healthcare workers alike.”

The research was funded by COG-UK, Wellcome, the Academy of Medical Sciences, the Health Foundation and the NIHR Cambridge Biomedical Research Centre.

Reference
Illingworth, CJR & Hamilton, WL et al. Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections. eLife; 24 Aug 2021; DOI: 10.7554/eLife.67308

The majority of patients who contracted COVID-19 while in hospital did so from other patients rather than from healthcare workers, concludes a new study from researchers at the University of Cambridge and Addenbrooke’s Hospital.

COVID-19CoronavirusGenomicshealthcareChris IllingworthWilliam HamiltonWellcomeThe Academy of Medical SciencesHealth FoundationNIHR Cambridge Biomedical Research CentreSchool of Clinical MedicineCOVID-19 Genomics UK (COG-UK) ConsortiumAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustDepartment of MedicineThe fact that the vast majority of infections were between patients suggests that measures taken by hospital staff to prevent staff transmitting the virus to patients, such as the wearing of masks, were likely to have been effectiveChris Illingworth Preventing hospital acquired Covid-19 infection | Estée Torok outsideclickCoronavirus


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News

10,000 autistic people to take part in the UK’s largest study of autism

Latest Research in Cambridge - Tue, 24/08/2021 - 00:01

Spectrum 10K is led by researchers at the world-leading Autism Research Centre (ARC), the University of Cambridge, together with the Wellcome Sanger Institute and University of California Los Angeles (UCLA) and will study how biological and environmental factors impact on the wellbeing of autistic individuals.

In the UK, there are approximately 700,000 autistic individuals. The level of support needed by autistic individuals varies considerably. Many autistic people have additional physical health conditions such as epilepsy, or mental health conditions such as anxiety or depression.

It is unclear what gives rise to the diversity within the autism spectrum or why some autistic people have better outcomes than others. The project aims to answer this question and to identify what support works best for each individual.

Professor Simon Baron-Cohen, leading Spectrum 10K and Director of the ARC, explained: “There is an urgent need to better understand the wellbeing of autistic individuals. Spectrum 10K hopes to answer questions such as why some autistic people have epilepsy or poor mental health outcomes and others do not.”

Individuals of all ages, genders, ethnicities and intellectual capacities will take part in Spectrum 10K. Eligible participants join by completing an online questionnaire and providing a DNA saliva sample by post. Autistic participants involved in Spectrum 10K can also invite their biological relatives (autistic or otherwise) to participate. Information collected from the questionnaire and DNA saliva sample, and information from health records will be used to increase knowledge and understanding of wellbeing in autism.

Dr James Cusack, CEO of the autism research charity Autistica and an autistic person, said: “We are delighted to support Spectrum 10K. This project enables autistic people to participate in and shape autism research to build a future where support is tailored to every individual’s needs.”

The Spectrum 10K team views autism as an example of neurodiversity and is opposed to eugenics or looking for a cure for preventing or eradicating autism itself.  Instead, their research aims to identify types of support and treatment which alleviate unwanted symptoms and co-occurring conditions that cause autistic people distress.

The Spectrum 10K team collaborates with an Advisory Panel consisting of autistic individuals, parents of autistic children, clinicians, and autism charity representatives to ensure Spectrum 10K is designed in a way that best serves the autistic community. 27 specialist NHS sites around the UK are also helping with recruitment for Spectrum 10K.

Dr Venkat Reddy, Consultant Neurodevelopmental Paediatrician in the Community Child Health Services at Cambridgeshire and Peterborough NHS Foundation Trust, said: “There is a need to conduct further research into autism and co-occurring conditions to enable researchers and clinicians to build a better understanding of autism. I would encourage autistic individuals and their families to consider taking part in Spectrum 10K.”

Chris Packham, naturalist and TV presenter who is also autistic, said: “I’m honoured to be an ambassador of Spectrum 10K because I believe in the value of science to inform the support services that autistic kids and adults will need.”

Paddy McGuinness, actor, comedian, television presenter, and father of three autistic children, said: “As a parent of three autistic children, I am really excited to support Spectrum 10K. This research is important to help us understand what makes every autistic person different, and how best to support them.”

Dr Anna and Alastair Gadney, parents of a teenager with autism and learning difficulties: “We have been exploring, over many years, how to implement the best support for our son. We wholeheartedly endorse Spectrum 10K and hope our involvement can help increase understanding of autism and in-turn support many families out there.”

Recruitment for Spectrum 10K is now open. Autistic children under the age of 16 must be registered by their parent or legal guardian. Autistic adults who lack the capacity to consent by themselves must be registered by a carer/or family member. To register, participants should visit www.spectrum10k.org

An ambitious new research project, Spectrum 10K, launches today and will recruit 10,000 autistic individuals, as well as their relatives, living in the UK.

Spotlight on neuroscienceautismgeneticsSimon Baron-CohenWellcome Sanger InstituteUniversity of California Los AngelesSchool of Clinical MedicineAutism Research CentreDepartment of PsychiatryThere is an urgent need to better understand the wellbeing of autistic individuals. Spectrum 10K hopes to answer questions such as why some autistic people have epilepsy or poor mental health outcomes and others do notSimon Baron-CohenSpectrum 10kSpectrum 10k image


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

10,000 autistic people to take part in the UK’s largest study of autism

Research in Medicine - Tue, 24/08/2021 - 00:01

Spectrum 10K is led by researchers at the world-leading Autism Research Centre (ARC), the University of Cambridge, together with the Wellcome Sanger Institute and University of California Los Angeles (UCLA) and will study how biological and environmental factors impact on the wellbeing of autistic individuals.

In the UK, there are approximately 700,000 autistic individuals. The level of support needed by autistic individuals varies considerably. Many autistic people have additional physical health conditions such as epilepsy, or mental health conditions such as anxiety or depression.

It is unclear what gives rise to the diversity within the autism spectrum or why some autistic people have better outcomes than others. The project aims to answer this question and to identify what support works best for each individual.

Professor Simon Baron-Cohen, leading Spectrum 10K and Director of the ARC, explained: “There is an urgent need to better understand the wellbeing of autistic individuals. Spectrum 10K hopes to answer questions such as why some autistic people have epilepsy or poor mental health outcomes and others do not.”

Individuals of all ages, genders, ethnicities and intellectual capacities will take part in Spectrum 10K. Eligible participants join by completing an online questionnaire and providing a DNA saliva sample by post. Autistic participants involved in Spectrum 10K can also invite their biological relatives (autistic or otherwise) to participate. Information collected from the questionnaire and DNA saliva sample, and information from health records will be used to increase knowledge and understanding of wellbeing in autism.

Dr James Cusack, CEO of the autism research charity Autistica and an autistic person, said: “We are delighted to support Spectrum 10K. This project enables autistic people to participate in and shape autism research to build a future where support is tailored to every individual’s needs.”

The Spectrum 10K team views autism as an example of neurodiversity and is opposed to eugenics or looking for a cure for preventing or eradicating autism itself.  Instead, their research aims to identify types of support and treatment which alleviate unwanted symptoms and co-occurring conditions that cause autistic people distress.

The Spectrum 10K team collaborates with an Advisory Panel consisting of autistic individuals, parents of autistic children, clinicians, and autism charity representatives to ensure Spectrum 10K is designed in a way that best serves the autistic community. 27 specialist NHS sites around the UK are also helping with recruitment for Spectrum 10K.

Dr Venkat Reddy, Consultant Neurodevelopmental Paediatrician in the Community Child Health Services at Cambridgeshire and Peterborough NHS Foundation Trust, said: “There is a need to conduct further research into autism and co-occurring conditions to enable researchers and clinicians to build a better understanding of autism. I would encourage autistic individuals and their families to consider taking part in Spectrum 10K.”

Chris Packham, naturalist and TV presenter who is also autistic, said: “I’m honoured to be an ambassador of Spectrum 10K because I believe in the value of science to inform the support services that autistic kids and adults will need.”

Paddy McGuinness, actor, comedian, television presenter, and father of three autistic children, said: “As a parent of three autistic children, I am really excited to support Spectrum 10K. This research is important to help us understand what makes every autistic person different, and how best to support them.”

Dr Anna and Alastair Gadney, parents of a teenager with autism and learning difficulties: “We have been exploring, over many years, how to implement the best support for our son. We wholeheartedly endorse Spectrum 10K and hope our involvement can help increase understanding of autism and in-turn support many families out there.”

Recruitment for Spectrum 10K is now open. Autistic children under the age of 16 must be registered by their parent or legal guardian. Autistic adults who lack the capacity to consent by themselves must be registered by a carer/or family member. To register, participants should visit www.spectrum10k.org

An ambitious new research project, Spectrum 10K, launches today and will recruit 10,000 autistic individuals, as well as their relatives, living in the UK.

Spotlight on neuroscienceautismgeneticsSimon Baron-CohenWellcome Sanger InstituteUniversity of California Los AngelesSchool of Clinical MedicineAutism Research CentreDepartment of PsychiatryThere is an urgent need to better understand the wellbeing of autistic individuals. Spectrum 10K hopes to answer questions such as why some autistic people have epilepsy or poor mental health outcomes and others do notSimon Baron-CohenSpectrum 10kSpectrum 10k image


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

Integrated conservation strategies could simultaneously meet biodiversity, climate, and water objectives

Latest Research in Cambridge - Mon, 23/08/2021 - 16:02

To halt the decline of nature and meet Paris Agreement objectives, strategies must be designed and implemented to better manage land use for agriculture, infrastructure, biodiversity conservation, climate change mitigation and adaptation, water provision, and other needs.

A new paper by the Nature Map consortium, published today in the journal Nature Ecology and Evolution, presents an approach for spatial planning to support such integrated conservation strategies.

The study demonstrates that by jointly considering biodiversity, carbon, and water, synergies can be gained from conservation efforts compared to placing emphasis on any individual asset alone. Through strategic action in selected locations, significant benefits can be achieved across all three dimensions. However, conservation efforts need to be greatly scaled-up to meet global biodiversity and climate objectives. 

The paper sets out to determine areas of global importance to manage for conservation that would simultaneously protect the greatest number of species from extinction, conserve vulnerable terrestrial carbon stocks, and safeguard freshwater resources. 

This work is the first of its kind to truly integrate biodiversity, carbon, and water conservation within a common approach and a single global priority map. 

“To implement post-2020 biodiversity strategies such as the Global Biodiversity Framework, policymakers and governments need clarity on where resources and conservation management could bring the greatest potential benefits to biodiversity,” said lead author Martin Jung, a researcher in the IIASA Biodiversity, Ecology, and Conservation Research Group.

He added: “Biodiversity should not be looked at in isolation. Other aspects such as conserving carbon stocks within natural ecosystems should also be considered, so that synergies and trade-offs can be evaluated when pursuing multiple objectives.” 

“This type of approach can support decision makers in prioritising locations for conservation efforts, and shows just how much both people and nature could gain,” said Lera Miles, Principal Technical Specialist – Planning for Places, UN Environment Programme World Conservation Monitoring Centre.

She added “To be successful long-term, these areas must be managed effectively and equitably. That includes respecting the rights of, and empowering indigenous peoples and local communities.” 

“Maps for integrated land use planning can accelerate progress towards climate and biodiversity objectives and have many important additional policy uses, including helping to generate finance for natural climate solutions, improving carbon markets, and greening supply chains,” said Guido Schmidt-Traub, an author of the paper who has also written a related commentary in the same issue of Nature Ecology and Evolution.

The global priority maps can be explored interactively on the UN Biodiversity lab to support decision makers and generate insight and impact for conservation and sustainable development.

Reference
Jung, M., et al.: Areas of global importance for conserving terrestrial biodiversity, carbon, and water. Nature Ecology and Evolution. August 2021. DOI: 10.1038/s41559-021-01528-7

Adapted from a press release by The International Institute for Applied Systems Analysis (IIASA).
 

Managing a strategically chosen 30% of land for conservation could safeguard 70% of all terrestrial plant and vertebrate animal species, while simultaneously conserving around two-thirds of the world’s vulnerable carbon and clean water, according to a new study carried out by the Nature Map Consortium, involving the University of Cambridge. 

Biodiversity conservationSustainable EarthMatt LewisThe International Institute for Applied Systems AnalysisDepartment of ZoologySchool of the Biological SciencesThis type of approach can support decision makers in prioritising locations for conservation effortsLera MilesAdam Islaam | International Institute for Applied Systems Analysis (IIASA)Global areas of importance for terrestrial biodiversity, carbon and water (dark blue = highest priority, dark orange = lowest priority)


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

Integrated conservation strategies could simultaneously meet biodiversity, climate, and water objectives

Research in Medicine - Mon, 23/08/2021 - 16:02

To halt the decline of nature and meet Paris Agreement objectives, strategies must be designed and implemented to better manage land use for agriculture, infrastructure, biodiversity conservation, climate change mitigation and adaptation, water provision, and other needs.

A new paper by the Nature Map consortium, published today in the journal Nature Ecology and Evolution, presents an approach for spatial planning to support such integrated conservation strategies.

The study demonstrates that by jointly considering biodiversity, carbon, and water, synergies can be gained from conservation efforts compared to placing emphasis on any individual asset alone. Through strategic action in selected locations, significant benefits can be achieved across all three dimensions. However, conservation efforts need to be greatly scaled-up to meet global biodiversity and climate objectives. 

The paper sets out to determine areas of global importance to manage for conservation that would simultaneously protect the greatest number of species from extinction, conserve vulnerable terrestrial carbon stocks, and safeguard freshwater resources. 

This work is the first of its kind to truly integrate biodiversity, carbon, and water conservation within a common approach and a single global priority map. 

“To implement post-2020 biodiversity strategies such as the Global Biodiversity Framework, policymakers and governments need clarity on where resources and conservation management could bring the greatest potential benefits to biodiversity,” said lead author Martin Jung, a researcher in the IIASA Biodiversity, Ecology, and Conservation Research Group.

He added: “Biodiversity should not be looked at in isolation. Other aspects such as conserving carbon stocks within natural ecosystems should also be considered, so that synergies and trade-offs can be evaluated when pursuing multiple objectives.” 

“This type of approach can support decision makers in prioritising locations for conservation efforts, and shows just how much both people and nature could gain,” said Lera Miles, Principal Technical Specialist – Planning for Places, UN Environment Programme World Conservation Monitoring Centre.

She added “To be successful long-term, these areas must be managed effectively and equitably. That includes respecting the rights of, and empowering indigenous peoples and local communities.” 

“Maps for integrated land use planning can accelerate progress towards climate and biodiversity objectives and have many important additional policy uses, including helping to generate finance for natural climate solutions, improving carbon markets, and greening supply chains,” said Guido Schmidt-Traub, an author of the paper who has also written a related commentary in the same issue of Nature Ecology and Evolution.

The global priority maps can be explored interactively on the UN Biodiversity lab to support decision makers and generate insight and impact for conservation and sustainable development.

Reference
Jung, M., et al.: Areas of global importance for conserving terrestrial biodiversity, carbon, and water. Nature Ecology and Evolution. August 2021. DOI: 10.1038/s41559-021-01528-7

Adapted from a press release by The International Institute for Applied Systems Analysis (IIASA).
 

Managing a strategically chosen 30% of land for conservation could safeguard 70% of all terrestrial plant and vertebrate animal species, while simultaneously conserving around two-thirds of the world’s vulnerable carbon and clean water, according to a new study carried out by the Nature Map Consortium, involving the University of Cambridge. 

Biodiversity conservationSustainable EarthMatt LewisThe International Institute for Applied Systems AnalysisDepartment of ZoologySchool of the Biological SciencesThis type of approach can support decision makers in prioritising locations for conservation effortsLera MilesAdam Islaam | International Institute for Applied Systems Analysis (IIASA)Global areas of importance for terrestrial biodiversity, carbon and water (dark blue = highest priority, dark orange = lowest priority)


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: AttributionNews type: News

Worsening GP shortages in disadvantaged areas likely to widen health inequalities

Latest Research in Cambridge - Wed, 18/08/2021 - 08:43

In a study published today in the BJGP Open, a team from the University of Cambridge looked at the relationship between shortages in the healthcare workforce and levels of deprivation. The team found significantly fewer full time equivalent (FTE) GPs per 10,000 patients in practices within areas of higher levels of deprivation. This inequality has widened slightly over time. By December 2020, there were on average 1.4 fewer FTE GPs per 10,000 patients in the most deprived areas compared to the least deprived areas.

The same was the case for total direct patient care staff (all patient-facing general practice staff excluding GPs and nurses), with 1.5 fewer FTE staff per 10,000 patients in the most deprived areas compared to the least deprived areas.

The lower GP numbers in deprived areas, was compensated, in part, by more nurses.

The analysis used data captured between September 2015 and December 2020 from the NHS Digital General Practice Workforce collection. They compared this workforce data against practice population sizes and levels of deprivation across England.

In addition to their report, the team have today launched an interactive dashboard that maps local-level primary care workforce inequalities to accompany the national-level analysis done in the paper. Clear local-level inequalities in GP distribution can be seen within West, North and East Cumbria, Humber, Coast and Vale, and Coventry and Warwickshire STP (Sustainability and Transformation Plan) areas, among others. 

Workforce shortages, especially in primary care, have been a problem for health care systems for some time now, and the gap between the growing demand for services and sufficient staff has been widening. Although the number of consultations in general practice has been increasing, staff numbers have not kept up with demand. The number of GPs relative to the size of population has been decreasing since 2009, and the GP workforce is ageing. Doctors are increasingly working part-time, which suggests that shortages will grow steadily worse.

In 2015, then-Secretary of State for Health Jeremy Hunt promised an additional 5,000 GPs for the NHS by 2020, but this was not achieved. Instead, it is predicted that there will be a shortage of 7,000 GPs by 2024.

Dr John Ford from the Department of Public Health and Primary Care at the University of Cambridge, the study’s senior author, said: “People who live in disadvantaged regions of England are not only more likely to have long-term health problems, but are likely to find it even more difficult to see a GP and experience worse care when they see a GP. This is just one aspect of how disadvantage accumulates for some people leading to poor health and early death.

“There may be some compensation due to increasing number of other health professionals, which may partially alleviate the undersupply of GPs in more socioeconomically disadvantaged areas. But this is not a like-for-like replacement and it is unlikely to be enough.”

The researchers say there are a number of reasons that may account for why GP workforce shortages disproportionately affect practices in areas of higher deprivation. Previous studies have suggested that the primary driver of GP inequality was the opening and closing of practices in more disadvantaged areas, with practice closures increasing in recent years.

Claire Nussbaum, the study’s first author, added: “The government has made reducing health inequalities a core commitment, but this will be challenging with the increasing shortage of GPs in areas of high socioeconomic disadvantage, where health needs are greatest. The primary care staffing inequalities we observed are especially concerning, as they suggest that access to care is becoming increasingly limited where health needs are greatest.

“Addressing barriers to health care access is even more urgent in the context of COVID-19, which has widened pre-existing health and social inequities.”

The researchers say that the imbalance in recruitment of staff within primary care must be addressed by policymakers, who will need to consider why practices and networks in disadvantaged areas are relatively under-staffed, and how this can be reversed. Potential options include increased recruitment to medical school from disadvantaged areas, incentivisation of direct patient care posts in under-staffed areas, enhanced training offers for these roles, and offering practices and networks in under-staffed areas additional recruitment support.

Expanded use of additional roles under the Additional Roles Reimbursement Scheme, designed to provide financial reimbursement for Primary Care Networks to build workforce capacity, may partially alleviate GP workload in overstretched practices, but the report’s authors argue that there is a risk that additional workforce will gravitate to more affluent areas, further perpetuating inequity in primary care staffing.

Dr James Matheson, a GP at Hill Top Surgery in Oldham, said: "People living in socioeconomically disadvantaged areas shoulder a much higher burden of physical and mental health problems but have less access to the GPs who could support them towards better health. For the primary care teams looking after them this means a greater workload with fewer resources - a burnout risk which can further exacerbate the problem.

“General Practice in disadvantaged areas is challenging but also enjoyable and professionally rewarding but now, more than ever, we need to see a more equitable distribution of workforce and resources to ensure it is sustainable."

Reference
Nussbaum, C et al. Inequalities in the distribution of the general practice workforce in England. BJGP Open; 18 Aug 2021; DOI: 10.3399/BJGPO.2021.0066

Areas of high socioeconomic disadvantaged are being worst hit by shortages of GPs, a trend that is only worsening with time and is likely to widen pre-existing health inequalities, say researchers at the University of Cambridge.

health servicesinequalityJohn FordClaire NussbaumSchool of Clinical MedicineDepartment of Public Health and Primary CareThe government has made reducing health inequalities a core commitment, but this will be challenging with the increasing shortage of GPs in areas of high socioeconomic disadvantage, where health needs are greatestClaire NussbaumpunggolzenithGP


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News

Worsening GP shortages in disadvantaged areas likely to widen health inequalities

Research in Medicine - Wed, 18/08/2021 - 08:43

In a study published today in the BJGP Open, a team from the University of Cambridge looked at the relationship between shortages in the healthcare workforce and levels of deprivation. The team found significantly fewer full time equivalent (FTE) GPs per 10,000 patients in practices within areas of higher levels of deprivation. This inequality has widened slightly over time. By December 2020, there were on average 1.4 fewer FTE GPs per 10,000 patients in the most deprived areas compared to the least deprived areas.

The same was the case for total direct patient care staff (all patient-facing general practice staff excluding GPs and nurses), with 1.5 fewer FTE staff per 10,000 patients in the most deprived areas compared to the least deprived areas.

The lower GP numbers in deprived areas, was compensated, in part, by more nurses.

The analysis used data captured between September 2015 and December 2020 from the NHS Digital General Practice Workforce collection. They compared this workforce data against practice population sizes and levels of deprivation across England.

In addition to their report, the team have today launched an interactive dashboard that maps local-level primary care workforce inequalities to accompany the national-level analysis done in the paper. Clear local-level inequalities in GP distribution can be seen within West, North and East Cumbria, Humber, Coast and Vale, and Coventry and Warwickshire STP (Sustainability and Transformation Plan) areas, among others. 

Workforce shortages, especially in primary care, have been a problem for health care systems for some time now, and the gap between the growing demand for services and sufficient staff has been widening. Although the number of consultations in general practice has been increasing, staff numbers have not kept up with demand. The number of GPs relative to the size of population has been decreasing since 2009, and the GP workforce is ageing. Doctors are increasingly working part-time, which suggests that shortages will grow steadily worse.

In 2015, then-Secretary of State for Health Jeremy Hunt promised an additional 5,000 GPs for the NHS by 2020, but this was not achieved. Instead, it is predicted that there will be a shortage of 7,000 GPs by 2024.

Dr John Ford from the Department of Public Health and Primary Care at the University of Cambridge, the study’s senior author, said: “People who live in disadvantaged regions of England are not only more likely to have long-term health problems, but are likely to find it even more difficult to see a GP and experience worse care when they see a GP. This is just one aspect of how disadvantage accumulates for some people leading to poor health and early death.

“There may be some compensation due to increasing number of other health professionals, which may partially alleviate the undersupply of GPs in more socioeconomically disadvantaged areas. But this is not a like-for-like replacement and it is unlikely to be enough.”

The researchers say there are a number of reasons that may account for why GP workforce shortages disproportionately affect practices in areas of higher deprivation. Previous studies have suggested that the primary driver of GP inequality was the opening and closing of practices in more disadvantaged areas, with practice closures increasing in recent years.

Claire Nussbaum, the study’s first author, added: “The government has made reducing health inequalities a core commitment, but this will be challenging with the increasing shortage of GPs in areas of high socioeconomic disadvantage, where health needs are greatest. The primary care staffing inequalities we observed are especially concerning, as they suggest that access to care is becoming increasingly limited where health needs are greatest.

“Addressing barriers to health care access is even more urgent in the context of COVID-19, which has widened pre-existing health and social inequities.”

The researchers say that the imbalance in recruitment of staff within primary care must be addressed by policymakers, who will need to consider why practices and networks in disadvantaged areas are relatively under-staffed, and how this can be reversed. Potential options include increased recruitment to medical school from disadvantaged areas, incentivisation of direct patient care posts in under-staffed areas, enhanced training offers for these roles, and offering practices and networks in under-staffed areas additional recruitment support.

Expanded use of additional roles under the Additional Roles Reimbursement Scheme, designed to provide financial reimbursement for Primary Care Networks to build workforce capacity, may partially alleviate GP workload in overstretched practices, but the report’s authors argue that there is a risk that additional workforce will gravitate to more affluent areas, further perpetuating inequity in primary care staffing.

Dr James Matheson, a GP at Hill Top Surgery in Oldham, said: "People living in socioeconomically disadvantaged areas shoulder a much higher burden of physical and mental health problems but have less access to the GPs who could support them towards better health. For the primary care teams looking after them this means a greater workload with fewer resources - a burnout risk which can further exacerbate the problem.

“General Practice in disadvantaged areas is challenging but also enjoyable and professionally rewarding but now, more than ever, we need to see a more equitable distribution of workforce and resources to ensure it is sustainable."

Reference
Nussbaum, C et al. Inequalities in the distribution of the general practice workforce in England. BJGP Open; 18 Aug 2021; DOI: 10.3399/BJGPO.2021.0066

Areas of high socioeconomic disadvantaged are being worst hit by shortages of GPs, a trend that is only worsening with time and is likely to widen pre-existing health inequalities, say researchers at the University of Cambridge.

health servicesinequalityJohn FordClaire NussbaumSchool of Clinical MedicineDepartment of Public Health and Primary CareThe government has made reducing health inequalities a core commitment, but this will be challenging with the increasing shortage of GPs in areas of high socioeconomic disadvantage, where health needs are greatestClaire NussbaumpunggolzenithGP


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News

Ageing cuttlefish can remember the details of last week’s dinner

Latest Research in Cambridge - Wed, 18/08/2021 - 08:04

The results, published today in the journal Proceedings of the Royal Society B, are the first evidence of an animal whose memory of specific events does not deteriorate with age.

Researchers from the University of Cambridge, the Marine Biological Laboratory in Woods Hole, Massachusetts, and the University of Caen, conducted memory tests on twenty-four common cuttlefish, Sepia officinalis. Half of these were 10-12 months old - not-quite adult, and the other half were in old age at 22-24 months - equivalent to humans in their 90s.

“Cuttlefish can remember what they ate, where and when, and use this to guide their feeding decisions in the future. What’s surprising is that they don’t lose this ability with age, despite showing other signs of ageing like loss of muscle function and appetite,” said Dr Alexandra Schnell in the University of Cambridge’s Department of Psychology, first author of the paper.

As humans age, we gradually lose the ability to remember experiences that happened at particular times and places – for example, what we had for dinner last Tuesday. This is termed ‘episodic memory’, and its decline is thought to be due to deterioration of a part of the brain called the hippocampus.

Cuttlefish do not have a hippocampus, and their brain structure is dramatically different to ours. The ‘vertical lobe’ of the cuttlefish brain is associated with learning and memory. This does not deteriorate until the last two to three days of the animal’s life, which the researchers say could explain why episodic-like memory is not affected by age in cuttlefish.

To conduct the experiment, the cuttlefish were first trained to approach a specific location in their tank marked with a black and white flag. Then they were trained to learn that two foods they commonly eat were available at specific flag-marked locations and after specific delays. At one spot, the flag was waved and a piece of king prawn, their less preferred food, was provided. Live grass shrimp, which they like more, was provided at a different spot where another flag was also waved - but only every three hours. This was repeated for four weeks.

Then the cuttlefishes’ recall of which food would be available, where, and when was tested. To make sure they hadn’t just learned a pattern, the two feeding locations were unique each day. All the cuttlefish - regardless of age - watched which food first appeared at each flag and used that to work out which feeding spot was best at each subsequent flag-waving. This suggests that episodic-like memory does not decline with age in cuttlefish, unlike in humans.

“The old cuttlefish were just as good as the younger ones in the memory task – in fact, many of the older ones did better in the test phase. We think this ability might help cuttlefish in the wild to remember who they mated with, so they don’t go back to the same partner,” said Schnell.

Cuttlefish only breed at the end of their life. By remembering who they mated with, where, and how long ago, the researchers think this helps the cuttlefish to spread their genes widely by mating with as many partners as possible.  

Cuttlefish have short lifespans – most live until around two years old – making them a good subject to test whether memory declines with age. Since it is impossible to test whether animals are consciously remembering things, the authors used the term ‘episodic-like memory’ to refer to the ability of cuttlefish to remember what, where and when specific things happened.

This research was funded by the Royal Society and the Grass Foundation. 

Reference
Schnell, A.K. et al: ‘Episodic-like memory is preserved with age in cuttlefish.’ Proceedings of the Royal Society B, August 2021. DOI: 10.1098/rspb.2021.1052

Cuttlefish can remember what, where, and when specific things happened - right up to their last few days of life, researchers have found.

animal behaviourZoologyAlex SchnellNicola ClaytonMarine Biological LaboratoryUniversity of CaenDepartment of PsychologySchool of the Biological SciencesThe old cuttlefish were just as good as the younger ones in the memory task Alexandra Schnell Ageing cuttlefish can remember the details of last week’s dinner


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

Ageing cuttlefish can remember the details of last week’s dinner

Research in Medicine - Wed, 18/08/2021 - 08:04

The results, published today in the journal Proceedings of the Royal Society B, are the first evidence of an animal whose memory of specific events does not deteriorate with age.

Researchers from the University of Cambridge, the Marine Biological Laboratory in Woods Hole, Massachusetts, and the University of Caen, conducted memory tests on twenty-four common cuttlefish, Sepia officinalis. Half of these were 10-12 months old - not-quite adult, and the other half were in old age at 22-24 months - equivalent to humans in their 90s.

“Cuttlefish can remember what they ate, where and when, and use this to guide their feeding decisions in the future. What’s surprising is that they don’t lose this ability with age, despite showing other signs of ageing like loss of muscle function and appetite,” said Dr Alexandra Schnell in the University of Cambridge’s Department of Psychology, first author of the paper.

As humans age, we gradually lose the ability to remember experiences that happened at particular times and places – for example, what we had for dinner last Tuesday. This is termed ‘episodic memory’, and its decline is thought to be due to deterioration of a part of the brain called the hippocampus.

Cuttlefish do not have a hippocampus, and their brain structure is dramatically different to ours. The ‘vertical lobe’ of the cuttlefish brain is associated with learning and memory. This does not deteriorate until the last two to three days of the animal’s life, which the researchers say could explain why episodic-like memory is not affected by age in cuttlefish.

To conduct the experiment, the cuttlefish were first trained to approach a specific location in their tank marked with a black and white flag. Then they were trained to learn that two foods they commonly eat were available at specific flag-marked locations and after specific delays. At one spot, the flag was waved and a piece of king prawn, their less preferred food, was provided. Live grass shrimp, which they like more, was provided at a different spot where another flag was also waved - but only every three hours. This was repeated for four weeks.

Then the cuttlefishes’ recall of which food would be available, where, and when was tested. To make sure they hadn’t just learned a pattern, the two feeding locations were unique each day. All the cuttlefish - regardless of age - watched which food first appeared at each flag and used that to work out which feeding spot was best at each subsequent flag-waving. This suggests that episodic-like memory does not decline with age in cuttlefish, unlike in humans.

“The old cuttlefish were just as good as the younger ones in the memory task – in fact, many of the older ones did better in the test phase. We think this ability might help cuttlefish in the wild to remember who they mated with, so they don’t go back to the same partner,” said Schnell.

Cuttlefish only breed at the end of their life. By remembering who they mated with, where, and how long ago, the researchers think this helps the cuttlefish to spread their genes widely by mating with as many partners as possible.  

Cuttlefish have short lifespans – most live until around two years old – making them a good subject to test whether memory declines with age. Since it is impossible to test whether animals are consciously remembering things, the authors used the term ‘episodic-like memory’ to refer to the ability of cuttlefish to remember what, where and when specific things happened.

This research was funded by the Royal Society and the Grass Foundation. 

Reference
Schnell, A.K. et al: ‘Episodic-like memory is preserved with age in cuttlefish.’ Proceedings of the Royal Society B, August 2021. DOI: 10.1098/rspb.2021.1052

Cuttlefish can remember what, where, and when specific things happened - right up to their last few days of life, researchers have found.

animal behaviourZoologyAlex SchnellNicola ClaytonMarine Biological LaboratoryUniversity of CaenDepartment of PsychologySchool of the Biological SciencesThe old cuttlefish were just as good as the younger ones in the memory task Alexandra Schnell Ageing cuttlefish can remember the details of last week’s dinner


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

Discovery of origin of oesophageal cancer cells highlights importance of screening for pre-cancerous Barrett’s oesophagus

Latest Research in Cambridge - Thu, 12/08/2021 - 19:00

The study, published today in Science, found that a particular subtype of oesophageal cancer known as oesophageal adenocarcinoma is always preceded by Barrett’s oesophagus – abnormal cells of the oesophagus – even if these cells are no longer visible at the time of cancer diagnosis. This confirms that screening for Barrett’s is an important approach to oesophageal cancer control.

Cancer of the oesophagus is the sixth most deadly cancer, and oesophageal adenocarcinoma is on the rise in western countries. Scientists and doctors have known for some time that the development of this cancer is linked with Barrett’s oesophagus, which shows up in endoscopy as a pink ‘patch’ in the surface of oesophagus and affects around one out of every 100 to 200 people in the United Kingdom – and between 3 and 13 people out of 100 with this condition will go on to develop oesophageal adenocarcinoma in their lifetime. However, the question of where these abnormal cells come from has been a mystery that has baffled scientists for decades.

A multidisciplinary group of scientists led by Professor Rebecca Fitzgerald at the Medical Research Council Cancer Unit, University of Cambridge, today provides the most comprehensive explanation to date.

Dr Lizhe Zhuang, joint first author of the study, said: “It’s intriguing that, although Barrett’s oesophagus predominately occurs in the lower part of oesophagus close to stomach, it has so-called ‘goblet cells’ resembling a much more distant organ, the small intestine. Over the past twenty years there have been at least six different hypotheses about the origin of Barrett’s oesophagus. Using the latest techniques, we believe we have arrived at an answer to this mystery.”

The research team analysed tissue samples from patients with Barrett’s oesophagus and from organ donors who have never had the condition. The samples were collected as part of the Cambridge Biorepository for Translational Medicine at Addenbrooke’s Hospital, part of Cambridge University Hospitals NHS Foundation Trust.

Lead authors Dr Karol Nowicki-Osuch and Dr Lizhe Zhuang established a detailed ‘atlas’ of human cells and tissues from all possible origins of Barrett’s oesophagus, including oesophageal submucosal glands, an elusive tissue structure that acts in a similar way to saliva glands and has never before been isolated from fresh human tissue.

The researchers then compared the maps of cells from healthy tissues, Barrett’s oesophagus and oesophageal adenocarcinoma using a number of state-of-the-art molecular technologies. These included single cell RNA sequencing, a powerful technology that enables researchers to investigate the functions of a large number of individual cells. They also looked at methylation profiles –chemical modifications to the DNA of cells in the tissue – and at genetic linage to trace back where a particular cell type originated.

The results showed a striking similarity between stomach cells and Barrett’s oesophagus, suggesting that the cells at the very top of the stomach can be reprogrammed to adopt a new tissue identity, becoming more like intestine cells, and replace the oesophageal cells. Furthermore, in this new study the team showed that two genes, MYC and HNF4A, are the keys that switch the tissue identity from stomach to intestinal cells.

Dr Karol Nowicki-Osuch, joint first author of the study, said: “The techniques we used have shown us the internal processes that happen in the stomach cells when they become Barrett’s. The big question now is: what triggers these genes? It’s likely to be a complex combination of factors that include bile acid reflux (often felt as heartburn) and other risk factors, such as obesity, age, male sex and Caucasian ethnicity.”

Importantly, the researchers found that all oesophageal adenocarcinoma cells begin as stomach cells before transforming into Barrett’s cells and then into cancer cells.

Professor Fitzgerald added: “Even if the pre-cancerous Barrett’s is not visible at the time of cancer diagnosis, our data suggests the cancer cells will have been through this stage. This has been debated for some time, but our conclusion is important as it means that screening for Barrett’s is an important approach to controlling oesophageal cancer.”

Michelle Mitchell, Chief Executive of Cancer Research UK, said, “Today’s insights into the origin of oesophageal adenocarcinoma could help inform future research efforts into how to diagnose this type of cancer early – which is key for improving patient outcomes.

“This research goes hand in hand with other recent successes in early detection such as Cytosponge, the sponge-on a-string test, which we funded to detect Barrett’s in patients with heartburn symptoms.”

Detecting cancer earlier will be a key focus of the Cambridge Cancer Research Hospital, a partnership between Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge to build a new specialist cancer hospital. The hospital will combine modern NHS clinical space with two new research institutes, including the National Institute for the Early Detection of Cancer, which will lead the way in helping advance early cancer detection techniques.

The research was largely funded by the Medical Research Council, Wellcome and Cancer Research UK.

Further information on oesophageal cancer and Barrett’s oesophagus is available via Cancer Research UK.

Reference
Nowicki-Osuch, K & Zhuang, L et al. Molecular phenotyping reveals the identity of Barrett’s esophagus and its malignant transition. Science; 13 Aug 2021; DOI: 10.1126/science.abd1449

Abnormal cells that go on develop into oesophageal cancer – cancer that affects the tube connecting the mouth and stomach – start life as cells of the stomach, according to scientists at the University of Cambridge.

Canceroesophageal cancerRebecca FitzgeraldKarol Nowicki-OsuchLizhe ZhuangMedical Research CouncilWellcomeCancer Research UK (CRUK)School of Clinical MedicineCancer Research UK Cambridge InstituteCambridge Cancer CentreMedical Research Council (MRC) Cancer UnitThe techniques we used have shown us the internal processes that happen in the stomach cells when they become Barrett’s. The big question now is: what triggers these genes?Karol Nowicki-OsuchAdobe StockMan experiencing heartburn


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

Discovery of origin of oesophageal cancer cells highlights importance of screening for pre-cancerous Barrett’s oesophagus

Research in Medicine - Thu, 12/08/2021 - 19:00

The study, published today in Science, found that a particular subtype of oesophageal cancer known as oesophageal adenocarcinoma is always preceded by Barrett’s oesophagus – abnormal cells of the oesophagus – even if these cells are no longer visible at the time of cancer diagnosis. This confirms that screening for Barrett’s is an important approach to oesophageal cancer control.

Cancer of the oesophagus is the sixth most deadly cancer, and oesophageal adenocarcinoma is on the rise in western countries. Scientists and doctors have known for some time that the development of this cancer is linked with Barrett’s oesophagus, which shows up in endoscopy as a pink ‘patch’ in the surface of oesophagus and affects around one out of every 100 to 200 people in the United Kingdom – and between 3 and 13 people out of 100 with this condition will go on to develop oesophageal adenocarcinoma in their lifetime. However, the question of where these abnormal cells come from has been a mystery that has baffled scientists for decades.

A multidisciplinary group of scientists led by Professor Rebecca Fitzgerald at the Medical Research Council Cancer Unit, University of Cambridge, today provides the most comprehensive explanation to date.

Dr Lizhe Zhuang, joint first author of the study, said: “It’s intriguing that, although Barrett’s oesophagus predominately occurs in the lower part of oesophagus close to stomach, it has so-called ‘goblet cells’ resembling a much more distant organ, the small intestine. Over the past twenty years there have been at least six different hypotheses about the origin of Barrett’s oesophagus. Using the latest techniques, we believe we have arrived at an answer to this mystery.”

The research team analysed tissue samples from patients with Barrett’s oesophagus and from organ donors who have never had the condition. The samples were collected as part of the Cambridge Biorepository for Translational Medicine at Addenbrooke’s Hospital, part of Cambridge University Hospitals NHS Foundation Trust.

Lead authors Dr Karol Nowicki-Osuch and Dr Lizhe Zhuang established a detailed ‘atlas’ of human cells and tissues from all possible origins of Barrett’s oesophagus, including oesophageal submucosal glands, an elusive tissue structure that acts in a similar way to saliva glands and has never before been isolated from fresh human tissue.

The researchers then compared the maps of cells from healthy tissues, Barrett’s oesophagus and oesophageal adenocarcinoma using a number of state-of-the-art molecular technologies. These included single cell RNA sequencing, a powerful technology that enables researchers to investigate the functions of a large number of individual cells. They also looked at methylation profiles –chemical modifications to the DNA of cells in the tissue – and at genetic linage to trace back where a particular cell type originated.

The results showed a striking similarity between stomach cells and Barrett’s oesophagus, suggesting that the cells at the very top of the stomach can be reprogrammed to adopt a new tissue identity, becoming more like intestine cells, and replace the oesophageal cells. Furthermore, in this new study the team showed that two genes, MYC and HNF4A, are the keys that switch the tissue identity from stomach to intestinal cells.

Dr Karol Nowicki-Osuch, joint first author of the study, said: “The techniques we used have shown us the internal processes that happen in the stomach cells when they become Barrett’s. The big question now is: what triggers these genes? It’s likely to be a complex combination of factors that include bile acid reflux (often felt as heartburn) and other risk factors, such as obesity, age, male sex and Caucasian ethnicity.”

Importantly, the researchers found that all oesophageal adenocarcinoma cells begin as stomach cells before transforming into Barrett’s cells and then into cancer cells.

Professor Fitzgerald added: “Even if the pre-cancerous Barrett’s is not visible at the time of cancer diagnosis, our data suggests the cancer cells will have been through this stage. This has been debated for some time, but our conclusion is important as it means that screening for Barrett’s is an important approach to controlling oesophageal cancer.”

Michelle Mitchell, Chief Executive of Cancer Research UK, said, “Today’s insights into the origin of oesophageal adenocarcinoma could help inform future research efforts into how to diagnose this type of cancer early – which is key for improving patient outcomes.

“This research goes hand in hand with other recent successes in early detection such as Cytosponge, the sponge-on a-string test, which we funded to detect Barrett’s in patients with heartburn symptoms.”

Detecting cancer earlier will be a key focus of the Cambridge Cancer Research Hospital, a partnership between Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge to build a new specialist cancer hospital. The hospital will combine modern NHS clinical space with two new research institutes, including the National Institute for the Early Detection of Cancer, which will lead the way in helping advance early cancer detection techniques.

The research was largely funded by the Medical Research Council, Wellcome and Cancer Research UK.

Further information on oesophageal cancer and Barrett’s oesophagus is available via Cancer Research UK.

Reference
Nowicki-Osuch, K & Zhuang, L et al. Molecular phenotyping reveals the identity of Barrett’s esophagus and its malignant transition. Science; 13 Aug 2021; DOI: 10.1126/science.abd1449

Abnormal cells that go on develop into oesophageal cancer – cancer that affects the tube connecting the mouth and stomach – start life as cells of the stomach, according to scientists at the University of Cambridge.

Canceroesophageal cancerRebecca FitzgeraldKarol Nowicki-OsuchLizhe ZhuangMedical Research CouncilWellcomeCancer Research UK (CRUK)School of Clinical MedicineCancer Research UK Cambridge InstituteCambridge Cancer CentreMedical Research Council (MRC) Cancer UnitThe techniques we used have shown us the internal processes that happen in the stomach cells when they become Barrett’s. The big question now is: what triggers these genes?Karol Nowicki-OsuchAdobe StockMan experiencing heartburn


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesNews type: News

AI could detect dementia years before symptoms appear

Latest Research in Cambridge - Thu, 12/08/2021 - 09:44
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Dandelion clock (Credit: Ýlona María Rybka)

Dandelion clock (Credit: Ýlona María Rybka)

Artificial intelligence could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.

Dementias are characterised by the build-up of different types of protein in the brain, which damages brain tissue and leads to cognitive decline. In the case of Alzheimer’s disease, these proteins include beta-amyloid, which forms ‘plaques’, clumping together between neurons and affecting their function, and tau, which accumulates inside neurons.

Molecular and cellular changes to the brain usually begin many years before any symptoms occur. Diagnosing dementia can take many months or even years. It typically requires two or three hospital visits and can involve a range of CT, PET and MRI scans as well as invasive lumber punctures.

A team led by Professor Zoe Kourtzi at the University of Cambridge and Alan Turing Institute has developed machine learning tools that can detect dementia in patients at a very early stage. Using brain scans from patients who went on to develop Alzheimer’s, their machine learning algorithm learnt to spot structural changes in the brain. When combined with the results from standard memory tests, the algorithm was able to provide a prognostic score – that is, the likelihood of the individual having Alzheimer’s disease.

For those patients presenting with mild cognitive impairment – signs of memory loss or problems with language or visual/spatial perception – the algorithm was higher than 80% accurate in predicting those individuals who went on to develop Alzheimer’s disease. It was also able to predict how fast their cognition will decline over time.

MRI brain scan of healthy volunteer (Credit: Timothy Rittman)

MRI brain scan of healthy volunteer (Credit: Timothy Rittman)

MRI brain scan of Alzheimer's patient (Credit: TImothy Rittman)

MRI brain scan of Alzheimer's patient (Credit: TImothy Rittman)

Professor Kourtzi, from Cambridge's Department of Psychology, said: “We have trained machine learning algorithms to spot very early signs of dementia just by looking for patterns of grey matter loss – essentially, wearing away – in the brain. When we combine this with standard memory tests, we can predict whether an individual will show slower or faster decline in their cognition.

“We’ve even been able to identify some patients who were not yet showing any symptoms, but went on to develop Alzheimer’s."

"In time, we hope to be able to identify patients as early as five to ten years before they show symptoms as part of a health check.”Professor Zoe Kourtzi, Department of Psychology

Although the algorithm has been optimised to look for signs of Alzheimer’s disease, Professor Kourtzi and colleagues are now training it to recognise different forms of dementia, each of which has its own characteristic pattern of volume loss.

Dr Timothy Rittman from the Department of Clinical Neurosciences and a consultant at Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, is now leading a trial to look at whether this approach is useful in a clinical setting.

“We’ve shown that this approach works in a research setting – we now need to test it in a ‘real world’ setting,” explained Dr Rittman.

To date around 80 patients have taken part in the trial, which was run by CUH, Cambridgeshire and Peterborough NHS Foundation Trust and two NHS trusts in Brighton.

Catching dementia early is important for several reasons, explained Dr Rittman. “When patients begin to experience memory and cognitive problems, this can understandably be a very difficult time. Being able to provide an accurate diagnosis gives them clarity and, depending on the diagnosis, can either ease their minds or help them and their loved ones put preparations in place for the longer term."

“If we catch the disease early enough, there are lifestyle changes we can recommend – blood pressure medication, improved diet and exercise, stopping smoking, for example – that may help slow the progression of the disease.”Dr Timothy Rittman

There are currently very few drugs available to help treat dementia. One of the reasons that clinical trials often fail is thought to be because once a patient has developed symptoms, it may be too late to make a major difference. Having the ability to identify individuals at a very early stage could therefore help researchers develop new medicines.

If the trial is successful, the algorithm could be rolled out to thousands more patients across the country.

Living with Alzheimer’s disease

Addenbrooke’s patient Dennis Clark was one of the first people in the country to take part in the new trial. Before lockdown, the 75-year-old retired sales director had been enjoying his retirement with wife Penny, going on holiday and walking his two dogs. But Penny soon noticed he was starting to forget things.

“If I asked him to do something, he would do the opposite. Then when we went out for a meal – which we didn’t do for a long time because of lockdown – he couldn’t remember how to pay for anything.”

Penny decided to call the GP for help when Dennis, who had always taken pride in his appearance, started to wear the same clothes over and over again.

“The GP did a quick test over the phone and said Dennis needed to be referred. I had heard Addenbrooke’s had a very comprehensive memory unit, so I was really pleased that we were able to be referred there.

“We had an initial consultation and we were asked if we wanted to go down the research route, which I was really keen for Dennis to do because it doesn’t just help him, it helps others as well.”

Dennis underwent an MRI scan and later that same day he and Penny received the news that his results were consistent with early onset of Alzheimer’s disease. Dennis will begin taking medication to help treat the symptoms of Alzheimer’s disease.

“We are very grateful to Addenbrooke’s and would recommend other people take up trials as well. Quicker diagnosis means Dennis will be able to start medication that will hopefully delay his disease. It also means we can plan for the future and start to accept what is happening.”

Case study courtesy of Cambridge University Hospitals NHS Foundation Trust.

Reference

Giorgio, J et al. Modelling prognostic trajectories of cognitive decline due to Alzheimer's disease. NeuroImage: Clinical; 26 Jan 2020; DOI: 10.1016/j.nicl.2020.102199

Giorgio, J et al. Predicting future regional tau accumulation in asymptomatic and early Alzheimer’s disease. BioRXiv (pre-print)

Article posted 12 August 2021

TopBuilt with Shorthand Summary: 

Artificial intelligence could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.Artificial intelligence (AI) could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.

Image: Affiliation (schools and institutions): School of Clinical MedicineSchool of the Biological SciencesDepartment of Clinical NeurosciencesDepartment of PsychologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustExternal Affiliations: The Alan Turing InstitutePeople (our academics and staff): Zoe KourtziTimothy RittmanSubject (including Spotlight on ... where applicable): Spotlight on neuroscienceNeurosciencehealthdementiaAlzheimer's diseaseArtificial intelligenceSection: ResearchNews type: Features

AI could detect dementia years before symptoms appear

Research in Medicine - Thu, 12/08/2021 - 09:44
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Dandelion clock (Credit: Ýlona María Rybka)

Dandelion clock (Credit: Ýlona María Rybka)

Artificial intelligence could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.

Dementias are characterised by the build-up of different types of protein in the brain, which damages brain tissue and leads to cognitive decline. In the case of Alzheimer’s disease, these proteins include beta-amyloid, which forms ‘plaques’, clumping together between neurons and affecting their function, and tau, which accumulates inside neurons.

Molecular and cellular changes to the brain usually begin many years before any symptoms occur. Diagnosing dementia can take many months or even years. It typically requires two or three hospital visits and can involve a range of CT, PET and MRI scans as well as invasive lumber punctures.

A team led by Professor Zoe Kourtzi at the University of Cambridge and Alan Turing Institute has developed machine learning tools that can detect dementia in patients at a very early stage. Using brain scans from patients who went on to develop Alzheimer’s, their machine learning algorithm learnt to spot structural changes in the brain. When combined with the results from standard memory tests, the algorithm was able to provide a prognostic score – that is, the likelihood of the individual having Alzheimer’s disease.

For those patients presenting with mild cognitive impairment – signs of memory loss or problems with language or visual/spatial perception – the algorithm was higher than 80% accurate in predicting those individuals who went on to develop Alzheimer’s disease. It was also able to predict how fast their cognition will decline over time.

MRI brain scan of healthy volunteer (Credit: Timothy Rittman)

MRI brain scan of healthy volunteer (Credit: Timothy Rittman)

MRI brain scan of Alzheimer's patient (Credit: TImothy Rittman)

MRI brain scan of Alzheimer's patient (Credit: TImothy Rittman)

Professor Kourtzi, from Cambridge's Department of Psychology, said: “We have trained machine learning algorithms to spot very early signs of dementia just by looking for patterns of grey matter loss – essentially, wearing away – in the brain. When we combine this with standard memory tests, we can predict whether an individual will show slower or faster decline in their cognition.

“We’ve even been able to identify some patients who were not yet showing any symptoms, but went on to develop Alzheimer’s."

"In time, we hope to be able to identify patients as early as five to ten years before they show symptoms as part of a health check.”Professor Zoe Kourtzi, Department of Psychology

Although the algorithm has been optimised to look for signs of Alzheimer’s disease, Professor Kourtzi and colleagues are now training it to recognise different forms of dementia, each of which has its own characteristic pattern of volume loss.

Dr Timothy Rittman from the Department of Clinical Neurosciences and a consultant at Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, is now leading a trial to look at whether this approach is useful in a clinical setting.

“We’ve shown that this approach works in a research setting – we now need to test it in a ‘real world’ setting,” explained Dr Rittman.

To date around 80 patients have taken part in the trial, which was run by CUH, Cambridgeshire and Peterborough NHS Foundation Trust and two NHS trusts in Brighton.

Catching dementia early is important for several reasons, explained Dr Rittman. “When patients begin to experience memory and cognitive problems, this can understandably be a very difficult time. Being able to provide an accurate diagnosis gives them clarity and, depending on the diagnosis, can either ease their minds or help them and their loved ones put preparations in place for the longer term."

“If we catch the disease early enough, there are lifestyle changes we can recommend – blood pressure medication, improved diet and exercise, stopping smoking, for example – that may help slow the progression of the disease.”Dr Timothy Rittman

There are currently very few drugs available to help treat dementia. One of the reasons that clinical trials often fail is thought to be because once a patient has developed symptoms, it may be too late to make a major difference. Having the ability to identify individuals at a very early stage could therefore help researchers develop new medicines.

If the trial is successful, the algorithm could be rolled out to thousands more patients across the country.

Living with Alzheimer’s disease

Addenbrooke’s patient Dennis Clark was one of the first people in the country to take part in the new trial. Before lockdown, the 75-year-old retired sales director had been enjoying his retirement with wife Penny, going on holiday and walking his two dogs. But Penny soon noticed he was starting to forget things.

“If I asked him to do something, he would do the opposite. Then when we went out for a meal – which we didn’t do for a long time because of lockdown – he couldn’t remember how to pay for anything.”

Penny decided to call the GP for help when Dennis, who had always taken pride in his appearance, started to wear the same clothes over and over again.

“The GP did a quick test over the phone and said Dennis needed to be referred. I had heard Addenbrooke’s had a very comprehensive memory unit, so I was really pleased that we were able to be referred there.

“We had an initial consultation and we were asked if we wanted to go down the research route, which I was really keen for Dennis to do because it doesn’t just help him, it helps others as well.”

Dennis underwent an MRI scan and later that same day he and Penny received the news that his results were consistent with early onset of Alzheimer’s disease. Dennis will begin taking medication to help treat the symptoms of Alzheimer’s disease.

“We are very grateful to Addenbrooke’s and would recommend other people take up trials as well. Quicker diagnosis means Dennis will be able to start medication that will hopefully delay his disease. It also means we can plan for the future and start to accept what is happening.”

Case study courtesy of Cambridge University Hospitals NHS Foundation Trust.

Reference

Giorgio, J et al. Modelling prognostic trajectories of cognitive decline due to Alzheimer's disease. NeuroImage: Clinical; 26 Jan 2020; DOI: 10.1016/j.nicl.2020.102199

Giorgio, J et al. Predicting future regional tau accumulation in asymptomatic and early Alzheimer’s disease. BioRXiv (pre-print)

Article posted 12 August 2021

TopBuilt with Shorthand Summary: 

Artificial intelligence could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.Artificial intelligence (AI) could spot the early signs of dementia from a simple brain scan long before major symptoms appear – and in some cases before any symptoms appear – say Cambridge researchers.

Image: Affiliation (schools and institutions): School of Clinical MedicineSchool of the Biological SciencesDepartment of Clinical NeurosciencesDepartment of PsychologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustExternal Affiliations: The Alan Turing InstitutePeople (our academics and staff): Zoe KourtziTimothy RittmanSubject (including Spotlight on ... where applicable): Spotlight on neuroscienceNeurosciencehealthdementiaAlzheimer's diseaseArtificial intelligenceSection: ResearchNews type: Features

Lab-grown beating heart cells identify potential drug to prevent COVID-19-related heart damage

Latest Research in Cambridge - Thu, 05/08/2021 - 09:35

The heart is one the major organs damaged by infection with SARS-CoV-2, particularly the heart cells, or ‘cardiomyocytes’, which contract and circulate blood. It is also thought that damage to heart cells may contribute to the symptoms of long COVID.

Patients with underlying heart problems are more than four times as likely to die from COVID-19, the disease caused by SARS-CoV-2 infection. The case fatality rate in patients with COVID-19 rises from 2.3% to 10.5% in these individuals.

To gain entry into our cells, SARS-CoV-2 hijacks a protein on the surface of the cells, a receptor known as ACE2.  Spike proteins on the surface of SARS-CoV-2 – which give it its characteristic ‘corona’-like appearance – bind to ACE2. Both the spike protein and ACE2 are then cleaved, allowing genetic material from the virus to enter the host cell. The virus manipulates the host cell’s machinery to allow itself to replicate and spread.

A team of scientists at the University of Cambridge has used human embryonic stem cells to grow clusters of heart cells in the lab and shown that these cells mimic the behaviour of the cells in the body, beating as if to pump blood. Crucially, these model heart cells also contained the key components necessary for SARS-CoV-2 infection – in particular, the ACE2 receptor.

Working in special biosafety laboratories and using a safer, modified synthetic (‘pseudotyped’) virus decorated with the SARS-CoV-2 spike protein, the team mimicked how the virus infects the heart cells. They then used this model to screen for potential drugs to block infection.

Dr Sanjay Sinha from the Wellcome-MRC Cambridge Stem Cell Institute said: “Using stem cells, we’ve managed to create a model which, in many ways, behaves just like a heart does, beating in rhythm. This has allowed us to look at how the coronavirus infects cells and, importantly, helps us screen possible drugs that might prevent damage to the heart.”

The team showed that some drugs that targeted the proteins involved in SARS-CoV-2 viral entry significantly reduced levels of infection. These included an ACE2 antibody that has been shown previously to neutralise pseudotyped SARS-CoV-2 virus, and DX600, an experimental drug.

DX600 is an ACE2 peptide antagonist – that is, a molecule that specifically targets ACE2 and inhibits the activity of peptides that play a role in allowing the virus to break into the cell.

DX600 was around seven times more effective at preventing infection compared to the antibody, though the researchers say this may be because it was used in higher concentrations. The drug did not affect the number of heart cells, implying that it would be unlikely to be toxic.

Professor Anthony Davenport from the Department of Medicine and a fellow at St Catharine’s College, Cambridge said: “The spike protein is like a key that fits into the ‘lock’ on the surface of the cells – the ACE2 receptor – allowing it entry. DX600 acts like gum, jamming the lock’s mechanism, making it much more difficult for the key to turn and unlock the cell door.

“We need to do further research on this drug, but it could provide us with a new treatment to help reduce harm to the heart in patients recently infected with the virus, particularly those who already have underlying heart conditions or who have not been vaccinated. We believe it may also help reduce the symptoms of long COVID.”

The research was largely supported by Wellcome, Addenbrooke’s Charitable Trust, Rosetrees Trust Charity and British Heart Foundation.

Reference
Williams, TL et al. Human embryonic stem cell-derived cardiomyocyte platform screens inhibitors of SARS-CoV-2 infection. Communications Biology; 29 Jul 2017; DOI: 10.1038/s42003-021-02453-y

Cambridge scientists have grown beating heart cells in the lab and shown how they are vulnerable to SARS-CoV-2 infection. In a study published in Communications Biology, they used this system to show that an experimental peptide drug called DX600 can prevent the virus entering the heart cells.

Stem cellsCOVID-19Coronavirusheartcardiovascular disease (CVD)Anthony DavenportSanjay SinhaWellcomeAddenbrooke’s Charitable TrustRosetrees TrustBritish Heart FoundationSchool of Clinical MedicineDepartment of MedicineWellcome-MRC Cambridge Stem Cell InstituteDepartment of Experimental Medicine and ImmunotherapeuticsSt Catharine's CollegeUsing stem cells, we’ve managed to create a model which, in many ways, behaves just like a heart does, beating in rhythm. This has allowed us to look at how the coronavirus infects cells and, importantly, helps us screen possible drugs that might prevent damage to the heartSanjay SinhasbtlneetHeart


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News

Lab-grown beating heart cells identify potential drug to prevent COVID-19-related heart damage

Research in Medicine - Thu, 05/08/2021 - 09:35

The heart is one the major organs damaged by infection with SARS-CoV-2, particularly the heart cells, or ‘cardiomyocytes’, which contract and circulate blood. It is also thought that damage to heart cells may contribute to the symptoms of long COVID.

Patients with underlying heart problems are more than four times as likely to die from COVID-19, the disease caused by SARS-CoV-2 infection. The case fatality rate in patients with COVID-19 rises from 2.3% to 10.5% in these individuals.

To gain entry into our cells, SARS-CoV-2 hijacks a protein on the surface of the cells, a receptor known as ACE2.  Spike proteins on the surface of SARS-CoV-2 – which give it its characteristic ‘corona’-like appearance – bind to ACE2. Both the spike protein and ACE2 are then cleaved, allowing genetic material from the virus to enter the host cell. The virus manipulates the host cell’s machinery to allow itself to replicate and spread.

A team of scientists at the University of Cambridge has used human embryonic stem cells to grow clusters of heart cells in the lab and shown that these cells mimic the behaviour of the cells in the body, beating as if to pump blood. Crucially, these model heart cells also contained the key components necessary for SARS-CoV-2 infection – in particular, the ACE2 receptor.

Working in special biosafety laboratories and using a safer, modified synthetic (‘pseudotyped’) virus decorated with the SARS-CoV-2 spike protein, the team mimicked how the virus infects the heart cells. They then used this model to screen for potential drugs to block infection.

Dr Sanjay Sinha from the Wellcome-MRC Cambridge Stem Cell Institute said: “Using stem cells, we’ve managed to create a model which, in many ways, behaves just like a heart does, beating in rhythm. This has allowed us to look at how the coronavirus infects cells and, importantly, helps us screen possible drugs that might prevent damage to the heart.”

The team showed that some drugs that targeted the proteins involved in SARS-CoV-2 viral entry significantly reduced levels of infection. These included an ACE2 antibody that has been shown previously to neutralise pseudotyped SARS-CoV-2 virus, and DX600, an experimental drug.

DX600 is an ACE2 peptide antagonist – that is, a molecule that specifically targets ACE2 and inhibits the activity of peptides that play a role in allowing the virus to break into the cell.

DX600 was around seven times more effective at preventing infection compared to the antibody, though the researchers say this may be because it was used in higher concentrations. The drug did not affect the number of heart cells, implying that it would be unlikely to be toxic.

Professor Anthony Davenport from the Department of Medicine and a fellow at St Catharine’s College, Cambridge said: “The spike protein is like a key that fits into the ‘lock’ on the surface of the cells – the ACE2 receptor – allowing it entry. DX600 acts like gum, jamming the lock’s mechanism, making it much more difficult for the key to turn and unlock the cell door.

“We need to do further research on this drug, but it could provide us with a new treatment to help reduce harm to the heart in patients recently infected with the virus, particularly those who already have underlying heart conditions or who have not been vaccinated. We believe it may also help reduce the symptoms of long COVID.”

The research was largely supported by Wellcome, Addenbrooke’s Charitable Trust, Rosetrees Trust Charity and British Heart Foundation.

Reference
Williams, TL et al. Human embryonic stem cell-derived cardiomyocyte platform screens inhibitors of SARS-CoV-2 infection. Communications Biology; 29 Jul 2017; DOI: 10.1038/s42003-021-02453-y

Cambridge scientists have grown beating heart cells in the lab and shown how they are vulnerable to SARS-CoV-2 infection. In a study published in Communications Biology, they used this system to show that an experimental peptide drug called DX600 can prevent the virus entering the heart cells.

Stem cellsCOVID-19Coronavirusheartcardiovascular disease (CVD)Anthony DavenportSanjay SinhaWellcomeAddenbrooke’s Charitable TrustRosetrees TrustBritish Heart FoundationSchool of Clinical MedicineDepartment of MedicineWellcome-MRC Cambridge Stem Cell InstituteDepartment of Experimental Medicine and ImmunotherapeuticsSt Catharine's CollegeUsing stem cells, we’ve managed to create a model which, in many ways, behaves just like a heart does, beating in rhythm. This has allowed us to look at how the coronavirus infects cells and, importantly, helps us screen possible drugs that might prevent damage to the heartSanjay SinhasbtlneetHeart


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

YesLicense type: Public DomainNews type: News