Science News » NIMH Scientific Director Susan Amara Selected as AAAS President-Elect

Susan Amara, Ph.D.Susan Amara, Ph.D., scientific director of the Intramural Research Program at the National Institute of Mental Health (NIMH), has been selected to serve as president-elect of the American Association of the Advancement of Science (AAAS).

Dr. Amara’s one-year term as president-elect will begin on February 17, 2020 at the conclusion of the 2020 AAAS Annual Meeting in Seattle, Wash. After serving for one year as president-elect, Dr. Amara will become AAAS president in February 2021 and chair of the AAAS Board of Directors in February 2022.

In her role at NIMH, Dr. Amara provides scientific, programmatic, and administrative leadership for the NIMH Division of Intramural Research Programs; promotes an environment conducive to productive research; and coordinates activities, establishes priorities, and analyzes and evaluates progress.

She is also a principal investigator and chief of the NIMH Laboratory of Molecular and Cellular Neurobiology (LMCN). Dr. Amara and the researchers in her laboratory have examined the impact of psychostimulant and antidepressant drugs on the signaling properties, physiology, and acute regulation of biogenic amine transporters. They have also addressed the structure, function, and physiology of glutamate transporters.

Dr. Amara received her B.S. in Biological Sciences from Stanford University and her Ph.D. in Physiology and Pharmacology from the University of California, San Diego. Before joining NIMH in 2013, she held faculty positions at Yale University School of Medicine and the Vollum Institute in Portland, Oregon. She was a Howard Hughes Medical Institute Investigator at each of these institutions. Additionally, she was the Thomas Detre Professor of Neurobiology and Distinguished Professor at the University of Pittsburgh School of Medicine.

Throughout her career, Dr. Amara has received numerous accolades. She is a recipient of the George Herbert Hitchings Award for innovative methods in drug discovery from the Burroughs Wellcome Fund, the Young Investigator Award from the Society for Neuroscience, the John Jacob Abel Young Investigator Award from the American Society of Pharmacology and Experimental Therapeutics (ASPET), a McKnight Neuroscience Investigator Award, a Method to Extend Research in Time (MERIT) Award from NIDA, a National Alliance for Research on Schizophrenia & Depression (NARSAD) Distinguished Investigator Award, the Julius Axelrod Award from the Catecholamine Society (ASPET) and the Julius Axelrod Prize from the Society for Neuroscience (SfN). In addition, she has had twenty U.S. patents issued on technology from her laboratory.

Original Article

Video » Suicide Risk Screening Training: How to Use the ASQ to Detect Patients at Risk for Suicide

Suicide Risk Screening Training: How to Use the ASQ to Detect Patients at Risk for Suicide

 

Watch on YouTube.

Transcript

>> LISA HOROWITZ: Hi, my name is Lisa Horowitz, and I'm a pediatric psychologist and staff scientist in the Intramural Program at the National Institute of Mental Health at the National Institutes of Health. I'm here to talk to you today about how to use the ASQ to detect patients at risk for suicide. I want to put this slide up just to tell you that I have no financial conflicts to disclose.

Objectives today will be to describe suicide into suicide behavior as a national and global public health crisis. And we also want to train medical providers to appropriately administer the ASQ (Ask Suicide Risk Screening Tool) to young patients.

The take home message is going to be that we should universally screen all patients in the medical setting for suicide risk. And the best way to do this is to ask directly.

And that clinicians require population, site specific, validated screening instruments. And I'm going propose a three-tiered system where you start with a brief screen like the ASQ, which takes about twenty seconds. And then you follow up positive screens with the brief suicide safety assessment that should take about ten minutes. And that's that intermediate step will help determine whether, or not, you go on to the third step, which is a full psychiatric or safety evaluation.

And I just want to remind people that anyone who screens positive should be discharged with the safety plan with resources like the National Suicide Prevention Lifeline and the crisis text line and they should have means restriction education.

Just to give you a brief background to suicide is an international public health crisis right now but nationally it is the second leading cause of death for youth aged ten to twenty-four in the United States. In fact, in two thousand and seventeen, over six thousand young people died of suicide and a quarter of all young death in this country occur by suicide. This is the graph you have in front of you is the suicide rate overtime and as you can see it just keeps creeping up.

And in fact, there are more deaths from suicide for young people, then these seven others leading medical causes combined. So, it's just an enormous public health crisis right now.

So, our research team looked into, can we save lives by screening for suicide risk and detecting early by finding kids that risk in the medical setting and we think the answer to this is yes. Why is the medical settings such an important place to identify suicide risk? Well, when you look at death registry studies, it turns out that the majority of patients who die by suicide, both kids and adults, have had contact with medical professional within three months of killing themselves. And sometimes even within weeks of killing themselves.

I want to talk about the difference between a suicide screening tool and a suicide risk assessment. A screening tool is meant to be very brief and just identify someone who needs further evaluation.

A suicide risk assessment is a more comprehensive evaluation that confirms the risk and guides the next steps. So, the ASQ is a suicide risk screening tool and it's not an assessment tool.

What are the valid questions nurses and physicians can use to screen patients for suicide risk in the medical setting?

So we did a research study, and we created the ASQ, which is a suicide risk screening tool. And the questions are: In the past few weeks, have you wish you were dead? Have you felt that your family would be better off if you were dead? In the past week, have you been having thoughts about killing yourself? And have you ever tried to kill yourself? If the patient answers yes to any one of those four questions you ask the fifth question – Are you having thoughts of killing yourself right now? That's the acuity question.

The ASQ was found to have good sensitivity, which is true positive rate and good specificity, which is the true negative rate and that limits false positives and it has a strong negative predictive value.

So, the ASQ was developed for the pediatric emergency department, but it has been validated and is being used now on inpatient medical surgical units and outpatient primary care specialty units, clinics in schools and child abuse clinics, and detention facilities. It's being rolled out in the Indian Health Service, and it's being tested right now in young people with autism spectrum disorder and neurodevelopmental disorders. It is also been translated into these sixteen languages and is available for free for anybody to use in the public domain.

So, one of the most common myths and concerns that parents have about asking young people about suicide is can asking questions about suicidal thought put ideas into their head. At least four research studies have refuted that you will implant suicidal thoughts, it is very safe to ask kids about to suicide. In fact, the best way to keep a young person from killing themselves is to ask directly – Are you thinking of killing yourself?

So, let's talk about how to administer the ASQ.

There is a tool kit that we created, and the web address is above. And here's the summary of what is in the tool kit, and we've divided it by venue.

So, there's a section for the emergency department, the inpatient medical surgical unit, and the outpatient primary care clinic.

We have provided a script for nurses and medical assistants who are the most common providers that screen using the ASQ.

And so, here's the script and so we you start by saying to the parent or guardian if there is one of the rooms “National safety guidelines, recommend that we screen all kids for suicide risk. We asked these questions in private. So, I'm going to ask you to step out of the room for a few minutes. If we have any concerns about your child safety, we will let, you know.” So, it's important when you're doing this, to tell the parent to step out and to not turn to the child and ask permission – don't say what, would you prefer your mother to stay or to go, because that puts too much a burden on the child to make a decision. So you just tell the parent in a very casual, normal kind of way. We're just going ask you step out for a minute or two. So, this is not go get a cup of coffee from the cafeteria because the ASQ only takes twenty seconds.
This is just step outside the room for a minute or two. And then once the parent leaves, you say, now I'm going to the patient now, I'm going ask you a few more questions and you minister we ask at that time, you could also administer any other questions that you need to do in private, for example, a domestic violence screening question this would be a good time to ask.

It's the parent refuses to leave the room, it is OK to administer the ASQ in front of the parent we prefer, and we believe that kids will give more frank answers if you have the parent out of the room but if the parents in the room is actually a good way to model how to ask a child about suicide risk. If the patient screens positive, you can say to them – “I'm so glad you spoke up about this. I'm going to talk to your parents and your medical team. Someone who is trained to talk with kids about suicide is going to come speak with you.” It's important, not to turn to the kid and say your suicidal or anything like that. Because this is a screen and remember the screen just identify someone who needs further evaluation. And then the same thing goes for the parent, we don't want to walk outside and say your child is suicidal. We are going say “we have some concerns about your child safety that we would like to further evaluate. It's really important that he or she spoke up about this. I'm going to talk to your medical team and someone who's trying to talk with kids about suicide is going come speak with you and your child.”

So, this is a template for a script and of course, people can adapt to how they feel comfortable introducing the ASQ. It's important though that you do not change the questions for the ASQ that they're asked verbatim, because each question, each item, and the ASQ was empirically develop and validated. So, it's important that you stay true to the test and ask every question verbatim.

Okay, so what happens when a patient screens positive.

So, what is considered a positive screen on the ASQ? Any yes to questions one through four is considered a positive screen. In addition, any young person that refuses to answer is also considered a positive screen. And that's because we have data showing that young people that refused to answer the questions on the ASQ had significant psychiatric histories and were at greater risk. So, we can, we will further evaluate.

Once someone has said, yes to questions one through four, they're administered question five. Are you having thoughts of killing yourself right now?

So, there's two ways to screen positive – the first way and the more common way is the non-acute that is a yes to any one of the four questions and a no to question five.

Those patients will need further evaluations via a brief suicide safety assessment to determine if more extensive psychiatric evaluation is necessary. These patients do not need full safety precautions. They do not need a one to one observer. They are considered a non- acute positive. The joint commission has deemed this valid and they need a further brief safety assessment to determine whether or not they are imminent risk or whether or not what else they need and that is in another training. The patient shouldn't leave until they have the brief suicide safety assessment. However, if they refused to stay, then they should sign out against medical advice. Just like someone who had high blood pressure and wanted to leave before cardiologist showed up with sign out against medical advice.

The more rare way to screen positive is a acute positive which is a yes the question five. Are you having thoughts of killing yourself? Right now? This is considered urgent and an emergency, and it's very rare for non-behavioral health patients presenting with medical chief complaints to screen acutely positive and that happens less than one percent of the time. But these patients should not be left alone and you cannot leave these patients and they will require a one to one observer and full on safety precautions.

The brief suicide safety assessment is not necessary for these patients, because they are automatically deemed at imminent risk and will need a full psychiatric evaluation and safety evaluation.

However, if you want to do a brief suicide safety assessment, as part of the way your implementation program goes, that is also understandable.

Studies reveals that screening does not overburden the system and that universal screening is it's feasible.

So, this is just the pathway and again three tier system with a brief screen with the brief screen, the suicide safety assessment that is conducted by a mental health clinician, or an MD, NP, or PA. And that determines whether or not the patient needs full mental health evaluation.

Brief suicide safety assessments are available in these different versions and in worksheets on the website.

There are also resources to give to patients and links to videos for staff, if you have further interest in this.

Every single one of you can save a life and make a difference. There are things any individual can do right now to prepare to save a life. Everyone should save these numbers in their phone, the National Suicide Prevention Lifeline and the Crisis Text Line. These are twenty-four, seven resources available and there's also some action steps that one can look at AQS suicide prevention web page.

We don't have a crystal ball, so we say safety first is best. You can there's nothing easy about this. It's not simple to figure out if someone's going to try to kill themselves or not. But we believe this screening can be a very feasible way to identify kids that need further evaluation.

The best predictor of future behaviors past behavior. So, anyone who's tried to kill themselves in the past is at greater risk. Let's all remember that there's limits are in our ability to predict, but we all need to err on the side of caution and just do the best we can. So, I'm going to end with a patient example.

This was during our inpatient validation study, there was sixteen-year-old medical surgical patient who had cystic fibrosis, who screened negative on the depression screen. And then one of the data collectors Dr Abby Ross administered the ASQ, and this is how the patient screen. They said no, to the first, no to the second and no to the third. But have you ever tried to kill yourself? They said, yes. They were not an acute risk, but they had suicide behavior in the past that they never told anyone about. And when Dr Ross said to her why did you tell me today? The patient said because you asked the right questions. This was important, because this initiated a way for the patient to talk about her suicidal behavior and to get some mental healthcare, which was important to the patient.

There are a lot of teams to thank, and a lot of people that went into making the ASQ and testing the ASQ and implementing the ASQ. So, thank you for your attention.

Original Article

Twitter Chat » Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

Date/Time:

Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

About SBIR and STTR Programs

The U.S. Congress created the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, which require eligible governmental agencies to set aside a percentage of their extramural budget so that domestic small businesses can engage in federal research and development (R&D) that has a strong potential for technology commercialization. The SBIR and STTR programs at the National Institute of Mental Health (NIMH) aim to support small businesses in developing technologies that can advance the mission of the Institute, including basic neuroscience research, translational and clinical research, clinical diagnosis and treatment, and in the dissemination and implementation of evidence-based research on mental disorders.

Event Details

NIMH’s SBIR and STTR program coordinator, Dr. Margaret Grabb participated in a Reddit “Ask Me Anything” (AMA) event on Wednesday, January 29, 2020, from 11:00 a.m. to 12 p.m. ET. This event was intended for academic entrepreneurs and small businesses to ask Dr. Grabb about these funding programs, as well as how and when to apply. Dr. Grabb answered questions from the u/NIMH_AMA user profile. To view the archive of the AMA, visit https://www.reddit.com/r/IAmA/comments/evod0s/small_business_research_transforming_mental/

About Reddit

Reddit is a collection of online message boards where people can hold discussions. The Reddit website is composed of a large number of “subreddits” focused on particular themes. The host of this Reddit event is the “Ask Me Anything” subreddit (r/IAmA/). Through a Reddit account, you can post your thoughts or questions to the discussion page. Reddit users can also “upvote” specific comments or questions they find particularly interesting, causing them to rise to the top of the message board. In this way, the best contributions to the conversation become the most visible.

Original Article

Blog Post » Addressing Disparities: Advancing Mental Health Care for All Americans

As I sit down to write this message, I’m thinking of two former patients. One of them, a Hispanic man, I met in the emergency room at NewYork-Presbyterian Hospital when I was a resident in the early 2000s. Floridly psychotic, disheveled, and homeless, he was shouting at the emergency room nurse when I first saw him, demanding medications that he said were stolen from a locker in the homeless shelter across the street. The second patient, a middle-aged White woman, was referred to my private practice in Midtown Manhattan a few years later. Composed and controlled, she asked compelling questions about her illness and its management, bringing with her dozens of pages of medical records. Both patients were young adults. Both had severe bipolar disorder. Both had survived a suicide attempt. Their medication lists were the same. Their lives were not.

Differences in health outcomes like these can reflect a number of underlying factors, including biological factors or environmental exposures; social, economic, and cultural contexts; and access to quality health care. When these differences adversely affect disadvantaged populations, they are known as health disparities.

Disparities in mental health are significant and easily documented. Deaths by suicide, for example, are much more common in American Indians and Alaska Natives compared to the general population. The rate of deaths by suicide is also higher in rural areas. Another example: Black and Hispanic children may be diagnosed with autism at a later age compared to White children. That is an important factor because the earlier the diagnosis, the earlier treatment can start, and the earlier treatment starts, the better these children will do. These and other mental health disparities further disadvantage members of minority groups and increase the burden of mental illnesses on individuals, families, and communities.

Accordingly, the National Institute of Mental Health (NIMH) supports a research agenda aimed at understanding and reducing mental health disparities. One early success comes from research led by Emily Haroz, Ph.D., a promising early-career investigator at the Johns Hopkins Bloomberg School of Public Health. Using an approach that has worked for the U.S. Army, the U.S. Department of Veterans Affairs, and a group of health management organizations (HMOs), Haroz and colleagues built an algorithm that uses electronic health record data to identify individuals in the White Mountain Apache Tribe in Arizona who are at increased risk of suicide. Such a predictor could be used by health professionals to refer these individuals to appropriate mental health care. Meanwhile, NIMH continues to support three hubs for collaborative research focused on suicide prevention in Native American communities. These hubs are busy establishing common protocols for novel interventions and testing the efficacy of these interventions. This research holds the promise of making a real difference in the near term, helping health professionals and community leaders understand how to reduce deaths by suicide in their communities.

Similar efforts are underway in other communities to help families with children who may have autism. The Autism Spectrum Disorder Pediatric, Early Detection, Engagement and Services Network (ASD PEDS) is an NIMH-funded network of investigators studying a diverse array of strategies and interventions aimed at identifying and treating children with autism as early as possible. This collaborative group is committed to eliminating disparities by reducing the age at which children from underserved populations are diagnosed and has several projects that are nearing completion. For example, Alice Carter, Ph.D., at the University of Massachusetts Boston, is finishing a study designed to test whether a system-level intervention can reduce these disparities. The intervention involves outreach to primary care pediatricians, a comprehensive multi-stage screening process, and motivational interviewing with parents and other caregivers. Wendy Stone, Ph.D., at the University of Washington, is testing a complementary intervention that aims to reduce disparities by improving screening and referral procedures in primary care pediatric practices. Stone and colleagues will examine the acceptability and efficacy of the intervention in four diverse communities.

While we at NIMH are justifiably proud of these and other investments in research on mental health disparities, I can’t help but ask whether similar projects would remedy the disparate situations faced by my former patients. Would early intervention have saved my first patient from homelessness? Are there treatment approaches for bipolar disorder that work better for individuals from disadvantaged backgrounds? How can we promote better access to and engagement in community-based mental health care? These are the sorts of questions we need to answer to ensure that improved mental health care meets the needs of all Americans.

References

Allen. J., Rasmus, S. M., Fok, C. C. T., Charles, B., Henry, D., & Qungasvik Team. (2018). Multi-level cultural intervention for the prevention of suicide and alcohol use risk with Alaska Native youth: A nonrandomized comparison of treatment intensity. Prevention Science, 19(2), 174-185. doi:10.1007/s11121-017-0798-9

Daniels, A. M., & Mandell, D. S. (2014). Explaining differences in age at autism spectrum disorder diagnosis: a critical review. Autism, 18(5), 583-597. doi: 0.1177/136236131348027

Haroz, E. E., Walsh, C. G., Goklish, N., Cwik, M. F., O'Keefe, V., & Barlow, A. (2019). Reaching those at highest risk for suicide: Development of a model using machine learning methods for use with Native American communities. Suicide and Life-Threatening Behavior. doi:10.1111/sltb.12598

Ibañez, L. V., Stoep, A. V., Myers, K., Zhou, C., Dorsey, S., Steinman, K. J., Stone, W. L. (2019). Promoting early autism detection and intervention in underserved communities: Study protocol for a pragmatic trial using a stepped-wedge design. BMC Psychiatry, 19, 169. doi:10.1186/s12888-019-2150-3

Ivey-Stephenson, A. Z., Crosby, A. E., Jack, S. P., Haileyesus, T., & Kresnow-Sedacca, M. (2017). Suicide trends among and within urbanization levels by sex, race/ethnicity, age group, and mechanism of death — United States, 2001–2015. MMWR Surveillance Summary, 66(No. SS-18), 1–16. doi:10.15585/mmwr.ss6618a1

O'Keefe, V. M., Haroz, E. E., Goklish, N., Ivanich, J., The Celebrating Life Team, Cwik, M. F., & Barlow, A. (2019). Employing a sequential multiple assignment randomized trial (SMART) to evaluate the impact of brief risk and protective factor prevention interventions for American Indian youth suicide. BMC Public Health, 19, 1675. doi:10.1186/s12889-019-7996-2.

Original Article

Twitter Chat » Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

Date/Time:

Reddit “Ask Me Anything” with Dr. Margaret Grabb – NIMH’s Small Business Research Programs

About SBIR and STTR Programs

The U.S. Congress created the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, which require eligible governmental agencies to set aside a percentage of their extramural budget so that domestic small businesses can engage in federal research and development (R&D) that has a strong potential for technology commercialization. The SBIR and STTR programs at the National Institute of Mental Health (NIMH) aim to support small businesses in developing technologies that can advance the mission of the Institute, including basic neuroscience research, translational and clinical research, clinical diagnosis and treatment, and in the dissemination and implementation of evidence-based research on mental disorders.

Event Details

NIMH’s SBIR and STTR program coordinator, Dr. Margaret Grabb will participate in a Reddit “Ask Me Anything” (AMA) event on Wednesday, January 29, 2020, from 11:00 a.m. to 12 p.m. ET. This event is intended for academic entrepreneurs and small businesses to ask Dr. Grabb about these funding programs, as well as how and when to apply. Dr. Grabb will answer questions from the u/NIMH_AMA user profile.

About Reddit

Reddit is a collection of online message boards where people can hold discussions. The Reddit website is composed of a large number of “subreddits” focused on particular themes. The host of this Reddit event is the “Ask Me Anything” subreddit (r/IAmA/). Through a Reddit account, you can post your thoughts or questions to the discussion page. Reddit users can also “upvote” specific comments or questions they find particularly interesting, causing them to rise to the top of the message board. In this way, the best contributions to the conversation become the most visible.

Original Article

Scientific Meeting » Expanding Career Pathways for Youth and Young Adults on the Autism Spectrum: Employment as a Social Determinant of Health

Expanding Career Pathways for Youth and Young Adults on the Autism Spectrum: Employment as a Social Determinant of Health

Date/Time:

banner image for NIMH Webinar: Expanding Career Pathways for Youth and Young Adults on the Autism Spectrum: Employment as a Social Determinant of Health

Location: Webinar

On January 27, 2020, the National Institute of Mental Health is sponsoring a webinar about expanding career pathways for youth and young adults on the autism spectrum and the importance of employment to health.

The webinar will provide information about supports and resources to improve access to competitive, integrated employment for youth and young adults on the autism spectrum and enhance their career pathways. The discussion will:

  • Highlight how greater access to work-based learning can increase opportunities for gainful employment.
  • Share federally funded resources to support access to needed workplace accommodations for people on the autism spectrum.
  • Emphasize employment as a key social determinant of health and the need to support the physical and mental health of job seekers and employees on the autism spectrum.

Presenter:

Scott Michael Robertson, PhD, Policy Advisor, U.S. Department of Labor's Office of Disability Employment Policy

Webinar Details:

Registration is not necessary.

Join WebEx Meeting
Meeting number (access code): 621 958 303
Meeting password: NIMH-ASD

Join From a Video System or Application
Dial sip:621958303@nih.webex.com
You can also dial 173.243.2.68 and enter your meeting number.

Join by Phone
1-650-479-3208 Call-in toll number (US/Canada)

Tap here to call (mobile phones only, hosts not supported): tel:%2B1-650-479-3208,,*01*621958303%23%23*01*

Original Article

Medical News Today: Cancer: Using copper to boost immunotherapy

An interdisciplinary group of scientists has successfully destroyed tumor cells in mice by using nano-sized copper compounds alongside immunotherapy. Importantly, the tumors did not return after the treatment ceased.

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Could copper compounds combined with immunotherapy help combat cancer?

According to the World Health Organization, cancer is the second leading cause of death worldwide — in 2018, it was responsible for approximately 9.6 million deaths.

Reducing behavioral or dietary risks associated with cancer is an important way of lowering the total number of cancer deaths; however, finding effective treatments is also crucial.

Doctors usually treat cancer with chemotherapy, but this often has significant side effects. For example, some chemotherapy medication can wipe out a person's white blood cells, leaving their immune system compromised and open to infection.

Although chemotherapy treatment can be successful, there is always a risk that a person's cancer might return.

Recent advances in cancer treatment include immunotherapy, which involves using a person's immune system to fight cancer cells. However, this does not always work or may only slow down the growth of cancer, so it cannot yet replace chemotherapy.

Copper nanoparticles

In the new study on mice, the scientists combined immunotherapy with copper-based nanoparticles. This combination treatment destroyed the tumor cells without the use of chemotherapy. Most importantly, however, the tumor cells did not return after treatment ceased.

The team of scientists — from KU Leuven in Belgium, the University of Bremen, the Leibniz Institute of Materials Engineering both in Germany, and the University of Ioannina in Greece — found that tumors in mice are sensitive to copper oxide nanoparticles.

Typically, these nanoparticles are toxic when inside an organism. The scientists found that by using iron oxide to create the nanoparticles, they could control which cells the nanoparticles destroyed, leaving healthy cells unaffected. They recently published their findings in the journal Angewandte Chemie International Edition.

Prof. Stefaan Soenen and Dr. Bella B. Manshian from the Department of Imaging and Pathology at KU Leuven worked together on the study. They explain how "any material that you create at a nanoscale has slightly different characteristics than its normal-sized counterpart." They continue:

"If we ingest metal oxides in large quantities, they can be dangerous, but at a nanoscale and at controlled, safe concentrations, they can actually be beneficial."

The scientists began by using only the nanoparticles to target the tumor cells. As expected, the cancer returned. However, the team discovered that the nanoparticles could work in conjunction with the mice's immune systems.

"We noticed that the copper compounds not only could kill the tumor cells directly, they also could assist those cells in the immune system that fight foreign substances, like tumors," said Dr. Manshian.

Blocking cancer's return

When the scientists combined the nanoparticles with immunotherapy, the tumor cells died and did not return.

To confirm the results, the scientists injected the mice with new tumor cells. The mice's immune systems immediately destroyed the new tumor cells.

The researchers believe that a combination of nanoparticles and immunotherapy could work as a vaccine for lung cancer and colon cancer, which were the two types of cancer the scientists studied.
However, they think that this technique could treat up to 60% percent of cancers, including breast cancer and ovarian cancer, that develop from the same gene mutation.

"As far as I'm aware, this is the first time that metal oxides [have been used] to efficiently fight cancer cells with long lasting immune effects in live models," Prof. Soenen says. "As a next step, we want to create other metal nanoparticles and identify which particles affect which types of cancer. This should result in a comprehensive database."

Results derived from animal testing do not necessarily work when it comes to humans, and to take the research further, the team intends to test the treatment on human tumor cells. If that is successful, they will conduct a clinical trial.
However, according to Prof. Soenen, there are still several hurdles along the way:

"Nanomedicine is on the rise in the United States and Asia, but Europe is lagging behind. It's a challenge to advance in this field because doctors and engineers often speak a different language. We need more interdisciplinary collaboration so that we can understand each other better and build upon each other's knowledge."

Original Article

Medical News Today: Could a probiotic prevent or reverse Parkinson’s?

A new study using a roundworm model of Parkinson's disease found that a probiotic bacterium could prevent, and in some cases reverse, toxic protein buildup.

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Could a probiotic be the key to treating Parkinson's?

Misfolded alpha-synuclein proteins in the brain are the hallmark sign of Parkinson's disease.

Many experts believe that these toxic protein clumps lead to the progressive loss of brain cells that control movement.

But the science is not clear-cut, and the underlying mechanisms that cause Parkinson's remain elusive.

Without an effective way of preventing or curing Parkinson's, treatment primarily focuses on alleviating symptoms.

A recent line of research has been looking into a possible link to the gut microbiome, the trillions of microbial species that populate our intestines.

Could changing a person's gut microbiome be a way of modifying their risk of developing Parkinson's or even serve as an effective treatment?

A group of scientists from the Universities of Edinburgh and Dundee, both in the United Kingdom, set out to investigate.

Maria Doitsidou, a fellow at the University of Edinburgh's Centre for Discovery Brain Sciences, is the senior study author, and the team's research features in the journal Cell Reports.

Probiotic 'inhibits and reverses' aggregation

For their study, Doitsidou and her colleagues used a nematode worm model that scientists had genetically engineered to express a human version of the alpha-synuclein protein.

These worms normally develop aggregates, or clumps, of alpha-synuclein at day 1 of their adulthood, which is 72 hours after they hatch.

However, when the researchers fed worms a diet containing a probiotic bacterial strain called Bacillus subtilis PXN21, they observed "a nearly complete absence of aggregates," as they state in their paper. The worms still produced the alpha-synuclein protein, but it did not aggregate in the same way.

In worms that had already developed protein aggregates, switching their diet to B. subtilis cleared the aggregates from the affected cells.

The team then followed a set of worms through their lifespan and compared a B. subtilis diet with a conventional laboratory diet.

"The maximum number of aggregates reached in animals fed with B. subtilis was far lower than that observed on the [standard] diet, indicating that B. subtilis does not simply delay aggregate formation," the authors explain in the paper.

"B. subtilis PXN21 inhibits and reverses [alpha-synuclein] aggregation in a [roundworm] model," they note.

Is this effect specific for B. subtilis PXN21, though? To answer this question, the team compared a number of different strains of the bacterium and found that they had similar effects.

Several pathways working together

To find out how B. subtilis is able to prevent and clear alpha-synuclein aggregates, the team used RNA sequencing analysis to compare the gene expression of animals receiving a standard diet with that of those receiving the probiotic.

This analysis revealed changes in sphingolipid metabolism. Sphingolipids are a type of fat molecule, and they are important components of the structure of our cell membranes.

"Previous studies suggest that an imbalance of lipids, including ceramides and sphingolipid intermediates, may contribute to the pathology of [Parkinson's disease]," the authors comment in the paper.

Yet, changes in sphingolipid metabolism were not the only pathways that the researchers identified.

They also saw that B. subtilis was able to protect older animals from alpha-synuclein aggregation through both the formation of complex structures called biofilms and the production of nitric oxide. In addition, the team saw changes in the dietary restriction and the insulin-like signaling pathways.

Importantly, when the team switched animals that had first received a standard diet over to a B. subtilis diet, their motor skills improved.

"The results provide an opportunity to investigate how changing the bacteria that make up our gut microbiome affects Parkinson's. The next steps are to confirm these results in mice, followed by fast-tracked clinical trials since the probiotic we tested is already commercially available."

Maria Doitsidou

Original Article

Medical News Today: Catnip: What do we know about the feline drug?

The internet is rife with funny cat videos showing their reactions to a plant commonly known as "catnip." What is catnip, does it affect all felines, is it safe for cats, and should humans use it? This Special Feature investigates these questions and more.

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Does your feline friend go crazy for catnip? In this Special Feature, we find out why — or why not.

Nepeta cataria, or "catnip," is an herb belonging to the same plant family as mint. Although it originated in parts of Europe and Asia, the plant is now common across several continents, including North America.

Because, like regular mint, catnip proliferates easily, many cat owners grow the plant in pots as a special treat for their feline friends.

As part of the mint family, fresh catnip also smells minty, though this is not the case for the dried catnip sometimes present in commercial cat treats or toys, which may smell more like dried grass.

Why is catnip such a special treat? People who share their life with a cat will know that this plant often has a marked, and sometimes very funny, effect on these beloved animals — not unlike the effect that a mild recreational drug might have on humans.

Do all felines react to catnip? Why does this plant affect cats, exactly? Is it really akin to recreational drugs? Read on to find out.

1. Why does catnip affect cats?

In his book Intoxication: The Universal Drive for Mind-Altering Substances, psychopharmacologist Ronald Siegel estimates that around "70% of domestic cats respond to catnip," and that those who do have reached sexual maturity. Cats reach sexual maturity at around 6 months of age.

Cats who react to catnip will sniff the plant, or any toys that contain it, and then start chewing on it. Following this, they may start rubbing their head against the plant or toy, and then roll or flip from side to side.

"Both of [my cats] love it, and it makes them go crazy," one reader told Medical News Today. "[The female] likes to lick it, then she attacks the toy it's on, often adopting the bunny leg attack. [The male] goes more soppy with it, often rolling around with the toy in his paws," they said.

Although in most cases, when it does affect them, catnip stimulates cats in a pleasurable way, the American Society for the Prevention of Cruelty to Animals deem it "toxic to cats." They warn that some domestic felines may experience adverse reactions after coming into contact with this plant. These effects can include vomiting and diarrhea, as well as states of sedation.

Some cats may even become aggressive when they encounter the plant. Another reader told MNT that she avoids giving her cat any catnip for this very reason. "[My cat] just gets a bit like she wants to fight me [and] starts punching my foot," they said.

For the many cats that respond well to catnip, Siegel notes, this may be "an example of animal addiction to pleasure behavior." Both male and female cats respond to catnip in a way that is reminiscent of sexual arousal among these felines.

Because of these similarities, some researchers have suggested that the plant may once have been a timely and natural enhancer of reproductive behaviors.

"These displays have prompted naturalists to speculate that catnip once served the evolutionary function in the wild of preparing cats for sex, a natural springtime aphrodisiac."

Ronald Siegel

He explains that the molecules that carry catnip's scent, called terpenoids, are what causes the reaction. Catnip features a specific type of terpenoid called nepetalactones. These molecules, Siegel explains, can be toxic. However, they are usually harmless in the quantity in which they are present in catnip.

Cats absorb nepetalactones by sniffing the catnip. The molecules then bind to olfactory (smell) receptors in the nose, which send additional signals to the amygdala, which are two small clusters in the mammal brain. These are linked with both the regulation of emotions and some sexual behaviors.

2. Why do some cats not respond?

About 30% of domestic cats have absolutely no reaction to catnip. One MNT reader exclaimed that it "has no effect on [her cat] whatsoever!"

Why does catnip affects some cats but not others? The difference, Siegel argues, lies in cat DNA. Some cats inherit the "catnip sensitive" gene, while others simply do not.

"The reason for the failure of some cats to become even the least bit excited about catnip and for the exaggerated reaction of others is genetic," he writes.

"Cats can inherit a dominant gene that guides the reaction to catnip," adds Siegel. He adds that some studies have demonstrated that the offspring of cats sensitive to catnip are also sensitive to this plant, and that those of cats with no reaction to it also will not respond.

In addition to this, he says, some felines may become avoidant of catnip if they have had a bad experience with it.

For instance, notes Siegel, if a feline has sniffed or chewed on catnip and then injured itself, in the future, it may turn around when encountering the plant, instead of jumping at the occasion of accessing the stimulant.

3. Does catnip affect other felines?

If catnip can have a striking effect on domestic cats, does it also affect larger felines, such as lions, jaguars, and tigers?

The answer is "yes" — and it seems to act, to a much lesser extent, on other cat-like mammals that are not actually felines.

An experiment conducted in the early 1970s at what is now Zoo Knoxville in Tennessee found that lions and jaguars were "extremely sensitive" to catnip.

Some of the tigers, cougars, and bobcats at the zoo also responded to catnip, though not at all strongly. The two cheetahs on site at the time showed no interest in the plant.

Other animals have shown curiosity about catnip, though to a much lesser extent than domestic cats.

Non-felines that have shown an interest in catnip include civets, which are carnivorous animals native to Asia and Africa that look like cats but belong to a different family, called Viverridae.

4. What other stimulants affect cats?

Though catnip is by far the best known cat stimulant, researchers have noted that there are many other plants that can alter felines' moods and behaviors.

Siegel, for instance, speaks of matatabi, or silver vine (Actinidia polygama). This is a plant native to areas of Japan and China. In an experiment at Osaka Zoo in Japan, large felines exposed to high quantities of the active substance in matatabi showed signs of intense pleasure — and addiction.

"This plant contains secondary compounds closely related in chemical structure and behavioral activity to nepetalactones," Siegel explains.

"After an initial exposure, the [large] cats became so eager for more that they would ignore whatever else they were doing — eating, drinking, or even having sexual intercourse — whenever the chemicals were made available."

Ronald Siegel

One 2017 study confirmed that matatabi can be just as, if not more, effective than catnip when it comes to stimulating domestic cats.

The study's authors also identified two more plants that had a similar effect: Tatarian honeysuckle (Lonicera tatarica) and valerian (Valeriana officinalis).

Almost 80% of the domestic cats in this study reacted to matatabi, and around 50% of cats also responded to Tatarian honeysuckle and valerian root.

Matatabi, the study authors also note, actually elicited a response in 75% of the domestic cats that had no reaction to catnip.

"Olfactory enrichment using silver vine, Tatarian honeysuckle, or valerian root may, similar to catnip, be an effective means to improve the quality of life for cats," the researchers conclude.

5. Is catnip safe for humans?

Although humans tend to buy or cultivate catnip purely for the entertainment of their feline friends, some people think that the plant can have a soothing effect on their own minds.

For example, some people like to brew catnip tea, and some have even tried rolling the plant into cigarettes and smoking it. "It makes people feel happy, contented, and intoxicated, like marijuana," an older study notes.

As a supplement, people have also used catnip to treat symptoms such as coughs or toothaches, and as a digestive aid.

Is it safe? This much remains unclear. So far, there has been little research into the effectiveness or safety of catnip when it comes to treating various conditions in humans.

Some specialists suggest that catnip can cause contractions of the uterus, so they recommend that pregnant women avoid this plant.

Given the scarcity of evidence regarding the safety of this plant, however, our readers may be better off saving it for their cats' enjoyment — that is, if they are part of the majority that do appreciate it.

Original Article

Medical News Today: Giving TB vaccine intravenously boosts efficacy

Experiments in rhesus macaques show that changing the mode of administration of an existing vaccine yields "amazing" results in the fight against tuberculosis (TB).

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Delivering the TB vaccine intravenously rather than intradermally may prove significantly more effective.

Globally, TB is one of the top 10 causes of death and the leading cause of death from infection, ranking higher than HIV and AIDS.

Approximately 10 million people across the world contracted TB in 2018, according to the World Health Organization (WHO).

Although most of these cases tend to occur in Southeast Asia and Africa, drug resistant TB is a "public health threat" worldwide.

There is currently only one available vaccine, which is called bacillus Calmette–Guérin (BCG). Healthcare professionals administer the vaccine intradermally; that is, they inject it directly under the skin.

However, with this mode of administration, the effectiveness of the vaccine varies significantly from person to person. But, new research suggests, administering the vaccine intravenously instead could drastically improve its efficiency.

JoAnne Flynn, Ph.D., who is a professor of microbiology and molecular genetics at the University of Pittsburgh's Center for Vaccine Research in Pennsylvania, led the new research together with Dr. Robert Seder from the National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, MD.

Flynn and her colleagues published their findings in the journal Nature.

The importance of T cells for TB immunity

As the authors explain in their paper, preventing and controlling TB infection requires T cell immunity. T cells are white immune cells, also called lymphocytes.

One of the major challenges of creating an effective vaccine is triggering and maintaining a T cell response in the lungs to control the infection while simultaneously triggering memory cells that can replenish the lung tissue.

With direct injection into the skin, the BCG vaccine does not produce many resident memory T cells in the lungs, explain the authors.

However, some previous studies in nonhuman primates have shown that injecting vaccines intravenously makes them more efficacious.

So, the researchers hypothesized that "a sufficiently high dose" of intravenous BCG would do the trick.

They set out to test their hypothesis and find out how to elicit a sufficient number of T cells that could protect against TB infection in rhesus macaques that were prone to the infection.

'100,000-fold reduction in bacterial burden'

The researchers divided the monkeys into six groups: monkeys that did not receive a vaccine, monkeys that received a standard human injection, monkeys that received a stronger dose but by the same standard injection route, monkeys that inhaled the vaccine in the form of a mist, monkeys that got an injection plus mist, and monkeys that got a stronger dose of BCG but in a single intravenous shot.

After 6 months, the scientists exposed the monkeys to TB. As a result, the majority of the monkeys developed lung inflammation.

The team examined the signs of infection and the course of the disease among the different groups of macaques.

Of all the groups, those that received the vaccine intravenously had the most protection against TB bacteria. There were almost no TB bacteria in the lungs of these monkeys, whereas the monkeys that had received the vaccine the standard way had nearly as many bacteria as those that did not undergo vaccination at all.

"The effects are amazing," says Flynn. "When we compared the lungs of animals given the vaccine intravenously versus the standard route, we saw a 100,000-fold reduction in bacterial burden. Nine out of 10 animals showed no inflammation in their lungs."

"The reason the intravenous route is so effective […] is that the vaccine travels quickly through the bloodstream to the lungs, the lymph nodes, and the spleen, and it primes the T cells before it gets killed."

JoAnne Flynn

A 'paradigm shift' for TB vaccines

Flynn and team found that the T cell response in the lungs of the monkeys that had received an intravenous injection was far more active than in the other groups. They also noted that T cells were more numerous in these monkeys, particularly in their lung parenchyma lobes.

Intravenous administration "induced substantially more CD4 and CD8 T cell responses in blood, spleen, bronchoalveolar lavage, and lung lymph nodes," write the authors.

Before moving on to humans, the scientists need to run more tests to assess the safety and practicality of this vaccine.

"We're a long way from realizing the translational potential of this work," Flynn says. "But eventually, we do hope to test in humans."

Until then, the study marks a "paradigm shift" in how we develop TB vaccines to "prevent latency, active disease, and transmission," conclude the authors in their paper.

Original Article