Β-blocker use associated with lower rates of violence

Study assesses medicated vs. non-medicated behavioral health in 1.4 million individuals over an eight-year period

Peer-Reviewed Publication

PLOS

 

IMAGE: Β-BLOCKERS MAY REDUCE AGGRESSION IN PERSONS WITH MAJOR PSYCHIATRIC DISORDERS view more 

CREDIT: DAN BURTON, UNSPLASH (CC0, HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

Reductions in violence are seen in individuals using Beta adrenergic-blocking agents (β-blockers) compared with periods that they are not taking the medication, in a study published January 31st in the open access journal PLOS Medicine. If the findings are confirmed by other studies, β-blockers could be considered as a way to manage aggression and hostility in individuals with psychiatric conditions.

β-blockers are used to treat hypertension, angina and acute cardiovascular events, heart failure and arrhythmias as well as, migraine, symptoms of hyperthyroidism and glaucoma. They are often used for anxiety and have been suggested for clinical depression and aggression, but evidence is conflicting. They have been linked to an increased risk of suicidal behavior though evidence is inconclusive.

Seena Fazel of the University of Oxford, UK, and colleagues at the Karolinska Institute in Sweden investigated psychiatric and behavioral outcomes: hospitalizations for psychiatric disorders; suicidal behavior and deaths from suicide; and charges of violent crime. They compared 1.4 million β-blocker users in Sweden to themselves during medicated and non-medicated periods over an eight-year period from 2006-2013.

Periods on β-blocker treatment were associated with a 13% lower risk of being charged with a violent crime by the police, which remained consistent across the analyses. Additionally, an 8% lower risk of hospitalization due to a psychiatric disorder was reported as well as an 8% increased association of being treated for suicidal behavior. However, these associations varied depending on psychiatric diagnosis, past psychiatric problems, as well as the severity and type of the cardiac condition the β-blockers were being used to treat.

Previous research has linked severe cardiac events to an increased risk of depression and suicide, and these results might suggest that the psychological distress and other disabilities associated with serious cardiac problems, rather than the β-blocker treatment, increases the risk of serious psychiatric events. In secondary analyses, associations with hospitalization were lower for major depressive but not for anxiety disorders.

In order to understand the role of β-blockers in the management of aggression and violence, further studies including randomized controlled trials are needed. If these confirm the results of this study, β-blockers could be considered to manage aggression and violence in some individuals.

Fazel adds, “In a real-world study of 1.4 million persons, β-blockers were associated with reduced violent criminal charges in individuals with psychiatric disorders. Repurposing their use to manage aggression and violence could improve patient outcomes.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004164

Citation: Molero Y, Kaddoura S, Kuja-Halkola R, Larsson H, Lichtenstein P, D’Onofrio BM, et al. (2023) Associations between β-blockers and psychiatric and behavioural outcomes: A population-based cohort study of 1.4 million individuals in Sweden. PLoS Med 20(1): e1004164. https://doi.org/10.1371/journal.pmed.1004164

Author Countries: Sweden, United Kingdom, United States of America

Funding: This study was supported by the Wellcome Trust (No 202836/Z/16/Z): https://wellcome.org/grant-funding (SF), the Swedish Research Council for Health Working Life and Welfare (2015-0028): https://forte.se/en/ (PL and HL), the American Foundation for Suicide Prevention (DIG-1-037-19): https://afsp.org/research-grant-information (BMD), and Karolinska Institutet Funds (2016fobi50581): https://staff.ki.se/ki-foundations-funds-list-of-grants (YM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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JOURNAL

PLoS Medicine

DOI

10.1371/journal.pmed.1004164 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

COI STATEMENT

Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: HL reports receiving grants from Shire Pharmaceuticals; personal fees from and serving as a speaker for Medice, Shire/Takeda Pharmaceuticals and Evolan Pharma AB; and sponsorship for a conference on attention-deficit/hyperactivity disorder from Shire/Takeda Pharmaceuticals and Evolan Pharma AB, all outside the submitted work. All other authors have declared that no competing interests exist.

Why reflecting on your values before opening your mouth makes for happier relationships

University of Bath Press Release

Peer-Reviewed Publication

UNIVERSITY OF BATH

Ever found yourself angry at a situation and in desperate need to tell the world about it by ranting to anyone who’ll listen? Maybe it’s time to pause; inhale and reflect on what values you hold dear.

A new interdisciplinary study, conducted by philosophers and linguists at Cardiff University and psychologists at the University of Bath has found that a process of reflecting on life values before a debate can enhance people’s willingness to listen to others and engage with them in a civil dialogue.

For the study, the research team recruited 303 participants. Participants were all put in small groups where they were asked to discuss the merits of charging tuition fees for education. Before the debate, half were first asked to write about the life values* they considered important. All discussions were recorded, coded, and analysed. 

The analysis revealed that the process of reflecting on values first helped to inspire individuals’ ‘intellectual humility’: their awareness of their own fallibility and openness to others’ views. 60.6% of participants who reflected on their values first showed more humility compared to the average person who was not given this task.

In a seemingly ever-distant world where opinions appear increasingly polarised, the researchers suggest their results show grounds for optimism. If people were to stop and reflect on the values which are important to them, debates in the online and offline world could be far more harmonious, they speculate.

Co-lead for the study, Dr Paul Hanel who conducted the research at the University of Bath but is now based at the University of Essex explained: “We are often told that we live in a polarised world where having the ‘wrong’ view about topics will get you shouted down before you have had a chance to finish.

“This research suggests that polarisation might be exaggerated and that by pausing to reflect on personal values before engaging in these kinds of conversations, our interactions could become more harmonious.”

Previous research from the University of Bath-based team in 2019 found that people are in fact much more united in their beliefs and values than media reporting often suggests. The work forms part of a wider project all about ‘Changing Attitudes in Public Discourse’, led by Cardiff University. 

Co-author, Professor Greg Maio, Head of the Department of Psychology at the University of Bath added: “The good news from this study is that the vitriol we often see perpetuated online does not have to be that way. By presenting participants with an opportunity to reflect on their values, we found a marked improvement in how they engaged with discussions.

“In the future, we would like to see if this kind of value reflection also works online, to encourage less arrogant dialogue among social media users. We would certainly be interested in sharing our findings with social media developers and others.”

Co-author, Professor Alessandra Tanesini, a philosopher at Cardiff University adds: “Our research shows that strategies promoting virtuous attitudes by means of value affirmation improve people’s ability to learn from each other. Ours is an intervention whose implementation in schools and universities can also make an important pedagogical contribution to students’ education”.

This research was funded by Templeton Foundation**.

Notes

* The most frequently chosen values by participants were ‘self-direction thought’, which is the freedom to cultivate one’s own ideas and abilities (chosen by 32 participants); ‘universalism-concern’, which represents commitment to equality, justice, and protection for all people (26 participants); ‘self-direction action’, which is the freedom to determine one’s own actions (19 participants); and ‘personal security’, which is safety in one’s immediate environment (16 participants).

**Research leading to the paper was partially funded by a subaward agreement from the University of Connecticut with funds provided by Grant No. 58942 from John Templeton Foundation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of UConn or the John Templeton Foundation.

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JOURNAL

Royal Society Open Science

DOI

10.1098/rsos.220958 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Using self-affirmation to increase intellectual humility in debate

ARTICLE PUBLICATION DATE

1-Feb-2023

OR AS I LIKE TO SAY; 

'BEFORE SHOOTING YOURSELF IN THE FOOT 

BE SURE YOU HAVE REMOVED IT FROM YOUR MOUTH'

IQ changes over time may help track development, guide intervention in autistic youth

UC Davis MIND Institute study identifies three paths of intellectual development

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - DAVIS HEALTH

A long-term study by UC Davis MIND Institute researchers confirms that changes in the IQ level of autistic children may help predict their path of communication and behavioral development as adolescents.

The new work builds on a previous MIND Institute study of IQ trajectories in autistic children ages 2-8. It expands the findings to older youth.

The study, published in JCPP Advances, has identified three distinct paths of intellectual development in autistic children: persistent intellectual disability, an increase in IQ, or an IQ that remained average or above.

“Once more, we have shown that we can use IQ to identify a subtype of autism,” said lead author Marjorie Solomon. She is the MIND Institute’s associate director and a professor in the Department of Psychiatry and Behavioral Sciences. “Given that IQ is perhaps the strongest predicter of later outcomes in autistic children, we believe that studying IQ trajectories in childhood is very important. It provides clues about their potential different future paths and how we can help individuals to flourish.”

Study methods

The study’s participants were from the MIND Institute’s Autism Phenome Project, one of the world’s most comprehensive longitudinal studies of its kind. Researchers have been following a group of autistic children from about age 3 through adolescence

The study included 373 (115 females, 258 males) autistic participants ranging from age 2 to age 12. Importantly, individuals with all levels of intellectual ability were part of the sample.

Assessments of behavior and autistic characteristics were collected across childhood. IQ was evaluated at three timepoints: T1 (mean age of 3 years), T2 (mean age of 5.6 years) and T3 (mean age of 11.5 years).

Licensed clinical psychologists specializing in autism evaluated the participants using autism assessment tools. These included the ADOS (Autism Diagnostic Observation Schedule), ADOS-2, ADI-R (Autism Diagnostic Interview – Revised), and the Vineland Adaptive Behavior Scales (VABS).

Based on these assessments, the participants were divided into three subgroups:

• “Changers” described those who began with low IQs in early childhood, followed by a substantial increase that slowed as they entered middle childhood. “Changers” made up 39% of the participants.
• “Persistent Intellectual Disability” described the individuals who began with a below average IQ that persisted across childhood. Around 45% of the participants were in this group.
• “Persistently High IQ” described the individuals who began with an average or above average IQ and remained relatively stable throughout childhood. Sixteen percent belonged to this group.

Results

The researchers analyzed changes in autism traits and communication adaptive functioning. This is the ability to understand language, engage in meaningful verbal expression, and read and write, over time.

They also looked at internalizing behaviors, such as anxiety or depression, and externalizing behaviors, such as impulsivity or aggressiveness.

Of the 191 participants with assessments at two timepoints or more, 10 lost their autism diagnosis. This included about 5% of the “Changers,” 10% of the “Persistently High IQ” group and none of those in the “Persistent Intellectual Disability” group. Identifying what makes the “Changers” group different from those in the groups with more stable IQs is a major goal of the research.

Individuals with stronger early communication adaptive function and lower autism ‘severity’ scores were more likely to be in the “Persistently High IQ” group versus the “Persistent Intellectual Disability” group by adolescence.

Both the “Changers” and “Persistent Intellectual Disability” groups had lower IQ scores in early childhood. However, those that showed improved communication adaptive function and decreased externalizing behaviors into adolescence were more likely to be in the “Changers” group compared to the “Persistent Intellectual Disability” group.

“It is striking that we found so much overlap in individuals following different trajectories of intellectual development when assessed at the early childhood and adolescent time points,” Solomon said. “Of course, many other factors are involved in determining outcomes, but intellectual ability level is a core feature and an important starting point.”

Brain differences among the three autistic groups

Last year, a closely related MIND Institute study compared MRI scans of the three IQ subgroups at age 3. The researchers evaluated two brain networks associated with intellectual functioning: the frontoparietal network and the default mode network.

The frontoparietal network is involved in sustained attention, problem-solving and working memory. The default mode network contributes to remembering, thinking about the future and mind wandering.

The 2022 study was led by Joshua Lee, an assistant professional researcher in the Department of Psychiatry and Behavioral Sciences. The team found that the “Changers” and “Intellectual Disability” groups, which both had low IQs at age 3, differed from the group with average IQs in several regions of the frontoparietal network.

In contrast, the default mode network differed between the “Changers” group and the other two groups. This difference suggested that this network may be involved in mechanisms related to improving intellectual function.

“The findings of both studies provide clues about how brain differences between autistic individuals with and without intellectual disability during early childhood might predict future outcomes,” said Christine Wu Nordahl, director of the Autism Phenome Project, a professor in the Department of Psychiatry and Behavioral Sciences and a coauthor on both studies. “Future studies will evaluate brain structure and function development across childhood and how they differ across various subgroups of intellectual development in autism.”

Additional coauthors on the new study included Billy Cho, Ana-Maria Iosif, Brianna Heath, Apurv Srivastav, Emilio Ferrer and David G. Amaral, all of UC Davis.

This study received funding from the National Institute of Mental Health (R01MH106518, R01MH103284, R01MH103371 and R01MH104438); National Institutes of Health (R01MH104438); the T32 Ruth L. Kirchstein Institutional National Research Service Award (T32 MH073124); The MIND Institute Intellectual and Developmental Disabilities Research Center (P50 HD103526); and an Autism Center of Excellence grant from the National Institute of Child Health and Development (P50 HD093079).

Read the full study.

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JOURNAL

JCPP Advances

DOI

10.1002/jcv2.12127 

ARTICLE TITLE

IQ trajectories in autistic children through preadolescence

Suicide risk screening in high schools successfully identifies at-risk students

New research demonstrates the ability of in-school suicide risk screening to identify and facilitate adolescents to get the help they need

Peer-Reviewed Publication

PENN STATE

UNIVERSITY PARK, Pa. — Suicide death rates have increased significantly among adolescents in the U.S. in recent years, according to the Centers for Disease Control and Prevention. But while children are typically screened for scoliosis, body mass index, and vision and hearing problems in school, mental health screening has not been standardized in school settings. New research, led by the Penn State College of Medicine, evaluated the effectiveness of a school-based, adolescent suicide risk screening and found that it successfully identified at-risk adolescents and increased initiation of mental health services.

“Unfortunately, more than half of U.S. adolescents lack routine preventive health care, which limits the ability of primary care to address this worsening public health concern,” said Deepa Sekhar, associate professor of pediatrics and executive director of Penn State PRO Wellness. “Schools create a more equitable setting for screening given that most adolescents attend, regardless of race, ethnicity and socioeconomic status.”

In previous research, the team developed and tested Screening in High Schools to Identify, Evaluate and Lower Depression (SHIELD), a protocol to evaluate the effectiveness of school-based depression screening. The study used the Patient Health Questionnaire-9 (PHQ-9), a standard tool used by primary care providers to screen for symptoms of major depressive disorder. The team found that the universal depression screening approach in which everyone was screened was more effective than the existing process of targeted referral of students based on concerning behaviors such as acting out, failing classes or not showing up for classes.

“One of the challenging parts of the study was item 9 of the PHQ-9, which asks, ‘How often have you been bothered by … thoughts that you would be better off dead or of hurting yourself in some way?’” Sekhar said. “Students with a positive response to this question required same day follow-up, which can be difficult for resource- and staff-limited schools.”

While the PHQ-9 is not a suicide risk assessment tool, the team conducted a follow-up analysis to better understand the necessity of including suicide risk as part of screening.

The team worked with nearly 13,000 students in 14 Pennsylvania high schools. Half of the participating schools were randomized so that students in grades 9 and 11 received targeted screening and those in grades 10 and 12 received universal screening. The other half were randomized so that students in grades 10 and 12 received targeted screening and those in grades 9 and 11 received universal screening.

Students who were identified as at risk for suicide were referred to the Student Assistance Program, which is mandated in all Pennsylvania schools. Managers of this program then determined the follow-up procedure for these individuals.

The team found that adolescents in the universal screening arm had 7.1-fold greater odds of being identified as at risk for suicide, 7.8-fold greater odds of follow-up needs and 4.0-fold greater odds of initiating mental health treatment. The results were published in The Journal of Pediatrics.

“Although the PHQ-9 is a screening tool for major depressive disorder, we found that its use in universal screening increased identification and treatment initiation for adolescents at risk for suicide,” said Sekhar. “Our study confirms the value of universal screening and suggests that a suicide-specific risk assessment would have even greater impact on treatment initiation for identified youth.”

Other authors on the paper include Erich Batra, associate professor of family and community medicine and of pediatrics; Eric Schaefer, biostatistician, Penn State College of Medicine; Leslie Walker-Harding, chair, Department of Pediatrics, University of Washington; Krista Pattison, implementation coordinator, Crane Center for Early Childhood Research & Policy, Ohio State University; Alissa Molinari, registered nurse, St. Luke’s University Health Network; Perri Rosen, project director, Garrett Lee Smith Youth Suicide Prevention Grant; Jennifer Kraschnewski, director, Penn State Clinical and Translational Science Institute; James Waxmonsky, University Chair in Child Psychiatry, Penn State.

This research was supported by the Patient-Centered Outcomes Research Institute, the U.S. Department of Health and Human Services and the National Institutes of Health.  

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DOI

10.1016/j.jpeds.2022.07.036 

Mocktails or cocktails? Having a sense of purpose in life can keep binge drinking at bay

A new study reveals that having a sense of purpose in daily life can influence college students’ decisions on day-to-day alcohol consumption

Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA

Heavy alcohol use is common among college students—and as a consequence, it puts young adults at risk for a wide range of health issues, from cardiovascular disease to cancer. Day in and day out, college students are bombarded with cues to drink, whether that’s seeing a group of friends toast at a party or celebrating after an exam.

Using functional MRI (fMRI) scanning technology, researchers from the University of Pennsylvania, Columbia University, and Dartmouth College examined the relationship between these cues, alcohol craving, and alcohol consumption. They found that having a strong sense of purpose in life decreases the temptation to consume alcohol to excess among some social drinkers.

Why purpose in life?

Lead author Yoona Kang, a research director of the Communication Neuroscience Lab at the Penn’s Annenberg School for Communication, is deeply interested in the impact of purpose in life on health.

Her previous research has found that having a strong life purpose—the sense that your life is guided by personally meaningful values and goals—is associated with many health benefits, including easing the loneliness of COVID-19 isolation and reducing the effort it takes to make healthy choices.

“Values and purposes can have powerful effects on how people think and behave,” Kang says. “And what's interesting about this study is that we asked participants, ‘How much sense of purpose in life do you feel right now?’ Because your level of purpose can fluctuate day by day.”

Craving alcohol

For this study, Kang and colleagues charted the behavior and attitudes of 54 healthy college students, with daily surveys over the course of a month. Once a day, participants answered questions about their current level of purpose in life—and every morning and evening they reported how much they craved and consumed alcohol.

“We focused on craving because it is one of the strongest predictors of actual drinking. If you crave, then you’re more likely to drink,” Kang says. “But just because you crave alcohol doesn’t mean that you’re going to go out and drink, so we wanted to know what’s nudging these social drinkers into drinking when they crave alcohol.”

The student volunteers also received fMRI brain scans, which gave a real-time picture of their brain activity while they were exposed to alcohol cues, like photos of beer, wine, and liquor or photos of people toasting at a party. Researchers analyzed the participants’ brain activity within the ventral striatum, the area of the brain previously associated with reward and craving.

Individuals whose brains showed greater activity when they saw alcohol cues—people with higher neural alcohol cue reactivity—were more likely to drink after craving alcohol.

When this data was matched with life purpose data, Kang and colleagues found something interesting: These neurally sensitive drinkers did not necessarily drink more if they were feeling a strong life purpose when they craved alcohol. And if they felt less purposeful? They were more likely to drink heavily after a craving for alcohol.

Further implications

This finding opens the door to discovering new strategies to discourage binge drinking in college students, especially those with higher neural cue reactivity, not by talking about drinking specifically, but by helping students focus on their mission, purpose, and values. Kang suggests that future research could test interventions used in other purposes in life and related studies—strategies like reflecting on what matters to you or making positive wishes for other people.

While the researchers caution that further testing would be needed to determine whether the findings would generalize to non-college populations, they note that many studies point to the strong link between purpose in life and health behavior across diverse populations. 

And Kang underlines the importance of studying college populations. “College students are in a formative time in their lives where they are learning the norms around alcohol use and setting their own habits that will affect their health later in life,” she says. “So, I think there’s a lot of preventive values in studying alcohol use in college populations.”

The study, published in Addiction, is entitled “Purpose in life, neural alcohol cue reactivity and daily alcohol use in social drinkers.” In addition to Kang, authors include Emily Falk, Danielle Cosme, David Lydon-Staley, Jeesung Ahn, Mia Jovanova, Dani S. Bassett, Silicia Lomax, Faustine Corbani (Columbia University), Ovidia Stanoi (Columbia University), Kevin Ochsner (Columbia University), Victor Strecher (University of Michigan), and Peter J. Mucha (Dartmouth College).

Research was funded by the Army Research Office; Hopelab Foundation; and Mind and Life Institute.

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JOURNAL

Addiction

DOI

10.1111/add.16012 

ARTICLE TITLE

Purpose in life, neural alcohol cue reactivity and daily alcohol use in social drinkers

Silver nanoparticles show promise in fighting antibiotic-resistant bacteria

Peer-Reviewed Publication

UNIVERSITY OF FLORIDA

 

IMAGE: NEW RESEARCH INVESTIGATED WHETHER SILVER NANOPARTICLES COULD AMPLIFY THE EFFECTS OF ANTIBIOTICS ON ANTIBIOTIC-RESISTANT BACTERIA view more 

CREDIT: GARRETT ELLWARD

In a new study, scientists with the University of Florida found that a combination of silver nanoparticles and antibiotics was effective against antibiotic-resistant bacteria.

The researchers hope to turn this discovery into viable treatment for some types of antibiotic-resistant infections. Antibiotic-resistant infections kill more than a million people globally each year.

For centuries, silver has been known to have antimicrobial properties. However, silver nanoparticles — microscopic spheres of silver small enough to operate at the cellular level — represent a new frontier in using the precious metal to fight bacteria.

In this study, the research team tested whether commercially available silver nanoparticles boost the power of antibiotics and enable these drugs to counter the very bacteria that have evolved to withstand them. 

“We found that the silver nanoparticles and a common class of broad-spectrum antibiotics called aminoglycosides work together synergistically,” said Daniel Czyż, senior author of the study and an assistant professor in the UF/IFAS department of microbiology and cell science.

“When combined with a small amount of silver nanoparticles, the amount of antibiotic needed to inhibit the bacteria decreased 22-fold, which tells us that the nanoparticles make the drug much more potent,” Czyż explained. “In addition, aminoglycosides can have negative side effects, so using silver nanoparticles could allow for a lower dose of antibiotic, reducing those side effects.”

The findings were both surprising and exciting, said Autumn Dove, first author of the study and a doctoral candidate studying microbiology and cell science in the UF/IFAS College of Agricultural and Life Sciences.

“When I first saw the result, my first thoughts were, ‘Wow, this works!’” said Dove.

Over the last several decades, overuse of antibiotics had led to the emergence of antibiotic-resistant bacteria and a decline in the effectiveness of traditional antibiotic drugs, the researchers said. The study’s findings indicate that silver nanoparticles have the potential to renew the effectiveness of some of these drugs.  

“Let’s say you get a bad burn on your hand, and it gets infected with one of these resistant strains of bacteria,” Dove said. “It’s possible that dressing that burn with a combination of silver nanoparticles and antibiotics could both clear that infection and prevent those resistant bacteria from spreading elsewhere.”

Though antibiotics mainly target bacteria, they can also damage human and animal cells. Using a microscopic worm called C. elegans, the researchers confirmed that the silver nanoparticles did not also make the antibiotic more toxic to non-bacterial cells.

Building off the study’s promising findings, the scientists next plan to seek FDA authorization for clinical trials and work with UF Innovate to patent an antimicrobial product that uses silver nanoparticles.

The silver nanoparticles used in the study were manufactured by the Natural Immunogenics Corporation, which helped fund the study through the UF Industry Partnerships Matching Grant Program. This program pairs UF researchers with Florida-based technology and energy companies to research and develop new products.

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JOURNAL

Frontiers in Microbiology

DOI

10.3389/fmicb.2022.1064095 

METHOD OF RESEARCH

Data/statistical analysis

ARTICLE TITLE

Silver nanoparticles enhance the efficacy of aminoglycosides against antibiotic-resistant bacteria

Smart stitches could reduce infection and simplify post op monitoring

A new antimicrobial suture material that glows in medical imaging could provide a promising alternative for mesh implants and internal stitches.

Peer-Reviewed Publication

RMIT UNIVERSITY

 

IMAGE: PROFESSOR ELISA HILL-YARDIN, DR SHADI HOUSHYAR AND PROFESSOR JUSTIN YEUNG INSPECT A PROTOTYPE OF THE IODINE-INFUSED FILAMENT. view more 

CREDIT: RMIT UNIVERSITY.

A new antimicrobial suture material that glows in medical imaging could provide a promising alternative for mesh implants and internal stitches.

Surgical site infections are one of the most common medical infections, occurring in 2 to 4% of patients post-surgery. For some procedures, such as vaginal mesh implants to treat prolapse, infection rates can be higher.

Study lead author and Vice Chancellor’s Senior Research Fellow, Dr Shadi Houshyar, said their suture was being developed in partnership with clinicians specifically for this type of procedure.

“Our smart surgical sutures can play an important role in preventing infection and monitoring patient recovery and the proof-of-concept material we’ve developed has several important properties that make it an exciting candidate for this,” said Houshyar, from the School of Engineering at RMIT University, Australia.

Lab tests on the surgical filament, published in OpenNano, showed it was easily visible in CT scans when threaded through samples of chicken meat, even after three weeks. It also showed strong antimicrobial properties, killing 99% of highly drug-resistant bacteria after six hours at body temperature.

Houshyar said the team was not aware of any commercially available suture products that combined these properties.

How they did it

The multidisciplinary team led by RMIT – included nano-engineering, biomedical and textile experts working in partnership with a practicing surgeon – used the university’s cutting-edge textile manufacturing facility to develop their proof-of-concept material.

The suture’s properties come from the combination of iodine and tiny nanoparticles, called carbon dots, throughout the material.

Carbon dots are inherently fluorescent, due to their particular wavelength, but they can also be tuned to various levels of luminosity that easily stand out from surrounding tissue in medical imaging.

Attaching iodine to these carbon dots, meanwhile, provides them with their strong antimicrobial properties and greater X-ray visibility.

Houshyar said carbon nano dots were safe, cheap and easy to produce in the lab from natural ingredients.

“They can be tailored to create biodegradable stitches or a permanent suture, or even to be adhesive on one side only, where required,” she said.

“This project opens up a lot of practical solutions for surgeons, which has been our aim from the start and the reason we have involved clinicians in the study.”

Clinical possibilities

Consultant colorectal surgeon and Professor of Surgery at the University of Melbourne, Justin Yeung, was involved in the study. He said it addressed a real challenge faced by surgeons in trying to identify the precise anatomical location of internal meshes on CT scans.

"This mesh will enable us to help with improved identification of the causes of symptoms, reduce the incidence of mesh infections and will help with precise preoperative planning, if there is a need to surgically remove this mesh,” he said.

“It has the potential to improve surgery outcomes and improve quality of life for a huge proportion of women, if used as vaginal mesh for example, by reducing the need for infected mesh removal.”

“It may also significantly reduce surgery duration and increase surgical accuracy in general through the ability to visualise mesh location accurately on preoperative imaging.” 

Next steps

Study co-author from RMIT’s School of Health and Biomedical Sciences, Professor Elisa Hill-Yardin, said the next steps were pre-clinical trials.

“While this research is at an early stage, we believe we are onto something very promising that could help a lot of people and are really keen to speak with industry partners who are interested in working with us to take it further,” she said.

“We see potential especially in vaginal mesh implants and similar procedures.”

The research team used Australia’s leading university-based textile manufacturing facilities at RMIT’s Centre for Materials Innovation and Future Fashion to produce the proof-of-concept material. They will soon be producing larger suture samples to use in pre-clinical trials, which they have just received seed funding for from RMIT.

‘Smart suture with iodine contrasting nanoparticles for computed tomography’ is published in OpenNano (DOI: 10.1016/j.onano.2022.100120).

The filament visible in chicken samples, as seen under CT scan.

A sample of the iodine-infused filament in the lab.

CREDIT

RMIT University

JOURNAL

OpenNano

DOI

10.1016/j.onano.2022.100120 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animal tissue samples

ARTICLE TITLE

Smart suture with iodine contrasting nanoparticles for computed tomography

Contributing to the utilization of big data! Developing new data learning methods for artificial intelligence

Proposed a method for continual learning of data and their labels in multi-label classification problems

Peer-Reviewed Publication

OSAKA METROPOLITAN UNIVERSITY

 

IMAGE: THE FIGURE SHOWS HOW NEW INFORMATION IS LEARNED EACH TIME A DATA DISTRIBUTION IS INPUT, WHILE RETAINING INFORMATION LEARNED IN THE PAST. view more 

CREDIT: NAOKI MASUYAMA, OSAKA METROPOLITAN UNIVERSITY

Advances in IoT technology have made it possible for us to easily and continually obtain large amounts of diverse data. Artificial intelligence technology is gaining attention as a tool to put this big data to use.

Conventional machine learning mainly deals with single-label classification problems, in which data and corresponding phenomena or objects (label information) are in a one-to-one relationship. However, in the real world, data and label information rarely have a one-to-one relationship. In recent years, therefore, attention has focused on the multi-label classification problem, which deals with data that has a one-to-many relationship between data and label information. For example, a single landscape photo may include multiple labels for elements such as sky, mountains, and clouds. In addition, to efficiently learn from big data that is obtained continually, the ability to learn over time without destroying things that were learned previously is also required.

A research group led by Associate Professor Naoki Masuyama and Professor Yusuke Nojima of the Osaka Metropolitan University Graduate School of Informatics, has developed a new method that combines classification performance for data with multiple labels, with the ability to continually learn with data. Numerical experiments on real-world multi-label datasets showed that the proposed method outperforms conventional methods.

The simplicity of this new algorithm makes it easy to devise an evolved version which can be integrated with other algorithms. Since the underlying clustering method groups data based on the similarity between data entries, it is expected to be a useful tool for continual big data preprocessing. In addition, the label information assigned to each cluster is learned continually, using a method based on Bayesian approach. By learning the data and learning the label information corresponding to the data separately and continually, so that both high classification performance and continual learning capability are achieved.

“We believe that our method is capable of continual learning from multi-label data and has capabilities required for artificial intelligence in a future big data society,” Professor Masuyama concluded.

The research results were published in IEEE Transactions on Pattern Analysis and Machine Intelligence on December 19, 2022.

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About OMU 

Osaka Metropolitan University is a new public university established by a merger between Osaka City University and Osaka Prefecture University in April 2022. For more science news, see https://www.omu.ac.jp/en/, and follow @OsakaMetUniv_en, or search #OMUScience. 

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JOURNAL

IEEE Transactions on Pattern Analysis and Machine Intelligence

DOI

10.1109/TPAMI.2022.3230414 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Multi-label Classification via Adaptive Resonance Theory-based Clustering