Opioids, methadone and babies

A Children’s Hospital Los Angeles study shows that methadone use following surgery in infants can increase hospital stay and delay recovery.

Peer-Reviewed Publication

CHILDREN'S HOSPITAL LOS ANGELES

 

IMAGE: LORRAINE KELLEY-QUON, MD, MSHS, CHILDREN'S HOSPITAL LOS ANGELES, IS LEADING A STUDY ON MINIMIZING OPIOID USE IN INFANTS. view more 

CREDIT: CHLA

LOS ANGELES (August 8, 2023) — Whatever the opioid crisis calls to mind, it likely isn’t pacifiers and diapers. But when 1 out of every 5 hospitalized infants receives opioids, and when some infants require methadone treatment, it’s time to widen the scope. A new study led by pediatric surgeons at Children’s Hospital Los Angeles shows that methadone use after surgery can prolong a baby’s recovery and increase an infant’s dependence on ventilators and intravenous (IV) nutrition. 

To call the opioid problem in the United States a crisis is not hyperbole. The rate of death due to opioid overdose has risen exponentially in the last 10 years, reaching 80,000 in 2021 alone. But the dangers of opioids are not limited to overdose. 

Opioids are highly addictive—and withdrawal can be severe. “It seems unbelievable, but the same thing happens to babies,” says Lorraine Kelley-Quon, MD, MSHS, a pediatric surgeon at CHLA. “If you abruptly stop opioids in babies, they can show signs of withdrawal—irritability, intestinal problems or even seizures.” For this reason, babies receiving a prolonged course of opioids may need to be weaned off of them with methadone, a longer-acting, weaker opioid. 

In her latest study, published in JAMA Network Open, Dr. Kelley-Quon examined how methadone use impacted recovery in infants. The study included over 2,000 babies from 48 children’s hospitals who were surgically treated for necrotizing enterocolitis (NEC), a life-threatening inflammatory condition that can develop in premature newborns. While rare, NEC is the most common reason for emergency surgery in newborn babies. 

The findings: Babies who required methadone needed to stay in the hospital an average of 21 days longer after surgery. They also required more days on the ventilator and longer reliance on IV nutrition. 

“It ends up being a snowball effect,” she says. “The longer a baby is on opioids, the more likely the need for methadone, which is still an opioid.” Side effects of opioids are respiratory depression and decreased intestinal motility. 

So why are opioids given to babies in the first place? The answer is simple: babies in the hospital may need surgery or painful interventions, and opioids are effective at treating their pain. However, babies can’t take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for pain, like older children can. “Nobody wants a baby to be in pain,” says Dr. Kelley-Quon. “We don’t want to stop using opioids, especially when a baby is undergoing an operation. What we do want is to understand the impact of opioids and use them more judiciously.” 

More judicious use of opioids doesn’t just mean limiting prescriptions. It also means standardizing opioid use. "We found such a wide range in what hospitals were doing,” she says. “In some hospitals, over 40% of infants received methadone. In other hospitals, methadone isn’t used at all.” This wide variability points to the need to standardize opioid and methadone use among hospitals.  

Dr. Kelley-Quon has spent the last several years uncovering how widespread the impact of the opioid epidemic fallout has become for children. A few years ago, she established the first evidence-based guidelines for safer pain management in children and adolescents. Her work continues to uncover the need for what she calls “opioid stewardship.”  

Other authors on the study include first author Olivia A. Keane, MD; Abigail K. Zamora, MD; Shadassa Ourshalimian, MPH; Elaa M. Mahdi, MD, MPH; Ashley Y. Song, MPH, PhD; Eugene Kim, MD and Ashwini Lakshmanan, MD, MPH. 

The study was supported by grant KL2TR001854 from the National Center for Advancing Translational Science (NCATS) and grant R01HD105656 from the National Institute of Child Health and Human Development of the National Institutes of Health (NIH). 

About Children’s Hospital Los Angeles  

Children’s Hospital Los Angeles is at the forefront of pediatric medicine, offering acclaimed care to children from across the world, the country and the greater Southern California region. Founded in 1901, Children’s Hospital Los Angeles is the largest provider of care for children in Los Angeles County and the No. 1 pediatric hospital in California and the Pacific region, and is consistently ranked in the top 10 in the nation on U.S. News & World Report’s Honor Roll of Best Children’s Hospitals. Clinical expertise spans the pediatric care continuum from newborns to young adults, from everyday preventive medicine to the most medically complex cases. Inclusive, compassionate, child- and family-friendly clinical care is led by physicians who are faculty members of the Keck School of Medicine of USC. Physicians translate the new discoveries, treatments and cures proven through the work of scientists in The Saban Research Institute of Children’s Hospital Los Angeles—among the top 10 children’s hospitals for National Institutes of Health funding—to bring answers to families faster. The hospital also is home to one of the largest training programs for pediatricians in the United States. To learn more, follow us on Facebook, Instagram, LinkedIn, YouTube and Twitter, and visit our blog at CHLA.org/blog. 

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JOURNAL

JAMA Network Open

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Opioid and Methadone Use for Infants With Surgically Treated Necrotizing Enterocolitis

What makes individuals fall through the safety nets during disasters?

Peer-Reviewed Publication

ESTONIAN RESEARCH COUNCIL

The International Journal of Disaster Risk Reduction, a flagship journal of crisis sociology, has published a special issue that brings together the latest insights into why people's lives, health or property suffer in crises, despite the best efforts of individuals, communities or authorities. The special issue was initiated and edited by Kati Orru, Associate Professor of Sociology of Sustainability at the University of Tartu (Estonia) and Tor-Olav Nævestad from the Institute of Transport Economics (Norway).

Barely recovered from the effects of the pandemic and still in the grip of war aggression, Europe and the world are shaken by heat waves, forest fires and floods. The ongoing poly-crisis is accompanied by instability in the natural environment, the economy and geopolitics, highlighting more than ever the structural inequalities and disadvantages that hinder the adaptation of societies to exceptional circumstances. To understand why thousands of individuals still suffer and so many have perished in these crises, crisis sociologists Kati Orru from the University of Tartu and Tor-Olav Nævestad from the Institute of Transport Economics (Norway) called for a special issue. The journal brings together knowledge gathered from recent pan-European research projects on how social vulnerability is defined and whether and how vulnerability can be prevented or mitigated.

According to Kati Orru, crisis research often focuses on the functioning of the institutions solving the crises and the resilience of the infrastructure. At the same time, the root causes of social vulnerability get little attention. However, understanding them is crucial to increase crisis preparedness and support the coping of those groups in society most likely to find themselves in a vulnerable situation.

One of the key questions in this special issue is who is vulnerable in a crisis. It discusses whether vulnerability is static and depends on a person's characteristics (e.g. age) or socioeconomic coping (e.g. poverty) or whether it is dynamic and anyone can become vulnerable. Among other topics, the journal focuses on people living in extreme poverty and explains that economic hardship is often not the main determinant of coping with crises. In addition to an individual's characteristics and abilities, reasons for poor coping should be sought, for example, in the limited availability of their personal or formal support network. Crisis-time measures themselves may also create or aggravate vulnerabilities.

"Crisis-time measures should be thoroughly analysed to avoid exacerbating exclusion and inequalities and to ensure access to the information, support networks and economic resources needed to cope in crises," explained Orru. The special issue offers valuable food for thought not only for researchers but also for policymakers in the field and crisis managers in municipalities and other responsible authorities.

The special issue examines the mechanisms of crisis vulnerability in European crisis management systems through examples of a variety of crises (e.g. COVID-19 pandemic, floods, earthquakes, residential fire). The articles draw on the results of European Commission Horizon 2020 research projects BuildERS (Building European Communities' Resilience and Social Capital), LINKS (Strengthening links between technologies and society for European disaster resilience) and HERoS (Health Emergency Response in Interconnected Systems).

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JOURNAL

International Journal of Disaster Risk Reduction

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

How to build healthier communities — and people

New guidelines show how changes to our built environment can help Canadians get more active, eat better and stay socially connected.

UNIVERSITY OF ALBERTA

 

IMAGE: TELFORD MEWS MIXED-INCOME HOUSING IN LEDUC, ALTA., IS ONE OF THREE PILOT DEVELOPMENTS DESIGNED TO BRING CANADA'S NEW HEALTHY COMMUNITY GUIDELINES TO LIFE. view more 

CREDIT: FAITH KAMPEN, HOUSING FOR HEALTH

Telford Mews, a mixed-income housing development in Leduc, Alta., is pioneering healthier retirement living by adopting Canada's newly released Healthy Community Guidelines. Developed by the University of Alberta's Housing for Health initiative with funding from the Public Health Agency of Canada, these guidelines promote physical activity, healthy eating, and social connections through thoughtful building and neighbourhood environment changes.

Residents of Telford Mews experience a welcoming stairwell flooded with natural light and a sign reminding them to use the stairs for better well-being. The building's restaurant offers healthier breakfast and lunch options, such as coconut mango chia bowls and vanilla blueberry oatmeal, alongside standard menu choices. A move-in package includes a map to nearby healthy amenities, encouraging walking access to essential services like a grocery store.

Designed as one of three pilot projects, Telford Mews showcases how building and site design, along with neighbourhood amenities, can align with the new Healthy Community Guidelines to support healthier lifestyles among residents. These guidelines resulted from extensive consultation and collaboration over nearly three years, engaging over 100 partners, including urban planners, architects, developers, health professionals and community leaders.

"Our strategies to promote healthy living encompass a wide range of approaches that can be implemented at minimal to no extra cost," explains Karen Lee, director of Housing for Health and an associate professor in the Division of Preventive Medicine at the U of A. "From incorporating healthy amenities in and around housing, to using art and coloured paint to entice people into spaces we want them to use, like the stairs, and wayfinding signage for healthy amenities, these changes can have a significant impact on public health."

Evidence suggests that even simple changes to our building and neighbourhood environments can have substantial effects on public health. Non-communicable illnesses, like heart disease, stroke, cancer, diabetes, and chronic lung diseases, are now the leading causes of death in Canada and globally, as reported by the World Health Organization.

Informed by experiences from New York City, where similar multi-sector collaborations led to positive health outcomes, the Canadian guidelines aim to support various partners, including municipalities, builders, public health advocates, and communities, in planning, designing, building, and maintaining healthier living spaces. The focus on physical activity, healthy eating, and social connections helps combat key risk factors for health issues.

The guidelines emphasize improving housing designs and housing proximity to healthy retail businesses to promote walking and access for those who can't drive, like seniors. Additionally, they provide recommendations for better signage, sidewalks, and transit access, even in rural and smaller communities.

Besides Leduc, other pilot projects in Alberta include an affordable housing development for seniors in Edmonton and a seniors’ complex in Whitecourt that includes independent living, supportive living and dementia care.

 

Sustainable Cocoa Innovation Challenge for Colombia: Supporting innovation in the cocoa value chain to foster climate change mitigation and peacebuilding

Grant and Award Announcement

THE ALLIANCE OF BIOVERSITY INTERNATIONAL AND THE INTERNATIONAL CENTER FOR TROPICAL AGRICULTURE

 

IMAGE: SUPPORTING INNOVATION IN THE COCOA VALUE CHAIN FOR FOREST CONSERVATION AND PEACEBUILDING view more 

CREDIT: A4IP/ALLIANCE OF BIOVERSITY AND CIAT/ROCKSTART

Bogotá, 04 August 2023. The Sustainable Cocoa Innovation Challenge for Colombia has been launched as the result of the joint effort between CGIAR research initiatives AgriLAC Resiliente and Mitigate+ and the project “Implementing Sustainable Agricultural and Livestock Systems for Simultaneous Targeting of Forest Conservation for Climate Change Mitigation (REDD+) and Peacebuilding in Colombia,” otherwise known as the IKI-SLUS Project.

The CGIAR Accelerate for Impact Platform and Rockstart power this innovation challenge with the aim of providing know-how and network to entrepreneurs in Latin America who are working to ensure the cocoa industry contributes to climate change mitigation and peacebuilding.

Are you an innovator working on a solution that is applicable to the cocoa value chain in Colombia?

Click here to apply. Applications are open until 31 August 2023.

The business opportunity is enormous, with Colombia being one of the top ten cocoa-producing nations, yielding over 69,000 tons of cocoa beans in 2021 alone. The local demand is robust given the fundamental role of cocoa as a staple food domestically. This presents an opportunity for entrepreneurs, business leaders, and innovators to contribute to the development of this industry and embrace sustainable practices, such as agroforestry, which combines cocoa production with tree planting to increase biodiversity, protect soil from erosion, and provide natural shade.

"For us at Rockstart, there are three industries of utmost importance: technology, energy, and agriculture. We believe that in these three industries, there is a tremendous opportunity to transform and solve current societal problems. That's why, after working with hundreds of entrepreneurs in Latin America and various industries, we see a great opportunity in the agriculture sector, specifically in Cocoa," states Felipe Santamaria, Managing Director of Rockstart Latam.

The Sustainable Cocoa Innovation Challenge for Colombia is seeking cutting-edge solutions to address priority areas within the cocoa industry. These areas include promoting sustainable and ethical sourcing of cocoa, ensuring transparency and traceability in cocoa bean processing, fostering sustainable farming practices, adding value to cocoa products through innovative processing, improving market access, and empowering cocoa farmers.

"We know that innovations are out there to lower greenhouse gas emissions. What we want is to scale innovations for climate change mitigation that can also drive an increase in incomes and foster peace, which in the case of the Sustainable Cocoa Innovation Challenge, would be along the cocoa value chain in Colombia. Our experience under the Sustainable Land Use Project suggests to us that if we can scale such innovations, we can help Colombia become an active player in markets that demand sustainable commodities and meet its sustainable development commitments," says Augusto Castro, senior scientist and leader of the low-emission food systems research theme at the Alliance of Bioversity International and CIAT and leader of the IKI-SLUS Project in Colombia.

Example solutions include supply chain technologies, food processing and packaging innovations, new sales channels such as online trading platforms, efficient irrigation technologies, fertilizer management practices, circular economy and waste management solutions, farm management software, advisory services, water management, small-scale irrigation systems, and education tech platforms.

Eligible applicants should have a minimum viable product or proof of concept, verified commercial value, and evidence of user or customer validation. The business model must include an inclusive strategy for smallholder farmers, women, and youth. The innovative solutions should primarily benefit small-scale farmers, food processing companies, small and medium-sized enterprises, consumers, youth, and/or women. Ventures should be for-profit or social enterprises, locally rooted in Colombia, and demonstrate commercial viability or a clear path to profitability. NGOs, large corporations, and consultants are not eligible. Additionally, applicants should exhibit a diverse, non-discriminatory, gender-balanced culture.

The Sustainable Cocoa Innovation Challenge offers selected applicants an array of valuable resources and connections, including access to SLUS project documents, a fully sponsored acceleration program combining business training and technical assistance, on-the-ground experimentation and pilot testing in Colombia, support in grant raising and sales pitch preparation, an equity-free grant of up to $15,000 each for two sustainable winners with scaling plans, networking and technical assistance from CGIAR scientists and industry partners, mentorship from local Colombian entrepreneurs, exposure to potential investors, and support to accelerate go-to-market and growth.

“CGIAR's Accelerate for Impact Platform leads the way in forging innovative partnership models, mainstreaming evidence-based solutions through market mechanisms, and nurturing the next generation of entrepreneurs. The Sustainable Cocoa Innovation Challenge is the result of a concerted effort among diverse partners, unified by a shared vision to create meaningful synergies for a greater impact along the cocoa value chain”, says Gianpiero Menza, Senior Manager at the Alliance of Bioversity International and CIAT.

Apply now to be part of this transformative journey. The deadline for applications is 31 August 2023 at 23:59 CET.

For more information visit https://colombia.agritechchallenge.org

For inquiries, contact info@agritechchallenge.org or m.vanegas@cgiar.org

A path to defeating crop-killing gray mold without toxic chemicals

Study reveals how fungus delivers RNA weaponry

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - RIVERSIDE

 

IMAGE: GRAY MOLD GROWING ON PRODUCE. view more 

CREDIT: HAILING JIN/UCR

It’s a mold that causes billions in crop losses every year, infecting berries, tomatoes and most other fruits and vegetables. Now, researchers have found a way to defeat the mold without showering toxic chemicals on the crops. 

If you’ve ever seen a fuzzy gray strawberry, you’ve seen gray mold. It affects more than 1,400 different plant species, and there is no real cure for it. Being able to control it may hinge on the discovery of lipid “bubbles” secreted by the mold cells, which some researchers previously dismissed as insignificant. 

In fact, new UC Riverside research shows these bubbles are essential for communications between pathogens and their hosts, including many types of fungi, as well as bacteria and mammals. In this case, the researchers found that gray mold has learned how to use the bubbles to achieve successful infections.  

“Because they are hard to isolate and study, the important functions of these lipid bubbles, also called extracellular vesicles, have been overlooked for decades,” said Hailing Jin, UCR professor of microbiology and plant pathology, who led the research project. 

“Now we know the mold, just like its plant hosts, also uses extracellular vesicles to protect and deliver what amount to weapons — small RNA molecules that silence genes involved in plants’ immune systems,” Jin said.

This finding is detailed in the journal Nature Communications, where the researchers not only show that gray mold secretes virulent RNA in these lipid-based bubbles, but that a particular protein is key to the mold’s ability to produce the bubbles. 

The protein, tetraspanin, appears on the surface of the bubbles. The researchers found that if they eliminated the mold’s ability to make tetraspanin, the mold’s ability to secrete and deliver the bubbles was largely reduced. 

“If we knock out this key component of the vesicles, we can attenuate their ability to deliver the weapons of small RNAs or other molecules that suppress host immunity,” Jin said. 

Previously, the same research team also identified genes that allow the fungus to produce small RNA molecules. Knocking out those genes, as well as the ones that allow the fungus to make tetraspanin, would enable a new generation of “RNA fungicides” that inhibit grey mold disease.

“Everything has RNA in it, and it is easily digested by humans and animals. RNA can be degraded quickly in the environment and wouldn’t leave any toxic residues,” Jin said. Currently the main treatments for gray mold are fungicides and these chemicals can negatively impact human and animal health and our environment.”

Gray mold is the second most damaging fungus for food crops in the world, preceded only by the rice pathogen Magnaporthe. An eco-friendly fungicide based on RNA, and which attacks the ability to secrete extracellular vesicles may also be effective against Magnaporthe, and other fungal pathogens.

“With the climate changing so fast, many fungal infections can get worse. We are excited to develop new eco-friendly methods of protecting the global food supply that may be so widely applicable,” Jin said. 

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JOURNAL

Nature Communications

DOI

10.1038/s41467-023-40093-4 

ARTICLE TITLE

Fungal small RNAs ride in extracellular vesicles to enter plant cells through clathrin-mediated endocytosis

 

Experimental constraints on the viscosity of the Earth’s inner core

Rheology of hexagonal close-packed iron determined by high-pressure and high temperature deformation experiments

Peer-Reviewed Publication

EHIME UNIVERSITY

 

IMAGE: X-RAY RADIOGRAPHIC IMAGES BEFORE AND DURING DEFORMATION EXPERIMENTS OF HCP-IRON AT 16.5-17.5 GPA AND 823-873 K. THE SAMPLE STRAIN DURING DEFORMATION WAS DETERMINED FROM THESE RADIOGRAPHS. view more 

CREDIT: YU NISHIHARA, EHIME UNIVERSITY

Although many geodynamical mechanisms have been proposed regarding the origin of the observed complex structure of Earth’s inner core, no clear consensus has been reached. This is partly owing to the lack of accurate knowledge of the viscosity in the inner core. It has been discussed that the dominant mechanism of inner core dynamics depends on the inner core age and viscosity, and there are several candidate mechanisms including the equatorial inner core growth and plume convection models. Since the inner core is considered to consist of hexagonal close-packed iron (hcp-iron), information of the viscosity of hcp-iron is a key to understanding the inner core dynamics. In this study, we studied the rheology of hcp-iron based on high-pressure and high-temperature deformation experiments.

Uniaxial deformation experiments were carried out using a D111-type apparatus installed on a beamline NE7A at PF-AR, KEK, and a deformation-DIA apparatus installed on a beamline BL04B1 at SPring-8. Using a pre-sintered iron rod as a starting material, deformation experiments were carried out at pressures of 16.9-22.6 GPa and temperatures of 423-873 K where hcp-iron stably exists. The stress and strain of the sample during deformation were determined based on two-dimensional X-ray diffraction and X-radiography, respectively, using a monochromatized synchrotron X-ray.

The results showed that the dominant deformation mechanism in hcp-iron changes depending on the temperature, with power-law dislocation creep and low-temperature creep being most important above and below ~800 K, respectively. Based on extrapolation of these experimental results we estimate the inner core viscosity to be ≥ 1019 Pa s,suggesting that the equatorial growth or translation mode model is the dominant geodynamical mechanism in the Earth’s inner core.

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JOURNAL

Journal of Geophysical Research Solid Earth

DOI

10.1029/2022JB026165 

Disclaimer: AAAS and EurekAlert! are n

TRADITIONAL EAST INDIAN MEDICINE 

Lead poisoning from Ayurvedic medicines: rare but cautionary

Peer-Reviewed Publication

CANADIAN MEDICAL ASSOCIATION JOURNAL

An article in CMAJ (Canadian Medical Association Journal) highlights a case of lead toxicity from Ayurvedic medicines in a young woman, and the complexity in diagnosing the rare condition https://www.cmaj.ca/lookup/doi/10.1503/cmaj.230592.

"Given that lead toxicity is uncommon and its presentation nonspecific, patients are often seen by many health care providers before the diagnosis is made," writes Dr. Julian Gitelman, Dalla Lana School of Public Health, University of Toronto, with coauthors. "A careful exposure history is essential to suggest the diagnosis."

The patient, a 39-year-old woman, visited the emergency department 3 times in 6 weeks for abdominal pain, constipation, nausea and vomiting. On her third visit, she was admitted to hospital for anemia and possible gastrointestinal bleeding. Numerous, invasive investigations failed to reveal a cause of her symptoms. At a follow-up visit weeks later, she reported having taken Ayurvedic medicines daily for more than a year to treat infertility. Her blood lead level was high at 55 µg/dL, compared with a normal level of less than 2 µg/dL. The patient stopped taking the Ayurvedic treatments and began chelation therapy. Her blood lead level decreased and her symptoms resolved.

Once the diagnosis of lead toxicity was made, the medical team contacted Public Health Ontario (PHO), which tested 17 different pill samples provided by the patient. After testing revealed high levels of lead in most of the pills, PHO involved the local public health unit, Toronto Public Health, and Health Canada, as it regulates natural health products. A joint investigation of the Ayurvedic clinic resulted in the seizure of hundreds of pills due to noncompliance with the Natural Health Products Regulations. Both Health Canada and Toronto Public Health issued public advisories to warn people that the products from this specific business were health hazards. 

The authors emphasize the importance of communication and collaboration between clinicians and public health to minimize the health risk of lead in consumer products. "A recent systematic review of case reports on lead poisoning found traditional or herbal ­medications to be a common cause." the authors write. "Heavy metals are sometimes intentionally added for their perceived healing properties."

"When consumer products may be contaminated with lead, or when lead exposure is linked to sources in the community, involving public health can facilitate broader actions to reduce and prevent exposures to other people at risk," they conclude.

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JOURNAL

Canadian Medical Association Journal

DOI

10.1503/cmaj.230592 

METHOD OF RESEARCH

Case study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Lead toxicity from Ayurvedic medicines

ARTICLE PUBLICATION DATE

8-Aug-2023

 

New model reduces bias and enhances trust in AI decision-making and knowledge organization

Researchers aim to bridge the gap between AI technology and human understanding

Peer-Reviewed Publication

UNIVERSITY OF WATERLOO

University of Waterloo researchers have developed a new explainable artificial intelligence (AI) model to reduce bias and enhance trust and accuracy in machine learning-generated decision-making and knowledge organization. 

Traditional machine learning models often yield biased results, favouring groups with large populations or being influenced by unknown factors, and take extensive effort to identify from instances containing patterns and sub-patterns coming from different classes or primary sources. 

The medical field is one area where there are severe implications for biased machine learning results. Hospital staff and medical professionals rely on datasets containing thousands of medical records and complex computer algorithms to make critical decisions about patient care. Machine learning is used to sort the data, which saves time. However, specific patient groups with rare symptomatic patterns may go undetected, and mislabeled patients and anomalies could impact diagnostic outcomes. This inherent bias and pattern entanglement leads to misdiagnoses and inequitable healthcare outcomes for specific patient groups.

Thanks to new research led by Dr. Andrew Wong, a distinguished professor emeritus of systems design engineering at Waterloo, an innovative model aims to eliminate these barriers by untangling complex patterns from data to relate them to specific underlying causes unaffected by anomalies and mislabeled instances. It can enhance trust and reliability in Explainable Artificial Intelligence (XAI.)

“This research represents a significant contribution to the field of XAI,” Wong said. “While analyzing a vast amount of protein binding data from X-ray crystallography, my team revealed the statistics of the physicochemical amino acid interacting patterns which were masked and mixed at the data level due to the entanglement of multiple factors present in the binding environment. That was the first time we showed entangled statistics can be disentangled to give a correct picture of the deep knowledge missed at the data level with scientific evidence.” 

This revelation led Wong and his team to develop the new XAI model called Pattern Discovery and Disentanglement (PDD).

“With PDD, we aim to bridge the gap between AI technology and human understanding to help enable trustworthy decision-making and unlock deeper knowledge from complex data sources,” said Dr. Peiyuan Zhou, the lead researcher on Wong’s team. 

Professor Annie Lee, a co-author and collaborator from the University of Toronto, specializing in Natural Language Processing, foresees the immense value of PDD contribution to clinical decision-making.  

The PDD model has revolutionized pattern discovery. Various case studies have showcased PDD, demonstrating an ability to predict patients’ medical results based on their clinical records. The PDD system can also discover new and rare patterns in datasets. This allows researchers and practitioners alike to detect mislabels or anomalies in machine learning. 

The result shows that healthcare professionals can make more reliable diagnoses supported by rigorous statistics and explainable patterns for better treatment recommendations for various diseases at different stages.

The study, Theory and rationale of interpretable all-in-one pattern discovery and disentanglement system, appears in the journal npj Digital Medicine.

The recent award of an NSER Idea-to-Innovation Grant of $125 K on PDD indicates its industrial recognition. PDD is commercialized via Waterloo Commercialization Office.   

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JOURNAL

Digital Medicine

Dentists could soon have a new AI co-pilot to detect tooth decay

Grant and Award Announcement

UNIVERSITY OF SURREY

An artificial intelligence (AI) platform could allow dentists and dental students to read radiograms (X-rays) with higher accuracy, helping them to better detect tooth decay and gum diseases. 

The platform, led by the University of Surrey, in partnership with King's College London, Royal Surrey NHS Foundation Trust, and Oral Health Foundation, allows an AI model to recognise abnormalities in anatomical structures.  

This project aims to provide a one-stop solution for collecting and annotating dental radiographs and assisting with disease diagnosis while building on how best to implement this in a clinical setting. 

The venture has received £1.55 million in grant funding from the National Institute for Health and Care Research (NIHR). 

Dr Yunpeng Li, Senior lecturer in Artificial Intelligence and the project lead at the University of Surrey, commented:  

"The technology could save valuable time and money if rolled out more widely, enabling dentists to have abnormalities pop up in front of them and read radiograms with higher accuracy.  

"This next phase of the project is incredibly exciting as we work collaboratively to build a working prototype suitable for real-life clinical settings. Efforts so far have included gathering a representative set of annotated radiograms and training a custom-built AI model on dental disease detection. We look forward to comprehensive outcomes over the next few years."  

Professor Owen Addison, Professor of Oral Rehabilitation and the joint project lead at King's College London, said: 

"AI systems that support more accurate diagnosis and clinical decision-making will help patients, but they must be trustworthy. We look forward to supporting this project by providing dental expertise and consideration of the needs of end-users." 

The University of Surrey is a research-intensive university, producing world-leading research and delivering excellent innovation in teaching to transform lives and change the world for the better. The University brings together research and teaching excellence in animal and human health under a One Health, One Medicine approach, to protect and enhance the mutual welfare of humans, other animals and the planet we share. This approach is focused on the quest for better health outcomes for all, exploring the links between human, animal and plant health to find solutions to grand challenges such as ageing, climate change, malnutrition, obesity, zoonotic diseases and cancer.  

### 

Notes to Editor 

• Project leads Dr Yunpeng Li (University of Surrey (UoS) and Owen Addison (Kings College London). Other collaborators include: Mark Halling-Brown (Royal Surrey NHS Foundation Trust), Nigel Carter (Oral Health Foundation), Philip Evans (UoS), Samaneh Kouchaki (UoS), Simon Skene (UoS), Matthew Glover (UoS), and Heather Gage (UoS).  

• Project collaborators: Guy's and St. Thomas NHS Foundation Trust, Guildford Dental Academy, JM Radiology. 

• The team acknowledges the funding support from National Institute for Health and Care Research (NIHR), the Engineering & Physical Sciences Research Council (EPSRC) Impact Acceleration Account (IAA), Higher Education Innovation Funds (HEIF), University Global Partnership Network (UGPN), Public Engagement with STEM Research Seed Fund (PER-STEM), and Royal Academy of Engineering.  

• The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: Funding high-quality, timely research that benefits the NHS, public health and social care; Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services; Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research; Attracting, training and supporting the best researchers to tackle complex health and social care challenges; Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system; Funding applied global health research and training to meet the needs of the poorest people in low and middle-income countries. 

• Oral Health Foundation is a charity with a mission of improving oral health for all not only in the UK but globally.  In the 50 years since the Foundation was formed, oral health has improved dental disease is still the number one non-communicable disease worldwide, affecting more than 3.5 billion people worldwide.  AI to improve diagnosis will have a key role in combatting this massive burden of disease.  We look forward to leading the patient involvement with this initiative.   

 

AI designs sustainable electricity storage at Graz University of Technology

Based on the vanillin made usable for electricity storage in 2020, an AI-optimised prototype of an environmentally friendly electricity storage system is now being developed in an international project

Business Announcement

GRAZ UNIVERSITY OF TECHNOLOGY

 

IMAGE: AN ENVIRONMENTALLY FRIENDLY AND EFFICIENT ELECTRICITY STORAGE SYSTEM BASED ON THE STORAGE MEDIUM VANILLIN IS BEING DEVELOPED. view more 

CREDIT: LUNGHAMMER - TU GRAZ

In 2020, Stefan Spirk from the Institute of Bioproducts and Paper Technology at Graz University of Technology (TU Graz) described the research achievement with which he and his team had succeeded as a “ground-breaking success in the field of sustainable energy storage technologies” to make redox flow batteries more environmentally friendly. They had replaced redox-active components of batteries with conventional vanillin, which meant that critical or environmentally harmful raw materials were no longer needed.

But the new storage medium alone was not enough. Meanwhile, Stefan Spirk is working to design a vanillin electricity storage system that is as sustainable as possible in its overall composition and yet efficient. Areas of application for the fully developed storage unit are primarily the industrial sector and the storage of electricity surpluses from renewable energies. Part of the research project called VanillaFlow are other institutes at TU Graz, Stefan Spirk’s Science Park Graz-based start-up Ecolyte and numerous other project partners.

The project is being funded within the EIC Pathfinder Challenge of the European Research Council and is therefore part of the EU Horizon programme, which is funding research and innovation. The Pathfinder Challenge aims to support the exploration of bold ideas for radically new technologies.

Optimisation of all components and processes

In the VanillaFlow project all components and processes of the storage unit are to be optimised: in addition to vanillin compounds as the storage medium, the membrane, the electrode and the control system. Among other things used for this are the possibilities of Artificial Intelligence and Machine Learning. This allows predictions for models of promising vanillin compounds to be made in a much shorter time than before. The most promising models are then also developed and tested in the laboratory to ultimately find the ideal composition for the storage fluid.

In the case of the membrane and the electrode, the primary aim is to replace the less environmentally friendly materials previously used for this purpose in battery storage systems with sustainable materials as well. For membranes, the Teflon modification Nafion has been used so far. By now, a paper-based membrane has been created, which is constantly being further developed. The patent for this has already been applied for. For the electrode, the project team relies on a carbon felt that offers less resistance through compression and also develops fewer deposits. New coatings and treatments are intended to achieve even better performance here.

Preliminary fine-tuning on digital twin

In order not to have to produce all iterations of the storage medium, membrane and electrode in advance, the project team also resorts to digital support here. By means of a digital twin, the individual components and their interaction can be virtually tested and checked in advance. At the same time, the control system of the storage unit is also being further developed in order to optimise its operation. An underlying artificial intelligence links these virtual results with the VanillaFlow project data. In addition, a techno-economic and ecological review is being conducted to ensure that the storage system is not toxic and complies with current legislation. After all, the finished product should be safe for people and the environment.

As soon as a first prototype of this AI co-designed storage system is ready, it is planned to integrate it into the TU Graz network. The maximum storage performance is intended to be at 10 kW. For future users, however, the performance is scalable according to demand. “When we harnessed vanillin for use in redox flow batteries about three years ago, it was clear to us that this was just the beginning on the road to environmentally friendly and efficient electricity storage for users in industry and power generation,” says Stefan Spirk. “By using AI to design, test and ultimately manufacture a sustainable electricity storage system from A to Z based on this storage medium, we are taking the next important step. Once we have fully developed a storage system without harmful materials, without rare raw materials, but with high efficiency and safety for people and the environment, this is an important piece of the puzzle for the further decarbonisation of the energy system and industry.”

The VanillaFlow Team

The VanillaFlow project is led at TU Graz by Ulrich Hirn, head of the Institute of Bioproducts and Paper Technology. Together with TU Darmstadt, he also supports the Ecolyte team in improving the paper based, proton-conductive membranes. The know-how in the area of Machine Learning is provided by the TU Graz computer scientists Roman Kern from the Institute of Interactive Systems and Data Science and Robert Peharz from the Institute of Theoretical Computer Science. Research into sustainable synthesis methods for vanillin compounds at the Institute of Molecular Biotechnology at TU Graz is being led by Harald Pichler and the carbon felt for the electrode is in further development with Ecolyte and Montanuniversität Leoben. A team surrounding Günter Getzinger, head of the Science, Technology and Society Unit at TU Graz, and the Spanish company Biobide are in charge of the techno-economic and ecological review.

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METHOD OF RESEARCH

Computational simulation/modeling

Stefan Spirk from the Institute of Bioproducts and Paper Technology at TU Graz.

CREDIT

Lunghammer - TU Graz