Monthly Archives: December 2023

Neuroscience

Navigating the neuroscientific landscape with Dr Judy Illes – Drug Target Review

In a world grappling with the growing spectre of eco-anxiety and the pressing challenges posed by climate change, Dr Judy Illes, a distinguished figure in the field of neuroscience, sheds light on the role neuroscientists play in contributing to the discourse on environmental issues and their profound impact on individual and collective well-being. In this interview, Judy emphasises the need for evidence-based neuroscience to address the mental health implications of environmental changes, urging a departure from geographical silos to foster global collaboration. The discussion extends to strategies for disseminating neuroscientific research across diverse cultural landscapes and the practical implications of bridging the gap between research and public awareness.

I dont think it is a question of neuroscientists having to shoulder the responsibility of responding to and addressing questions of eco-anxiety, climate change, and environmental change, but rather a matter of upping the interest in this space and delivering more evidence through great research. We need more good neuroscience discovery and meaningful clinical translation to address the issues that were seeing and that are being debated. On the mental health side, there is anxiety around climate change Eco-Anxiety. On the neurologic side, there are findings about neurotoxins and environmental contaminants showing correlations with a variety of neurologic diseases across the lifespan from children to adults. Good study design, solid evidence, and good information dissemination with explicit evidence-based mitigation of misinformation will really contribute to climate change and environmental decision-making, policymaking, and improvements in brain-related health systems and care.

That is such an important question and it speaks directly to the global movement in neuroscience today. Global neuroscience cross-national, cross-geographic collaboration is so important to bring the kind of evidence about which I spoke in response to your first question. There is no point in addressing climate change, environmental change, contaminants from neurotoxins and so on in geographic silos. These affect all people across all nations. We have so much to learn from each other. We have different perspectives, different languages, and potentially different belief systems. When we combine these into an integrated, concerted collaborative program, we will be able to advance the kind of neuroscience that I hope that my lecture at the Society for Neuroscience inspired and also help to propel forward the work of the International Brain Initiative whose headquarters reside with me now in Canada. This is precisely what were trying to achieve: geopolitically conscious, border-free global cooperation in neuroscience.

This question is a good segue from the previous one. Thank you. First, let me say that I am a person of European background and I have had the privilege and the honour of working with indigenous peoples across Canada to learn about indigenous ways of knowing, of knowledge, of methods. My team has done empirical work through systematic literature reviews, scoping reviews, and a variety of research collaborations with indigenous Canadian people. I am also currently working around questions about portable MRI, for example, with colleagues across the USA, led by the University of Minnesota, to understand the important relationships and ethical considerations that come into play when were talking about work, research, and clinical translation that has to do with expanded access to MRI scanning with people from multiple cultures, and many who are in rural and remote regions of North America and the world.

With that preamble, to respond, I respectfully refer to Elder Albert Marshall and to what he called two-eyed seeing, which is a powerful way to bring together traditional belief systems, rooted in the medicine wheel, holism, relationships with the land and the earth, sky, water, air and fire, with biomedical explanations of mental health and neurologic disease. On the neuroscience side, we think about cells to systems: genes, brain development, demyelination, degeneration. It is equally meaningful to integrate this thinking with learnings and knowledge that preceded our understanding about genes and neuroanatomy and neurophysiology. In the past, we to dismissed traditional forms of belief systems. Today, we are seeing through the work of people in neuroscience, health sciences, ethics and law, anthropology and sociology that coupling the two can really bring wellness to an understanding of some of the major burdens of brain and mental health that affect people and societies today.

Again, a wonderful question, Taylor. So there are innumerable strategies. I will only mention three that immediately come to mind.

The first is about data and evidence. Evidence, good science, and design that takes into account not only Western approaches but approaches from different people of different backgrounds and ways of knowing and doing that might date back to time immemorial. That is number one: data, and irrefutable evidence that are respectful of all methods of doing.

The second is working collaboratively in a very engaged way with people of different cultures and different geographies, whether they are Elders from communities or whether they are neuroscientists from different communities and geographic locations. In this way, the maximum breadth and potential of neuroscience discovery will be realised.

The third is collaboration among people who have expertise in the ethics of communication and dissemination of results, or with science communicators to maximize not only what results or findings are disseminated but how they are disseminated. That takes the form of K-12 teaching, undergraduate teaching, graduate teaching, postdoctoral teaching, teaching and communicating throughout the academic ranks, and equally importantly, through public outreach. I think what weve seen over the past 25 years of neuroethics is a tremendous improvement in the way that science reporting is taking place around brain and mind around neuroscience. There really is a commitment, I believe, to working in a far more reciprocal way between the communication side and the science side to ensure that what gets out there is meaningful and appropriately-tailored to distinct audiences. It is multi-layered. It starts well before data collection, at the design and planning phases of research, and then all the way through engaging with the public as I mentioned, and with students of all ages.

I think the responsible way to answer your question is to speak to the importance of systematic neuroscience discovery and systematic engagement. A very small study pharmacologic, behavioral, whatever that is robust can have a huge impact on changing the way health and policymakers think about an aspect of climate change, or a neurotoxin. For example, in my lecture, I spoke about glyphosates. I talked about methylmercury. Neuroscientists could not possibly take on the whole scope of neurotoxic contaminants for a research platform. The challenge is to choose one, choose an important one, and help decode and disentangle why there seems to be still controversies and debates around harms versus benefits that are leading to heterogeneous and conflicting international policies. Solve critical questions for one neurotoxin. Then move on to the next.

I talked a lot about fracking and how data show that the pushing hydrochloric acid into the earth to create fissures not great for the environment, for keeping the land and water clean, or for ensuring that traditional relationships with the land are preserved. The risk of fracking have to be taken in balance though with the economic benefits to communities that dont have a lot of resources, for example, and may even be faced with food and water security. We must look at harms and benefits always, always in balance. We have to take these problems and tackle them bit by bit. Climate change, too big as a whole. But finding ways to protect children with severe brain disorders such as epilepsy whose condition might be exacerbated by extreme heat that can be tackled. Environmental change with respect to neurotoxins too big. Discovering and addressing differential proximate and epigenetic effects of different neurotoxins that can be tackled.

Neuroscience requires patience and systematic, rigorous deliberate methods. Today there is a new openness to thinking about all aspects of what results may suggest and how they may inform how people behave, govern, and invest in each other going forward.

About the author

Dr Judy Illes, CM, PhD, FCAHS, FRSC

University of British Columbia (UBC)

Dr Judy Illes is Professor of Neurology at the University of British Columbia (UBC),Distinguished University Scholar, UBC Distinguished Scholar in Neuroethics, and Director of Neuroethics Canada. She is a pioneer of the field of neuroethics through which she has made groundbreaking contributions to cross-cultural ethical, legal, social and policy challenges at the intersection of the brain sciences and biomedical ethics. Among her many commitments, she is Chair of the International Brain Initiative and co-Lead of the IBIs Canadian Brain Research Strategy. She serves as Director-at-Large of the Canadian Academy of Health Sciences,and is a member of the Ethics, Law and Humanities Committee of the American Academy of Neurology.

Dr Illes is the immediate past Vice Chair of the Advisory Board of the Institute for Neuroscience, Mental Health and Addiction of the Canadian Institutes of Health Research (CIHR), and of CIHRs Standing Committee on Ethics.Her recent books, a series calledDevelopments in Neuroethics and Bioethics, focus on pain, global mental health, neurotechnology, transnational laws, environmental neuroethics, neurodevelopment, and neuroAI. Dr Illes was awarded the Order of Canada, the countrys highest recognition of its citizens, in 2017.

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Navigating the neuroscientific landscape with Dr Judy Illes - Drug Target Review

Neuroscience

AI’s memory-forming mechanism found to be strikingly similar to that of the brain – EurekAlert

image:

(a) Diagram illustrating the ion channel activity in post-synaptic neurons. AMPA receptors are involved in the activation of post-synaptic neurons, while NMDA receptors are blocked by magnesium ions (Mg) but induce synaptic plasticity through the influx of calcium ions (Ca) when the post-synaptic neuron is sufficiently activated. (b) Flow diagram representing the computational process within the Transformer AI model. Information is processed sequentially through stages such as feed-forward layers, layer normalization, and self-attention layers. The graph depicting the current-voltage relationship of the NMDA receptors is very similar to the nonlinearity of the feed-forward layer. The input-output graph, based on the concentration of magnesium (), shows the changes in the nonlinearity of the NMDA receptors.

Credit: Institute for Basic Science

An interdisciplinary team consisting of researchers from the Center for Cognition and Sociality and the Data Science Group within the Institute for Basic Science (IBS) revealed a striking similarity between the memory processing of artificial intelligence (AI) models and the hippocampus of the human brain. This new finding provides a novel perspective on memory consolidation, which is a process that transforms short-term memories into long-term ones, in AI systems.

In the race towards developing Artificial General Intelligence (AGI), with influential entities like OpenAI and Google DeepMind leading the way, understanding and replicating human-like intelligence has become an important research interest. Central to these technological advancements is the Transformer model [Figure 1], whose fundamental principles are now being explored in new depth.

The key to powerful AI systems is grasping how they learn and remember information. The team applied principles of human brain learning, specifically concentrating on memory consolidation through the NMDA receptor in the hippocampus, to AI models.

The NMDA receptor is like a smart door in your brain that facilitates learning and memory formation. When a brain chemical called glutamate is present, the nerve cell undergoes excitation. On the other hand, a magnesium ion acts as a small gatekeeper blocking the door. Only when this ionic gatekeeper steps aside, substances are allowed to flow into the cell. This is the process that allows the brain to create and keep memories, and the gatekeeper's (the magnesium ion) role in the whole process is quite specific.

The team made a fascinating discovery: the Transformer model seems to use a gatekeeping process similar to the brain's NMDA receptor [see Figure 1]. This revelation led the researchers to investigate if the Transformer's memory consolidation can be controlled by a mechanism similar to the NMDA receptor's gating process.

In the animal brain, a low magnesium level is known to weaken memory function. The researchers found that long-term memory in Transformer can be improved by mimicking the NMDA receptor. Just like in the brain, where changing magnesium levels affect memory strength, tweaking the Transformer's parameters to reflect the gating action of the NMDA receptor led to enhanced memory in the AI model. This breakthrough finding suggests that how AI models learn can be explained with established knowledge in neuroscience.

C. Justin LEE, who is a neuroscientist director at the institute, said, This research makes a crucial step in advancing AI and neuroscience. It allows us to delve deeper into the brain's operating principles and develop more advanced AI systems based on these insights.

CHA Meeyoung, who is a data scientist in the team and at KAIST, notes, The human brain is remarkable in how it operates with minimal energy, unlike the large AI models that need immense resources. Our work opens up new possibilities for low-cost, high-performance AI systems that learn and remember information like humans.

What sets this study apart is its initiative to incorporate brain-inspired nonlinearity into an AI construct, signifying a significant advancement in simulating human-like memory consolidation. The convergence of human cognitive mechanisms and AI design not only holds promise for creating low-cost, high-performance AI systems but also provides valuable insights into the workings of the brain through AI models.

Experimental study

Not applicable

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Neuroscience

Metabolic Markers of Depression Identified – Neuroscience News

Summary: Researchers revealed a crucial link between cellular metabolism and major depressive disorder, particularly in treatment-refractory cases and suicidal ideation. This research found specific blood metabolites that differ in people with depression, providing new biomarkers for risk assessment.

The study also highlights sex-based differences in depressions metabolic impact and suggests that mitochondrial dysfunction plays a role in suicidal ideation. These insights offer new avenues for personalized treatment and prevention strategies, potentially utilizing supplements like folate and carnitine to address metabolic gaps.

Key Facts:

Source: UCSD

Major depressive disorder affects 16.1 million adults in the United States and costs $210 billion annually. While the primary symptoms of depression are psychological, scientists and doctors have come to understand that depression is a complex disease with physical effects throughout the body.

For example, measuring markers of cellular metabolism has become an important approach to studying mental illnesses and developing new ways to diagnose, treat and prevent them.

Researchers at University of California San Diego School of Medicine have now advanced this line of work in a new study, revealing a connection between cellular metabolism and depression.

They found that people with depression and suicidal ideation had detectable compounds in their blood that could help identify individuals at higher risk of becoming suicidal. The researchers also found sex-based differences in how depression impacts cell metabolism.

The findings, published December 15, 2023 inTranslational Psychiatry, could help personalize mental health care and potentially identify new targets for future drugs.

Mental illnesses like depression have impacts and drivers well beyond the brain, saidRobert Naviaux, MD, PhD, a professor in the Department of Medicine, Pediatrics and Pathology at UC San Diego School of Medicine.

Prior to about ten years ago it was difficult to study how the chemistry of the whole body influences our behavior and state of mind, but modern technologies like metabolomics are helping us listen in on cells conversations in their native tongue, which is biochemistry.

While many people with depression experience improvement with psychotherapy and medication, some peoples depression is treatment-refractory, meaning treatment has little to no impact. Suicidal thoughts are experienced by the majority of patients with treatment-refractory depression, and as many as 30% will attempt suicide at least once in their lifetime.

Were seeing a significant rise in midlife mortality in the United States, and increased suicide incidence is one of many things driving that trend, said Naviaux. Tools that could help us stratify people based on their risk of becoming suicidal could help us save lives.

The researchers analyzed the blood of 99 study participants with treatment-refractory depression and suicidal ideation, as well as an equal number of healthy controls.

Among the hundreds of different biochemicals circulating in the blood of these individuals, they found that five could be used as a biomarker to classify patients with treatment-refractory depression and suicidal ideation. However, which five could be used differed between men and women.

If we have 100 people who either dont have depression or who have depression and suicidal ideation, we would be able to correctly identify 85-90 of those at greatest risk based on five metabolites in males and another 5 metabolites in females, said Naviaux.

This could be important in terms of diagnostics, but it also opens up a broader conversation in the field about whats actually leading to these metabolic changes.

While there were clear differences in blood metabolism between males and females, some metabolic markers of suicidal ideation were consistent across both sexes. This included biomarkers for mitochondrial dysfunction, which occurs when the energy-producing structures of our cells malfunction.

Mitochondria are some of the most important structures of our cells and changed mitochondrial functions occur in a host of human diseases, added Naviaux.

Mitochondria produce ATP, the primary energy currency of all cells. ATP is also an important molecule for cell-to-cell communication, and the researchers hypothesize it is this function that is most dysregulated in people with suicidal ideation.

When ATP is inside the cell it acts like an energy source, but outside the cell it is a danger signal that activates dozens of protective pathways in response to some environmental stressor, said Naviaux.

We hypothesize that suicide attempts may actually be part of a larger physiological impulse to stop a stress response that has become unbearable at the cellular level.

Because some of the metabolic deficiencies identified in the study were in compounds that are available as supplements, such as folate and carnitine, the researchers are interested in exploring the possibility of individualizing depression treatment with these compounds to help fill in the gaps in metabolism that are needed for recovery. Naviaux hastens to add that these supplements are not cures.

None of these metabolites are a magic bullet that will completely reverse somebodys depression, said Naviaux.

However, our results tell us that there may be things we can do to nudge the metabolism in the right direction to help patients respond better to treatment, and in the context of suicide, this could be just enough to prevent people from crossing that threshold.

In addition to suggesting a new approach to personalize medicine for depression, the research could help scientists discover new drugs that can target mitochondrial dysfunction, which could have wide implications for human health in general.

Many chronic diseases are comorbid with depression, because it can be extremely stressful to deal with an illness for years at a time, said Naviaux.

If we can find ways to treat depression and suicidal ideation on a metabolic level, we may also help improve outcomes for the many diseases that lead to depression.

Many chronic illnesses, such as post-traumatic stress disorder and chronic fatigue syndrome, are not lethal themselves unless they lead to suicidal thoughts and actions. If metabolomics can be used to identify the people at greatest risk, it could ultimately help us save more lives.

Co-authors include: Jane C. Naviaux, Lin Wang, Kefeng Li, Jonathan M. Monk and Sai Sachin Lingampelly at UC San Diego, Lisa A. Pan, Anna Maria Segreti, Kaitlyn Bloom, Jerry Vockley, David N. Finegold and David G. Peters at University of Pittsburgh School of Medicine, and Mark A. Tarnopolsky at McMaster University.

Author: Miles Martin Source: UCSD Contact: Miles Martin UCSD Image: The image is credited to Neuroscience News

Original Research: Open access. Metabolic features of treatment-refractory major depressive disorder with suicidal ideation by Robert Naviaux et al. Translational Psychiatry

Abstract

Metabolic features of treatment-refractory major depressive disorder with suicidal ideation

Peripheral blood metabolomics was used to gain chemical insight into the biology of treatment-refractory Major Depressive Disorder with suicidal ideation, and to identify individualized differences for personalized care.

The study cohort consisted of 99 patients with treatment-refractory major depressive disorder and suicidal ideation (trMDD-SIn=52 females and 47 males) and 94 age- and sex-matched healthy controls (n=48 females and 46 males). The median age was 29 years (IQR 2242). Targeted, broad-spectrum metabolomics measured 448 metabolites. Fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15) were measured as biomarkers of mitochondrial dysfunction.

The diagnostic accuracy of plasma metabolomics was over 90% (95%CI: 0.801.0) by area under the receiver operator characteristic (AUROC) curve analysis. Over 55% of the metabolic impact in males and 75% in females came from abnormalities in lipids.

Modified purines and pyrimidines from tRNA, rRNA, and mRNA turnover were increased in the trMDD-SI group. FGF21 was increased in both males and females. Increased lactate, glutamate, and saccharopine, and decreased cystine provided evidence of reductive stress. Seventy-five percent of the metabolomic abnormalities found were individualized.

Personalized deficiencies in CoQ10, flavin adenine dinucleotide (FAD), citrulline, lutein, carnitine, or folate were found. Pathways regulated by mitochondrial function dominated the metabolic signature.

Peripheral blood metabolomics identified mitochondrial dysfunction and reductive stress as common denominators in suicidal ideation associated with treatment-refractory major depressive disorder.

Individualized metabolic differences were found that may help with personalized management.

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Neuroscience

URI’s new neuro-learning center to boost brain education – EurekAlert

image:

A young study participant wears a functional Near Infrared Spectroscopy system cap, which allows neuro scientists to measure brain activity by monitoring changes in blood flow in the brain.

Credit: Submitted Photo

University of Rhode Island students and faculty members in multiple health disciplines will soon have access to state-of-the-art neuroscientific technology to enhance classroom lessons and research education, thanks to a grant from the Champlin Foundation.

College of Health Sciences Professors Mariusz Furmanek and Alisa Baron, along with collaborators Mark Hartman, Nicole Logan, Ellen McGough and Kunal Mankodiya, will establish a Neuro-Learning Center that includes some of the most cutting-edge equipment available to neuroscientific researchers, allowing for the non-invasive study of relationships between brain activity and behavior, functional brain mapping, and mechanisms of neuroplasticity. The equipment will be available to undergraduate and graduate students as well as faculty in such disciplines as communicative disorders, physical therapy, kinesiology and biomedical engineering.

We are planning to establish the Neuro-Learning Center, which will allow that interdisciplinary interaction with faculty members from different departments, Furmanek said. In the majority of institutions, these are only used for research. Primarily, we would use them for education. There is, of course, a research component with this equipment, but the primary goal is to educate our students in neuroscience and knowledge about the brain.

The non-invasive technology includes a Transcranial Magnetic Stimulation system, which uses low-intensity magnetic stimulation to facilitate or inhibit neural activity in areas of the brain; and a functional Near Infrared Spectroscopy system (fNIRS), which is an advanced neuroimaging technique used to measure brain activity by monitoring changes in blood flow in the brain. The TMS is used in conjunction with a NeuroNavigation System to target specific areas of the brain for neurostimulation. Basically, the technology will allow students to look at specific areas of the brain and determine which areas of the brain are active and which should be stimulated.

Its a cap thats put on the head and it can be configured in any way depending on the part of the brain you want to look at, Baron said of the fNIRS system. You put the sources and detectors in the areas you are interested in on the scalp, and when a participant does a particular task, you can analyze the data to see what part of the brain lights upthe part of the brain that has more blood circulating to it. That shows the part of the brain that is the most active in trying to process that information from whatever task youre asking the participant to do. This is a non-invasive system thats used across the lifespan, which is a big benefit since a lot of people think of an MRI when thinking about neuroimaging techniques, having to put people into a scanner thats quite loud and not child friendly.

The systems are essential to study, diagnose and treat neurological diseases, such as depression, Alzheimers, Parkinsons, stroke and more. Both systems can be used together by multiple clinicians. For example, the fNIRS system can identify parts of the brain that have died or have decreased function due to a stroke. Physical therapists can then use the TMS system to apply stimulation to those parts of the brain. If needed, a neurosurgeon would use the NeuroNavigation system to improve precision and safety of surgery, then a speech language pathologist could use fNIRS again to examine the post-procedure brain activity and its impact on communication.

Such a collaborative and interdisciplinary approach will be emphasized when teaching our students to ensure the patients comprehensive care and recovery, the professors wrote in their funding proposal. There have been rapid advancements in the neuroscience field, including the types of equipment used. University courses and the training they provide must simultaneously evolve to ensure students are familiar with the techniques and technologies that will be utilized during their careers in patient care and research.

Having the advanced equipment available to undergraduate students will be unique to URI. Furmanek and Baron are unaware of any other institutions that have the equipment for training undergraduate students and early-career graduate students, despite their widespread use by researchers and clinicians in the field. As important as the research capabilities is the educational component for students seeking careers in multiple health disciplines.

The huge benefit to these systems is their portability. We can actually take them into the classroom so students can see how to use it, how to put it on someone, how to analyze the data, all in the classroom without having to pull them out of the class into the lab, Baron said. A lot of these technologies are only available in laboratory spaces, which creates a lot of inequity for students. Were getting students access to these technologies early so they can understand and get comfortable using them, so thats one more marketable skill when they go on the job market.

Baron and Furmanek expect to begin acquiring the advanced technology in the spring, and expect to have it available for classroom use by fall 2024. The Neuro-Learning Center and the equipment will be housed between Furmaneks and Barons labs in Independence Square on the Kingston campus.

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Physiology

Influence of Sleep-Disordered Breathing and Hypoxia on AF: A Pulmonary Physiological Perspective – Physician’s Weekly

The following is a summary of SleepDisordered Breathing, Hypoxia, and Pulmonary Physiologic Influences in Atrial Fibrillation, published in the November 2023 issue of Cardiology by Heinzinger et al.

In this study, using a substantial clinical cohort, researchers investigated the link between sleep-disordered breathing, sleep-related hypoxia, and atrial fibrillation (AF) development. The relationship between sleep-related hypoxia, pulmonary physiology, and their contributions to the onset of AF remains ambiguous, prompting the comprehensive analysis. Their retrospective cohort comprised patients undergoing sleep studies at Cleveland Clinic between January 2, 2000, and December 30, 2015. Using Cox proportional hazards models, they assessed various parameters, including apnea-hypopnea index, oxygen saturation levels, and end-tidal carbon dioxide about incident AF, adjusting for multiple factors. The cohort of 42,057 individuals, with a median age of 50.7 years and diverse demographic characteristics, saw 4.6% developing AF within 5 years. Elevated apnea-hypopnea index, reduced oxygen saturation levels, and increased carbon dioxide were associated with heightened AF risk. Specifically, a 10-unit increase in the apnea-hypopnea index led to a 2% higher risk, while similar changes in oxygen saturation levels were linked to a 6% to 30% increased AF risk.

After considering spirometry factors, sleep-related hypoxia remained significantly associated with incident AF, indicating a substantial role in AF development independent of pulmonary physiological impairment. These findings underscore the substantial impact of sleep-related hypoxia on AF incidence, highlighting its significance even when accounting for pulmonary physiological factors.

Source: ahajournals.org/doi/10.1161/JAHA.123.031462

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Influence of Sleep-Disordered Breathing and Hypoxia on AF: A Pulmonary Physiological Perspective - Physician's Weekly

Physiology

If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear – PsyPost

Heart in your throat. Butterflies in your stomach. Bad gut feeling. These are all phrases many people use to describe fear and anxiety. You have likely felt anxiety inside your chest or stomach, and your brain usually doesnt hurt when youre scared. Many cultures tie cowardice and bravery more to the heart or the guts than to the brain.

But science has traditionally seen the brain as the birthplace and processing site of fear and anxiety. Then why and how do you feel these emotions in other parts of your body?

I am a psychiatrist and neuroscientist who researches and treats fear and anxiety. In my book Afraid, I explain how fear works in the brain and the body and what too much anxiety does to the body. Research confirms that while emotions do originate in your brain, its your body that carries out the orders.

While your brain evolved to save you from a falling rock or speeding predator, the anxieties of modern life are often a lot more abstract. Fifty-thousand years ago, being rejected by your tribe could mean death, but not doing a great job on a public speech at school or at work doesnt have the same consequences. Your brain, however, might not know the difference.

There are a few key areas of the brain that are heavily involved in processing fear.

When you perceive something as dangerous, whether its a gun pointed at you or a group of people looking unhappily at you, these sensory inputs are first relayed to the amygdala. This small, almond-shaped area of the brain located near your ears detects salience, or the emotional relevance of a situation and how to react to it. When you see something, it determines whether you should eat it, attack it, run away from it or have sex with it.

Threat detection is a vital part of this process, and it has to be fast. Early humans did not have much time to think when a lion was lunging toward them. They had to act quickly. For this reason, the amygdala evolved to bypass brain areas involved in logical thinking and can directly engage physical responses. For example, seeing an angry face on a computer screen can immediately trigger a detectable response from the amygdala without the viewer even being aware of this reaction.

The hippocampus is near and tightly connected to the amygdala. Its involved in memorizing what is safe and what is dangerous, especially in relation to the environment it puts fear in context. For example, seeing an angry lion in the zoo and in the Sahara both trigger a fear response in the amygdala. But the hippocampus steps in and blocks this response when youre at the zoo because you arent in danger.

The prefrontal cortex, located above your eyes, is mostly involved in the cognitive and social aspects of fear processing. For example, you might be scared of a snake until you read a sign that the snake is nonpoisonous or the owner tells you its their friendly pet.

Although the prefrontal cortex is usually seen as the part of the brain that regulates emotions, it can also teach you fear based on your social environment. For example, you might feel neutral about a meeting with your boss but immediately feel nervous when a colleague tells you about rumors of layoffs. Many prejudices like racism are rooted in learning fear through tribalism.

If your brain decides that a fear response is justified in a particular situation, it activates a cascade of neuronal and hormonal pathways to prepare you for immediate action. Some of the fight-or-flight response like heightened attention and threat detection takes place in the brain. But the body is where most of the action happens.

Several pathways prepare different body systems for intense physical action. The motor cortex of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas. That might contribute to a feeling of tightness in your chest and stomach in stressful conditions.

The sympathetic nervous system is the gas pedal that speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response.

To assure sufficient blood supply to your muscles when theyre in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions to your heart.

In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of shortness of breath.

As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety.

All bodily sensations, including those visceral feelings from your chest and stomach, are relayed back to the brain through the pathways via the spinal cord. Your already anxious and highly alert brain then processes these signals at both conscious and unconscious levels.

The insula is a part of the brain specifically involved in conscious awareness of your emotions, pain and bodily sensations. The prefrontal cortex also engages in self-awareness, especially by labeling and naming these physical sensations, like feeling tightness or pain in your stomach, and attributing cognitive value to them, like this is fine and will go away or this is terrible and I am dying. These physical sensations can sometimes create a loop of increasing anxiety as they make the brain feel more scared of the situation because of the turmoil it senses in the body.

Although the feelings of fear and anxiety start in your brain, you also feel them in your body because your brain alters your bodily functions. Emotions take place in both your body and your brain, but you become aware of their existence with your brain. As the rapper Eminem recounted in his song Lose Yourself, the reason his palms were sweaty, his knees weak and his arms heavy was because his brain was nervous.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear - PsyPost

Physiology

MBRSC to host International Society for Gravitational Physiology meeting – BroadcastProME.com

Abstract submission is now open for the 43rd International Society for Gravitational Physiology Meeting, which will be hosted in the UAE from May 26-31, 2024.

The Mohammed Bin Rashid Space Centre (MBRSC) is set to host the 43rd International Society for Gravitational Physiology (ISGP) Meeting for the first time ever in the Arab world. Scheduled to be held from May 26-31, 2024, at the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), the event will bring together eminent scientists, representatives from space agencies, young researchers, as well as students.

The meeting aims to foster an exchange of knowledge on the biological and physiological effects of gravity on living organisms. The meeting will not only serve as a collaborative platform, but also be utilised to announce new research and educational opportunities in the field.

Salem Humaid AlMarri, Director General, MBRSC, said: Hosting the 43rd ISGP Meeting is a significant milestone in our continuous efforts to foster knowledge sharing and scientific collaboration. This event aligns perfectly with our commitment to enhancing the understanding of space and its impact on life. By bringing together leading experts in gravitational physiology, we aim to further the boundaries of space science research and education, contributing substantially to the local and global scientific community. We are grateful to our partners at MBRU for partnering on this event. The university has collaborated on numerous projects, including on experiments for astronaut Sultan AlNeyadi during his historic mission aboard the International Space Station. It is through such collaborations that we can truly unlock the potential of space and its profound effects on human health, driving innovation and discovery in the space sector. We look forward to gaining new insights into the world of gravitational science through this meeting and hope it fosters a culture of scientific excellence and exploration, ultimately contributing to the progress of humanity and our understanding of the universe.

Dr Amer Sharif, Chief Executive Officer of Dubai Health and President of MBRU, added: We are proud to be part of the 43rd ISGP meeting which will be held at MBRU. This event is an excellent opportunity for our students, to learn, network and gain insights into the impact of gravity on physiological processes and enhance their understanding of human health in different gravitational environments. Such scientific events perfectly align with our missions at MBRU and Dubai Health. Our integrated academic health system places a strong emphasis on lifelong learning, as we are very much committed to ensuring that our learners are fully equipped with the knowledge and skills needed to contribute to the local and global scientific community, ultimately advancing health for humanity. We are very thankful to our friends at the Mohammed Bin Rashid Space Centre who afforded this opportunity to our students, which is truly unique as it is the first meeting of its kind in the Arab world. We look forward to the insightful discussions, learnings and new research that will emerge from this gathering.

The ISGP association, established in 1979, has a rich history of promoting scientific knowledge on gravitys effects on living organisms and encouraging public and academic interest in this field. Hosting the event in the UAE symbolises the growing stature of the nation in the international science community, providing an opportunity for the UAE science community to engage with global experts, promote the latest findings, including those of Sultan AlNeyadis research projects during his six-month mission on the International Space Station (ISS), as well as the opportunity to highlight the countrys participation in Analog simulation missions.

Pr.Marc-Antoine Custaud, President of ISGP, stated: We are very pleased to announce that our 43rd annual ISGP meeting will be held in Dubai and hosted by MBRSC. This will be an important event for all international researchers working in the field of space physiology, providing a wonderful opportunity to meet each other. The meeting is already shaping up to be a great success.

Abstract submissions for the 43rd ISGP Meeting are now open, while registrations will be opened in February 2024.

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MBRSC to host International Society for Gravitational Physiology meeting - BroadcastProME.com

Emergency Medicine

Study pinpoints ideal locations for public bleeding control kits in shopping centers – News-Medical.Net

Where should bleeding control equipment be located to save as many lives as possible? Researchers at Linkping University in Sweden, in collaboration with US researchers, have found the answer to this through computer simulations of a bomb exploding in a shopping center. One of the most important conclusions: bleeding control kits should not be located at entrances.

In the event of an accident or an attack, members of the public can save lives by performing first aid measures until the arrival of emergency medical services. But it is not enough that people see themselves as life-saving immediate responders, prepared and able to act.

There must also be certain equipment available to manage major bleeding. The question then is where this equipment should be placed, so that people who want to help can quickly access bleeding control kits."

Carl-Oscar Jonson, adjunct senior associate professor at the Department of Biomedical and Clinical Sciences at Linkping University and head of research at the Center for Disaster Medicine and Traumatology in Linkping

Until now, there have been no guidelines for where such bleeding control kits should be located to ensure maximal utility. The current study, published in the journal Disaster Medicine and Public Health Preparedness, now contributes research-based recommendations.

"We found that the largest number of lives saved correlated with bleeding control kits being placed in two or more locations on the premises, but most importantly they shouldn't be placed at entrances. We also concluded that the equipment must be accessible within 90 seconds' walking distance," says Anna-Maria Grnbck, doctoral student at the Department of Science and Technology at Linkping University, who was involved in developing the simulation.

This means that bleeding control kits should not be placed at entrances, which is often the case with automated external defibrillators (AEDs). The reason for this is that they may be difficult to reach in a situation where many people have to be evacuated at once, such as in the case of attack or major accident. According to attack statistics, roughly 20 injured people will need first aid including a bleeding control kit each. It may be helpful to locate bleeding control kits in the same places as clearly marked AEDs, as long as not located at the entrances.

The recommendations are based on conclusions reached by the research team by developing a computer-based simulation of an explosion in a large shopping centre with thousands of simultaneous visitors. In their simulation, the researchers have looked at what happens right after an explosion. The majority of the simulated people try to get out of the premises and move towards the exits. Simulated people close to the blast suffer varying degrees of injury and start bleeding. In the simulation, some individuals help those injured by applying direct pressure to reduce bleeding, or by trying to find equipment. It is a race against time. Depending on how long it takes to get the equipment, the simulated injured people may die from blood loss.

To find the best strategy for the placement of bleeding control kits, the researchers tested four different scenarios in their simulation. They weighed together the outcomes of the many simulated courses of events for each scenario and compared them to understand which placement of equipment saved the largest number of lives.

The current study is a collaboration project between the Center for Disaster Medicine and Traumatology in Linkping, the Department of Computer and Information Science and the Department of Science and Technology at Linkping University and American experts affiliated with the National Center for Disaster Medicine and Public Health. While the placement of bleeding control kits in sports arenas and similar has become increasingly common in the US, it is so far a rarity in Sweden.

"I hope policymakers and public venues can use this study to guide plans and decisions about where to locate public-access bleeding control supplies. For example, our study suggests that supplies co-located with AEDs would be more beneficial than those located near exits. In an emergency when minutes matter, having equipment readily accessible might mean the difference between life and death," says Craig Goolsby, Professor of Clinical Emergency Medicine at the David Geffen School of Medicine at UCLA and Chair of the Department of Emergency Medicine at Harbor-UCLA Medical Center, USA.

The project was funded by the Swedish Civil Contingencies Agency (MSB), the Department of Homeland Security Science and Technology Directorate in the USA, and Linkping University. The Center for Disaster Medicine and Traumatology in Linkping is a national knowledge centre located at Region stergtland and Linkping University.

Some of the researchers behind the study have patents related to bleeding control kits.

Source:

Journal reference:

Steins, K., et al. (2023). Recommendations for Placement of Bleeding Control Kits in Public Spaces a Simulation Study. Disaster Medicine and Public Health Preparedness. doi.org/10.1017/dmp.2023.190.

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Study pinpoints ideal locations for public bleeding control kits in shopping centers - News-Medical.Net

Emergency Medicine

Quebec emergency room doctors warn conditions out of control due to surge of COVID and other respiratory infections – WSWS

With the onset of winter, Quebecs emergency rooms are overflowing, endangering the health and lives of Quebecers. A major driver of the increased burden on hospitals is a surge in COVID-19 cases.

This is a repeat of the situation experienced in November and December 2022. According to the governments Index Sant website, the provinces overall emergency-room (ER) occupancy rate has exceeded 100 percent on every single day since Nov. 12. On Tuesday, the average rate across the province was 131 percent. In Laval, Quebecs third-largest city, it was 182 percent and in the nearby Lanaudire region, 171 per cent.

ER doctors wrote to Health Minister Christian Dub last Friday to warn that conditions in emergency rooms across the province are out of control. Overcrowding in the emergency department leads to daily mortality, says the letter, which was written by Dr. Marie-Maud Couture, the president of the Regroupement des Chefs dUrgence du Qubec (Association of Emergency Rooms Chiefs), and supported by the hundreds of doctors and residents who comprise the Association des spcialistes en mdecine durgence du Qubec(Quebec Association of Specialists in Emergency Medicine).

Congestion in emergency departments leads to mortality, recently estimated at one excess death for every 82 patients admitted, wrote Dr. Couture. This statistic does not take into account indirect deaths, i.e. people who present late despite having an urgent medical condition, for fear of waiting more than 24 hours in a waiting room, and sometimes even for fear of being a nuisance.

The immediate cause of the current overcrowding crisis is the triple epidemic of respiratory viruses that is hitting the province. As in 2022, influenza, COVID-19 and respiratory syncytial virus (RSV) are infecting Quebecers en masse.

According to the Institut national de sant publique du Qubec (INSPQ), some 130,000 Quebecers contract a respiratory virus every day.

COVID-19 is believed to be responsible for a third of these infections, although official figures (4,987 new cases for the week ending November 26) continue to seriously underestimate the number of cases. This is because they are based on PCR tests, which are accessible to only a small minority of people. These incomplete official figures and voluntary declarations of positive rapid tests have been steadily increasing since the end of September.

As of last week, 2,200 people were hospitalized with COVID-19, a number that exceeds what was seen in 2020 and 2021 before the arrival of the Omicron wave. This shows that the policy of mass infection adopted by the ruling class at the time has allowed the disease to take hold permanently, with a very high baseline.

COVID-19 also continues to kill. The 70 people who died between November 26 and December 2 in Quebec brought the official count of COVID deaths since 2020 to 19,084. At the end of November, Statistics Canada published its annual report on life expectancy in Canada. For the third year in a row, life expectancy in the country has fallen, from 82.3 years in 2019 to 81.3 in 2022.

The Statscan report also revealed that COVID-19 caused more deaths in the country last year than in any other year of the pandemic. With over 19,700 deaths attributable to it in 2022, COVID-19 is now the third leading cause of death in the country, responsible for around 6 percent of all deaths. In Quebec and Ontario, the two most populous provinces, mortality caused by COVID-19 increased by 38 percent in 2022 as compared to 2021.

The right-wing Coalition avenir Qubec (CAQ) government, with the complicity of the corporate-controlled media outlets and the federal Liberal government, is doing everything in its power to prevent the public from becoming aware of the immense dangers it faces. Its aim is to continue pursuing a deliberate policy of mass infection.

The COVID-19 health emergency was lifted in Quebec on June 1, 2022, and all measures, including the mandatory wearing of masks in healthcare centers, were eliminated. Even tracking the evolution of COVID-19 has become almost impossible due to the lack of data.

In the most recent example, on December 6 the INSPQ discreetly announced on its website that data on hospitalizations linked to COVID had also become imprecise with the end of the obligation for hospitals to record specific information. In particular, it will no longer be possible to know the number of COVID patients hospitalized in intensive care units.

Government and media propaganda downplaying the dangers associated with COVID has also led to a collapse in the number of Quebecers keeping their COVID vaccinations up to date. As of the middle of December, barely 900,000 people, or around 14 percent of the population, had received a booster dose designed to combat the Omicron XBB.1.5 sub-variant since the vaccination campaign began in October.

The data are just as alarming for the most vulnerable people, the only ones for whom the government and INSPQ officially recommend the vaccine. Vaccination rates are 39.1 percent for those over 60 and 45.8 percent for people aged 70-79. Of those 80 and over barely half, 50.5 percent, have received the latest booster.

Quebec Public Health Director Dr. Luc Boileau has warned of a cocktail of COVID-19 and flu for Christmas, even while downplaying the dangers. He is urging those over 70 to get vaccinated, and recommends that those with symptoms wash their hands and wear a mask. Quebec Premier Franois Legault appointed Boileau as the provinces interim public health director in Jan. 2022, as the government was moving to eliminate all mitigation measures amid the Omicron wave, and later made his posting permanent, precisely because of Boileaus readiness to implement the governments murderous profits-before-lives pandemic policy.

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According to Dr. Boileau, cases of influenzawhose main strain this year is H1N1, which is particularly dangerous for childrenare also rising sharply in Quebec. The test positivity rate has risen from 3.9 percent to almost 7.3 percent in the space of a week, and several adults with influenza are hospitalized in intensive care. Authorities fear that the situation will evolve in the same way as in Alberta, where the test positivity rate has risen from 3 percent to 33 percent in the space of a month.

The deeper causes of the ongoing crisis in emergency departments and, more generally, in the healthcare system, are also well known. They include the savage cuts made for decades by successive Parti Qubcois and Quebec Liberal Party governments, and the intensification of capitalist austerity by the CAQ, which announced in its March budget an increase in healthcare spending below inflation when non-recurring, COVID-19-related expenses are deducted.

Meanwhile, Dubs solutions to the ER crisis are collapsing miserably one after the other. At the end of November, the only two full-time nurses in the first Specialized Nurse Practitioner (SNP) clinic resigned, citing issues impacting the quality and safety of care, including a lack of equipment.

The clinic was opened with great fanfare at the suggestion of the crisis unit set up by Dub in December 2022, when emergency departments were in acute crisis. It was intended to relieve emergency departments and hospitals by treating less urgent cases.

Similarly, the Info-Sant line (811), where sick people are supposed to be able to talk to a professional and be directed to an alternative to ER care if their case is not too serious, is itself overwhelmed. People sometimes have to wait several hours to talk to someone.

In the first week of December, 42.3 percent of 811 callers hung up before getting any advice. Despite this, Dub reiterated on Tuesday that people should avoid the ER if at all possible, encouraging sick people to self-diagnose the severity of their illness and decide if they have the right to seek ER treatment.

The crisis in the healthcare system and the indifference of the ruling class are a serious threat to the lives of Quebecers. Recently, the media revealed that two people died in the emergency room of the Anna-Laberge hospital in Chteauguay, near Montreal, on November 29 and 30.

Although the authorities have refused to give details of these tragic incidents on the pretext that administrative investigations are underway, it appears that one person died after waiting 12 hours, although he was supposed to see a doctor within 30 minutes of arrival according to the preliminary examination carried out in triage. The stretcher occupancy rate at Anna-Laberge Hospital was 184 percent.

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Quebec emergency room doctors warn conditions out of control due to surge of COVID and other respiratory infections - WSWS

Emergency Medicine

Security at hospitals’ emergency departments get $5.7 million funding boost over summer – RNZ

The government is spending an extra $5.7 million on security in emergency departments across the country for summer. Photo: RNZ / Marika Khabazi

An emergency doctor says having more security guards over summer will make a difference to hospitals' waiting room safety.

The government is spending an extra $5.7 million on security in emergency departments across the country for summer, after an "increased frequency" of violent incidents at hospitals.

Auckland City Hospital will get five dedicated security guards for its emergency department, and emergency medicine specialist Dr Mark Friedericksen said it would make a difference.

"They're not a let's cause trouble presence, they're a calming presence to try and reduce people actually becoming aggressive, and aggressive to our staff. We value all our staff, all our patients and their whnau," he said.

"If you can de-escalate before there's any physical violence, you've won. Emergency departments survive on teamwork and our security officers are a big part of that teamwork."

Dr Friedericksen said the emergency department's waiting room was often an intense environment.

"One of our main pressures is within our waiting room area. It's not fit for purpose in 2023 and patients wait a long time and if you or I were sitting in the waiting room for a long time, you would be upset," he said.

"Physical assault luckily is rare, verbal assault happens on a daily basis."

Dr Mark Friedericksen said the five additional security guards for Auckland City Hospital would make a difference. Photo: Supplied

Te Whatu Ora said there were 1267 assaults at its hospitals between January and March this year alone - more than the total for 2021.

"The important thing to understand in [regard to] most of the patient or whnau violence interactions is they're vulnerable," Dr Friedericksen said.

"We see them at their most vulnerable when they're at their lowest, they're worried for their healthcare, under the influence of drugs, alcohol and they're just worried. There's a lot of verbal abuse, physical abuse, and we just don't condone that."

Association of Salaried Medical Specialists executive director Sarah Dalton said the increased security needed to continue beyond summer.

"A lot of our EDs are very busy and they're quite crowded so having more support for the clinical staff to get on and do the work that they are trained to do is a really welcome development," she said.

"By the time we get through summer then we'll be starting to hit the winter surge. EDs are the front doors of our hospitals they are never really not busy so it's important that workforce supports are made longer term."

Dr Shane Reti said the additional 200 security guard roles would be funded until late February. Photo: Supplied

Health Minister Dr Shane Reti said he was working on a longer-term plan to improve security in hospitals.

"We'll learn a lot from this period of time, have we got the numbers right for the eight high risk hospitals five FTE [full-time equivalent positions], is that the right number? It's my plan to bring up a proposal to have pervasive improved security across all of the emergency departments."

The extra 200 security guard roles would be funded till late February, he said.

"They'll have all of the training that an ED security guard might be expected to have," Reti said.

"They have all the tools that current security guards have, there's no new tools that we're giving them. They don't have the tools of police for example. In certain circumstances in a triaged way they do have the tools of restraint but a large part of the toolset is actually talking."

Reti said the rise in violence at hospital waiting rooms was concerning.

"The ED teams here and across the country are describing physical assaults on their person as well as verbal assaults and that is not acceptable and that is what we want to appropriately manage."

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Security at hospitals' emergency departments get $5.7 million funding boost over summer - RNZ