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Aston University and Birmingham Women’s and Children’s NHS Foundation Trust (BWCH) have pledged to work together to address health provision in the city by signing a Memorandum of Understanding to co-develop paediatric health initiatives and the health services workforce of the future to deliver them. The strategic partnership between the University and BWCH aims to develop the health services workforce of the future together (particularly focusing on course development and delivery, including placements). It will also invest in shared posts that support closer links between academic, education and healthcare provision and support honorary appointments and initiate collaborative projects including joint research, to develop world-leading research and provision in the field of paediatric health and wellbeing. The partnership will make the most efficient use of resources and reduce duplication by providing a range of shared services, as well as continuously developing new ways to work together, with a view to supporting innovation in the field of healthcare. These activities will build on the existing joined up work taking place between Aston University and Birmingham Women’s and Children’s NHS Foundation Trust, such as shared use of the MRI scanning services in the Aston Institute for Health and Neurodevelopment and joint research projects examining topics including epilepsy in children, eating behaviours and neurodevelopment. Both organisations are also members of Birmingham Health Partners, the city’s clinical-academic research alliance, which includes maternal health as one as its key strategic focus areas. Professor Anthony Hilton, pro-vice-chancellor and executive dean of the College of Health and Life Sciences at Aston University, said: “The signing of this Memorandum of Understanding formalises the existing relationship between our two organisations and represents a strong joint commitment to improving healthcare provision in our city. “Working collaboratively enables us to bring together world-leading research with outstanding clinical provision, for the benefit of our students, patients accessing BWCH services and our city and region. I look forward to developing the many ways in which our organisations can work together to improve healthcare provision in Birmingham.” Matthew Boazman, deputy chief executive officer of Birmingham Women’s and Children’s Hospital NHS Foundation Trust, said: “The partnership between BWCH and Aston University represents a wonderful opportunity for us to ensure that Birmingham has access to world-class healthcare provision and that those entering the workforce are as ready as they can be.”
West Grove Campus Awarded $2.5M Grant from Chester County for Capital Improvement Projects
Funds earmarked for information technology, medical equipment and facility upgrades The ChristianaCare West Grove campus has received a $2.5 million American Rescue Fund Plan Act (ARPA) grant from the Chester County Government for capital improvement projects related to information technology, medical equipment and facility renovation. ChristianaCare finalized the purchase of its West Grove campus (formerly Jennersville Hospital) from Tower Health in June 2022. The hospital has been closed since Dec. 31, 2021. “We are enormously grateful to the Chester County Commissioners for this generous grant,” said Douglas Azar, MHA, ChristianaCare senior vice president, Strategic Clinical Integration. “Our assessment and inventory of the facility indicate that while it contains some usable equipment, including hospital beds and some imaging and diagnostic equipment, there is a lot of work to be done in many key areas. For example, the building currently contains no information technology infrastructure and no laboratory equipment. This funding will provide much-needed help as we build out these critical areas,” he said. “This grant is a tremendous resource as we plan next steps for the West Grove campus,” said Heather Farley, M.D., MHCDS, FACEP, ChristianaCare’s co-lead for the campus development strategy. “Ensuring that the facility has the very best technology and medical equipment will enable us to provide expert care to our neighbors in southern Chester County for many years to come.” The Chester County Commissioners approved ARPA grants to 73 groups and organizations totaling close to $40 million last month, following recommendations by six independent review teams. The teams, comprised of county residents and county government staff, developed a system that followed ARPA guidelines to review proposals and address priorities for funding. “These funds represent a substantial investment in much-needed local programs and services including support for public health,” said County Commissioners’ Chair Marian Moskowitz. “Being able to financially assist ChristianaCare as they work toward bringing hospital services back to southern Chester County firmly met ARPA guidelines and was very important to us.” (From left) Bettina Tweardy Riveros, Chief Health Equity Officer and Senior Vice President, Government Affairs and Community Engagement at ChristianaCare, Marian Moskowitz, Chair of the Board of Commissioners of Chester County, Michelle Kichline, Chester County Commissioner, Heather Farley, M.D., MHCDS, FACEP, ChristianaCare’s co-lead for the campus development strategy and Douglas Azar, MHA, ChristianaCare senior vice president, Strategic Clinical Integration Commissioner Josh Maxwell added that “when ChristianaCare stepped up to take over Jennersville Hospital and bring health care services back to the county, we pledged to support them in those efforts in ways that we, as county government, can. The ARPA program has provided us with the opportunity to fulfill that pledge, with funding that might otherwise be cost-prohibitive.” ChristianaCare is reimagining health care at the West Grove campus and is taking a phased approach to the opening of services. The first phase will be to re-establish emergency services. Subsequent phases are still under consideration. Due to required facility upgrades and plan development, it is unlikely that any services will open within the next 12 months. Since June, Azar, Farley and others at ChristianaCare have participated in meetings and listening sessions with community leaders and small groups to gain input into planning for services at the campus. They have met with local and state government officials, school officials, chambers of commerce, nonprofit organizations, emergency responders, faith leaders and employers in the area. Commissioner Michelle Kichline noted the correlation between ChristianaCare’s focus on meeting community needs and the county’s focus on community involvement in the ARPA grant review process. “Having county residents involved in reviewing and recommending our ARPA applications has been exciting and rewarding,” she said. “They know their local communities best and evaluated and selected projects that address needs across the county. “We know that ChristianaCare is doing the same and see the $2.5 million ARPA grant as a smart investment in restoring crucial health care services to our residents.” The West Grove campus represents a significant expansion and commitment of ChristianaCare to provide health services to communities in southern Chester County. Since 2020, ChristianaCare has added three primary care practices located in Jennersville, West Grove and Kennett Square. Combined, these three practices are now the “medical home” for 22,000 residents in these communities.
Research suggests nutrition education should be on the curriculum of all medical students as well as other healthcare professionals Association for Nutrition develops new curriculum ready for medical students Aston University is one of the pioneers in delivering and embedding nutrition education as part of its medical school undergraduate programme. All healthcare professionals should study a curriculum of nutrition education during their studies in order to help better support public health – new paper suggests. Nutritional researchers from Aston University, with colleagues from other universities and leading nutritional groups, worked with the Association of Nutrition (AfN) to help develop a curriculum that can be rolled out amongst all undergraduate medical school students with potential for modules to be taught to other healthcare professional courses. The paper jointly published in the British Journal for Nutrition and BMJ Nutrition, Prevention and Health examined the development of a new curriculum aimed at undergraduate medical students and made recommendations on its roll out nationally, with a view to it subsequently being implemented into other healthcare courses. The AfN Undergraduate Curriculum in Nutrition for medical doctors has been designed to be presented to medical students as an integral part of their general undergraduate training, making it clear how nutrition interrelates with the study of other systems and contributes to an inclusive understanding of health and disease. Dr Duane Mellor, clinical dietitian and senior lecturer at Aston Medical School at Aston University and co-author on the paper, said: “At present, lifestyle related health problems from living with obesity, through to high blood pressure, type 2 diabetes, heart disease and several cancers can all be linked to diet across our communities. Whereas in hospitals around a third of patients coming in can be undernourished. “Nutrition and food play a key role to both keeping us healthy and helping to manage disease, which is why it is imperative we educate our future doctors and other health professionals about the role of nutrition in patient care.” The paper sets out not only the need for nutrition education and the gaps, but how it can be included as part of what is already a very busy and content heavy curriculum. It builds on areas of the curriculum where nutrition could even be used to help teach concepts such as epidemiology. It highlights how historically medical education along with the education of many health professionals not specialising in nutrition often have only a few hours of teaching on the subject. Dr Glenys Jones, deputy chief executive at the Association for Nutrition, who led the curriculum development project and is co-author on the recent paper, said: “Nutrition is a key and modifiable determinant of health and wellbeing, therefore it is essential our future medical and healthcare professionals are equipped to be able to identify when nutrition could be involved in a patient’s condition in order for this to form part of their care. “The curriculum is not designed to turn our doctors into nutritionists or dietitians, but to give them the knowledge and skills to be able to think about whether nutrition could be playing a role and having the confidence and knowledge of who, when and how to refer on to suitable nutrition professionals when this is needed.” Aston University is a pioneer in the key area of nutrition education of the future healthcare workforce. As one of few UK universities with a dietitian or nutritionist as part of the teaching team within its medical school, these skills are now being developed to benefit the training of other health professionals. Dr Mellor added: “As one of a few dietitians and nutritionists embedded into the teaching team at Aston Medical School, we have been able to integrate nutrition across our curriculum. “It is great to be able to highlight how nutrition links to the basic science areas such as biochemistry through to how you can encourage a patient to think about changing their diet in clinical skills". Aston University has also started to explore with the Association for Nutrition the potential need for nutrition education in other professions. From this an outline of a core curriculum for nutrition for a range of health professionals is in development. Dr Mellor also plans to work with colleagues to further develop nutrition teaching at Aston University, thus helping students across subjects such as optometry and pharmacy to gain a better understanding of nutrition and how it impacts on their areas of expertise. For more information about Aston Medical School please visit our website.
• Menopause: Continuing the Conversation will premiere at 12 noon on 18 October • The news-style programme features key industry interviews and news-style reports along with sponsored editorial profiles • It includes a film of Aston University staff telling their own stories. Aston University has joined forces with the British Menopause Society and ITN’s bespoke production hub, ITN Business, to contribute to a programme which raises awareness of the menopause for World Menopause Day. Menopause: Continuing the Conversation features key industry interviews and news-style reports, along with sponsored editorial profiles. It is anchored by television presenter and journalist Louise Minchin and will premiere at 12 noon on 18 October 2022 on the British Menopause Society's YouTube channel. The programme takes a holistic look – from lifestyle to changes in workplace policy - to support and empower women embarking on the perimenopause and beyond. Staff from Aston University tell their own stories in a film which forms part of the programme. World Menopause Day is held every year on 18 October. The day was designated by the International Menopause Society (IMS) to raise awareness of the menopause and to support options to improve health and wellbeing for women in mid-life and beyond. The theme for World Menopause Day 2022 is cognition and mood. According to research by the Chartered Institute of Personnel and Development (CIPD), three out of five working women between the ages of 45 and 55 who are experiencing menopause symptoms say it has a negative impact on them at work, nearly two-thirds of women surveyed said they were less able to concentrate, more than half said they experience more stress, 30 per cent of women said they had taken sick leave because of their symptoms and only a small minority said they told their managers about the real reason for taking sick leave. Beth Lloyd, associate director of organisational development at Aston University, said: “We are excited to announce our involvement in a news-style programme Menopause: Continuing the Conversation in partnership with ITN Business and the British Menopause Society for World Menopause Day. “Menopause is not just a gender or age issue; it is an organisational issue. It can impact on colleagues both directly or indirectly. Awareness on this topic is fundamental to reduce the stigma attached to it so that more people will talk openly about it so it can begin to be normalised and people can get the support they need. “Aston University has taken a proactive approach to raising awareness of the topic including hosting a range of workshops for managers and staff, introducing menopause mentors and creating an informal networking group. Our hope is that these activities will create a truly inclusive workplace and achieve our goal of becoming a recognised menopause friendly employer.”
Expert Perspective: UC Irvine's David Feldman on 'How to address the American megadrought?'
With the American West suffering from its worst megadrought in 1,200 years, and the Mississippi River as its lowest levels in recent history, water resource management is key to the America’s future. It’s a political challenge as much as a climate change mitigation one. UCI Water’s director David Feldman studies how water is allocated and distributed, and the difficulties in achieving institutional reform to promote equity in water management in the U.S. and elsewhere. He specializes in water resources management and policy, global climate change policy, ethics and environmental decisions, adaptive management, and sustainable development. Recently, David was featured on the UCI podcast to talk about this issue. If you're a journalist looking to cover this important topic - then let our experts help with your stories. David Feldman is a professor of Urban Planning & Public Policy and Political Science, Director of Water UCI. He is an expert in the areas of water resources management and policy, global climate change policy, ethics and environmental decisions, adaptive management, and sustainable development. David is available to speak with media - simply click on his icon now to arrange an interview today or call Tom Vasich with UCI media relations at 949-285-6455.
Aston Institute of Health and Neurodevelopment to host third in a series of livestreamed public lectures This episode of Molecules to Minds will explore Dr Laura Shapiro’s research into how children’s experiences of learning to read impacts on how they learn in the future The one-hour livestream will be followed by a Q&A and round table discussion Aston Institute of Health and Neurodevelopment (IHN) will host a livestreamed public lecture in the series Molecules to Minds on Aston University’s digital channel Aston Originals on Thursday 3 November 2022. Dr Laura Shapiro, a reader in psychology, will present her lecture ‘From gobbledygook to goblins: how a child learns to crack the written code’. Laura will reveal the hurdles and fortunes on the journey from spoken to written language and will discuss how our experience of learning to read changes the way we learn forever. Dr Shapiro's research focuses on the causes and consequences of children’s language and literacy development and is shaped both by fundamental scientific questions and by the concerns of practitioners and policymakers. The lecture will be co-presented with James McTaggart from the Highland Council, Scotland and hosted by Professor Jackie Blissett, co-director of IHN. Laura said: “Most adults take reading for granted, yet for a beginner reader, writing is just gobbledygook. The ability to crack the written code underpins all subsequent learning and provides the key to discovering new worlds and fictional friends.” After the livestreamed lecture, Dr Shapiro and guests will host a Q&A and round table discussion, where audience members can address researchers with their questions. The panel includes a variety of guests: James Cook, headteacher at Cawdor Primary, Scotland, Roxanne Mahroof, a parent and Dr Pamela Wadende a senior lecturer in education at Kisii University, Kenya. Dr Shapiro added: “Being able to read is like a key to the adult world: it underpins our ability to learn. Our research shows that strong language skills are needed to learn to read, and the journey to mastery is a long one. “The good news is that getting better at reading helps you learn more from each thing you read, and in turn spurs you to read more widely. Warning: reading can be addictive.” The lecture is targeted at anyone interested in literacy development in children and young people, including academics, teachers, parents and young people themselves. The livestream will take place at 16:00 – 17:00 BST on Thursday 3 November on the Aston Originals YouTube channel. To register for this event please visit our Eventbrite page.
Babies react to taste and smell in the womb – new research
Scientists have recorded the first direct evidence that babies react differently to various smells and tastes while in the womb Study took 4D ultrasound scans of 100 pregnant women to see how their unborn babies responded to flavours from foods eaten by their mothers The research team, which also included scientists from Aston University, scanned some mothers to see fetal facial reactions to the kale and carrot flavours. Scientists have recorded the first direct evidence that babies react differently to various smells and tastes while in the womb by looking at their facial expressions. A study led by Durham University’s Fetal and Neonatal Research Lab, UK, took 4D ultrasound scans of 100 pregnant women to see how their unborn babies responded after being exposed to flavours from foods eaten by their mothers. Researchers looked at how the fetuses reacted to either carrot or kale flavours just a short time after the flavours had been ingested by the mothers. Fetuses exposed to carrot showed more “laughter-face” responses while those exposed to kale showed more “cry-face” responses. Their findings could further our understanding of the development of human taste and smell receptors. The researchers also believe that what pregnant women eat might influence babies’ taste preferences after birth and potentially have implications for establishing healthy eating habits. The study is published in the journal Psychological Science. Humans experience flavour through a combination of taste and smell. In fetuses it is thought that this might happen through inhaling and swallowing the amniotic fluid in the womb. Lead researcher Beyza Ustun, a postgraduate researcher in the Fetal and Neonatal Research Lab, Department of Psychology, Durham University, said: “A number of studies have suggested that babies can taste and smell in the womb, but they are based on post-birth outcomes while our study is the first to see these reactions prior to birth. “As a result, we think that this repeated exposure to flavours before birth could help to establish food preferences post-birth, which could be important when thinking about messaging around healthy eating and the potential for avoiding ‘food-fussiness’ when weaning. “It was really amazing to see unborn babies’ reaction to kale or carrot flavours during the scans and share those moments with their parents.” The research team, which also included scientists from Aston University, Birmingham, UK, and the National Centre for Scientific Research-University of Burgundy, France, scanned the mothers, aged 18 to 40, at both 32 weeks and 36 weeks of pregnancy to see fetal facial reactions to the kale and carrot flavours. Mothers were given a single capsule containing approximately 400mg of carrot or 400mg kale powder around 20 minutes before each scan. They were asked not to consume any food or flavoured drinks one hour before their scans. The mothers also did not eat or drink anything containing carrot or kale on the day of their scans to control for factors that could affect fetal reactions. Facial reactions seen in both flavour groups, compared with fetuses in a control group who were not exposed to either flavour, showed that exposure to just a small amount of carrot or kale flavour was enough to stimulate a reaction. Co-author Professor Nadja Reissland, head of the Fetal and Neonatal Research Lab, Department of Psychology, Durham University, supervised Beyza Ustun’s research. She said: “Previous research conducted in my lab has suggested that 4D ultrasound scans are a way of monitoring fetal reactions to understand how they respond to maternal health behaviours such as smoking, and their mental health including stress, depression, and anxiety. “This latest study could have important implications for understanding the earliest evidence for fetal abilities to sense and discriminate different flavours and smells from the foods ingested by their mothers.” Co-author Professor Benoist Schaal, of the National Centre for Scientific Research-University of Burgundy, France, said: “Looking at fetuses’ facial reactions we can assume that a range of chemical stimuli pass through maternal diet into the fetal environment. “This could have important implications for our understanding of the development of our taste and smell receptors, and related perception and memory.” The researchers say their findings might also help with information given to mothers about the importance of taste and healthy diets during pregnancy. They have now begun a follow-up study with the same babies post-birth to see if the influence of flavours they experienced in the womb affects their acceptance of different foods. Research co-author Professor Jackie Blissett, of Aston University, said: “It could be argued that repeated prenatal flavour exposures may lead to preferences for those flavours experienced postnatally. In other words, exposing the fetus to less ‘liked’ flavours, such as kale, might mean they get used to those flavours in utero. “The next step is to examine whether fetuses show less ‘negative’ responses to these flavours over time, resulting in greater acceptance of those flavours when babies first taste them outside of the womb.”
Expertfile Spotlight on National Plan for Health Workforce Well-Being
ChristianaCare Participates in National Academy of Medicine National Plan for Health Workforce Well-Being and Calls for Collective Movement to Address Burnout Crisis The capacity and well-being of the U.S. health workforce has been under threat for years by an epidemic of burnout, and two years of the COVID-19 pandemic has further exacerbated this systems issue. Now at least 40% of nurses, 20% of physicians, and more than 25% of state and local public health department employees are considering leaving their professions. Recognizing that the function of the U.S. health system is at stake due to dangerously mounting health care system pressures, the National Plan for Health Workforce Well-Being by the National Academy of Medicine calls for immediate action to safeguard this precious national resource dedicated to protecting the country’s health. ChristianaCare is proud to have contributed this publication. “The NAM Clinician Well-Being Collaborative’s National Plan for Health Workforce Well-Being will drive urgently needed collective action to strengthen health workforce well-being and reverse existing alarming trends in burnout and turnover,” said ChristianaCare Chief Wellness Officer Heather Farley, M.D., MHCDS, FACEP. “ChristianaCare has served as a strategic network partner with the NAM to design this National Plan, which will coordinate action across several priority areas, including understanding the effects of COVID-19 on the health care workforce, recruiting of the next generation, and increasing access to much-needed mental health resources.” The National Plan calls on multiple actors to work together to drive policy and systems change to better support the health workforce and the health of all communities – including health care and public health leaders, government, payers, industry, educators, and leaders in other sectors. A draft of the National Plan was made available for public feedback and received nearly 2,000 constructive comments. To date the final Plan has received endorsements from over 25 organizations representing the diverse organizational membership of the Clinician Well-Being Collaborative and the various actors needed to collectively advance the practical strategies laid out in the Plan – including ChristianaCare. ChristianaCare has been engaged in all National Plan priority areas, such as: The creation and sustaining of positive work and learning environments and culture. Efforts in this priority area include development of the Center for WorkLife Wellbeing, which utilizes a comprehensive, multimodal approach to foster caregiver work-life meaning, connection, and joy. The Center offers multiple support services and culture change initiatives, including the implementation of resident well-being rounds, OASIS rooms for caregiver restoration, and opportunities for caregivers to develop long-standing mutual support systems. The support of mental health and reduction of mental health stigma, which included the championing of the physician mental health bill that became law this year. It also includes psychological first aid training that ChristianaCare has implemented for health system leaders and managers. Additionally, ChristianaCare offers free comprehensive behavioral health support services and an individual peer and group support program to help caregivers when they experience stress in the workplace. The commitment to well-being as a long-term value, which includes integration of caregiver collective well-being as a systemwide strategic goal. The National Plan visualizes that, when all actors take responsibility, we can create a health system in which care is delivered with joy and with meaning, by a committed care team, in partnership with engaged patients and communities. The National Plan identifies a range of actions for the near-, medium-, and long-term to achieve seven priority areas for health workforce well-being, clearly naming associated goals and responsible actors. Access the full National Plan here to learn more about the priority areas for action. For more information on the Action Collaborative on Clinician Well-Being and Resilience, of which ChristianaCare is a member, visit this site.
Physical models of a patient’s brain help researchers treat neurological disorders and diseases
Brain phantoms are a creative solution for a challenging question: How do you tune an electromagnetic field to a patient without testing on the actual patient? Transcranial magnetic stimulation (TMS) is an application of electromagnetic research with the potential to change the way we treat migraines, depression, obsessive compulsive disorder and even conditions like schizophrenia and Parkinson’s disease. Ravi Hadimani, Ph.D., associate professor of mechanical and nuclear engineering, leads a team of researchers who seek to use TMS to excite or inhibit brain neurons to alter specific brain functions and treat these conditions. This team includes faculty from VCU Health, including Mark Baron, M.D., professor of neurology and Kathryn Holloway, M.D., professor of neurosurgery, as well as outside collaborators like Joan Camprodon, M.D., associate professor of psychiatry at Harvard Medical School. “The brain phantom is a first step,” says Hadimani, “Our ultimate goal is to 3D print a brain fabricated with biomaterial scaffolds and printed neurons that produce a stimulation response similar to neurons in our brain. This model would behave more realistically than current brain phantoms. Our future work involves collaborating with researchers who are able to print lab-grown neurons on biomaterial scaffolds or researchers who directly fabricate artificial neurons onto any scaffold.” Coils used in TMS are responsible for generating the electromagnetic field used in treatment. Individual coils are designed to treat specific diseases, but additional settings like current strength, number of pulses and coil direction are unique to each patient. Refining these settings on the actual patient is not feasible. Computer modeling is also inefficient because creating head models and running simulations from MRI scans of the brain’s complex structure are not spontaneous. Hadimani and his team developed the brain phantom as a novel solution to this problem. In 2018, the first model was created by Hamzah Magsood, one of Hadimani’s Ph.D. students. The brain phantom is a physical model of a patient’s brain designed to specifications obtained from MRI scans. Materials used in brain phantom construction are designed to replicate the electrical conductivity and electromagnetic permeability of different brain sectors. The result is a representation that, when connected to electrodes, provides instantaneous feedback to researchers calibrating TMS coils. Elements of material science, electromagnetics and mechanical prototyping come together to create each brain phantom. The process starts with an MRI, which serves as a map for researchers designing the customized model. This is a careful process. Unlike other areas of the body with clear distinguishing features, like skin, muscle and bone, the brain has subtle differences between its many regions. Researchers must carefully distinguish between these areas to create an accurate brain phantom that will simulate a patient’s skin and skull as well as the brain’s gray and white matter. A composite material of polymer and carbon nanotubes that exhibits electric properties similar to the human brain is the foundation for the brain phantom. Additive manufacturing, more commonly known as 3D printing, is used to create shells for different brain regions based on the patient’s MRI. This shell becomes a mold for the polymer and carbon nanotube solution. Once the brain phantom takes shape within the mold, it is placed within a solution that dissolves the casing, leaving only the brain phantom behind. The conductive parts of the brain phantom are dark because of the carbon nanotubes and non-conductive parts are lighter in color. Electrodes are easily inserted into the brain phantom and provide feedback when an electromagnetic field from the TMS coil is applied. Adjustments to the strength, number of pulses of the field, and coil direction can then be made before applying the treatment to a patient. Having recently received a patent for the brain phantom, Hadimani and Wesley Lohr, a senior biomedical engineering undergraduate, formed Realistic Anatomical Model (RAM) Phantom. The pair have been awarded both the Commonwealth Commercialization Fund Award and the Commonwealth Cyber Initiative Dreams to Reality Incubator Grant. RAM Phantom’s goal is to market brain phantom technology to the growing neuromodulation market, which also includes transcranial direct current stimulation and deep brain stimulation. The company will also aid in the development of advanced brain models that more accurately simulate the properties of the human brain.
Researchers explore alternate delivery method for potential Alzheimer’s treatment
“Traditionally, the nose has been used as a route for delivery of locally acting drugs,” Laleh Golshahi, Ph.D., explained. “But recently, there has been a great deal of interest in the direct pathway through the olfactory region. That’s the same region where we smell, and that route is a direct pathway to the brain.” Golshahi, associate professor in VCU’s Department of Mechanical and Nuclear Engineering, leads the collaboration. Other members of the group are Worth Longest, Ph.D., the Louis S. and Ruth S. Harris Exceptional Scholar and Professor in the Department of Mechanical and Nuclear Engineering; Michael Hindle, Ph.D., the Peter R. Byron Distinguished Professor in VCU’s Department of Pharmaceutics; and Arya Bazargani, a Ph.D. student in VCU’s Interdisciplinary Center for Pharmaceutical Engineering and Sciences. The project is supported by a $200,000 internal grant from VCU Breakthroughs, a new internal funding mechanism as part of the Optimizing Health thrust of the One VCU Research Strategic Priorities Plan being implemented by the university’s Office of the Vice President for Research and Innovation. Hindle said that studies of nasally administered insulin have shown some promise for reducing the effects of Alzheimer’s. Unfortunately, delivery by injection, the most common way to deliver insulin, is ineffective for Alzheimer’s and other cerebral conditions because of the blood-brain barrier. Bazargani explained that nose-to-brain delivery of pharmaceuticals circumvents the blood-brain barrier, the lining of the blood vessels that surround the brain, guarding the central nervous system against a host of pathogens. “It’s usually a good thing,” he said. “But not when you’re trying to induce therapeutic effects into the brain.” Bazargani explained that insulin molecules are so large that the blood-brain barrier filters out most of the insulin. Hindle pointed out that even though the VCU team is avoiding the blood-brain barrier, insulin delivery still presents a number of challenges. “Insulin is a pretty fragile molecule, you know. It’s stored in the fridge,” Hindle said. “We need to include insulin in some sort of stable formulation — either a powder or a liquid nasal spray. We have to create the right particle or droplet size to get it into the right area of the nose.” Formulation development is only half of a two-pronged challenge, Golshahi said. The second aspect is the creation of a device that can deliver a dose way up to the olfactory region. “The nose is a challenge, because it’s designed as a filter to keep aerosols out of the body,” said Longest, who, along with Golshahi and Hindle, brings expertise in computational fluid dynamics to the team. “And the olfactory region is an especially troubling or difficult region to target, because it’s designed just to let a few molecules of what we inhale deposit.” Chief among the nasal filtering defenses, Golshahi said, is mucociliary clearance. Nasal passages are lined with mucous-coated cilia — moving microscopic projections on cells — sweeping foreign substances out of the air we breathe. The cilia do an excellent job, she said, but their efficiency makes it difficult to achieve a consistent delivery to the olfactory region. Another challenge, she added, lies in the fact that all noses are different. The collaborators are using in vitro and in silico methodologies. For the in vitro work, they have an array of 3D printed nose models, based on computed tomography (CT) scans. Golshahi said they have multiple anatomical casts of human nasal airways to test likely device/formulation combinations for their insulin/Alzheimer’s initiative. “We are going to use three of those nasal casts as our starting point,” she said. “We’ll connect the casts to a breathing simulator, which is basically a machine you can program to add the air going through — sort of bringing them to life.” Golshahi added that data from the casts will inform the in-silico component of the work — computational analysis that is expected to verify or challenge observations from the lab. Hindle said that once the team has developed a satisfactory formulation-device system, they can tackle the next challenge: identifying the dominant pathway from the olfactory region to the brain. “There are a variety of theories out there,” he said. “It could go along the nerve passageway. It could go between the nerve walls and the cells linking them.” “We have all the equipment and all the expertise necessary to be able to develop a formulation, and to put it in a device that leads to the highest amount of delivery to the target region,” Golshahi said. “And we are able to quantify how successful that combination of formulation and device is.”
