The Honours were originally meant to be announced in June, but were delayed due to the COVID-19 pandemic. Following approval from Her Majesty the Queen, hundreds of additional people were added to the 2020 Queen’s Birthday Honours list for their contributions tackling the virus on the frontline and in their communities.

Professor Julia Gog from the Department of Applied Mathematics and Theoretical Physics is one of the many individuals recognised for their work on the COVID-19 pandemic. Professor Gog, who is a Fellow of Queens’ College, has been made OBE for services to academia and the COVID-19 response.

In 2018, Julia and her team were behind the UK’s largest citizen science experiment in collaboration with the BBC, using location data from mobile phones to map how pandemic influenza might spread across the UK. The massive dataset that resulted from the experiment, the largest and most detailed of its kind, has been used in the response to COVID-19.

Since the start of the SARS-CoV-2 pandemic, Julia has provided expert advice on infectious disease modelling and COVID-19 to SAGE and its sub-groups - particularly SPI-M-O and the Children’s Task and Finish working group (TFC).

As the lead modelling representative and co-deputy chair of the SAGE’s TFC, Julia has shaped and co-ordinated the modelling advice on options for re-opening schools, a key government priority. Her input has been pivotal to the development of DfE’s response and in developing principles for future interventions.

Through her role on the steering committee of the Royal Society’s Rapid Assistance in Modelling the Pandemic (RAMP) initiative and involvement with other groups (such as the Isaac Newton Institute and Virtual Forum for Knowledge Exchange in Mathematical Sciences), Julia has established working relationships between SAGE and the wider scientific community.

She said: “It’s hugely rewarding to see so many scientists recognised in this way. While I am of course thankful for this personal honour, science is a team pursuit, and I am grateful to so many colleagues for their work and support particularly during this year. While there are still many challenges ahead, we will continue to do all we can to help bring this pandemic to an end.”

Dr Giles Yeo, Principal Research Associate at the Metabolic Research Laboratories and MRC Metabolic Diseases Unit, has been made MBE for services to research and communication and engagement.

Dr Yeo, a Fellow of Wolfson College, is a geneticist interested in studying the brain's control of food intake and body weight, and how these might be dysregulated in obesity. He is from San Francisco, receiving his bachelor’s degree in Molecular and Cell Biology from the University of California, Berkeley. He came to Cambridge in 1994 for his PhD studies. In 1998 he began his postdoctoral training with Professor Sir Stephen O’Rahilly in the Department of Clinical Biochemistry, working on the genetics of severe human obesity.

Giles was the first to report that mutations in the melanocortin-4 receptor (MC4R) and in the neurotrophic receptor TRKB resulted in severe human obesity. In 2007, he became Scientific Director of the core Genomics/Transcriptomics facilities and a group leader at the University of Cambridge Metabolic Research Labs. He is also the current President of the British Society for Neuroendocrinology.

He said: “I can assure you that this was entirely unexpected. Because it was in times of COVID, the notification, instead of being on expensive official stationery, came via email, and I initially thought it was a phishing scam! Anyway, it wasn’t, and I’m deeply honoured to be recognised for my contributions to communicating and engagement in research. I am grateful to be working at an Institution which has allowed me to breathe and to follow my passion.”

Professor Sarah Worthington, from the Faculty of Law and Trinity College, is made DBE for services to English Private Law. She is one of the most prolific, original and influential academics working in the broad field of private law. Since 2011 she has been Downing Professor of the Laws of England at the University of Cambridge, and is currently also a Deputy Vice Chancellor of the University; in 2012 she helped found, and is Director of, the Cambridge Private Law Centre, which promotes informed debate across all branches of private law including obligations, property, family and private international law.

She said: “I feel surprised, delighted and overwhelmed by the honour. It’s wonderful to see legal research recognised in this way, especially research in private law. But research endeavours are never solo projects. I’ve been immensely fortunate to have met and worked with a lot of very warm and clever people who have helped me in all sorts of ways. Thank you to all of them, as I continue to learn from their example.”

Professor Stefan Reif, Fellow of St John’s College and Founder of the Taylor-Schechter Genizah Research Unit at the University of Cambridge, has been made OBE for services to Scholarship. Under his directorship, the Cambridge Genizah Collection was transformed from an overlooked, under-used and only partially available resource to a major literary treasure that is now widely exploited by scholars, and that has revolutionised the understanding of medieval Jewish life. He has contributed significantly to international developments in the historical study of Jewish liturgy, especially clarifying the evolution of Jewish prayer texts in the eastern Mediterranean in Crusader times.

Mark Enzer, CTO at Mott MacDonald and Digital Director at the Centre for Digital Built Britain (CDBB), is made OBE for services to the National Infrastructure. Mark is a keen champion of innovation in the context of collaborative delivery models and he is particularly interested in transformational change in the infrastructure industry. As Mott MacDonald’s Chief Technical Officer, he is accountable to the Executive Board for technical excellence across the Group.  As the Chair of CDBB’s Digital Framework Task Group, Mark is contributing to the leadership of the National Digital Twin Programme.

The result - about 36 km per second - is around twice as fast as the speed of sound in diamond, the hardest known material in the world.

Waves, such as sound or light waves, are disturbances that move energy from one place to another. Sound waves can travel through different mediums, such as air or water, and move at different speeds depending on what they’re travelling through. For example, they move through solids much faster than they would through liquids or gases, which is why you’re able to hear an approaching train much faster if you listen to the sound propagating in the rail track rather than through the air.

Einstein’s theory of special relativity sets the absolute speed limit at which a wave can travel which is the speed of light and is equal to about 300,000 km per second. However, until now it was not known whether sound waves also have an upper speed limit when travelling through solids or liquids.

The study, published in the journal Science Advances, shows that predicting the upper limit of the speed of sound is dependent on two dimensionless fundamental constants: the fine structure constant and the proton-to-electron mass ratio.

These two numbers are already known to play an important role in understanding our Universe. Their finely-tuned values govern nuclear reactions such as proton decay and nuclear synthesis in stars and the balance between the two numbers provides a narrow ‘habitable zone’ where stars and planets can form and life-supporting molecular structures can emerge. However, the new findings suggest that these two fundamental constants can also influence other scientific fields, such as materials science and condensed matter physics, by setting limits to specific material properties such as the speed of sound.

The scientists tested their theoretical prediction on a wide range of materials and addressed one specific prediction of their theory that the speed of sound should decrease with the mass of the atom. This prediction implies that the sound is the fastest in solid atomic hydrogen. However, hydrogen is an atomic solid at very high pressure above 1 million atmospheres only, pressure comparable to those in the core of gas giants like Jupiter. At those pressures, hydrogen becomes a fascinating metallic solid conducting electricity just like copper and is predicted to be a room-temperature superconductor. Therefore, researchers performed state-of-the-art quantum mechanical calculations to test this prediction and found that the speed of sound in solid atomic hydrogen is close to the theoretical fundamental limit.

Professor Chris Pickard, from Cambridge's Department of Materials Science and Metallurgy, said: “Soundwaves in solids are already hugely important across many scientific fields. For example, seismologists use sound waves initiated by earthquakes deep in the Earth's interior to understand the nature of seismic events and the properties of Earth's composition. They’re also of interest to materials scientists because sound waves are related to important elastic properties including the ability to resist stress.”

Professor Kostya Trachenko, Professor of Physics at Queen Mary, said: “We believe the findings of this study could have further scientific applications by helping us to find and understand limits of different properties such as viscosity and thermal conductivity relevant for high-temperature superconductivity, quark-gluon plasma and even black hole physics.”

Reference:
K. Trachenko et al. ‘Speed of sound from fundamental physical constants.’ Science Advances (2020). DOI: 10.1126/sciadv.abc8662

Adapted from a Queen Mary University of London press release. 

The software, called vLUME, was created by scientists at the University of Cambridge and 3D image analysis software company Lume VR Ltd. It allows super-resolution microscopy data to be visualised and analysed in virtual reality, and can be used to study everything from individual proteins to entire cells. Details are published in the journal Nature Methods.

Super-resolution microscopy, which was awarded the Nobel Prize for Chemistry in 2014, makes it possible to obtain images at the nanoscale by using clever tricks of physics to get around the limits imposed by light diffraction. This has allowed researchers to observe molecular processes as they happen. However, a problem has been the lack of ways to visualise and analyse this data in three dimensions.

“Biology occurs in 3D, but up until now it has been difficult to interact with the data on a 2D computer screen in an intuitive and immersive way,” said Dr Steven F. Lee from Cambridge’s Department of Chemistry, who led the research. “It wasn’t until we started seeing our data in virtual reality that everything clicked into place.”

The vLUME project started when Lee and his group met with the Lume VR founders at a public engagement event at the Science Museum in London. While Lee’s group had expertise in super-resolution microscopy, the team from Lume specialised in spatial computing and data analysis, and together they were able to develop vLUME into a powerful new tool for exploring complex datasets in virtual reality.

“vLUME is revolutionary imaging software that brings humans into the nanoscale,” said Alexandre Kitching, CEO of Lume. “It allows scientists to visualise, question and interact with 3D biological data, in real time all within a virtual reality environment, to find answers to biological questions faster. It’s a new tool for new discoveries.”

Viewing data in this way can stimulate new initiatives and ideas. For example, Anoushka Handa – a PhD student from Lee’s group – used the software to image an immune cell taken from her own blood, and then stood inside her own cell in virtual reality. “It’s incredible - it gives you an entirely different perspective on your work,” she said.

The software allows multiple datasets with millions of data points to be loaded in and finds patterns in the complex data using in-built clustering algorithms. These findings can then be shared with collaborators worldwide using image and video features in the software.

“Data generated from super-resolution microscopy is extremely complex,” said Kitching. “For scientists, running analysis on this data can be very time-consuming. With vLUME, we have managed to vastly reduce that wait time allowing for more rapid testing and analysis.”

The team is mostly using vLUME with biological datasets, such as neurons, immune cells or cancer cells. For example, Lee’s group has been studying how antigen cells trigger an immune response in the body. “Through segmenting and viewing the data in vLUME, we’ve quickly been able to rule out certain hypotheses and propose new ones,” said Lee. This software allows researchers to explore, analyse, segment and share their data in new ways. All you need is a VR headset.”

Reference:
Alexander Spark et al. ‘vLUME: 3D Virtual Reality for Single-molecule Localization Microscopy.’ Nature Methods (2020). DOI: 10.1038/s41592-020-0962-1

Electronics that consume tiny amounts of power are key for the development of the Internet of Things, in which everyday objects are connected to the internet. Many emerging technologies, from wearables to healthcare devices to smart homes and smart cities, need cost-effective transistors and electronic circuits that can function with minimal energy use.

Printed electronics are a simple and inexpensive way to manufacture electronics that could pave the way for low-cost electronic devices on unconventional substrates – such as clothes, plastic wrap or paper – and provide everyday objects with ‘intelligence’.

However, these devices need to operate with low energy and power consumption to be useful for real-world applications. Although printing techniques have advanced considerably, power consumption has remained a challenge – the different solutions available were too complex for commercial production.

Now, researchers from the University of Cambridge, working with collaborators from China and Saudi Arabia, have developed an approach for printed electronics that could be used to make low-cost devices that recharge out of thin air. Even the ambient radio signals that surround us would be enough to power them. Their results are published in the journal ACS Nano.

Since the commercial batteries which power many devices have limited lifetimes and negative environmental impacts, researchers are developing electronics that can operate autonomously with ultra-low levels of energy.

The technology developed by the researchers delivers high-performance electronic circuits based on thin-film transistors which are ‘ambipolar’ as they use only one semiconducting material to transport both negative and positive electric charges in their channels, in a region of operation called ‘deep subthreshold’ – a phrase that essentially means that the transistors are operated in a region that is conventionally regarded as their ‘off’ state. The team coined the phrase ‘deep-subthreshold ambipolar’ to refer to unprecedented ultra-low operating voltages and power consumption levels.

If electronic circuits made of these devices were to be powered by a standard AA battery, the researchers say it would be possible that they could run for millions of years uninterrupted.

The team, which included researchers from Soochow University, the Chinese Academy of Sciences, ShanghaiTech University, and King Abdullah University of Science and Technology (KAUST), used printed carbon nanotubes – ultra-thin cylinders of carbon – as an ambipolar semiconductor to achieve the result.

“Thanks to deep-subthreshold ambipolar approach, we created printed electronics that meet the power and voltage requirements of real-world applications, and opened up opportunities for remote sensing and ‘place-and-forget’ devices that can operate without batteries for their entire lifetime,” said co-lead author Luigi Occhipinti from Cambridge’s Department of Engineering. “Crucially, our ultra-low-power printed electronics are simple and cost-effective to manufacture and overcome long-standing hurdles in the field.”

“Our approach to printed electronics could be scaled up to make inexpensive battery-less devices that could harvest energy from the environment, such as sunlight or omnipresent ambient electromagnetic waves, like those created by our mobile phones and wifi stations,” said co-lead author Professor Vincenzo Pecunia from Soochow University. Pecunia is a former PhD student and postdoctoral researcher at Cambridge’s Cavendish Laboratory.

The work paves the way for a new generation of self-powered electronics for biomedical applications, smart homes, infrastructure monitoring, and the exponentially-growing Internet of Things device ecosystem.

The research was funded in part by the Engineering and Physical Sciences Research Council (EPSRC).

Reference:
L. Portilla et al. ‘Ambipolar Deep-Subthreshold Printed-Carbon-Nanotube Transistors for Ultralow-Voltage and Ultralow-Power Electronics.’ ACS Nano (2020). DOI: 10.1021/acsnano.0c06619

A new study of beliefs and attitudes toward COVID-19 in five different countries – UK, US, Ireland, Mexico and Spain – has identified how much traction some prominent conspiracy theories have within these populations.

The research reveals 'key predictors' for susceptibility to fake pandemic news, and finds that a small increase in the perceived reliability of conspiracies equates to a larger drop in the intention to get vaccinated.

Scientists from the University of Cambridge gathered data from national samples in each country, and asked participants to rate the reliability of several statements, including six popular myths about COVID-19.

While a large majority of people in all five nations judged the misinformation to be unreliable, researchers found that certain conspiracy theories have taken root in significant portions of the population.

The conspiracy deemed most valid across the board was the claim that COVID-19 was engineered in a Wuhan laboratory. Between 22-23% of respondents in the UK and United States rated this assertion as “reliable”. In Ireland this rose to 26%, while in Mexico and Spain it jumped to 33% and 37% respectively.

This was followed by the idea that the pandemic is “part of a plot to enforce global vaccination”, with 22% of the Mexican population rating this as reliable, along with 18% in Ireland, Spain and the US, and 13% in the UK.

The notorious 5G conspiracy – that some telecommunication towers are worsening COVID-19 symptoms – holds sway over smaller but still significant segments: 16% in Mexico, 16% in Spain, 12% in Ireland, and 8% in both the UK and US. The study is published today in the journal Royal Society Open Science.

“Certain misinformation claims are consistently seen as reliable by substantial sections of the public. We find a clear link between believing coronavirus conspiracies and hesitancy around any future vaccine,” said Dr Sander van der Linden, co-author and Director of the Cambridge Social Decision-Making Lab.

“As well as flagging false claims, governments and technology companies should explore ways to increase digital media literacy in the population. Otherwise, developing a working vaccine might not be enough.”

Earlier this week, the Social Decision-Making Lab launched a project with the UK Cabinet Office: Go Viral!, a short online game that helps 'inoculate' players against fake news by lifting the lid on common misinformation techniques.  

For the new study, the team – including Cambridge’s Winton Centre for Risk and Evidence Communication – looked at correlations between certain beliefs and demographic categories and the perceived reliability of misinformation.

Scoring highly on a series of numeracy tasks given as part of the study, as well as declaring high levels of trust in scientists, are 'significantly and consistently' associated with low levels of susceptibility to false information across all nations. 

“Numeracy skills are the most significant predictor of resistance to misinformation that we found,” said Dr Jon Roozenbeek, lead author and Postdoctoral Fellow in Cambridge’s Department of Psychology.

“We all now deal with a deluge of statistics and R number interpretations. The fostering of numerical skills for sifting through online information could well be vital for curbing the ‘infodemic’ and promoting good public health behaviour.”  

Moreover, and despite ‘boomer’ memes, the team found that being older is actually linked to lower susceptibility to COVID-19 misinformation in all nations except Mexico (where the opposite is true).

Identifying as more right-wing or politically conservative is associated with higher likelihood of believing COVID-19 conspiracies and falsehoods in Ireland, Mexico and Spain – but less so in the UK or US.

Trusting that politicians can effectively tackle the crisis predicts higher likelihood of buying into conspiracies in Mexico, Spain and the US, but not in the UK and Ireland. Exposure to information about the virus on social media is linked to misinformation susceptibility in Ireland, the UK and US.

Researchers asked participants about their attitude to a future coronavirus vaccine. They were also asked to rate the reliability of conspiratorial COVID-19 claims on a scale of one to seven.

On average, an increase by one-seventh in someone’s perceived reliability of misinformation is associated with a drop of almost a quarter – 23% – in the likelihood they will agree to get vaccinated.  

Similarly, a one-point increase on the conspiracy reliability scale is linked, on average, to a 28% decrease in the odds of someone recommending vaccination to vulnerable friends and family.

Conversely, on average, a one-seventh increase in trust in scientists is associated with a 73% increase in the likelihood of getting vaccinated and a 79% increase in the odds of recommending vaccination to others.

The researchers controlled for many other factors – from age to politics – when modelling levels of 'vaccine hesitancy', and found the results to be consistent across all countries except Spain.

A team of psychology researchers from Cambridge, Columbia and Harvard Universities surveyed over 101,000 people in 55 countries to find out whether they were staying at home because of coronavirus between late March and early April 2020. The results are published today in the journal American Psychologist.

The researchers found that extroverts are least likely to follow official guidance to stay at home. The team suggest that tailoring public health messages towards the more extroverted in society could encourage greater overall compliance in populations and help prevent the spread of coronavirus.

“Extroverts are gregarious and sociable, and they found it especially hard to stay cooped up at home and not see other people. They were most likely to break lockdown rules, and stayed at home less than people of any other personality type during March and April,” said Friedrich Götz, a PhD researcher in the University of Cambridge’s Department of Psychology, and first author of the report.

Late March and early April 2020 coincided with the early, accelerating stage of the COVID-19 pandemic. This was also when government policies on staying at home varied between countries and were changing rapidly over time. Halting the spread of coronavirus relied on people following official guidance. 

The survey explored the five key traits commonly used by psychologists to characterise personality: agreeableness, conscientiousness, extroversion, neuroticism, and openness. Agreeable people tend to be more compliant and trusting, and conscientious ones are diligent and law-abiding. People scoring highly for these personality traits tend to stay at home when advised to do so.

People who scored as highly neurotic, and those with very open-minded personalities decided to stay at home more even before lockdowns were put into place - they were already concerned about catching coronavirus. The researchers think that as restrictions on movements lift, these groups are more likely to maintain social distancing than other personality types.

“Highly neurotic people had decided early on that this virus wasn’t something to mess with, and they were staying at home,” said Götz.

“Open-minded people tend to be very well-connected and interested in the wider world, so we think they realised the potential impact of coronavirus earlier than others and acted accordingly,” added Andrés Gvirtz, a PhD researcher in Cambridge’s Department of Psychology and second author of the study.

He added: “Watching TV reports of the COVID-19 situation in Italy for instance, which was ahead of the UK in terms of the impact of the virus, was informing the behaviour of open-minded people at the beginning of the pandemic.” 

As governments tightened lockdown rules in late March and early April, a greater number of people started following them, regardless of their personality. The study recorded high compliance by this time, with over 80% of people surveyed across the world reporting they were staying at home.

Survey participants’ personalities were scored on the ‘strength’ of each of the five key personality traits on a seven point scale. A single point change in a person’s tendency towards any of the five traits was found to alter their likelihood of staying at home by around 1%. The researchers stress that even this small percentage has important consequences, given the global scale of the pandemic and the contagiousness of coronavirus.

The researchers suggest that public health messages could be tailored towards extroverts, to encourage greater compliance with lockdown rules in the population as a whole. They suggest that such messages could try to convey an understanding of how hard it is to stay at home - particularly for people who really enjoy being with their friends and family - and point out that the guidance is in place to protect those people.  

“Government regulations do very much influence the behaviour of the population at large,” said Götz, “but we need to recognise that not all of the people will follow all of the rules. Extroverts pose a particular challenge during the pandemic, because they are least likely to stay at home when governments advise it.” 

Governments around the world have tried to prevent the spread of coronavirus by encouraging or enforcing social distancing behaviours, with periods of lockdown in which people are asked not to leave home except for specific purposes. 

This research was funded by the UK Economic and Social Research Council (part of UK Research and Innovation), the Cambridge Trust and Peterhouse Cambridge.  

Reference
Götz, F.M. et al: ‘How Personality and Policy Predict Pandemic Behaviour: Understanding Sheltering-in-Place in 55 Countries at the Onset of COVID-19.’ American Psychologist, 2020. DOI: 10.1037/amp0000740

How you can support Cambridge’s COVID-19 research

Following advice from Public Health England and local public health authorities, the Collegiate University’s Incident Management Team has asked 223 students resident in West House, Homerton College to self-isolate from 9.30pm on Friday 16 October following 18 positive cases of COVID-19. Those who are not already in self-isolation must isolate for 14 days and anyone who was already isolating must finish their 14 day period. All other areas of the University and Homerton College remain open.

This step has been taken based on information from the University’s rigorous testing programme, designed to detect outbreaks of infection early and allow the Collegiate University to respond rapidly. In consultation with local public health authorities, the University and the College have taken this preventative step to reduce the chance of transmission within the wider College, the University and the city.

The students in affected households are self-isolating, and the College has brought in additional staff over the weekend to support them. Advice on medical issues and support for mental health and wellbeing is being made available.

Humans are hard-wired to prefer experiences that end well, and the influence of previous experience declines the longer ago it happened. This means we can’t always trust that choices we make based on previous experience will serve our best interests in the future. 

New research, published today in the Journal of Neuroscience, has revealed that two different parts of the brain are activated, and compete with each other, when we make decisions based on past experience. They can cause us to overvalue experiences that end well despite starting badly, and undervalue experiences that end badly despite starting well - even if both are equally valuable overall.

“When you’re deciding where to go for dinner, for example, you think about where you’ve had a good meal in the past. But your memory of whether that meal was good isn’t always reliable - our brain values the final few moments of the experience more highly than the rest of it,” said Dr Martin Vestergaard, a researcher in the University of Cambridge’s Department of Physiology, Development and Neuroscience, who led the study.

“If we can’t control our in-built attraction to happy endings, then we can’t trust our choices to serve our best interests.”

The part of the brain called the amygdala works out the ‘objective value’ of an experience - the overall tastiness of a three-course meal, for example. Meanwhile a brain region called the anterior insula was shown to ‘mark down’ our valuation of an experience if it gets gradually worse over time.

The further back in time an experience was, even if still quite recent, the less weight it carries in making the next decision. The researchers call it the ‘happy ending effect’: we tend to make decisions based on previous experiences that ended well, irrespective of how good the experiences were overall. 

In the study, twenty-seven healthy male volunteers were asked to choose which of two pots of coins, viewed on-screen one at a time, had the greatest total value. They watched as coins of varying sizes - representing their value – fell from the pots in quick succession, while a brain scanner revealed what was happening in their brain using functional magnetic resonance imaging (fMRI). The task was repeated several times with different sequences of coins.

The volunteers systematically chose the wrong pot when the coins decreased in size towards the end of the sequence. This reveals that the brain was imposing a penalty on the whole sequence, irrespective of its total value, when the ending was not good. The effect varied from person to person, but only a few were able to ignore it entirely and make a completely rational decision.

The results verify theoretical models of decision-making, and challenge the popular belief that sub-optimal decision-making is routed in the amygdala - the primitive part of our brain - whereas more astute reasoning happens in the more evolved part. They show that our evaluation of an extended experience is encoded robustly in the amygdala.

The attraction to the final moments of an experience is a fundamental mechanism in the human brain and important to be aware of, say the researchers. While there are clear advantages to paying attention to whether things are on an upward or downward trajectory, our judgements can fail us when we try to evaluate an overall experience afterwards.

While bad decision-making in the context of eating out might not be disastrous, this inaccurate valuation in summarising past events could lead to bad choices when using the information to make decisions for the longer-term – for example, deciding which politician to vote for.

“Our attraction to the quality of the final moment of an experience is exploited by politicians seeking re-election; they will always try to appear strong and successful towards the end of their time in office,” said Vestergaard. “If you fall for this trick, and disregard historical incompetence and failure, then you might end up re-electing an unfit politician.

“Sometimes it’s worth taking the time to stop and think. Taking a more analytical approach to complement your intuitive judgement can help ensure you’re making a rational decision.” 

This research was funded by Wellcome. 

Reference
Vestergaard & Schultz: ‘Retrospective valuation of experienced outcome encoded in distinct reward representations in the anterior insula and amygdala.’ Journal of Neuroscience, October 2020. DOI: 10.1523/JNEUROSCI.2130-19.2020.

Cambridge University Press and Cambridge Assessment publish and create world-leading content and examinations that are used across more than 170 countries. 

The move is in response to a growing desire from learners, teachers and researchers to engage with Cambridge in a joined up digital way, and the demand for innovative products that combine expertise in learning and assessment. The need for an integrated approach has been accelerated by the rapid uptake of digital education during the COVID-19 pandemic. The new organisation will have the capabilities to provide world leading assessment, learning and academic research offerings globally, under the Cambridge brand and backed by first class teaching and research departments.

University of Cambridge Vice-Chancellor Professor Stephen J Toope said, ‘I am delighted to announce this major and hugely exciting development. Cambridge Assessment and Cambridge University Press have a proud history of contributing to scholarship and education around the world. By bringing together their enormous strengths and capabilities, they will be able to contribute to society more effectively and more powerfully than ever.’ 

Over the next few months Cambridge University Press Chief Executive Peter Phillips and Cambridge Assessment Chief Executive Saul Nassé will work together to create the new unified organisation for launch on 1st August 2021, which Phillips will then lead.

Peter Phillips said, ‘our customers already see us simply as Cambridge, so joining the two organisations is a natural next step that is given added impetus by the rapid changes we are seeing in education and research. Saul and I have brought the Press and Cambridge Assessment ever closer  over the last few years and we have a shared commitment to this change which will enable yet more impact by Cambridge on teachers, learners and researchers.’

Saul Nassé said, ‘this is a challenging but exciting time for learning and assessment and this move positions Cambridge to make the most of the opportunities ahead. I will be heading for pastures new, but am looking forward to leading Cambridge Assessment into 2021 and working with Peter to build a single organisation that’s all set for great success in the future.’

I usually work in the University’s Department of Psychology on the Downing Site. Currently I work from home most of the week, and go into the department one day each week to have socially distanced face-to-face meetings with students and lab members.
 
My group's research focuses on brain and social development and mental health in adolescence. We run large-scale behavioural studies in schools and in the lab, as well as neuroimaging studies. Humans are inherently social. Our research has shown that the network of brain regions that enable us to recognise the mental states, feelings and actions of others develops throughout adolescence, and that adolescence is a period of increased social interaction and peer affiliation.

It is important to consider the developmental needs and wellbeing of children and adolescents in this pandemic. Young people around the world now have fewer opportunities to interact face-to-face with peers at a time in their lives when this is crucial for their development. Waves of social distancing and restrictions, even if only temporary, represent a large portion of a young person’s life. At the beginning of lockdown I wrote a paper with my colleagues, Dr Amy Orben and Dr Livia Tomova, on the effects of social distancing on adolescent development and mental health.*

Right now, young people around the world are being blamed and shamed for their role in the spread of coronavirus. In my view, this is not fair and might be counterproductive. Young people are naturally driven to socialise, and meet new people and romantic partners. There is evidence that empowering young people to influence each other to make positive and healthy decisions works better than adult-led campaigns. In the case of COVID-19, educating young people about the importance of social distancing and reducing social contact in order to reduce infection rates, and then incentivising them to run their own campaigns amongst their social networks, might have more of an impact than adults lecturing and blaming them. I recently wrote a short paper on this with my PhD student Jack Andrews and our colleague Dr Lucy Foulkes.** 

It's crucial to take into account the social needs of young people when making policy decisions, and to allow the voices of young people to be heard. I was recently involved in setting up an organisation called Reachwell, to highlight the importance of considering the needs of children and adolescents when making policy decisions around the pandemic. It draws on the expertise of a group of developmental psychologists and psychiatrists. 

Education is a basic human right. Schools shutting for long periods will be detrimental to the development and learning of the younger generation. The pandemic has thrown up many challenges and nothing is simple. From my point of view, one of the biggest challenges is reducing the spread of the virus so that schools are safe for teachers, children and adolescents and can stay open. 

Cambridge provided written evidence to the Education Select Committee reviewing the impact of COVID-19 on education and children’s services. This was a fantastic example of Cambridge experts from different areas coming together in a time of crisis, and prioritising this vitally important issue. We formed the Cambridge University Cross-Disciplinary Special Interest Group for Policy related to children and young people (CUSP), galvanised and brilliantly chaired by Professor Tamsin Ford in the Department of Psychiatry. 

My group has been planning a study on the effects of social isolation in adolescence since early 2019. The pandemic has made this a much larger part of our research plans. We recently embarked on a large-scale study to investigate the effects of social isolation on adolescent cognition and emotion processing, led by Dr Tomova, a research fellow at Hughes Hall who is based in my lab. It involves participants having a brain scan, and experiencing short periods of social isolation followed by behavioural tasks and questionnaires.

When the pandemic is over I’m looking forward to enormous amounts of face-to-face social interaction with friends and family, with lots of hugs. 

Sarah-Jayne Blakemore is Professor of Psychology and Cognitive Neuroscience in the Department of Psychology at the University of Cambridge. 

*Orben, A, Tomova, L & Blakemore, S-J. (2020). The effects of social deprivation on adolescent development and mental health. The Lancet Child & Adolescent Health, 4(8), 634-640. 

**Andrews, J.L., Foulkes, L. & Blakemore, S-J. (2020). Peer influence in adolescence: Public-health implications for COVID-19. Trends in Cognitive Science, 24(8), 585-587. 

How you can support Cambridge’s COVID-19 research

To date, there have been more than 40 million cases of COVID-19 and almost 1.13 million deaths worldwide. The main target tissues of SARS-CoV-2, the virus that causes COVID-19, especially in patients that develop pneumonia, appear to be alveoli – tiny air sacs in the lungs that take up the oxygen we breathe and exchange it with carbon dioxide to exhale.

To better understand how SARS-CoV-2 infects the lungs and causes disease, a team of scientists from the UK and South Korea turned to organoids – ‘mini-organs’ grown in three dimensions to mimic the behaviour of tissue and organs.

The team used tissue donated to tissue banks at the Royal Papworth Hospital NHS Foundation Trust and Addenbrooke’s Hospital, Cambridge University NHS Foundations Trust, UK, and Seoul National University Hospital to extract a type of lung cell known as human lung alveolar type 2 cells. By reprogramming these cells back to their earlier ‘stem cell’ stage, they were able to grow self-organising alveolar-like 3D structures that mimic the behaviour of key lung tissue.

Dr Joo-Hyeon Lee, co-senior author, and a Group Leader at the Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, said: “We still know surprisingly little about how SARS-CoV-2 infects the lungs and causes disease. Our approach has allowed us to grow 3D models of key lung tissue – in a sense, ‘mini-lungs’ – in the lab and study what happens when they become infected.”

The team infected the organoids with a strain of SARS-CoV-2 taken from a patient in South Korea who was diagnosed with COVID-19 on 26 January 26 2020 after traveling to Wuhan, China. Using a combination of fluorescence imaging and single cell genetic analysis, they were able to study how the cells responded to the virus.

When the 3D models were exposed to SARS-CoV-2, the virus began to replicate rapidly, reaching full cellular infection just six hours after infection. Replication enables the virus to spread throughout the body, infecting other cells and tissue.

Around the same time, the cells began to produce interferons – proteins that act as warning signals to neighbouring cells, telling them to activate their antiviral defences. After 48 hours, the interferons triggered the innate immune response – its first line of defence – and the cells started fighting back against infection.

Sixty hours after infection, a subset of alveolar cells began to disintegrate, leading to cell death and damage to the lung tissue.

Although the researchers observed changes to the lung cells within three days of infection, clinical symptoms of COVID-19 rarely occur so quickly and can sometimes take more than ten days after exposure to appear. The team say there are several possible reasons for this. It may take several days from the virus first infiltrating the upper respiratory tract to it reaching the alveoli. It may also require a substantial proportion of alveolar cells to be infected or for further interactions with immune cells resulting in inflammation before a patient displays symptoms.

“Based on our model we can tackle many unanswered key questions, such as understanding genetic susceptibility to SARS-CoV-2, assessing relative infectivity of viral mutants, and revealing the damage processes of the virus in human alveolar cells,” said Dr Young Seok Ju, co-senior author, and an Associate Professor at Korea Advanced Institute of Science and Technology. “Most importantly, it provides the opportunity to develop and screen potential therapeutic agents against SARS-CoV-2 infection.”

“We hope to use our technique to grow these 3D models from cells of patients who are particularly vulnerable to infection, such as the elderly or people with diseased lungs, and find out what happens to their tissue,” added Dr Lee.

The research was a collaboration involving scientists from the University of Cambridge, UK, and the Korea Advanced Institute Science and Technology (KAIST), Korea National Institute of Health, Institute for Basic Science (IBS), Seoul National University Hospital and GENOME INSIGHT Inc. in South Korea.

Reference
Jeonghwan Youk et al. Three-dimensional human alveolar stem cell culture models reveal infection response to SARS-CoV-2. Cell Stem Cell; 21 Oct 2020; DOI: 10.1016/j.stem.2020.10.004

Funding
The research was supported by: the National Research Foundation of Korea; Research of Korea Centers for Disease Control and Prevention; Ministry of Science and ICT of Korea; Ministry of Health & Welfare, Republic of Korea; Seoul National University College of Medicine Research Foundation; European Research Council; Wellcome; the Royal Society; Biotechnology and Biological Sciences Research; Suh Kyungbae Foundation; and the Human Frontier Science Program.

Image caption
Representative image of three-dimensional human lung alveolar organoid showing alveolar stem cell marker, HTII-280 (red) and SARS-CoV-2 entry protein, ACE2 (green). (Credit: Jeonghwan Youk, Taewoo Kim, and Seon Pyo Hong)

Accurately predicting how an individual’s chronic illness is going to progress is critical to delivering better-personalised, precision medicine. Only with such insight can a clinician and patient plan optimal treatment strategies for intervention and mitigation. Yet there is an enormous challenge in accurately predicting the clinical trajectories of people for chronic health conditions such as cystic fibrosis (CF), cancer, cardiovascular disease and Alzheimer’s disease.

“Prediction problems in healthcare are fiendishly complex,” said Professor Mihaela van der Schaar, Director of the Cambridge Centre for AI in Medicine (CCAIM). “Even machine learning approaches, which deal in complexity, struggle to deliver meaningful benefits to patients and clinicians, and to medical science more broadly. Off-the-shelf machine learning solutions, so useful in many areas, simply do not cut it in predictive medicine.”

Unlock this complexity, however, and enormous healthcare gains await. That is why several teams led by Professor van der Schaar and CCAIM Co-Director Andres Floto, Professor of Respiratory Biology at the University of Cambridge and Research Director of the Cambridge Centre for Lung Infection at Royal Papworth Hospital, have developed a rapidly evolving suite of world-class machine learning (ML) approaches and tools that have successfully overcome many of the challenges.

In just two years, the researchers have developed technology that has moved from producing ML-based predictions of lung failure in CF patients using a snapshot of patient data – itself a remarkable improvement on the previous state of the art – to dynamic predictions of individual disease trajectories, predictions of competing health risks and comorbidities, ‘temporal clustering’ with past patients, and much more.

The researchers are presenting three of their new ML technologies this week at the North American Cystic Fibrosis Conference 2020. In-depth details of the technologies and their potential implications are available on the CCAIM website.

The tools developed by the Cambridge researchers represent astonishing progress in a very short time, and reveal the power of ML methods to tackle the remaining mysteries of common chronic illnesses and provide highly precise predictions of patient-specific health outcomes of unprecedented accuracy. What’s more, such techniques can be readily applied to other chronic diseases.

Applying new ML techniques in cystic fibrosis

“Cystic fibrosis is an excellent example of a hard-to-treat, chronic condition,” said Floto. “It is often unclear how the disease will progress in a given individual over time, and there are multiple, competing complications that need preventative or mitigating interventions.”

CF is a genetic condition that affects a number of organs, but primarily the lungs, where it leads to progressive respiratory failure and premature death. In 2019, the median age of the 114 people with CF who died in the UK was 31. Only about half of the people born in the UK with CF in 2019 are likely to live to the age of 50.

Cystic fibrosis is also a fertile ground to explore ML methods, in part because of the UK Cystic Fibrosis Registry, an extensive database that covers 99% of the UK’s CF population which is managed by the UK Cystic Fibrosis Trust. The Registry holds both static and time-series data for each CF patient, including demographic information, CFTR genotype, disease-related measures including infection data, comorbidities and complications, lung function, weight, intravenous antibiotics usage, medications, transplantations and deaths.

“Almost everyone with cystic fibrosis in the UK entrusts the Registry to hold their patient data, which is then used to ensure the best care for all people with the condition,” said Dr Janet Allen, Director of Strategic Innovation at the Cystic Fibrosis Trust. “What’s exciting is that the approaches developed by Professor van der Schaar take this to a completely new level, developing tools to harness the complexity of the CF data. Turning such data into medical understanding is a key priority for the future of personalised healthcare.”

Looking to the future

The suite of new tools offers tremendous potential benefit to everyone in the CF ecosystem, from patients to clinicians and medical researchers. “Our medical ML technology has matured rapidly, and it is ready to be deployed,” said van der Schaar. “The time has come to bring its clear benefits to the individuals who need it most – in this case, the people living with cystic fibrosis. This means collaborating further with clinicians and increasing our engagement with wider healthcare systems and with data guardians beyond the UK.”

Machine learning technologies have proven to be adept at predicting the clinical trajectories of people with long-term health conditions, and innovation will continue at pace. The patient-centred revolution in precision healthcare will enable and empower both clinicians and researchers to extract greater value from the growing availability of healthcare data.

The challenge ahead is to realise the potential of these tools by making them available to clinicians and hospitals around the world, where they can help improve and save the lives of people living with chronic illness. This is one of the goals of the Cambridge Centre for AI in Medicine.

The rate has risen in boys aged five to 16 from 11.4% in 2017 to 16.7% in July 2020 and in girls from 10.3% to 15.2%3 over the same time period, according to The Mental Health of Children and Young People in England 2020 report.

The likelihood of a probable mental disorder increases with age, with a noticeable difference in gender for the older age group (17 to 22 year olds). 27.2% of young women and 13.3% of young men in this age group were identified as having a probable mental disorder in 2020.

This report looks at the mental health of children and young people in England in July 2020, and how this has changed since 2017. Experiences of family life, education and services, and worries and anxieties during the COVID-19 pandemic are also examined. The findings draw on a sample of 3,570 children and young people aged between 5 to 22 years old, surveyed in both 2017 and July 20204.

The report revealed that among girls aged 11 to 16, nearly two-thirds (63.8%) with a probable mental disorder had seen or heard an argument among adults in their household, compared to 46.8% of girls unlikely to have a mental disorder.

Professor Tamsin Ford from the Department of Psychiatry at the University of Cambridge said: “These findings suggest that more children are struggling with poor mental health than in 2017, particularly those reporting having a difficult time during lockdown – this deterioration in mental health was evident for boys and girls and in all ages from 5 years old to 22.

“The figures of older teenagers and emerging adults, particularly for young women are especially alarming, particularly as they replicate others findings from the UK Longitudinal Survey, which also had pre-pandemic data on the same people.

“All who work with children and families need to be working hard to mitigate the impact of the pandemic, as mental health conditions in childhood predict worse adult health and reduce the ability to learn and achieve at school.”

Sleep problems seemed to be a factor during the pandemic with more than a quarter (28.5%) of 5 to 22 year olds having problems sleeping. Again, those with a probable mental disorder reported experiencing sleep problems (58.9%) more than those unlikely to have a mental disorder (19.0%).

This was more common in girls, with 32.4% reporting sleep problems compared with 24.7% of boys. Issues with sleep affected 17 to 22 year olds (41.0%), more than any other age group.

One in ten (10.1%) children and young people aged 11 to 22 years said that they often or always felt lonely. This was more common in girls (13.8%) than boys (6.5%). Children and young people with a probable mental disorder were about eight times more likely to report feeling lonely often or always (29.4%) than those unlikely to have a mental disorder (3.7%).

When it came to receiving help for mental health problems during the pandemic, 7.4% of all 17 to 22 year olds reported they tried to seek help for mental health problems but didn’t receive the help they needed. This rose to 21.7% of those with a probable mental disorder.

The report also covers changes in household circumstances during the pandemic. It was revealed that children with a probable mental disorder were more likely to live in a household that had fallen behind with payments (16.3%) during lockdown, than those unlikely to have a mental health disorder (6.4%).

Overall 37.0% of 11 to 16 year olds and 36.4% of 17 to 22 year olds reported that lockdown had made their life a little worse, while 5.9% of 11 to 16 year olds and 6.7% of 17 to 22 year olds said it had made it much worse.

The report is published by NHS Digital, in collaboration with the Office for National Statistics, the National Centre for Social Research, the University of Cambridge and the University of Exeter.

Adapted from a press release by NHS Digital

Countries meet their needs for goods and services through domestic production and international trade. As a result, countries place pressures on natural resources both within and beyond their borders.

Researchers from the University of Cambridge used macroeconomic data to quantify these pressures. They found that the vast majority of countries and industrial sectors are highly exposed both directly, via domestic production, and indirectly, via imports, to over-exploited and insecure water, energy and land resources. However, the researchers found that the greatest resource risk is due to international trade, mainly from remote countries.

The researchers are calling for an urgent enquiry into the scale and source of consumed goods and services, both in individual countries and globally, as economies seek to rebuild in the wake of COVID-19. Their study, published in the journal Global Environmental Change, also invites critical reflection on whether globalisation is compatible with achieving sustainable and resilient supply chains.

Over the past several decades, the worldwide economy has become highly interconnected through globalisation: it is now not uncommon for each component of a particular product to originate from a different country. Globalisation allows companies to make their products almost anywhere in the world in order to keep costs down.

Many mainstream economists argue this offers countries a source of competitive advantage and growth potential. However, many nations impose demands on already stressed resources in other countries in order to satisfy their own high levels of consumption.

This interconnectedness also increases the amount of risk at each step of a global supply chain. For example, the UK imports 50% of its food. A drought, flood or other severe weather event in another country puts these food imports at risk.

Now, the researchers have quantified the global water, land and energy use of 189 countries and shown that countries which are highly dependent on trade are potentially more at risk from resource insecurity, especially as climate change continues to accelerate and severe weather events such as droughts and floods become more common.

“There has been plenty of research comparing countries in terms of their water, energy and land footprints, but what hasn’t been studied is the scale and source of their risks,” said Dr Oliver Taherzadeh, who led the research while a PhD student in Cambridge’s Department of Geography. “We found that the role of trade has been massively underplayed as a source of resource insecurity – it’s actually a bigger source of risk than domestic production.”

To date, resource use studies have been limited to certain regions or sectors, which prevents a systematic overview of resource pressures and their source. This study offers a flexible approach to examining pressures across the system at various geographical and sectoral scales.

“This type of analysis hasn’t been carried out for a large number of countries before,” said Taherzadeh. “By quantifying the pressures that our consumption places on water, energy and land resources in far-off corners of the world, we can also determine how much risk is built into our interconnected world.”

The authors of the study linked indices designed to capture insecure water, energy, and land resource use, to a global trade model in order to examine the scale and sources of national resource insecurity from domestic production and imports.

Countries with large economies, such as the US, China and Japan, are highly exposed to water shortages outside their borders due to their volume of international trade. However, many countries in sub-Saharan Africa, such as Kenya, actually face far less risk as they are not as heavily networked in the global economy and are relatively self-sufficient in food production. 

In addition to country-level data, the researchers also examined the risks associated with specific sectors. Surprisingly, one of the sectors identified in Taherzadeh’s wider research that had the most high risk water and land use – among the top 1% of nearly 15,000 sectors analysed – was dog and cat food manufacturing in the USA, due to its high demand for animal products.

“COVID-19 has shown just how poorly-prepared governments and businesses are for a global crisis,” said Taherzadeh. “But however bad the direct and indirect consequences of COVID-19 have been, climate breakdown, biodiversity collapse and resource insecurity are far less predictable problems to manage – and the potential consequences are far more severe. If the ‘green economic recovery’ is to respond to these challenges, we need radically rethink the scale and source of consumption.”

Reference:
Oliver Taherzadeh et al. ‘Water, energy and land insecurity in global supply chains.’ Global Environmental Change (2020). DOI: 10.1016/j.gloenvcha.2020.102158

A new study, published today in the journal Nature Communications, suggests that sgACC is a crucial region in depression and anxiety, and targeted treatment based on a patient’s symptoms could lead to better outcomes.  

Depression is a debilitating disorder affecting hundreds of millions of people worldwide, but people experience it differently. Some mainly have symptoms of elevated negative emotion like guilt and anxiety; some have a loss of ability to experience pleasure (called anhedonia); and others a mix of the two. 

Research at the University of Cambridge has found that increased activity in sgACC – a key part of the emotional brain– could underlie increased negative emotion, reduced pleasure and a higher risk of heart disease in depressed and anxious people. More revealing still is the discovery that these symptoms differ in their sensitivity to treatment with an antidepressant, despite being caused by the same change in brain activity. 

Using marmosets, a type of non-human primate, the team of researchers infused tiny concentrations of an excitatory drug into sgACC to over-activate it. Marmosets are used because their brains share important similarities with those of humans and it is possible to manipulate brain regions to understand causal effects.

The researchers found that sgACC over-activity increases heart rate, elevates cortisol levels and exaggerates animals’ responsiveness to threat, mirroring the stress-related symptoms of depression and anxiety. 

“We found that over-activity in sgACC promotes the body’s ‘fight-or-flight’ rather than ‘rest-and-digest’ response, by activating the cardiovascular system and elevating threat responses,” said Dr Laith Alexander, one of the study’s first authors from the University of Cambridge’s Department of Physiology, Development and Neuroscience. 

“This builds on our earlier work showing that over-activity also reduces anticipation and motivation for rewards, mirroring the loss of ability to experience pleasure seen in depression.”  

To explore threat and anxiety processing, the researchers trained marmosets to associate a tone with the presence of a rubber snake, an imminent threat which marmosets find innately stressful. Once marmosets learnt this, the researchers ‘extinguished’ the association by presenting the tone without the snake. They wanted to measure how quickly the marmosets could dampen down and ‘regulate’ their fear response.

“By over-activating sgACC, marmosets stayed fearful for longer as measured by both their behaviour and blood pressure, showing that in stressful situations their emotion regulation was disrupted,” said Alexander. 

Similarly, when the marmosets were confronted with a more uncertain threat in the form of an unfamiliar human, they appeared more anxious following over-activation of sgACC. 

“The marmosets were much more wary of an unfamiliar person following over-activation of this key brain region - keeping their distance and displaying vigilance behaviours,” said Dr Christian Wood, one of the lead authors of the study and senior postdoctoral scientist in Cambridge’s Department of Physiology, Development and Neuroscience. 

The researchers used brain imaging to explore other brain regions affected by sgACC over-activity during threat. Over-activation of sgACC increased activity within the amygdala and hypothalamus, two key parts of the brain’s stress network. By contrast, it reduced activity in parts of the lateral prefrontal cortex – a region important in regulating emotional responses and shown to be underactive in depression.

“The brain regions we identified as being affected during threat processing differed from those we’ve previously shown are affected during reward processing,” said Professor Angela Roberts in the University of Cambridge’s Department of Physiology, Development and Neuroscience, who led the study. 

“This is key, because the distinct brain networks might explain the differential sensitivity of threat-related and reward-related symptoms to treatment.” 

The researchers have previously shown that ketamine – which has rapidly acting antidepressant properties – can ameliorate anhedonia-like symptoms. But they found that it could not improve the elevated anxiety-like responses the marmosets displayed towards the human intruder following sgACC over-activation. 

“We have definitive evidence for the differential sensitivity of different symptom clusters to treatment – on the one hand, anhedonia-like behaviour was reversed by ketamine; on the other, anxiety-like behaviours were not,” Professor Roberts explained.

“Our research shows that the sgACC may sit at the head and the heart of the matter when it comes to symptoms and treatment of depression and anxiety.”

This research was funded by Wellcome.

Reference
Alexander, L. et al; ‘Over-activation of primate subgenual cingulate cortex enhances the cardiovascular, behavioural and neural responses to threat.’ Nature Communications, October 2020. DOI: 10.1038/s41467-020-19167-0

Enterococcus faecium is a bacterium commonly found in the gastrointestinal tract, where it usually resides without causing the host problems. However, in immunocompromised patients, it can lead to potentially life-threatening infection.

Over the last three decades, strains have emerged that are resistant to frontline antibiotics including ampicillin and vancomycin, limiting treatment options – and particularly worrying, these strains are often those found in hospital-acquired E. faecium infections.

A team of scientists at the University of Cambridge and the London School of Hygiene and Tropical Medicine has pioneered an approach combining epidemiological and genomic information to chart the spread of bacteria within healthcare settings. This has helped hospitals identify sources of infection and inform infection control measures.

In a study published today in Nature Microbiology, the team has applied this technique to the spread of drug-resistant E. faecium in a hospital setting.

Dr Theodore Gouliouris from the Department of Medicine at the University of Cambridge, and joint first author on the study, said: “We’ve known for over two decades that patients in hospital can catch and spread drug-resistant E. faecium. Preventing its spread requires us to understand where the bacteria lives – its ‘reservoirs’ – and how it is transmitted.

“Most studies to date have relied on culturing the bacteria from samples. But as we’ve shown, whole genome sequencing – looking at the DNA of the bacteria – combined with detailed patient and environmental sampling can be a powerful tool to help us chart its spread and inform ways to prevent further outbreaks.”

The team followed 149 haematology patients admitted to Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, over a six-month period. They took stool samples from the patients and swabs from the hospital environment and cultured them for E. faecium.

Genomic analysis of the bacteria was much more effective at identifying hospital-acquired E. faecium: out of 101 patients who could be followed up, genomic analysis identified that two thirds of patients acquired E. faecium, compared to less than half using culture methods alone.

Just under half (48%) of the swabs taken from the hospital environment were positive for vancomycin-resistant E. faecium. This included 36% of medical devices, 76% of non-touch areas such as air vents, 41% of bed spaces and 68% of communal bathrooms tested.

The researchers showed that even deep cleaning could not eradicate the bacteria. The hospital undertook deep cleaning on one ward over a three-day period during the study, when patients were moved elsewhere; however, when the team sampled locations prior to patients returning to the ward, they found that 9% of samples still tested positive for the bacteria. Within three days of patients returning to the ward, around half of the sampled sites tested positive.

Three-quarters (74%) of the patients (111/149) were carriers of the A1 clade – a multi-drug resistant strain of E. faecium commonly seen in hospitals that is resistant to the antibiotic ampicillin and which frequently acquires resistance to vancomycin. Of these 111 patients, 67 had strong epidemiological and genomic links with at least one other patient and/or their direct environment.

“The fact that these cases were all linked to another patient or their environment suggests strongly that they had picked up the multi-drug resistant bacteria while in the hospital,” said Dr Francesc Coll from the London School of Hygiene and Tropical Medicine, joint first author.

Further genomic analysis showed that within this multi-drug resistant strain were several subtypes (defined by how genetically-similar they were). However, it was not uncommon for a patient to be carrying more than one subtype, which – without detailed genomic analysis – could confound attempts to identify the route of transmission of an infection. Notably, despite the circulation of as many as 115 subtypes, 28% of E. faecium acquisitions were caused by just two superspreading subtypes. The authors found no evidence of resistance or tolerance to common disinfectants to explain the success of these subtypes.

Six study patients contracted an ‘invasive infection’, meaning that they had been carrying E. faecium asymptomatically in their gut, but subsequently developed a symptomatic infection. Comparing the genomes of the infecting and gut strains the authors determined that invasive E. faecium infections originated from the patients’ own gut.

“Our study builds on previous observations that drug-resistant strains of E. faecium can persist in the hospital environment despite standard cleaning – we were still surprised to find how short-lasting was the effect of deep cleaning,” added Dr Gouliouris.

“We found high levels of hospital-adapted E. faecium despite the use of cleaning products and procedures that have proven effective against the bug. It highlights how challenging it can be to tackle outbreaks in hospitals.”

Senior author Professor Sharon Peacock from the Department of Medicine at the University of Cambridge added: “The high rates of infection with drug-resistant E. faecium in specific vulnerable patient groups and its ability to evade cleaning measures pose an important challenge to infection control. Patient screening, adequate provision of isolation and ensuite toilet facilities, improved and more frequent cleaning procedures, and stricter health-care worker hygiene practices will all be needed to curtail this global epidemic.

“But this is also a sign of how urgently we need to tackle inappropriate use of antibiotics worldwide, which is widely recognised as posing a catastrophic threat to our health and our ability to control infections.”

The research was funded by the Department of Health and Wellcome.

Reference
Gouliouris, T, Coll, F et al. Quantifying acquisition and transmission of Enterococcus faecium using genomic surveillance. Nature Microbiology; 26 Oct 2020; DOI: 10.1038/s41564-020-00806-7

In a study published today in journal Small, the researchers demonstrate that once inside the cancer cells, the nanotubes absorb light, causing them to heat up, thereby killing the cells.

More than 2,600 people are diagnosed in the UK each year with mesothelioma, a malignant form of cancer caused by exposure to asbestos. Although the use of asbestos is outlawed in the UK now, the country has the world’s highest levels of mesothelioma because it imported vast amounts of asbestos in the post-war years. The global usage of asbestos remains high, particularly in low- and middle-income countries, which means mesothelioma will become a global problem.

“Mesothelioma is one of the ‘hard-to-treat’ cancers, and the best we can offer people with existing treatments is a few months of extra survival,” said Dr Arsalan Azad from the Cambridge Institute for Medical Research at the University of Cambridge. “There’s an important unmet need for new, effective treatments.”

In 2018, the University of Cambridge was awarded £10million from the Engineering and Physical Sciences Research Council to help develop engineering solutions, including nanotech, to find ways to address hard-to-treat cancers.

In a collaboration between the University of Cambridge and University of Leeds, researchers have developed a form of gold nanotubes whose physical properties are ‘tunable’ – in other words, the team can tailor the wall thickness, microstructure, composition, and ability to absorb particular wavelengths of light.

The researchers added the nanotubes to mesothelioma cells cultured in the lab and found that they were absorbed by the cells, residing close to the nucleus, where the cell’s DNA lies. When the team targeted the cells with a laser, the nanotubes absorbed the light and heated up, killing the mesothelioma cell.

Professor Stefan Marciniak, also from the Cambridge Institute for Medical Research and a Fellow at St Catharine’s College, Cambridge, added: “The mesothelioma cells ‘eat’ the nanotubes, leaving them susceptible when we shine light on them. Laser light is able to penetrate deep into tissue without causing damage to surrounding tissue. It then gets absorbed by the nanotubes, which heat up and, we hope in the future, could be used to cause localised cancer-cell killing.”

The team will be developing the work further to ensure the nanotubes are targeted to cancer cells with less effect on normal tissue.

The nanotubes are made in a two-step process. First, solid silver nanorods are created of the desired diameter. Gold is then deposited from solution onto the surface of the silver. As the gold builds-up at the surface, the silver dissolves from the inside to leave a hollow nanotube. 

The approach advanced by the Leeds team allows these nanotubes to be developed at room temperature, which should make their manufacture at scale more feasible.

Professor Stephen Evans from the School of Physics and Astronomy at the University of Leeds said: “Having control over the size and shape of the nanotubes allows us to tune them to absorb light where the tissue is transparent and will allow them to be used for both the imaging and treatment of cancers. The next stage will be to load these nanotubes with medicines for enhanced therapies.”

The research was funded by the British Lung Foundation, Victor Dahdaleh Foundation, National Institute for Health Research Cambridge Biomedical Research Centre, Royal Papworth Hospital NHS Foundation Trust, Alpha1-Foundation, Medical Research Council and the Engineering & Physical Sciences Research Council.

Reference
Ye, S & Azad, AA et al. Exploring High Aspect Ratio Gold Nanotubes as Cytosolic Agents: Structural Engineering and Uptake into Mesothelioma Cells. Small; 25 Oct 2020: DOI: 10.1002/smll.2003793

A biological chemist, he was a pioneer in the field of fragment-based drug discovery, a successful entrepreneur, a founding director of Cambridge Enterprise, and the University’s first Director of Postdoctoral Affairs.

A major focus of his highly interdisciplinary research in the Department of Chemistry was to understand the mechanisms of key enzymes and develop approaches to their inhibition, an approach that could lead to new treatments for diseases such as tuberculosis, cystic fibrosis and cancer.

The advances he made in fragment-based drug discovery led him to co-found Astex, a world-leading company in this area, in 1999. Fragment-based approaches are now adopted throughout the pharmaceutical industry and in many academic laboratories.

He also made major contributions to the development of microfluidic microdroplets as a platform for experimental science, with applications in cell biology, chemistry and materials science. This interest resulted in the co-founding of Sphere Fluidics (2010) and Aqdot (2013).

He was an undergraduate and postgraduate student at St John’s College, Cambridge, before conducting postdoctoral research at Brown University, USA. He was named a Fellow of the Academy of Medical Sciences in 2012 and a Fellow of the Royal Society in 2016.

Vice-Chancellor Professor Stephen J Toope said: “Chris’ death is a huge loss to the University, and to me personally. Our thoughts and our deepest sympathies are with his wife, Dr Katherine Abell, their son Daniel, and with Chris’ friends and colleagues at the Department of Chemistry, at the Research Operations and Research Strategy Offices, and at Christ’s College.”

Professor Jane Stapleton, Master of Christ’s College, said: “In Christ’s we are devastated by the shocking news of the death of Chris Abell, our warm, wise friend. He has long been held in the greatest esteem by the College to which he devoted so much of his remarkable energy.”

Dr James Keeler, Head of the Department of Chemistry, said: “Chris has for many years been a leading figure in the field of biological chemistry and has been responsible for significant advances in the field. He has also been conspicuously successful in commercialising aspects of his work, most notably as co-founder of Astex. Chris is remembered by us all as an outstanding scientist, a valued and loyal colleague, and a tireless champion for the Department and the University.”

A digital condolences book has been set up at: www.remembr.com/professor.chris.abell. 

COVID-19 has become a global pandemic, affecting millions of people worldwide. In many cases, the symptoms include fever, persistent dry cough and breathing difficulties, and can lead to low blood oxygen. However, the infection can cause disease in other organs, including the brain, and in more severe cases can lead to stroke and brain haemorrhage.

A team of researchers at the Stroke Research Group, University of Cambridge, carried out a systematic review and meta-analysis of published research into the link between COVID-19 and stroke. This approach allows researchers to bring together existing – and often contradictory or under-powered – studies to provide more robust conclusions.

In total, the researchers analysed 61 studies, covering more than 100,000 patients admitted to hospital with COVID-19. The results of their study are published in the International Journal of Stroke.

The researchers found that stroke occurred in 14 out of every 1,000 cases. The most common manifestation was acute ischemic stroke, which occurred in just over 12 out of every 1,000 cases. Brain haemorrhage was less common, occurring in 1.6 out of every 1,000 cases. Most patients had been admitted with COVID-19 symptoms, with stroke occurring a few days later.  

Age was a risk factor, with COVID-19 patients who developed stroke being on average (median) 4.8 years older than those who did not. COVID-19 patients who experienced a stroke were on average (median) six years younger than non-COVID-19 stroke patients. There was no sex difference and no significant difference in rates of smokers versus non-smokers.

Pre-existing conditions also increased the risk of stroke. Patients with high blood pressure were more likely to experience stroke than patients with normal blood pressure, while both diabetes and coronary artery disease also increased risk. Patients who had a more severe infection with SARS­CoV­2 – the coronavirus that causes COVID-19 – were also more likely to have a stroke.

The researchers found that COVID-19-associated strokes often followed a characteristic pattern, with stroke caused by blockage of a large cerebral artery, and brain imaging showing strokes in more than one cerebral arterial territory. They argue that this pattern suggests cerebral thrombosis and/or thromboembolism are important factors in causing stroke in COVID-19.  COVID-19-associated strokes were also more severe and had a high mortality.

An important question is whether COVID-19 increases the risk of stroke or whether the association is merely a result of COVID-19 infection being widespread in the community.

“The picture is complicated,” explained Dr Stefania Nannoni from the Department of Clinical Neurosciences at the University of Cambridge, the study’s first author. “For example, a number COVID-19 patients are already likely to be at increased risk of stroke, and other factors, such as the mental stress of COVID-19, may contribute to stroke risk.

“On the other hand, we see evidence that COVID-19 may trigger – or at least be a risk factor for – stroke, in some cases. Firstly, SARS­CoV­2 more so than other coronaviruses – and significantly more so than seasonal flu – appears to be associated with stroke. Secondly, we see a particular pattern of stroke in individuals with COVID-19, which suggests a causal relationship in at least a proportion of patients.”

The researchers say there may be several possible mechanisms behind the link between COVID-19 and stroke. One mechanism might be that the virus triggers an inflammatory response that causes thickening of the blood, increasing the risk of thrombosis and stroke. Another relates to ACE2 – a protein ‘receptor’ on the surface of cells that SARS-CoV-2 uses to break into the cell. This receptor is commonly found on cells in the lungs, heart, kidneys, and in the lining of blood vessels – if the virus invades the lining of blood vessels, it could cause inflammation, constricting the blood vessels and restricting blood flow.

A third possible mechanism is the immune system over-reacting to infection, with subsequent excessive release of proteins known as cytokine. This so-called ‘cytokine storm’ could then cause brain damage.

The team say their results may have important clinical implications.

“Even though the incidence of stroke among COVID-19 patients is relatively low, the scale of the pandemic means that many thousands of people could potentially be affected worldwide,” said Professor Hugh Markus, who leads the Stroke Research Group at Cambridge.

“Clinicians will need to look out for signs and symptoms of stroke, particularly among those groups who are at particular risk, while bearing in mind that the profile of an at-risk patient is younger than might be expected.”

While the majority of strokes occurred after a few days of COVID-19 symptoms onset, neurological symptoms represented the reason for hospital admission in more than one third of people with COVID-19 and stroke.

Dr Nannoni added: “Given that patients admitted to hospital with symptoms of stroke might have mild COVID-19-related respiratory symptoms, or be completely asymptomatic, we recommend that all patients admitted with stroke be treated as potential COVID-19 cases until the results of screening in the hospital are negative.”

The research was supported by the Medical Research Council, the National Institute for Health Research (NIHR), the NIHR Cambridge Biomedical Research and the British Heart Foundation.

Reference
Nannoni S, de Groot R, Bell S, Markus HS. Stroke in COVID-19: a systematic review and meta-analysis. Int J Stroke; 26 Oct 2020; DOI: 10.1177/1747493020972922. Epub ahead of print. PMID: 33103610.

The researchers, from the University of Cambridge and Northwestern University, tested the effectiveness of different fabrics at filtering particles between 0.02 and 0.1 micrometres – about the size of most viruses – at high speeds, comparable to coughing or heavy breathing. They also tested N95 and surgical masks, which are more commonly used in healthcare settings.

Previous studies have only looked at a small selection of fabrics when the wearer is breathing normally, when particles are expelled at lower speed. Studying more fabrics and testing them at higher speeds provides a more robust evidence base for the effectiveness of fabric masks.

The results, reported in the journal BMJ Open, show that most of the fabrics commonly used for non-clinical face masks are effective at filtering ultrafine particles. N95 masks were highly effective, although a reusable HEPA vacuum bag actually exceeded the N95 performance in some respects.

As for homemade masks, those made of multiple layers of fabric were more effective, and those which also incorporated interfacing, which is normally used to stiffen collars, showed a significant improvement in performance. However, this improvement in performance also made them more difficult to breathe through than an N95 mask.

The researchers also studied the performance of different fabrics when damp, and after they had gone through a normal washing and drying cycle. They found that the fabrics worked well while damp and worked sufficiently after one laundry cycle, however previous studies have shown that repeated washing degrades the fabrics, and the researchers caution that masks should not be reused indefinitely.

“Fabric masks have become a new necessity for many of us since the start of the COVID-19 pandemic,” said first author Eugenia O’Kelly from Cambridge’s Department of Engineering. “In the early stages of the pandemic, when N95 masks were in extremely short supply, many sewers and makers started making their own fabric masks, meeting the demands that couldn’t be met by supply chains, or to provide a more affordable option.”

While there are numerous online resources which help people make their own masks, there is little scientific evidence on what the most suitable materials are.

“There was an initial panic around PPE and other types of face masks, and how effective they were,” said O’Kelly. “As an engineer, I wanted to learn more about them, how well different materials worked under different conditions, and what made for the most effective fit.”

For the current study, O’Kelly and her colleagues built an apparatus consisting of sections of tubing, with a fabric sample in the middle. Aerosolised particles were generated at one end of the apparatus, and their levels were measured before and after they passed through the fabric sample at a speed similar to coughing.

The researchers also tested how well each fabric performed in terms of breathing resistance, based on qualitative feedback from users. “A mask which blocks particles really well but restricts your breathing isn’t an effective mask,” said O’Kelly. “Denim, for example, was quite effective at blocking particles, but it’s difficult to breathe through, so it’s probably not a good idea to make a mask out of an old pair of jeans. N95 masks are much easier to breathe through than any fabric combinations with similar levels of filtration.”

In preparation for the study, the researchers consulted with online sewing communities to find out what types of fabric they were using to make masks. Due to the severe shortage of N95 masks at the time, several of the sewers reported that they were experimenting with inserting vacuum bags with HEPA filters into masks.

The researchers found that single-use and reusable vacuum bags were effective at blocking particles, but caution that the single-use bags should not be used in face masks, as they fall apart when cut, and may contain component materials which are unsafe to inhale.

“It’s a matter of finding the right balance – we want the materials to be effective at filtering particles, but we also need to know they don’t put users at risk of inhaling fibres or lint, which can be harmful,” said O’Kelly.

The researchers caution that their study has several limitations: namely, that they did not look at the role which fit plays in filtering particles. In a related project, O’Kelly has been studying how the fit of masks in healthcare settings can be improved. In addition, many viruses are carried on droplets which are larger than those looked at in the current study.

However, O’Kelly says the results may be useful for sewers and makers when choosing which fabric to use for making masks. “We’ve shown that in an emergency situation where N95 masks are not available, such as in the early days of this pandemic, fabric masks are surprisingly effective at filtering particles which may contain viruses, even at high speeds.”

Further information about the research can be found at: www.facemaskresearch.com

Reference:
Eugenia O’Kelly et al. ‘Ability of fabric face mask materials to filter ultrafine particles at coughing velocity.’ BMJ Open (2020). DOI: 10.1136/bmjopen-2020-039424