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Poop has been an easy target for microbiome research, but voyages into the small intestine shed new light on ways to improve gut health

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theconversation.com – Christopher Damman, Associate Professor of Gastroenterology, School of Medicine, University of Washington – 2024-06-14 07:38:49

Much of the small intestine microbiome remains an undiscovered frontier.

Stefano Madrigali/Moment via Getty Images

Christopher Damman, University of Washington

Microbiome research to date has been much like the parable of the blind men and the elephant. How much can be said about an elephant by examining just its tail? Researchers have studied what is most readily available – stool rescued from a flush down the toilet – but have been missing the microbial masterminds upstream in the small intestine. Until recently.

Likened by some scientists to another human organ, your microbiome is collectively the tens of trillions of microorganisms that live in interconnected populations on and in your body. They serve as miniature sentinels that help protect your body’s surfaces from pathogenic invaders. In the upper intestine, distinct microbial populations also aid in digestion, metabolism and even immunity.

I am a gastroenterologist who has spent the past 20 years studying the microbiome’s role in health and disease. Advances in technology are helping scientists investigate the small intestine microbiome and the promise it holds for better understanding and treating many diseases.

Big transformations come from small places

Certain members of the small intestine microbiome are linked to obesity and overweight, while other microbial members are linked to a healthy metabolic state. Indeed, small intestine microbes aid in digestion by turning certain simple carbohydrates into the molecular building blocks of a healthy gut and body.

While analogous in function to the colon, small intestine metabolites can be quite distinct from the fiber-derived metabolites of the large intestine microbiome. Some small intestine metabolites help regulate the upper gut’s production of GIP, a sister molecule to the lower gut hormone GLP-1, which makes up the weight loss and type 2 diabetes drugs Wegovy and Ozempic. Together, with another lower gut hormone called PYY, this triumvirate is critical for coordinating your body’s response to food by regulating your appetite and blood sugar.

Monjaro is an incrementally more powerful combination of GIP and GLP-1 compared with Wegovy and Ozempic. The full complement of these hormones is naturally stimulated by the breakdown of products from both the large and small intestine microbiome.

The upshot on gut breakdown

Research has linked a disrupted small intestine microbiome to diseases of the gut. These include irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohn’s disease and Celiac disease.

These diseases are thought to arise partly from disturbances in the way the microbiome breaks down food. Celiac disease, for example, is associated with the small intestine microbiome’s decreased ability to digest gluten. IBS and SIBO are linked to the opposite: the small intestine microbiome’s ability to too readily ferment fibers and sugars.

Small intestinal bacterial overgrowth, or SIBO, shares similar symptoms with irritable bowel syndrome.

Foods like wheat, garlic, onion, beans and certain processed products that are high in FODMAPs – a set of fermentable short-chain carbohydrates – have been shown to contribute to symptoms in individuals with SIBO and IBS. Lactose-rich dairy is a high FODMAP food group implicated in lactose intolerance and linked to an overzealous small intestine microbiome.

The body’s not-so-diplomatic immunity

Diseases associated with the small intestine microbiome aren’t limited to metabolism and the gut. In the gut’s lining resides a virtual embassy of immune cells that remain in an ever-vigilant state surveying the motley stream of microbial and nutritional antigens passing through your gut.

Compromise in the security systems that separate the fecal stream from the rest of the body and the processes that keep immune responses in check are hypothesized to play a role in triggering various autoimmune conditions in which the body becomes confused as to who’s friend and who’s foe.

Studies have linked inflammatory changes in the small intestine microbiome to type 1 diabetes, where the body’s circulating immune cells attack insulin-producing cells in the pancreas, and to the extra-intestinal symptoms of Celiac disease, where immune cells can lead to destructive processes in the body’s eyes, skin and joints.

Lights shed in and on the tunnel

Up until very recently, small intestinal research has moved slowly. Scientists relied on upper endoscopy procedures, which involve sedation and inserting a small camera at the end of pinky-thick tubes through the mouth into the very first part of the small intestine.

One of the few alternatives to endoscopies has been studying patients who have had intestinal surgeries that leave direct portals into their small intestine via a hole in their abdominal wall.

Newly developed technologies are removing the need for sedating medications and unique anatomical situations by allowing scientists to more easily sample the furthest reaches of the gut. Such technologies include camera capsules tethered to angel-hair-thin filaments and other even more streamlined devices that create minimally invasive direct lines of access to the small intestine. Researchers have also developed capsules with sample compartments that open when they reach certain acidity levels in the body.

Close-up of person dangling pill-like device over tongue

Improvements in endoscopy techniques are making it easier to study the small intestine.

Simon Belcher/imageBROKER via Getty Images

These new sampling techniques have unlocked unprecedented access to the upper gut, paving the way for new insights and therapies. In a real-life parallel to a childhood favorite, “The Magic School Bus, Inside the Human Body,” researchers can now ride along through the gut like Ms. Frizzle and her class, shining light on the microbial secrets held within.

Accrued alliance in a still-crude science

Therapies based on early understandings of the gut microbiome have included approaches ranging from probiotics to fecal transplants and prebiotics to fermented foods.

But new treatments for gut health are still in their early days. Studying the small intestine could provide insights to improve therapeutic development. A couple of promising future possibilities include partnering small intestine bacteria with their preferred prebiotics and personalized combinations of low FODMAP prebiotics designed to avoid small intestine fermentation.

Treatments that partner food and the microbiome are likely early harbingers of what’s to come in the rapidly developing field of microbiome medicine. Researching the small intestine – and not only the gut’s tail end – might just be microbiome medicine’s most pioneering upstream start.The Conversation

Christopher Damman, Associate Professor of Gastroenterology, School of Medicine, University of Washington

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Pearl Young, the first woman to work in a technical role at NASA, overcame barriers and ‘raised hell’ − her legacy continues today

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theconversation.com – Caitlin Milera, Research Assistant Professor of Aerospace, University of North Dakota – 2024-12-10 07:44:00

Caitlin Milera, University of North Dakota

Thirteen years before any other woman joined the National Advisory Committee for Aeronautics – or the NACA, NASA’s predecessor – in a technical role, a young lab assistant named Pearl Young was making waves in the agency. Her legacy as an outspoken and persistent advocate for herself and her team would pave the way for women in science, technology, engineering and mathematics for decades to come.

My interest in Young’s story is grounded in my own identity as a woman in a STEM field. I find strength in sharing the stories of women who made lasting impacts in STEM. I am the director of the NASA-fundedNorth Dakota Space Grant Consortium, where we aim to foster an open and welcoming environment in STEM. Young’s story is one of persistence through setbacks, advocacy for herself and others, and building a community of support.

Facing challenges from the beginning

Young was a scientist, an educator, a technical editor and a researcher. Born in 1895, she was no stranger to the barriers that women faced at the time.

In the early 20th century, college degrees in STEM fields were considered “less suited for women,” and graduates with these degrees were considered unconventional women. Professors who agreed to mentor women in advanced STEM fields in the 1940s and 1950s were often accused of communism.

In 1956, the National Science Foundation even published an article with the title: “Women are NOT for Engineering.”

Despite society’s sexist standards, Young earned a bachelor’s degree in 1919 with a triple major in physics, mathematics and chemistry, with honors, from the University of North Dakota. She then began her decades-long career in STEM.

A group of people standing outside a plane holding a sign that says 'Aloha from Hilo'
An avid traveler, Pearl Young – waving at the top of the stairs – traveled to Hawaii on a UND alumni trip in 1960.
Pearl Young Papers collection in UND’s Special Collections

Becoming a technical editor

Despite the hostile culture for women, Young successfully navigated multiple technical roles at the NACA. With her varied expertise, she worked in several divisions – physics, instrumentation and aerodynamics – and soon noticed a trend across the agency. Many of the reports her colleagues wrote weren’t well written enough to be useful.

In a 1959 interview, Young spoke of her start at the NACA: “Those were fruitful years. I was interested in good writing and suggested the need for a technical editor. The engineers lacked the time to make readable reports.”

Three years after voicing her suggestion, Young was reassigned to the newly created role of assistant technical editor in the publications section in 1935. After six years in that role, Young earned the title of associate technical editor in 1941.

In 1941, the NACA established the Aircraft Engine Research Laboratory, now known as NASA Glenn Research Center, in Cleveland. This new field center needed experienced employees, so two years later, NACA leadership invited Young to lead a new technical editing section there.

A black and white photo of ten women, with five standing behind five seated at a table.
Pearl Young, seated in the front row, far right, with the technical editing section at the Aircraft Engine Research Laboratory. The AERL’s Wing Tips described Young’s office as one which embodied ‘constant vigilance’ and encompassed a ‘rigidly trained crew.’
NASA Glenn Research Center Archives

It was at the Aircraft Engine Research Laboratory that Young published her most notable technical work, the Style Manual for Engineering Authors, in 1943. NASA’s History Office even referred to Young as the architect of the NACA technical reports system.

Young’s style manual allowed the agency to communicate technological progress around the globe. This manual included specific formatting rules for technical writing, which would increase consistency for engineers and researchers reporting their data and experimental results. It was essential for efficient World War II operations and was translated into multiple languages.

But it wasn’t until after this publication that Young finally received the promotion to full technical editor, 11 years after she voiced the need for the role at the agency. She was the first person to hold this role, but she had to start at the assistant level, then move up to associate before receiving the full technical editor designation.

Pearl Young ‘raising hell’

Perhaps the most noteworthy piece of Young’s story is her character. While advocating for herself and her colleagues, Young often had to challenge authority.

She stood up for her editing section when male supervisors wrongfully accused them of making mistakes. She wrote official proposals to properly classify her office in the research division at the Aircraft Engine Research Laboratory. She regularly acknowledged the contributions of her entire team for the achievements they shared.

She also secured extra personnel to lessen unbearable workloads and wrote official memorandums to ensure that her colleagues earned rightful promotions. Young often referred to these actions as “raising hell.”

A letter typed on a typewriter, which includes the sentence 'one false move on their part and I'll raise hell.'
Excerpt of Pearl Young’s letter to colleague and friend Viola Ohler Phillips, stating she’ll ‘raise hell’ if the Washington office refused to follow proper technical editing practices.
NASA Glenn Research Center Archives

The archival documents I’ve analyzed indicate that Young’s performance at the NACA was exemplary throughout her career. In 1967, she was awarded the University of North Dakota’s prestigious Sioux Award in recognition of her professional achievements and service to the university.

In 1995, and again in 2014, NASA Langley Research Center dedicated a theater in her name. The new theater is located in NASA’s Integrated Engineering Services Building.

In 2015, Young was inducted into the inaugural NASA/NACA Langley Hall of Honor. But throughout her career, not all of her colleagues shared this complimentary view of Young and her work.

One of Young’s supervisors in 1930 thought it necessary to assess her “attitude” and fitness as an employee in her progress report – and justified his position by typing these additional words into the document himself.

Later that year, Young requested time off – likely for the holiday season – prompting a different supervisor to draft an official memorandum to the engineer in charge, a position akin to today’s NASA center director. He referred to Young’s “attitude” in requesting to use her vacation days.

A scanned file reads 'this employee's attitude is to take legally all that is possible.'
A 1930 memorandum to the engineer in charge, from the official personnel folder of Pearl Irma Young, describes her ‘attitude.’
National Archives and Records Administration – National Personnel Records Center

Women not welcome in STEM

While sexism in STEM has shifted its forms over time, gender-based inequities still exist. Women in STEM frequently confront microaggressions, marginalization and hostile work environments, including unequal pay, lack of recognition and additional service expectations.

Women often lack supportive social networks and encounter other systemic barriers to career advancement, such as not being recognized as an authority figure, or the double standard of being perceived as too aggressive instead of as a leader.

Women of color, women who belong to LGBTQ+ communities and women who have one or more disabilities face even more barriers rooted in these intersectional identities.

One of the ways to combat these inequities is to call attention to systemic barriers by sharing stories of women who persisted in STEM – women like Pearl Young.The Conversation

Caitlin Milera, Research Assistant Professor of Aerospace, University of North Dakota

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Hypnosis is not just a parlor trick or TV act − science shows it helps with anxiety, depression, pain, PTSD and sleep disorders

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theconversation.com – David Acunzo, Assistant Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia – 2024-12-10 07:43:00

Although hypnosis can help with a number of medical conditions, it doesn’t work for everything.
Paula Connelly/iStock via Getty Images Plus

David Acunzo, University of Virginia

We’ve all seen it, typically on television or on stage: A hypnotist selects a few members from the audience, and with what seems to be little more than a steely stare or a few choice words, they’re suddenly “under the spell.” Depending on what the hypnotist suggests, the participants laugh, dance and perform without inhibition.

Or perhaps you’ve experienced hypnosis another way – with a trip to a hypnotherapist for a series of sessions to help you stop smoking, lose weight, manage pain or deal with depression. This is no longer unusual; thousands of Americans have done the same thing. And many were helped.

Hypnosis has been found to be effective for treating irritable bowel syndrome, and it may be beneficial for weight reduction, sleep disorders and anxiety. For mild to moderate depression in adults, hypnotherapy is as effective as cognitive behavioral therapy, and it can help with depression in children. Hypnosis is also used to treat phobias, PTSD and to control pain during surgery and dental procedures in both adults and children.

Yet despite the evidence, its widespread use and its growing popularity, hypnosis is still viewed with skepticism by some scientists, and with curiosity by much of the public. As a researcher studying altered states from a cognitive and neuroscientific perspective, I’m happy to help pull back the curtain to show you how hypnosis works.

In a comfortable office setting, a woman lies down on a couch, with a therapist sitting nearby in a chair.
People are more hypnotizable if they are receptive to the therapy.
PeopleImages/iStock via Getty Images Plus

A hypnotherapy session

In simple terms, hypnosis is a procedure that helps people imagine different experiences that feel very real. When that occurs, the person can be said to be in a state of hypnosis.

Little is known about what characterizes a hypnotic state in terms of brain activity, but neuroimaging studies indicate a decrease in activity in the parts of the brain responsible for self-referential thought and daydreaming, and increased links between the parts responsible for attention and action.

These results are consistent with the idea that people who are hypnotized are in a state that inhibits internal thoughts and other distractions, such as bodily sensations or noises, that may interfere with the hypnosis.

A therapist’s first set of suggestions typically includes the “hypnotic induction,” which helps the subject increase their responsiveness to other suggestions. An induction may be like this: “I will now count from 5 to 1. At every count, you will feel even more relaxed, and that you are going deeper and deeper into hypnosis.”

When responding to suggestions, the subject’s experience feels involuntary. That is, it’s happening to them, rather than generated by them. This is known as the classical suggestion effect. Following a suggestion to move their arm, the subject may feel as though their arm rises on its own, rather than being raised of their own volition.

For perceptual suggestions, the experience can feel quite real and distinct from voluntary imagination. If I ask you to imagine hearing a dog barking outside, it requires an effort, and the experience does not feel like there’s really a dog barking outside. But through hypnotic suggestion, responsive subjects will feel like they hear a dog barking, and they won’t be cognizant of any effort to make it happen.

What makes people hypnotizable?

You can’t force anyone to be hypnotized. Willingness to participate, a positive attitude, motivation and expectation are hugely important. So is the ability to set aside the fact that the situation is imaginative. It’s like when you become fully absorbed with the story and characters in a movie – so absorbed you forget you’re in a theater.

Good rapport with the therapist is also critical. If you refuse to cooperate or decide hypnosis won’t work, it won’t. A good comparison may be meditation: You can listen to a meditation recording, but if you’re unwilling to follow the instructions, or if you’re unmotivated or distracted, it won’t have any effect.

Few traits predict whether someone is easily hypnotizable, but people are not equal in their ability to respond to hypnotic suggestions. Some people vividly experience a wide array of suggestions; others, not nearly as much. There are indications that women respond slightly better to hypnotic suggestions than men, and that peak hypnotizability occurs during late childhood and early teenage years.

From a neuroscientific perspective, it appears that hypnotic suggestions do not act directly on our executive functions, but rather on our self-monitoring functions. That is, hypnosis does not directly decide our behaviors for us. Rather, it modifies how the brain monitors what it’s doing. So when the hypnotist suggests that you raise your arm, you’re still the one making that decision – although your experience may seem like the arm is moving by itself.

Some myths and realities about a hypnotherapy session.

Exposure therapy, self-hypnosis

The aim of hypnotherapy is to induce changes in negative emotions, perceptions and actions. Suppose you are afraid of public speaking. Through suggestions, the therapist may make you go through the experience of talking in front of an audience. Again, it feels real – your stress level will rise, but ultimately you’ll habituate yourself and learn to cope with the stress, even as the therapist suggests increasingly challenging scenarios.

Hypnosis can also be used as a preparation or replacement for exposure therapy, which is a method to treat phobias or anxiety related to specific situations by progressively exposing the patient to increasingly challenging situations. If you’re afraid of birds, the therapist may suggest you imagine holding a feather; then imagine getting near a bird in a cage; then imagine going to the park and feeding pigeons. This is more effective, and feels more real, than mere visualization.

The hypnotherapist can also teach self-hypnosis techniques. Subjects can learn to induce a state of relaxation that’s associated with a gesture, such as closing the left hand.

Hypnotic suggestions like this decrease anxiety by promoting activation of the parasympathetic nervous system, which stimulates bodily functions during times of rest, such as digestion and sexual arousal, and deactivates the sympathetic nervous system, which stimulates the fight-or-flight response.

Progress can occur after less than 10 sessions with some disorders, such as insomnia in children. But it may take longer for others, such as depression. And just as hypnosis is not suitable for everyone, it’s also not suitable for everything.

What’s more, not all hypnotherapy products on the market are backed by scientific evidence. It is safer to go to a hypnotherapist who’s licensed in your state. You should ask whether they are affiliated with or certified by a professional association of hypnotherapists. You can then confirm their affiliation on the association’s website. For instance, the American Society of Clinical Hypnosis allows you to search members by name.

Although Medicare does not cover hypnotherapy, some private insurance partially covers the costs for some conditions, provided the treatment is performed by a licensed clinical mental health professional. One session will typically cost between US$100 and $250.The Conversation

David Acunzo, Assistant Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia

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Some black holes at the centers of galaxies have a buddy − but detecting these binary pairs isn’t easy

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theconversation.com – Marco Ajello, Professor of Physics and Astronomy, Clemson University – 2024-12-05 07:40:00

Some black holes, bound by gravity, rotate around each other, as shown in this simulated image.
Simulating eXtreme Spacetimes Lensing (SXS), CC BY-SA

Marco Ajello, Clemson University and Jonathan Zrake, Clemson University

Every galaxy has a supermassive black hole at its center, much like every egg has a yolk. But sometimes, hens lay eggs with two yolks. In a similar way, astrophysicists like us who study supermassive black holes expect to find binary systems – two supermassive black holes orbiting each other – at the hearts of some galaxies.

Black holes are regions of space where gravity is so strong that not even light can escape from their vicinity. They form when the core of a massive star collapses on itself, and they act as cosmic vacuum cleaners. Supermassive black holes have a mass a million times that of our Sun or larger. Scientists like us study them to understand how gravity works and how galaxies form.

Figuring out whether a galaxy has one or two black holes in its center isn’t as easy as cracking an egg and examining the yolk. But measuring how often these binary supermassive black holes form can help researchers understand what happens to galaxies when they merge.

In a new study, our team dug through historical astronomical data dating back over a hundred years. We looked for light emitted from one galaxy that showed signs of harboring a binary supermassive black hole system.

Galactic collisions and gravitational waves

Galaxies like the Milky Way are nearly as old as the universe. Sometimes, they collide with other galaxies, which can lead to the galaxies merging and forming a larger, more massive galaxy.

The two black holes at the center of the two merging galaxies may, when close enough, form a pair bound by gravity. This pair may live for up to hundreds of millions of years before the two black holes eventually merge into one.

Supermassive black holes orbiting around each other can emit gravitational waves.

Binary black holes release energy in the form of gravitational waves – ripples in space-time that specialized observatories can detect. According to Einstein’s general relativity theory, these ripples travel at the speed of light, causing space itself to stretch and squeeze around them, kind of like a wave.

Pulsar timing arrays use pulsars, which are the dense, bright cores of collapsed stars. Pulsars spin very fast. Researchers can look for gaps and anomalies in the pattern of radio waves emitted from these spinning pulsars to detect gravitational waves.

While pulsar timing arrays can detect the collective gravitational wave signal from the ensemble of binaries within the past 9 billion years, they’re not yet sensitive enough to detect the gravitational wave signal from a single binary system in one galaxy. And even the most powerful telescopes can’t image these binary black holes directly. So, astronomers have to use clever indirect methods to figure out whether a galaxy has a binary supermassive black hole in its center.

Searching for signs of binary black holes

One type of indirect method involves searching for periodic signals from the centers of active galaxies. These are galaxies that emit significantly more energy than astronomers might expect from the amount of stars, gas and dust they contain.

These galaxies emit energy from their nucleus, or center – called the active galactic nucleus. In a process called accretion, the black hole in each active galaxy uses gravity to pull nearby gas inward. The gas speeds up as it approaches the black hole’s event horizon – like how water surrounding a whirlpool moves faster and faster as it spirals inward.

As the gas heats up, it glows brightly in optical, ultraviolet and X-ray light. Active galactic nuclei are some of the most luminous objects in the universe.

Some active galactic nuclei can launch jets, which are particle beams accelerated to near the speed of light. When these jets line up with our observatories’ lines of sight, they appear extremely bright. They’re like cosmic lighthouses.

Some active galactic nuclei have periodic light signals that get bright, fade and then get bright again. This unique signal could come from the cyclical motion of two supermassive black holes inside, and it suggests to astronomers to look for a binary black hole system in that galaxy.

On the hunt for a binary black hole system

Our team studied one such active galactic nucleus, called PG 1553+153. The light from this object gets brighter and dimmer about every 2.2 years.

These periodic variations suggest that PG 1553+153 has a supermassive black hole binary inside. But a binary isn’t the only explanation for this variation. Other phenomena, such as wobbly jets or changes in the flow of material around the black hole, could also explain this pattern without the presence of a binary black hole, so we had to rule those out.

To understand whether the PG 1553+153 system’s light emission patterns came from a binary black hole, we simulated how binary supermassive black holes collect gas. Our models suggested that sometimes, when the black holes pull in gas, dense clumps of gas collect around the outside of the hole.

We calculated that the time it takes for these clumps to orbit around the two black holes should be five to 10 times longer than the time it takes for the two black holes to circle each other.

So, we finally had a clear prediction that we could test. If a binary black hole system caused the 2.2-year periodic variation in PG 1553+153, then we should also be able to see a longer pattern of variation, about every 10 to 20 years, when the clumps of gas circle around the black holes.

But to see whether this was really a pattern, we needed to watch it repeat for four to five cycles. For PG 1553+153, that would be 40 to 100 years.

Astronomers have observed the sky for hundreds of years. But the era of digital astronomy, where astronomical images are recorded on computers and saved in databases, is very recent – only since the year 2000 or so.

Before then, starting around 1850, astronomers recorded images of the sky on photographic plates. These are flat pieces of glass coated with a light-sensitive chemical layer traditionally used in photography. Many observatories around the world have photographic images of the night sky dating back to more than a hundred years ago. Before that, astronomers would sketch what the sky looked like in their notebooks.

Projects like DASCH, Digital Access to a Sky Century at Harvard, have started digitalizing photographic plates from a few observatories to make them available for scientists and nonscientists alike.

Our team learned that the DASCH database provided data on PG 1553+153 dating back to 1900 – more than 120 years. We used this dataset to see whether we could see a pattern repeating every 10 to 20 years.

Somewhat to our surprise, we found a 20-year pattern that adds more evidence to our theory that there’s a binary system at the core of PG 1553+153. The detection of this second pattern also helped us figure out that the masses of the two supermassive black holes are in a 2.5:1 ratio – with one 2½ times as large as the other – and that their orbit is nearly circular.

While this historical data makes us more confident that there are two supermassive black holes in PG 1553+153, we still can’t say for sure. The final confirmation might need to wait until pulsar timing arrays become sensitive enough to detect the gravitational waves coming from PG 1553+153.The Conversation

Marco Ajello, Professor of Physics and Astronomy, Clemson University and Jonathan Zrake, Assistant Professor of Physics, Clemson University

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