A software engineering student at University of Limerick is working on a project that could help to revolutionise the early detection of cerebral palsy.

Aaron Roche, a 20-year-old student on the Immersive Software Engineering (ISE) programme at UL, is working on the ELEVATE project, which is a ground-breaking five-year research programme that aims to improve the prevention, detection and treatment of early brain injury and cerebral palsy in Ireland.

He selected the ELEVATE project for his residency as part of ISE, a transformational teaching and research initiative that aims to rethink and disrupt computer science education. ELEVATE is led by the INFANT Research Centre at University College Cork and partnered with RCSI University of Medicine and Health Sciences, Trinity College Dublin and the tertiary-level maternity hospitals in Ireland.

The team at INFANT Research Centre are focussed on 3 key areas to improve care pathways: prevention, early detection, and intervention. Leveraging the latest advancements in AI will help them identify risk factors in pregnancy, labour and the early neonatal period that increase the likelihood of CP. This may help them to prevent CP from occurring in the first place and to reduce its severity when it does occur. ISE students learn by doing, working on projects and in paid residencies at some of ISE’s more than fifty partner organisations. They will also achieve a Masters’ qualification in four years.

When Aaron was selecting the residency, the opportunity was more than just a mix of research, machine learning, and healthcare, it connected to something personal, finding that his interests matched with the project’s goals.

“We had modules on research and machine learning in ISE that really caught my attention. Then, when it came time to pick our placements, the ELEVATE project ticked all the boxes. It had research and machine learning, and it was in the medical industry, and it seemed like something that was going to have a genuine impact on the line. Plus, the project had just launched, so it was a chance to get in at the start of something meaningful.

“One of the biggest issues with cerebral palsy is that it can’t be diagnosed early enough. It’s usually after two years when the child is diagnosed and that’s too late for early intervention. So, the aim of the project is to create screening algorithms to assess the risk of cerebral palsy in children from soon after birth.”

Aaron, who is from Wexford, took inspiration from his secondary school days in selecting the residency.

“I went to St Peter’s College Secondary School in Wexford and there was a boy in our year who had cerebral palsy that affected his entire body. Our school motto was ‘Disce Prodesse’ which means ‘learn to be useful’ and there was a Disce Prodesse school award every year. He was nominated for this award because he was so inspiring to the rest of us.  He was an inspiration for me to go this route.”

Part of the ELEVATE project aims to develop a screening process that could identify potential risks even before birth.

The UL ISE student’s role on the project is vital. He is working with a small team to build algorithms that will analyse large amounts of data.

“We’re looking at hundreds of variables. Everything from the mother’s lifestyle, background, ethnicity, to any complications during pregnancy. Then, after birth, we monitor babies in neonatal intensive care units and track their development over a five-year period, recording things like their general intelligence, speech, and physical development. My job is to build the software that can sift through all this data and help predict the risk of cerebral palsy.”

For Aaron, the personal motivations to use his skills and knowledge for good and his passion for software engineering make this an exciting challenge.

“It’s amazing to think that the work we’re doing could eventually lead to cerebral palsy being diagnosed much earlier, to give a better chance for early intervention.”

As for his time in UL’s ISE programme, Aaron feels that it has prepared him well for his career plans.

“ISE was always my first choice. The idea of getting a masters degree and two years of industry experience by the time you’re 22 or 23 is such a huge advantage. And it’s so immersive, we have our own building, and all our lecturers are experts in their field. They’re not just teaching us how to work in a company, but how to start our own businesses.”

While Aaron is deeply committed to his current work on the ELEVATE project, his future ambitions are clear.

“I’d like to start my own company someday. I’m not sure exactly what that will look like yet, but I see myself in a leadership role.”

The ELEVATE project itself is still in its early stages.

“Right now, we’re setting up the tools to collect data from pregnancies, working with  Karolinska Institute in Sweden to gather that information. We hope to create algorithms that will assess the risk of cerebral palsy while the child is still in the womb. If the risk is high, the next step will be further screening with another algorithm, and so on. It’s a multi-step process.”

Funded under the Science Foundation Ireland (SFI) Strategic Partnership Programme, with co-funding partner The Cerebral Palsy Foundation (CPF), ELEVATE aims to revolutionise the delivery of CP care in Ireland. The project was officially launched by Tánaiste, Minister for Foreign Affairs and Minister for Defence, Micheál Martin TD in March 2024.

For Aaron, though, the impact is personal.

“I think of my classmate from school sometimes, and it reminds me why I wanted to work on something like this. To be part of a project that could change lives for the better – that’s really what it’s all about.”

News Coverage:

• UL student developing AI to revolutionize early cerebral palsy detection | Irish Independent
• UL student working on project that could ‘revolutionise early detection of cerebral palsy’ – Limerick’s Live 95 (live95fm.ie)

4 in 5 Pregnant Women in Ireland are Iron Deficient by Third Trimester, a research study reveals

Worrying findings sparking call for action

Four out of five pregnant women in Ireland are iron deficient by their third trimester, a University College Cork (UCC) study reveals. Researchers at the Irish Centre for Maternal and Child Health Research (INFANT) and School of Food and Nutritional Sciences in UCC have shown that over 80% of women are iron deficient by their third trimester.

The findings raise concerns as the participants in the study were a low-risk and generally healthy cohort. Iron deficiency during pregnancy is linked to increased risks of complications for both mother and child, including neurodevelopmental challenges for the baby.

This study is the largest of its kind globally and was conducted in collaboration with the University of Minnesota and the Masonic Institute of the Developing Brain. Led by UCC’s Dr Elaine McCarthy, the study was published in the prestigious American Journal of Clinical Nutrition.

The study analysed data collected from 641 women in Ireland who were pregnant with their first baby and had a successful delivery.  Blood samples were taken from the women throughout pregnancy, at 15, 20 and 33 weeks to determine iron status. “In Cork, which is a high-resource setting,” the authors found that “iron deficiency defined by a variety of markers was very common during pregnancy, despite the mothers being generally healthy.” Interestingly, despite these high rates of iron deficiency, none of the study participants were anemic in the first trimester. In particular, the authors noted that “our cohort had higher rates of deficiency in the third trimester than even some low-resource settings.”

In this study, almost three-quarters of the participants took an iron-containing supplement that contained the Irish/European recommended daily iron allowance of 15-17mg. The authors did note that “iron-containing supplements (mainly multivitamins) taken pre/early pregnancy were associated with a reduced risk of iron deficiency throughout pregnancy, including the third trimester.” The study did not have information on maternal diet, so it was not possible to investigate other dietary or lifestyle practices that were protective.

Lead researcher, Dr Elaine McCarthy from UCC’s INFANT Research Centre and the School of Food and Nutritional Sciences, explains the significance of the results:

“Iron deficiency is the most common micronutrient deficiency in the world, but it has often been thought of as mainly a problem in low-resource settings. Our research clearly illustrates that iron deficiency is extremely common amongst pregnant women, even in a generally healthy population, such as this cohort in Ireland, with greater than 80% of women iron deficient in their third trimester.”

A National Health Concern

Routine screening for iron deficiency during pregnancy is not common in Ireland or further afield and Dr McCarthy emphasises the need for a shift in healthcare practices:

“Our findings highlight the importance of screening to identify the women at the greatest risk of iron deficiency early in their pregnancy. In addition to this, we need to support and educate pregnant women around the importance of iron in their diets, something which we at UCC and colleagues in Cork University Maternity Hospital and the Ireland South Women and Infants Directorate are working on. We have a patient resource on iron during pregnancy launching in the coming months.”

Impact on Irish Families

Iron deficiency is associated with a higher risk of complications for both mother and child and can have long-term consequences on the child’s brain development, affecting cognition, behaviour and motor skills.  Previous research from the team at UCC has shown that iron deficiency in early life is associated with behavioural problems at 5 years of age.  This research highlights the value and urgent need for strategies to identify women at risk of iron deficiency during pregnancy. Such strategies can play a crucial role in reducing these health risks, benefiting families for generations to come, the researchers state.

Call for Policy Changes

Co-author Prof Michael Georgieff of the University of Minnesota echoes the call for urgent action:

“This data strongly supports a global policy that includes a systematic method of screening all women for iron status in early pregnancy with the goal of treating those that are frankly deficient or are below a threshold of sufficiency that will lead to deficiency during pregnancy. Part of medical practice has always been identifying nutritional deficiencies and addressing them. This study illustrates how incredibly common iron deficiency is in pregnant women even in the healthiest of populations and it is well documented that the rates are higher in less-well-resourced and unhealthier populations.”

With iron needs increasing nearly tenfold during pregnancy, expectant mothers are urged to focus on increasing the amount of iron in their diets. Iron is found in different foods including red meats like beef and lamb, green leafy vegetables, beans, nuts and dried fruit. However, while reminding women that the heme iron from animal sources is more easily absorbed than the non-heme iron found in plant-based sources, a wide-range of iron-rich food from both sources is important, when possible.

This research was funded through the European Union FP7 Framework and supported by the Health Research Board, link to the publication can be found: https://doi.org/10.1016/j.ajcnut.2024.08.010

News Coverage

• Examiner: https://www.irishexaminer.com/news/arid-41483410.html
• Journal.ie: https://www.thejournal.ie/iron-deficient-pregnancy-ireland-6497189-Sep2024/
• Newsweek: https://www.newsweek.com/pregnant-women-become-iron-deficient-staggering-says-doctor-1959294

• Study shows that using a novel advancement therapy called the “Milk Ladder”, was almost four times more likely to be successful in safely reintroducing cow’s milk to children with milk allergies in comparison to other classic approaches used in other countries.
• Research conducted at the Irish Centre for Maternal and Child Health Research (INFANT) at University College Cork and Cork University Hospital.
• This discovery marks a significant breakthrough in allergy management and opens the door for parents to play an active role in successfully re-introducing milk to children with milk allergies.

Researchers have demonstrated how a novel approach to managing cow’s milk allergy could transform how food allergies are treated.

Food allergies occur when the immune system reacts abnormally to otherwise harmless food proteins, which can cause immediate symptoms such as vomiting, diarrhoea, hives, and respiratory issues. Severe reactions can lead to anaphylaxis, a life-threatening condition requiring emergency medical attention.

Now researchers at the Irish Centre for Maternal and Child Health Research (INFANT) at University College Cork and Cork University Hospital have shown that cow’s milk can be safely and effectively reintroduced to children with milk allergies which affects 2-3% of infants, marking a significant breakthrough in allergy management.

Traditionally, IgE-mediated cow’s milk allergy is managed through strict avoidance of milk in all forms, followed by a series of outpatient appointments and allergy tests, often culminating in a hospital-based milk reintroduction between the ages of 3 to 5 years. This process can be lengthy and stressful for both the patient and their family, requiring extensive time and medical resources.

However, INFANT, UCC researchers have demonstrated that using the “Milk Ladder” method as a step-by-step approach, allows for a home-based reintroduction of milk under the careful supervision of caregivers. This method significantly reduces the need for hospital visits and enables the immune system to gradually become less reactive to milk proteins. Most notably, the children managed with the Milk Ladder were almost 4 times more likely to successfully reintroduce milk compared to those who followed the traditional avoidance approach.

The findings from the study are published in the Journal of Paediatric Allergy and Immunology.

Earlier this year, CUH and UCC were designated a World Allergy Organisation Center of Excellence.

Dr. Juan Trujillo, Consultant Paediatric Allergist at Cork University Hospital, University College Cork and the lead researcher on the study, highlighted the impact of food allergies on Irish families, stating, “The diagnosis of food allergy can be life-changing, bringing significant challenges to households, including psychological stress. In Ireland, the three most common food allergies in children under 3 years old are eggs, cow’s milk, and peanuts.  Our research aims to support these families, enabling more successful and quicker recoveries.”

Dr. Trujillo also emphasised the importance of Ireland’s role in advancing food allergy management, saying, “Ireland should be proud of being at the forefront of this novel therapy. The Milk Ladder has been used for over a decade and is now the first choice of management for milk allergy across Ireland, thanks to the efforts of my colleague Prof. Jonathan Hourihane at the Royal College of Surgeons of Ireland who introduced this method and supported us in the research. The National Dairy Council and Dairy Research Ireland played a key role in making this research possible”

Dr. Trujillo cautioned against the unnecessary avoidance of certain foods, particularly in young children, as this avoidance of certain food types at the wrong time in their lives can negatively impact their growth and increase the risk of developing food allergies. He advised, “We strongly recommend consulting with a GP for an appropriate referral and diagnosis and avoid unregulated allergy testing methods”