 I know that Friday afternoons in Washington, D.C. are a challenge, so this shows your commitment to this topic and thank you very much. And just to let you know, there are a number of people that reached out to us who were not able to join and have asked if we could video this so that they could watch it live stream, as well as be available later, especially for field teams or country teams or those who cannot watch it live. So we will arrange to have it available on the website so that it can be watched, you can share it with your groups. And I know the Burma team on an earlier event that Angelina was a panelist on resilience shared it with your team and had a discussion around it. So we asked Dr. Jawad to give a very detailed presentation, it will be about 40 minutes so that there will be enough substance there for folks who were not able to be here that they will be able to pick up on it and after his presentation we will have a question and answer. And we intentionally kept this small so that we know that in an earlier event there wasn't enough time to have people have a discussion and ask questions about your programs or things that you are curious about, so there will be plenty of time for that, so please don't even hesitate to do that. So I would like to just do a few introductory comments. My name is Colette Roush and I am a senior advisor here at USIP and the event today is a discussion with Dr. Ali Jawad on epigenetics, the role of childhood and intergenerational trauma and protracted conflicts. And what I would like to just briefly say is to talk about Dr. Jawad's background and he is a physician scientist with training in neuroscience. He is currently at the Brain Research Institute at the University of Zurich and is a leading expert in the field of intergenerational trauma. Dr. Jawad has also recently contributed to a chapter on epigenetics to USIP's edited volume on neuroscience and peace building that is currently going through the peer review process and that's how we came to know each other. He was a lead author on a chapter that is going to discuss in detail what he'll talk about today. He is a strong proponent for using science for humanitarian causes that are not only limited to disease prevention and therapeutics but also for the resolution of human conflicts and peace building. His research and focus on neuroepigenetics and trauma is a critical component of his work to stimulate innovative ideas and approaches to prevent, mitigate and resolve violent conflict. In light of the complexity of today's crisis and the number of protracted violent conflicts that we're seeing around the world and many of you are working on on a daily basis he will discuss what peace builders can learn from the field of epigenetic inheritance to help restore peace and resilience and prosperity to individuals and communities. Efforts such as these will help pave the way for greater and deeper social transformation that is required if we're going to be able to have sustainable peace in the world. And again thank you for joining us for what I know will be a very thoughtful presentation and as I mentioned we very much look forward to the discussion afterwards and getting any answers to your burning questions and Dr. Jawad's also offered up his business cards so if afterwards a question comes up or if you go back and watch the video and something comes up I will be sure to give you his card. So I would now like to turn it over to Dr. Jawad. Alright thank you very much Kola this has been an absolute honor and a pleasure to be here. So what I'll be talking over the next 40 minutes or so is there's a story which you don't normally hear in academic conferences because we get a bit carried away with the whole charm of being in an academic setting in which it's about curiosity, it's about novelty but somehow the compassion component is not highlighted enough. But what you would see is that what this research has taught us is not only about biology I mean there has been a significant conceptual advance of course about biology and heritability and from a neuroscience perspective but it has taught us a lot about society and humanity and the things which we need to stop overlooking and the things which we need to be aware of if we want a sustainable like harmonious and peace-loving environment. I'll be talking about science but I will be trying my best to communicate at a level where all of us can relate to each other. I'm going to stand up I just always find it easier. So you know a lot of us are of course interested in this topic of childhood trauma and for very fair and very like valid reasons but like not all of us read scientific journals and not all the scientists who are working on trauma or who are working on epigenetic inheritance are communicating to the people like you who actually matter. So what I did was I was like let's approach it in a different way let's approach it like how my nephew who's 15 year old would approach something you know you start from Google right so and then whenever you start by searching any topic on Google you get some listings and then you get maps and then you get images. So if you look up childhood trauma these are the images you guys would probably find children suffering conflicts pretty much this this agony on the on the faces of these children which which induces enough empathy and then what we see is something like this sorry. Yeah so we see things which are not related to the science of childhood trauma but things which are impacting humanity at a very large level at a policymaking level at a conflict level and we see that the population which is most vulnerable in the face of these world conflicts is actually the population of children and we see children being detained whether it's it's in China it's the immigration crisis whether it's in Kashmir in India we see that wherever there's a conflict the population which is suffering the most is the population of children how many of you know about this girl probably everyone right I mean everyone working at USIP I would assume would know about the Afghan girl now there have been like controversies that the the agony you see on her face was actually something more acute because apparently the journalist who took the photograph was was very condescending towards her regardless of that you definitely see a lot of pain in those eyes and what I'm going to show you next is that it probably stayed with her it probably still is a part of her and it probably even got passed on to her own children and this is what we study this is what we study from a more biological standpoint and what we have found out is that what happens in childhood it doesn't always stay in childhood it's something which is persistent it's something which has very wide-ranging effects and you you would see that trauma which we consider to be an emotional experience it actually has a lot of outcomes which are purely physical which are which are at the very biochemical level which is affecting the you know the juices we are made of practically the primordial juices and this is something which we have gone on to discover that this these effects are not only persistent over a lifetime but a lot of these are transmitted across generations now long before like you know I got got involved in this excellent initiative um you know with usip I was trying to link science to world conflicts and um one of the one of the little propositions I had was published in science back in 2013 where um so originally I come from Pakistan and what I tried to propose was that you know with this whole war against terror and in the crisis which we had the Pakistan and Afghan border the the population which is suffering the most is actually children and we need to intervene before a war orphan picks up a gun himself or herself um and that we need to think and approach this question this this crisis in a more scientific manner where we come we need to come up with neuropsychological predictive models of what kind of effects witnessing a war would have on these children and what kind of interventions we need to enrich their environment before they start exhibiting exclusionist behaviors themselves because that is what we often see another initiative I worked on was to promote human rights through science um and there were a couple of scientific journals who were very um I would say I would actually say that they were kind enough to cater to these ideas because generally scientific journals don't they do not want to step out of this little bubble of academia where where they're usually like you know very happy to be in and then I actually started working on traumatic stress both for personal and professional reasons years ago um when I was actually um at Baylor College of Medicine in Houston Texas and I had this horrible hairstyle as you can see over here um and I worked on traumatic stress in PTSD back then and we had a population of veterans who had um served in the vietnam war um and we wanted to see that what kind of physical manifestations they would have years after so we had a population of elderly they were veterans above the age of 65 um some of them were coming for routine health care some of them were coming for dementia screenings and we started taking their history at the broader level and we started implicating you know the effects of trauma and post-traumatic stress they had with that there are a few things which are important to keep into mind when you go into traumatic stress and one of them is that there are specific vulnerability periods um early post-natal periods and then especially in boys what we call the slow growth period this period of nine to eleven years and then later on the the periods of adolescence the brain is particularly sensitive to any kind of stimuli and now those stimuli can also be positive but here we are focusing on the effects of traumatic stress that is where any event any traumatic event could have long lasting impact um now here we are talking about the effects on an individual but then later on you will see that these effects are actually also getting transmitted across generations right so in the study of veterans um what we did was that we divided them into two categories those who had experienced trauma um and we sort of isolated that group we identified that group based on whether someone had a purple heart recommendation or not so purple heart um was like usually given I think until a couple of years ago it was usually given to veterans who experienced any physical injury any physical injury requiring medical assistance now it's also being given to people who um experienced like you know significant emotional trauma requiring psychological help but at that time we focused on trauma in this purple heart group and then we had also had a group in which veterans served but they did not have a purple heart commendation now not everyone who experiences trauma develops PTSD some do and the others don't and we looked at these groups as well so this is the group with purple heart and they develop PTSD and this is a group in which there is purple heart but they did not develop PTSD so they showed you could say you know as in layman terminology they showed more resilience they were resistant to the long-term effects of trauma then we also had groups in which there was no purple heart recommendation but still there was PTSD coming from other sources so this was not war trauma but this was PTSD based on some other trauma exposure and finally a group in which there was no exposure to trauma so there was no purple heart and then there was no PTSD now what we found out was that irrespective of where PTSD was coming from irrespective of whether the trauma was leading to PTSD or not we saw an increased incidence in prevalence of diabetes hyperlipidemia and like you know there there are eventual outcomes in terms of stroke and cerebrovascular accidents so basically all different cardiovascular diseases metabolic disorders were much more common in individuals who experience trauma in the form of purple heart who experience PTSD irrespective of trauma or who had purple heart and then develop PTSD but you would appreciate that in the group where we have both purple heart and PTSD the incidence is actually the highest and this is our control group no purple heart no PTSD where incidence is the lowest we did some statistical modeling to actually look at the effects look at like you know what was the proportion what was the risk factor which was increasing in these individuals and you would see that compared to controls you know the group with the purple heart the group with the PTSD the risk of developing these disorders which much higher like you know sometimes even reaching up to more than two falls now this was work on veterans who experienced trauma and adulthood from literature from biology we knew that there are periods of susceptibility which are even before you're in childhood and adolescence which are implicated we started looking at like some of the the work of some of the other people and actually one person who stands out in that is Rachel Yehuda in Mount Sinai who had looked at trauma and Holocaust survivors and what she reported was that not only were the effects of trauma persistent in these survivors but a lot of these effects were getting transmitted to their offspring and then it led to a lot of different you know the headlines in New York Times and some of the other magazines where she showed that the study of Holocaust survivors they pass on trauma to their children even affect their genes that there is parental PTSD which is affecting the healthy aging of the of the offspring and similarly descendants of Holocaust survivors have altered stress hormones and she showed that this was spread not only in the offspring of Holocaust survivors but even in the grand offspring of Holocaust survivors now she does a lot of psychology and psychiatry work and while she made that observation there were no like you know molecular mechanisms which were identified behind and that's where our work comes into play and that's where we take the lead so if trauma is something which is transmissible then how is it transmissible and that's where I would open up the question to all a few just very quickly so what do you think with which which means do you think could be which mechanisms could be responsible for this transmission so one possibility of course is that you know parents who experience trauma themselves maybe they just turn out to be bad parents right that's one possibility and of course that could be the case that is indeed the case on many occasions but then there is a mechanism which is much more actually likely affected as we know now and where we could come up with more straightforward predictions and that is that there is a transmission of these effects which is based on epigenetics which is based on what we call the interaction between the nature and nurture so epigenetics to put it simply is the study of changes which are heritable so these are changes which are acquired by a cell or an individual and then are passed on now the process is not as simple as it seems you know there are things which are occurring at the level of genetics you know so we all inherit things from our parents right so how is epigenetics different so epigenetics is different because in epigenetics the initial change the initial insult is occurring in the very first generation it is leading to a number of molecular changes we don't need to go into details of that but these changes are occurring in all different cells of the body including the germline and they are leading to some specific phenotypic changes so some specific symptoms so you could say that there can be an exposure in the parent you know let's imagine like a 30 year old individual who experiences trauma that trauma would lead to some changes in that individual which will be which will leave the signatures in different cells of the body including the germline which in case of this individual this gentleman would be the sperm now when this guy like eventually has children of his own then these changes are transmitted leading to the same symptoms with this individual had although the initial environmental insult initial trauma exposure is not there and then this is carried on across generations even when the stressor was only present in the previous generation so this is where it differs from genetics because this is a change induced by an experience and it is like you know constantly transmitted through these cycles of reproduction now we know now based on primarily animal research that a lot of different environmental exposures are transmissible like this these exposures are not necessarily bad I mean I'm going to start with something positive because we now know that exercise in the parents lead to beneficial metabolic outcomes in offspring but then there are other things like high fat diet a negative exposure which leads to increased disease susceptibility in the offspring exposure to toxins like jet fuels plastic waste etc all these exposures in the parents especially when they are at a certain threshold level they lead to changes in the cells which then are like you know getting transmitted to the offspring and finally the work on early life trauma which I'll go more detail into so when we focus on the epigenetic inheritance of trauma again the principle is that the trauma exposure is on like you know the first generation I'm showing it the mouse work here but then you will see that all of this is also applicable in humans it is causing a multitude of changes so like you know in the circulation in the blood and body fluids a lot of things get changed after the exposure to trauma the hormones the chemicals in the brain the chemicals in the periphery and the blood things like cytokines things which are induced by inflammation all of these get altered and then these chemical changes in the blood they are leading to some very strong molecular changes in the germline which then manifests as different symptoms across these different generations we learned all of that by working on a mouse model of trauma which you would see is very close to many different scenarios of human childhood trauma it's based on impaired maternal care and what happens in this model is that during the first two weeks of life supposed natal day 1 to 14 which would roughly be equivalent to like you know in in in terms of human lifespan a child until the age of like around 12-13 years these little bubs they are subjected to separation from their mothers for three hours every day now that is done in an unpredictable fashion so that seems to be something which the which these animals are not used to they they feel forced to do that and at the same time the mother is stressed so during this period of separation the mother is placed into cold water now mice they do like water they just don't like when the water is cold you know so that leads to stress and mice and then you see you see that in their behavior you see that also in their hormonal profiles that they are extremely stressed this combination this dual hit of maternal separation and maternal stress leads to an impaired maternal care for these mice which continues during the time when they are receiving milk from the mothers during the time when you know they are depending on the nurturing from the mothers for their early development when these mice grow to be adults they have a lot of different neuro behavioral manifestations so we see that they are more anxious we see that they are more depressed we see that they indulge in more risk-taking behaviors and then not only there are these neurocognitive symptoms but we also see that there are changes in their glucose and their cholesterol so their their fat levels in the circulation would be very similar to to to a mouse which is fed high fat diet for a long time so now these mice they're not given any special diet they're given the regular diet but they start showing manifestations of someone who would be fed like you know this unhealthy diet similarly they have changes in their glucose metabolism level they show like a phenotype where they are very sensitive to the effects of hypoglycemia so whenever their sugar levels drop they're not able to recover from those these are the different manifestations which we see in these mice so you see that they are very sensitive to any further environmental insult the most important thing is that these symptoms are not only present in the exposed mice but when these mice grow to be adults when they mate with like you know the wild type naive mice the resulting offspring shows similar manifestations so trauma in the parent mouse is leading to all these different symptoms in the in the baby mouse and actually this is something which we now know is getting transmitted down to four generations and in fact I have a colleague who's now studying the fifth generation and there might be even you know some negative effects getting transmitted up to the fifth generation we also know that this transmission one of the mechanisms which you have identified is that it is dependent on changes in the RNA of the sperm so these these are not changes which are genetic so these are not you know we all like you know from high school we all remember that DNA has a sequence right this sort of this a b c d kind of like sequence that sequence is not altered but the way the genes manifest themselves is altered and if we took you know this the sort of these apogenetic marks from the germ line of the mice and you injected them you know into a developing embryo you would be able to transmit those changes so this is something which is functioning at the epigenetic level and it is not psychological transmission only so what happens what happens to these mice or their offspring and that is something which which I want to go more like you know into into more detail off because I think this is also very applicable to humans and later on when I talk about the human study you would see that trauma is something that nature has somehow kept it in a way that the way trauma affects mice and humans is actually not so much different from each other so we can learn a lot by studying trauma and mice which is applicable to humans so we all know that mice are nocturnal animals they prefer staying in the dark but these mice who were subjected to early life trauma they kind of you know in a way their the nurture is affecting their their nature because what we observe is that these mice prefer staying for longer in the brightly lit compartment which we interpret as increased risk-taking behavior now in certain scenarios this might even be beneficial because maybe if you think about it taking these risks could in certain scenarios could be advantageous for these mice because it means more access to food and like you know other amenities to look for but definitely what we see is the trauma is affecting their nature making them more of risk takers but then there are some other things where there are no advantages for example we see that they start showing these tendencies which are very similar to the tendons which we see in depressed patients so when you place when you would place like a non traumatized mouse in cold water they try to escape you see this behavior that they are trying to get out of the beaker you know their survival instinct kind of kicks in and they are trying to escape the beaker of cold water what happens in these traumatized mice is that they keep on floating as if they've given up on life as if they're okay with that they don't want to try to escape that that scenario where pretty much death is imminent so this is very similar to suicidal tendencies which we see in depressed individuals their social interactions go down like the mice who have been subjected to trauma they do not interact with their species that much anymore their navigational skills go down so they're generally we see also cognitive impairment in which they show um it affects in their memory but importantly their navigational skills go down so now you know if you if you try to correlate the things here what we saw was that they're taking more risks right but because their cognitive skills and their navigational skills are down these risks are probably not likely to lead to any kind of positive outcome because they do not have the cognition to support these risk-taking behaviors lastly what we see is that um they become more vulnerable so you know mice uh they live in these communities where they establish hierarchies where one mouse becomes the leader of the other mice what we see in these traumatized mice are that somehow are not fitting in this hierarchical system anymore so they get a lot into fights and this mouse you know the the the poor guy who's getting beaten up is the one who was traumatized early in life or his like you know his or her parents were traumatized early in life so you see that they are not somehow fitting in these community systems anymore now if you think about it you know for me like you know it's very it's very intuitive to think that we see a lot of similar behaviors and populations of humans who were subjected to trauma and children anymore we see exclusionist behaviors we see that they get depressed we see we see that they start taking more risks they show like a lot of these borderline like manifestations um and then yeah like this this sort of not fitting into the community is also something which we see a lot in people who are subjected to trauma early in life now here it's not only the direct exposure but also something which is coming from the parents importantly besides these neuro behavioral changes we also see changes in their metabolism you know like we previously mentioned that they are showing you know like like a phenotype like a symptoms which are very similar to someone who has been fed fed on high fat diet so what we see is that in these mice they're good cholesterol which is the HDL that goes down you know so there are two different types of cholesterol the the good one which is HDL and the bad one which is LDL so we see that typically their good cholesterol starts going down now importantly HDL does not only have nutritional value but it also is a carrier of different regulatory molecules in the blood in the generally in the body these molecules are called microRNAs I won't go into too much details of that but the important thing to know is that these molecules they have a regulatory role so they are present in the blood they can travel from one tissue to another tissue and they can go and regulate the gene expression in the other tissue so for example there have been studies where they've shown that there are these regulatory molecules which are released from the fats in the body from the adipose deposits the the fats towards in the body they go to the liver and they cause fatty liver disease by just regulating the genes in the liver so that's why these changes in the in the HDL are very important because not only do they increase the susceptibility to all these cardiovascular illnesses but they can potentially affect how these regulatory molecules in the blood can go and affect other tissue now we were interested in finding out if these changes are also mediating the central effects of trauma to the germline because you know trauma is something which which initially affects the brain that's how that's where the perception arises but then if we see that the effects are getting transmitted it means germline is affected so what is connecting the brain to the germline the blood and these cholesterol changes in the blood could be very relevant to that so in order to study that further what we did was that we took the blood from these msus mice the traumatized mice we took the blood and then we injected it into the mice which were not exposed to trauma and what we saw was that just by doing these blood injections we were able we were able to recapitulate the symptoms which the trauma was having in these mice now again think about the implications of this work think about like you know the the possible impact of blood transfusions think about like you know all these different like symptoms they could that could be induced by that and how many times do we screen like you know the blood for traumatic exposures or dietary exposures before doing the transfusion anyways moving on so we found out that blood is a potential mediator of these effects and the blood cholesterol especially is more likely to be implicated the next question was that okay in mice we have found out this pathway um it seems like you know that we have strong evidence in support of this but how do we apply it to humans now one thing which um like I'm sure most of you have heard about that is that you know laboratory mice they're very similar you know they are genetically very similar compared to humans who are very diverse the reason mice are genetically very similar is because they are subjected to what we call inbreeding you know um they are always mating practically in case of mice with their siblings and that is why they do not diversify too much their advantage is to keep the mice like that because then you know our inferences can be stronger and we do not see like changes which are dependent on the diversification at the genetic level so when we wanted to validate the findings which we have from the mouse model to humans the first challenge was to identify a population of humans which were also genetically very like you know homogenous secondly the the challenge was to study an exposure which was very similar to the trauma exposure in mice um the reason why we had to do that was because we wanted the academic community to appreciate our work it was clear to me even before that all of this has strong implications for humanity but first it was important to convince the academic community so that's where actually where I come from um turn out to be helpful because besides some other unique features um what is very relevant for for Pakistan in terms of you know scientific studies is that the population is genetically very homogenous the reason why it is very homogenous is because it has the highest rate of consenginity in the world so they have been marrying like you know cousin marriages have been very common in Pakistan for hundreds and hundreds of years um and because of that the population has the highest rate of consenginity they're all sort of distant cousins so this becomes very similar to the mouse model and then in Pakistan we collaborated with the SOS children's village um because we wanted to study trauma and children and something which was very similar to our mouse model we were able to identify similar cohorts while working with the SOS village and what we work on what we worked on in the SOS village is this cohort of children who had paternal loss and maternal separation um now these are the children who unfortunately lost their fathers very early in life um and you know they're losing their fathers so it means that for their mothers there is the um you know the grief the bereavement stress of spousal death and then because of the social dynamics in Pakistan the social economic dynamics in Pakistan the mothers were not able to raise the children on their own so they had to give up their children for adoption by the SOS village so there is this component of forced maternal separation combined with maternal stress now this is very similar to to the exposure the trauma exposure we have in mice um some of our work was actually recently published in science and the reason I'm highlighting that is because I realized the importance of communicating your work to somebody who's not from science because somehow the way they make the point about your work is much more relatable and this this was actually written by like Andrew Curry he um he has written for New York Times before very nice guy he's like German American and he he spent a lot of time like you know practically trying to learn what I was doing or what like you know my my previous boss he's a bilman so he was doing he wanted pictures of the children he wanted me to make videos of the children record their experiences and then like he wrote a feature actually which was um I think which has been way stronger than any of our scientific papers because just the choice of words he used just advocacy he did it has been very well received and I think now finally people are talking about work and like um in a much stronger sense right so in these children like roughly like around 80 children which we have in our cohort uh first we wanted to ensure that there was nothing which was very unique about them in terms of their demographics you know which could be affecting their symptomatology so we found a control group of children which um were comparable to our children with trauma in terms of age gender as well as body mass index so body mass index over here it served as a proxy for the dietary intake so you know going with the idea that if they are maintaining their body mass index then they are not malnourished at least at the macronutrient level and that would not be affecting any of our results finally the the consenginity in the parents was also more or less similar in both the groups now what we found out was that when we screen these children for depression very similar to what we see in mice we see much higher susceptibility towards depression much higher severity of the protopressive symptoms in these children we then screen them through validated uh tests for anxiety for different psychological uh manifestation of anxiety and again we found out that they are more prone to have generalized anxiety disorder um they show a trend towards having more panic symptoms and they also show the social anxiety related deficits similar to what we saw in mice also the metabolism is affected you know the the cholesterol levels in these children are very similarly affected to what saw what we saw in mice um and importantly again this is not based on dietary intake because when you look at them like you know physique wise they are comparable it's just that internally something is happening which is affecting their metabolism in a negative way um they also show inflammation so we made sure that none of the children we assessed were like you know having an active infection at the time of assessment but we still see that there is a chronic low-grade inflammation in these children their inflammatory markers were higher compared to their um schoolmates who were living with their parents then we also show that there were deficiencies or excessive amounts of different electrolytes different salts in the body which of course shows that the effects were at a very wide physiological level and then importantly um this is actually one of my master students who who helped me out in this project and she found out that some of these micro RNAs some of these regulatory molecules which are present in the blood and can um sort of regulating expression in distal tissue they were altered in this human population as well so now we are seeing changes at the epigenetic level which are very strong which are very prominent which could lead to susceptibility to diseases and they are present in this larger human cohort and we also found out that some of these changes are actually you know they are sustainable over a long period of time because we not only started children but we also started some of the former residents of the SOS village who are young adults now who had just crossed 1800 had just left the SOS village but when we sampled their blood and when we looked for these regulatory molecules we saw also abnormalities in those right so all of this was um you know changes in the blood um which could affect which could be affecting different issue but it was important for us to show that it is likely that these changes are getting transmitted to the germline so that's where we did a combination of uh like you know some in vivo work you know what we call scientifically things in which we study the whole organism versus in vitro work where we take the cells out of an individual or out of an animal and we study them in a petri dish so we looked at the effect of these changes in the blood on the germ cell like cells which were present in a petri dish and we found out that some of these changes were actually getting transmitted and when these changes were getting transmitted they were showing a dependence on this specific receptor which is the receptor for colesterol in the body so it seems like colesterol had a huge role in mediating these effects of trauma early in life to eventually um how the germline could be affected and this is some additional work where we also saw changes in different metabolites again everything is sort of getting connected to this fat metabolism um in a in a in a in a bigger picture and finally this is like a very important study and the way it also came about is very important because this is a group of volunteers which we were able to like identify in Pakistan and they they heard about this project because SOS village in Pakistan they like you know they put it they shared it on their social media that they are now a part of this initiative about studying trauma and children and then it turned out that I was approached by um like a guy who owns this huge diagnostic lab there and he said that he gets like a lot of young adults who come here for their routine seminal fluid screening um or some of them come there for their infertility assessments and he said that a lot of these individuals are saying that you know um after hearing about this we would like to disclose that we were traumatized like you know as during our childhood and we would like to be assessed we would like to find out if there are changes in our germline um which could then lead to increased risk or susceptibilities in our children so we ended up having like a group of volunteers which was which uh in total mounted to about 90 individuals and then we did like um sort of like you would say like uh through using validated tools we did a systematic assessment of the trauma exposures in their childhood and we found out that one the childhood trauma was very common um and you know like here you would see that there were many individuals who either were exposed to death of a parent or parental separation due to other reasons traumatic sexual experience physical victimization severe illness or injury or other significant traumatic experiences which range from um witnessing like a terrorist attack to to having like a friend commit a suicide like all these different exposures and then from those individuals those volunteers we did like an assessment of their seminal fluid this is just like showing the severity of all these different trauma exposures and you can you would see that traumatic sexual experiences were rated as the most severe ones but all of these different exposures in fact um are leading to severe subjective perception of trauma um yeah this part is the most important one so based on the germline assessments the sperm assessments we found out that there were changes significant changes in the sperm which we collected from these individuals what you would also see over here is that these changes are actually based on the severity of the exposure so here there is ctq zero ctq stands for childhood trauma questionnaire so ctq zero means people who did not have any significant childhood trauma versus ctq one which is significant to at least one significant trauma exposure in childhood so before the age of 17 years and this is ctq two which is um like you know experiencing at least two significant traumatic events before the age of 17 and what we see is that the expression of these regulatory molecules is dependent on that we saw the step ladder pattern so with increased severity increased exposure to trauma there was this abnormal pattern which was getting like you know accentuated when we compared the the things at a statistical level and when we compared no trauma exposure in the germline to exposure to at least two or more traumatic events we found that there were significant differences in all these different regulatory molecules now again i would not go into too much details at the at the molecular level but what i can tell you is that these different regulatory molecules they give susceptibility to more depression they are important for control of metabolism and they are important for you know the general well-being and um what what he would call like you know a resilience level in the individuals and we see that these things are affected in the germline so the offspring which is likely to result is going to carry all these risks as well this by the way is the first human study of its kind where we have looked at the effects of early life trauma directly on the germline so putting it all together what we have found out based on extensive studies in mice and its validation in humans is that traumatic stress especially early in life is leading to changes in whole body metabolism these changes in whole body metabolism manifest by changing these regulatory molecules and the blood which then are carried on to the germline and it has a risk of susceptibility transmission to the next generation now importantly studying this at the scientific level also gives us windows of opportunity windows where we can make interventions interventions which are not only at an individual level but together with all of you we'll we'll find out if there are interventions which we can do at a larger community or society level as well so at an individual level what we know is that you know for parents who are planning to conceive we can do certain things to one promote their mental well-being through providing them enriched environments now this is an intervention which has to start early in life for it to be most beneficial and then other things where we can try to mitigate these negative effects in cholesterol metabolism we see and these effects which which could be like you know altered by supplementation with polyunsaturated fatty acids which improve the good cholesterol and the blood which we saw in mice and in the human study that early life trauma was decreasing the second thing is is there something which can be done at the time of conception now what we do know is that now there are techniques which of course it will take a lot of time until we find whether they are operational whether they are safe in humans and we also have to look into the whole ethical dynamics of it but there are techniques where we can now edit the apigenome and at least in animals we can see by using those if the effects are then less transmitted to the next generation importantly what can be done after the offspring is born now the important thing is that here clinicians pediatricians you know like people who work with children they need to be very well aware of what are the risks which could be transmitted and that's where we need to identify the susceptibilities earlier we need to do screenings we need to take parental exposure histories in the clinics you know like in the clinics we always focus on genetic histories but it's important to also now focus on epigenetic histories you know exposure based histories to identify what are the risks which are getting transmitted to the next generation and then talking about the lessons for peace builders I think it's very important that these things are communicated at a larger level we definitely need to raise awareness that there is a transmission of perturbations at the behavioral level at the metabolic level at the disease level like you know at a very large level which are just stemming from early life trauma exposures and people need to be more aware of that I like you know what I would love to see is a world where when I talk about this people don't get fascinated anymore I want that everyone should be aware of that I want that this is something which starts appearing you know in textbooks and mainstream media because we need that before people will actually start to make policies about it first we need awareness then this gap between the academicians working on it and the people who are actually going to make a difference that needs to be bridged and that is again where initiatives like neuroscience and peace building could be the key we need to create a consensus about it you know so for example like when I'm when we talk about the windows of opportunity now a lot of questions arise which are you know not only scientific in nature but also you know we need to know like you know whether when we do these interventions if eventually we'll be doing these interventions what will be the ethics of it whether it's okay to do apigenome editing whether it's okay to ask for parental history of exposures now I can only tell you that science has shown the evidence for that but whether this will be well received by the wider community or not that is something which we need to collectively put our heads together and find out I mean I think in the end the goal is the same we want less suffering we want less suffering in children we want less suffering in the next generation and we just need to sit together and find out optimal ways in which this can be achieved and definitely having integrated programs now my work with the SOS village was actually a starting point of that like you know SOS village irrespective of whatever we worked on they would continue to take care of these children anyways but now they have a scientific basis and they can actually make interventions which will also be received by academicians we what we tried to do was that not only did we screen these children from for all these sort of perturbations but we also provided them support wherever we could especially working in Pakistan we were able to through our screenings identify children who were anemic and we provide them nutritional support we started an intervention program in which we are giving cod liver oil to the children to increase their good cholesterol levels their HDL levels and what we actually see is that the children who have been supplemented with cod liver oil for at least six months they start to show less depressive behaviors so the interventions are also working and this collaboration with the SOS village has been like very beneficial to that so it started from Pakistan then I was approached recently by someone from Irvanda and they wanted to implement it over there somebody from Macedonia approached me and like you know that this is this is the sort of platform we needed to spread the message and to implement it at a larger level which is not only good for the scientific community but also humanity in general and lastly I'll just briefly mention my my personal story of struggles so so you would find out that all these names which I'm mentioning over here New York Times Guardian Wall Street Journal Washington Post I have not managed to publish in any of those I have tried to publish in each one of those because I wanted this message to be conveyed so over the last one year my first attempt detention of immigrant children for a man affected generations for the mankind I sent it actually to all these different like you know mainstream newspapers magazines it was rejected so I was like okay Ali maybe like it was very strongly worded maybe I wanted to I don't know signal towards a particular person maybe that wasn't the right way to go so I changed the title family separation a possible crisis for generations still it was rejected next attempt if we fail our children their children will not forget I think maybe by this time it became too romantic and I shouldn't I should have stopped trying but I still tried it was not accepted then there has been a recent you know political conflict in Kashmir so where again the children are being detained so I collaborated with an Indian neuroscientist we turn it around a little bit and we are like an Indian and a Pakistani neuroscience perspective so we thought if we both teamed up maybe it will be better received because there is no political angling there and there are two you know people who belong to two countries which have been in conflict for a long time but if they're writing something together it means that it's pure collaborative science and nothing else still it was rejected so the key message here is that somehow what we do as scientists like you know our our our passion our curiosity our compassion all of them help us to identify these pathways we can come up with predictive models we can come up with very strong scientific rational to put behind things but I think in terms of communication maybe we need to learn more and maybe you guys need to teach us how to communicate better or maybe you can serve as that means of communication to mainstream media to policy makers I believe that maybe if one of you would write that piece you know perhaps it has a much better chance of getting accepted of having the impact it's supposed to have and I think in the end like for me at a personal level so this is you know what what I was telling Colette as well like I lost my father at the age of 13 for me this project the reason why it's so close to my heart is because I have experienced it personally and I know the implications of losing your parents early in life would have for these individuals importantly it's not only for these individuals it's for generations and generations of mankind and I think this is where we all need to put our forces together and try to spread this message as much as possible recently very recently I've started the survey in which we are trying to find out if people are actually aware whether something like epigenetic inheritance could exist in humans the results the preliminary results are not very promising it seems like people do know that you know they think that okay there could be a psychological transmission but very few people are aware that there is actually an effect on the germline by early life trauma and similar other experiences which could be transmitted so we need to spread the message more and finally I would like to thank like all the people like you know in my lab you know my my friends my family which have contributed in different capacities to this work and and have kept me sane enough to pursue this challenge so thank you very much and I'd love to take any questions okay thank you Ali first of all for your presentation and walking us through the research and making it so accessible that's the skill set that already you've started on the bridging the gap and working in ways to integrate your research with SOS Village and other platforms and also thank you for your personal commitment it's very apparent that this is important for for mankind and humankind and womankind and all kind um and for animals as you talked about the the the reality of the effect um on the biology across the species um and so I just want to thank you for your commitment towards that and it's interesting the big rejected thing and I think it's probably a time for another discussion a broader discussion and we'll start with questions but I find it very challenging at times when there's something that through research and something that connects and resonates that makes so much sense and for me it was novel a few years ago and now having done so much of the reading and learning from people like you it just so apparent to me it's hard for me to grasp what is the impediment that it that this aspect of trauma neuroscience and its nexus to transformation and peace building is is a hard sell in some way so that's probably another study of what is it about humans where we reject this what is it within us that whether it's at some you know neurobiological level that we reject this in some way um so that would be an interesting study so let me turn it over to the group and any questions or any thoughts that you have and in anything whether it's in your program a question you have about how this could be made applicable anything that comes up and we'll go right around okay good I have just first a clarification question regarding the study that you did with the mothers and you know the mice separating them and whether the stress that the mother was put through was necessary for observing the effects that you see in the metabolic metabolic changes that occur afterwards um and and if you thought about doing you know the experiment where the mother doesn't so are there mitigating then effects that this would trigger right if the mother only experienced the stress of just the separation but not this additional stressful event whether she's more able than to mitigate the effect of the stress that the litter experiences and would that be transmitted because I think for uh even though I'm kind of new to the policy arena one of the areas that I'm already very familiar with is well what are the mitigating right what are the the ways in which we can help this and I know you talked a bit at the end more from um you know the cholesterol path but from the more behavioral anxiety you know that part that area and you know would that be you know a point so what would be yeah the factors that you would see that would be helpful but first I guess I want to answer to that question about the mother's stress right yeah no thank you very much these are these are very important questions so there are two reasons why like you know the mothers are stressed in this paradigm so they're also paradigms of just maternal separation but what we see in these maternal separation paradigms is that after the mothers are united you know with their pops and mice they actually try to compensate so they try to like you know lick and groom the the pops more and they just try to be better you know in a way more nurturing mothers after they are reunited so they really try to compensate and when they are compensating we see that the transmission across you know generations does not take place so they are able to somehow compensate for this period of separation and that is good to know that is good to know but the the other thing is that we also want it to be um like a little bit realistic because a lot of times mothers who are separated you know from their children are forcibly separated from their children so we wanted it to be like that that the that the mother has this complete uh behavioral experience in which you know she is separated from the pops and she is struggling during that time which is very applicable to what we see in in terms of like you know a lot of different conflicts even like you know for example in our children cohort these mothers like you know they forcibly were separated from their children just because they could not they did not have the financial means to raise the children on their own um so these are the two reasons but yeah it's important that if those mothers like you know uh if they are not stressed themselves then they try to compensate by being like you know over nurturing in their behavior in terms of mitigating factors we also know that giving an enriched environment to these mice after the trauma exposure it does partially reverse like some of the transmitted symptoms um and what I mean here um in this like environment enrichment is that you know mice are usually kept in cages in the in the laboratory but then um if you make their cages if you turn them into mouse playgrounds if you provide them different like you know um toys they can play with if they have a running wheel where they can do their exercise voluntarily if you put them like you know little mazes in there in their cages where they go and if they press a lever they will get a reward if you give them this nurturing exploratory environment then we see that uh the the brain connectivity becomes more positive in them and then also the transmission of the phenotypes across generations it is partially reversed so again good mothering would compensate for that and environment enrichment for compensate for that um well you answered one of my questions but another one was um whether there were differential effects based on the type of trauma experience you indicated kind of the um the the intensity I think was was my interpretation of yeah of that was there different types of effects that you observed um yeah that's that's again a very important question so what we see is that um you know like in these in the study of adult men where we look at the germline changes um the trauma severity is perceived as the highest for traumatic sexual experience early um but the other all other traumas like you know they are more or less at the same severity level um what we have analyzed so far is that with increasing severity we see increased dysregulation of these regulatory molecules in the germline but at the next step we will separate the effects of all these different trauma exposures um but generally I think that the important thing is that the one which stands out is the traumatic sexual experience all the other different traumas they are considered to be more or less at the same severity level yes please yeah so one was a comment and then one was a question um the comment is kind of related to what you were alluding to Colette is why is this so difficult to break through this is a very general comment and observation not science-based but I mean with this this um understanding comes a level of responsibility that um it's kind of like climate change you know this ability to accept responsibility for what I can do to affect future generations or society's responsibility to care for those who are traumatized through their own fault or something they did in a violent situation or something that was done to them but the level of responsibility when you get this information increases dramatically and I think that's a very hard barrier to overcome um as humans so I don't know the answer to that but it's worth the thought of um what this means the comment is a little but the question is based on the comment about that they become less sociable um and I think that's what we're grappling with whether it's in the work that you are um Mona you're doing with Leanne um and how we how we work with the individual effects of the individual individual but what what do we need to do at the community level right what do we need to do to to bridge those bonds um it makes sense that they would isolate themselves and become less sociable but this gives us more to think about in terms of what are the interventions to mitigate right what this individual is experienced and so how do we rebuild those social bonds when this person has clearly lost the ability to do that but it's so critical to our our human experience so um I don't know if it's a question so much as I think we need to better understand that impact of them becoming less sociable yeah um so I would mention like a couple of things it's it's again like a very important question and something which which I've been asking myself you know because that's interventions which are applicable to humans eventually they are the key you know that's that's the level which we want to reach so I've mentioned three things one which was in this talk that we do see that um you know even like you know in the in the human cohort we see like an inverse correlation between the the levels of HDL and the depressive behavior as they show so the ones who have low HDL are also the ones who have the highest you know the more severe manifestation of depression I believe that this is something which probably is applied to their social isolation as well because social isolation is something which goes hand in hand with depression we are going to study that also at the behavioral level and then see if chord liver oil the way it is affecting depressive behaviors if it also has a benefit in terms of sociability there are two other things so one is that like you know actually like I've recently become an independent group leader and I've started some projects which are more at the at the intervention level and something which we first want to try out in the in these mouse studies is what what we call social environment in enrichment so when we turn these mouse cages into a playground what we want to do is to put a foster mother there and to mix letters you know to put like siblings from one letter together with siblings from another letter to give them a feeling of a larger community and they are becoming in a way a part of a different family of mice and then we want to see if that will have a mitigating effect so if you ask me in a year I would have like you know some more like solid observations about that the third thing which we are now like we recently actually wrote a proposal for that is to use virtual reality to do to provide psychotherapy in these children because psychotherapy is something which generally like children are not you know they're the kind of run away from that also talking to an adult who you do not strongly connect to and sharing your like traumatic experiences I don't think children find it easy to do that you know a repo needs to be established and usually child psychologists I don't think they are spending too much time with the children you know in their in their daily living to reach that level so what we are trying to do is to provide psychotherapy in virtual reality based immersive environments so in the end children like to explore you know I mean even when they want to remain isolated even those children are up for playing a video game in virtual reality now we will provide them psychotherapy in this virtual reality based immersive environment and see if it's going to lead to any additional beneficial outcomes of that so we are doing some interventions and hopefully we will get to a point where we can we'll find a way to reverse as many symptoms as possible one thing that Rose said and just extend the question one step further with the interventions with the children through you know the headsets or something like that for virtual reality and then you talked about periods of intervention where they're most responsive and I know I had a little stress out when I found out that it's for males it's 15 to 17 year olds and I have a 16 year old so I thought I'm in right in the middle of a crucial period of where where you can intervene but also things could happen so that was enlightening something I did not know until today and so I'm curious if we're dealing primarily at least in the work we're doing I know definitely with peace building development some work with the the youth population children if you're dealing with primarily adults or even if they're on the younger side you're talking late teens early 20s is there anything around interventions that you know one might say well we're all too old now or is it you know are there windows of opportunity that close at a certain point yeah I would say that they do not close the the the levels of efficacy might be different you know so probably like and any kind of intervention you know I think if it's done before they become adults before the age of 18 is more likely to be efficacious but I I think like in the end definitely any intervention is going to be better than no intervention you know so I think that is also something which we need to keep in keep in mind importantly before they conceive like you know which you know most of these individuals do let's say around the age of you know 30 years like let's say roughly so I think before that any intervention would definitely decrease the risk now whether they themselves benefit from that intervention that probably is going to be a bit less the more delayed it is you know so early would always be better but yeah I would say that any intervention is better than no intervention even in adulthood I'm not sure if this is a question you can answer but I'll ask you anyway so we work a lot with in conflict affected communities likely trauma affected communities but working on kind of intercommunal dynamics trying to like reduce bias kind of what was that came up in the last neuroscience presentation and build kind of intercommunal cohesion to a certain degree and sometimes I worry we're working with these trauma affected communities the absorptive capacity of of a 17 year old whose experience trauma is limited is limited and it's limiting our ability to actually get reach them and that to a certain degree like our work is kind of it's like what we need to be doing this work addressing trauma first before we get to the stage of doing any trainings on dialogue mediation on living in a diverse society these sorts of things what would you say to to that type of an intervention would you like is it are the things we need to be keeping in mind when we're designing interventions like that with a trauma affected community on intergroup dynamics and us versus them so that field of neuroscience and social psychology linked with your field how where are those connections and is there a primacy over one over yeah yeah so yeah so I would say that I mean the like what you ask is very crucial you know I think in the in the neuroscience field I at least to my knowledge this has not been studied like you know at a level where let's say we have studied trauma I think it's very important to also like you know study these these biases these like you know prejudices between communities it is a bit it's hard to model those things into laboratories because you know communities like you know let's say in mice they are based on this hierarchical structure of strength you know but it is not it doesn't have the same kind of biases which we see in humans what I can tell you is like this this other project which which we have written up in which we are again using immersive environments to see how communities would relate to each other better if we if they themselves feel that they are belonging to the other community you know so so imagine it's like this like let's say if we if we want to get more insight about misogyny or a decree that you would see a populations of of men who would see themselves as women and the avatar in this immersive environment and then what we are trying to do at the same time is to detect activity in the parts of the brain which are known to induce empathy if this relatability by looking at themselves as belonging to the other gender or you can apply it to other race etc whether it would lead to more empathy towards that particular one I think finding these things at the molecular level still we are like far from it what there are some new techniques in which you can access like you know the molecular architecture of the neurons by converting blood cells into neurons and that is something which which which can be used to study the molecular signatures of that but yeah I think that that field needs to be explored further definitely yes please thanks so as you've been speaking I've been pondering the complexity of a place like the L-hole displacement camp which is you know nearly 70 000 primarily women primarily children two-thirds are children and I'm wondering how what you're talking about and in particular what do interventions look like in that kind of setting and in particular I think I'd highlight two characteristics one is that it is a camp setting and that in particular you know in the annex where foreign mothers and their children live it's highly highly controlled there's no ability really to move around very freely so this idea of freedom of movement ability to play etc in a healthy ways seems to not be there but more importantly these are children that have already experienced trauma by virtue of having lived you know in the caliphate and witnessed and even in some cases been coerced or compelled into committing themselves atrocities and their mothers in some instances are radicalized and will often inhibit their or forbid them from participating in any sort of psychosocial activity that's being developed and that's that's prompting a big debate about the whole question of separation of children from their mothers where in this instance the mothers who are radicalized may in fact be an inhibiting factor to their healing so I'm wondering what you think about all of that and then lastly sort of how if at all do you see the intersection of radicalization with trauma yeah it's a very crucial question but I I do feel that I'm perhaps not qualified to answer it you know in a way that I could suggest an intervention but I think it's it's important to again study this you know first to see what is happening you know like we need to model it you know maybe in mice in which we actually induce violence in the mothers you know and make their maternal care not impaired but going towards more like you know there's sort of this you know this radicalization which you talk about and then see what is happening to the offspring and then whether it will be better for them to have foster care compared to living with like a radicalized mother I think um what I would say is that definitely any kind of maternal care is important you know especially early in life um if there is a foster care which compensates for it you know even when let's say the the the original mother like you know biological mother is giving a more um sort of violent or radicalized care then I think maybe it's better but I think having maternal care is very important that's that's what we have seen like you know that's what we observed in animals that's what we found out from the SOS children's village by working with them as well I mean so they do provide foster care you know to these children they even give them like you know these um sort of family units in which they have siblings and they're together they live with their mother but still we see that having this you know foster mom does not lead to like you know uh mitigation of all these uh neuro behavioral symptoms a metabolic defect so I think having maternal care is definitely important but we we need to study that I think it's very important to study that before we come up with the recommendation yes please um I have two questions the first is I was interested when you were talking about intermarriage in Pakistan because um I'm from Palestine and there's also a lot of intermarriage there yeah and also a lot of collective trauma and so I was wondering if you think that that cultural tradition of intermarriage may in fact make the trauma more severe definitely it does and then the second question was just which organizations we should be on the lookout that are looking to spread awareness um about the link between trauma and epigenetics yeah it's a great um so the first question definitely so what what I can tell you is that these you know intermarriages so there there are so in in Pakistan there are two different kinds of consensualities you know one is cousin marriages and the other one is they call it like intra intraperadury marriages which is basically they follow the male lineages you know generations across generations and then it's not a cousin marriage but still you're staying with the same gene pool and um so on its own it causes many genetic disorders like you know intellectual disability uh like you know the spectral disorders autism spectrum disorders a lot of these are you know what we call autosomal recessive so these are recessive genes which get um sort of um you would say that they get multiplied they get amplified because of these like you know intra like uh peradury marriages or these consensualities marriages another thing which we see is that these like marriages within within you know your consensualities group it leads to increased anxiety so and we don't know the basis for it but based on like you know what we study over here it seems like that's an additional factor which would make these populations even more vulnerable to trauma compared to like you know let's say a more diverse genetically more diverse population so definitely it is an additional negative impact which is over going over there in terms of foundation so I think like I do know that anything which gets published in the mainstream media it gets highlighted way more than a scientific paper the thing is that also it depends on how you want to portray your science like you know I I've been trained you know I've been lucky enough to be trained by very rigorous scientists and we try not to sort of hyperbole our findings you know we talk in very rigorous scientific towns um somehow what what we feel is that mainstream media doesn't buy that they want you to come up with something like really kind of like you know out of the world um I think it's important that we find a bit of a balance in between and if we started doing things which are more at the at the policy making level at like you know the human rights activist lawyers if these kind of organizations they start having more discussions about it it would really help out and again I think an article in New York Times is equivalent to like a five articles in nature or science in the end it's still that that remains like the fact of this world and we can't change that but I think we need to sort of target mainstream media more like I would I would talk about like one particular example so it's it's actually like a good friend of mine I worked with him at some point when I was interested in the topic it's it's it's actually like a Syrian public health researcher who worked a lot on shisha smoking shisha and like water pipe you know and arguably smoking and he was the first one to actually show that one session of shisha smoking is equivalent to like 40 cigarette smoking sessions and and then his work actually led to a lot of awareness and a lot of policy making things you know in many of these like you know countries in the Middle East shisha smoking was not subjected to the same regulation which you know like cigarette smoking is to and then just his work led to this policy making change and they were like okay if we don't sell cigarettes to people under 18 we're not going to offer shisha to like you know individuals under 18 as well so those kind of things would really make a difference if we somehow can get it to policymakers and mainstream media that's going to help yes please first thank you for your lightning presentation my question deals but basically with the offspring and the genes would not so in a situation where you have a parent that was traumatized in their lifetime who then I guess through the epigenic inheritance passes on that trauma through the offspring have you come across any findings where those like trauma gene expressions remain dormant in the childhood of the offspring and become activated in the offspring's adult life maybe do some type of trigger points and what now I'm not sure if you've come across any findings yeah so that's that's that's again like a very important question and I'm sure that you know some of these susceptibilities like you know they would lead to manifestations under certain conditions and not under the other conditions for example like you know in in in the mice we see that there are changes at the cholesterol level right now let's say if we further subjected the offspring to high fat diet probably already having like you know dyslipidemia this kind of that cholesterol profile would further accentuate that similarly if they are further exposed to stressors probably the risk would even amplify more the reason why we have tried not to expose these mice to these for additional stressors actually is for purely ethical reasons I mean we think that already like you know it's it's it's never good to be involved in work which are voluntarily doing something in which you are stressing these little you know pups so if we we just tried not to expose them to further stressors but we can predict that definitely the the effects would be amplified a lot more if there were and definitely we we see changes you know like all the micro RNA changes we see they show that there would be a lot more cardiovascular effects in these mice under certain conditions they will develop like a lot of different manifestations like very bad manifestations under certain stressors I guess just one more question regarding what the CSO's children get um in that environment because it is kind of depressing to find out that they are showing these markers right even though they are in an environment that presumably is trying to help them and I guess I just want your observations as to what do you think is missing in that particular environment I know you mentioned that they had foster parents but somehow that it's not right coming through do you think is that particular kind of foster parenting that model that is not helping or is it something else about the entire environment I guess I don't know enough about yeah so I'm just again I'm thinking okay how you know if that doesn't help it would seem yeah yeah so so I'll I'll try to explain it this way that um you know like so like our metabolism depends a lot on what we eat right and if we have like a healthy lifestyle and like you know if we eat more balanced diet then we are less likely to develop like you know cholesterol related disorders but if we eat unhealthy we are more likely now there are certain people who are born with what we call familial hypercholesterolemia no matter what they eat their cholesterol levels would always be impaired so for them we need even more rigorous dietary interventions exercise based interventions so I would say that something very similar applies to these children that just giving them foster care and just giving them like you know an environment where they get like somewhat of like a healthy diet and schooling and stuff like other children it's not sufficient it's not sufficient to completely mitigate the susceptibilities which they have been like you know passed on I think importantly in these cases we need to take additional measures we need to give them like you know we need to make their environment even more enriching we need to find ways in which somehow they get like you know a psychotherapy over a course of a lifetime where these issues are addressed so I think like you know what what the SOS village people are doing that's great but actually our studies like you know and other other people who if they're doing similar work we are going to help them optimize that care to reach to a level where we see that these these effects are completely mitigated or as mitigated as possible actually I had like a very important crucial discussion with one of the psychologists who was taking care of these children and she was like you know we do everything for them you know they they they get like a family-like environment they get schooling but she doesn't understand why a lot of children who were under her care they would wake up in the night and have nightmares you know and these these are the things where we need to do more and where we need to study more and find out more pathways which are getting affected and find ways to reverse those hi um I don't know if you can hear me yeah go ahead yes please oh hi um I'm I'm calling in from Peru thank you so much for for this presentation I'm I'm Rebecca Kinian and I'm just wondering if you've looked at all at the role of the vagus nerve and vagal theory um you know stimulating the vagus nerve to help increase well-being and um as a neuroscientist I'd be very I mean since you're the neuroscientist I'd be very interested to hear if you've looked at the role of the vagus nerve and perhaps we can that would be a good way to create societal level interventions if we can't work one-on-one so much with each individual person but activities that would promote stronger vagal tone like meditation yoga group singing group dancing this type of thing just real quickly Rebecca is with the State Department okay great great thanks a lot that's that's again that's that's a very nice question I would actually call it a suggestion and that's not something which we have looked into um but like you know I I do know that like all these activities and mindfulness and the vagus nerve stimulation in in different ways I mean it has very strong like um antidepressive effect so that is definitely an intervention which should be started um I would say at this point you know like a lot of this was until a year ago a lot of this was work was done in mice where we looked at the things at more molecular level like the human part of it is more recent um so that's why we do not have many intervention studies which have been published as of yet but a lot of things are in the pipeline and I'd love to talk more about this vagus nerve thing with you if that would be possible I would love that too thank you is there anyone else online that would like to ask a question okay great um so again I wanted to thank um Ollie for his very very interesting that we hope will not be so interesting in the future but will become such common sense and integrated that we'll be talking about at the grocery store with you know the person standing next to us online and there will be interventions and it'll all just be so normalized and part of our day to day that's the vision um so thanks so much Ollie and thanks to everyone here as well as who um is participating in the live uh online version and I wanted to thank um Tina Lu and Angelina Mendez for all of the work that you have done to make this possible this event possible as well as the other events that we've held around neuroscience and peace building the first one was on resilience and we talked about some of the interventions and we talked a lot about polyvagal theory um through one of the the participants and then Angelina talked about her work and we talked about mindful meditation through um someone who's with our military who works with soldiers on mindfulness and meditation as a resilience tool um the second one was just a few weeks ago which was on Emil Bruno from Beyond Conflict was here and talked about his research um intergroup dynamics looking at dehumanization the us versus them miss you and some of the interventions around that and so um all you are third so thank you so much and all of them will be available online in parts um the so that people can watch them later so again thank you Angelina it's been a pleasure all throughout and Tina this would not have been possible without both of you so thanks everybody on a Friday afternoon we're giving back three minutes of your time so what are you going to do with it so thank you