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March 30, 2006

RESEARCH NOTES

Cancer researchers receive Hillman funding

The 23 researchers who make up the second wave of Hillman fellows at the University of Pittsburgh Cancer Institute (UPCI) have received grants totaling $2 million to pursue novel, high priority cancer projects. The grants are part of a $20 million gift donated to UPCI by the Henry L. Hillman Foundation and the Hillman Foundation that established the Hillman fellows program for innovative cancer research in 2005.

The program funds cancer research that promises to have a far-reaching impact on the field. It has funded research in cancer stem cell biology, biomarkers for the early detection of cancer, cancer vaccines and cellular therapies, methods for diagnosing and monitoring cancer, and programs in cancer prevention that are based on genetic and environmental risks for disease.

The 2006 Hillman fellows (from the School of Medicine, except where noted) and their research topics are:

Lisa Butterfield of the medicine, surgery and immunology departments and associate director, UPCI Immune Monitoring Laboratory, and John Kirkwood, vice chairman of clinical research and director of the melanoma program, for research on determinant spreading in melanoma immunotherapy.

William Chambers of pathology, for research evaluating the effects of stress on spontaneous breast cancer development.

Shi-Yuan Cheng of pathology, for research on signaling mechanisms in glioma invasion.

Albert Deleo of pathology, for research on aldehyde dehydrogenase type 1, a novel tumor antigen for the development of vaccines for immunotherapy of squamous cell carcinoma of the head and neck.

Stefan Duensing of molecular genetics and biochemistry, for research on genomic instability induced by tumor viruses: identification of molecular mechanisms and possible therapeutic implications.

Seymour Garte and Emanuela Taioli of the Graduate School of Public Health (GSPH), for research on interactions between genetic factors and environmental exposures in human cancer causation.

Elieser Gorelik of immunology, for research into a new approach in anticancer drug screening.

Pamela Hershberger of pharmacology, for research on improving vitamin D as a treatment for lung cancer by preventing its destruction within tumor cells.

Bo Hu of medicine, for research on target deregulated transcription factors and co-factors for cancer prevention.

Michael Lotze, director of translational research at Pitt’s Molecular Medicine Institute, for research to improve on interleukin-2 therapy for cancer.

Ruth Modzelewski of medicine, for research on tumor blood vessel targeting as a strategy for cancer intervention to improve diagnosis and targeted treatment options.

Mark Nichols of pharmacology, for research on understanding resistance to anti-hormone therapy in breast cancer treatment: developing new RNA interference tools and drug screens to find novel and effective therapies.

Donna Posluszny of medicine, for research on brief psychosocial intervention for head and neck cancer patients and partners.

Hannah Rabinowich of pathology and immunology, for research on harnessing Ncl-1 anti-apoptotic mechanisms for the protection of T lymphocytes from prostate cancer-induced dysfunction.

Sanjay Srivastava and Shivendra Singh, both of pharmacology, for research on prostate cancer prevention by guggulsterone, a constituent of Indian ayurvedic medicinal plants.

Richard Steinman of the molecular pharmacology training program, for research on the role of post-transcriptional regulation in differentiation and cancer.

Nikola Vujanovic of immunology, for research on cancer immunotherapy by stimulation of NK cell-dendritic cell cross talk.

Yong Wan of cell biology and physiology, for research on the functional proteomic study of proteolysis in DNA damage/repair and tumor formation.

Qingde Wang of medicine, for research on the regulation of the NF-xB signaling pathway in cancer stem cells and its clinical implications.

Joel Weissfeld of the GSPH epidemiology department, for follow-up research-based lung cancer screening at UPCI.

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Researchers find brain’s reward gate

Amid reports that a drug used to treat Parkinson’s disease has caused some patients to become addicted to gambling and sex, Pitt researchers have published a study that sheds light on what may have gone wrong.

In the current issue of Proceedings of the National Academy of Sciences, professor of neuroscience, psychiatry and psychology Anthony Grace and neuroscience research associate Daniel Lodge suggest a new mechanism for how the brain’s reward system works.

The main actor in the reward system is a chemical called dopamine. When you smell, touch, hear, see or taste a pleasurable stimulus, the dopamine neurons in your brain start firing in bursts. So-called “burst firing” is how the brain signals reward and modulates goal-directed behavior. But just how the stimulus perceived neurons to switch into or out of this mode has been a mystery.

Using anesthetized rats, Lodge and Grace found that one area in the brain stem, known as the laterodorsal tegmental nucleus, is critical to normal dopamine function.

“We’ve found, for the first time, the brain area that acts as the gate, telling neurons either to go into this communication mode or to stop communicating,” said Grace. “All the other parts of the brain that talk to the dopamine neurons can only do it when this area puts them into the communication mode.”

As a result, disruption in that area may play a major role in dopamine-related brain function, both in normal behaviors and psychiatric disorders.

The brain area the researchers identified is regulated by the “planning” part of the brain, the prefrontal cortex (PFC), thereby providing a powerful indirect means for the PFC to affect the activity of dopamine neurons. Such a link could explain how changes in the PFC, seen in disorders like schizophrenia and drug addiction, disrupt the signaling of dopamine neurons.

This research was funded by the U.S. Public Health Service.

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Diabetes predictors found

Massimo Pietropaolo, associate professor of pediatrics, medicine and immunology in the School of Medicine, associate professor of epidemiology at the Graduate School of Public Health and scientist in the Division of Immunogenetics at Children’s Hospital has been awarded $4 million in National Institutes of Health grants to develop a combination of tests to predict diabetes. The study of the markers that predict who will develop type 1 diabetes opens the door for clinical trials and the potential development of new therapeutic strategies in an effort to find a cure for type 1 diabetes.

Pietropaolo is studying the effectiveness of combining various tests to predict who will develop type 1 diabetes, a crucial first step if new successful therapies are to be developed.

By combining an older chemical test, known as an islet cell antibody assay, with two newer biochemical tests known as GAD65 and IA-2, Pietropaolo and colleagues have been able to predict more accurately type 1 diabetes in family members of those with type 1 diabetes. By combining the three tests, they predicted with 80 percent accuracy who would develop type 1 diabetes in a study of nearly 1,500 individuals who were first-degree relatives of type 1 diabetics. This is the highest level of accuracy ever achieved in predicting type 1 diabetes.

Results of this research are published in Pediatric Diabetes.

“In order to develop a vaccine or cure for diabetes, scientists must first be able to accurately identify those at risk, because it is unknown whether the vaccine will cause harm or effectively prevent the disease,” Pietropaolo said. “By using this combination of tests, we now have the tools to predict type 1 diabetes, particularly in relatives of type 1 diabetic patients. This opens the door for researchers to screen patients for clinical trials of a vaccine.”

In the course of this research, Pietropaolo’s team also has discovered a protein that may forecast a more rapidly developing form of type 1 diabetes. Work is now underway to determine why the protein may cause a rapid onset of type 1 diabetes.

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New pigs make omega-3s

Researchers report they have created pigs that produce omega-3 fatty acids, which are known to improve heart function and help reduce the risks for heart disease, representing the first cloned transgenic livestock in the world that can make the beneficial compound.

The research could be a boost to both farmers and health-conscious consumers seeking an alternative and safer source of omega-3 fatty acids. Currently, the only way for humans to realize the benefits of omega-3 fatty acids is by taking dietary supplements or by eating certain types of fish that may also contain high levels of mercury.

The results, which are being published by Nature Biotechnology, are the work of a team assembled by Yifan Dai, an associate professor of surgery at the School of Medicine’s Thomas E. Starzl Transplantation Institute. The team includes researchers from the University of Missouri-Columbia (MU) National Swine Resource and Research Center, Massachusetts General Hospital (MGH) and the laboratories of Dai and Rhobert Evans at Pitt.

To stimulate production of omega-3 fatty acids in pigs, Dai’s team transferred a gene known as fat-1 to pig primary fetal fibroblasts, the cells that give rise to connective tissue. MU researchers then created the transgenic pigs from these cells using a method called nuclear transfer cloning. The transgenic pig tissues then were analyzed for omega-3 fatty acids at MGH and at Pitt.

The fat-1 gene is responsible for creating an enzyme that converts less desirable, but more abundant, omega-6 fatty acids in the animals to omega-3 fatty acids. The results could lead to a better understanding of cardiovascular function not only in pigs, but in humans as well.

“Pigs and humans have a similar physiology,” said Randy Prather, distinguished professor of reproductive biology in MU’s College of Agriculture, Food and Natural Resources and a corresponding author with Dai. “We could use these animals as a model to see what happens to heart health if we increase the omega-3 levels in the body. It could allow us to see how that helps cardiovascular function. If these animals are put into the food chain, there could be other potential benefits. First, the pigs could have better cardiovascular function and therefore live longer, which would limit livestock loss for farmers. Second, they could be healthier animals for human consumption.”

Dai said, “While fish, especially salmon and tuna, is one of the best food sources of omega-3 fatty acids, we have been warned to limit consumption because of high mercury levels. These animals could represent an alternative source as well as be an ideal model for studying cardiovascular disease and autoimmune disorders.”

“Livestock with a health ratio of omega-3 to omega-6 fatty acids may be a promising way to re-balance the modern diet without relying solely on diminishing fish supplies or supplements,” Jing X. Kang of MGH said.

The transgenic pigs were created using technology developed by Kang. Kang’s group created the first omega-3 rich mammals (mice) and published that work in Nature in 2004. Because of this earlier study, Dai initiated the collaboration with the aim of creating cloned transgenic pigs capable of making omega-3 fatty acids.

Other Pitt authors of the study are Dai’s research associate William T. Witt and Thomas E. Starzl, Distinguished Service Professor of Surgery at the School of Medicine.

The research was supported by the National Institutes of Health, the American Cancer Society and an unrestricted gift to the Starzl Transplantation Institute from the Robert E. Eberly Program for Transplant Innovation.

The findings are to appear in the April 6 issue of Nature Biotechnology.

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Crime’s impact on churches to be studied

John Wallace, an associate professor in the School of Social Work, has received a $50,000 grant from the Louisville Institute to study the impact of inner-city crime and drug-related violence on clergy and local church congregations.

Wallace, also a pastor at Bible Center Church of God in Christ in Homewood, will conduct a one-year study titled “Congregations Helping to Unite and Revitalize Communities Holistically” through Pitt’s Center on Race and Social Problems, which is part of social work.

“The project gives me an opportunity to combine my research-based knowledge and experience with qualitative insights I have gained from being involved in the community,” said Wallace.

As the ones who frequently counsel grieving families, visit shooting victims in hospitals, and preside over funerals, clergy often are on the front lines of inner-city violence. Through focus groups and interviews with pastors throughout Homewood, Wallace hopes to identify the challenges that members of the clergy face as they lead congregations in communities that experience high levels of crime, violence, and poverty.

Research has indicated that involvement in religious organizations reduces the likelihood a person will engage in criminal behavior. However, Wallace said there is little information on how criminal activity influences the clergy and congregations who reach out to those affected by crime. Initially the study will focus mainly on Homewood and its approximately 28 churches, but Wallace is hoping to expand the study once the key issues facing clergy are better understood.

The Louisville Institute, based at Louisville Presbyterian Seminary, is a Lilly Endowment program for the study of American religion. Pitt’s Center on Race and Social Problems conducts applied social science research on race, color and ethnicity and their influence on the quality of life for all Americans.

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Women’s health research presented

Research findings from more than a dozen studies were presented by researchers from the Pitt-affiliated Magee-Womens Research Institute (MWRI) at a recent meeting of the Society for Gynecologic Investigation in Toronto.

In addition, MWRI director James Roberts was featured in a major conference debate on the essence of pre-eclampsia. Roberts argued that pre-eclampsia is a maternal disease, while Christopher Redman, of the University of Oxford, England, argued that pre-eclampsia is a fetal disease.

“It’s a way to present the state-of-the-art in pre-eclampsia research,” said Roberts, professor and vice chairman of research in the Department of Obstetrics, Gynecology and Reproductive Sciences at the School of Medicine. “But the impact goes beyond pregnancy because the risks for pre-eclampsia are the same as those for cardiovascular disease later in life.”

Some 5 percent of first pregnancies are complicated by pre-eclampsia, a condition characterized by soaring blood pressure and protein in the urine, that is a leading cause of maternal, fetal and neonatal disability and death, particularly in undeveloped countries and among underserved populations.

Among the research findings presented were:

*Heart disease biomarker remains high 30 years after eclamptic pregnancy

C-reactive protein (CRP), an inflammatory marker associated with a higher risk of cardiovascular disease, remains elevated even 30 years after a pregnancy distinguished by eclampsia, according to a study from MWRI.

A life-threatening complication of pregnancy, eclampsia occasionally succeeds pre-eclampsia and can involve coma, convulsions and organ failure. Although intravenous infusion of magnesium sulfate can decrease the likelihood that a woman with pre-eclampsia will develop eclamptic seizures, the only effective treatment for the syndrome is immediate delivery, which can be dangerous for the baby if it is too early in the pregnancy.

“We found that levels of CRP were doubled in postmenopausal women who had a prior episode of eclampsia compared to those who had a history of normal pregnancies,” said Carl Hubel, assistant professor of obstetrics, gynecology and reproductive sciences at the School of Medicine and environmental and occupational health at the Graduate School of Public Health, MWRI assistant investigator and lead author of the study.

The difference remained even after adjusting for other risk factors such as age, weight, smoking and use of hormone-replacement therapy, Hubel said.

The finding indicates that pregnancy outcome could be viewed as “a natural early stress test” for future risk of cardiovascular disease — the leading cause of death for women. “We propose that prior pre-eclampsia — particularly severe pre-eclampsia — be considered as a red flag to identify women of reproductive age who stand to benefit from cardiovascular risk factor modification,” said Hubel. “If we can identify these differences during a woman’s reproductive years and intervene with lifestyle changes early and aggressively, we may be able to impact her future risk. Early screening here is vital.”

Hubel and his colleagues compared data available from a previous study on 25 Icelandic women with prior eclampsia and 28 Icelandic women with normal pregnancies.

Additional Pitt authors include Robert Powers, an assistant investigator at MWRI and associate professor of obstetrics, gynecology and reproductive sciences in the School of Medicine; Hilary Gammill, a fellow in obstetrics, gynecology and reproductive sciences; James Roberts, MWRI senior scientist and director, professor and vice chair research in obstetrics, gynecology and reproductive sciences and professor of epidemiology; and Roberta Ness, MWRI associate investigator, professor and chair of the department of epidemiology, Graduate School of Public Health, and professor of obstetrics, gynecology and reproductive sciences, School of Medicine.

*PET imaging allows non-invasive view of infection related to pre-term birth

Using positron emission tomography (PET) scanning, Pitt researchers were able to visualize changes associated with intrauterine infection for the first time in a non-invasive way, according to lead author Hyagriv Simhan, assistant professor of obstetrics, gynecology and reproductive sciences in the School of Medicine and a specialist in infectious diseases in pregnancy.

“Much of preterm birth can be associated with infection and inflammation,” said Simhan, an assistant investigator at MWRI. “Using this powerful technology gives us an opportunity to evaluate therapeutic strategies with respect to the inflammatory response and may lead to future clinical application for the detection of fetal inflammation.”

In the current study, Simhan’s team used microPET imaging to evaluate biomarkers employed to trace the action of amniotic fluid infection in an animal model. Tracer molecules attached to immune system cells, called macrophages, that are part of the body’s inflammatory response allowed the researchers to see evidence of inflammation in infected animals, all of which delivered preterm. By contrast, control animals experienced normal pregnancies.

“Using PET, we also discovered decreased activity in fetal brain glucose metabolism in the infected animals,” said Simhan. “Although we don’t yet know what this means, the ability to visualize these changes is significant. To be able to do this non-invasively is a real advance in the possible treatment of preterm birth related to infection.”

Additional Pitt authors include Neal Mason of radiology in the School of Medicine; Saviero Capuano of molecular genetics and biochemistry in the School of Medicine; Gerald Schatten, MWRI deputy director and vice chair of obstetrics, gynecology and reproductive sciences and cell biology and physiology in the School of Medicine, Brian Lopresti of radiology, and Steve Caritis of obstetrics, gynecology and reproductive sciences.

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Switching drugs may help depression

One in four people with treatment-resistant depression will do better by switching to a different antidepressant and one in three will benefit from adding an additional drug to their current antidepressant therapy, according to research results from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study recently published in the New England Journal of Medicine.

STAR*D is the largest and longest trial to date of clinical depression in the United States to determine what treatments work for patients in “the real world.”

The multi-site study was led by researchers from the University of Texas Southwestern Medical Center and involved 14 regional centers, including one at the Pitt School of Medicine, led by Michael E. Thase, Edward S. Friedman and Robert H. Howland, all of psychiatry. Additionally, the Data Coordinating Center for the study was located at Pitt’s Epidemiology Data Center (EDC), and directed by Stephen R. Wisniewski, deputy director of the EDC and an associate dean for research at the Graduate School of Public Health.

In the first level of the study, researchers enrolled 4,041 participants who were treated for depression with the selective serotonin reuptake inhibitor (SSRI) citalopram. One-third of those participants reached remission. The remaining two-thirds were eligible to enroll in level 2 of the study. Of those, 1,439 chose to participate.

Level 2 participants were then asked if they would prefer to be switched to a different treatment, receive treatment to add to the citalopram they were currently taking, or if they had no preference. Interestingly, only 21 participants out of the 1,439 said that any of the treatment options would be acceptable, while the remainder stated a preference.

In the medication switch study, 727 participants stopped taking citalopram and were treated with sertaline, bupropion-SR or venlafaxine-XR, all drugs commonly prescribed for depression, for up to 14 weeks. Twenty-five percent of the participants became symptom-free. While the three drugs represented three different classes of antidepressants, the differences in remission rates among the three drugs were small and unlikely to be significant clinically.

In the medication addition study, 565 participants continued taking citalopram and also were given either bupropion-SR or buspirone for up to 14 weeks. The two drugs are thought to enhance the efficacy of SSRIs in different ways: bupropion-SR acts on the serotonin neurotransmitter, while buspirone blocks other neurotransmitters. Overall, 30 percent of the participants became symptom-free. Bupropion-SR provided a slightly better outcome than buspirone in terms of symptom reduction and severity and tolerability of side effects, though these differences were not significant clinically.

“Most clinicians have a favorite drug or two for treatment of their depressed patients. With this study we tried to find out if one of the common first choice antidepressants didn’t help, is there one ‘best’ or even one ‘better’ treatment. What we are seeing is that different treatments work for different people,” said Thase.

“It’s critical for doctors and their patients to realize that while the first treatment they use may not work, they should not give up. There still may be an available treatment that will.”

Wisniewski said,. “By using information on the characteristics of the participants, we may be able to determine who would benefit from specific treatments.”

The study was funded by the National Institute of Mental Health. Medications for levels 1 and 2 were provided by Forest Laboratories, Pfizer, GlaxoSmithKline, Wyeth and Bristol-Myers-Squibb.

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Bariatric surgery lowers blood pressure long term for some patients

Severely obese patients may experience significant, long-term improvements in blood pressure as they lose substantial amounts of weight after gastric bypass surgery, thereby contributing to their overall health, according to a Pitt study published in the March issue of the Archives of Surgery.

Excess body weight is associated with a host of health complications including diabetes, certain cancers and joint stress, with nearly two-thirds of very obese patients suffering from high blood pressure — the primary risk factor for both stroke and heart disease.

Researchers led by John Fernstrom of psychiatry, pharmacology and neuroscience in the School of Medicine and research director of the UPMC Weight Management Center, analyzed data from 347 patients at the upper extreme of body weight, with a beginning Body Mass Index (BMI) of greater than 40 who underwent gastric bypass surgery at UPMC between 1992 and 2001.

(BMI is a height-to-weight ratio that determines a patient’s degree of obesity. A BMI less than 25 is considered to be healthy, while a BMI of 40 or greater is categorized as extreme obesity.) At the time of data analysis, 18 months after surgery, study patients’ BMIs had stabilized to about 35 — still categorized as obese.

Half of the study patients were classed as hypertensive prior to gastric bypass surgery. Of those, some were unmedicated and had high blood pressure while others were being treated for their hypertension.

The patients who were not being treated for hypertension prior to surgery experienced significant blood pressure decreases that continued to remain low 18 months after surgery. Of the patients under active drug treatment for hypertension prior to surgery, about one-third were able to reduce or eliminate their blood pressure medications after surgery. The group of patients with normal blood pressure who were taking no blood pressure medications before surgery showed insignificant changes following surgery.

“These results suggest that the blood pressure status of patients prior to gastric bypass surgery may give us good and realistic indicators of those patients who are likely to experience substantial improvements in blood pressure after surgery over the long term and who may, as a result, avoid cardiovascular disease or stroke,” said Fernstrom. “Our data also indicate that following surgery, certain patients may no longer need the medications they were taking to control their blood pressure prior to surgery,” he said.

Study co-author Madelyn Fernstrom said, “Extremely obese patients have great difficulty reducing their body weight through lifestyle changes and pharmacotherapy, so their overall health remains compromised and high blood pressure represents a serious health problem. In counseling patients who are considering gastric bypass surgery, this study will help us to identify those patients who can reasonably expect the long-lasting health benefits from significantly reduced blood pressure.” Madelyn Fernstrom is a faculty member in psychiatry, epidemiology and surgery at the School of Medicine and director of the UPMC Weight Management Center.

“For those severely overweight patients with elevated blood pressure, or under treatment for elevated blood pressure, bariatric surgery offers the promise of improved health, with not only substantial and sustained weight loss, but also the added benefit of significant blood pressure improvements,” said study co-author Anita Courcoulas, associate professor of surgery at the School of Medicine and director of the minimally invasive bariatric and general surgery program at UPMC.

“It also is important to note that blood pressure reductions occurred in patients even though they remained obese with BMIs in the 35 range, which is still not ideal, further suggesting that weight loss itself — in this study, achieved through gastric bypass surgery — can improve health outcomes,” said Madelyn Fernstrom.

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A first view of electrons in limbo

Two recent papers by physicist Hrvoje Petek offer a deeper understanding of how electrons behave on surfaces, with applications in electronics and energy. Petek co-directs Pitt’s Gertrude E. and John M. Petersen Institute of NanoScience and Engineering (PINSE).

In the first paper, Petek and Miroslav Nyvlt of Charles University in Prague explored the properties of metals under intense light — a situation “where the classical physics of electron emission from metals emerges from its quantum roots,” Petek said. They found that when light of a certain energy and intensity is shone onto a metal surface, a few electrons in the metal become stuck on the surface (that is, they are neither emitted from nor reabsorbed into the metal). As Petek put it, the electrons are “in limbo.”

These electrons undergo the process of “total internal reflection” — a process well known for light, but observed by Petek and Nyvlt for the first time in electrons.

The findings, published in the March 3 issue of Physical Review Letters (PRL), could lead to the ability to transmit electrons, without scattering, over larger distances than previously possible. For example, electrons on the surface of carbon nanotubes could be excited to make “very small and very fast” transistors, Petek said.

“We anticipate that these elusive electrons will provide exquisite probes for how photons and electrons interact with metal surfaces,” he added.

In Petek’s second paper, published in the journal Science, he and Pitt professor of chemistry and PINSE researcher Kenneth Jordan make new progress toward extracting hydrogen from water using titanium dioxide as a catalyst.

In a May 2005 Science paper, Petek and Jordan presented their findings on the properties of water on the surface of titanium dioxide. In their current experiment, they used methanol instead of water, because they discovered that excited electrons last longer in methanol than in water, allowing chemical reactions to be observed.

The new research shows how protons in methanol molecules move in such a way that they control the re-absorption of electrons into the titanium dioxide. Such motion, correlated between protons and electrons, is needed to convert light into chemical energy on solid surfaces, as well as by light-harvesting proteins.

The work for the PRL paper was performed at the Max Planck Institute of Microstructure Physics in Halle, Germany, where Petek was an Alexander von Humboldt Senior Scholar and Nyvlt was the group leader. That work was supported by the Alexander von Humboldt Foundation, the U.S. National Science Foundation, the Italian National Research Council, and the Czech Ministry of Education.

Other Pitt authors on the Science paper are graduate students Bin Li and Jin Zhao and postdoctoral fellow Ken Onda, all of physics and astronomy.

The work was supported by the U.S. Department of Defense Multidisciplinary University research initiative program, the New Energy Development Organization of Japan and the national science foundations of the United States and China.

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Heavy diabetics tend to overestimate healthy weight

Heavier patients with diabetes are more likely to overestimate their “healthiest” body weight compared to those of normal weight, according to a study recently published in Diabetes Care.

“We wanted to understand how well patients with diabetes could identify healthy body weight because self-management is an essential part of diabetes treatment,” said Kathleen McTigue, assistant professor of medicine and first author of the study. “Understanding weight-related health risk could be an important step toward setting healthy lifestyle goals and effective weight management.”

In a survey of 2,461 diabetes patients, responses revealed that many had a less-than-accurate view of healthy body weight.

“Among respondents, 41 percent reported a ‘healthiest’ weight for their height that actually measured in the overweight body mass index (BMI) range, and 6 percent reported a ‘healthiest’ weight that was obese,” said McTigue, who also is an internal medicine specialist associated with the University of Pittsburgh Diabetes Institute. “One participant selected a BMI in the underweight range as ‘healthiest.’”

Among respondents whose BMI measurements classified them as obese, 66 percent identified overweight or obese dimensions as ideal for health. Among the overweight, some 41 percent chose a higher-than-optimal body weight as healthy. In contrast, only 4 percent of normal-weight patients overestimated healthy body weight.

Body size and gender were associated with accurate choice of a healthy body weight. Women were more likely than men to identify correctly a weight in the normal BMI range as healthy.

Even so, the survey revealed considerable confusion about body weight in general. Some 65 percent of those reporting normal-BMI height and weight considered themselves to be overweight, leading the authors to speculate that current educational initiatives may fall short.

“These findings are concerning given the importance of body weight in managing diabetes,” McTigue concluded. “Counseling regarding excess body size deserves more attention in the routine care of patients with diabetes.”

Funding for the study was provided by the United States Air Force and administered through the U.S. Army Medical Research Acquisition Activity at Fort Detrick, Md.

In addition to McTigue, other Pitt authors are Gary Fischer, Katharine Fitzgerald and Rachel Hess of the Department of Medicine; Cindy L. Bryce of the Department of Medicine and the Graduate School of Public Health, and Ellen Olshansky and Diane Sacco of the School of Nursing.

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NSF awards funds to computer science project

Three Pitt computer science faculty have been awarded a three-year, $500,000 grant from the National Science Foundation to develop new and better data stream management systems (DSMS).

Panos K. Chrysanthis, director of the Pitt Advanced Data Management Technologies Laboratory; co-director Alexandros Labrinidis and Kirk Pruhs seek to design a new generation of DSMS to optimize performance and enhance their usefulness in their project, “Algorithms and Metrics for New Generation Data Stream Management Systems.”

New generation DSMS simplify the development of a wide range of monitoring applications, which are core components in scientific exploration, health alerting, environmental monitoring and business support systems.

The DSMS project re-examines all four critical components of a DSMS: query scheduler, load shedder, query processor and data dissemination modules. Key innovations in the project include examination into how these four modules can be integrated to work in combination, instead of making important performance decisions in isolation and formalizing quality of service/quality of design metrics for DSMS and developing algorithms to optimize these metrics.


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