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December 9, 2010

Research Notes

Snoring, insomnia can predict metabolic syndrome

A School of Medicine study found loud snoring and two common insomnia symptoms —  difficulty falling asleep and unrefreshing sleep — each significantly predicted the development of metabolic syndrome. The findings are reported in the December issue of SLEEP, the official publication of the Associated Professional Sleep Societies.

Lead author Wendy M. Troxel, a faculty member in psychiatry and psychology, said: “This study shows us that a broader array of commonly reported sleep symptoms, including insomnia and sleep-disordered breathing symptoms, predict the development of metabolic syndrome, a key risk factor for cardiovascular disease. It was rather striking that the effects of difficulty falling asleep and loud snoring were largely independent of one another.”

According to the National Heart, Lung and Blood Institute, metabolic syndrome is a group of obesity-related risk factors that increases an individual’s risk of heart disease, diabetes and stroke. A person with at least three of these five risk factors is considered to have metabolic syndrome: excess abdominal fat, high triglycerides, low HDL cholesterol, high blood pressure and high blood sugar.

Analyses of these five individual components of metabolic syndrome revealed that loud snoring significantly predicted the development of high blood sugar and low HDL cholesterol. Difficulty falling asleep and unrefreshing sleep did not predict any of the individual metabolic abnormalities.

The study involved 812 participants ages 45-74. Individuals who were classified as having metabolic syndrome or diabetes at baseline were excluded from the analyses. During the three-year follow-up period, 14 percent of participants developed metabolic syndrome.

“Our results show that the risk of developing metabolic syndrome over a three-year follow-up period was more than two times higher in adults who reported frequent loud snoring,” noted Troxel. “This risk also was increased by 80 percent in adults who reported having difficulty falling asleep and by 70 percent in those who reported that their sleep was unrefreshing.”

Further analysis showed that unrefreshing sleep was reduced to marginal significance with additional adjustment for loud snoring. However, both loud snoring and difficulty falling asleep remained significant independent predictors of metabolic syndrome. “We believe these results emphasize the importance of screening for common sleep complaints in routine clinical practice,” said Troxel. Loud snoring continued to predict the development of metabolic syndrome even after accounting for the number of metabolic risk factors present at baseline. Troxel suggests that these findings “may implicate loud snoring as a causal risk factor for adverse cardiovascular and metabolic changes.”

Co-authors of the study included Daniel J. Buysse, Martica Hall and Karen A. Matthews of psychiatry, and Patrick J. Strollo, Oliver Drumheller and Steven E. Reis of medicine.

DNA repair in breast cancer studied

Breast cancers that arise sporadically, rather than through inheritance of certain genes, likely start with defects of DNA repair mechanisms that allow environmentally triggered mutations to accumulate, according to researchers at the School of Medicine, Magee-Womens Hospital and the University of Pittsburgh Cancer Institute.

The findings, reported recently in the early online edition of the Proceedings of the National Academy of Sciences, indicate that potent chemotherapy drugs that target DNA in later-stage cancers could be an effective way to treat the earliest of breast tumors.

Recent research has focused on familial breast cancers, in part because the predisposing genes have been well characterized and women at risk can be identified, said Jean J. Latimer, a faculty member in obstetrics, gynecology and reproductive sciences. But these cases only comprise 15 percent of the 190,000 breast cancers that are diagnosed every year.

Research on sporadic breast cancer has involved the use of available cell lines derived from late-stage tumors, but most newly diagnosed tumors in the United States are stage I, the earliest form of invasive disease.

“Our team is able to grow stage I breast cancer cells — before they have spread to adjacent tissues and lymph nodes — allowing us to examine the mechanisms that underlie cancer development in people who didn’t inherit a faulty gene,” Latimer said. “The advent of innovative tissue engineering techniques has finally made it possible for us to culture these cells to determine what has gone wrong.”

In earlier work, she and her colleagues found that breast tissue does not repair everyday damage to DNA as well as other tissues, such as skin. Ultraviolet light, for example, can cause mutations, but a sophisticated system of nucleotide excision repair (NER) proteins trolls the DNA strands to identify problems and initiate repair processes. The same system repairs damage caused by many environmental carcinogens, including tobacco smoke.

“Even in healthy breast tissue, this system is only about one-fifth as effective as it is in skin,” Latimer noted. “This deficiency could set the stage for sporadic cancer development, with the risk increasing with age as DNA damage accumulates.”

For the study, the researchers grew and assessed 19 sporadic, stage I breast tumors placed into culture directly from surgeries to test their NER pathways. In every case, there was a deficiency in repair capacity compared to disease-free breast tissue.

“That is a remarkably consistent feature for cancers that might otherwise seem random in their genesis,” Latimer noted. “We rarely see a universal rule when it comes to breast cancer, but then until now, we have rarely studied stage I disease.”

Some chemotherapy drugs work especially well on cells that exhibit reduced DNA repair, but they are typically given in later-stage disease. The new findings suggest, however, that these approaches could be effective in treating early stage disease, she noted.

Co-authors included Jennifer M. Johnson, Crystal M. Kelly, Tiffany D. Miles, Kelly A. Beaudrey-Rodgers and Nancy A. Lalanne of the Latimer laboratory;  Victor G. Vogel of medicine and epidemiology;  Amal Kanbour-Shakir of pathology; Joseph L. Kelley of obstetrics, gynecology and reproductive sciences; Ronald R. Johnson of surgery, and Stephen G. Grant of environmental and occupational health.

The research was funded by the National Institutes of Health, the U.S. Department of Defense, the Pennsylvania Department of Health, the Komen for the Cure Awards and the American Cancer Society.

Weight loss study funded

Can text messaging and technology help young adults lose weight? Pitt’s Physical Activity and Weight Management Research Center will investigate the notion through the IDEA (Innovative Approaches to Diet, Exercise and Activity) study, one of seven clinical trials to be funded by the National Institutes of Health’s (NIH) National Heart, Lung and Blood Institute with a total of $36 million over five years.

NIH’s Early Adult Reduction of Weight through Lifestyle Intervention (EARLY) Trials seek to prevent weight gain and promote weight loss among young adults — ages 18-35 — through healthy eating and physical activity. Few studies have examined how to effectively engage this high-risk age group in achieving and maintaining a healthy weight.

Conducted at universities throughout the United States, the trials will incorporate such technologies as text messaging, online social networking and Bluetooth-enabled scales as part of their weight-loss efforts.

John Jakicic, chair of the Department of Health and Physical Activity in the School of Education and director of the Physical Activity and Weight Management Research Center, said: “We’re really excited about using technology to enhance our weight-loss and physical-activity studies. We think these technology enhancements will significantly improve this age group’s overall health.”

IDEA will test whether an enhanced weight-loss intervention with the use of text messaging reminders and wearable exercise monitors improves weight loss in young adults compared to a standard behavioral weight-loss intervention. Researchers will examine these interventions on changes in body composition, body-fat distribution, fitness, physical activity, dietary intake and behavioral/psychosocial measures that may be predictive of behavior change.

The IDEA study will involve 480 overweight and obese young adults who will be assessed at the beginning of the study and at six, 12, 18 and 24 months. The 24-month behavioral weight-loss program includes a reduction in calorie intake and moderate-to-vigorous intensity exercise, progressively increasing from 100 to 250 minutes per week.

Subjects will be randomized to receive the standard intervention or the enhanced intervention that includes state-of-the-art technologies. These technologies will be implemented from months 7-24 and include daily text messaging prompts to reinforce adherence to the behavioral intervention and a monitor that is worn to provide real-time feedback on energy expenditure and achievement of daily physical activity goals.

For more information about the study, call 412/488-4184.

Flu shots OK for kids with egg allergies

Children with egg allergies may be able to receive influenza vaccination if properly administered, according to a Children’s Hospital study.

During the 2009-10 flu season, allergists at the hospital provided flu vaccines containing the highest content of egg protein available and found that the vaccine was well tolerated in egg-allergic children.

Results of the study by Gregory Owens and Andrew J. MacGinnitie were published online in the Journal of Allergy and Clinical Immunology.

For this study, Children’s used the Sanofi-Pasteur seasonal and H1N1 vaccines, which contain the highest levels of egg protein among available vaccines. The vaccine was administered in a two-step process, giving 10 percent of the vaccine initially and then observing the patient for allergic reaction for up to 30 minutes before providing the remaining 90 percent of the vaccine.

Children’s researchers gave a total of 96 vaccinations to 64 patients and observed four mild allergic reactions, including redness and rashes. No patients developed anaphylaxis. “It’s reassuring that even using these higher egg protein-content vaccines, no patients developed anaphylaxis,” said Owens, an allergist/immunologist.

“While current guidelines recommend against vaccinating children with egg allergy, the risk is not clear or fully understood. The results of our and other studies indicate that using the two-step protocol allows egg allergic patients to safely receive the influenza vaccination,” said Owens. “Families of children with egg allergy should consider vaccination using this protocol because influenza causes significant morbidity and mortality every season.”

UPB aiding FBI hostage database

Pitt-Bradford criminal justice faculty member Tony Gaskew is taking part in a two-year research project to create a database to help law enforcement handle hostage situations.

The project, coordinated by the FBI, pairs law enforcement officials with academic researchers who have experience with hostage situations. Gaskew’s experience in hostage situations and negotiations as a law enforcement officer dealing with drug trafficking in South Florida led to his involvement.

The Global Hostage-Taking and Analysis Project (GHosT-RAP) is now in its second phase, which focuses on domestic and school violence. During the first phase, researchers compiled information on hostage situations that arose from drug trafficking.

The research protocol involves interviewing actual hostage takers.

The final result will be a database that law enforcement officials can access to help them know what is likely to occur in a given hostage situation or help them decode who might be holding someone and where, based on the histories of criminal organizations.

“It provides another piece of information to assess a hostage situation,” Gaskew said. That information will be all the more valuable for small or rural law enforcement agencies that don’t have experienced SWAT teams or hostage negotiators.

With the rise in drug violence in Mexico along the United States border, this information “is needed more than ever now,” he said.

Gaskew is a certified police academy instructor and has more than 2,000 hours of specialized criminal investigations’ training. His background includes 18 years of professional law enforcement experience. He also worked as a member of the Southeast Asia counterterrorism/counterdrug task force in the Republic of the Philippines.

He later served as a detective in a special operations unit, where he was assigned to an organized crime drug enforcement task force working with the U.S. Attorney’s Office, U.S. Drug Enforcement Administration, Internal Revenue Service, U.S. Customs, FBI and the Florida Department of Law Enforcement, conducting wiretap and conspiracy investigations targeting violent criminal organizations.

Program to target pre-eclampsia

James Roberts, a faculty member in obstetrics, gynecology and reproductive sciences at the School of Medicine and researcher at Magee-Womens Research Institute (MWRI), will help lead a multi-project program to prevent and treat the pregnancy complication pre-eclampsia. He also will head a component project that attempts to create a database of biological samples from women around the world.

Roberts is the senior adviser to the executive committee of PRE-eclampsia–Eclampsia Monitoring, Prevention and Treatment (PRE–EMPT), a $7 million, four-year international research and community intervention effort funded by the Bill and Melinda Gates Foundation (BMGF). PRE–EMPT is being led by researchers at the University of British Columbia (UBC) and the Child & Family Research Institute (CFRI). Roberts’s database initiative is one of five projects within PRE–EMPT.

“By using a strategy that has been quite successful in studying cardiovascular disease and cancer, we will bring together data, blood, urine and other biological samples from study groups around the world to gain rapid insight into pre-eclampsia and its treatment,” said Roberts. “These samples currently come from developed countries, but the BMGF has 50,000 women in pregnancy studies, and we plan to begin collections at sites in developing countries. Also, we will extend our studies to other pregnancy complications, such as preterm birth and stillbirth, that have great impact in low- and middle-income countries by using data and samples especially relevant to women in these settings.”

Hypertensive disorders complicate 5-10 percent of pregnancies and can lead to serious maternal and fetal illness or death. Pre-eclampsia, the most serious of these disorders, is the second leading cause of maternal death worldwide, resulting in up to 76,000 maternal deaths each year.

“That translates into the death of one mother every seven minutes, and 99 percent of these deaths occur in lower- and middle-income countries,” said UBC’s Peter von Dadelszen, co-director of the Reproduction & Healthy Pregnancy research cluster at CFRI.

Led by von Dadelszen, the PRE–EMPT team of researchers, physicians and community health professionals from Canada, the United States, Africa, Asia, Oceania, the United Kingdom and the World Health Organization (WHO) will develop and implement a set of clinical guidelines tailored for lower- and middle-income countries. The underlying cause and potential new community-based treatments for pre-eclampsia also will be investigated.

Other PRE–EMPT projects are:

A clinical trial of pre-pregnancy and early pregnancy calcium supplementation in women with low calcium intake and at high risk for pre-eclampsia in their next pregnancy. The goal of this South African and Zimbabwean trial is to determine whether or not pre- and early-pregnancy calcium supplementation prevents both the diagnosis and consequences of pre-eclampsia.

A study to develop and validate tools to better identify, diagnose and assess risks in order to accelerate triage and transport to centers where women will receive effective and evidence-based treatment. This care will avert the adverse maternal and perinatal consequences of pre-eclampsia.

A study to test the impact of a community-level care program for reducing adverse maternal and perinatal outcomes related to pre-eclampsia. This program will be tailored to different levels of care in four South Asian and sub-Saharan countries.

A knowledge translation group to update the relevant WHO guidelines.

Robots safely aid pancreas surgery

Robotic-assisted surgery for complex pancreatic procedures can be performed safely in a high-volume facility, according to a study published recently online in Archives of Surgery, one of the JAMA/Archives journals.

Complex pancreatic surgery remains the final frontier for use of minimally invasive procedures, according to James Moser and Herb Zeh, co-directors of the UPMC Pancreatic Cancer Center and the study’s corresponding authors.

“There are two challenges when attempting minimally invasive procedures for complex pancreatic surgeries,” said Moser.

“The first challenge is controlling bleeding from major blood vessels. The second is the reconstruction of the ducts in the liver and pancreas. While recent data [have]suggested that complex pancreatic operations can be performed laparoscopically, this approach requires that critical technical principles of open pancreatic surgery be modified to overcome the limitations of the technology, such as limited range of instrument motion, poor surgeon ergonomics and reduced dexterity.”

For this study, the researchers report their experiences with 30 patients who underwent robotic-assisted pancreatic resection between October 2008 and February 2010. According to the researchers, the length of surgery time, duration of hospital stay and follow-up complications were all consistent with those observed in large groups of patients undergoing open procedures.

“As robotic-assisted pancreatic surgery continues to evolve, we may be able to reduce operative times,” said Zeh. “Ideally, we believe robotic-assisted pancreatic surgeries could lead to shorter hospital stays, fewer wound and lung-related complications and decreased recovery time for patients.”

Pharmacy researchers awarded funds

The School of Pharmacy announced funding has been awarded for the following research projects by pharmaceutical sciences faculty:

• Alexander Doemling received a three-year, $1 million grant from the National Institutes of Health for his research “Protein-Protein Interaction Directed Libraries.” Protein interactions are involved in all disease-relevant pathways and are important for the future design of drugs to address unmet medical needs, such as diabetes, cancer and Alzheimer’s disease.

This effort will develop libraries of new, diverse and biologically inspired compounds that encourage or discourage interactions between proteins. The libraries will reveal novel biological patterns and lead to follow-up projects to better understand individual protein-protein interactions and their involvement in disease pathology.

• Robert Gibbs received a three-year, $400,000 grant from the National Science Foundation to study the role of a cell membrane protein called GPR30 in estrogen-mediated effects on cholinergic function and cognition.

• Song Li received a $114,000 grant from the U.S. Department of Defense for research to develop a nanotechnology-based targeted therapy for the treatment of breast cancer.

Flu vaccine research funded

Department of Microbiology and Molecular Genetics faculty member Ted M. Ross of the Center for Vaccine Research has been awarded a $946,000 contract from the nonprofit organization PATH to advance research on universal influenza vaccines that can elicit coverage across influenza strains.

The collaborative project will focus on H1N1 and H5N1 and use a class of antigens that are broadly reactive against current and future strains of influenza.

The goal of the 18-month project is to initiate research to support the development of strong influenza vaccine candidates with the potential to be accessible and affordable for low-resource countries in an influenza outbreak.

Nano light sensor developed

Pitt researchers have created a nanoscale light sensor that can be combined with near-atomic-size electronic circuitry to produce hybrid optic and electronic devices with new functionality. The team, which also involved researchers from the University of Wisconsin-Madison, reports in Nature Photonics that the development overcomes one of nanotechnology’s most daunting challenges.

The group, led by physics and astronomy faculty member Jeremy Levy, fashioned a photonic device less than 4 nanometers wide, enabling on-demand photonic interaction with objects as small as single molecules or quantum dots.

In another first, the tiny device can be tuned electrically to change its sensitivity to different colors in the visible spectrum, which may forgo the need for the separate light filters other sensors typically require.

The researchers produced the photonic devices via a rewritable nanoelectronics platform developed in Levy’s lab that works like a microscopic Etch A Sketch, the drawing toy that initially inspired him.

“These results may enable new possibilities for devices that can sense optical properties at the nanoscale and deliver this information in electronic form,” Levy said.

Other Pitt researchers involved on the team were postdoctoral researcher and lead author Patrick Irvin, postdoctoral researchers Daniela Bogorin and Cheng Cen and graduate student Yanjun Ma, all of physics and astronomy.

The Nature Photonics paper is available at

Nursing student success studied

Pitt-Bradford nursing faculty member Jean Truman recently presented research on predictors of nursing student success on the NCLEX (National Council Licensure Examination) state board nursing licensure exam.

In her work, “First Generation Student Preparedness for NCLEX-RN Success,” presented recently at the “Meeting the Challenges of the 21st-Century Classroom” conference at Penn State-Shenango, Truman focused on whether the NCLEX scores of first-generation college students differed from others’.

She found that first-generation students (who make up about one-third of college students nationwide, but two-thirds of Pitt-Bradford nursing students) do not score much differently on the NCLEX than non-first-generation students.

However, she found characteristics of first-generation students that can make it harder for those students to succeed in college.

“They often have greater family responsibilities and are likely to work more than 20 hours each week. They are more likely to attend a local college and less likely to complete their degrees on time,” she said. Also, they relate having greater academic and social challenges, Truman said, adding that it is important for these first-generation students to receive additional academic support to help them succeed.

Truman’s study was an expansion of the research she did for her doctoral dissertation, which focused on predictors of student success on the NCLEX.

Software industry success studied

Throughout the 1990s and 2000s, news about 20-somethings becoming billionaires from the sale of their software companies flooded the media, giving the impression that a good idea was all it took to succeed in the software industry.

Jennifer Shang, a business management faculty member in the Joseph M. Katz Graduate School of Business, along with colleagues from McGill University and the Georgia Institute of Technology, investigated what caused software companies to succeed or fail. Their research study, “Why Do Software Firms Fail? Capabilities, Competitive Actions and Firm Survival in the Software Industry From 1995 to 2007,” has been published in the journal Information Systems Research.

Because of low entry and exit barriers and low marginal-production cost, new-product development takes place rapidly in the software industry, said Shang. However, the industry’s bankruptcy rate of 15.9 percent is much higher than in other industries. For example, the bankruptcy rate in the pharmaceutical industry is 4.7 percent.

Shang and her colleagues examined software-company data collected between 1995 and 2007 from 870 firms. The collaborators looked at three aspects of internal business capabilities — marketing, operating and research and development.

They also examined two types of competitive actions: those that were innovation-related (product and marketing actions) and those that were resource-related (capacity and scale expansion, operations, service, mergers and acquisition). They found that a higher operating capability has the greatest influence on a software firm’s chance of survival. Firms with a greater emphasis on innovation-related competitive actions have a greater likelihood of survival, and this likelihood increases when the firms also have higher marketing and operating abilities.

The researchers divided the software industry into three subsections: one that included desktop suites and other business-enabling software; another that included video games and graphics software, and one that included operating systems and security programs.

Depending on their sectors, software businesses need a slightly different approach to investments, said Shang. Firms producing games, for example, must emphasize marketing, whereas companies making products with a long life cycle (such as operating systems) must focus on operating abilities and research and development. Traditional software companies, those producing desktop applications, should follow a strategy somewhere between these two approaches.

“Our research underscores the importance of operating capability in the software industry,” said Shang. “Managers of knowledge-based firms often emphasize big ideas (innovation). Our study shows that operational efficiency is even more important for firm survival. Also, competitive strategies and dynamic actions will have more impact if they are supported by strong capabilities. In short, to improve performance and competitiveness, software companies should focus on synergies between firm capabilities and strategic actions.”

UPB faculty study txt

Text messaging has been the subject of recent study by several Pitt-Bradford researchers.

Fang-Yi Flora Wei, a faculty member in broadcast communications, and Y. Ken Wang, a faculty member in computer information systems and technology, published “Students’ Silent Messages: Can Teacher Verbal and Nonverbal Immediacy Moderate Student Use of Text Messaging in Class?” in the fall issue of the scholarly journal Communication Education. The article examines the relationship between in-class texting and professors’ teaching behaviors.

The researchers surveyed 228 Pitt-Bradford students, asking them about what levels of immediacy behavior (smiling, eye contact, calling them by name, etc.) professors used and how frequently the students sent and received texts in class (about three of each in a 45-minute class). Wei said in-class texting mainly is between students and close family members for entertainment, and friends and boyfriends/girlfriends for affection.

The researchers hypothesized that there would be a relationship between the professor’s communication immediacy and the students’ texting behavior. But analysis showed that the professors’ behaviors do not affect students’ use of text messaging during class, due to students’ addiction and habitual use of texting.

Not surprisingly, the researchers found students who were heavy text messaging users in general also were heavy text users during class.

“When somebody’s already addicted to texting, you cannot easily change their behaviors just because of their professors’ verbal and nonverbal immediacy,” Wei said, explaining that many professors feel that students texting in their classes must be their fault — that they somehow are failing to engage students.

That’s not the case, Wang said. “Our research tells professors to ‘take it easy’ as once a student established the habit of texting, it is overwhelmingly powerful in his or her everyday behaviors, including in the classroom.”

Wei said the behavior is like that of “looking at a watch” — just something students do.

• Sociology faculty member Michael Klausner recently presented a paper about teens’ use of texting devices at the Pennsylvania Sociological Society’s annual meeting.

Klausner’s paper, titled “The Ubiquitous Use of Electronic Devices by Teens for Communication and Learning: An Interdisciplinary Analysis,” discussed the effects that teens’ frequent use of electronic devices may have on their learning, identity, attention span, interpersonal relationships and tendency toward bullying.

Research has shown that it is not uncommon for teens to send as many as 2,000 text messages a month, he said, noting that the use of electronic devices for many has become an essential part of their identity and has led to dependence — if not a downright addiction — to the technology.

Klausner discussed research indicating that both teens and adults process material that is read from computer monitors differently than they process what is read from a printed page. In addition, he noted that while bullying always has been common among teens, electronic modes of communication have allowed it to be done around the clock and without the immediate consequences of such behavior.

He also discussed research that shows declines in “emotional intelligence,” civility and attention span among teens who send and receive a large number of text messages.

His preliminary research indicates that children who are home-schooled text-message their friends at a significantly lower rate than those who are not home-schooled. He intends to determine what factors are responsible for such a difference.


The University Times Research Notes column reports on funding awarded to Pitt researchers as well as findings arising from University research.

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